American Journal of Nursing最新文献

Background: Discharge readiness is a critical determinant of patient outcomes, particularly for patients with aortic dissection, a highly lethal cardiovascular disease.

Purpose: This study aimed to assess the level of discharge readiness in patients with acute aortic dissection, and to analyze the influencing factors in order to better support patients' postdischarge recovery and improve their long-term prognoses.

Methods: Patients who underwent surgery for aortic dissection at our hospital and were in the process of recovery and preparing for discharge were included in the study. Discharge readiness was assessed with a widely used, validated discharge readiness scale. Multiple linear regression analysis was performed to identify influencing factors.

Results: A total of 218 patients with aortic dissection were enrolled. The mean (SD) total discharge readiness score for these patients was 160.75 (21.38), and the mean (SD) score per item was 7.38 (1.02). Correlation analysis revealed that age, education level, place of residence, family monthly income, and recurrent aortic dissection were each significantly correlated with discharge readiness. Multiple linear regression analysis identified age, education level, place of residence, family monthly income, and recurrent aortic dissection as significant independent predictors of discharge readiness in patients with aortic dissection.

Conclusions: This study revealed that patients with aortic dissection generally had discharge readiness scores at the lower end of the moderate range, indicating the need for improvement. It's imperative that health care providers emphasize patient education prior to discharge and develop and implement personalized discharge plans for these patients in order to improve not only their discharge readiness but also their postdischarge quality of life and long-term prognoses.

Background: The accuracy of colonoscopy results is significantly affected by the quality of bowel preparation. Identifying and understanding the factors that contribute to effective bowel preparation are crucial for optimizing patient outcomes.

Purpose: The aim of this meta-analysis was to systematically evaluate the variables influencing bowel preparation efficacy in order to inform the development of improved clinical protocols and patient care strategies.

Methods: We conducted a literature search of several databases to find studies that investigated factors affecting the quality of bowel preparation over a period ranging from the inception of each database to November 5, 2024. Studies were independently screened based on preestablished inclusion and exclusion criteria. The meta-analysis was conducted using RevMan 5.4 software.

Results: The meta-analysis included 27 articles containing data from 30,716 patients who underwent bowel preparation for colonoscopy. Eight factors were identified that were significantly associated with suboptimal bowel preparation: older age (odds ratio [OR], 1.28; 95% CI, 1.12-1.68; P = 0.019), male gender (OR, 1.33; 95% CI, 1.16-1.53; P < 0.001), chronic constipation (OR, 3.46; 95% CI, 2.65-4.09; P < 0.001), diabetes (OR, 4.72; 95% CI, 2.18-10.22; P < 0.001), use of opioids (OR, 1.62; 95% CI, 1.24-2.45; P = 0.006), a preprocedure high-fiber diet (OR, 2.94; 95% CI, 1.65-5.22; P < 0.001), an interval exceeding five hours between the final administration of the bowel cleansing agent and the procedure (OR, 2.82; 95% CI, 1.79-4.45; P < 0.001), and a last bowel movement that is not watery (OR, 4.78; 95% CI, 2.35-9.71; P < 0.001).

Conclusion: Health care providers, including nurses, should consider these determinants of bowel preparation effectiveness and implement appropriate interventions in a timely manner to enhance patient education and care.

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