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[Knowledge and attitudes of health workers' hands hygiene during Covid-19's pandemic: an observational study]. [Covid-19大流行期间卫生工作者的手卫生知识和态度:一项观察性研究]。
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.7429/pi.2021.744205
M. Y. Tolentino Diaz, Marzia Lommi, B. Raffaele, Graziella Montini, M. Cava, C. Lupo, Maurizio Tana, Barbara Porcelli
INTRODUCTION the infections correlated to the assistance represent the most common adverse events and sets up a world public sanity problem. Preventative behaviour, such as proper hand hygiene, are based on the knowledge and attitudes of care staff. Valuing health workers' knowledge and attitudes becomes fundamental for the individuation of any cognitive gaps. METHODS a cross sectional study has been conducted in a healthcare authority, during the first lockdown of Covid-19 pandemic. The knowledge's' data have been collected using the World Health Organization's Hand Hygiene Knowledge Questionnaire in its italian version and, for exploring attitudes, questions have been created on the basis of scientific literature. RESULTS a sample of 363 healthcare workers was enrolled in this study. The 60% of respondent showed a sufficient level and 26.3% were at a good level of knowledge and all the personnel present good attitudes. There has been found an association between knowledge, gender and work area and between attitude, work area and presence of the alcoholic product in the structure. CONCLUSIONS healthcare workers showed a knowledge level from sufficient to good, and positive attitudes towards hands hygiene. There still remains some cognitive gaps that have to be fixed with formative courses for prevent infections according to the principles of the patient safety program "Clinic Care in Safer Care" of the World Health Organization.
与援助相关的感染是最常见的不良事件,并造成了一个世界性的公共卫生问题。适当的手部卫生等预防行为是基于护理人员的知识和态度。重视卫生工作者的知识和态度对于个性化任何认知差距至关重要。方法在Covid-19大流行的第一次封锁期间,在医疗保健机构进行了一项横断面研究。这些知识的数据是使用世界卫生组织的意大利语版《手部卫生知识调查表》收集的,为了探索人们的态度,在科学文献的基础上提出了问题。结果共纳入363名医护人员。60%的受访者表示有足够的知识水平,26.3%的受访者表示有良好的知识水平,所有人员都表现出良好的态度。已经发现知识、性别和工作区域之间以及态度、工作区域和结构中酒精产品的存在之间存在关联。结论卫生工作者对手卫生的认识程度由充分到良好,态度积极。仍然存在一些认知上的差距,必须根据世界卫生组织病人安全方案“更安全护理中的诊所护理”的原则,通过预防感染的形成性课程加以弥补。
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引用次数: 0
Sexual and reproductive health in adolescents: validation of the questionnaire SexContraKnow instrument in Italian. 青少年的性健康和生殖健康:意大利语SexContraKnow问卷的验证。
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.7429/pi.2021.744271a
V. Rossi, F. Napolitano
BACKGROUND Adolescents have an inadequate level of health literacy, particularly regarding sexual and reproductive health and the use of birth control methods. This contributes to a high percentage of unintentional pregnancies and sexual behaviors that endanger the entire population. AIM The purpose of this study is to validate the questionnaire, Sexcontraknow Instrument, in Italian, in order to evaluate the health literacy of adolescents, aged 14 to 19, regarding sexual and reproductive health, particularly on the use of contraceptive methods. METHODS This is a quantitative research study that aims to validate a knowledge tool on sexual and reproductive health in the adolescent population. RESULTS The Sexcontraknow Instrument questionnaire has been translated according to the process indicated by the EORTC Quality of Life Group validation criteria. The linguistic validation of the questionnaire in Italian was carried out using the forward-backward translation method. The content validity process was carried out by a group of 9 experts in the area of sexual education addressed to the study population, such as: doctors, midwives, gynecologists, teachers and health assistants. The face validity process, however, was carried out with a sample of convenience made up of 12 students aged 14 to 19 years, homogeneous in the gender. CONCLUSIONS The SexContraKnow Instrument questionnaire has been transalated in Italiana and face and content validity has been performed. NURSING IMPLICATIONS Having a tool that help evaluate the knowledge of young people, aids the nurse in preparing and making up for shortcomings through proper education, reducing the negative effects of poor literacy.
背景:青少年的卫生知识水平不足,特别是在性健康和生殖健康以及使用节育方法方面。这导致了高比例的意外怀孕和危及整个人口的性行为。目的:本研究的目的是验证意大利语的Sexcontraknow问卷,以评估14至19岁青少年在性健康和生殖健康方面,特别是在使用避孕方法方面的健康素养。方法本研究是一项定量研究,旨在验证青少年性健康和生殖健康知识工具的有效性。结果Sexcontraknow问卷已按照EORTC生活质量组验证标准的流程进行翻译。意大利语问卷的语言验证采用正向倒译法进行。内容效度过程是由针对研究对象的性教育领域的9名专家组成的小组进行的,这些专家包括:医生、助产士、妇科医生、教师和保健助理。然而,面部效度过程是在一个方便的样本中进行的,该样本由12名年龄在14至19岁之间的学生组成,性别相同。结论《性行为认知量表》问卷已翻译成意大利语,并进行了面效度和内容效度验证。护理意义这是一种有助于评估年轻人知识的工具,有助于护士通过适当的教育做好准备并弥补不足,减少读写能力低下的负面影响。
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引用次数: 0
Can a user-friendly system improve reporting of workplace violence towards emergency nurses? Findings of a multicenter study. 用户友好型系统能否改善对急诊护士的工作场所暴力报告?多中心研究的结果。
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.7429/pi.2021.744261b
N. Ramacciati, A. Guazzini, R. Caldelli, L. Rasero
BACKGROUND Nurses, particularly emergency nurses, are among the health workers most exposed to workplace violence (WPV). Despite WPV recording systems are becoming more common, the under-reporting is still widespread. Studies suggest that the use of simple and easy registration systems could facilitate the reporting of violent events. AIM To verify if a friendly reporting system based on a Mobile-app can facilitate the WPV reporting. METHODS The University of Florence has developed an application for Android and iOs to report incidents of violence towards emergency nurses. Started from 5 February 2018 and ended on 17 March 2019 in 20 Italian emergency departments, our 6-month study involved the participation of 386 nurses enabled to use this mobile app. RESULTS 189 participants answered the questionnaire at the beginning (time T0) and at the end (time T1) of the trial period. The questionnaire item about the frequency of reporting of violent events in the last 6 months was scored: 1 for "Yes, all", 2 for "Yes, some", 3 for "No, only informally", and 4 for "No, not at all". The answers obtained the following arithmetic mean values (M), standard deviation (SD) at time T0 and T1, respectively M = 2.65, SD = 0.972, and M = 2.26, SD = 0.864. The result of the Paired Samples t-Test returned a t=3.614, df= 99 CONCLUSIONS: This result indicates a statistically significant difference in the change in the propensity to report, even if for small values. NURSING IMPLICATIONS The technology cannot solve the problem of underreporting alone. To solve this problem it is necessary to act on several front.
背景护士,特别是急诊护士,是最容易遭受工作场所暴力的卫生工作者之一。尽管WPV记录系统正变得越来越普遍,但低报现象仍然普遍存在。研究表明,使用简单易行的登记系统可以促进暴力事件的报告。目的验证基于移动应用程序的友好报告系统是否可以促进WPV报告。方法佛罗伦萨大学开发了一款Android和iOs应用程序,用于报告针对急诊护士的暴力事件。从2018年2月5日开始到2019年3月17日结束,我们在20个意大利急诊科进行了为期6个月的研究,涉及386名能够使用该移动应用程序的护士。结果189名参与者在试验开始(时间T0)和结束(时间T1)时回答了问卷。对近6个月暴力事件的报告频率进行打分:“有,全部”为1分,“有,部分”为2分,“没有,只是非正式地”为3分,“没有,根本没有”为4分。得到T0和T1时刻的算术平均值(M)和标准差(SD),分别为M = 2.65, SD = 0.972和M = 2.26, SD = 0.864。配对样本t检验的结果为t=3.614, df= 99。结论:该结果表明,即使数值很小,报告倾向的变化也具有统计学意义。护理意义单靠这项技术并不能解决漏报的问题。要解决这个问题,有必要在几个方面采取行动。
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引用次数: 0
[The professional skills of the nurse involved in the care of individuals with sexually transmitted infections]. [护理性传播疾病患者的护士的专业技能]。
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.7429/pi.2021.744241
B. Suligoi, A. Luzi, M. Salfa, Giuseppe Esposito
INTRODUCTION Accurate pain assessment and management in critically ill patients withcognitive alterations who are unable to communicate constitute a major challenge for themedical and nursing staff of Intensive Care Units (ICUs). This study want assess the impact of Critical Care Pain Observation Tool (CCPOT) scale in ICU practice and evaluate the effects on pain assessment and management in brain-injured critically ill adult patients. METHODS This before-and-after study was carried out in an Italian ICU, where data were collected before (T0) and after (T1) implementation of the CCPOT in brain-injured critically ill adults. RESULTS The study population consisted of 81 patients (35 before and 46 after intervention). The use of propofol fell significantly (propofol: t(80) = 1.83) and at the same time the use of morphine increase significantly (morphine: t(80) = 1.51) after intervention.Analysis of the data with respect to pain relief and prevention during some nursing care activities revealed a significant increase in the use of fentanyl citrate (x2(1)= 4.04, p =.04) and paracetamol (x2(1)= 5.30, p =.02). Pain management was in line with the protocol, which envisaged administration of pain medications to patients with CCPOT scores > 3 in 76.8% of cases. CONCLUSION The present findings strongly support the value of the CCPOT scale in managing ICU patient pain in conjunction with medical and nursing staff training. However, further studies of larger patient samples should be performed.
对认知改变且无法沟通的危重患者进行准确的疼痛评估和管理是重症监护病房(icu)医护人员面临的主要挑战。本研究旨在评估重症监护疼痛观察工具(CCPOT)量表在ICU实践中的作用,并评估其对脑损伤成人危重患者疼痛评估和管理的影响。方法在意大利一家ICU进行了前后对比研究,收集了脑损伤危重症成人实施CCPOT前(T0)和后(T1)的数据。结果81例患者(干预前35例,干预后46例)。干预后异丙酚的使用明显下降(异丙酚:t(80) = 1.83),同时吗啡的使用明显增加(吗啡:t(80) = 1.51)。对部分护理活动中缓解和预防疼痛的数据进行分析,发现枸橼酸芬太尼(x2(1)= 4.04, p =.04)和扑热息痛(x2(1)= 5.30, p =.02)的使用显著增加。疼痛管理与方案一致,76.8%的CCPOT评分为bb0 - 3的患者设想给予止痛药治疗。结论本研究结果有力地支持CCPOT量表在管理ICU患者疼痛以及医护人员培训方面的价值。然而,应该对更大的患者样本进行进一步的研究。
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引用次数: 0
[The image of the nurse in the first phase of Covid-19 sanitary emergency in Italy: a Content Analysis of national and local newspapers]. [意大利Covid-19卫生突发事件第一阶段护士形象:国家和地方报纸内容分析]。
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.7429/pi.2021.741031
Stefano Giorgetta, Laura Pasquot

Background: Media play a key part in shaping nurses' social perception. Newspapers were chosen as the subject of this content analysis, as they are the main resource that Italians use to inform themselves. For this reason, ne wspapers are an appropriate resource to analyse the image of the nurse that, as found in literature, is seen as a dynamic phenomenon that changes according to different scenarios. Given the media focus on nurses during COVID- 19 it seems reasonable to analyse what nurse image was emerged.

Method: A Content Analysis with an inductive process was conducted. The analysis' objective was to evaluate the image of the nurse in national and local newspapers, published between the 30th of January and the 18th of May 2020. A triangulation methodology was used between the two researchers to ensure data quality.

R esults: Five themes were identified. The risks for the nurse's psycho-physic wellbeing. Taking responsibility and human relations despite barriers. The acknowledgment of professional attributes. Uncertainty on the continuity of the nurses' social role emerged from the media. Nurses only wish to be appreciated for what they do. The agreement between the researchers on the themes has a Krippendor ff 's alpha between =0.713 and =0.985.

Conclusions: The media's interest highlighted the nurses' competence in assisting patients with COVID-19. However, there isn't in-depth analysis, of the contemporar y image of the nurse, specifically in relation to leadership. Positive and negative tropes are recalled. The superficiality and fragility of the mediatic phenomena emerged, as opposed to a real positive strengthening of the nurse's social perception.

背景:媒体在护士社会认知的形成中起着关键作用。报纸被选为内容分析的主题,因为它们是意大利人获取信息的主要资源。因此,报纸是分析护士形象的合适资源,正如在文献中发现的那样,护士形象被视为一种动态现象,根据不同的情况而变化。鉴于媒体在COVID- 19期间对护士的关注,分析出现的护士形象似乎是合理的。方法:采用归纳法进行含量分析。该分析的目的是评估2020年1月30日至5月18日期间出版的国家和地方报纸上护士的形象。在两位研究者之间使用三角测量方法来确保数据质量。R结果:确定了五个主题。对护士身心健康的风险。不计障碍地承担责任和人际关系。对职业属性的承认。对护士社会角色连续性的不确定性从媒体中浮现。护士只希望自己所做的工作得到赞赏。研究人员在主题上的一致性在=0.713 ~ =0.985之间。结论:媒体的关注突出了护士协助COVID-19患者的能力。然而,并没有深入分析当代护士的形象,特别是与领导能力有关的形象。积极和消极的比喻被回忆起来。媒介现象的肤浅和脆弱出现了,而不是真正积极地加强护士的社会认知。
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引用次数: 4
[Palliative rehabilitation interventions in palliative care: a scoping review]. [姑息治疗中的姑息康复干预:范围回顾]。
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.7429/pi.2021.741055
Vitor Parola, Adriana Coelho, Hugo Neves, João Teixeira, Andreia Lima, Jorge Ferreira, Arménio Cruz

Background: Palliative rehabilitation is defined as the process of helping a person with a progressive, commonly advanced, and/or incurable disease reach their physical, psychological, and social potential consistent with physiological and environmental limitations and life preferences. However, the evidence on this subject is dispersed in the literature.

Objective: To examine and map interventions of palliative rehabilitation, implemented and evaluated in palliative care.

Methodology: A scoping review, using the Joanna Briggs Institute's guideline, was conducted. Multiple databases were searched: CINAHL Complete; PubMed; Scopus; SciELO; Cochrane Central Register of Controlled Trials; PEDro, as well as grey literature for studies that focus on qualified healthcare professionals caring for patients 18 years of age or older, working in palliative care, that focus on the concepts of palliative rehabilitation interventions.

Results: Of the 314 studies retrieved, two were included in this review. Both were conducted with physiotherapists, and none mentioned nursing rehabilitation. One of the studies implemented and evaluated an intervention of exclusively physical domain and another of physical and emotional domain. The interventions still differ in the number of treatments which ranged from 4 to 7 sessions. Both studies were implemented in oncological and non-oncological patients.

Conclusion: Further research is needed to explore the rehabilitation strategies used by healthcare professionals working in palliative care that help patients. Moreover, since nurses are often the healthcare professionals who are in closest proximity to, and who spend the most time with, the patient, which rehabilitation interventions do these professionals should be focus of intervention.

背景:姑息康复被定义为帮助患有进行性、通常是晚期和/或无法治愈的疾病的人在生理和环境限制以及生活偏好的情况下达到他们的生理、心理和社会潜力的过程。然而,关于这个问题的证据在文献中是分散的。目的:探讨姑息治疗康复的干预措施,以及在姑息治疗中的实施和评价。方法:使用乔安娜布里格斯研究所的指导方针,进行了范围审查。检索多个数据库:CINAHL Complete;PubMed;斯高帕斯;收录了;Cochrane中央对照试验登记册;PEDro,以及灰色文献的研究,这些研究关注的是护理18岁或以上患者的合格医疗保健专业人员,从事姑息治疗,关注姑息康复干预的概念。结果:在检索到的314项研究中,有2项纳入了本综述。两者均由物理治疗师进行,均未提及护理康复。其中一项研究实施并评估了一种纯物理领域的干预和另一种物理和情感领域的干预。干预措施在治疗次数上仍然不同,从4到7个疗程不等。两项研究均在肿瘤和非肿瘤患者中进行。结论:需要进一步的研究来探讨医护人员在姑息治疗中使用的康复策略对患者的帮助。此外,由于护士通常是最接近患者的医疗保健专业人员,并且他们与患者相处的时间最多,因此康复干预措施应该将这些专业人员作为干预的重点。
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引用次数: 0
[Assessment of the perceived quality of nursing care in internship departments: an observational study in a Spanish reality]. [实习科室护理感知质量评估:西班牙现实的观察性研究]。
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.7429/pi.2021.741048
Alessandro Delli Poggi, Giulia Pintus, Josè Munsuri Rosado, Carles Saus-Ortega, Manuela Batta, Emanuele Brai, Daniela Tartaglini

Background: Nursing students represent an important resource both for the patients and for the company organization; however, the impact of their presence on the quality of care is still underestimated.

Objective: To provide an objective assessment of the quality of care perceived by the patient admitted to hospital departments where internships are held for nursing students.

Method: A descriptive observational study was conducted, recruiting a convenience sample made up of patients hospitalized in clinical departments where internships for nursing students of La Fe Hospital in Valencia (ES) are located.

Results: 75 patients out of 160 hospitalized partecipated to the survey, with a response rate equal to 46.87%. Most patients believe that nurses have careless attitudes towards them (42.9%) even though there is a noticeable emotional support from nurses perceived by patients (90.1%). The degree of relationship and information perceived by patients (96%) suggests that nurses in most cases guaranteed confidentiality and the assistance time employed (70.5%) was perceived as longer than usual, defining a high opinion of patients about the treatment received.

Conclusions: The data showed that patients were very keen to be taken into consideration from a social and human point of view and not only from a clinical point of view, so much so that they claimed to perceive a careless attitude from nurses. Despite this, however, the perceived quality of nursing care by the patient was not affected. Regarding the presence of the trainee student, being the latter in the Spanish reality totally flanked by that of the nurse, almost in symbiosis, the degree of attention perceived by the patient in relation to the assistance provided does not vary.

背景:护生是患者和公司组织的重要资源;然而,他们的存在对护理质量的影响仍然被低估了。目的:为护理专业学生实习科室住院患者对护理质量的感知提供客观评价。方法:采用描述性观察性研究,选取瓦伦西亚La Fe医院(ES)护生实习所在临床科室住院患者作为方便样本。结果:160例住院患者中有75例参与调查,有效率为46.87%。大多数患者认为护士对他们态度粗心(42.9%),尽管患者认为护士对他们有明显的情感支持(90.1%)。患者感知的关系和信息程度(96%)表明,在大多数情况下,护士保证保密,所雇用的协助时间(70.5%)被认为比平时更长,这表明患者对所接受的治疗有很高的评价。结论:数据显示,患者非常渴望从社会和人类的角度考虑,而不仅仅是从临床的角度考虑,以至于他们声称感觉到护士的粗心态度。然而,尽管如此,患者对护理质量的感知并未受到影响。关于实习学生的存在,后者在西班牙现实中完全被护士包围,几乎是共生的,病人所感受到的与所提供的援助有关的关注程度并没有变化。
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引用次数: 0
[Nurses and their courage during COVID-19]. [护士和她们在COVID-19期间的勇气]。
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.7429/pi.2021.741002
Luigi Apuzzo, Gennaro Apuzzo, Tiziana Immacolata Licciardi, Maddalena Iodice
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引用次数: 0
[COVID 19: Nursing Leadership and innovations on the field to face the pandemic]. [COVID - 19:面对大流行的护理领导力和创新]。
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.7429/pi.2021.741021
Gabriella Costamagna, Nicoletta Dasso, Giulia Ottonello, Milko Zanini, Gianluca Catania, Loredana Sasso, Annamaria Bagnasco

Introduction: In the Italian and European literature there are still few studies describing the impact of the COVID-19 pandemic on the organization of nursing care in hospitals, on the actions taken by nursing leaders to contain it, and on the outcomes of these interventions.

Aim: To describe nursing leaders' experiences with reorganizing healthcare pathways, through management data and personal accounts.

Methods: A retrospective quali-quantitative observational study was conducted at the Mauriziano Hospital in Turin, with 484 beds and over 1,700 workers. Quantitative data were analyzed through descriptive statistical indices and integrated with qualitative data collected through semi-structured telephone interviews. The analysis of the quantitative and qualitative data provided an objective and experiential representation of the implemented interventions.

Results: We described the impact of interventions introduced by the nursing leadership during the pandemic on hospital services. In particular, the reorganization of the emergency department and of the prevention and psychological support services for the hospital's health workers. In addition, specific initiatives to support the discharge of COVID-19 positive patients, and to support and manage contacts with family members both during the hospitalization of their loved ones and following death are described.

Discussion and conclusion: This study contributes to the discussion on some crucial issues: the increasingly clear relationship between adequate staffing and safety of patients and professionals, the importance of a good working environment and a solid leadership, the importance of continuing education for professionals and adequate skill mixes; all highlighted by the pandemic.

导言:在意大利和欧洲的文献中,仍然很少有研究描述COVID-19大流行对医院护理组织的影响,对护理领导采取的遏制行动的影响,以及对这些干预措施的结果。目的:通过管理数据和个人账户描述护理领导者重组医疗路径的经验。方法:在都灵Mauriziano医院进行回顾性定性定量观察研究,该医院有484张床位,1700多名工作人员。定量数据通过描述性统计指标进行分析,并与半结构化电话访谈收集的定性数据相结合。定量和定性数据的分析提供了实施干预措施的客观和经验代表。结果:我们描述了大流行期间护理领导引入的干预措施对医院服务的影响。特别是重组急诊科以及医院保健工作者的预防和心理支持服务。此外,还介绍了支持COVID-19阳性患者出院的具体举措,以及在亲人住院期间和死亡后支持和管理与家人接触的具体举措。讨论和结论:本研究有助于对一些关键问题的讨论:适当的人员配备与患者和专业人员安全之间日益明确的关系,良好的工作环境和坚实的领导的重要性,专业人员继续教育和适当技能组合的重要性;大流行凸显了这一切。
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引用次数: 0
Nursing management and prevention of malnutrition in the patient with head-neck cancer. 头颈癌患者营养不良的护理管理与预防。
Q3 Medicine Pub Date : 2021-01-01 DOI: 10.7429/pi.2021.744269a
Francesca Mantero
BACKGROUND The nursing record is often devoid of tools for nutritional evaluation: detection of signs and symptoms, nutritional screening such as the Malnutrition Universal Screening Tool (MUST) and the Mini Nutritional Assessment (MNA), anthropometric parameters: such as weight; with these tools. Therefore, it is possible to frame the patient according to his nutritional status and establish the most appropriate care path. Inappropriate documentation can create a negative nutritional spiral that carries an increased risk of serious health-related complications. It also hinders follow-up. In the literature it emerges the importance of using dysphagia screening and nutritional status assessment, these must be introduced into the hospital routine to avoid the damage caused by dysphagia and malnutrition. The literature shows how nutritional risk affects the increase in mortality, morbidity, days of hospitalization and re-admission to hospital one year after discharge. Malnourished patients had a longer hospital stay than normally fed patients, used more drugs and underwent more diagnostic tests and finally greater mortality. Malnutrition, to treat it appropriately, would be enough to be detected with simple screening tools. AIM This study aimed to estimate the prevalence of hypoalbuminemia in hospidalized elders before treatment for free flap plastic surgery after intervention for head-neck cancer, their nutritional status and lenght of stay. METHODS Retrospective observational study with 28 patients with head and neck cancer who underwent free flap recostruction in hospital at the Galliera Hospital Genoa during two years from Jenuary 2017 to December 2018. Clinical and surgical procedure-related factors were retrieved from a database and analyzed. RESULTS 28 patients ( 19 men, 9 women) were included in this study. The mean age of the study population was 61 years (range, 18 to 80 yr). The mean BMI was 23.30 kg/m2 ( range, 17.53 to 30.9 kg/m2). The mean lenght of stay was 35 days ( range, 11 to 122 days). The mean of the level albumin was 3.34 g/dl ( range, 2.1 to 4.5 g/dl). One surgical mortality was noted. The data emerged from the survey report the values of albumin and lymphocytes decreasing compared to the entrance, an extremely significant figure is also that of the days of hospitalization, which almost double in presence of one or more complications. The comparison between the average value of the days of stay of the stitches in patients without complications and the mean value of the days of stay of sutures in patients with complications, with a percentage deviation of 51.96%. The difference in patients with a lower incoming plasma albumin level compared to the group with normal levels allowed comparative analyses with respect to outcomes. 13 patients demonstrated albuminemia levels below the threshold of normal input, 15 adequate levels. The 13 patients with different albumenemic libellus developed site infection with an increase in a
背景:护理记录往往缺乏营养评估工具:体征和症状的检测,营养筛查,如营养不良普遍筛查工具(MUST)和迷你营养评估(MNA),人体测量参数:如体重;有了这些工具。因此,可以根据患者的营养状况来制定患者的框架,并建立最合适的护理路径。不恰当的记录会造成不良的营养循环,增加严重健康相关并发症的风险。这也阻碍了后续行动。在文献中出现了使用吞咽困难筛查和营养状况评估的重要性,这些必须引入医院常规,以避免吞咽困难和营养不良造成的损害。文献显示营养风险如何影响死亡率、发病率、住院天数和出院后一年再次住院的增加。营养不良的患者比正常饮食的患者住院时间更长,使用更多的药物,接受更多的诊断测试,最终导致更高的死亡率。如果对营养不良进行适当的治疗,用简单的筛查工具就足以发现营养不良。目的本研究旨在了解老年人头颈癌干预后行游离皮瓣整形术前低白蛋白血症的发生率、营养状况及住院时间。方法回顾性观察分析2017年1月至2018年12月在热那亚Galliera医院行游离皮瓣重建的28例头颈癌患者。从数据库中检索临床和手术相关因素并进行分析。结果28例患者(男19例,女9例)纳入本研究。研究人群的平均年龄为61岁(18至80岁)。平均BMI为23.30 kg/m2(范围为17.53 ~ 30.9 kg/m2)。平均住院时间为35天(11 ~ 122天)。白蛋白水平平均值为3.34 g/dl(范围为2.1 ~ 4.5 g/dl)。注意到一例手术死亡率。从调查报告中得出的数据显示,白蛋白和淋巴细胞的值与入口处相比有所下降,住院天数也有非常显著的数字,如果出现一种或多种并发症,住院天数几乎翻了一番。无并发症患者缝线停留天数平均值与有并发症患者缝线停留天数平均值的比较,偏差百分比为51.96%。血浆白蛋白水平较低的患者与正常血浆白蛋白水平组的差异允许对结果进行比较分析。13例患者表现为白蛋白血症水平低于正常输入阈值,15例表现为正常水平。13例不同白蛋白血症患者发生部位感染,平均住院天数49.92天(st.dev 26.26)比其他组平均22.80天(st.dev 10.50)增加,差异有统计学意义,双尾P值= 0.0011;两组患者的缝合时间也存在差异,平均为45.77天(st.dev 20.31),而另一组平均为23.80天(st.dev 6.20)。双尾P值= 0.0003。结论:低白蛋白血症的患病率与营养状况和住院时间有关。因此,建议监测白蛋白水平,以评估患者在住院期间发生营养不良和其他并发症的风险。
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