scholarly journals Effect of ERAS Combined with Comfortable Nursing on Quality of Life and Complications in Femoral Neck Fractures of the Aged People

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Hu Ping ◽  
Xu Ling ◽  
Yiwei Xue ◽  
Fanghui Dong

Objective. To explore the effect of enhanced recovery after surgery (ERAS) combined with comfortable nursing on the quality of life and complications of elderly patients with femoral neck fracture (FNF). Methods. From May 2019 to May 2020, 80 senile FNF patients who admitted to our hospital were treated by total hip arthroplasty (THA). All patients were randomly divided upon admission into a control group (CG) with usual care and a study group (RG) with ERAS combined with comfort care of 40 patients each. The postoperative efficacy was assessed by Harris score of hip joint function, and the psychology was evaluated by self-rating anxiety scale (SAS). The SF-36 score of quality of life, the time of catheter removal, the time of getting out of bed, the hospital stays, the satisfaction of nursing, and the Barthel score of self-care ability were compared between the two groups before and after nursing, and the incidence of postoperative complications was also evaluated. Results. Compared with the CG, the SF-36 score of quality of life and Barthel score of self-care ability in the RG were dramatically higher, while the SAS score of anxiety was dramatically lower. Besides, the time of catheter removal, the time of getting out of bed, and the hospital stays in the RG were dramatically lower ( P  < 0.05). Furthermore, the nursing satisfaction and postoperative efficacy of patients in the RG were obviously higher (both P  < 0.05), while the incidence of complications in the RG was obviously lower ( P  < 0.05). Conclusion. ERAS combined with comfortable nursing can improve the hip joint function, quality of life, and self-care ability scores of senile FNF patients; relieve the anxiety in patients; and reduce the incidence of postoperative complications, which is valuable to be applied extensively.

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Adi Sofer ◽  
Racheli Magnezi ◽  
Ram Eitan ◽  
Oded Raban ◽  
Orna Tal ◽  
...  

Abstract Background This retrospective study compared perioperative measures, costs, quality of life and survival after open vs. robotic surgery, among obese women diagnosed with low-grade endometrial cancer. Methods Obese women (body mass index (BMI) ≥ 30) who underwent open or robotic surgery for endometrial cancer, in one of two tertiary medical centers in the center of Israel, 2013–2016, postoperative grade 1–2, were included. Costs per patient, including 30-days post-surgery were calculated. Quality of life was evaluated by Physical and Mental Components of the SF-36 and a recovery from surgery questionnaire. Overall survival outcomes were obtained from patients’ files. Surgical outcomes, including operating and anesthesia times, length of hospital stay, and intraoperative and postoperative complications according to the Clavien-Dindo classification scale were reviewed. Results In all, 138 women with BMI ≥30 underwent open (n = 61) or robotic surgery (n = 77) during the study period. The groups had similar BMI, comorbidities, demographics and tumor characteristics. Robotic surgery was associated with shorter hospital stays (mean 1.7 vs. 4.8 days; P < .0001) and fewer postoperative complications (Clavien-Dindo > 2, 5.2% vs. 19.7%; P = .0008), but longer operating theater time (3.8 vs. 2.8 h; P < .001). Costs are equivalent when at least 350 robotic surgeries are performed annually, not including the initial system costs. Quality of life measures were better after robotic surgery. SF-36 showed better measures for robotic surgery (Physical 56 vs. 39 and Mental 73 vs. 56; P < .01). After robotic surgery, patients tended to recover quicker when compared to open surgery, as they returned to normal activities earlier, with less need for family and governmental assistance (mean recovery time, 23 vs. 70 days; P < 0.006 and mean change in preoperative total functioning score, − 1.5 vs. -3.9: P < 0.05, respectively). Overall, 5-year survival was 89.8% for the open surgery group vs. 94% for the robotic surgery group (log rank, P = 0.330). Conclusions Obese women with low-grade endometrial cancer had better quality of life after robotic vs. open surgery. They also had shorter hospital stays and fewer postoperative complications. Centers with high volumes of robotic surgery can achieve similar costs when comparing both methods. These results were achieved without jeopardizing survival. Our results further emphasize the need for the Israeli healthcare system to include specific reimbursement for robotic procedures in the population we studied.


2019 ◽  
Vol 101-B (3) ◽  
pp. 272-280 ◽  
Author(s):  
F. G. M. Verspoor ◽  
M. J. L. Mastboom ◽  
G. Hannink ◽  
W. T. A. van der Graaf ◽  
M. A. J. van de Sande ◽  
...  

Aims The aim of this study was to evaluate health-related quality of life (HRQoL) and joint function in tenosynovial giant cell tumour (TGCT) patients before and after surgical treatment. Patients and Methods This prospective cohort study run in two Dutch referral centres assessed patient-reported outcome measures (PROMs; 36-Item Short-Form Health Survey (SF-36), visual analogue scale (VAS) for pain, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)) in 359 consecutive patients with localized- and diffuse-type TGCT of large joints. Patients with recurrent disease (n = 121) and a wait-and-see policy (n = 32) were excluded. Collected data were analyzed at specified time intervals preoperatively (baseline) and/or postoperatively up to five years. Results A total of 206 TGCT patients, 108 localized- and 98 diffuse-type, were analyzed. Median age at diagnosis of localized- and diffuse-type was 41 years (interquartile range (IQR) 29 to 49) and 37 years (IQR 27 to 47), respectively. SF-36 analyses showed statistically significant and clinically relevant deteriorated preoperative and immediate postoperative scores compared with general Dutch population means, depending on subscale and TGCT subtype. After three to six months of follow-up, these scores improved to general population means and continued to be fairly stable over the following years. VAS scores, for both subtypes, showed no statistically significant or clinically relevant differences pre- or postoperatively. In diffuse-type patients, the improvement in median WOMAC score was statistically significant and clinically relevant preoperatively versus six to 24 months postoperatively, and remained up to five years’ follow-up. Conclusion Patients with TGCT report a better HRQoL and joint function after surgery. Pain scores, which vary hugely between patients and in patients over time, did not improve. A disease-specific PROM would help to decipher the impact of TGCT on patients’ daily life and functioning in more detail. Cite this article: Bone Joint J 2019;101-B:272–280.


Hand Surgery ◽  
2006 ◽  
Vol 11 (03) ◽  
pp. 103-107 ◽  
Author(s):  
Izuru Kitajima ◽  
Kazureru Doi ◽  
Yasunori Hattori ◽  
Semih Takka ◽  
Emmanuel Estrella

To evaluate the subjective satisfaction of brachial plexus injury (BPI) patients after surgery based on the medical outcomes study 36-item short form health survey (SF-36) and to correlate their SF-36 scores with upper extremity functions. Four items were assessed statistically for 30 patients: SF-36 scores after BPI surgery were compared with Japanese standard scores; the correlation between SF-36 scores and objective joint functions; difference in SF-36 scores between each type of BPI; and influence of each joint function on the SF-36 scores. The SF-36 subscale: PF — physical functioning, RP — role-physical, BP — bodily pain, and the summary score PCS — physical component summary, were significantly inferior to the Japanese standard scores. SF-36 is more sensitive to shoulder joint function than to elbow and finger joint functions. Little correlation was found between SF-36 scores and objective evaluations of joint functions. Greater effort is needed to improve the quality of life (QOL) of BPI patients. This study showed that SF-36 is not sensitive enough to evaluate regional conditions. A region- or site-specific questionnaire is required to evaluate upper extremity surgery.


Author(s):  
В.А. Бывальцев ◽  
А.А. Калинин ◽  
А.К. Оконешникова ◽  
А.В. Егоров ◽  
Э.Е. Сатардинова ◽  
...  

Цель исследования - анализ результатов использования лазерной деструкции суставной ветви запирательного нерва у пациентов пожилого и старческого возраста с дегенеративным коксартрозом. Проспективно изучены результаты лечения 34 пациентов старше 65 лет c симптоматичным дегенеративным заболеванием тазобедренного сустава (ТБС), имеющим соматические противопоказания к выполнению его тотального эндопротезирования. В обследуемой группе в период с 2017 по 2019 г. проведена лазерная деструкция суставной ветви запирательного нерва (970 нм, частотой 9 Гц и мощностью 3 Вт в суммарной дозе 100 Дж). Средний катамнез наблюдения составил 12 мес. Для оценки эффективности хирургического лечения анализировали динамику уровня болевого синдрома в ТБС по визуально-аналоговой шкале, качества жизни - по анкете SF-36, функционального состояния ТБС - по шкале W.H. Harris и наличие операционных осложнений. В результате установлено, что применение лазерной деструкции суставной ветви запирательного нерва при дегенеративном коксартрозе у пациентов пожилого и старческого возраста (при невозможности проведения тотального эндопротезирования ТБС) позволило значительно снизить уровень дооперационного болевого синдрома, восстановить качество жизни и улучшить функциональное состояние пациентов при низком риске развития неблагоприятных последствий. The aim of the study was to analyze the results of the use of laser destruction of the articular branch of the obturator nerve in elderly and senile patients with degenerative coxarthrosis. The results of treatment of 34 patients over 65 years of age with symptomatic degenerative diseases of the hip joint (HJD) and somatic contraindications for total hip arthroplasty have been prospectively studied. In the study group, in the period from 2017 to 2019, laser destruction of the articular branch of the obturator nerve (970 nm, frequency 9 Hz and power 3 W in a total dose of 100 J) was carried out. The average follow-up was 12 months. To assess the effectiveness of surgical treatment, the dynamics of the pain syndrome in the hip joint was analyzed according to the visual analogue scale, the quality of life according to the SF-36 questionnaire, the functional state of the hip joint according to the W.H. Harris scale and the presence perioperative surgical complications. As a result, it was found that the use of laser destruction of the articular branch of the obturator nerve in degenerative coxarthrosis in elderly and senile patients (if total hip arthroplasty was not possible) made it possible to significantly reduce the level of preoperative pain syndrome, restore the quality of life and improve the functional state of patients with low risks of surgical complications.


2021 ◽  
Vol 7 (4) ◽  
pp. 635-646
Author(s):  
Feifei Peng ◽  
Guangchi Xu ◽  
Caihong Zhu ◽  
Lanchun Sun ◽  
Bo Dong ◽  
...  

To explore the influence of human-oriented nursing mode on the self-care ability, unhealthy emotion and quality of life of patients with benign prostatic hyperplasia (BPH), 147 patients with BPH admitted to our hospital from February 2018 to August 2019 were selected and all patients were separated into two groups on the basis of the nursing intervention mode. 77 cases in the research group (RG) were given the human-oriented nursing mode and 70 cases in the control group (CG) were given the conventional nursing mode. The bladder irrigation time (BIT), indwelling catheter time (ICT), postoperative hospitalization time (PHT) and the incidence rate of postoperative complications were observed in the two groups after nursing intervention. Before and after nursing intervention, the self-care ability of patients was evaluated in the two groups by Exercise of Self-Care Agency Scale (ESCA). In the two groups, the anxiety and depression status were evaluated by the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS). The Quality of Life Scale for Benign Prostatic Hyperplasia Patient (BPHQLS) was applied to evaluate the quality of life in both groups before and after nursing intervention. The International Prostate Symptom Score (IPSS) was used to assess the lower urinary tract symptoms (LUTS) of patients in the two groups before and after nursing intervention. The self-made nursing satisfaction questionnaire was used to evaluate the nursing satisfaction in the two groups. The BIT, ICT and PHT in RG after nursing intervention were obviously lower than those in CG, and the incidence of postoperative complications in RG was also obviously lower than that in CG (p < 0.05). The ESCA score of patients in RG after nursing intervention was significantly higher than that in CG (P < 0.05). The SAS and SDS scores of patients in RG after nursing intervention were significantly lower than those in CG (P < 0.05). The BPHQLS score in RG after nursing intervention was obviously higher than that in CG (P < 0.05). The IPSS score of patients in RG after nursing intervention was obviously lower than that in CG (p < 0.05). The nursing satisfaction score in RG after nursing intervention was obviously higher than that in CG (p < 0.05).Condusion: The application effect of the human-oriented nursing mode on patients with BPH is definite, which can improve self-care ability, unhealthy emotion and effectively ameliorate the quality of life.


2018 ◽  
Vol 14 (1-2) ◽  
pp. 24-33
Author(s):  
M.B. Dzhus

Relevance. The study of the frequency of remission in adult patients  with JRA treated in accordance with the "Unified clinical protocol for medical care for patients with juvenile rheumatoid arthritis" is relevant. Objective. The aim of our study was to evaluate the association of the clinical, psycho-emotional state and the pathogenetic therapy with the development of remission in adult patients with JRA. Materials and methods. 168 adult patients with JRA were examined at the transition period of the health care and adolescents. A retrospective analysis of medical records was performed to evaluate clinical symptoms and laboratory data in childhood and evaluated the clinical status, duration of the disease, activity on the JADAS and DAS-28 scales, quality of life, depression and alexithymia by scales SF-36, PHQ-9, TAS- 20, bone mineral density and methods of treatment in childhood and in adulthood. Results. All patients were divided into 2 groups: Group I - 138 patients (82.1%) with active disease at the time of examination, and II group - 30 patients (17.9%) who achieved remission. Patients who achieved remission did not differ by age at the time of the study, although the prevalence of women (58.1%) in the I group was determined, compared with 31.0% in the II group. Patients in both groups did not differ in height, however, patients with remission had a greater body weight (p <0.01) and BMI (p <0.01). There were no differences between the groups in the level of RF and A-CCP, ANA and the presence of HLA-B27, as well as in total cholesterol, LDL-cholesterol, glucose as risk factors for atherosclerosis (all p> 0.05). Patients with active disease had lower BMD in femoral neck and in ultradistal forearm area (all p <0.05). There were no difference in the the appointment of the IBT in doth groups. However, patients with remission more often did not receive GC in history (p <0.001) and at the time of examination (p <0.001), which is explained by less activity in the onset of the disease (p <0.05). Both groups did not differ in either the duration of the DMARD therapy, nor on the doses of methotrexate and sulfosalazine. Of the 53 patients with RF(+)/RF(-) polyarthritis - the most prognostically unfavorable variant of JRA, had arthritis > 3 joints (p <0.01), symmetrical arthritis (p <0.05), higher ESR ( p <0,05) compared patients with remission, and the absence of differences in the levels of CRP and JADAS. Conclusions. Patients with JRA in adulthood in 82.1% continue to have an active disease of varying degrees. The negative influence of the active disease on the BMD is found, mainly in the area of ​​femoral neck and ultradistal forearm in adult patients with active JRA compared with patients in remission. The significant influence of active disease in adulthood on the quality of life according to the SF-36 questionnaire was determined such as physical well-being, physical, role and social functioning, bodily pain, general health, and mental health compared with the group of patients in remission. An increase level of depression was found by PHQ-9 questionnaire in the I group compared to II group, although they did not differ in the level of Alexithymia. Patients who achieved remission compared with patients with active polyarthritis, were less likely to take GC in adulthood and reseived a higher dose of methotrexate.


2018 ◽  
Vol 14 (1-2) ◽  
pp. 24-33
Author(s):  
M.B. Dzhus

Relevance. The study of the frequency of remission in adult patients  with JRA treated in accordance with the "Unified clinical protocol for medical care for patients with juvenile rheumatoid arthritis" is relevant. Objective. The aim of our study was to evaluate the association of the clinical, psycho-emotional state and the pathogenetic therapy with the development of remission in adult patients with JRA. Materials and methods. 168 adult patients with JRA were examined at the transition period of the health care and adolescents. A retrospective analysis of medical records was performed to evaluate clinical symptoms and laboratory data in childhood and evaluated the clinical status, duration of the disease, activity on the JADAS and DAS-28 scales, quality of life, depression and alexithymia by scales SF-36, PHQ-9, TAS- 20, bone mineral density and methods of treatment in childhood and in adulthood. Results. All patients were divided into 2 groups: Group I - 138 patients (82.1%) with active disease at the time of examination, and II group - 30 patients (17.9%) who achieved remission. Patients who achieved remission did not differ by age at the time of the study, although the prevalence of women (58.1%) in the I group was determined, compared with 31.0% in the II group. Patients in both groups did not differ in height, however, patients with remission had a greater body weight (p <0.01) and BMI (p <0.01). There were no differences between the groups in the level of RF and A-CCP, ANA and the presence of HLA-B27, as well as in total cholesterol, LDL-cholesterol, glucose as risk factors for atherosclerosis (all p> 0.05). Patients with active disease had lower BMD in femoral neck and in ultradistal forearm area (all p <0.05). There were no difference in the the appointment of the IBT in doth groups. However, patients with remission more often did not receive GC in history (p <0.001) and at the time of examination (p <0.001), which is explained by less activity in the onset of the disease (p <0.05). Both groups did not differ in either the duration of the DMARD therapy, nor on the doses of methotrexate and sulfosalazine. Of the 53 patients with RF(+)/RF(-) polyarthritis - the most prognostically unfavorable variant of JRA, had arthritis > 3 joints (p <0.01), symmetrical arthritis (p <0.05), higher ESR ( p <0,05) compared patients with remission, and the absence of differences in the levels of CRP and JADAS. Conclusions. Patients with JRA in adulthood in 82.1% continue to have an active disease of varying degrees. The negative influence of the active disease on the BMD is found, mainly in the area of ​​femoral neck and ultradistal forearm in adult patients with active JRA compared with patients in remission. The significant influence of active disease in adulthood on the quality of life according to the SF-36 questionnaire was determined such as physical well-being, physical, role and social functioning, bodily pain, general health, and mental health compared with the group of patients in remission. An increase level of depression was found by PHQ-9 questionnaire in the I group compared to II group, although they did not differ in the level of Alexithymia. Patients who achieved remission compared with patients with active polyarthritis, were less likely to take GC in adulthood and reseived a higher dose of methotrexate.


2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Jing Luo ◽  
Xiaohua Dong ◽  
Jing Hu

Abstract Background Nursing intervention following discharge is a long-term rehabilitation process that is essential for improving hip joint function and quality of life in affected patients. This study aimed to assess the effect of nursing intervention via WeChat on the rehabilitation of patients after total hip arthroplasty (THA). Methods We conducted a retrospective analysis of 232 patients who underwent THA at our hospital from January 2013 to October 2015. Of the 232 patients, 114 received nursing intervention via telephone (Group A), and 118 received nursing intervention via WeChat (Group B). Furthermore, the Harris hip score and Short-Form 36 (SF-36) health survey score were used to evaluate hip joint function and quality of life in patients in the two groups at discharge and 1, 3 and 6 months following discharge. Moreover, the functional independence measure was applied to assess the recovery of joint function in the patients. Results No significant difference was observed in the Harris hip score and the SF-36 health survey score between the two groups at discharge and 1 month following discharge (p > 0.05). However, the Harris hip score and SF-36 health survey score were lower in group A than in group B at 3 and 6 months following discharge (p < 0.05). Furthermore, no obvious difference was observed in terms of functional independence between the two groups at discharge (p > 0.05). However, more individuals were completely independent in group B than in group A at 1, 3 and 6 months following discharge (p < 0.05). Conclusions Nursing intervention via WeChat can improve the effect of rehabilitation after THA and promote the recovery of joint function in patients.


2021 ◽  
Vol 2 (3) ◽  
pp. 40-47
Author(s):  
A. I. Kabargina ◽  
Yu. M. Lopatin

Aim: to assess self-care skills and quality of life in patients with chronic coronary syndromes (CCS). Material and methods: the study involved 100 consecutive patients with stable coronary heart disease (CHD) admitted to cardiology departments. All patients admitted to the clinic underwent standard examination and treatment, taken in the management of patients with CCS. Besides, we assessed socio-demographic properties (marital status, education level, profession, disability for all reasons, income level), quality of life (using SF-36, SAQ questionnaires), levels of anxiety and depression (HADS scale), type D personality (DS-14 questionnaire), treatment adherence (Four-Item Morisky-Green-Levine medication adherence scale), Charlson comorbidity index, The Self Care of Coronary Heart Disease Inventory. Data processing was carried out using descriptive statistics, correlation and variance analysis. results: type D personality was identified in 60 patients (10.2 ± 5.6) on the scale of negative excitability, in 59 people (10.4 ± 3.7) — on the scale of social inhibition. An increased level of anxiety was found in 48 patients (7.6 ± 3.5), depression — in 49 people (7.1 ± 3.4). The average values of the physical component of the quality of life according to the SF-36 questionnaire were 36.9 ± 18.7 and 45.9 ± 19.6 points, respectively. The quality of life associated with exertional angina pectoris, according to the SAQ questionnaire, was 48.8 ± 19.7 points on the scale of limiting physical activity, 49.7 ± 28.2 points for seizure stability, and 70.5 ± 17.8 points for satisfaction with treatment. Treatment adherence according to the Morisky-Green scale was, on average, 2.6 ± 1.2 (Me: 2, [2.4]). Self-care skills on the scale A was 61.3 ± 12.2 points, on the scale B — 49.0 ± 16.2 points, on the scale C — 32.3 ± 14.5 points. In groups of CCS, significant (p <0.05) differences were found on the scales A and B. Significant differences in the self-care skills were obtained among the groups of patients with and without a history of postinfarction cardiosclerosis. Conclusion: the capacity for self-care skills and the quality of life of Russian comorbid patients with CCS is unsatisfactory, which requires active medical intervention and the development of tools for their effective modification.


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