Gastroenterology Nursing最新文献

Multiple primary cancers (MPCs) refer to the occurrence of 2 or more primary malignant tumors simultaneously or sequentially in different organs or regions of the body. Based on the time interval between the cancers, MPC can be classified into synchronous and metachronous types. Risk factors include environmental and lifestyle influences, such as smoking, excessive alcohol consumption, and unhealthy dietary habits. The unique nature of MPC increases the complexity of treatment and nursing care. This paper summarizes the nursing process and outcomes for a patient diagnosed with three primary cancers: gastric cancer, nasopharyngeal cancer, and liver cancer. The key nursing strategies included forming a multidisciplinary care team, focusing on antitumor drug management and post-chemotherapy bone marrow suppression care, addressing the patient's nutritional status, implementing nasopharyngeal care, providing supportive psychological interventions, and ensuring follow-up care. These measures aimed to enhance the patient's quality of life and therapeutic outcomes.

Irritable bowel syndrome (IBS) is a common functional gastrointestinal (GI) disorder that is frequently exacerbated by stress leading to a detrimental effect on the quality of life (QOL). This systematic review assessed the efficacy of cognitive behavioral therapy (CBT) as a therapeutic approach for irritable bowel syndrome (IBS), taking into account GI symptoms, psychological distress, sleep quality, and quality of life. Additionally, variables such as anxiety levels, depression, and inflammatory markers were assessed to provide a comprehensive evaluation of patient outcome. Database search from 2000 - 2023 yielded the identification and analysis of 12 research trials out of 1,703 articles. The studies varied in study design, participant demographics, CBT technique, intervention duration, and outcome measurement instruments. Despite variability, the majority of studies demonstrated a significant positive impact of CBT interventions on IBS. The quality of life, GI symptoms, psychological distress, and sleep disturbances all improved. However, inconsistencies in certain outcome measures and a paucity of long-term follow-up were observed in some studies. Our findings highlighted the potential of CBT as a valued therapeutic intervention for IBS, demonstrating significant improvements in various aspects of the condition.

Abstract: This article aims to explore the clinical characteristics and corresponding nursing points of elderly patients with massive hiatal hernia. A case study of an elderly patient with massive hiatal hernia and severe cardiopulmonary disease was reviewed, along with relevant literature. Nursing points are the following: multidisciplinary team to estimate surgical risks and develop individualized pre-rehabilitation management strategies; assessment and intervention for thrombosis and bleeding risks; postoperative hemodynamic monitoring and precise fluid management; dynamic observation of inflammatory indicators and infection prevention and care; and follow-up visits and health guidance after discharge. Hiatal hernia is common clinically, but it is rare in elderly patients with severe cardiopulmonary disease. Thorough literature review, familiarity with the characteristics of this condition in elderly patients, and proper perioperative nursing management and guidance are crucial for the successful recovery of elderly patients with massive hiatal hernia.

Health literacy is a fundamental component of today's healthcare system and self-managed healthcare. Health literacy should be considered another important vital sign and is imperative to improving adherence and patient outcomes. Assessing and improving health literacy of clinicians, patients, and caregivers in the Pancreatitis Center at a major children's hospital is a steppingstone to improve the health literacy across the organization. Surveys using a 5-point Likert scale along with free text were conducted to assess the clinician's and patient and/or caregiver's health literacy. Patients and caregivers were asked their preferred ways of learning. An education sheet about pancreatitis was developed for patients and caregivers. The focus-analyze-develop-execute cycle was utilized. Survey data were analyzed using descriptive statistics. The results were further examined by the research team to improve the educational materials needed for patients and caregivers. The education sheet had a 70% satisfaction rate by caregivers. While mildly effective, patients and caregivers prefer materials with more in-depth explanation, support groups, and youth friendly materials. Educating clinicians on the health literacy of their patients will impact patient education and satisfaction. Improving health literacy in one clinic can be replicated across ambulatory clinics globally.

Anemia is often underdiagnosed and suboptimally managed in patients with inflammatory bowel disease. The purpose of this quality improvement (QI) project was to evaluate the impact of utilizing the Crohn's and Colitis Foundation's Anemia Care Pathway on clinicians' anemia screening frequency and confidence level in anemia management. Patients' perspectives regarding anemia care and treatment methods were also evaluated. Clinicians in outpatient gastroenterology clinics of a large Pennsylvania health care system were given surveys to assess the frequency of anemia screening and their confidence level in anemia management, before and after incorporating the Anemia Care Pathway into their care for patients with inflammatory bowel disease. Patients were given anonymous surveys about anemia care and treatment modalities. The results showed a significant increase in anemia screening frequency, from once a year to twice a year (p = .008). There was also a significant increase in clinicians' confidence levels in anemia management (p = .001). Patient surveys indicated that over half of patients were unaware of how often they were screened for anemia. Utilizing the Anemia Care Pathway in inflammatory bowel disease care could positively impact patient outcomes. The results further indicate the need for better patient education on how anemia in inflammatory bowel disease is screened, managed, and treated.

Endoscopy nurses work in all phases of endoscopic procedures, guaranteeing privacy, respect for dignity, comfort, and safety by applying specific theoretical knowledge and practical skills. However, in several countries, a structured training process in this specific area is lacking. This document defines the skills and roles of nurses working in the endoscopy and gastroenterology units in Italy. The National Association of Endoscopic Technique Operators - National Association of Gastroenterology Nurses and Associates (ANOTE-ANIGEA) National Committee created a working group including 20 expert nurses and 2 physicians, divided into 4 working groups. Each group worked on one level of training: trainee endoscopy nurse, competent endoscopy nurse, advanced endoscopy nurse, and nontechnical skills. For the final declaration, the Delphi method was adopted. This position paper defined the role and training of endoscopy nurses, proposing three progressive levels of professional preparation. This is the first document aimed at defining the role and training of endoscopy nurses, suggesting progressive levels of professional preparation. It could be an appropriate tool for both nurses who are beginning to work in an endoscopic unit, as well as for all subjects involved in training nurses practicing in digestive endoscopy.

Colon cancer is a global disease that continues to increase in middle-aged adults. Although screening colonoscopies are recommended to prevent colon cancer colonoscopy rates continue to decline, notably in the middle-aged adult population. At a gastroenterology clinic in the United States, 32% of middle-aged adults were found to not be up-to-date on their screening colonoscopy exams. Reasons for this included a lack of communication secondary to patient awareness and provider failure. The purpose of this project is to improve surveillance colonoscopy rates among middle-aged adults by improving communication efforts. At a gastroenterology clinic in Southeast Alabama, an electronic chart review was used to identify middle-aged adult patients due for a screening colonoscopy. Each participant was issued two reminder phone calls and a letter. The phone call and letter alerted participants they were due for a screening colonoscopy and provided them with an opportunity to schedule the procedure. A pre-and post-chart audit was utilized to analyze completed colonoscopy rates before and after the intervention. Post-chart audit findings revealed a 60% increase in completed colonoscopy rates within three months of project completion. These results reveal that implementing a phone and mail recall is effective at increasing screening colonoscopy rates.