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Effects of comprehensive nursing interventions on wound pain in patients undergoing catheter insertion for peritoneal dialysis

Abstract

This study investigates the effects of comprehensive nursing interventions on wound pain in patients undergoing catheter insertion for peritoneal dialysis. Sixty patients who underwent catheter insertion for peritoneal dialysis from January 2021 to January 2023 at our hospital were selected as subjects and randomly divided into an experimental group and a control group using a random number table method. The control group received routine nursing care, while the experimental group was subjected to comprehensive nursing interventions. The study compared the impact of nursing measures on visual analogue scale (VAS), self-rating anxiety scale (SAS), self-rating depression scale (SDS) and nursing satisfaction between the two groups. The analysis revealed that on the third, fifth and seventh days post-intervention, the experimental group's wound VAS scores were significantly lower than those of the control group (p < 0.001). Furthermore, levels of anxiety and depression were markedly lower in the experimental group compared with the control group (p < 0.001). In addition, the nursing satisfaction rate was significantly higher in the experimental group than in the control group (96.67% vs. 73.33%, p = 0.011). This study indicates that the application of comprehensive nursing interventions in patients undergoing catheter insertion for peritoneal dialysis is highly effective. It can alleviate wound pain and negative emotions to a certain extent, while also achieving high patient satisfaction, thus demonstrating significant clinical value.

Factors related to psychosocial adjustment in patients with enterostomy: Based on a national cross‐sectional survey

Abstract

Aims

This study aimed to explore the psychosocial adjustment of enterostomy patients on a national scale.

Design

Based on a national cross-sectional survey.

Methods

From December 2021 and February 2023, a total of 22,040 enterostomy patients were assessed using the ostomy adjustment inventory-20. Initial analysis involved employing the chi-square test or Kruskal-Wallis H test to identify factors influencing the psychosocial adjustment of these patients. Subsequently, multinomial logistic regression was used to determine the factors affecting the classification of psychosocial adjustment levels of enterostomy patients. The reporting of this study adhered to the STROBE checklist.

Results

Eventually 21,124 patients with enterostomy were included in this study, out of which 7788 (36.9%) patients with low level of psychosocial adjustment, 11,803 (55.8%) patients with medium level of psychosocial adjustment and 1533 (7.3%) patients with high level of psychosocial adjustment. The factors influencing the classification of psychosocial adjustment levels of enterostomy patients were gender, educational background, carer, enterostomy self-care knowledge score and medical payment method.

Conclusions

The overall psychosocial adjustment level of enterostomy patients is not optimistic, and the factors that may affect the classification of their psychosocial adjustment level are analysed. Individualised intervention should be given according to different psychosocial adjustment levels of enterostomy patients.

Relevance to Clinical Practice

The number of enterostomy patients with a high level of psychosocial adjustment is small in relation to the total number of enterostomy patients, and caregivers can provide health education to enterostomy patients by analysing the factors affecting the level of psychosocial adjustment of enterostomy patients.

Patient or Public Contribution

None.

Impacts of continuous quality improvement on wound pain in the puncture site of arteriovenous fistula in haemodialysis patient

Abstract

This study analyses the effects of a continuous quality improvement nursing model on wound pain at the arteriovenous fistula (AVF) puncture site in patients undergoing haemodialysis. Forty haemodialysis patients from the First Affiliated Hospital of Chongqing Medical University, from September 2020 to December 2022, were selected as study subjects. They were randomly divided into an observation group and a control group. The control group received conventional nursing care, while the observation group was treated with a continuous quality improvement nursing model. The study compared the impact of these nursing approaches on pain intensity post-AVF puncture, wound visual analogue scale scores, self-rating anxiety scale, self-rating depression scale, quality of life scores and patient satisfaction with nursing care. In the observation group, the proportion of patients experiencing moderate to severe pain during AVF puncture was lower than that in the control group, whereas the proportion of patients with no pain or mild pain was higher (P = 0.008). After nursing, the observation group exhibited significantly lower wound visual analogue scale scores, self-rating anxiety scale scores, and self-rating depression scale scores compared to the control group (P < 0.001), with a significantly higher quality of life score (P < 0.05). The nursing satisfaction rate was 95.00% in the observation group, significantly higher than the 65.00% in the control group (P = 0.018). The continuous quality improvement nursing model significantly reduces wound pain at the AVF puncture site in haemodialysis patients, alleviates negative emotions, enhances the quality of life, and achieves high patient satisfaction. It is thus a highly recommendable approach in nursing practice.

Exploring wound management in dental pulp: Utilizing single‐cell RNA sequencing for global transcriptomic analysis in healthy and inflamed pulpal tissues

Abstract

The process of wound healing in the dental pulp is characterized by intricate interplay of signalling cascades, cellular responses, and extracellular matrix (ECM). The objective of this research was to examine the intricate interaction between signalling cascades, cellular responses, and extracellular matrix (ECM) dynamics that comprise the wound healing process of dental pulp. We conducted a controlled laboratory analysis of transcriptomic landscape of dental pulp tissues, including both healthy and inflamed samples, utilizing single-cell RNA sequencing. We identified significant change in cellular composition under carious conditions by analysing samples from 50 patients. Specifically, the proportion of immune cells increased from 25% to 40%, while the proportion of fibroblasts decreased from 20% to 10%. A transition towards ECM remodelling and fibrosis was indicated by this change. In addition, substantial increase inexpression of critical genes including COL1A1, FN1, IL-1B, IL-6 and TNC was detected, indicating that the extracellular matrix (ECM) was actively remodelled and that a robust inflammatory response was present, both of which are vital for tissue repair. Increased cell–cell interactions among B cells, plasma cells, macrophages and MSCs, and fibroblasts were highlighted in our study, demonstrating the intricate cellular dynamics that occur in response to dental pulp injury. The knowledge gained regarding the cellular and molecular processes underlying pulp wound healing contributed to the advancement of knowledge regarding pulp pathology and regeneration. Moreover, it established a foundation for creation of targeted therapeutic interventions that seek to maximize pulp repair and regeneration. This study represented noteworthy achievement in the field of dental surgery, establishing a solid groundwork for subsequent investigations into regenerative medicine, wound healing, and dental tissue restoration.

Risk factors related to surgical wound infection after caesarean section: A systematic review and meta‐analysis

Abstract

Surgical site infection (SSI) is one of the common postoperative complications after caesarean section for pregnant women. Previous studies have investigated the risk factors for SSI in pregnant women undergoing caesarean delivery. Whereas big differences in research results exist, and the correlation coefficients of different research results are quite different. A meta-analysis was conducted to examine the risk factors related to SSI in pregnant women undergoing caesarean delivery. We searched English databases to collect case–control studies or cohort studies published between 1 January 2015 and 15 November 2023, including PubMed, Web of Science and ScienceDirect. The risk of bias of the included studies was assessed via Newcastle-Ottawa Scale. The analysis was performed using RevMan 5.4.1 tool. A total of 24 articles (n = 581, 895) were selected in this meta-analysis. The following risk factors were presented to be significantly correlated with SSI in pregnant women following caesarean delivery: smoking (odds ratio [OR] = 1.64, 95% confidence interval [CI] [1.31, 2.04]), previous caesarean section (OR = 1.46, 95% CI [1.18, 1.82]), multiple vaginal examinations (OR = 2.92, 95% CI [1.91, 4.46]), membrane rupture (OR = 1.68, 95% CI [1.19, 2.38]), hypertensive disorders (OR = 1.85, 95% CI [1.33, 2.57]), diabetes mellitus (OR = 1.36, 95% CI [1.18, 1.57]), high body mass index (OR = 1.57, 95% CI [1.35, 1.84]). Occurrence of SSI is influenced by a variety of factors. Thus, we should pay close attention to high-risk subjects and take crucial targeted interventions to lower the SSI risk after caesarean section. Owing to the limited quality and quantity of the included studies, more rigorous studies with adequate sample sizes are needed to verify the conclusion.

Implications for long COVID: A systematic review and meta‐aggregation of experience of patients diagnosed with COVID‐19

Abstract

Aims and Objectives

This review aims to synthesize the available evidence of what patients experience when infected with COVID-19, both in hospital and post-discharge settings.

Design

This review was conducted using the Joanna Briggs Institute (JBI) methodology for qualitative systematic reviews and evidence synthesis. Reporting of results was presented according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) checklist.

Background

Coronavirus disease 2019 (COVID-19) continues to be a public health crisis worldwide. Many patients diagnosed with COVID-19 have varied levels of persisting mental disorders. Previous studies have reported the degree, prevalence and outcome of psychological problems. Minimal research explored the experience of patients with long COVID. The real-life experience of patients with COVID-19 from diagnosis to post-discharge can deepen the understanding of nurses, physicians and policymakers.

Methods

All studies describing the experience of patients were included. Two authors independently appraised the methodological quality of the included studies using the JBI Critical Appraisal Checklist for Qualitative Research 2020.

Results

This systematic review aggregated patients’ experience of being diagnosed with COVID-19 in both hospitalized and post-discharge settings. Finally, 17 studies met inclusion criteria and quality appraisal guidelines. The selected studies in the meta-synthesis resulted in 12 categories, and further were concluded as five synthesized findings: physical symptoms caused by the virus, positive and negative emotional responses to the virus, positive coping strategies as facilitators of epidemic prevention and control, negative coping strategies as obstacles of epidemic prevention and control, and unmet needs for medical resource.

Conclusions

The psychological burden of patients diagnosed with COVID-19 is heavy and persistent. Social support is essential in the control and prevention of the epidemic. Nurses and other staff should pay more attention to the mental health of the infected patients both in and after hospitalization.

Relevance to clinical practice

Nurses should care about the persistent mental trauma of COVID-19 survivors and provide appropriate psychological interventions to mitigate the negative psychological consequences of them. Besides, nurses, as healthcare professionals who may have the most touch with patients, should evaluate the level of social support and deploy it for them. It is also needed for nurses to listen to patient's needs and treat them with carefulness and adequate patience in order to decrease the unmet needs of patients.

Effects of parasternal intercostal block on surgical site wound infection and pain in patients undergoing cardiac surgery: A meta‐analysis

Abstract

This study aimed to assess the effect of parasternal intercostal block on postoperative wound infection, pain, and length of hospital stay in patients undergoing cardiac surgery. PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP, and Wanfang databases were extensively queried using a computer, and randomised controlled studies (RCTs) from the inception of each database to July 2023 were sought using keywords in English and Chinese language. Literature quality was assessed using Cochrane-recommended tools, and the included data were collated and analysed using Stata 17.0 software for meta-analysis. Ultimately, eight RCTs were included. Meta-analysis revealed that utilising parasternal intercostal block during cardiac surgery significantly reduced postoperative wound pain (standardised mean difference [SMD] = −1.01, 95% confidence intervals [CI]: −1.70 to −0.31, p = 0.005) and significantly shortened hospital stay (SMD = −0.40, 95% CI: −0.77 to −0.04, p = 0.029), though it may increase the risk of wound infection (OR = 5.03, 95% CI:0.58–44.02, p = 0.144); however, the difference was not statistically significant. The application of parasternal intercostal block during cardiac surgery can significantly reduce postoperative pain and shorten hospital stay. This approach is worth considering for clinical implementation. Decisions regarding its adoption should be made in conjunction with the relevant clinical indices and surgeon's experience.

Assessment of consistency between peer‐reviewed publications and clinical trial registrations in nursing journals

Abstract

Background

The inconsistencies between randomized clinical trials (RCTs) registrations and peer-reviewed publications may distort trial results and threaten the validity of evidence-based medicine. Previous studies have found many inconsistencies between RCTs registrations and peer-reviewed publications, and outcome reporting bias is prevalent.

Aims

The aims of this review were to assess whether the primary outcomes and other data reported in publications and registered records in RCTs of nursing journals were consistent and whether discrepancies in the reporting of primary outcomes favored statistically significant results. Moreover, we reviewed the proportion of RCTs for prospective registration.

Methods

We systematically searched PubMed for RCTs published in the top 10 nursing journals between March 5, 2020, and March 5, 2022. Registration numbers were extracted from the publications, and registered records were identified from the registration platforms. The publications and registered records were compared to identify consistency. Inconsistencies were subdivided into discrepancies and omissions.

Results

A total of 70 RCTs published in seven journals were included. The inconsistencies involved sample size estimation (71.4%), random sequence generation (75.7%), allocation concealment (97.1%), blinding (82.9%), primary outcomes (60.0%) and secondary outcomes (84.3%). Among the inconsistencies in the primary outcomes, 21.4% were due to discrepancies and 38.6% resulted from omissions. Fifty-three percent (8/15) presented discrepancies in the primary outcomes that favored statistically significant results. Additionally, although only 40.0% of the studies were prospective registrations, the number of prospectively registered trials has trended upward over time.

Linking Evidence to Action

While not including all RCTs in the nursing field, our sample reflected a general trend: inconsistencies between publications and trial registrations were prevalent in the included nursing journals. Our research helps to provide a way to improve the transparency of research reports. Ensuring that clinical practice has access to transparent and reliable research results are essential to achieve the best possible evidence-based medicine.

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