| Objective:Our purpose is to construct the exercise rehabilitation pathway for perioperative nursing of liver surgery and,through applying it to the patients with primary liver cancer,to investigate its safety,efficiency and feasibility.Methods:The evidence-based problem was constructed according to the evidence-based medicine pattern based on evidence-based nursing practice.The literature was thoroughly searched and the information for the solutions was extracted and reviewed to construct the preliminary exercise rehabilitation nursing pathway for perioperative patients with primary liver cancer.The nursing pathway was modified and finalized through expert interview and clinical trials.A total of 60 patients from the Department of Hepatobiliary of a third grade hospital meeting the inclusion criteria were recruited from October 2016 to October 2017 and were assigned randomly into experimental group(n=30)and control group(n=30).The patients of experimental group were treated with exercise rehabilitation nursing pathway care,while patients of control group accepted routine nursing.The information about the implementation of the exercise rehabilitation nursing pathway was recorded.Patients' physical performance,including six-minute walking test(6MWT)distance,difficulty in breathing(Borg score)and activity of daily life(ADL)score,was tested and recorded in both groups.Meanwhile,other parameters related to patient recovery and prognosis,including scores of pain,the time point of first postoperative anal exhaust,the duration for keeping intraperitoneal drainage tube,the days of postoperative hospitalization,the incidence rate of complications,and the readmission rate in 30 days,were observed,and the score of postoperative state anxiety(State-Anxiety Inventory,S-AI)and degree ofsatisfaction for nursing service were evaluated.Results:(1)The implementation of the exercise rehabilitation nursing pathwayThere was no rejection or drop-out and no adverse event occurred during the implementation of the pathway.The patients had excellent compliance.The time point(h)and the duration(min)of the first out-of-bed activity,based on the regulations,were significantly higher in experimental group than that in the control group(P <0.05).(2)Physical performanceThe 6MWT distance,Borg score and ADL score of the two groups significantly changed at different time points.At the fifth and seventh day,the 6MWT distance,Borg score and ADL score of experimental group were significantly better than those of the control group,and the difference was statistically significant(P <0.05).(3)Patients' recovery and prognosisThe pain score in experimental group was significantly lower than that in the conventional group(P <0.05).Other parameters,including the time point of first postoperative anal exhaust,the duration for keeping intraperitoneal drainage tube,the days of postoperative hospitalization,the incidence rate of complications and the readmission rate in 30 days,were significantly better in experimental group than in control group(P<0.05).(4)Psychological state and satisfaction degreeThe 7d S-AI score was significantly lower and the degree of satisfaction for nursing service was significantly higher in experimental group than in the control group after the intervention(P <0.05).Conclusion:(1)The exercise rehabilitation nursing pathway developed in this study is safe,effective and feasible for perioperative patients with primary liver cancer.(2)The application of the exercise rehabilitation nursing pathway can promote postoperative rehabilitation of patients,and further enhance their physical performancecompared with conventional nursing way.At the same time,it promotes disease recovery and prognosis,and has positive effects on patients' anxiety and their degree of satisfaction for nursing service.(3)The application of the exercise rehabilitation nursing pathway can shorten the duration of hospitalization,thereby reducing medical expense and lightening the burden on patients,families and hospitals. |
PDF Full Text Request