The Effects of Continuous Care Model of Information-Based Hospital-Family Integration on Colostomy Patients: a Randomized Controlled Trial

The use of asynchronous digital two-way communication between patients and healthcare professionals after hospital discharge: A scoping review

OBJECTIVE

This scoping review aimed to identify and map how asynchronous digital two-way communication is used between patients and healthcare professionals after hospital discharge, as well as identify facilitators and barriers to implementation.

METHODS

Following the JBI guidance for scoping reviews, we searched seven databases on August 29, 2022. Rayyan was employed for screening the articles, and data were extracted using a predefined and iteratively modified data extraction tool. Facilitators and barriers were systematically categorized according to the domains and constructs of the Consolidated Framework for Implementation Research (CFIR).

RESULTS

Forty articles were included, primarily published between 2012 and 2022 and from the USA. In the majority of articles (77.5 %), asynchronous digital two-way communication was a part of a larger eHealth intervention. Nurses were the healthcare professionals most frequently mentioned as answering patients' messages (35 %) with response times sparsely described, and varying between four hours and three days. Efforts done to implement asynchronous digital two-way communication were only mentioned in 37.5 % of the articles. Facilitators included easy access, convenience, less disturbance, shared expectations for use and communication with professionals familiar to the patient. Barriers involved fear of overlooking health issues, risk of answers being delayed, technical issues and unclear response times.

CONCLUSION

There is a gap in the literature between studies that describe the use of asynchronous digital two-way communication after hospital discharge exhaustively and reports on facilitators and barriers to implementation.

PRACTICE IMPLICATIONS

This scoping review serves as an overview of the current use of asynchronous digital two-way communication after hospital discharge and sheds light on facilitators and barriers to implementation pertinent to this specific period.

Assessing the impact of educational eHealth and mHealth interventions on health outcomes in continuity of care for enterostomy patients: A meta-analysis

PURPOSE

To evaluate the effectiveness of educational eHealth and mHealth interventions on self-care ability, quality of life (QoL), ostomy complications and other health outcomes in enterostomy patients.

METHODS

A comprehensive database search yielded 7385 records, which were narrowed down to 13 RCTs through stringent PRISMA-guided selection. These studies, conducted globally from 2015 to 2023, involved a total of 1530 participants and employed various eHealth and mHealth platforms, from mobile apps to telehealth systems. Primary outcomes assessed were self-care ability, QoL, and ostomy complications, mostly analyzed using a random-effects model due to inherent study heterogeneity.

RESULTS

The meta-analysis showed significant improvements in self-care ability (SMD = 0.85, CI = [0.23, 1.47], P = 0.007) and QoL (SMD = 0.64, CI = [0.50, 0.79], P < 0.001) among participants receiving eHealth and mHealth interventions compared to those receiving standard care. eHealth and mHealth interventions also led to a reduction in ostomy complications (SMD = 0.18, CI = [0.12, 0.27], P < 0.001). Secondary outcomes revealed significant improvements in stoma adjustment (SMD = 1.13, CI = [0.70, 1.56], P < 0.001) and self-efficacy (SMD = 0.51, CI = [0.38, 0.64], P < 0.001). The effects on psychological well-being were mixed, with some studies showing benefits in reducing depression and anxiety symptoms, albeit with high heterogeneity.

CONCLUSIONS

eHealth and mHealth interventions appear effective in improving essential health outcomes for enterostomy patients, though the heterogeneity among studies suggests that results should be interpreted with caution. The effectiveness of these interventions underscores the need for their integration into routine care, tailored to individual patient needs and local healthcare settings. Further research is required to determine the most effective eHealth and mHealth modalities and to explore their long-term benefits and scalability.

The clinical application value of psychological nursing intervention for patients with prostatic hyperplasia during treatment

OBJECTIVE

To investigate the therapeutic utility of psychological nursing interventions for prostatic hyperplasia clients while they are receiving therapy.

METHODS

Clinical data of 110 patients with prostate group hyperplasia who underwent treatment in our hospital were collected and analysed retrospectively, and the selected period was from October 2021 to October 2023. The 110 cases of prostate group hyperplasia patients were divided into a research group and a control group according to the different methods of care, and each group had 55 cases each. The research group received psychological nursing intervention based on the conventional nursing care given to the control group. The total treatment compliance rate and contentment with nursing were contrasted between the research and control groups, and changes in the Self Rating Anxiety Scale (SAS) score, Self Rating Depression Scale (SDS) score, Health Survey Short Form score, and sleep problems were observed between the research group and the control group.

RESULTS

The research group's overall compliance rate was 94.55% (52/53), a substantial increase over the control group's rate, 69.09% (38/55), P < 0.01. Following nursing, the research group's SAS and SDS scores were considerably more reduced than those of the control group, and both groups' scores were substantially lower than they were prior to nursing (P < 0.05).

CONCLUSION

This retrospective study found that psychological nursing intervention applied to patients with prostatic hyperplasia can effectively improve the patient's compliance with treatment, effectively reduce the occurrence of negative emotions, improve the patient's quality of life, and improve sleep problems. In addition, psychological nursing intervention can effectively alleviate the tension between nurses and patients, and is worthy of clinical application.

Nursing interventions for the self-efficacy of ostomy patients: A systematic review

BACKGROUND

Self-efficacy interventions, which include the acquisition of skills that enable patients to manage their health on a daily basis, play a key role in ostomy patients, which leads to significant changes in the quality of life of patients. In this context, nursing interventions to increase self-efficacy of ostomy patients are very important. In this context, nursing interventions are crucial to increase the self-efficacy of ostomy patients.

OBJECTIVES

The aim of this systematic review is to describe nursing interventions for ostomy patients' self-efficacy (primary outcome) and the impact of these interventions on patient outcomes (complications, quality of life, satisfaction, psychological resilience, stoma adaptation) (secondary outcomes).

METHOD

As a systematic review, this study included articles published in PUBMED, Web of Science, Science-Direct, TUBITAK-ULAKBIM, and TRDizin databases between January 2013 and January 2023 that included nursing interventions for self-efficacy ostomy patients. This systematic review was developed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. The risk of bias was assessed using the RoB2 tool developed by Cochrane.

RESULTS

A total of 1211 articles were retrieved from the databases using Turkish and English keywords. Fifteen studies met the study criteria. These studies found that various interventions, such as training, telephone follow-up, psychosocial support groups, or mobile applications provided to intervention groups, increased self-efficacy, decreased stoma-related complications, improved stoma adaptation, and improved quality of life by increasing patients' knowledge and awareness of stoma.

CONCLUSION

Nursing interventions to improve the self-efficacy and adaptation of ostomy patients are critical. This improvement leads to a reduction in adverse patient outcomes and ostomy complications, shorter hospital stays, and increased patient and nurse satisfaction.

Management of adult intestinal stomas: The 2023 French guidelines

AIM

Digestive stoma are frequently performed. The last French guidelines have been published twenty years ago. Our aim was to update French clinical practice guidelines for the perioperative management of digestive stoma and stoma-related complications.

METHODS

A systematic literature review of French and English articles published between January 2000 and May 2022 was performed. Only digestive stoma for fecal evacuation in adults were considered. Stoma in children, urinary stoma, digestive stoma for enteral nutrition, and rare stoma (Koch, perineal) were not included.

RESULTS

Guidelines include the surgical landmarks to create digestive stoma (ideal location, mucocutaneous anastomosis, utility of support rods, use of prophylactic mesh), the perioperative clinical practice guidelines (patient education, preoperative ostomy site marking, postoperative equipment, prescriptions, and follow-up), the management of early stoma-related complications (difficulties for nursing, high output, stoma necrosis, retraction, abscess and peristomal skin complications), and the management of late stoma-related complications (stoma prolapse, parastomal hernia, stoma stenosis, late stoma retraction). A level of evidence was assigned to each statement.

CONCLUSION

These guidelines will be very useful in clinical practice, and allow to delete some outdated dogma.

The impact of hospital-family integrated continuation nursing based on information technology on patients unhealthy mood, family function and sexual function after cervical cancer surgery

The objective of this study was to explore the impact on hospital-family integrated continuation care based on information technology on the negative emotions, family function, and sexual function of patients after cervical cancer surgery. The clinical case data onto 114 postoperative cervical cancer patients who were nursing in our hospital from July 2019 to July 2021 were selected and were divided into a control group and an observation group. The control group used routine nursing care, and on this basis, the observation group used information technology as the basis for hospital-family integrated continuation care, and we observed and compared the differences in the 2 groups of patients bad mood, family function, and sexual function. The score of anxiety (P = .017), depression (P = .009), fatigue rating (P = .012), and anger (P < .001) in the observation group after care were significantly lower than those in the control group. Problem solving, role, emotional response, emotional involvement, and family function total score in the observation group after care was significantly lower than those in the control group (P < .05). Sexual desire score, sexual arousal score, vaginal lubrication score, orgasm score, sexual satisfaction score, dyspareunia score, and Female Sexual Function Inventory total scores in the observation and control groups after care were significantly higher than those before care (P < .05). The sexual function scores in the observation group after care was significantly higher than those in the control group (P < .05). The hospital-family integrated continuation care based on information technology is more effective than conventional nursing care for patients after cervical cancer surgery.

The Value of Applying a Continuous Nursing Model Based on Virtual Platforms for Patients with Colostomy or Ileostomy

OBJECTIVE

To explore the application potential of continuous nursing training based on a comprehensive virtual platform in patients with colostomy or ileostomy.

METHODS

A total of 100 patients with colostomy or ileostomy were equally divided into two groups. Patients in the control group received standardized routine care, whereas patients in the experimental group received continuous nursing care through the virtual platform. Both the control group and the experimental group were followed up by regular telephone calls once per week and completed the following questionnaires both 1 week after discharge and 3 months after discharge: Stoma Care Self-efficacy Scale, Exercise of Self-care Agency Scale, State-Trait Anxiety Inventory, Short Form-36 Health Survey Questionnaire, and a questionnaire on postoperative complications.

RESULTS

Patients in the experimental group, who received continuous care, exhibited significantly higher scores in self-efficacy (P = .029), self-care responsibility (P = 0.030), state anxiety and trait anxiety (both Ps < .001), and mental health (P < .001) 1 week after discharge in comparison with patients in the control group. At 3 months postdischarge, compared with the control group, the experimental group showed significant advantages in all dimensions of self-efficacy, self-care ability, mental health, and quality-of-life questionnaires (P < .001). In addition, the incidence of complications in the experimental group was significantly lower (P < .0001).

CONCLUSIONS

The virtual platform-based continuous nursing model effectively improves the self-care ability and self-efficacy of patients with a colostomy or ileostomy after colorectal cancer, thereby promoting an improved quality of life and psychological state while simultaneously reducing the incidence of complications after discharge.

Effectiveness of Digital Mental Health Tools to Reduce Depressive and Anxiety Symptoms in Low- and Middle-Income Countries: Systematic Review and Meta-analysis

BACKGROUND

Depression and anxiety contribute to an estimated 74.6 million years of life with disability, and 80% of this burden occurs in low- and middle-income countries (LMICs), where there is a large gap in care.

OBJECTIVE

We aimed to systematically synthesize available evidence and quantify the effectiveness of digital mental health interventions in reducing depression and anxiety in LMICs.

METHODS

In this systematic review and meta-analysis, we searched PubMed, Embase, and Cochrane databases from the inception date to February 2022. We included randomized controlled trials conducted in LMICs that compared groups that received digital health interventions with controls (active control, treatment as usual, or no intervention) on depression or anxiety symptoms. Two reviewers independently extracted summary data reported in the papers and performed study quality assessments. The outcomes were postintervention measures of depression or anxiety symptoms (Hedges g). We calculated the pooled effect size weighted by inverse variance.

RESULTS

Among 11,196 retrieved records, we included 80 studies in the meta-analysis (12,070 participants n=6052, 50.14% in the intervention group and n=6018, 49.85% in the control group) and 96 studies in the systematic review. The pooled effect sizes were -0.61 (95% CI -0.78 to -0.44; n=67 comparisons) for depression and -0.73 (95% CI -0.93 to -0.53; n=65 comparisons) for anxiety, indicating that digital health intervention groups had lower postintervention depression and anxiety symptoms compared with controls. Although heterogeneity was considerable (I²=0.94 for depression and 0.95 for anxiety), we found notable sources of variability between the studies, including intervention content, depression or anxiety symptom severity, control type, and age. Grading of Recommendations, Assessments, Development, and Evaluation showed that the evidence quality was overall high.

CONCLUSIONS

Digital mental health tools are moderately to highly effective in reducing depression and anxiety symptoms in LMICs. Thus, they could be effective options to close the gap in depression and anxiety care in LMICs, where the usual mental health care is minimal.

TRIAL REGISTRATION

PROSPERO CRD42021289709; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=289709.

Parents' understanding and attitudes toward the use of the WeChat platform for postoperative follow-up management of children with congenital heart disease

OBJECTIVE

This study aimed to investigate parents' understanding and attitudes toward using the WeChat platform for postoperative follow-up management of children with congenital heart disease (CHD).

METHODS

A total of 196 children with CHD were followed up using the WeChat platform. A self-designed questionnaire was administered to their parents at discharge.

RESULTS

Only 188 parents completed the questionnaire. One hundred nineteen parents (63.3%) confirmed that they heard about using the WeChat platform for postoperative follow-up, and 104 (87.4%) of them expressed that they were willing to accept the WeChat platform for their follow-up. A total of 42 parents (35.3%) were willing to undergo a follow-up of 1 to 3 months, and 32 (26.8%) were willing to undergo a long-term follow-up. Eighty parents (67.2%) had a positive attitude toward the effect of the WeChat platform on follow-up. Parents in rural areas and those educated at the middle school level or below were more willing to engage with the WeChat platform for postoperative follow-up management (P < 0.05).

CONCLUSIONS

Although the WeChat platform is an essential tool for daily communication, its application in postoperative follow-up management is still under study. Most parents who participated in the follow-up study had a positive attitude toward the WeChat platform, especially those in rural areas and with lower education levels.

The effects of continuous nursing via the WeChat platform on neonates after enterostomy: a single-centre retrospective cohort study

BACKGROUND

Temporary enterostomy is an effective treatment for various neonatal intestinal diseases. However, family caregivers find it challenging to provide the required nursing care. Nursing management is very important for reducing parents' anxiety and improving the patients' quality of life. This research aimed to compare the effects of continuous nursing using the WeChat platform with traditional nursing for neonates after enterostomy.

METHODS

Neonates who underwent enterostomy from January 2014 to December 2020 in our hospital were retrospectively analysed. The patients were divided into the traditional nursing group and the continuous nursing group. The peri-stomal skin was evaluated with the DET scale. The mental status of the families was evaluated with the SAS and SDS.

RESULTS

There were 143 patients in the traditional nursing group (TG) and 165 in the continuous nursing group (CG). The mean weight was 2.7 ± 0.6 kg in TG and 2.8 ± 0.5 kg in CG. The mean age at surgery was 4.9 ± 7.3 d in TG and 4.8 ± 7.55 d in the CG. No statistically significant differences between the two groups were found in the demographic information. The continuous nursing group had an obviously lower DET score for the peri-stomal skin than the traditional nursing group (P = 0.003). Three months after discharge from the hospital, the continuous nursing group replaced 7.2 ± 1.8 ostomy bags every week, significantly less than the traditional nursing group (P = 0.002). Three months after discharge, the continuous nursing group had better SAS and SDS scores than the traditional nursing group.

CONCLUSIONS

Continuous nursing based on WeChat can effectively improve the quality of life of neonates after enterostomy. Family members can also receive proper psychological counselling to relieve their anxiety and depression.

Digital Health Interventions for Adult Patients With Cancer Evaluated in Randomized Controlled Trials: Scoping Review

BACKGROUND

Digital care has become an essential component of health care. Interventions for patients with cancer need to be effective and safe, and digital health interventions must adhere to the same requirements.

OBJECTIVE

The purpose of this study was to identify currently available digital health interventions developed and evaluated in randomized controlled trials (RCTs) targeting adult patients with cancer.

METHODS

A scoping review using the JBI methodology was conducted. The participants were adult patients with cancer, and the concept was digital health interventions. The context was open, and sources were limited to RCT effectiveness studies. The PubMed, CINAHL, Embase, Cochrane Library, Research Information Sharing Service, and KoreaMed databases were searched. Data were extracted and analyzed to achieve summarized results about the participants, types, functions, and outcomes of digital health interventions.

RESULTS

A total of 231 studies were reviewed. Digital health interventions were used mostly at home (187/231, 81%), and the web-based intervention was the most frequently used intervention modality (116/231, 50.2%). Interventions consisting of multiple functional components were most frequently identified (69/231, 29.9%), followed by those with the self-manage function (67/231, 29%). Web-based interventions targeting symptoms with the self-manage and multiple functions and web-based interventions to treat cognitive function and fear of cancer recurrence consistently achieved positive outcomes. More studies supported the positive effects of web-based interventions to inform decision-making and knowledge. The effectiveness of digital health interventions targeting anxiety, depression, distress, fatigue, health-related quality of life or quality of life, pain, physical activity, and sleep was subject to their type and function. A relatively small number of digital health interventions specifically targeted older adults (6/231, 2.6%) or patients with advanced or metastatic cancer (22/231, 9.5%).

CONCLUSIONS

This scoping review summarized digital health interventions developed and evaluated in RCTs involving adult patients with cancer. Systematic reviews of the identified digital interventions are strongly recommended to integrate digital health interventions into clinical practice. The identified gaps in digital health interventions for cancer care need to be reflected in future digital health research.

Nurse's Roles in Colorectal Cancer Prevention: A Narrative Review

The objective of this paper is to investigate the different roles of nurses as members of healthcare teams at the primary, secondary, and tertiary levels of colorectal cancer prevention. The research team conducted a narrative review of studies involving the role of nurses at different levels of colorectal cancer prevention, which included a variety of quantitative, qualitative, and mixed-method studies. We searched PubMed, Scopus, Web of Science, Cochrane Reviews, Magiran, the Scientific Information Database (SID), Noormags, and the Islamic Science Citation (ISC) databases from ab initio until 2021. A total of 117 studies were reviewed. Nurses' roles were classified into three levels of prevention. At the primary level, the most important role related to educating people to prevent cancer and reduce risk factors. At the secondary level, the roles consisted of genetic counseling, stool testing, sigmoidoscopy and colonoscopy, biopsy and screening test follow-ups, and chemotherapy intervention, while at the tertiary level, their roles were made up of pre-and post-operative care to prevent further complications, rehabilitation, and palliative care. Nurses at various levels of prevention care also act as educators, coordinators, performers of screening tests, follow-up, and provision of palliative and end-of-life care. If these roles are not fulfilled at some levels of colorectal cancer, it is generally due to the lack of knowledge and competence of nurses or the lack of instruction and legal support for them. Nurses need sufficient clinical knowledge and experience to perform these roles at all levels.

Influence of Information-Based Continuous Care on Disease Control and Treatment Compliance of Elderly Diabetic Patients

Background

The incidence of diabetes is increasing year by year. For elderly diabetic patients, poor blood glucose control and worsening immune function greatly increase the risk of complications, which will seriously affect their quality of life.

Purpose

This paper primarily clarifies the influence of information-based continuous care on disease control and treatment compliance of elderly diabetic patients.

Methods

From December 2018 to December 2021, 106 elderly diabetic patients were selected, and their clinical data were retrospectively studied. Patients were grouped according to the type of care they received: an observation group (OG) comprising 56 cases receiving information-based continuous care and a control group (CG) including 50 cases treated with routine nursing. The two cohorts of patients were compared regarding disease control, treatment compliance, glucose and lipid metabolism (GLM), and self-management.

Results

After analysis, it was found that the disease control and treatment compliance were statistically higher in OG compared with CG. OG also showed significantly reduced fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPG), total cholesterol (TC), and triglyceride (TG) after nursing that were all lower compared with CG. In terms of self-management, OG outperformed CG in diet, exercise, blood glucose monitoring, and adherence to medical regimens.

Conclusions

Information-based continuous care has beneficial effects on disease control and treatment compliance of elderly diabetic patients and can help control blood sugar and optimize patients' self-management level, with high clinical promotion value.

Continuing Care Bundle in Elderly Patients with Rectal Cancer after Radical Resection with Permanent Stoma

Objective. A continuing care bundle can achieve a better outcome than a single implementation after discharge. This study aims to investigate the effect of this intervention in elderly patients with rectal cancer after radical resection with a permanent stoma. Methods. Elderly patients diagnosed with rectal cancer underwent radical resection with permanent stoma, they were divided into the control group (n = 42) and bundle group (n = 42). The control group received the conventional care, and the bundle group received the continuing care bundle in addition to the conventional care. At 1- and 3-month after discharge, self-efficacy, self-care knowledge, ability to change stoma appliances, negative emotions, quality of life, and patient satisfaction were observed. Results. The increased levels of self-efficacy, self-care knowledge, and ability to change stoma appliances were displayed in the bundle group after discharge as compared with that in the control group, along with the enhanced score of SF-36 subscales, including physical function (PF), role physical (RP), global health (GH) and vitality (V), social function (SF), and mental health (MH). Furthermore, patients showed alleviated depression and anxiety after the continuing care bundle as compared to those after conventional care. Besides, the bundle groups had higher patient satisfaction than the control group. Conclusions. Continuing care bundle can serve as an effectiveness intervention in elderly rectal cancer patients after radical resection with permanent stoma via increasing self-efficacy and self-care knowledge, enhancing the ability to change stoma appliance, reliving the negative emotion, and improving quality of life and patient satisfaction.

Telemedicine in Surgical Care in Low- and Middle-Income Countries: A Scoping Review

BACKGROUND

Access to timely and quality surgical care is limited in low- and middle-income countries (LMICs). Telemedicine, defined as the remote provision of health care using information, communication and telecommunication platforms have the potential to address some of the barriers to surgical care. However, synthesis of evidence on telemedicine use in surgical care in LMICs is lacking.

AIM

To describe the current state of evidence on the use and distribution of telemedicine for surgical care in LMICs.

METHODS

This was a scoping review of published and relevant grey literature on telemedicine use for surgical care in LMICs, following the PRISMA extension for scoping reviews guideline. PubMed-Medline, Web of Science, Scopus and African Journals Online databases were searched using a comprehensive search strategy from 1 January 2010 to 28 February 2021.

RESULTS

A total of 178 articles from 53 (38.7%) LMICs across 11 surgical specialties were included. The number of published articles increased from 2 in 2010 to 44 in 2020. The highest number of studies was from the World Health Organization Western Pacific region (n = 73; 41.0%) and of these, most were from China (n = 69; 94.5%). The most common telemedicine platforms used were telephone call (n = 71, 39.9%), video chat (n = 42, 23.6%) and WhatsApp/WeChat (n = 31, 17.4%). Telemedicine was mostly used for post-operative follow-up (n = 71, 39.9%), patient education (n = 32, 18.0%), provider training (n = 28, 15.7%) and provider-provider consultation (n = 16, 9.0%). Less than a third (n = 51, 29.1%) of the studies used a randomised controlled trial design, and only 23 (12.9%) reported effects on clinical outcomes.

CONCLUSION

Telemedicine use for surgical care is emerging in LMICs, especially for post-operative visits. Basic platforms such as telephone calls and 2-way texting were successfully used for post-operative follow-up and education. In addition, file sharing and video chatting options were added when a physical assessment was required. Telephone calls and 2-way texting platforms should be leveraged to reduce loss to follow-up of surgical patients in LMICs and their use for pre-operative visits should be further explored. Despite these telemedicine potentials, there remains an uneven adoption across several LMICs. Also, up to two-thirds of the studies were of low-to-moderate quality with only a few focusing on clinical effectiveness. There is a need to further adopt, develop, and validate telemedicine use for surgical care in LMICs, particularly its impact on clinical outcomes.

A systematic review and meta-analysis on the effectiveness of web-based psychosocial interventions among patients with colorectal cancer

AIMS

To synthesize the effectiveness of web-based psychosocial interventions on self-efficacy, anxiety, depression, quality of life (QoL), non-specific psychological and cancer-specific distress among patients with colorectal cancer (CRC).

DESIGN

A systematic review and meta-analysis.

DATA SOURCES

Six databases (PubMed, PsycINFO, Embase, Scopus, CINAHL and CNKI) were searched from inception to December 2021.

REVIEW METHODS

Experimental/quasi-experimental studies involving patients with CRC for the improvement of aforementioned outcomes were included. Two reviewers screened and extracted the data, and assessed studies' methodological quality using risk of bias tools. Meta-analyses and narrative syntheses were performed.

RESULTS

Nineteen studies consisting of 1386 participants were identified. Cognitive-behavioural therapy delivered online was the most common trialled web-based psychosocial intervention. Meta-analyses revealed no positive effect for self-efficacy (standardized mean difference 0.93, 95% CI: 0.52 to 1.35, p < .01) and minimal benefit for QoL (mean difference [MD] 2.83, 95% CI: -0.31 to 5.98, p = .08) but significant positive effects for anxiety (MD -2.23, 95% CI: -3.31 to -1.14, p < .01) and depression (MD -2.84, 95% CI: -4.09 to -1.59, p < .01) among CRC survivors in the intervention group as compared with the control group. Narrative synthesis suggested possible benefits in reducing distress.

CONCLUSION

Web-based psychosocial interventions are promising alternatives to conventional delivery methods in reducing patients' anxiety, depression and distress. However, evidence on self-efficacy and QoL remains inconsistent. More adequately powered, well-designed trials with targeted and theory-based interventions are required to ascertain findings.

IMPACT

By highlighting the potential of web-based psychosocial interventions in reducing anxiety and depression among CRC survivors, this review has put forth beneficial information supporting the use and acceptance of web-based care delivery in light of COVID-19 restrictions and nationwide lockdowns. Meanwhile, the paucity of empirical support reflects the necessity of more extensive research to test and improve other health outcomes. PROSPERO registration number: CRD42021261396.

Effects of Nutritious Meal Combined with Online Publicity and Education on Postoperative Nutrition and Psychological State in Patients with Low Rectal Cancer After Colostomy

Objective

To investigate the effects of nutritious meal combined with online publicity and education on postoperative nutrition and psychological state in patients with low rectal cancer after colostomy.

Methods

The clinic data of 88 patients with low rectal cancer who received the colostomy in our hospital (August 2020-August 2021) were retrospectively reviewed. Among them, 44 patients received nutritious meal combined with online publicity and education and they made up the study group, and the others were given conventional care and they made up the reference group. The nutrition indicators, scores of the World Health Organization Quality of Life (WHOQOL)-BREF, and other materials of the patients in the two groups were compared.

Results

After intervention, the various nutrition indicators, immune indexes, and WHOQOL-BREF score of the study group were all prominently higher than those of the reference group (P < 0.001). Compared with the reference group, the study group after intervention achieved markedly lower self-rating anxiety scale (SAS) score and self-rating depression scale (SDS) score (P < 0.001) and obviously lower total incidence of complications (P < 0.05).

Conclusion

Combining nutritious meal with online publicity and education can effectively improve the postoperative nutrition and immune function of the patients with low rectal cancer after colostomy, and this intervention contributes to releasing the patients' adverse emotions. Further study helps to provide these patients with favorable solutions.

The effects of continuous care model using a smartphone application on adherence to treatment and self-efficacy among patients with multiple sclerosis

Background

Adherence to disease-modifying therapy is important in patients with Multiple Sclerosis (MS) to increase the positive outcomes and improve the quality of life. This study aimed to determine the effects of Continuous Care Model (CCM) using a smartphone application on adherence to treatment and self-efficacy among MS patients.

Methods

This quasi-experimental study with pre/posttest design was conducted on 72 MS patients in Shiraz, Iran from June 2020 to August 2021. The samples were randomly assigned to intervention (n = 36) and control (n = 36) groups. In the intervention group, the CCM using a smartphone application was implemented during two months. However, no intervention was performed for the control group. The data were collected using the self-report Multiple Sclerosis Treatment Adherence Questionnaire (MS-TAQ) and MS Self-Efficacy Scale (MSSS) at baseline and two and four months after the intervention.

Results

The results showed an improvement in adherence to treatment and self-efficacy in the intervention group compared to the control group after implementing the virtual CCM and at the two-month follow-up (p < 0.001).

Conclusions

Implementing the CCM using a smartphone application resulted in improvements in the MS patients’ adherence to treatment and self-efficacy. It can be concluded that providing care using an interactive multimedia application can improve the outcomes as well as patients’ satisfaction, especially during the COVID-19 pandemic. Therefore, this approach is recommended to be used for nurses, healthcare providers, and clinicians.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12911-022-01785-x.

Clinical Observation of Comfort Nursing Combined With Continuous Nursing Intervention After Discharge on Improving Pressure Ulcers, Falls, Quality of Life, and Prognosis in Patients With Intracerebral Hemorrhage

In this prospective study, we randomly divided 131 patients with intracerebral hemorrhage (ICH) who met the inclusion criteria into two groups. One group received routine nursing during hospitalization, and the “Stroke Prevention Knowledge Manual” was issued before discharge, and was recorded as the control group (n = 61); one group received comfort nursing during hospitalization, and implemented continuous nursing after discharge, and was recorded as the research group (n = 70). The indicators we observed were the occurrence of pressure ulcers and falls during the hospitalization of the two groups of patients and the improvement in neurological function, limb function, quality of life, ability of daily living, and emotional state after the intervention. We also compared the disability degree of the two groups 6 months after discharge, the readmission status within 6 months of discharge, and the nursing satisfaction after the intervention. Our conclusion is that comfort nursing combined with continuous nursing intervention after discharge can effectively reduce the occurrence of pressure ulcers and falls during the nursing period of patients with ICH and contribute to the improvement of their quality of life and prognosis. It is worthy of clinical promotion.

Nursing Interventions to Promote Self-Care in a Candidate for a Bowel Elimination Ostomy: Scoping Review

Objectives: To identify nursing interventions, their characteristics, and outcomes for promoting self-care in candidates for a bowel elimination ostomy. Materials and methods: A scoping review was carried out based on the Joanna Briggs Institute’s recommendations. For this, studies published in Portuguese, English, and Spanish on the Web of Science, CINAHL, and Scopus databases and without a time limit were selected on November 9, 2020. Results: Of 2248 articles identified, 41 were included in this review. We identified 20 nursing interventions associated with the self-care of patients with an ostomy; most of them have gaps in their content, method, and frequency or dosing. More than 30 indicators were identified to assess the impact of nursing interventions; however, most of them were indirect assessments. Conclusion: There is scarce evidence regarding the different aspects that must be involved in nursing interventions for patients with a stoma. Moreover, there is no standardization in methods, frequency, or dosing of intervention. It is urgent to define the content, method, and frequency of nursing interventions necessary to promote self-care in patients with a bowel elimination ostomy and to use assessment tools that directly measure stoma self-care competence.

Effects of continuous care on health outcomes in patients with stoma: A systematic review and meta-analysis

Objective

Continuing care, which is an extension of post-discharge care, is recognized as a crucial element of high-quality health services and is essential to patients. This systematic review aims to identify the effectiveness of continuing care for patients with stomas.

Methods

PubMed, EMBASE, Cochrane Trial Register and Web of Science databases were searched. Study selection and quality appraisal were performed independently by two reviewers. We calculated the mean differences (MD) or the relative risk (RR) with 95% confidence intervals and assessed heterogeneity.

Results

Nine studies (1134 participants) met the inclusion criteria. This meta-analysis revealed that, in the continuous care group, the stoma self-efficacy (MD ​= ​6.46; 95% CI ​= ​3.81–9.11; P ​< ​0.001; I² ​= ​0%), and the quality of life (MD ​= ​7.48; 95% CI ​= ​5.13–9.82; P ​< ​0.001; I² ​= ​0%) increased significantly 1 month after discharge; stoma adjustment and care satisfaction also showed a trend toward improvement while stoma complications (RR ​= ​0.71; 95% CI ​= ​0.58–0.87; P ​= ​0.001; I² ​= ​25%) decreased significantly. Continuing care did not decrease hospital readmission rates or medical costs.

Conclusions

Continuing care showed beneficial effects in improving health outcomes and care satisfaction for patients with stomas compared with routine care. We proposed an integrated continuing care program with different elements and recommendations for its implementation.

The effects of WeChat follow-up management to improve the parents' mental status and the quality of life of premature newborns with patent ductus arteriosus

Objective

This study aimed to explore the effect of WeChat follow-up management on improving the parents’ mental status and the quality of life of premature newborns with patent ductus arteriosus (PDA) after discharge.

Methods

Participants were randomly divided into an intervention group and a control group. WeChat was used in the intervention group for the postdischarge follow-up management, while the control group was managed traditionally. The psychological status and quality of life of the parents of the two groups were analyzed and compared.

Results

The SAS and SDS scores in the intervention group at three months after discharge were significantly better than those at discharge, but there was no significant change in the control group. During the three-month follow-up, the SAS and SDS scores in the intervention group were significantly better than those in the control group. The WHOQOL-BREF scale scores in the intervention group were significantly better than those in the control group in physiology, psychology, social relations, and the environment. The total quality of life score in the intervention group was also significantly better than that in the control group. All patients in the intervention group were followed up as appropriate, while five patients in the control group were lost to follow-up. The incidence of pneumonia and feeding intolerance in the intervention group were significantly lower than those in the control group.

Conclusion

The application of WeChat in the follow-up management of premature infants with PDA could alleviate parents’ anxiety and depression in taking care of their children at home and can improve their quality of life.

Effects of WeChat follow-up management of infants who underwent ventricular septal defect repair on parents' disease knowledge and quality of life: A prospective randomized controlled study

OBJECTIVE

To investigate the effect of WeChat follow-up management of infants who underwent ventricular septal defect (VSD) repair on parents' disease knowledge and quality of life.

METHODS

Participants were randomly assigned to an intervention group (n = 40) or a control group (n = 40). The intervention group was followed up with WeChat, while the control group was followed up using a traditional method. The disease knowledge, mental state, and quality of life of the two groups of parents were analyzed and compared.

RESULTS

During the 3-month follow-up period, the PedSQL (PedsQL family impact module) results showed that the overall score in the intervention group was significantly higher than that in the control group. The parents in the intervention group were better at managing "emotion control," "worry," and "family communication" than those in the control group. The results of the LKQCHD (Leuven congenital heart disease knowledge questionnaire) showed that the parents in the intervention group had a higher mastery of "basic knowledge and treatment of congenital heart disease," "related complications," and "postoperative rehabilitation" than those in the control group.

CONCLUSION

Knowledge education and psychological counseling for parents of children who underwent VSD repair through WeChat follow-up management can effectively improve parents' knowledge, relieve their anxiety and sadness, and improve their quality of life.

Immediate postoperative experiences before discharge among patients with rectal cancer and a permanent colostomy: A qualitative study

PURPOSE

Patients with rectal cancer with a permanent colostomy often have issues in physical, psychological and social domains. Since discharge is an important transition period, the patient experience at that time is worthy of attention. The aim of this study was to explore the immediate postoperative experiences before discharge among patients with rectal cancer and a permanent colostomy in China.

METHODS

A qualitative design was used. Semi-structured interviews were conducted with 18 patients newly living with colostomy in China, who were asked open-ended questions about their postoperative experience. The thematic analysis approach was used to analyze the data.

RESULTS

Four themes and twelve sub-themes were identified from the interviews: (1) psychological reactions (stoma self-acceptance, negative emotion and social isolation), (2) daily life concern (daily life misunderstandings, sexual life compromise and work restriction), (3) stoma care consideration (strong stoma self-care willingness, decreased stoma self-care confidence and access to high-quality stoma care), and (4) support from others (enterostomal nurses, family members and stoma friends).

CONCLUSION

Colostomy patients experience various obstacles in physiological, psychological, and societal aspect. Nurses should provide effective discharge guidance to correct misunderstandings about the stoma, refer patients to psychological care, and promote transitional care.

Application of the WeChat Platform to Implement Continuous Nursing for Patients After Percutaneous Coronary Intervention

Background

Percutaneous coronary intervention (PCI) is an effective treatment for coronary heart disease. However, a lack of cardiac rehabilitation and continuous nursing management leads to repeated patient hospitalizations. Long-term systematic rehabilitation and nursing management after discharge are key to ensuring quality of treatment and patient quality of life. This study aimed to explore the application of the WeChat platform in continuous nursing after PCI.

Material/Methods

This was a retrospective case-control study. The clinical data of 63 patients in our cardiac center who underwent PCI between June 2017 and January 2018 were recorded. Patients were divided into 2 groups: the continuous nursing through the WeChat platform (intervention) group and the conventional nursing (control) group. The Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and Seattle Angina Questionnaire (SAQ) were used as the evaluation tools.

Results

The SAQ scores in all 5 SAQ dimensions in the continuous nursing group were significantly higher than those of the control group at the 1-year follow-up. Scores on the SAS and SDS scales at 1-year follow-up were significantly better in the intervention group than in the control group. The SAS and SDS scores in both groups were better at the 1-year follow-up, but the difference was statistically significant in the continuous nursing group and not in the control group.

Conclusions

Using the WeChat platform can make continuous nursing more convenient and effective for patients after PCI. It may reduce the occurrence of complications, relieve patient depression and anxiety, and improve patient quality of life.

Chat-based hotlines for health promotion: a systematic review

BACKGROUND

Chat-based hotlines use online messaging services or popular chat applications such as WhatsApp, Facebook Messenger, and WeChat, to connect users to trained health providers or staff. Chat-based hotlines can provide real-time communication between health providers and patients.

METHODS

The evidence for chat-based hotlines for health promotion has not been reviewed systematically. Electronic databases (PubMed, Cochrane Database, Google Scholar) were searched to identify English-language studies describing original research published from 2009 to 2020. This review was registered with Prospero Register of Systematic Reviews (ID: CRD42020156670).

RESULTS

Twelve publications met our criteria. Ten studies reported on user characteristics, eight on comparing use of chat-based hotlines with different modes of support, six on health outcomes and six on user satisfaction. Included studies report that chat-based hotlines have been used primarily for crisis and emotional support in high-income countries. Chat-based hotlines using instant messenger applications were preferred over other modes of services such as email, text messaging, voice calls, and face-to-face counselling. Evaluations of health outcomes, although limited in rigor due to mostly observational study designs, indicate mostly positive and statistically significant effects on mental health outcomes such as anxiety, depression, well-being and suicidality. User satisfaction with chat-based hotlines were moderately high.

CONCLUSIONS

Chat-based hotlines may be effective ways to deliver crisis support services in high income settings. They may have the potential to be effective in low- and middle-income countries to expand the reach of mental health and crisis support services although such services have not yet been publicly evaluated.