Objective To explore the experience and needs of orthopedic inpatients for pre-hospital examinations led by nurses, provide a reference for optimizing the pre-hospital examination procedures and improve the pre-hospital examination experience of patient. Methods Using the method of phenomenology, semi-structured in-depth interviews were conducted on 35 patients who attended the Department of Orthopedics of the Second Affiliated Hospital of Army Medical University from July to August 2018 and had undergone pre-hospital examinations. Colaizzi’s seven-step method was used to encode, analyze, organize, summarize, and refine topics. Results Patients’ experience and needs for pre-hospital examinations led by nurses could be divided into three major sections: attitudes and emotions, individualized pre-rehabilitation needs and pre-hospital examination feelings. Attitudes and emotions included high treatment expectations, feelings of loss, and some patients’ understanding of pre-hospital examinations. Individualized pre-rehabilitation needs included pre-rehabilitation needs with cardiopulmonary diseases, pre-rehabilitation needs with sleep dysfunction, nutritional conditioning needs, and medication safety needs. Patients’ feelings during pre-hospital examinations mainly included complicated procedures and staff attitudes that need to be improved. Conclusion Some links in the pre-hospital inspection process urgently need to be optimized. In pre-hospital examinations, it is necessary to focus on patient expectation management and predictive communication, improve multidisciplinary cooperation, formulate personalized pre-rehabilitation plans, optimize examination procedures, strengthen humanistic care, and improve patient experience.
Objective To systematically review the incidence and risk factors of postoperative urinary retention (POUR) in patients undergoing hip or knee arthroplasty, and provide a theoretical basis for medical staff to assess and identify high-risk groups in advance. Methods PubMed, Embase, the Cochrane Library, Medline, China National Knowledge Infrastructure, Wanfang Data, VIP database, and SinoMed were electronically searched from the establishment of the databases to January 2023, for literature on the incidence and risk factors of POUR in patients undergoing hip or knee arthroplasty. Two researchers independently screened studies, extracted data, and assessed study quality. Meta-analysis was performed using Stata 14.0 software. Results A total of 21 articles were included, including 9041 patients undergoing hip or knee arthroplasty. The results of meta-analysis showed that the incidence of POUR in patients undergoing hip or knee arthroplasty was 26% [95% confidence interval (CI) (19%, 32%)]. Age [odds ratio (OR)=1.03, 95%CI (1.00, 1.05), P=0.03], male [OR=2.68, 95%CI (1.72, 4.18), P<0.001], infusion volume [OR=2.17, 95%CI (1.08, 4.35), P=0.030], spinal anesthesia [OR=1.72, 95%CI (1.29, 2.30), P<0.001], history of urinary retention/urethral stricture [OR=1.84, 95%CI (1.35, 2.49), P<0.001], use of analgesic pump [OR=4.73, 95%CI (2.29, 9.78), P<0.001], use of glycopyrronium bromide [OR=2.79, 95%CI (1.53, 5.11), P=0.001] were risk factors for POUR in patients undergoing hip or knee arthroplasty. Conclusions The incidence of POUR in patients undergoing hip or knee arthroplasty is relatively high. Age, male, infusion volume, spinal anesthesia, history of urinary retention/urethral stenosis, use of analgesia pump, and use of glycopyrronium bromide are causes of POUR. It is suggested that medical staff should identify the risk of related factors and take early intervention to reduce the occurrence of POUR.
Objective To explore the effect of self-assessment of pain in perioperative pain management of total knee arthroplasty (TKA). Methods A total of 140 patients undergoing TKA from March 2016 to March 2017 were randomly divided into the control group and the trial group. The patients in the two groups were received the same education relating to pain knowledge. The intensity of pain was assessed by nurses in the control group, while in the trial group, it was assessed by patients themselves. According to the assessment of pain, treatments were given to both groups. Time of pain assessment, types and frequencies of temporary rescue medicine, pain intensity, the score of Self-efficacy for Rehabilitation Outcome Scale (SER) and the range of motion (ROM) of knee were observed and recorded. Results There were 132 patients who completed the final observation, with 67 in the trial group and 65 in the control group. There were significant differences between the two groups in evaluation time of pain (t=–2.736, P=0.007), types and frequencies of temporary rescue medicine (χ2=10.276, P<0.05), the overall postoperative pain score (Z=–2.146, P=0.032), average hospitalization time after surgery (t=–2.468, P=0.015), SER scores 7 days after surgery (F=2.390, P=0.018) and 14 days after surgery (F=3.427, P=0.001), and ROM at the postoperative day 7 (F=2.109, P=0.037); there were no significant differences in postoperative daily pain scores (Z=–1.779, P=0.077), SER scores at the postoperative day 3 (F=1.010, P=0.314), ROM at the postoperative day 1 (F=1.319, P=0.189) and day 14 (F=1.603, P=0.111). Conclusion Self-assessment of pain can motivate TKA patients to take part in pain management, and more accurate response to the pain intensity will help to optimize the management of perioperative pain and reduce the workload of the health staff, thereby contributing to enhanced recovery.
Objective To systematically analyze the relevant research on the application of preoperative exercise training in the pre-rehabilitation of elderly hip fracture patients, identify the specific content, outcome indicators, and application effects of exercise intervention, in order to provide reference for medical staff to carry out relevant interventions. Methods Computer searches were conducted on domestic and foreign databases such as China National Knowledge Infrastructure, Wanfang Database, China Biomedical Literature Database, VIP, Cochrane Library, PubMed, Embase, Web of Science. The search period was from the establishment of the database to January 2024. The scoping review method was used to screen, summarize, and analyze the included studies. ResultsA total of 10 studies were included, including 3 randomized controlled trial, 1 quasi experimental study, 5 retrospective studies and 1 case report. Preoperative exercise preparation includes completing relevant examinations and providing sufficient pain relief. The types of exercise include adaptive training, resistance training, and aerobic exercise. Monitor the patient’s symptoms, signs, and adverse reactions throughout the exercise process. Outcome measures include physical activity and function, pain, average length of hospital stay, and perioperative complications. Conclusions Preoperative exercise training has a positive effect on elderly patients with hip fracture. Elderly patients with hip fracture should be well prepared for preoperative exercise, based on adaptive training, with resistance exercise as the main focus, while monitoring the patient’s physical signs and adverse events during exercise.
Objective To explore the mental health status of college students in the Xining region. Methods A total of 1 875 college students were surveyed by the Symptom Checklist-90 (SCL-90) and the Eysenck Personality Questionnaire (EPQ).Results Out of the 1 875 college students, 21.5% had at least one item scoring more than 3. Compared with the normal samples, college students scored significantly higher on SCL-90 indicating that the students had worse mental health. Significant differences were noted in the dimensions of EPQ between college students and the normal samples. The total score of SCL-90 was found to be significantly related to four factors, namely neuroticism, family economic status, school and nationality. Conclusion The mental health status of college students in Xining region is lower than that of the normal population, and factors of neuroticism, family economic status, school and nationality are related to their mental health.