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Original Article Effects of Operating-Room Detailed Nursing on the Postoperative Recovery and Adverse Reactions of Patients Undergoing Gastrectomy

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Original Article Effects of Operating-Room Detailed Nursing on the Postoperative Recovery and Adverse Reactions of Patients Undergoing Gastrectomy Int J Clin Exp Med 2020;13(12):9526-9534 www.ijcem.com /ISSN:1940-5901/IJCEM0115660 Original Article Effects of operating-room detailed nursing on the postoperative recovery and adverse reactions of patients undergoing gastrectomy Hongling Wen Department of Operating Room, Qinghai Provincial People’s Hospital, No. 2 Gonghe Road, Chengdong District, Xining 810000, Qinghai Province, China Received June 4, 2020; Accepted September 10, 2020; Epub December 15, 2020; Published December 30, 2020 Abstract: Objective: To determine the effect of operating-room detailed nursing on the postoperative recovery and adverse reactions of patients undergoing gastrectomy. Methods: A total of 94 patients undergoing gastrectomy who were confirmed with gastric cancer and treated in our hospital from February 2018 to February 2019 were enrolled, of which 44 patients were given routine nursing against advanced gastric cancer as an routine nursing group, and the rest 50 patients were given operating-room detailed nursing based on the nursing for the routine nursing group as a detail group. Then the following items between the two groups after nursing were compared: The self-rating depression scale (SDS) score, self-rating anxiety scale (SAS) score, Hamilton anxiety scale (HAMA) score, Hamilton depression rating scale (HAMD) score, life quality, complications, and nursing satisfaction. Results: After nursing, the SDS, SAS, HAMA, and HAMD scores of both groups decreased significantly (allP < 0.001). The scores of nursing safety, disinfection and isolation, instrument and equipment management, surgical instrument preparation, nurs- ing operation specification, and cooperation with the nursing staff of the detail group were significantly better than those of the routine nursing group (all P < 0.001). The quality of life scale (QOL-C30) scores of the detail group were significantly higher than those of the routine nursing group (allP < 0.001). Moreover, the incidence of complications in the detail group was significantly lower than that in the routine nursing group (P < 0.05). Conclusion: Operating- room detailed nursing is more effective in improving the emotional state and life quality of patients undergoing gas- trectomy based on routine nursing, and it can reduce the occurrence rate of postoperative complications of patients undergoing gastrectomy to a certain extent. Keywords: Gastric cancer, operating-room details, nursing intervention, mental health, life quality Introduction With the continuous development of nursing concept, related medical environment requires Gastric cancer accounts for 6.8% of new can- increasingly higher psychology and life quality cer cases and 8.8% of cancer-related deaths of patients [6]. Operating-room nursing is a worldwide [1]. Although surgical resection is wildly risky nursing work in clinical practice, and the cornerstone of cure of it, some aspects of the nursing effect directly affects the operation surgical operation are still controversial or sub- quality and prognosis of patients. Therefore, optimal [2]. Surgical techniques and nursing more attention should be paid to nursing safety methods are strongly linked to the prognosis of in the nursing work in the operating room. patients [3]. Surgical resection is the main Moreover, researches have shown that rejec- treatment for patients with gastric cancer, but tion or non-cooperation with nursing of some the accompanying pain and related adverse patients in the clinical treatment progress seri- reactions also bring about great pain to the ously compromises the surgical efficacy and patients, so currently, it is important to take brings about high recurrence rate and metasta- appropriate and effective nursing intervention sis rate in some patients after surgery [7, 8]. for patients undergoing gastrectomy to improve Effective nursing measures are of great signifi- their prognosis and life quality [4, 5]. cance to improve the life quality of patients [9]. Effects of operating-room detailed nursing on patients undergoing gastrectomy Operating-room detailed nursing is usually app- detail that he/she needed to fast for solid for lied to patients with advanced cancer, and half a day and fast for liquid for 6 hours before implementation of it can strengthen the safety operation after confirming the data. In addition, management during nursing and improve the the nurses were required to inform the patient nursing quality, thus ensuring the treatment of the operation plan and procedure. The nurs- and nursing quality of patients [10]. This study es also arranged to explain the importance of was designed to determine the effect of operat- this operation to diseases, inform the safety of ing-room detailed nursing on the postoperative the operation, actively introduce the basic recovery and adverse reactions of patients information of the operation and related suc- undergoing gastrectomy by comparing the rou- cessful cases to the patient to relieve his/her tine nursing intervention and operating-room anxiety and other negative emotions, and build detailed nursing intervention a good doctor-patient relationship. (2) Preo- perative preparation: After preoperative visit, Materials and methods the relevant medical staff arranged to carefully examine all kinds of articles needed for this A total of 94 patients undergoing gastrectomy operation to ensure that there were sufficient who were confirmed with gastric cancer and first aid drugs and plasma in the operating treated in our hospital from February 2018 to room. In addition, the staff arranged to clean February 2019 were enrolled, of which 44 the patient’s body before operation, and asked patients were given routine nursing against the patient to wear a marking wrist belt to advanced gastric cancer as a routine nursing check the information and surgical site. (3) group and the rest 50 patients were given oper- Intraoperative nursing: Relevant medical staff ating-room detailed nursing based on the nurs- arranged to carefully check all kinds of articles ing for the routine nursing group as a detail required for this operation, strictly carried out group. The routine nursing group consisted of aseptic operation, and appropriately adjusted 23 males and 21 females, with an average age the operating room temperature. The staff also of 68.39±5.48 years and an average course of arranged to monitor the patient’s vital signs, disease of 2.13±0.53 years, while the detail timely established intravenous channels for group consisted of 25 males and 25 females, fluid infusion and blood transfusion. If there with an average age of 69.15±5.03 years and was any abnormality during the operation, the an average course of disease of 2.15±0.60 staff would report the situation to the attending years. Inclusion criteria: Patients diagnosed as gastric cancer based on clinical, imaging and physician in time, and actively assist the attend- pathological examination for the first time and ing physician to handle it according to the phy- patients with indications for radical resection sician’s advice. (4) Postoperative nursing: The of gastric cancer [11]. Exclusion criteria: medical staff arranged to closely monitor the Patients with other complications, mental dis- vital signs of the patient after operation, pro- order, cognitive disorder, or other mental disor- vided better diet to the patient, and appropri- ders. The patients and their family members ately instructed the patients of off-bed activity. were informed of the study before carrying out In addition, the nursing staff was required to of it, and the study was approved by the medical urge relevant nursing families to observe ethics committee. whether the patient had any signs of vomiting. Nursing methods Outcome measures Patients in the routine nursing group were given The following items of the routine nursing group routine preoperative, intraoperative, and post- and the detail group were compared: General operative nursing based on the operating-room clinical data, mental health and emotional nursing guidelines. state before nursing and at 1 month after nurs- ing intervention. The mental health and emo- Patients in the detail group were given operat- tional state of the two groups were scored using ing-room detailed nursing as follows: (1) the self-rating depression scale (SDS) [12], self- Preoperative visit and psychological counsel- rating anxiety scale (SAS) [13], Hamilton anxi- ing: Before operation, relevant operating room ety scale (HAMA) [14], and Hamilton depression nurses were required to confirm the clinical rating scale (HAMD) [15]. The scores were data of each patient, and inform him/her in directly proportional to the degree of anxiety 9527 Int J Clin Exp Med 2020;13(12):9526-9534 Effects of operating-room detailed nursing on patients undergoing gastrectomy Table 1. General data of the two groups Group The routine nursing group (n = 44) The detail group (n = 50) t/X2 P-value Age (Y) 68.39±5.48 69.15±5.03 0.701 0.485 Sex 0.048 0.826 Male 23 (52.27) 25 (50.00) Female 21 (47.73) 25 (50.00) Average course of disease (years) 2.13±0.53 2.15±0.60 0.170 0.865 BMI (kg/m2) 19.18±2.24 19.20±2.31 0.043 0.966 Smoking history 0.182 0.669 Yes 30 (68.18) 32 (64.00) No 14 (31.82) 18 (36.00) Drinking history 0.061 0.805 Yes 20 (45.45) 24 (48.00) No 24 (54.55) 26 (52.00) Hypertension 1.875 0.171 Yes 39 (88.64) 39 (78.00) No 5 (11.36) 11 (22.00) Diabetes mellitus 0.247 0.620 Yes 18 (40.91) 23 (46.00) No 26 (59.09) 27 (54.00) Clinical staging 0.000 1.000 Stage I/stage II 0 (0.00) 0 (0.00) Stage III/IV 44 (100.00) 50 (100.00) Lymph node metastasis 0.136 0.713 Yes 10 (22.73) 13 (26.00) No 34 (77.27) 37 (74.00) Notes: Enumeration data of the two groups were analyzed using the χ2 test.
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