Gastroenterology Nursing最新文献

This randomized clinical trial was conducted with the aim of comparing the effect of self-care education through two methods, a smartphone application (app) and teach-back (TB), on lifestyle and quality of life (QoL) in patients with inflammatory bowel diseases (IBD). This three-stage randomized clinical trial was conducted among 90 patients with IBD in Mashhad, Iran. Eligible patients were allocated to three groups (app, TB, and control) using simple blocked randomization. In each group, data were collected by a demographic checklist, the Crohn's Disease and Ulcerative Colitis questionnaire, and the Miller-Smith Lifestyle questionnaire. Before the intervention, the results of one-way analysis of variance showed that there was no statistically significant difference between the three groups in terms of the mean scores of lifestyle and QoL (p > .05). However, a significant difference was observed between the three groups after the intervention (p < .05). The results of this study show that self-care education through two methods of an app and TB has a significant effect on improving IBD patients' lifestyle and QoL, and there is no significant difference between the two methods in terms of effectiveness. Considering the advantages of apps, it is suggested to apply this method for patient education.

Medication errors remain problematic when using feeding tubes for enteral nutrition and pharmacotherapy. Adverse effects, reduced medication efficacy, and toxicity are reported despite best practice guidelines. This scoping review explores interventions to reduce feeding tube-related medication errors. Thirteen trials investigated error reduction or improvements in medication preparation and administration. Eight interventions were identified: pharmacist interventions, pharmacist attending rounds, addition of standard operating procedures, pharmacist-provided education, medication information, creation of medication error reporting systems, decision flow charts, and clinical decision support systems. The results were mixed. Some studies reported high acceptance rates of pharmacist recommendations, while others did not. The rates of error reduction varied (30.8%-85.2%) and we found decreased need for dosage modification or feeding tube-related medication error due to improvements in knowledge and practice after education. Only one study reported an increase in tube occlusion due to failure to pulverize medications. Most studies were small, lacked blinding or controls, and performed measurements immediately post-intervention. There is a need for additional research.

This study investigated the current occurrence of hypoglycemia during bowel preparation of outpatients undergoing colonoscopy in endoscopy centers. A total of 399 outpatients from an eastern province of China participated in the survey. Participants' characteristics and health information, colonoscopy information questionnaire and the state-trait anxiety inventory (STAI) were used as the study tools. Terminal blood glucose was measured by trained nurses before and after colonoscopy. The results showed that the incidence of hypoglycemia during bowel preparation was 17%. Mildly coughing when eating food (odds ratio [OR] = 3.821, 95% confidence interval [CI] = 1.570-9.299, p = .003), drinking alcohol 4-6 times per week (OR = 5.776, 95% CI = 1.794-18.600, p = .003), a history of hypoglycemia (OR = 2.275, 95% CI = 1.135-4.557, p = .020), fasting time ≥ 10 h (OR = 2.933, 95% CI = 1.118-7.699, p = .029), waiting time ≥ 12 h (OR = 0.446, 95% CI = 0.226-0.879, p = .020), subjective hunger (OR = 4.742, 95% CI = 2.255-9.972, p < .001), and STAI score (OR = 1.051, 95% CI = 1.012-1.090, p < .001), were the influencing factors of hypoglycemia in outpatients. It is suggested that clinical staff in endoscopy centers should identify the above risk factors as soon as possible, and conduct timely intervention to prevent hypoglycemia and avoid more serious consequences.

This qualitative study aimed to analyze the experiences and needs of colorectal cancer patients undergoing chemotherapy during the diagnosis and treatment process. Purposeful sampling was used in the study, and 15 colorectal cancer patients undergoing chemotherapy were included. Data were collected through face-to-face interviews using a semi-structured interview form and analyzed using Colaizzi's seven-stage method. In the study, 5 themes and 10 subthemes emerged that reflect the experiences and needs of individuals diagnosed with colorectal cancer. The main themes were: facing off cancer, navigating symptom challenges, navigating challenges beyond health, uncertain future full of fears, and finding strength in adversity. The study provided a comprehensive overview of the emotional, physical, psychological, social, and financial challenges encountered during the treatment process, as well as the coping methods, support systems, and needs of patients. The findings reveal that colorectal cancer patients have numerous ongoing needs including physical, emotional, psychological, spiritual, and financial support. The results emphasize that healthcare professionals need to take more initiative to improve colorectal cancer patients' quality of life and care processes.

Hepatolenticular degeneration (HLD), also known as Wilson's disease, is an autosomal recessive disorder of copper metabolism caused by mutations in the ATP7B gene. Due to defective copper excretion in the liver, excess copper accumulates in tissues such as the liver, brain, kidneys, and corneas. Clinically, this manifests as liver dysfunction, motor disturbances, psychiatric symptoms, and damage to the kidneys and eyes. Liver transplantation, by replacing the diseased liver with a healthy donor liver, addresses the underlying genetic defect, disrupting the cycle of copper accumulation and systemic damage, and is currently the only curative treatment for the disease. This case report discusses a 17-year-old male diagnosed with HLD for one year who developed severe liver failure and underwent emergency liver transplantation. The patient's critical condition meant that the comprehensiveness and effectiveness of postoperative nursing care were crucial to his outcome. This case study utilized a core Nursing Outcomes Classification system for liver transplantation, previously developed through research, and achieved satisfactory results based on the actual data from the patient.

To prepare patients' families for active care roles after discharge, a family involvement program was developed. We aimed to gain in-depth insight into patients' well-being and experience during the program regarding the active involvement of family caregivers after oncological gastrointestinal cancer surgery during their hospital stay. Semi-structured interviews were conducted with 13 patients who participated in the program. Patients emphasized that participation in the program gave them a sense of feeling at home. They reported that having a family caregiver on their side during hospitalization strengthened their existing relationship and contributed to their recovery by motivating them. Patients felt safer and more confident. Although patients described predominantly positive results, they also mentioned that unclear guidance from nurses made them feel less safe, especially when they saw their family caregivers struggling. Patients experience being accompanied and cared for by their family caregivers as meaningful and contributory to their recovery. Patients felt safer, more confident, and more relaxed.