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To explore the relationships among post-stroke fatigue, hope and discharge readiness in stroke patients, and to determine whether hope mediates the relationship between post-stroke fatigue and discharge readiness.
In stroke patients, inadequate discharge readiness has been found to correlate with higher readmission and mortality rates. Although previous qualitative studies have confirmed the impact of fatigue on discharge readiness, few studies explore the impact of post-stroke fatigue and hope on discharge readiness of stroke patients. Consequently, the current research on this relationship and its underlying mechanisms is still quite limited.
Cross-sectional study.
Data were collected from 340 stroke patients. The research tools included demographic and disease characteristics, Discharge Readiness Assessment Scale for Stroke, Neurological Fatigue Index for Stroke and Herth Hope Index. The STROBE checklist was used to guide the presentation of this study.
Discharge readiness was negatively correlated with post-stroke fatigue and positively correlated with hope. Additionally, post-stroke fatigue was negatively correlated with hope. Post-stroke fatigue had a direct negative effect on discharge readiness, and it can also generate indirect effects through hope. Hope was the partial mediator between post-stroke fatigue and discharge readiness, explaining 55.8% of the total effect.
Discharge readiness of this population can be improved by reducing post-stroke fatigue and increasing hope. Therefore, effective management of post-stroke fatigue and hope will help improve discharge readiness.
It is recommended that nursing staff should monitor the occurrence and development of post-stroke fatigue in stroke patients, dynamically evaluate the patient's level of hope, and pay attention to the important role of positive psychological qualities in the outcome of discharge. If medical staff can formulate corresponding intervention measures based on the influence path of discharge readiness, then the discharge readiness of stroke patients can be improved.
This study systematically evaluates the impact of comprehensive nursing interventions on the treatment efficacy for patients with diabetic foot ulcers. Utilizing computerized searches of databases including PubMed, Embase, Google Scholar, Cochrane Library, China National Knowledge Infrastructure and Wanfang databases, we identified randomized controlled trials pertaining to this topic, with the search timeframe extending to May 2023. Two independent researchers screened the literature, extracted data and conducted a quality assessment. Data analysis was performed using Stata 17.0 software. A total of 17 randomized controlled trials, encompassing 1306 patients with diabetic foot ulcers, were included in this analysis. The analysis revealed that the application of comprehensive nursing interventions significantly reduced the wound healing time in patients with diabetic foot ulcers (standard mean difference [SMD] = −2.44, 95% confidence interval [CI]: −3.05 to −1.83, P < 0.001). Additionally, there was a notable enhancement in nursing satisfaction (odds ratio [OR] = 7.54, 95% CI: 3.99–14.26, P < 0.001) and the overall treatment efficacy rate (OR = 6.97, 95% CI: 3.32–14.60, P < 0.001). This study demonstrates that comprehensive nursing interventions significantly shorten the wound healing time in patients with diabetic foot ulcers, enhance clinical nursing satisfaction and improve the overall efficacy of treatment. These findings underscore the value of such interventions for widespread clinical application.
This retrospective cohort study aims to assess whether the implementation of a multidisciplinary approach in the Gosford Hospital High-Risk Foot Clinic improved outcomes of diabetic foot ulcers. Ulceration is a common foot complication of diabetes mellitus and greatly increases patient morbidity and mortality. Patients who attended at least one appointment at the Gosford Hospital High-Risk Foot Clinic in 2017 or 2019 were identified through the Gosford Hospital Podiatry department's records. The 2017 and 2019 cohorts were compared on measures of ulcer healing, incidence of amputation, incidence of vascular intervention and surgical debridement, percentage of patients admitted to hospital due to complications and use of systemic antibiotic therapy. Sixty-one patients in 2017 and 59 patients in 2019 met inclusion criteria, and from them, 207 ulcers were included. Between 2017 and 2019, there was a 6.2-week reduction in time to 100% ulcer healing in 2019 (p = 0.021), and 10.1% more ulcers healed within 52 weeks (p = 0.22, 95% confidence interval [CI] [−5.9%, 25.5%]). Whilst there was no significant difference in incidence of patients receiving amputation, there was an increased absolute number of amputations in 2019. Implementation of a multidisciplinary approach at the Gosford Hospital High-Risk Foot Clinic led to improvements in diabetic foot ulcer healing.
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