Gastroenterology Nursing最新文献

Among adults with inflammatory bowel disease (IBD), self-reported sleep disturbances are associated with active symptoms, but the association between sleep measures and endoscopic disease activity is unknown. This study aimed to (1) compare sleep-wake behaviors among IBD patients based on endoscopic and clinical disease activity and (2) describe associations between actigraphy, self-reported sleep measures, and symptoms of fatigue, anxiety, and depression. Participants wore a wrist actigraph for 10 consecutive days and completed self-reported sleep questionnaires (Pittsburgh Sleep Quality Index [PSQI] and Patient-Reported Outcome Measures System [PROMIS] Sleep Disturbance and Sleep Interference questionnaires). Clinical and endoscopic disease activity were assessed. Based on actigraphic recordings ( n = 26), average total nighttime sleep was 437 minutes and sleep efficiency was 84%. Objective sleep measures did not differ based on endoscopic or clinical disease activity. Individuals with active clinical disease had higher PROMIS Sleep Disturbance (57.3 vs. 49.7, d = 1.28) and PROMIS Sleep-Related Impairment (58.1 vs. 52.8, d = 0.51) compared with those with inactive clinical disease. Self-reported sleep was significantly associated with anxiety, depression, and fatigue. Further research is needed to better characterize the relationship between sleep and endoscopic disease activity, and determine underlying mechanisms related to poor sleep in the IBD population.

This study is a randomized comparative trial designed to determine the effects of reflexology and abdominal massage on the improvement of constipation and quality of life of older persons. Participants were randomized to the reflexology group ( n = 50) or abdominal massage group ( n = 50). Data were collected by using a descriptive information form, the Standardized Mini-Mental Test (SMMT), the Katz Daily Life Activity Scale (Katz ADL), the Constipation Severity Scale (CSS), and the Constipation Quality of Life Questionnaire (CQOLQ). The comparison of the mean scores of participants from the total CSS and the total CQOLQ before and after reflexology and abdominal massage application indicated that the mean post-intervention scores on the total CSS and the total CQOLQ decreased significantly compared with preintervention scores ( p < .05). When the mean scores of the reflexology and abdominal massage groups for the total CSS and the total CQOLQ were compared, there was no significant difference between the groups ( p < .05). Both interventions improved the constipation problem of these older persons and their quality of life. The effects of both reflexology and abdominal massage were similar in improving constipation and quality of life in older persons.

Advanced gastrointestinal endoscopy includes a group of specialized procedures and interventions that are being performed more frequently, with little attention given to a patient's preprocedural anxiety issues. Compounding this concern, in 2020 the COVID-19 pandemic resulted in the delay of many endoscopy cases. It is unknown how this affected the anxiety of patients preparing for advanced endoscopy procedures. Patients with higher anxiety require higher doses of anesthetic medications, and experience increased pain and decreased satisfaction. The purpose of this study was to describe the biological, psychological, and social attributes of patients and identify whether social support, COVID-19-related anxiety, delay of procedure, patient's physical status, and procedural indication category were predictors of state anxiety levels in patients undergoing advanced gastrointestinal endoscopy during the COVID-19 pandemic. The research study was a cross-sectional descriptive design with 90 patients. Patients were classified into low state and high state anxiety groups. Fifty-eight percent of patients had high state anxiety scores. Using logistic regression, social support was identified as a predictor of preprocedural anxiety (odds ratio [OR] = 0.318 [95% confidence interval, CI = 0.170, 0.597, p < .001]) as less social support was associated with higher anxiety. It is imperative that strategies to maximize social support are reinforced.

Early-onset colorectal cancer prompted organizations to reduce the recommended screening initiation age from 50 to 45 years. The American Society for Gastrointestinal Endoscopy Quality Assurance in Endoscopy Committee recommends 3 priority quality indicators for colonoscopy services. The adenoma detection rate is considered the most important measure with the established benchmark based upon studies of patients 50 years or older. The incidence of polyps increases with age, so this change has an as-yet-unknown effect on the new benchmark. Five studies were reviewed. Based upon the results, 45- to 50-year-old patients should be included in facilities' adenoma detection rate calculations using the currently recommended benchmarks of 25% for women and men combined, or 20% for women and 30% for men when the genders are calculated separately. Males consistently had more adenomas than females in each of the 3 studies that separated genders, a detail that might merit gender-based adenoma detection rate determinations in some practices. One study indicated caution is advised; it recommends males and females be calculated separately and different benchmarks be used for each gender. The adenoma detection rate has been shown to increase over time. More studies are needed to guide screening quality metrics.

Upper gastrointestinal bleeding is a common medical emergency that requires prompt diagnosis and intervention. Patients may be hemodynamically stable or unstable depending on bleeding severity and vital signs. Immediate resuscitation and timely diagnosis are paramount to reducing mortality in this extremely vulnerable patient population. Upper gastrointestinal bleeding can be classified into two categories: variceal bleeding and nonvariceal bleeding, both of which can be life-threatening. This article aids bedside practitioners in understanding the pathogenesis of an upper gastrointestinal bleed to identify potential diagnoses. Furthermore, to ensure the proper diagnostic tests are prescribed, the algorithm provides guidance on collecting a pertinent medical history, discusses common presenting symptoms, and identifies the top risk factors for several disease processes that might present as an upper gastrointestinal bleed. A diagnostic algorithm that includes a myriad of the most common differential diagnoses of an upper gastrointestinal bleed is presented as a tool for bedside clinicians to utilize when encountering this serious gastrointestinal phenomenon.

Endoscopy staff suffer work-related musculoskeletal disorders at a rate greater than or comparable to nurses and technicians in other subspecialities, which may be attributable to the widespread use of manual pressure and repositioning during colonoscopy. In addition to negatively impacting staff health and job performance, colonoscopy-related musculoskeletal disorder injuries may also signal potential risks to patient safety. To assess the prevalence of staff injury and perceived patient harm relating to the use of manual pressure and repositioning techniques during colonoscopy, 185 attendees of a recent national meeting of the Society of Gastroenterology Nurses and Associates were asked to recall experiencing injuries to themselves or observing injuries to other staff or patients during colonoscopy. A majority of respondents (84.9%, n = 157) reported either experiencing or observing staff injury, whereas 25.9% ( n = 48) reported observing patient complications. Among respondents who perform manual repositioning and apply manual pressure during colonoscopy (57.3%, n = 106), 85.8% ( n = 91) reported experiencing musculoskeletal disorders from performing these tasks; 81.1% ( n = 150) reported no awareness of colonoscopy-specific ergonomics policies at their facility. Results highlight the relationship between the physical job requirements of endoscopy nurses and technicians, staff musculoskeletal disorders, and patient complications, and suggest that implementation of staff safety protocols may benefit patients as well as endoscopy staff.

The purpose of this study was to determine the effect of lavender oil inhalation on the anxiety and comfort levels of patients scheduled for colonoscopy. Seventy-three experimental group patients scheduled for colonoscopy at a training and research hospital in the west of Turkey in June to September 2022 and 72 control group patients were included in this randomized, controlled, prospective study. Minimal sedation (propofol 2-3 mg/kg) was applied in both groups. Lavender inhalation was applied to the experimental group, whereas the control group patients received nursing care (vital sign monitoring, prevention of complications, and rest). The State-Trait Anxiety Inventory and the Shortened General Comfort Questionnaire were used for pre- and postprocedural data collection. Median ages were 53.00 years (47.25-59.00) in the experimental group patients and 51.00 (44.00-59.5) in the control group. Although postprocedural state anxiety scores were lower in the experimental group compared with the control group, the difference was not statistically significant ( p = .069). The general postcolonoscopy comfort score was significantly higher in the experimental group compared with the control group ( p < .001). Trait anxiety scores also increased as the number of colonoscopies increased in both groups. We conclude that lavender oil inhalation, a simple and inexpensive intervention, increases patient comfort while exhibiting a positive, albeit statistically insignificant, effect on anxiety.