BACKGROUND Although chemotherapy is effective for treating advanced gastric carcinoma(aGC),it may lead to an adverse prognosis.Establishing a highly effective and low-toxicity chemotherapy regimen is necessary for imp...BACKGROUND Although chemotherapy is effective for treating advanced gastric carcinoma(aGC),it may lead to an adverse prognosis.Establishing a highly effective and low-toxicity chemotherapy regimen is necessary for improving efficacy and outcomes in aGC patients.AIM To determine the efficacy and safety of cetuximab(CET)combined with the FOLFOX4 regimen(infusional fluorouracil,folinic acid,and oxaliplatin)as firstline therapy for patients with aGC,who received evidence-based care(EBC).METHODS A total of 117 aGC patients who received EBC from March 2019 to March 2022 were enrolled.Of these,60 in the research group(RG)received CET+FOLFOX4 as first-line therapy,whereas 57 in the control group(CG)received FOLFOX4.The efficacy[clinical response rate(RR)and disease control rate(DCR)],safety(liver and kidney dysfunction,leukopenia,thrombocytopenia,rash,and diarrhea),serum tumor marker expression[STMs;carbohydrate antigen(CA)19-9,CA72-4,and carcinoembryonic antigen(CEA)],inflammatory indicators[interleukin(IL)-2 and IL-10],and quality of life(QOL)of the two groups were compared.RESULTS A markedly higher RR and DCR were observed in the RG compared with the CG,with an equivalent safety profile between the two groups.RG exhibited notably reduced CA19-9,CA72-4,CEA,and IL-2 levels following treatment,which were lower than the pre-treatment levels and those in the CG.Post-treatment IL-10 was statistically increased in RG,higher than the pre-treatment level and the CG.Moreover,a significantly improved QOL was evident in the RG.CONCLUSION The CET+FOLFOX4 regimen is highly effective as first-line treatment for aGC patients receiving EBC.It facilitates the suppression of STMs,ameliorates the serum inflammatory microenvironment,and enhances QOL,without increased adverse drug effects.展开更多
Objective.To analyze the effect of applying evidence-based care in rehabilitation nursing effect of patients with patellar fractures.Methods.A total of 54 patients with patellar fractures were randomly selected from t...Objective.To analyze the effect of applying evidence-based care in rehabilitation nursing effect of patients with patellar fractures.Methods.A total of 54 patients with patellar fractures were randomly selected from the hospital.The diagnosis and treatment time were from the beginning of July 2018 to end of June 2019.The digital table grouping was adopted to divide patients into two groups with each group consists of 27 patients with this disease.Both groups underwent routine nursing and the experimental group with increased evidence-based care.Results.Compared with the control group,the knee function evaluation,complications and nursing satisfaction of the experimental group were more ideal,and the difference was statistically significant(P<0.05).Conclusion.Evidence-based care in rehabilitation nursing of patients with patellar fracture can obtain ideal nursing effect.展开更多
Objective: To explore the application research of evidence-based nursing in the care of patients with severe acute pancreatitis. Methods: This study focuses on evidence-based nursing care of severe acute pancreatitis....Objective: To explore the application research of evidence-based nursing in the care of patients with severe acute pancreatitis. Methods: This study focuses on evidence-based nursing care of severe acute pancreatitis. Patients with severe acute pancreatitis who received treatment in our hospital were selected, from which 80 cases were chosen for detailed analysis. The patients were randomly grouped into a control group (conventional nursing care) and a study group (evidence-based nursing care), with 40 patients each. Relevant research data were recorded during the nursing process, analyzed, and used as research indicators. Results: The hospitalization time and morbidity and mortality rate of the research group were shorter than those of the control group, and the recovery rate was higher than that of the control group (P < 0.05). Patient satisfaction with nursing care in the observation group was higher than in the control group (P < 0.05). Conclusion: For patients with severe acute pancreatitis, the use of evidence-based nursing methods effectively reduced the patient’s mortality rate, improved its curative effect, and also shortened the patient’s hospitalization time.展开更多
BACKGROUND More and more evidence-based practices are emerging,but researchers mostly focus on short-term effects,resulting in evidence-based practices not being applied in the clinic in the long term.In this study,we...BACKGROUND More and more evidence-based practices are emerging,but researchers mostly focus on short-term effects,resulting in evidence-based practices not being applied in the clinic in the long term.In this study,we took the evidence-based practice of perioperative airway management in elderly fracture patients as an example and adopted a descriptive phenomenological approach to understand the influencing factors of its sustainability to provide a reference basis for promoting the continuity of evidence-based practice in the clinic.AIM To explore factors influencing the persistence of evidence-based practice in perioperative airway management in elderly patients with fractures.METHODS This study was qualitative research.Nine nurses who implemented evidencebased practice in the orthopedic ward of a tertiary comprehensive hospital in Shanghai from September 2023 to October 2023 were selected using purposive sampling as research subjects.Semi-structured interviews were conducted with them,and the data were analyzed using the Colaizzi phenomenological analysis method based on the three dimensions and ten factors of the NHS sustainability model.RESULTS Three main themes and ten subthemes were identified:Process aspects(benefits to patients,benefits to nurses,lack of follow-up,complex processes);staff aspects(insufficient human resources,inadequate training and education,lack of leadership support);and organizational environment aspects(inadequate infrastructure,poor patient compliance,poor doctor cooperation).CONCLUSION Human resources,training and education,leadership support,infrastructure,and patient-physician collaboration are important factors influencing the sustainability of evidence-based practice for perioperative airway management in older patients with fractures.展开更多
The field of orthopedic and regenerative medicine is rapidly evolving with the increasing utilization of orthobiologic.These biologically derived therapies,inc-luding platelet-rich plasma,mesenchymal stem cells,bone m...The field of orthopedic and regenerative medicine is rapidly evolving with the increasing utilization of orthobiologic.These biologically derived therapies,inc-luding platelet-rich plasma,mesenchymal stem cells,bone marrow aspirate con-centrate,stromal vascular fraction(SVF),and autologous chondrocyte implanta-tion,are gaining traction for their potential to enhance the body's natural healing processes.They offer a promising alternative to traditional surgical interventions for musculoskeletal injuries and degenerative conditions.Current evidence su-ggests significant benefits of orthobiologics in treating conditions like osteoarth-ritis,tendon injuries,and spinal disorders,yet inconsistencies in treatment pro-tocols and outcomes persist.The global market for orthobiologics is projected to grow substantially,driven by advancements in biologic therapies such as adipose-derived stem cells and SVF,and the demand for minimally invasive treatments.Despite their promise,regulatory and ethical challenges,as well as the need for high-quality,standardized research,remain significant obstacles.Future dire-ctions in the field include advancements in delivery systems,personalized medi-cine approaches,and the exploration of novel sources like induced pluripotent stem cells,aiming for more targeted and effective treatments.Collaborative efforts are crucial to overcoming these challenges and ensuring the safe and effective application of orthobiologics in clinical practice.展开更多
Objective: To explore the effect of evidence-based quality control circle (QCC) in improving the implementation rate of airway management measures in adult critically ill patients. Methods: Based on the Joanna Briggs ...Objective: To explore the effect of evidence-based quality control circle (QCC) in improving the implementation rate of airway management measures in adult critically ill patients. Methods: Based on the Joanna Briggs Institute (JBI) evidence-based health care model, the best evidence of airway management in adult critically ill patients was obtained and applied to the clinic. Results: The total implementation rate of airway management measures in adult critically ill patients increased from 23.62% before the implementation of quality control circle to 88.82%, and the pulmonary infection rate in critically ill patients decreased from 42.31% to 21.74%, with statistical significance between the two groups (P 0.05). Conclusion: Evidence-based quality control circle activities can standardize the practice standards of airway management in critically ill patients, reduce the occurrence of patients’ airway related complications, and improve clinical outcomes.展开更多
Purpose research on nursing sensitive indicators in tumor Patients application effect in immune-related skin toxicity management. Method select our hospital April to June, 202360 cases patients with immune therapy set...Purpose research on nursing sensitive indicators in tumor Patients application effect in immune-related skin toxicity management. Method select our hospital April to June, 202360 cases patients with immune therapy settings as the control group. August-October, 2023 60 cases the patients treated with immune therapy were the experimental group. The control group adopted regular nursing methods, while the experimental group sensitive Indicators, evidence-based give preventive care. The social situation, psychological state, physical function, quality of life score, incidence of skin toxicity caused by immune checkpoint inhibitors, moderate and above of the two groups of patients were compared. Incidence of skin toxicity. Result: experience group SAS score, SDS score higher than the control group, the difference was statistically significant (P < 0.05);The incidence of skin toxic reactions caused by immune checkpoint inhibitors and the incidence of moderate and above skin toxic reactions in the experimental group are lower than those in the control group, and the difference is statistically significant (P < 0.05). Conclusion: sensitive indicator guidance evidence-based preventive care can reduce the degree of immune-related skin toxicity, improve the psychological state and quality of life of tumor patients treated with immune therapy and reduce the incidence of adverse reactions, improve nursing quality and patient satisfaction.展开更多
Objective: To explore the nursing effect of evidence-based PDCA cycle management mode in accelerated rehabilitation of patients undergoing thoracoscopic lung cancer radical surgery. Methods: 104 patients who underwent...Objective: To explore the nursing effect of evidence-based PDCA cycle management mode in accelerated rehabilitation of patients undergoing thoracoscopic lung cancer radical surgery. Methods: 104 patients who underwent thoracoscopic lung cancer radical surgery in our hospital from June 2022 to February 2023 were randomly divided into control group and intervention group, with 52 cases in each group. The control group implemented evidence-based ERAS clinical pathway management, while the intervention group implemented evidence-based PDCA cycle quality management. The postoperative recovery of the two groups of patients was compared. Results: The postoperative recovery of the intervention group was significantly better than that of the control group. The first time to get out of bed, the first time to eat, the duration of chest drainage tube placement, and the length of hospital stay were significantly shorter than those of the control group. The incidence of postoperative chest complications and hospitalization costs were significantly lower than those of the control group, and patient satisfaction was significantly higher than that of the control group (P Conclusion: Evidence-based PDCA cycle quality management mode can effectively improve the implementation quality of accelerated rehabilitation nursing for patients undergoing thoracoscopic lung cancer radical surgery, and it is worthy of clinical promotion.展开更多
This study aimed to evaluate the correlation between nursing informatics(NI)competency and information literacy skills for evidencebased practice(EBP)among intensive care nurses.This cross-sectional study was conducte...This study aimed to evaluate the correlation between nursing informatics(NI)competency and information literacy skills for evidencebased practice(EBP)among intensive care nurses.This cross-sectional study was conducted on 184 nurses working in intensive care units(ICUs).The study data were collected through demographic information,Nursing Informatics Competency Assessment Tool(NICAT),and information literacy skills for EBP questionnaires.The intensive care nurses received competent and low-moderate levels for the total scores of NI competency and information literacy skills,respectively.They received a moderate score for the use of different information resources but a low score for information searching skills,different search features,and knowledge about search operators,and only 31.5%of the nurses selected the most appropriate statement.NI competency and related subscales had a significant direct bidirectional correlation with information literacy skills for EBP and its subscales(P<0.05).Nurses require a high level of NI competency and information literacy for EBP to obtain up-to-date information and provide better care and decision-making.Health planners and policymakers should develop interventions to enhance NI competency and information literacy skills among nurses and motivate them to use EBP in clinical settings.展开更多
Chinese medicine has been used for centuries to treat a range of health conditions.This history has produced a wealth of classical literature,case studies and clinical research data detailing its use and effectiveness...Chinese medicine has been used for centuries to treat a range of health conditions.This history has produced a wealth of classical literature,case studies and clinical research data detailing its use and effectiveness.However,high-quality and conclusive evidence that meets modern requirements for clinical decision support is lacking.This evidence gap limits the integration of Chinese medicine with contemporary medicine,which in turn limits global access and acceptance of Chinese medicine as a form of safe and effective health care.Over the past 20 years,researchers and organisations around the world,including the World Health Organization(WHO)and United Nations,have worked to support the integration of traditional medicines,such as Chinese medicine,with conventional medicines to improve global health care.This paper provides an overview of Chinese medicine studies published in the top four general medical journals(BMJ,JAMA,Lancet and New England Journal of Medicine)from February 2005 to February 2024 in the past 20 years to highlight the progress in the development of this evidence base.It also highlights key actions taken to promote evidence-based clinical Chinese medicine,including product and practitioner regulation,formalising education standards,and international collaborations.Research conducted at the China-Australia International Research Centre for Chinese Medicine demonstrates the benefits of such a collaboration.Through development of its unique and inclusive‘whole-evidence’approach,plus clinical studies and systematic reviews,the Centre has significantly contributed to the evidence base for clinical Chinese medicine.In addition,its high-impact papers and groundbreaking monographs have been cited in international conventional medicine guidelines.While progress has certainly been made during the past 20 years to build a stronger evidence base for clinical Chinese medicine,there is still a considerable gap that limits its integration with conventional medicine.Future funding and research are needed to continue this work and achieve to safe,effective and accessible traditional medicine as part of the WHO’s Universal Health Coverage strategy.展开更多
The aim of the article is to explore the influence of the water landscape design of a rehabilitation garden for patients with mental disorders on the recovery effect of patients,intending to provide a better rehabilit...The aim of the article is to explore the influence of the water landscape design of a rehabilitation garden for patients with mental disorders on the recovery effect of patients,intending to provide a better rehabilitation environment for patients with mental disorders.Based on literature research,this article reviews three aspects of evidence-based design theory,the concept of water landscape in rehabilitation gardens,and the types of water features in rehabilitation gardens.The results show that well-designed water features can significantly improve patients’psychological state and reduce anxiety and stress,and that water landscape design in rehabilitation gardens is an effective rehabilitation tool that can facilitate the recovery process of patients with mental disorders.Future designs should take into full consideration patients’needs and preferences,as well as best practices in waterscape design,to maximize its positive impact on patients’recovery.展开更多
Objective To sort out the problems in the selection model of essential medicines in China,and to put forward some suggestions to optimize the selection model to ensure the rationality of the medicines in the essential...Objective To sort out the problems in the selection model of essential medicines in China,and to put forward some suggestions to optimize the selection model to ensure the rationality of the medicines in the essential medicines list.Methods The domestic and foreign literature on the selection of essential medicines was reviewed.Then,the opinions on the selection methods and results of essential medicines from foreign literature were investigated to make a comparison with the selection of essential medicines in China.Finally,the general and special laws of the selection process of the essential medicines were explored.Results and Conclusion It is recommended that the selection model of essential medicines in China should be further optimized,and the evidence-based thinking and methods should be utilized to enhance the scientific nature of the selection process.展开更多
Statistical literacy is crucial for cultivating well-rounded thinkers.The integration of evidence-based strategies in teaching and learning is pivotal for enhancing students’statistical literacy.This research specifi...Statistical literacy is crucial for cultivating well-rounded thinkers.The integration of evidence-based strategies in teaching and learning is pivotal for enhancing students’statistical literacy.This research specifically focuses on the utilization of Share and Model Concepts and Nurturing Metacognition as evidence-based strategies aimed at improving the statistical literacy of learners.The study employed a quasi-experimental design,specifically the nonequivalent control group,wherein students answered pre-test and post-test instruments and researcher-made questionnaires.The study included 50 first-year Bachelor in Secondary Education majors in Mathematics and Science for the academic year 2023-2024.The results of the study revealed a significant difference in the scores of student respondents,indicating that the use of evidence-based strategies helped students enhance their statistical literacy.This signifies a noteworthy increase in their performance,ranging from very low to very high proficiency in understanding statistical concepts,insights into the application of statistical concepts,numeracy,graph skills,interpretation capabilities,and visualization and communication skills.Furthermore,the study showed a significant difference in the post-test scores’performance of the two groups in understanding statistical concepts and visualization and communication skills.However,no significant difference was found in the post-test scores of the two groups concerning insights into the application of statistical concepts,numeracy and graph skills,and interpretation capabilities.Additionally,students acknowledged that the implementation of evidence-based strategies significantly contributed to the improvement of their statistical literacy.展开更多
Abuse of infants and children is a public health problem that warrants immediate attention. It is estimated that over 7 million children are affected by child abuse yearly, with the highest rate of abuse in those less...Abuse of infants and children is a public health problem that warrants immediate attention. It is estimated that over 7 million children are affected by child abuse yearly, with the highest rate of abuse in those less than one year of age. Approximately 60% of child abuse victims are children under the age of three years, making infants and young children a particularly vulnerable population. Interventions targeting the perinatal period can be effective in mitigating child abuse, including parent education programs and trauma-informed care services. This paper provides an overview of the current evidence base related to child abuse following the COVID-19 pandemic, with a focus on prevention and intervention strategies that can be utilized to increase caregiver support and reduce child abuse rates during the perinatal period.展开更多
Objective:To analyze the value of applying evidence-based nursing in the perioperative care of patients with ankle fractures and propose corresponding measures to improve the quality of patient care.Methods:The study ...Objective:To analyze the value of applying evidence-based nursing in the perioperative care of patients with ankle fractures and propose corresponding measures to improve the quality of patient care.Methods:The study started in May 2022 and was terminated in March 2023.During this period,50 patients with ankle fractures treated by our hospital were selected as research subjects.They were divided into a control group and a research group.The control group had 25 patients who received routine care,and the research group had 25 who received evidence-based care.The nursing effects of the two groups were observed and compared.Results:The pain scores,quality of life,incidence of adverse reactions,and nursing satisfaction of patients in the research group were all significantly better than those in the control group(P<0.05).Conclusion:Evidence-based nursing can effectively improve the quality of care,reduce the risk of adverse reactions,and promote patient recovery,so it is suitable for clinical implementation.展开更多
BACKGROUND Perioperative hypothermia(PH)negatively affects the physical and mental health of patients to varying degrees.Currently,there is no effective multidisciplinary team(MDT)intervention for gynecological patien...BACKGROUND Perioperative hypothermia(PH)negatively affects the physical and mental health of patients to varying degrees.Currently,there is no effective multidisciplinary team(MDT)intervention for gynecological patients with PH.AIM To apply the best evidence on the prevention and management of PH in gynecological patients,improve the quality of perioperative evidence-based care based on treatment by an MDT for gynecological patients and analyze the effect of MDT-and evidence-based practice(EBP)projects on the psychological status and cognitive function of gynecological patients with PH.METHODS Under the guidance of knowledge translation and combined with the opinions of involved stakeholders and clinical experts,the best evidence for PH prevention and management in gynecological patients was selected and adjusted to suit the practice setting.Based on the evidence,the practice plan was developed,and the MDT intervention was carried out in the preoperative ward,the preoperative preparation room,the intraoperative operating room,the postanesthesia care unit,and the 24-hour postoperative gynecological ward through the EBP program.The incidence of hypothermia,the nurses’awareness,the implementation rate of examination indicators,and the thermal comfort level,psychological status and cognitive function of patients were compared before and after the implementation of the program.RESULTS The incidence of PH in gynecological patients decreased from 43.33%to 13.33%after the implementation of the scheme.The implementation rate of examination indicators 6-10,12,14,16-18,21,and 22 reached 100%,and that of other indicators was above 90%,except for examination indicators 5 and 13,which was 66.67%;the indices were significantly improved compared with the baseline(before evidence application)(P<0.05).The score of nurses'awareness of PH prevention and management in gynecological patients increased from 60.96±9.70 to 88.08±8.96,and the difference was statistically significant(P<0.001).The total score of the perioperative thermal comfort level of patients undergoing gynecological surgery was 27.97±2.04,which was significantly increased compared with the score of 21.27±1.57 observed by researchers at baseline(P<0.001).The perioperative Hamilton Depression Scale and Hamilton Anxiety Scale scores of patients undergoing gynecological surgery decreased from 15.03±3.16 and 13.93±2.64 to 4.30±1.15 and 3.53±0.78,respectively,with statistically significant differences(P<0.001).The perioperative Montreal Cognitive Assessment Scale score of the gynecological surgery patients increased from 23.17±1.68 to 26.93±1.11,also with statistical significance(P<0.001).CONCLUSION MDT-based EBP for PH prevention and management in gynecological patients during the perioperative period can standardize nursing operations,improve nurses'awareness and behavioral compliance with gynecological hypothermia management,and reduce the occurrence of PH in gynecological patients while playing a positive role in reducing patients’negative emotions and enhancing their cognitive function.展开更多
Rectal adenocarcinoma is an important cause of cancer-related deaths worldwide, and key anatomic differences between the rectum and the colon have significant implications for management of rectal cancer. Many advance...Rectal adenocarcinoma is an important cause of cancer-related deaths worldwide, and key anatomic differences between the rectum and the colon have significant implications for management of rectal cancer. Many advances have been made in the diagnosis and management of rectal cancer. These include clinical staging with imaging studies such as endorectal ultrasound and pelvic magnetic resonance imaging, operative approaches such as transanal endoscopic microsurgery and laparoscopic and robotic assisted proctectomy, as well as refined neoadjuvant and adjuvant therapies. For stage Ⅱ and Ⅲ rectal cancers, combined chemoradiotherapy offers the lowest rates of local and distant relapse, and is delivered neoadjuvantly to improve tolerability and optimize surgical outcomes, particularly when sphincter-sparing surgery is an endpoint. The goal in rectal cancer treatment is to optimize diseasefree and overall survival while minimizing the risk of local recurrence and toxicity from both radiation and systemic therapy. Optimal patient outcomes depend on multidisciplinary involvement for tailored therapy. The successful management of rectal cancer requires a multidisciplinary approach, with the involvement of enterostomal nurses, gastroenterologists, medical and radiation oncologists, radiologists, pathologists and surgeons. The identification of patients who are candidates for combined modality treatment is particularly useful to optimize outcomes. This article provides an overview of the diagnosis, staging and multimodal therapy of patients with rectal cancer for primary care providers.展开更多
BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective pr...BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.展开更多
With the rising global prevalence in diabetes, healthcare systems are facing a growing challenge to provide efficient and effective diabetes care management in the face of spiralling treatment costs. Diabetes is a maj...With the rising global prevalence in diabetes, healthcare systems are facing a growing challenge to provide efficient and effective diabetes care management in the face of spiralling treatment costs. Diabetes is a major cause of premature mortality and associated with devastating complications especially if managed poorly. Although diabetes care is improving in England and Wales, recent audit data suggests care remains imperfect with wide geographical variations in quality. Diabetes care is expensive with a sizeable amount of available expenditure used for treating the complications of diabetes. A target driven, long-term, multifactorial intervention in patients with type 2 diabetes has been shown to reduce mortality and morbidity. The alphabet strategy is a novel approach to effective diabetes care provision, aiming to address patient education and empowerment, provide consistent comprehensive care delivered in a timely fashion, and allowing multidisciplinary team work.展开更多
文摘BACKGROUND Although chemotherapy is effective for treating advanced gastric carcinoma(aGC),it may lead to an adverse prognosis.Establishing a highly effective and low-toxicity chemotherapy regimen is necessary for improving efficacy and outcomes in aGC patients.AIM To determine the efficacy and safety of cetuximab(CET)combined with the FOLFOX4 regimen(infusional fluorouracil,folinic acid,and oxaliplatin)as firstline therapy for patients with aGC,who received evidence-based care(EBC).METHODS A total of 117 aGC patients who received EBC from March 2019 to March 2022 were enrolled.Of these,60 in the research group(RG)received CET+FOLFOX4 as first-line therapy,whereas 57 in the control group(CG)received FOLFOX4.The efficacy[clinical response rate(RR)and disease control rate(DCR)],safety(liver and kidney dysfunction,leukopenia,thrombocytopenia,rash,and diarrhea),serum tumor marker expression[STMs;carbohydrate antigen(CA)19-9,CA72-4,and carcinoembryonic antigen(CEA)],inflammatory indicators[interleukin(IL)-2 and IL-10],and quality of life(QOL)of the two groups were compared.RESULTS A markedly higher RR and DCR were observed in the RG compared with the CG,with an equivalent safety profile between the two groups.RG exhibited notably reduced CA19-9,CA72-4,CEA,and IL-2 levels following treatment,which were lower than the pre-treatment levels and those in the CG.Post-treatment IL-10 was statistically increased in RG,higher than the pre-treatment level and the CG.Moreover,a significantly improved QOL was evident in the RG.CONCLUSION The CET+FOLFOX4 regimen is highly effective as first-line treatment for aGC patients receiving EBC.It facilitates the suppression of STMs,ameliorates the serum inflammatory microenvironment,and enhances QOL,without increased adverse drug effects.
文摘Objective.To analyze the effect of applying evidence-based care in rehabilitation nursing effect of patients with patellar fractures.Methods.A total of 54 patients with patellar fractures were randomly selected from the hospital.The diagnosis and treatment time were from the beginning of July 2018 to end of June 2019.The digital table grouping was adopted to divide patients into two groups with each group consists of 27 patients with this disease.Both groups underwent routine nursing and the experimental group with increased evidence-based care.Results.Compared with the control group,the knee function evaluation,complications and nursing satisfaction of the experimental group were more ideal,and the difference was statistically significant(P<0.05).Conclusion.Evidence-based care in rehabilitation nursing of patients with patellar fracture can obtain ideal nursing effect.
文摘Objective: To explore the application research of evidence-based nursing in the care of patients with severe acute pancreatitis. Methods: This study focuses on evidence-based nursing care of severe acute pancreatitis. Patients with severe acute pancreatitis who received treatment in our hospital were selected, from which 80 cases were chosen for detailed analysis. The patients were randomly grouped into a control group (conventional nursing care) and a study group (evidence-based nursing care), with 40 patients each. Relevant research data were recorded during the nursing process, analyzed, and used as research indicators. Results: The hospitalization time and morbidity and mortality rate of the research group were shorter than those of the control group, and the recovery rate was higher than that of the control group (P < 0.05). Patient satisfaction with nursing care in the observation group was higher than in the control group (P < 0.05). Conclusion: For patients with severe acute pancreatitis, the use of evidence-based nursing methods effectively reduced the patient’s mortality rate, improved its curative effect, and also shortened the patient’s hospitalization time.
基金The study was reviewed and approved by the Ethics Committee of Shanghai Tongren Hospital(Approval Number:Tongren Lun Audit 2022-075-01).
文摘BACKGROUND More and more evidence-based practices are emerging,but researchers mostly focus on short-term effects,resulting in evidence-based practices not being applied in the clinic in the long term.In this study,we took the evidence-based practice of perioperative airway management in elderly fracture patients as an example and adopted a descriptive phenomenological approach to understand the influencing factors of its sustainability to provide a reference basis for promoting the continuity of evidence-based practice in the clinic.AIM To explore factors influencing the persistence of evidence-based practice in perioperative airway management in elderly patients with fractures.METHODS This study was qualitative research.Nine nurses who implemented evidencebased practice in the orthopedic ward of a tertiary comprehensive hospital in Shanghai from September 2023 to October 2023 were selected using purposive sampling as research subjects.Semi-structured interviews were conducted with them,and the data were analyzed using the Colaizzi phenomenological analysis method based on the three dimensions and ten factors of the NHS sustainability model.RESULTS Three main themes and ten subthemes were identified:Process aspects(benefits to patients,benefits to nurses,lack of follow-up,complex processes);staff aspects(insufficient human resources,inadequate training and education,lack of leadership support);and organizational environment aspects(inadequate infrastructure,poor patient compliance,poor doctor cooperation).CONCLUSION Human resources,training and education,leadership support,infrastructure,and patient-physician collaboration are important factors influencing the sustainability of evidence-based practice for perioperative airway management in older patients with fractures.
文摘The field of orthopedic and regenerative medicine is rapidly evolving with the increasing utilization of orthobiologic.These biologically derived therapies,inc-luding platelet-rich plasma,mesenchymal stem cells,bone marrow aspirate con-centrate,stromal vascular fraction(SVF),and autologous chondrocyte implanta-tion,are gaining traction for their potential to enhance the body's natural healing processes.They offer a promising alternative to traditional surgical interventions for musculoskeletal injuries and degenerative conditions.Current evidence su-ggests significant benefits of orthobiologics in treating conditions like osteoarth-ritis,tendon injuries,and spinal disorders,yet inconsistencies in treatment pro-tocols and outcomes persist.The global market for orthobiologics is projected to grow substantially,driven by advancements in biologic therapies such as adipose-derived stem cells and SVF,and the demand for minimally invasive treatments.Despite their promise,regulatory and ethical challenges,as well as the need for high-quality,standardized research,remain significant obstacles.Future dire-ctions in the field include advancements in delivery systems,personalized medi-cine approaches,and the exploration of novel sources like induced pluripotent stem cells,aiming for more targeted and effective treatments.Collaborative efforts are crucial to overcoming these challenges and ensuring the safe and effective application of orthobiologics in clinical practice.
文摘Objective: To explore the effect of evidence-based quality control circle (QCC) in improving the implementation rate of airway management measures in adult critically ill patients. Methods: Based on the Joanna Briggs Institute (JBI) evidence-based health care model, the best evidence of airway management in adult critically ill patients was obtained and applied to the clinic. Results: The total implementation rate of airway management measures in adult critically ill patients increased from 23.62% before the implementation of quality control circle to 88.82%, and the pulmonary infection rate in critically ill patients decreased from 42.31% to 21.74%, with statistical significance between the two groups (P 0.05). Conclusion: Evidence-based quality control circle activities can standardize the practice standards of airway management in critically ill patients, reduce the occurrence of patients’ airway related complications, and improve clinical outcomes.
文摘Purpose research on nursing sensitive indicators in tumor Patients application effect in immune-related skin toxicity management. Method select our hospital April to June, 202360 cases patients with immune therapy settings as the control group. August-October, 2023 60 cases the patients treated with immune therapy were the experimental group. The control group adopted regular nursing methods, while the experimental group sensitive Indicators, evidence-based give preventive care. The social situation, psychological state, physical function, quality of life score, incidence of skin toxicity caused by immune checkpoint inhibitors, moderate and above of the two groups of patients were compared. Incidence of skin toxicity. Result: experience group SAS score, SDS score higher than the control group, the difference was statistically significant (P < 0.05);The incidence of skin toxic reactions caused by immune checkpoint inhibitors and the incidence of moderate and above skin toxic reactions in the experimental group are lower than those in the control group, and the difference is statistically significant (P < 0.05). Conclusion: sensitive indicator guidance evidence-based preventive care can reduce the degree of immune-related skin toxicity, improve the psychological state and quality of life of tumor patients treated with immune therapy and reduce the incidence of adverse reactions, improve nursing quality and patient satisfaction.
文摘Objective: To explore the nursing effect of evidence-based PDCA cycle management mode in accelerated rehabilitation of patients undergoing thoracoscopic lung cancer radical surgery. Methods: 104 patients who underwent thoracoscopic lung cancer radical surgery in our hospital from June 2022 to February 2023 were randomly divided into control group and intervention group, with 52 cases in each group. The control group implemented evidence-based ERAS clinical pathway management, while the intervention group implemented evidence-based PDCA cycle quality management. The postoperative recovery of the two groups of patients was compared. Results: The postoperative recovery of the intervention group was significantly better than that of the control group. The first time to get out of bed, the first time to eat, the duration of chest drainage tube placement, and the length of hospital stay were significantly shorter than those of the control group. The incidence of postoperative chest complications and hospitalization costs were significantly lower than those of the control group, and patient satisfaction was significantly higher than that of the control group (P Conclusion: Evidence-based PDCA cycle quality management mode can effectively improve the implementation quality of accelerated rehabilitation nursing for patients undergoing thoracoscopic lung cancer radical surgery, and it is worthy of clinical promotion.
文摘This study aimed to evaluate the correlation between nursing informatics(NI)competency and information literacy skills for evidencebased practice(EBP)among intensive care nurses.This cross-sectional study was conducted on 184 nurses working in intensive care units(ICUs).The study data were collected through demographic information,Nursing Informatics Competency Assessment Tool(NICAT),and information literacy skills for EBP questionnaires.The intensive care nurses received competent and low-moderate levels for the total scores of NI competency and information literacy skills,respectively.They received a moderate score for the use of different information resources but a low score for information searching skills,different search features,and knowledge about search operators,and only 31.5%of the nurses selected the most appropriate statement.NI competency and related subscales had a significant direct bidirectional correlation with information literacy skills for EBP and its subscales(P<0.05).Nurses require a high level of NI competency and information literacy for EBP to obtain up-to-date information and provide better care and decision-making.Health planners and policymakers should develop interventions to enhance NI competency and information literacy skills among nurses and motivate them to use EBP in clinical settings.
文摘Chinese medicine has been used for centuries to treat a range of health conditions.This history has produced a wealth of classical literature,case studies and clinical research data detailing its use and effectiveness.However,high-quality and conclusive evidence that meets modern requirements for clinical decision support is lacking.This evidence gap limits the integration of Chinese medicine with contemporary medicine,which in turn limits global access and acceptance of Chinese medicine as a form of safe and effective health care.Over the past 20 years,researchers and organisations around the world,including the World Health Organization(WHO)and United Nations,have worked to support the integration of traditional medicines,such as Chinese medicine,with conventional medicines to improve global health care.This paper provides an overview of Chinese medicine studies published in the top four general medical journals(BMJ,JAMA,Lancet and New England Journal of Medicine)from February 2005 to February 2024 in the past 20 years to highlight the progress in the development of this evidence base.It also highlights key actions taken to promote evidence-based clinical Chinese medicine,including product and practitioner regulation,formalising education standards,and international collaborations.Research conducted at the China-Australia International Research Centre for Chinese Medicine demonstrates the benefits of such a collaboration.Through development of its unique and inclusive‘whole-evidence’approach,plus clinical studies and systematic reviews,the Centre has significantly contributed to the evidence base for clinical Chinese medicine.In addition,its high-impact papers and groundbreaking monographs have been cited in international conventional medicine guidelines.While progress has certainly been made during the past 20 years to build a stronger evidence base for clinical Chinese medicine,there is still a considerable gap that limits its integration with conventional medicine.Future funding and research are needed to continue this work and achieve to safe,effective and accessible traditional medicine as part of the WHO’s Universal Health Coverage strategy.
文摘The aim of the article is to explore the influence of the water landscape design of a rehabilitation garden for patients with mental disorders on the recovery effect of patients,intending to provide a better rehabilitation environment for patients with mental disorders.Based on literature research,this article reviews three aspects of evidence-based design theory,the concept of water landscape in rehabilitation gardens,and the types of water features in rehabilitation gardens.The results show that well-designed water features can significantly improve patients’psychological state and reduce anxiety and stress,and that water landscape design in rehabilitation gardens is an effective rehabilitation tool that can facilitate the recovery process of patients with mental disorders.Future designs should take into full consideration patients’needs and preferences,as well as best practices in waterscape design,to maximize its positive impact on patients’recovery.
文摘Objective To sort out the problems in the selection model of essential medicines in China,and to put forward some suggestions to optimize the selection model to ensure the rationality of the medicines in the essential medicines list.Methods The domestic and foreign literature on the selection of essential medicines was reviewed.Then,the opinions on the selection methods and results of essential medicines from foreign literature were investigated to make a comparison with the selection of essential medicines in China.Finally,the general and special laws of the selection process of the essential medicines were explored.Results and Conclusion It is recommended that the selection model of essential medicines in China should be further optimized,and the evidence-based thinking and methods should be utilized to enhance the scientific nature of the selection process.
文摘Statistical literacy is crucial for cultivating well-rounded thinkers.The integration of evidence-based strategies in teaching and learning is pivotal for enhancing students’statistical literacy.This research specifically focuses on the utilization of Share and Model Concepts and Nurturing Metacognition as evidence-based strategies aimed at improving the statistical literacy of learners.The study employed a quasi-experimental design,specifically the nonequivalent control group,wherein students answered pre-test and post-test instruments and researcher-made questionnaires.The study included 50 first-year Bachelor in Secondary Education majors in Mathematics and Science for the academic year 2023-2024.The results of the study revealed a significant difference in the scores of student respondents,indicating that the use of evidence-based strategies helped students enhance their statistical literacy.This signifies a noteworthy increase in their performance,ranging from very low to very high proficiency in understanding statistical concepts,insights into the application of statistical concepts,numeracy,graph skills,interpretation capabilities,and visualization and communication skills.Furthermore,the study showed a significant difference in the post-test scores’performance of the two groups in understanding statistical concepts and visualization and communication skills.However,no significant difference was found in the post-test scores of the two groups concerning insights into the application of statistical concepts,numeracy and graph skills,and interpretation capabilities.Additionally,students acknowledged that the implementation of evidence-based strategies significantly contributed to the improvement of their statistical literacy.
文摘Abuse of infants and children is a public health problem that warrants immediate attention. It is estimated that over 7 million children are affected by child abuse yearly, with the highest rate of abuse in those less than one year of age. Approximately 60% of child abuse victims are children under the age of three years, making infants and young children a particularly vulnerable population. Interventions targeting the perinatal period can be effective in mitigating child abuse, including parent education programs and trauma-informed care services. This paper provides an overview of the current evidence base related to child abuse following the COVID-19 pandemic, with a focus on prevention and intervention strategies that can be utilized to increase caregiver support and reduce child abuse rates during the perinatal period.
文摘Objective:To analyze the value of applying evidence-based nursing in the perioperative care of patients with ankle fractures and propose corresponding measures to improve the quality of patient care.Methods:The study started in May 2022 and was terminated in March 2023.During this period,50 patients with ankle fractures treated by our hospital were selected as research subjects.They were divided into a control group and a research group.The control group had 25 patients who received routine care,and the research group had 25 who received evidence-based care.The nursing effects of the two groups were observed and compared.Results:The pain scores,quality of life,incidence of adverse reactions,and nursing satisfaction of patients in the research group were all significantly better than those in the control group(P<0.05).Conclusion:Evidence-based nursing can effectively improve the quality of care,reduce the risk of adverse reactions,and promote patient recovery,so it is suitable for clinical implementation.
基金The study was approved by the Institutional review board of The Affiliated Hospital of Southwest Medical University,No.KY2023184.
文摘BACKGROUND Perioperative hypothermia(PH)negatively affects the physical and mental health of patients to varying degrees.Currently,there is no effective multidisciplinary team(MDT)intervention for gynecological patients with PH.AIM To apply the best evidence on the prevention and management of PH in gynecological patients,improve the quality of perioperative evidence-based care based on treatment by an MDT for gynecological patients and analyze the effect of MDT-and evidence-based practice(EBP)projects on the psychological status and cognitive function of gynecological patients with PH.METHODS Under the guidance of knowledge translation and combined with the opinions of involved stakeholders and clinical experts,the best evidence for PH prevention and management in gynecological patients was selected and adjusted to suit the practice setting.Based on the evidence,the practice plan was developed,and the MDT intervention was carried out in the preoperative ward,the preoperative preparation room,the intraoperative operating room,the postanesthesia care unit,and the 24-hour postoperative gynecological ward through the EBP program.The incidence of hypothermia,the nurses’awareness,the implementation rate of examination indicators,and the thermal comfort level,psychological status and cognitive function of patients were compared before and after the implementation of the program.RESULTS The incidence of PH in gynecological patients decreased from 43.33%to 13.33%after the implementation of the scheme.The implementation rate of examination indicators 6-10,12,14,16-18,21,and 22 reached 100%,and that of other indicators was above 90%,except for examination indicators 5 and 13,which was 66.67%;the indices were significantly improved compared with the baseline(before evidence application)(P<0.05).The score of nurses'awareness of PH prevention and management in gynecological patients increased from 60.96±9.70 to 88.08±8.96,and the difference was statistically significant(P<0.001).The total score of the perioperative thermal comfort level of patients undergoing gynecological surgery was 27.97±2.04,which was significantly increased compared with the score of 21.27±1.57 observed by researchers at baseline(P<0.001).The perioperative Hamilton Depression Scale and Hamilton Anxiety Scale scores of patients undergoing gynecological surgery decreased from 15.03±3.16 and 13.93±2.64 to 4.30±1.15 and 3.53±0.78,respectively,with statistically significant differences(P<0.001).The perioperative Montreal Cognitive Assessment Scale score of the gynecological surgery patients increased from 23.17±1.68 to 26.93±1.11,also with statistical significance(P<0.001).CONCLUSION MDT-based EBP for PH prevention and management in gynecological patients during the perioperative period can standardize nursing operations,improve nurses'awareness and behavioral compliance with gynecological hypothermia management,and reduce the occurrence of PH in gynecological patients while playing a positive role in reducing patients’negative emotions and enhancing their cognitive function.
文摘Rectal adenocarcinoma is an important cause of cancer-related deaths worldwide, and key anatomic differences between the rectum and the colon have significant implications for management of rectal cancer. Many advances have been made in the diagnosis and management of rectal cancer. These include clinical staging with imaging studies such as endorectal ultrasound and pelvic magnetic resonance imaging, operative approaches such as transanal endoscopic microsurgery and laparoscopic and robotic assisted proctectomy, as well as refined neoadjuvant and adjuvant therapies. For stage Ⅱ and Ⅲ rectal cancers, combined chemoradiotherapy offers the lowest rates of local and distant relapse, and is delivered neoadjuvantly to improve tolerability and optimize surgical outcomes, particularly when sphincter-sparing surgery is an endpoint. The goal in rectal cancer treatment is to optimize diseasefree and overall survival while minimizing the risk of local recurrence and toxicity from both radiation and systemic therapy. Optimal patient outcomes depend on multidisciplinary involvement for tailored therapy. The successful management of rectal cancer requires a multidisciplinary approach, with the involvement of enterostomal nurses, gastroenterologists, medical and radiation oncologists, radiologists, pathologists and surgeons. The identification of patients who are candidates for combined modality treatment is particularly useful to optimize outcomes. This article provides an overview of the diagnosis, staging and multimodal therapy of patients with rectal cancer for primary care providers.
基金Supported by Science and Technology Support Program of Qiandongnan Prefecture,No.Qiandongnan Sci-Tech Support[2021]12Guizhou Province High-Level Innovative Talent Training Program,No.Qiannan Thousand Talents[2022]201701.
文摘BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.
文摘With the rising global prevalence in diabetes, healthcare systems are facing a growing challenge to provide efficient and effective diabetes care management in the face of spiralling treatment costs. Diabetes is a major cause of premature mortality and associated with devastating complications especially if managed poorly. Although diabetes care is improving in England and Wales, recent audit data suggests care remains imperfect with wide geographical variations in quality. Diabetes care is expensive with a sizeable amount of available expenditure used for treating the complications of diabetes. A target driven, long-term, multifactorial intervention in patients with type 2 diabetes has been shown to reduce mortality and morbidity. The alphabet strategy is a novel approach to effective diabetes care provision, aiming to address patient education and empowerment, provide consistent comprehensive care delivered in a timely fashion, and allowing multidisciplinary team work.
