A Study On The Effectiveness Of Comfort Care Used In Cholelithiasis Patients With ERCP During Peri-operative Period

Objects:Describe the use of comfort care in the ERCP patients during peri-operative period; analyze the effectiveness and determinants of comfort care; discuss the effect of comfort care on nursing quality.Method:Randomized Controlled Trial was used in this study. Subjects were recruited from digestive department of People’s Hospital in Hunan province during January1st,2012to December30th,2012. All the subjects were cholelithiasis patients and arranged endoscopic retrograde cholangiopancreatography (ERCP) in hospital. Those patients who had severe cardiopulmonary disease, severe hepatic and renal dysfunction had been excluded in this study. All the subjects were randomly divided into two groups which were comfort care group (treatment group) and usual care group(control group),comfort care group patients were arranged in the first ward and usual care group patients were arranged in the second ward. A questionnaire was used to acquire the information about gender, age, occupation, educational level, economic status, type of gallstones, the use of nasobiliary duct, comfort level, postoperative prognosis. Binary logistic model was used in single factor analysis and non-conditional logistic regression model was use in multiple-factor analysis.Result:1.General information:336subjects were recruited during January1st,2012to December30th,2012,including123usual care group patients and213comfort care group patients. In the control group, the minimum age is26and the max age is91(mean age58.61±13.73).In the treatment group, the minimum age is17and the max age is87(mean age60.96±14.15).Elementary school and illiteracy were in the majority (30.9%and27.7%in the control group and treatment group, respectively). Retirees and unemployed were in the majority (40.7%and41.3%in the control group and treatment group respectively).2. Multivariate logistic analysis showed that comfort care had statistical significance on sleep condition before ERCP operation (RR=0.64395%CI=0.411-0.964), blood pressure(RR=0.18395%CI=0.068～0.481), surgery cooperation(RR=0.30095%CI=0.145～0.604), suspend surgery(RR=0.44695%CI=0.208-0.926), sleep condition after ERCP operation(RR=0.46495%CI=0.274-0.757), food intake without authorization(RR=0.19395%CI=0.039-0.933), in-patients satisfaction (RR=0.17395%CI=0.048-0.618).Conclusion:Comfort care can calm patient’s mood and improve the sleep quality before ERCP operation; stabilize the patient’s blood pressure, improve the patient compliance and avoid surgery to suspend during the ERCP operation; decrease the incidence of food intake without authorization, improve the sleep quality after ERCP operation and increase in-patient satisfaction. However, there were no significant relationship between comfort care and patient recovery such as post-ERCP pancreatitis and cure rate.