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Influence of Nursing Intervention on Recurrent Vulvovaginal Can- Didiasis Patients Treated with ATP-Infrared Bio-Effect Technique

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Influence of Nursing Intervention on Recurrent Vulvovaginal Can- Didiasis Patients Treated with ATP-Infrared Bio-Effect Technique Iran J Public Health, Vol. 47, No.10, Oct 2018, pp.1511-1519 Original Article Influence of Nursing Intervention on Recurrent Vulvovaginal Can- didiasis Patients Treated with ATP-infrared Bio-effect Technique Wenxiang LI* Dept. of Gynecology, Women & Children’s Health Care Hospital of Linyi, Linyi, China *Correspondence: Email: [email protected] (Received 16 Aug 2017; accepted 10 Dec 2017) Abstract Background: We aimed to investigate the influence of nursing intervention on recurrent vulvovaginal candidi- asis (RVVC) patients treated with adenosine triphosphate (ATP)-infrared bio-effect technique. Methods: Sixty eight RVVC patients of Women & Children’s Health Care Hospital of Linyi were randomly divided into intervention group (n=34) and control group (n=34) from to June, 2016 to June 2017. Patients in intervention group received the one-to-one intervention based on ATP-infrared bio-effect technique; the indi- vidualized nursing intervention program was developed. Patients in control group were treated with routine nursing for vaginitis and follow-up. The intervention effect was evaluated via clinical efficacy and MOS 36-item short-form health survey (SF-36) scale. Results: After the total course of treatment, there was significant difference in the cure rate between the two groups of patients (P<0.05). 1 month after all courses of treatment, the scores of physical functioning (PF), mental health (MH), vitality (V) and bodily pain (BP) in intervention group were higher than those in control group, displaying statistically significant differences (P=0.029; P=0.049; P=0.042; P=0.039, respectively). 6 months after the total course of treatment, the score of each dimension in intervention group was higher than that in control group during the same period (P<0.01). Conclusion: Nursing intervention can increase the cure rate, change the adverse cognition and improve the quality of life of RVVC patients treated with ATP-infrared bio-effect technique. Keywords: Nursing intervention, ATP-infrared bio-effect technique, Recurrent vulvovaginal candidiasis, Quality of life Introduction Recurrent vulvovaginal candidiasis (RVVC) refers tionship and causing a heavy psychological bur- to the attack of mycologically-confirmed symp- den to patients. RVVC has always been a difficul- tomatic VVC for 4 times or above within 1 year, ty and hot spot in VCC research, but the research whose incidence rate is about 5% (1). It is mani- on RVVC nursing has not been paid enough at- fested as pruritus vulvae, increased vaginal secre- tention to. tions, soybean curb-like or curd-like secretions, At present, clinical treatment methods of RVVC burning pain, dyspareunia, dysuria and other include intensive therapy and consolidation ther- VVC symptoms. Due to repeated attack or inef- apy, in which the consolidation therapy is per- fective treatment, RVVC brings serious troubles formed for 6 months after mycological cure via to the patient's mental health, sexual life and so- intensive therapy (2). However, there are some cial functions, affecting daily life and family rela- problems, such as longer treatment cycle, poor 1511 Available at: http://ijph.tums.ac.ir Li: Influence of Nursing Intervention on Recurrent Vulvovaginal Candidiasis… compliance of patients, unsatisfactory results and Gram staining microscopy, 4) patients with the high recurrence rate. course of disease for more than 1 year, and the The concept of holistic nursing development in disease recurrence for at least 4 times within 1 modern nursing has been expanded to physical, year, 5) patients who did not take other antibacte- psychological, family, social, spiritual and cultural rial drugs within half a month before treatment levels, but the research on RVVC nursing has not and received no systemic anti-infective and anti- been paid enough attention to. In this study, fungal treatment during the test, and 6) patients RVVC patients treated with adenosine triphos- who could adhere to the therapeutic regimen and phate (ATP)-infrared bio-effect technique were follow-up on time. examined, and the nursing intervention was per- Exclusion criteria: 1) pregnant woman, 2) pa- formed during treatment according to the pa- tients with severe heart, liver, kidney or blood tient's understanding of disease and psychological disease, 3) patients who were allergic to drugs status, so as to observe the impact of nursing in- used in this study, 4) patients who breached the tervention on patients. therapeutic regimen and still had sexual life dur- ing treatment, or 5) patients who were unwilling Materials and Methods to cooperate in the follow-up. Objects of study Methods A total of 68 RVVC patients treated in the Gyne- Patients in intervention group were treated with cological Clinic of Women and Children's Health the nurse-led intervention measures based on Care Hospital of Linyi, China from June 2016 to routine nursing. The nurse-led intervention June 2017 were enrolled, and randomly divided measures refer to the well-defined comprehen- into intervention group (n=34) and control group sive intervention measures different from routine (n=34). They were aged (35.25±10.12) years old nursing, in which gynecological nurses serve as on average, including 8 patients aged <30 years intervention project managers and resource co- old and 60 patients aged >30 years old. In terms ordinators to provide consultation, interview, of educational level, there were 19 cases of junior reminder and health education for RVVC pa- college and above, 14 cases of senior high school, tients, so as to improve the RVVC treatment ad- 18 cases of junior high school and 17 cases below herence. Patients in control group were treated junior high school. The course of disease was 1-3 with routine nursing, namely the traditional years, and all patients were married or unmarried RVVC nursing service developed and imple- women with a history of sexual life. mented in our department. All patients in control The study was approved by the ethics committee group and intervention group received the same of Women & Children’s Health Care Hospital of nursing services in other aspects, except the Linyi and informed consents were signed by the nurse-led intervention measures. patients and/or guardians. Intervention group: (a) ATP treatment was divid- Inclusion criteria: 1) patients meeting diagnostic ed into 3 steps: 1) Rinsing: The special micro- criteria of RVVC, with the chief complaints of ecological anti-bacterial inhibitor I and 50% glu- genital and/or vaginal itching, burning sensation, cose were prepared into the macromolecular col- dyspareunia and increased vaginal secretions, 2) loid penetrating fluid. The vagina was first rinsed patients with vulvovaginal congestion, edema or with penetrating fluid (if the entire vagina was rupture, soybean curb-like or curd-like secretions filled with secretions, it was rinsed with bottled covered on vaginal mucosa and cervical surface, water for injection before being rinsed with pene- and red and swollen mucosa or mucosal erosion trating fluid), and then rinsed again with micro- exposed after being wiped, 3) blastospore and ecological anti-bacterial inhibitor I. During rins- pseudohypha could be seen in secretions via 10% ing, the vaginal circular folds should be paid at- potassium hydroxide solution wet film method or tention to, and the angle of speculum was adjust- Available at: http://ijph.tums.ac.ir 1512 Iran J Public Health, Vol. 47, No.10, Oct 2018, pp. 1511-1519 ed constantly, so that the hidden secretions could (III) Inquiry: The patient's educational level, per- be fully removed. Then the vagina was thorough- sonal hygiene, vaginal cleaning habits, frequent vag- ly wiped dry with large cotton swabs. 2) Irradia- inal lavage, frequency of abortion, oral administra- tion: After rinsing, the inner-middle vagina, ante- tion of contraceptives, placement of intrauterine rior and posterior vaginal walls and side wall were device, application of broad-spectrum antibiotics, irradiated by using the ATP-IR bio-effect therapy immunosuppressants and estrogen therapy recently, apparatus (Beijing ATP Medical Technology Co., absence or presence of hot spring and hip bath Ltd.) for a total of 5 min. The power was set as habits, examination results of blood glucose, dress- 30-40 based on the treatment grade during irradi- ing habits, replacement frequency of beddings, ation, and the probe was adjusted. The irradiation house orientation, etc., were understood. distance was adjusted at any time according to (IV) Propaganda and education: According to the the patient's feeling. 3) Medicine applying: After evaluation results and personal data, the individu- treatment, 500,000 units of nystatin tablets and alized health education was provided in straight- 0.2 g metronidazole tablets were placed into the away language to explain the related knowledge vagina once a day for intensive treatment for 7 d to VVC and RVVC, including the etiology, path- as 1 course of treatment, followed by consolida- ogenic characteristics and predisposing factors of tion therapy for 2 courses of treatment according VVC, route of transmission, treatment time, to the menstrual cycle. (b) Intervention program: knowledge of medication and precautions, so as The one-to-one intervention was adopted, and to strengthen the patient's understanding of dis- the individualized nursing intervention program ease and improve the compliance with medica- was developed based on the patient's symptom tion. 1) Elimination of etiological factors: Pa- characteristics
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