British journal of hospital medicine最新文献

{"title":"Significance of Relative Left Ventricle Wall Thickness in Predicting Acute Kidney Injury After Video-Assisted Thoracoscopic Surgery for Lung Cancer.","authors":"Xiaokang Shen, Yue Zhang, Chuanfei Zhan, Muhammad Zunair Bhatti, Hongyu Zhu, Lin Zheng","doi":"10.12968/hmed.2024.0840","DOIUrl":"https://doi.org/10.12968/hmed.2024.0840","url":null,"abstract":"<p><p><b>Aims/Background</b> Given the strong association between relative wall thickness (RWT) and cardiovascular dysfunction, this study aims to explore RWT as a novel cardiovascular indicator to predict the risk of acute kidney injury (AKI) after lung cancer surgery and guide clinical interventions. <b>Methods</b> This study retrospectively analyzed 170 patients who underwent video-assisted thoracoscopic surgery (VATS) for lung cancer in Nanjing First Hospital, China, between January 2022 and December 2023. Patients were divided into AKI group (n = 52) and non-AKI group (n = 118) based on the occurrence of AKI. Univariate analysis was performed to identify factors affecting the development of AKI in patients undergoing VATS for lung cancer. Moreover, multivariate logistic regression analysis was conducted to determine influencing factors. Correlation analysis was used to analyze the relationships between variables, and receiver operating characteristic (ROC) curve analysis was conducted to assess predictive ability. <b>Results</b> There were no statistically significant differences in gender, comorbidities, smoking history, tumor location, Tumor-Node-Metastasis (TNM) Staging System, tumor differentiation, neutrophil count, red blood cell count, white blood cell count, creatinine, urea nitrogen, intraoperative blood loss, and operation time (<i>p</i> > 0.05). The comparison of age, Acute Physiology and Chronic Health Evaluation (APACHE II) score, mean arterial pressure, and RWT between the two groups showed statistically significant differences (<i>p</i> < 0.05). Multivariate logistic regression analysis indicated that age, APACHE II score, mean arterial pressure, and RWT significantly influenced the development of AKI in patients undergoing VATS for lung cancer (<i>p</i> < 0.05). RWT was negatively correlated with mean arterial pressure (<i>r</i> = -0.558, <i>p</i> < 0.05), and positively correlated with age and APACHE II Score (<i>r</i> = 0.573, 0.520, <i>p</i> < 0.05). Moreover, AKI showed a positive correlation with age, APACHE II Score, and RWT (<i>r</i> = 0.726, 0.685, 0.772, <i>p</i> < 0.05), and a negative correlation with mean arterial pressure (<i>r</i> = -0.724, <i>p</i> < 0.05). ROC analysis revealed that the area under the predicted curve for RWT was 0.864, and the standard error was 0.030 (95% confidence interval (CI): 0.805~0.923), with a Youden index of 0.55. At this time, the sensitivity was 87.29% and the specificity was 67.31%. <b>Conclusion</b> RWT shows excellent predictive value for postoperative AKI in patients undergoing VATS for lung cancer.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 12","pages":"1-12"},"PeriodicalIF":1.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What You Need to Know About: The Management of Malignant Pleural Effusion.","authors":"Hainey Scott, Reid Phil","doi":"10.12968/hmed.2024.0311","DOIUrl":"https://doi.org/10.12968/hmed.2024.0311","url":null,"abstract":"<p><p>Malignant pleural effusion (MPE) is a common complication of malignancy and is regularly seen on the general medicine take. Diagnosis of MPE is indicative of advanced or metastatic disease and carries a poor prognosis, with median survival ranging from 3 to 12 months. Despite recent advancements in systemic anti-cancer treatment, the goal of management in MPE remains the palliation of symptoms. This article reviews the current guidelines and evidence on the assessment and management of MPE. Assessment involves imaging techniques such chest X-ray and computed tomography (CT) scans, whilst thoracic ultrasound has a crucial role in guiding diagnostic procedures. Diagnostic pleural aspiration remains a cornerstone for establishing a tissue diagnosis, although its yield is variable depending on tumour type. Emergence of targeted immunotherapy has necessitated the need for large tissue samples for molecular testing, driving the need for pleural biopsies in relevant cases. Management encompasses therapeutic aspiration, chemical pleurodesis and indwelling pleural catheter insertion, each offering distinct benefits and considerations. Recent developments in equipment and combined approaches have enhanced patient outcomes and quality of life. The complexity of MPE requires a patient-centred approach to assessment and management and where possible patients should be managed with specialists in pleural disease on an outpatient basis.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 12","pages":"1-18"},"PeriodicalIF":1.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a BOPPPS Teaching Model in Standardized Training for Nephrology Resident Physicians: A Retrospective Cohort Study.","authors":"Yuting Li, Fei Ren, Jin Qiu, Defu Li, Jiangmei Wang, Shan Lin","doi":"10.12968/hmed.2024.0437","DOIUrl":"https://doi.org/10.12968/hmed.2024.0437","url":null,"abstract":"<p><p><b>Aims/Background</b> Based on Bridge-in, Objective, Pre-assessment, Participatory learning, Post-assessment and Summary (BOPPPS), the teaching model has gained increasing attention in the field of medical education. This study aimed to evaluate the effectiveness of the BOPPPS teaching model in standardized training for nephrology residents, particularly in educating on hyperkalemia in chronic kidney disease (CKD). <b>Methods</b> This retrospective cohort study included students undergoing standardized training in the nephrology department at the Shanghai Traditional Chinese Medicine-Integrated Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from 2021 to 2024. The observation group (n = 55) received instructions using the BOPPPS teaching model, while the control group (n = 64) was educated using the traditional teaching methods. The study evaluated learning outcomes and teaching satisfaction through theoretical and practical assessments, as well as self-assessment by the students. <b>Results</b> The observation group demonstrated significantly higher scores in theoretical exams and practical assessments compared to the control group (<i>p</i> < 0.05). Additionally, the observation group reported higher self-assessment scores (<i>p</i> < 0.05) and greater teaching satisfaction (<i>p</i> < 0.05) than the control group. <b>Conclusion</b> The BOPPPS teaching model is an effective approach to enhancing theoretical knowledge, practical skills, and teaching satisfaction in standardized training for nephrology residents. Compared to traditional teaching methods, the BOPPPS model improves learning outcomes, thereby strengthening the quality of medical education.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 12","pages":"1-13"},"PeriodicalIF":1.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Value of Serum Lactate Levels for Mortality in Patients with Hepatitis B-Related Decompensated Cirrhosis: A Retrospective Analysis.","authors":"Hong Yang, Bin Zhang, Chunxian Peng, Chun Yu, Xiaolin Mou","doi":"10.12968/hmed.2024.0531","DOIUrl":"https://doi.org/10.12968/hmed.2024.0531","url":null,"abstract":"<p><p><b>Aims/Background</b> Decompensated cirrhosis is characterized by the progression of cirrhosis from an asymptomatic state to elevated portal pressure and marked deterioration of liver function. This pathological condition progresses rapidly following onset, significantly raising the risk for mortality. The aim of this study is to explore the association between serum lactate concentrations and mortality rates in individuals with hepatitis B-induced decompensated cirrhosis and to evaluate its potential as a clinical prognostic indicator. <b>Methods</b> This retrospective analysis involved 200 individuals (134 men and 66 women) diagnosed with decompensated cirrhosis related to hepatitis B and hospitalized between March 2017 and May 2023. Out of these patients, 162 survived while 38 did not. Clinical information and laboratory results, including the Model for End-Stage Liver Disease (MELD) score, Child-Pugh score, and serum lactate levels, were collected. Logistic regression was applied to identify mortality risk factors from the patient sample and groups categorized according to gender. The predictive value of serum lactate levels for mortality was assessed using the area under the curve (AUC), i.e., receiver operating characteristic (ROC) curve. <b>Results</b> The surviving patient group showed significantly lowered MELD scores, Child-Pugh scores, and serum lactate levels compared to those who were deceased (<i>p</i> < 0.05). Multivariate analysis revealed that the MELD score, Child-Pugh score, and serum lactate levels were independent predictors of mortality in patients with decompensated hepatitis B cirrhosis, with odds ratios (OR) of 1.321, 1.432, and 49.082, respectively (<i>p</i> = 0.012, 0.028, and <0.001, respectively). Additionally, the OR for serum lactate levels was notably higher in female patients compared to male patients (46.824 vs. 30.451). Thus, the MELD score, Child-Pugh score, and serum lactate levels are effective predictors for mortality in cirrhosis patients (AUCs = 0.628, 0.675, and 0.809; <i>p</i> = 0.014, 0.001, and <0.001, respectively), with serum lactate levels showing the most excellent predictive efficacy profile (sensitivity 65.8% and specificity 97.5%). Additionally, the AUC value for serum lactate levels was lower in male patients (0.785) compared to female patients (0.875), indicating that changes in serum lactate levels were more sensitive in female patients. In summary, serum lactate concentration is a prognostic indicator of mortality in individuals with decompensated cirrhosis due to hepatitis B, exhibiting higher predictive significance in female patients. <b>Conclusion</b> Deceased patients with decompensated cirrhosis linked to hepatitis B exhibit markedly increased serum lactate levels. Thus, monitoring serum lactate levels offers an effective tool for predicting patient prognosis, exhibiting higher sensitivity for disease detection in female patients.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 12","pages":"1-10"},"PeriodicalIF":1.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of Whole-Exome Sequencing in the Genetic Diagnosis of Prenatal Ultrasound Abnormalities.","authors":"Lili Qin, Datong Liu, Xuanyi Wang, Yu Xia, Meiling Sun, Huizi Chen","doi":"10.12968/hmed.2024.0475","DOIUrl":"https://doi.org/10.12968/hmed.2024.0475","url":null,"abstract":"<p><p><b>Aims/Background</b> Prenatal diagnosis is a crucial tool in reducing birth defects. Research indicates that whole-exome sequencing (WES) is particularly effective for detecting abnormalities associated with structural ultrasound findings. This study aimed to evaluate the utility of WES in the genetic diagnosis of prenatal ultrasound abnormalities. <b>Methods</b> A total of 50 pregnant women with prenatal ultrasound abnormalities, diagnosed at Rizhao People's Hospital between January 2023 and May 2024, were enrolled. Amniocytes, abortion tissues, and peripheral blood samples from the couples were collected for family-based WES. <b>Results</b> WES revealed genetic abnormalities in 20 out of 50 cases, resulting in a detection rate of 40%. The detection rates for specific abnormalities were as follows: skeletal abnormalities (41.7%), cardiovascular abnormalities (54.5%), central nervous system abnormalities (30%), urinary system abnormalities (50%), nuchal translucency thickening/hygroma colli (20%), and facial anomalies/cleft lip and palate (25%). The genetic detection rates for monosystemic and multisystemic abnormalities were 34.2% and 50%, respectively. <b>Conclusion</b> WES is crucial in the genetic diagnosis of prenatal ultrasound abnormalities, enhancing the accuracy of prenatal diagnostics and facilitating informed genetic counseling.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 12","pages":"1-21"},"PeriodicalIF":1.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Scalpel: Unravelling the Anaesthetic Maze in Elective C-Section for Placenta Accreta Spectrum.","authors":"Suraj Shah, Yasser Mandour","doi":"10.12968/hmed.2023.0243","DOIUrl":"https://doi.org/10.12968/hmed.2023.0243","url":null,"abstract":"<p><p>Placenta accreta spectrum (PAS) disorders pose significant challenges in the anaesthetic management of elective caesarean section. This article explores the anaesthetic considerations for patients with PAS focusing on the optimal techniques to ensure maternal safety and surgical success. The analysis examines the advantages and disadvantages of general anaesthesia, neuraxial anaesthesia, and combined techniques to inform considerations of anaesthetic management in this high-risk population.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 12","pages":"1-4"},"PeriodicalIF":1.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Value of Endobronchial Ultrasound-Guided Intranodal Forceps Biopsies Combined with Rapid On-Site Evaluation for Mediastinal/Hilar Lymph Node Disease.","authors":"Zhongli Wang, Peng Xu, Nansheng Wan, Jing Feng","doi":"10.12968/hmed.2024.0470","DOIUrl":"https://doi.org/10.12968/hmed.2024.0470","url":null,"abstract":"<p><p><b>Aims/Background</b> Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is the standard method for sampling mediastinal/hilar lymph node disease. However, the smaller samples obtained via needle aspiration have a lower diagnostic rate for benign compared to malignant diseases. The low diagnostic rates have been reported to be improved through using endobronchial ultrasound-guided intranodal forceps biopsy (EBUS-IFB), but the implementation of IFB presents technical challenges, as described with variable results in certain studies. The main objective of this study was to investigate the diagnostic value and safety of EBUS-IFB for mediastinal/hilar lymph node disease. <b>Methods</b> A retrospective analysis was conducted on 150 patients with mediastinal/hilar lymph node disease at Tianjin Medical University General Hospital. EBUS-TBNA was performed using a rigid bronchoscope on the same lymph node of each patient under general anesthesia, with rapid on-site evaluation (ROSE) conducted to determine the presence of pathological tissue. Following this, a tunnel was established, and a 1.5 mm biopsy forceps was employed for EBUS-IFB. Subsequently, diagnostic rates and safety of the methods used were determined. <b>Results</b> EBUS-IFB + EBUS-TBNA (the combined strategy) exhibited the highest diagnostic rates, with the addition of bronchial mucosa biopsy/transbronchial lung biopsy/neoplasm biopsy contributing to a successful diagnostic rate of 97.2% (139/143). The combined strategy (90.2%) and EBUS-IFB alone (88.1%) contributed to successful diagnosis for all diseases, with rates significantly higher than that of EBUS-TBNA (60.1%) (<i>p</i> < 0.001). The diagnostic rates for malignant disease detected with the combined strategy (97.4%) and EBUS-IFB alone (93.6%) were significantly higher than that with EBUS-TBNA alone (71.8%) (<i>p</i> < 0.001). Both the diagnostic rates for sarcoidosis detected with the combined strategy and EBUS-IFB alone were 87.8%, which was significantly higher than that with EBUS-TBNA alone (46.9%) (<i>p</i> < 0.001). The procedures implemented did not engender major complications. <b>Conclusion</b> Routine EBUS-TBNA followed by ROSE to acquire pathological tissue, followed by tunnel formation and EBUS-IFB, can enhance the overall diagnostic rate for mediastinal/hilar lymph node lesions. This approach is particularly valuable for diagnosing malignant diseases and sarcoidosis. EBUS-IFB serves as a safe and feasible complement to EBUS-TBNA, despite the fact that the procedure was extended in duration.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 12","pages":"1-19"},"PeriodicalIF":1.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Body Fat Percentage on Body Type Cognitive Bias Among Young Chinese Hospital Staff Members: A Cross-Sectional Study.","authors":"Lu Wang, Jing Wen, Zhen Xu, Ke Guan, Yongchun Chen","doi":"10.12968/hmed.2024.0444","DOIUrl":"https://doi.org/10.12968/hmed.2024.0444","url":null,"abstract":"<p><p><b>Aims/Background</b> This study expanded the existing literature on obesity and distortion of body image by examining subjective and objective body type among young medical workers, specifically investigating whether fat percentage independently influences body type cognitive bias. <b>Methods</b> We recruited 264 participants (41.29% male, mean age 26.2 ± 3.1 years, mean body mass index (BMI) 21.7 ± 3.1 kg/m²) at a comprehensive hospital in central China. The questionnaire responses of the enrolled participants concerning basic information and body type self-assessment were extracted. Their weights and body compositions were evaluated by the bioelectrical impedance analysis technique (BIA). Objective indicators included measured weight, BMI, fat percentage, waist circumference (WC) and waist-to-hip ratio (WHR). <b>Results</b> Based on this sample, the prevalence rate of body type cognitive bias was 28.79%. For women, the univariate regression analysis showed that fat percentage was significantly correlated with body type cognitive bias (odds ratio [OR] 1.107, 95% confidence interval [CI] 1.033-1.185, <i>p</i> = 0.004). BMI (OR 1.303, 95% CI 1.098-1.546, <i>p</i> = 0.002) and WC (OR 1.109, 95% CI 1.043-1.180, <i>p</i> = 0.001) might also be positively associated with body type cognitive bias. After adjusting for age, BMI, WHR, and job position, the risk of body type cognitive bias decreased with fat percentage up to the first inflection point (26.8%) (OR 0.78, 95% CI 0.62-0.98, <i>p</i> = 0.036), and then it increased up to the second inflection point (33.0%). When fat percentage exceeded 33.0%, the relationship lost statistical significance. No significant relationships were found for men. <b>Conclusion</b> Fat percentage is an independent, nonlinear factor influencing women's body type cognitive bias. Gender and fat percentage should be considered when establishing weight management intervention strategies to prevent obesity from becoming a public health problem.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 12","pages":"1-15"},"PeriodicalIF":1.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ruptured: Retrospective Analysis Undertaken for Patients Treated for Unexplained Retroperitoneal or Abdominal Pain in the Emergency Department.","authors":"Thomas J Mroczek, Shahzad Ahmed, Thim Yung Chan, John Zajac, Romaih Al-Idari, Anukiran Ravichandran","doi":"10.12968/hmed.2024.0357","DOIUrl":"https://doi.org/10.12968/hmed.2024.0357","url":null,"abstract":"<p><p><b>Aims/Background</b> Symptomatic abdominal aortic aneurysms carry significant mortality risk. This is supplemented by the Royal College of Emergency Medicine guidelines which suggest imaging for patients 50 years of age or older presenting with unexplained abdominal, flank, or back pain. This study aimed to evaluate the prevalence and mortality rates of patients with symptomatic abdominal aortic aneurysms in a high-risk population and to assess scanning rates in the accident and emergency department. <b>Methods</b> Retrospective analysis of patients presenting to the accident and emergency department at a district general hospital over 6 months was performed. Patients 50 years of age or older presenting with abdominal, flank, or back pain were included. Collected data points included; whether or not a scan was performed in the emergency department, the modality of imaging, whether an abdominal aortic aneurysm was identified on the scan, the age of patients with an abdominal aortic aneurysms identified on the scan, size of the identified abdominal aortic aneurysms, primary diagnosis at the time of review in the emergency department, and all-cause mortality rates. <b>Results</b> 361 patients were identified to have an indicated scan, of which only 122 (33.8%) had a scan in the emergency department. In the syndromic group, the prevalence and 30-day mortality of patients with an abdominal aortic aneurysm were 5.5% and 1.1% respectively. Only 12 out of 20 patients with an abdominal aortic aneurysm were identified in the emergency department. <b>Conclusion</b> The criteria outlined by the Royal College of Emergency Medicine does well at identifying patients with abdominal aortic aneurysms when followed. However, this study reveals that scanning rates in the emergency department are low. The encouragement of scanning and improved ultrasound skills among emergency medicine clinicians can reduce missed diagnoses. Additionally, we recommend further studies to assess the mortality rates of emergent abdominal aortic aneurysm presentations.</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 12","pages":"1-9"},"PeriodicalIF":1.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Application of Concept Map Thinking Combined with Kolcaba's Comfort Nursing in the Perioperative Care of Patients Undergoing Nasal Deformity Correction.","authors":"Yunping Deng, Yu Tian, Chang Guo, Yunping Fan, Jiaoqiong Guan, Yue Wang","doi":"10.12968/hmed.2024.0562","DOIUrl":"https://doi.org/10.12968/hmed.2024.0562","url":null,"abstract":"<p><p><b>Aims/Background</b> By addressing patients' physical, psychological, social, cultural, and environmental comfort needs holistically, Kolcaba's Comfort Theory raises the standard of care and increases patient satisfaction. This study explored the combined application of these nursing models during the perioperative period for patients undergoing nasal deformity correction surgery. <b>Methods</b> 92 patients undergoing nasal deformity correction at the Seventh Affiliated Hospital of Sun Yat-sen University were randomly divided into two groups: the conventional group (46 patients), which received standard perioperative nursing care, and the experimental group (46 patients), which received concept map thinking nursing combined with Kolcaba's comfort nursing intervention during the perioperative period. Clinical indicators, including the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Rhinoplasty Outcome Evaluation (ROE) and General Comfort Questionnaire (GCQ), were compared between the two groups at multiple time points. <b>Results</b> The experimental group demonstrated significantly shorter operation times (<i>p</i> < 0.001), faster recovery of nasal breathing (<i>p</i> = 0.002), and shorter hospital stays (<i>p</i> < 0.001) compared to the conventional group. Additionally, the experimental group experienced less intraoperative blood loss (<i>p</i> < 0.001) and a lower incidence of complications (<i>p</i> = 0.013). At 2 days, 1 month, and 3 months post-surgery, both groups showed decreases in SAS, SDS, and PSQI scores, with the experimental group demonstrating significantly lower scores (<i>p</i> < 0.05). At these same time points, the ROE and GCQ scores increased in both groups, with the experimental group achieving significantly higher scores than the conventional group (<i>p</i> < 0.05). <b>Conclusion</b> The integration of concept map thinking with Kolcaba's comfort nursing significantly improves the postoperative recovery of patients undergoing nasal deformity correction. Reduced surgical trauma, enhanced psychological health, better sleep, increased comfort, and quicker nasal function recovery are all results of this method. <b>Clinical Trial Registration</b> China Clinical Trial Registration Center (https://www.chictr.org.cn/showproj.html?proj=191278).</p>","PeriodicalId":9256,"journal":{"name":"British journal of hospital medicine","volume":"85 12","pages":"1-17"},"PeriodicalIF":1.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}