Effect of nursing intervention via a chatting tool on the rehabilitation of patients after Total hip Arthroplasty

Impact of precision nursing intervention based on DCO model on joint function and quality of life of elderly hip arthroplasty patients

BACKGROUND

This study aimed to explore the impact of precision nursing intervention based on Damage Control Orthopedics (DCO) model on joint function and quality of life of elderly hip arthroplasty patients.

METHODS

Elderly hip arthroplasty patients (n = 100) who underwent hip replacement surgery at our hospital from January 2023 to June 2024 were collected and randomly assigned into two groups, with 50 patients in each. The control group received conventional nursing intervention, while the observation group received precision nursing intervention based on the DCO model. The hip joint function (Harris), Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), Pittsburgh Sleep Quality Index (PSQI), Barthel Index (BI), and SF-36 were employed to assess hip joint function, psychological status, sleep quality, daily living abilities, and quality of life before and after intervention in both groups. Complications in both groups were also recorded.

RESULTS

Compared to pre-intervention, the hip joint function scores and BI scores in both groups significantly improved post-intervention, with the observation group scoring higher than the control group (P < 0.05). After the intervention, SAS, SDS, and PSQI scores decreased in both groups, with the observation group showing lower scores than the control group (P < 0.05). The quality of life scores in the observation group post-intervention were higher than those in the control group (P < 0.05).

CONCLUSION

Precision nursing intervention based on DCO model can significantly improve joint function and quality of life in elderly patients with hip arthroplasty.

[Research progress in application of intelligent remote follow-up mode in hip and knee arthroplasty]

Objective

To review the research progress of intelligent remote follow-up modes in the application after hip and knee arthroplasty.

Methods

Extensive literature on this topic published in recent years both domestically and internationally was reviewed, and the application of intelligent remote follow-up modes after hip and knee arthroplasty was summarized and analyzed.

Results

The intelligent remote follow-up mode is a novel follow-up method based on network information technology. Patients who undergo hip and knee arthroplasty require long-term follow-up and rehabilitation guidance after operation. Traditional outpatient follow-up is relatively time-consuming and inconvenient for some patients in terms of travel and transportation, which makes the application of intelligent remote follow-up modes increasingly widespread worldwide. The inherent attributes of remote interaction and instant feedback of this mode make it particularly valued in the field of hip and knee arthroplasty. Artificial intelligence (AI)-based voice follow-up systems and virtual clinics have significant advantages in improving follow-up efficiency, reducing human resource costs, and enhancing patient satisfaction.

Conclusion

The existing intelligent follow-up system has formed a standardized protocol in remote follow-up and rehabilitation guidance. However, there are still shortcomings in the formulation of personalized rehabilitation plans and the gerontechnological adaptation of human-computer interaction. In the future, it is necessary to construct a multimodal data fusion platform and establish technical application guidelines for different rehabilitation stages.

Efficacy of a WeChat-Based, Multidisciplinary, Full-Course Nutritional Management Program on the Nutritional Status of Patients With Ovarian Cancer Undergoing Chemotherapy: Randomized Controlled Trial

Background

As the most malignant type of cancer in the female reproductive system, ovarian cancer (OC) has become the second leading cause of death among Chinese women. Chemotherapy is the main treatment for patients with OC, and its numerous adverse effects can easily lead to malnutrition. It is difficult to centrally manage patients with OC in the intervals between chemotherapy. The use of WeChat, an effective mobile tool, in chronic disease management has been highlighted.

Objective

This study aimed to implement a continuous follow-up strategy and health monitoring based on the WeChat platform for patients with OC undergoing chemotherapy to ensure that each phase of chemotherapy was delivered on schedule and to improve the survival rate of patients with OC.

Methods

Participants were recruited and randomly assigned to either the WeChat-based nutrition intervention group or the usual care group. A self-administered general information questionnaire was used at enrollment to obtain basic information about the patients. The Patient-Generated Subjective Global Assessment (PG-SGA) Scale was used to investigate the nutritional status of the patients at 3 time points (T0=before the first admission to the hospital for chemotherapy, T1=2 weeks after the first chemotherapy, and T6=2 weeks after the sixth chemotherapy). The blood indices of patients were investigated through the inhospital health care system at 3 times（T0=before the first admission to the hospital for chemotherapy, T1=2 weeks after the first chemotherapy, and T6=2 weeks after the sixth chemotherapy). Patients in the intervention group were introduced to the nutrition applet, invited to join the nutrition management group chat, and allowed to consult on nutritional issues in private chats with nutrition management team members. Linear mixed models were used to analyze changes in each nutritional indicator in the 2 groups, with their baseline measurements as covariates; with group, time, and group-time interactions considered as fixed effects; and with patients considered as random effects.

Results

A total of 96 patients with OC undergoing chemotherapy were recruited into the study. Distribution was based on a 1:1 ratio, with 48 patients each in the nutrition intervention group and the usual care group. The attrition rate after the first chemotherapy session was 18.75%. The mixed linear model revealed that the group-based effect and the group-time interaction effect on PG-SGA scores were significant (F38,38=4.763, P=.03; F37,37=6.368, P=.01), whereas the time-based effect on PG-SGA scores was not (F38,38=0.377; P=.54). The findings indicated that the group-based effect, the time-based effect, and the group-time interaction effect on nutrition-inflammation composite indices were significant (F38,38=7.653, P=.006; F38,38=13.309, P<.001; F37,37=92.304, P<.001; F37,38=110.675, P<.001; F38,38=10.379, P=.002; and F37,37=5.289, P=.02).

Conclusions

This study provided evidence that a WeChat-based, multidisciplinary, full-course nutritional management program can significantly improve the nutritional status of patients with OC during chemotherapy.

The influence of WeChat education and care program on anxiety, depression, insomnia, and general state of health in parents of pediatric acute lymphoblastic leukemia patients

PURPOSE

WeChat-based education and care program serves as a promising nursing method for relieving mental stress in parents of pediatric patients. This study purposed to explore the influence of the WeChat education and care program (WECP) on mental health, insomnia, and general state of health in parents of pediatric acute lymphoblastic leukemia (ALL) patients.

METHODS

Totally, 146 parents of 73 primary pediatric ALL patients were randomized into the WECP group (74 parents of 37 patients) and standard care (SC) group (72 parents of 36 patients) to receive a 6-month corresponding intervention. Self-rating anxiety scale (SAS), self-rating depression scale (SDS), Athens insomnia scale (AIS), and 12-item general health questionnaire (GHQ-12) were assessed in parents of patients.

RESULTS

SAS scores at the third month (M3) (P = 0.041) and M6 (P = 0.032) were reduced in WECP group versus SC group. SAS-defined anxiety rate at M6 (P = 0.035) was declined in WECP group versus SC group. SDS score at M6 was descended in WECP group versus SC group (P = 0.024). However, there was no discrepancy in SDS-defined depression rate at any time point between groups (all P > 0.05). AIS scores at M1 (P = 0.015) and M6 (P = 0.021), as well as GHQ-12 scores at M3 (P = 0.007) and M6 (P = 0.001) were decreased in WECP group versus SC group. By subgroup analyses, WECP exhibited good effects at M6 in mothers, but not in fathers.

CONCLUSION

WECP is a feasible and efficacy intervention to improve mental stress and health status among parents of pediatric ALL patients, especially in mothers.

The Surgical Timing and Prognoses of Elderly Patients with Hip Fractures: A Retrospective Analysis

Background

Guidelines exist for the surgical treatment of hip fractures, but the association between the surgical timing and the incidence of postoperative complications and other important outcomes in elderly patients with hip fracture remains controversial.

Objective

This study aims to explore the association between the surgical timing and the prognoses in elderly patients with hip fracture.

Methods

A total of 701 elderly patients (age ≥ 65 years) with hip fractures who were treated in our hospital from June 2020 to June 2021 were selected. Patients who underwent surgery within 2 d of admission were assigned to the early surgery group, and those who underwent surgery after 2 d of admission were assigned to the delayed surgery group. The prognosis indices of the patients in the two groups were recorded and compared.

Results

The length of postoperative hospitalisation in the early surgery group was significantly lower than that in the delayed surgery group (P < 0.001). The European quality of life questionnaire (EQ-5D) utility in the delayed surgery group was significantly lower than that in the early surgery group at 30 days and 6 months after operation (P<0.05). Compared with the delayed surgery group, the incidence of pulmonary infection, urinary tract infection (UTI) and deep vein thrombosis (DVT) in the early surgery group were significantly lower. There were no significant differences between the two groups in terms of mortality and excellent rates of the HHS at six months after the operation. In addition, the early surgery group had a lower readmission rate than the delayed surgery group [34 (9.5%) vs 56 (16.3%), P = 0.008].

Conclusion

Earlier surgery can reduce the incidence of pulmonary infections, UTI, DVT and readmission rate among elderly patients with hip fractures, shorten postoperative hospitalisation.

Experience of nurses using the basic nursing science in performing nursing care for patients at RSUD Dr. Soedomo Trenggalek, Indonesia

Introduction: The provision of humanistic and professional nursing care services needs to be carried out comprehensively, and it must cover patients’ bio-psycho-socio-spiritual aspects. This indicates nurses have to integrate all the basic nursing science, including physiology, anatomy, pharmacology, and pathophysiology, while carrying out their duties. This integration helps to provide the best care for their patients, but they often uncertain about the basic science approach to use. Therefore, this study aimsto explore the experience of nurses using basic nursing science in caring for patients with chronic diseases. Design and Methods: In-depth interviews were conducted with 5 nurses working in chronic disease wards for at least 5 years. Each respondent was then interviewed using a self-constructed questionnaire. Results: All respondents agreed that basic nursing science is important in providing quality healthcare services. Furthermore, six themes were identified using the thematic analysis, namely (1) the process of collecting patient data, which was more focused and organized; (2) required for establishing the nursing diagnosis; (3) useful for determining the nursing care plan; (4) it is a basis for implementing nursing actions; (5) provides a basis for monitoring and follow-up; (6) and teamwork between health personnel is more effective. Conclusions: Based on the interview results, nurses need knowledge and skills in basic nursing science while caring for patients with chronic diseases. Furthermore, basic nursing sciences lay the foundation for nurses while assessing patients, diagnosing, planning the care, implementing nursing actions, evaluating patients’ condition, and collaborating with other health personnel.  

WeChat-platform-based education and care program as a candidate approach to relieve anxiety, depression, and post-traumatic stress disorder in parents of pediatric and adolescent patients with osteosarcoma

Background

WeChat is the main social platform in China, characterized by its versatility and ease of communication. This study aimed to explore the effect of a WeChat-platform-based education and care (WBEC) program on relieving anxiety, depression, and post-traumatic stress disorder (PTSD) in parents of pediatric and adolescent patients with osteosarcoma.

Methods

In total, 48 patients and 86 parents were enrolled in this randomized, controlled study and then assigned to the WBEC program (24 patients and 45 parents) and the usual education and care (UEC) program (22 patients and 41 parents) for 6 months as a 1:1 ratio.

Results

Parents in the WBEC group had lower Hospital Anxiety and Depression Scale (HADS) for anxiety (HADS-A) scores at M3 (7.8 ± 2.2 vs. 9.1 ± 2.5; p = 0.010) and M6 (7.7 ± 2.5 vs. 8.9 ± 2.4; p = 0.027) when compared to the UEC group, while anxiety rate was only decreased at M3 (43.2% vs. 63.4%; p = 0.049) in the WBEC group. Meanwhile, parental HADS for depression (HADS-D) scores were reduced at M3 (7.0 ± 2.0 vs. 8.0 ± 2.1; p = 0.047) and M6 (7.1 ± 1.9 vs. 8.0 ± 2.4; p = 0.045) in the WBEC group when compared with the UEC group; while depression rate remained the same. Parental Impact of Event Scale-Revised (IES-R) scores were slightly reduced among the WBEC group at M6 when compared with the UEC group [12.0 (interquartile range (IQR): 10.0–20.8] vs. 15.0 (IQR: 9.5–25.0; p = 0.077)], but not statistically significant.

Conclusion

WeChat-platform-based education and care is considered a feasible intervention to reduce anxiety and depression in parents of pediatric and adolescent patients with osteosarcoma, while also providing mild relief from PTSD.

Recommendations for the Design and Delivery of Transitions-Focused Digital Health Interventions: Rapid Review

Background

Older adults experience a high risk of adverse events during hospital-to-home transitions. Implementation barriers have prevented widespread clinical uptake of the various digital health technologies that aim to support hospital-to-home transitions.

Objective

To guide the development of a digital health intervention to support transitions from hospital to home (the Digital Bridge intervention), the specific objectives of this review were to describe the various roles and functions of health care providers supporting hospital-to-home transitions for older adults, allowing future technologies to be more targeted to support their work; describe the types of digital health interventions used to facilitate the transition from hospital to home for older adults and elucidate how these interventions support the roles and functions of providers; describe the lessons learned from the design and implementation of these interventions; and identify opportunities to improve the fit between technology and provider functions within the Digital Bridge intervention and other transition-focused digital health interventions.

Methods

This 2-phase rapid review involved a selective review of providers’ roles and their functions during hospital-to-home transitions (phase 1) and a structured literature review on digital health interventions used to support older adults’ hospital-to-home transitions (phase 2). During the analysis, the technology functions identified in phase 2 were linked to the provider roles and functions identified in phase 1.

Results

In phase 1, various provider roles were identified that facilitated hospital-to-home transitions, including navigation-specific roles and the roles of nurses and physicians. The key transition functions performed by providers were related to the 3 categories of continuity of care (ie, informational, management, and relational continuity). Phase 2, included articles (n=142) that reported digital health interventions targeting various medical conditions or groups. Most digital health interventions supported management continuity (eg, follow-up, assessment, and monitoring of patients’ status after hospital discharge), whereas informational and relational continuity were the least supported. The lessons learned from the interventions were categorized into technology- and research-related challenges and opportunities and informed several recommendations to guide the design of transition-focused digital health interventions.

Conclusions

This review highlights the need for Digital Bridge and other digital health interventions to align the design and delivery of digital health interventions with provider functions, design and test interventions with older adults, and examine multilevel outcomes.

International Registered Report Identifier (IRRID)

RR2-10.1136/bmjopen-2020-045596

A Social Media-Promoted Educational Community of Joint Replacement Patients Using the WeChat App: Survey Study

Background

Much effort has been made to optimize the results of total hip arthroplasty and total knee arthroplasty. With the rapid growth of social media use, mobile apps, such as WeChat, have been considered for improving outcomes and patient satisfaction after total hip arthroplasty and total knee arthroplasty.

Objective

We aimed to evaluate the effectiveness of a WeChat-based community as an intervention for overall patient satisfaction.

Methods

The study was conducted among discharged in-hospital patients who received hip or knee procedures in the First Affiliated Hospital of the University of Science and Technology of China from April 2019 to January 2020. An educational online social community was constructed with the WeChat app. Participants willing to join the community were enrolled in a WeChat group and received 3 months of intervention and follow-up. Those who were not willing to use the account were included in a control group and received routine publicity via telephone, mail, and brochures. The Danish Health and Medicine Authority patient satisfaction questionnaire was used to score perioperative patient education and overall satisfaction. The contents in the group chat were analyzed using natural language processing tools.

Results

A total of 3428 patients were enrolled in the study, including 2292 in the WeChat group and 1236 in the control group. Participants in the WeChat group had higher overall satisfaction scores than those in the control group (mean 8.48, SD 1.12 vs mean 6.66, SD 1.80, P<.001). The difference between the two groups was significant for primary surgery based on subgroup stratification. To control confounding factors and explore the effects of WeChat participation as a mediating variable between perioperative patient education and overall satisfaction, hierarchical regression was utilized. An interpatient interaction model was found in the community group chat, and it contributed to overall satisfaction. Patients in the group with more interpatient interactions were more likely to have better overall satisfaction.

Conclusions

The social media–promoted educational community using WeChat was effective among joint replacement patients. Provision of more perioperative education is associated with more active patient participation in the community and therefore more patient satisfaction in terms of the overall joint procedure. Community group chat could facilitate interactions among patients and contribute to overall satisfaction.

WeChat-based education and rehabilitation program in unprotected left main coronary artery disease patients after coronary artery bypass grafting: an effective approach in reducing anxiety, depression, loss to follow-up, and improving quality of life

This study aimed to investigate the effect of WeChat-based education and rehabilitation program (WERP) on anxiety, depression, health-related quality of life (HRQoL), major adverse cardiac/cerebrovascular events (MACCE)-free survival, and loss to follow-up rate in unprotected left main coronary artery disease (ULMCAD) patients after coronary artery bypass grafting (CABG). In this randomized controlled study, 140 ULMCAD patients who underwent CABG were randomly assigned to WERP group (n=70) or control care (CC) group (n=70). During the 12-month intervention period, anxiety and depression (using hospital anxiety and depression scale (HADS)) and HRQoL (using 12-Item Short-Form Health Survey (SF-12)) were assessed longitudinally. During the total 36-month follow-up period (12-month intervention and 24-month non-intervention periods), MACCE and loss to follow-up were recorded. During the intervention period, HADS-anxiety score at month 9 (M9) (P=0.047) and month 12 (M12) (P=0.034), anxiety rate at M12 (P=0.028), and HADS-D score at M12 (P=0.048) were all reduced in WERP group compared with CC group. As for HRQoL, SF-12 physical component summary score at M9 (P=0.020) and M12 (P=0.010) and SF-12 mental component summary score at M9 (P=0.040) and M12 (P=0.028) were all increased in WERP group compared with CC group. During the total follow-up period, WERP group displayed a trend of longer MACCE-free survival than that in CC group but without statistical significance (P=0.195). Additionally, loss to follow-up rate was attenuated in WERP group compared with CC group (P=0.033). WERP serves as an effective approach in optimizing mental health care and promoting life quality in ULMCAD patients after CABG.