Effect of biomechanics-correlated integrated nursing mode of physician and nursing on operation process, intraoperative and postoperative adverse reactions and resuscitation quality of elderly patients with painless gastroscopy
Abstract
Background: The elderly commonly exhibit stressful responses during painless gastroscopy. At the cellular molecular biomechanics level, this stress activates the sympathetic nervous system, leading to the release of catecholamines like adrenaline. These molecules bind to adrenergic receptors on cells, initiating a cascade of intracellular signaling events. The integrated medical and nursing care model is a modern nursing approach that has been gradually applied in clinical practice over the last few years. This study was conducted to survey the value of this nursing model in elderly patients undergoing painless gastroscopy. Objective: To survey the impact of the integrated medical and nursing care model in painless gastroscopy in the elderly on the quality of surgical procedures, intraoperative and postoperative adverse effects and resuscitation. Methods: From August 2020 to August 2022, eighty elderly patients who underwent painless gastroscopy in our hospital were enrolled. The patients were randomly allocated into two groups of 40 cases each. In the control group, the patients accepted routine intervention, and in the observation group, the patients accepted the intervention of the physician-nursing integrated nursing model. The differences of nursing effects were compared between the two groups. Statistical analysis was conducted to determine nursing satisfaction and adverse reactions. Results: The examination time, fully awake time, and residence time of resuscitation room in the observation group were remarkably shorter (P < 0.05). After the failure of 5min and anesthetics before the examination, the scores of SAS and SDS in the observation group were remarkably lower (P < 0.05), suggest that the model might impact the balance of neurotransmitters such as serotonin and dopamine. These neurotransmitters play crucial roles in mood regulation and are regulated by complex molecular mechanisms involving transporters and enzymes. In GCQ score, the physiological, psychological, social, and cultural, total environmental scores of the patients in the observation group were remarkably higher. After nursing, the VAS score of the observation group was lower, and the Ramsay score was higher. The total nursing satisfaction rate of the observation group was 97.50%, while that of the control group was 67.50%. Adverse reactions were recorded in both the observation group and the control group at a rate of 7.50% and 30.00%, respectively. Conclusion: The integrated medical and nursing care model holds significant value for elderly painless gastroscopy patients by potentially modulating diverse cellular molecular biomechanical aspects, alleviating negative emotions, decreasing adverse reaction risks, and enhancing nursing satisfaction.
References
1. Isoldi S, Cucchiara S, Repici A, Lerner DG, Thomson M, Oliva S. Gastrointestinal endoscopy in children and adults: How do they differ? Digest Liver Dis. 2021;53(6):697-705.
2. Min JK, Kwak MS, Cha JM. Overview of Deep Learning in Gastrointestinal Endoscopy. Gut Liver. 2019;13(4):388-393.
3. Daaboul DG, DiNardo JA, Nasr VG. Anesthesia for high-risk procedures in the catheterization laboratory. Paediatr Anaesth. 2019;29(5):491-498.
4. Taylor D, Habre W. Risk associated with anesthesia for noncardiac surgery in children with congenital heart disease. Paediatr Anaesth. 2019;29(5):426-434.
5. Reale SC, Bauer ME, Klumpner TT, Aziz MF, Fields KG, Hurwitz R, Saad M, Kheterpal S, Bateman BT; Multicenter Perioperative Outcomes Group Collaborators. Frequency and Risk Factors for Difficult Intubation in Women Undergoing General Anesthesia for Cesarean Delivery: A Multicenter Retrospective Cohort Analysis. Anesthesiology. 2022;136(5):697-708.
6. Nishizawa T, Suzuki H. Propofol for gastrointestinal endoscopy. United Eur Gastroent. 2018;6(6):801-805.
7. Mezoff EA, Williams KC, Erdman SH. Gastrointestinal Endoscopy in the Neonate. Clin Perinatol. 2020;47(2):413-422.
8. Bjørsum-Meyer T, Baatrup G, Koulaouzidis A. Colon Capsule Endoscopy as a Diagnostic Adjunct in Patients with Symptoms from the Lower Gastrointestinal Tract. Diagnostics (Basel). 2021;11(9):1671.
9. Chen, L., Zong, W., Luo, M., & Yu, H. (2024). The impact of comprehensive geriatric assessment on postoperative outcomes in elderly surgery: A systematic review and meta-analysis. PLOS ONE, 19. https://doi.org/10.1371/journal.pone.0306308.
10. Chen, H., & Wang, R. (2024). Effect of Preoperative Accurate Evaluation and Intervention on Prognosis and Outcome in Elderly Patients with Painless Gastroenteroscopy: Protocol for A Single-Centre Randomized Controlled Trial. Asploro Journal of Biomedical and Clinical Case Reports. https://doi.org/10.36502/2024/asjbccr.6336.
11. Wu, Z., & Han, Q. (2024). Effects of high-quality nursing interventions on outcomes and complication rate of elderly patients undergoing painless gastrointestinal endoscopy. Acta Paulista de Enfermagem. https://doi.org/10.37689/acta-ape/2024ao00014633.
12. Jokelainen J, Timonen M, Keinänen-Kiukaanniemi S, Härkönen P, Jurvelin H, Suija K. Validation of the Zung self-rating depression scale (SDS) in older adults. Scand J Prim Health. 2019;37(3):353-357.
13. Alp FY, Yucel SC. The Effect of Therapeutic Touch on the Comfort and Anxiety of Nursing Home Residents. J Relig Health. 2021;60(3):2037-2050.
14. Chiarotto A, Maxwell LJ, Ostelo RW, Boers M, Tugwell P, Terwee CB. Measurement Properties of Visual Analogue Scale, Numeric Rating Scale, and Pain Severity Subscale of the Brief Pain Inventory in Patients With Low Back Pain: A Systematic Review. J Pain. 2019;20(3):245-263.
15. Rasheed AM, Amirah MF, Abdallah M, P J P, Issa M, Alharthy A. Ramsay Sedation Scale and Richmond Agitation Sedation Scale: A Cross-sectional Study. Dimens Crit Care Nur. 2019;38(2):90-95.
16. Pardo E, Camus M, Verdonk F. Anesthesia for digestive tract endoscopy. Curr Opin Anaesthesiol. 2022;35(4):528-535.
17. Romano M, Gravina AG, Eusebi LH, Pellegrino R, Palladino G, Frazzoni L, Dajti E, Gasbarrini A, Di Mario F, Zagari RM; Members of SIGE; Members of SIED National Council. Management of Helicobacter pylori infection: Guidelines of the Italian Society of Gastroenterology (SIGE) and the Italian Society of Digestive Endoscopy (SIED). Digest Liver Dis. 2022;54(9):1153-1161.
18. Lahner E, Zagari RM, Zullo A, Di Sabatino A, Meggio A, Cesaro P, Lenti MV, Annibale B, Corazza GR. Chronic atrophic gastritis: Natural history, diagnosis and therapeutic management. A position paper by the Italian Society of Hospital Gastroenterologists and Digestive Endoscopists [AIGO], the Italian Society of Digestive Endoscopy [SIED], the Italian Society of Gastroenterology [SIGE], and the Italian Society of Internal Medicine [SIMI]. Digest Liver Dis. 2019;51(12):1621-1632.
19. Candia R. Herramientas para la interpretación de informes endoscópicos: clasificaciones y escalas en endoscopía digestiva [Classifications and scores used in digestive endoscopy]. Rev Med Chile. 2020;148(7):992-1003.
20. Cyrany J, Malý R, Rejchrt S, Tachecí I. Antithrombotic therapy and digestive endoscopy. Vnitr Lek. 2022;68(8):538-542.
21. Khader Y, Burmeister C, Patel D, Ambati A, Altorok N. Henoch-Schonlein Purpura Presenting as Upper Gastrointestinal Bleed in an Adult Patient. Cureus. 2021;13(3):13879.
22. Matli VVK, Zibari GB, Wellman G, Ramadas P, Pandit S, Morris J. A rare synchrony of adenocarcinoma of the ampulla with an ileal gastrointestinal stromal tumor: A case report. World J Gastro Oncol. 2022;14(11):2253-2265.
23. Yang Junna,Yang Jing,Guo Dongmei,Zhao Qingchao & Chen Yang.(2022).Outcome of Nursing Based on Health Belief United with Knowledge, Belief, and Practice Mode on Gastroscopy of Patients with Gastric Cancer..Computational and mathematical methods in medicine9491454-9491454.
24. Guo Qi,Jiang Wenhao,Wang Yu,Xue Xiaoqiang,Mu Dongdong,Chen Nanmei & Wang Ping.(2021).Observation on the effect, satisfaction and nursing quality of whole-course nursing in patients undergoing electronic gastroscopy..Minerva surgery(1),
25. Papaefthymiou A, Koffas A, Laskaratos FM, Epstein O. Upper gastrointestinal video capsule endoscopy: The state of the art. Clin Res Hepatol Gas. 2022;46(3):101798.
26. McGoran JJ, McAlindon ME, Iyer PG, Seibel EJ, Haidry R, Lovat LB, Sami SS. Miniature gastrointestinal endoscopy: Now and the future. World J Gastroenterol. 2019;25(30):4051-4060.
27. Peterson LL, Lustberg M, Tolaney SM, Ross M, Salehi E, Isakoff SJ. Integration of Physician and Nursing Professional Efforts to Deliver Supportive Scalp Cooling Care to Oncology Patients at Risk for Alopecia. Oncol Ther. 2020;8(2):325-332.
28. Kruser TJ, Kruser JM, Gross JP, Moran M, Kaiser K, Szmuilowicz E, Kircher SM. Medical oncologist perspectives on palliative care reveal physician-centered barriers to early integration. Ann Palliat Med. 2020;9(5):2800-2808.
29. Mchugh J, Shay P, Flansbaum B. The Critical Role of Hospitalists for Successful Hospital-SNF Integration Hospitalists and Hospital/SNF Integration. J Hosp Med. 2019;14(3):192-193.
30. Havreng-Théry C, Giner-Perot J, Zawieja P, Bertin-Hugault F, Belmin J, Rothan-Tondeur M. Expectations and Needs of Families in Nursing Homes: An Integrative Review. Med Care Res Rev. 2021;78(4):311-325.
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