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Williams JM, Berg LC, Clayton HM, Kirsch K, Marlin D, Randle H, Roepstroff L, van Oldruitenborgh-Oosterbaan MS, Weishaupt MA, Munsters C. A Delphi Study to Determine International and National Equestrian Expert Opinions on Domains and Sub-Domains Essential to Managing Sporthorse Health and Welfare in the Olympic Disciplines. Animals (Basel) 2023; 13:3404. [PMID: 37958159 PMCID: PMC10650931 DOI: 10.3390/ani13213404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
The public is increasingly questioning equestrianism's social license to operate. While the focus historically centered on horseracing, increased scrutiny is now being placed on how dressage, showjumping, and eventing are addressing equine management and welfare concerns. Nominated equestrian federation and equestrian organization experts (n = 104) directly involved in international and/or national-level horse sports took part in a four-stage, iterative Delphi to obtain consensus on what factors should be considered essential to manage sporthorse health and welfare. Five core domains were agreed as essential: training management, competition management, young horse management, health status and veterinary management, and the horse-human relationship. Two further domains: stable and environmental management, and welfare assessment were rated as important but not essential, as most respondents felt that these areas were already managed well. Participants felt increased education and guidance combined with further policy development and regulation are needed to support stakeholders to optimize sporthorse management. An appetite to engage with research to generate evidence that promotes sporthorse welfare was evident. The development of a sporthorse welfare charter and evidence-based guidelines to inform the management and monitoring of sporthorses' health and welfare are recommended to provide horses with a good life and to safeguard the future of equestrian sports.
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Affiliation(s)
| | - Lise C. Berg
- Department of Veterinary Clinical Science, University of Copenhagen, Hoejbakkegaards Alle 5, 2630 Taastrup, Denmark;
| | - Hilary M. Clayton
- Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, MI 48824, USA;
| | - Katharina Kirsch
- Department Sensors and Modeling, Leibniz Institute for Agricultural Engineering and Bioeconomy (ATB), Max-Eyth Allee 100, 14469 Potsdam, Germany;
| | - David Marlin
- AnimalWeb Ltd., Tennyson House, Cambridge CB4 0WZ, UK;
| | - Hayley Randle
- School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW 2678, Australia;
| | - Lars Roepstroff
- Department of Anatomy, Physiology and Biochemistry, Faculty of Veterinary Medicine and Animal Sciences, Swedish University of Agricultural Sciences, SE-75007 Uppsala, Sweden;
| | | | - Michael A. Weishaupt
- Equine Department, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland;
| | - Carolien Munsters
- Equine Integration B.V., Groenstraat 2c, 5528 NS Hoogeloon, The Netherlands;
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Rashidian N, Giglio MC, Van Herzeele I, Smeets P, Morise Z, Alseidi A, Troisi RI, Willaert W. Effectiveness of an immersive virtual reality environment on curricular training for complex cognitive skills in liver surgery: a multicentric crossover randomized trial. HPB (Oxford) 2022; 24:2086-2095. [PMID: 35961933 DOI: 10.1016/j.hpb.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/26/2022] [Accepted: 07/13/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND Virtual reality (VR) is increasingly used in surgical education, but evidence of its benefits in complex cognitive training compared to conventional 3-dimensional (3D) visualization methods is lacking. The objective of this study is to assess the impact of 3D liver models rendered visible by VR or desktop interfaces (DIs) on residents' performance in clinical decision-making. METHOD From September 2020 to April 2021, a single-blinded, crossover randomized educational intervention trial was conducted at two university hospitals in Belgium and Italy. A proficiency-based stepwise curriculum for preoperative liver surgery planning was developed for general surgery residents. After completing the training, residents were randomized in one of two assessment sequences to evaluate ten real clinical scenarios. RESULTS Among the 50 participants, 46 (23 juniors/23 seniors) completed the training and were randomized. Forty residents (86.96%) achieved proficiency in decision-making. The accuracy of virtual surgical planning using VR was higher than that using DI in both groups A (8.43 ± 1.03 vs 6.86 ± 1.79, p < 0.001) and B (8.08 ± 0.9 vs 6.52 ± 1.37, p < 0.001). CONCLUSION Proficiency-based curricular training for liver surgery planning successfully resulted in the acquisition of complex cognitive skills. VR was superior to DI visualization of 3D models in decision-making. CLINICALTRIALS GOV ID NCT04959630.
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Affiliation(s)
- Nikdokht Rashidian
- Department of Human Structure and Repair, Ghent University Faculty of Medicine, Belgium.
| | - Mariano C Giglio
- Division of HPB, Minimally Invasive and Robotic Surgery, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy
| | | | - Peter Smeets
- Department of Radiology, Ghent University Hospital, Belgium
| | - Zenichi Morise
- Department of Surgery, Fujita Health University School of Medicine, Toyoake, Japan
| | - Adnan Alseidi
- Department of Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Roberto I Troisi
- Department of Human Structure and Repair, Ghent University Faculty of Medicine, Belgium; Division of HPB, Minimally Invasive and Robotic Surgery, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy
| | - Wouter Willaert
- Department of Human Structure and Repair, Ghent University Faculty of Medicine, Belgium
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De Mol L, Desender L, Van Herzeele I, Van de Voorde P, Konge L, Willaert W. Assessing competence in Chest Tube Insertion with the ACTION-tool: A Delphi study. Int J Surg 2022; 104:106791. [DOI: 10.1016/j.ijsu.2022.106791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 10/16/2022]
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Ioannou LG, Dinas PC, Notley SR, Gofa F, Gourzoulidis GA, Brearley M, Epstein Y, Havenith G, Sawka MN, Bröde P, Mekjavic IB, Kenny GP, Bernard TE, Nybo L, Flouris AD. Indicators to assess physiological heat strain – Part 2: Delphi exercise. Temperature (Austin) 2022; 9:263-273. [PMID: 36211947 PMCID: PMC9542877 DOI: 10.1080/23328940.2022.2044738] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
In a series of three companion papers published in this Journal, we identify and validate the available thermal stress indicators (TSIs). In this second paper of the series, we identified the criteria to consider when adopting a TSI to protect individuals who work in the heat, and we weighed their relative importance using a Delphi exercise with 20 experts. Two Delphi iterations were adequate to reach consensus within the expert panel (Cronbach's α = 0.86) for a set of 17 criteria with varying weights that should be considered when adopting a TSI to protect individuals who work in the heat. These criteria considered physiological parameters such as core/skin/mean body temperature, heart rate, and hydration status, as well as practicality, cost effectiveness, and health guidance issues. The 17 criteria were distributed across three occupational health-and-safety pillars: (i) contribution to improving occupational health (55% of total importance), (ii) mitigation of worker physiological strain (35.5% of total importance), and (iii) cost-effectiveness (9.5% of total importance). Three criteria [(i) relationship of a TSI with core temperature, (ii) having categories indicating the level of heat stress experienced by workers, and (iii) using its heat stress categories to provide recommendations for occupational safety and health] were considered significantly more important when selecting a TSI for protecting individuals who work in the heat, accumulating 37.2 percentage points. These 17 criteria allow the validation and comparison of TSIs that presently exist as well as those that may be developed in the coming years.
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Affiliation(s)
- Leonidas G. Ioannou
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
- Department of Nutrition, Exercise and Sports, August Krogh Building, University of Copenhagen, Copenhagen, Denmark
| | - Petros C. Dinas
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Sean R. Notley
- Human and Environmental Physiology Research Unit, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Flora Gofa
- Hellenic National Meteorological Service, Athens, Greece
| | | | - Matt Brearley
- National Critical Care and Trauma Response Centre, Royal Darwin Hospital, Darwin, Northern Territory, Australia
- Thermal Hyperformance, Pty Ltd, Takura, Australia
| | - Yoram Epstein
- Heller Institute of Medical Research, Sheba Medical Center, Ramat Gan and the Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - George Havenith
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, UK
| | - Michael N. Sawka
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Peter Bröde
- Department of Immunology, Leibniz Research Centre for Working Environment and Human Factors (IfADO), Dortmund, Germany
| | - Igor B. Mekjavic
- Department of Automation, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia
| | - Glen P. Kenny
- Human and Environmental Physiology Research Unit, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Thomas E. Bernard
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Lars Nybo
- Department of Nutrition, Exercise and Sports, August Krogh Building, University of Copenhagen, Copenhagen, Denmark
| | - Andreas D. Flouris
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
- Human and Environmental Physiology Research Unit, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
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van der Hage J, Sandrucci S, Audisio R, Wyld L, Søreide K, Amaral T, Audisio R, Bahadoer V, Beets G, Benstead K, Berge Nilsen E, Bol K, Brandl A, Braun J, Cufer T, Dopazo C, Edhemovic I, Eriksen JG, Fiore M, van Ginhoven T, Gonzalez-Moreno S, van der Hage J, Hutteman M, Masannat Y, Onesti EC, Rau B, De Reijke T, Rubio I, Ruurda J, Sandrucci S, Soreide K, Stattner S, Trapani D, D'Ugo D, Vriens M, Wyld L, Zahl Eriksson AG. The ESSO core curriculum committee update on surgical oncology. Eur J Surg Oncol 2021; 47:e1-e30. [PMID: 34657781 DOI: 10.1016/j.ejso.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 09/29/2021] [Accepted: 10/05/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Surgical oncology is a defined specialty within the European Board of Surgery within the European Union of Medical Specialists (UEMS). Variation in training and specialization still occurs across Europe. There is a need to align the core knowledge needed to fulfil the criteria across subspecialities in surgical oncology. MATERIAL AND METHODS The core curriculum, established in 2013, was developed with contributions from expert advisors from within the European Society of Surgical Oncology (ESSO), European Society for Radiotherapy and Oncology (ESTRO) and European Society of Medical Oncology (ESMO) and related subspeciality experts. RESULTS The current version reiterates and updates the core curriculum structure needed for current and future candidates who plans to train for and eventually sit the European fellowship exam for the European Board of Surgery in Surgical Oncology. The content included is not intended to be exhaustive but, rather to give the candidate an idea of expectations and areas for in depth study, in addition to the practical requirements. The five elements included are: Basic principles of oncology; Disease site specific oncology; Generic clinical skills; Training recommendations, and, lastly; Eligibility for the EBSQ exam in Surgical Oncology. CONCLUSIONS As evidence-based care for cancer patients evolves through research into basic science, translational research and clinical trials, the core curriculum will evolve, mature and adapt to deliver continual improvements in cancer outcomes for patients.
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Affiliation(s)
- Jos van der Hage
- Department of Surgery, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands.
| | - Sergio Sandrucci
- Surgical Oncology Unit, City of Health and Science, University of Turin, Turin, Italy
| | - Riccardo Audisio
- Department of Surgery, Sahlgrenska University Hospital, University of Gothenburg, Sweden
| | - Lynda Wyld
- Department of Oncology and Metabolism, Sheffield University, Sheffield, United Kingdom
| | - Kjetil Søreide
- Department of Gastrointestinal Surgery, HPB unit, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway.
| | | | - Teresa Amaral
- Dermatology, Eberhard Karls Universitat Tubingen, Tubingen, Germany
| | | | - Viren Bahadoer
- Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | - Geerard Beets
- Department of Surgery, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Kim Benstead
- Gloucestershire Oncology Centre, Cheltenham General Hospital, United Kingdom
| | - Elisabeth Berge Nilsen
- Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway
| | - Kalijn Bol
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Andreas Brandl
- Department of Surgery, Campus Virchow-Klinikum and Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany; Digestive Unit, Champalimaud Foundation, Lisbon, Portugal
| | - Jerry Braun
- Department of Thoracic Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | - Tanja Cufer
- University Clinic Golnik, University of Ljubljana, 4204 Ljubljana, Slovenia
| | - Cristina Dopazo
- Department of Hepato-Pancreato-Biliary and Transplant Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Ibrahim Edhemovic
- Department of Surgery, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Jesper Grau Eriksen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Marco Fiore
- Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Tessa van Ginhoven
- Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | | | - Jos van der Hage
- Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | - Merlijn Hutteman
- Department of Thoracic Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | - Yazan Masannat
- University of Aberdeen, School of Medicine, Medical Science and Nutrition, Aberdeen, UK
| | - Elisa Concetta Onesti
- Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Rome, Italy
| | - Beate Rau
- Department of General Surgery, Charité University of Berlin, Berlin, Germany
| | - Theo De Reijke
- Department of Urology, Amsterdam UMC, Amsterdam, the Netherlands
| | - Isabel Rubio
- Breast Surgical Oncology, Clínica Universidad de Navarra, Madrid, Universidad de Navarra, Spain
| | - Jelle Ruurda
- Visceral Sarcoma Surgery Unit, Città della Salute e della Scienza, Turin, Italy
| | - Sergio Sandrucci
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway
| | - Kjetil Soreide
- Department of Surgery, Salzkammergutklinikum, Standort Vöcklabruck, Oberösterreich, Austria
| | - Stefan Stattner
- Department of Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria; New drugs development for innovative therapies, European Institute of Oncology, IRCCS, Milano, Italy
| | - Dario Trapani
- General Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University, 00168 Rome, Italy
| | - Domenico D'Ugo
- Department of Surgery, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Menno Vriens
- Department of Surgery, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Lynda Wyld
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
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Unifying the Hepatopancreatobiliary Surgery Fellowship Curriculum via Delphi Consensus. J Am Coll Surg 2021; 233:395-414. [PMID: 34166838 DOI: 10.1016/j.jamcollsurg.2021.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 06/03/2021] [Accepted: 06/03/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Hepatopancreatobiliary (HPB) Fellowship training in the Americas consists of 3 distinctive routes with variable curricula: Surgical Oncology Fellowship via the Society of Surgical Oncology (SSO), Abdominal Transplant Surgery Fellowship via the American Society of Transplant Surgeons (ASTS), and HPB Fellowship via the Americas Hepato-Pancreato-Biliary Association (AHPBA). Our objective was to establish a pan-American consensus among HPB surgeons, surgical oncologists, abdominal transplant surgeons, and general surgery residency program directors (GSPDs) on a core knowledge curriculum for HPB fellowship, and to identify topics appropriate for general surgery residency and subspecialty beyond HPB fellowship. STUDY DESIGN A 3-round modified Delphi process was used. Baseline statements were developed by the Education and Training Committee of the AHPBA, in collaboration with representatives of the SSO, ASTS, and GSPDs. The expert panel, consisting of members of the 3 societies together with GSPDs, rated the statements on a 5-point Likert scale and suggested editing or adding new statements. A statement was included in the final curriculum when Cronbach's alpha value was ≥ 0.8 and ≥ 80% of the panel agreed on inclusion. RESULTS The response rate was 100% for the first round, and 98% for the second and third rounds. Eighty-nine of 138 proposed statements were included in the final HPB fellowship curriculum. Curricula for general surgery residency and subspecialty beyond HPB fellowship included 50 and 29 statements, respectively. CONCLUSIONS A multinational consensus on core knowledge for an HPB fellowship curriculum was achieved via the modified Delphi method. This core curriculum may be used to standardize HPB fellowship training across different pathways in the Americas.
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Implementation of an educational program for pancreaticoduodenectomy in a university hospital: a retrospective observational study. JOURNAL OF PANCREATOLOGY 2021. [DOI: 10.1097/jp9.0000000000000070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Knowledge of the Culture of Safety in Cholecystectomy (COSIC) Among Surgical Residents: Do We Train Them Well For Future Practice? World J Surg 2021; 45:971-980. [PMID: 33454794 DOI: 10.1007/s00268-020-05911-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Biliary injury is the most feared complication of laparoscopic cholecystectomy (LC). This study aimed to assess the awareness of culture of safety in cholecystectomy (COSIC) concept among the surgical residents in India. METHODS A manual survey was conducted among general surgery residents attending a postgraduate course. Survey consisted of questions pertaining to knowledge of various aspects of COSIC, e.g., the critical view of safety (CVS). RESULTS With a response rate of 51%, 259 residents were included in this study. They had more exposure to LC (63.3% assisted / performed > 15 LC) than to open cholecystectomy (60.6% assisted / performed ≤ 10 open cholecystectomy). The majority (80.2%) clearly differentiated Calot triangle from the hepatocystic triangle (HCT). However, 25.8% could not correctly define HCT. The majority (88.5%) had seen the Rouviere's sulcus during LC. While almost all (98.4%) respondents claimed to know about the segment 4, only 41.9% could correctly describe it. Awareness of the correct direction of the gallbladder retraction was lower for the infundibulum (53.5%) than for fundus (89.2%). The majority (88.3%) claimed to know CVS but only 11.5% knew it correctly, and 15.1% described > 3 components. The majority (78.7%) practiced to identify the cystic duct-common bile duct junction. Awareness was low for time-out (28.1%), intraoperative cholangiography (20.6%), bailout techniques (18.9%), and for overall COSIC concept (15.7%). CONCLUSIONS Knowledge of COSIC among surgical residents seems to be suboptimal, especially for the CVS, time-out, bailout techniques, and overall concept of COSIC. Strategies to educate them more effectively about COSIC are highly imperative to train them well for future practice.
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Zhang Q, Wan R, Liu C. The impact of intense nursing care in improving anxiety, depression, and quality of life in patients with liver cancer: A systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e21677. [PMID: 32846784 PMCID: PMC7447416 DOI: 10.1097/md.0000000000021677] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Liver resection is a major, serious, and very delicate operation that should be done only by specialized, well-skilled, and experienced surgeons. However, the role of nurses, which has often been under-estimated, is also crucial for the success of the intervention or surgery. Intensive nursing care involves high quality nursing modes to achieve the expected goals of treatment smoothly and with less complications. In this analysis, we aimed to show the impact of intense nursing care in improving anxiety, depression, and quality of life in patients with intervention for liver cancers. METHODS Data sources included EMBASE, MEDLINE, Web of Science, the Cochrane central, Google scholar, and http://www.ClinicalTrials.gov. Three authors independently extracted data from the selected original studies. The statistical analysis was carried out by the Cochrane based RevMan software. For dichotomous data, the number of events and the total number of participants were required and for the continuous data, mean, standard deviation as well as the total number of participants were required in the input for analysis. Odds ratios (OR) with 95% confidence intervals (CI) were used to represent the data following assessment. RESULTS A total of 1205 participants with liver cancer enrolled between the years 2010 to 2018 were included in this analysis whereby 667 participants were assigned to an intensive nursing care. Our current analysis showed that most of the patients who were assigned to an intense nursing intervention were significantly very satisfied with their quality of life (OR: 4.07, 95% CI: 1.45 - 11.45; P = .008). However, a minor number of patients with liver cancer who were not assigned to intense nursing care were significantly dissatisfied with their quality of life with OR: 0.18, 95% CI: 0.04 - 0.77; P = .02. This analysis also showed that self-rating anxiety score (SAS) and self-rating depression score (SDS) were significantly in favor of the participants with intense nursing care with OR: - 7.66, 95% CI: [(-9.66) - (-5.66)]; P = .00001 and OR: -7.87, 95% CI: [(-8.43) - (-7.26)]; P = .00001 respectively. In addition, physical function (OR: 13.56, 95% CI: 12.39 - 14.74; P = .00001), and total activity score (OR: 16.58, 95% CI: 13.51 - 19.65; P = .00001) were also significantly in favor of an intense nursing care. CONCLUSIONS Our current analysis showed that intense nursing care significantly improved anxiety, depression, and quality of life following interventions in patients with liver cancers. Most of the patients with liver cancers who were assigned to an intense nursing care were very satisfied with their quality of life. However, this hypothesis should further be confirmed in larger nursing related studies based on patients with liver cancers.
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Affiliation(s)
| | - Rong Wan
- Department of Midwifery, Jingzhou Central Hospital, Jingzhou, Hubei, China
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