BACKGROUND Liver abscess is a common clinical liver disease mainly caused by suppurative bacteria or amoebae, with early clinical signs of chills, high fever, jaundice, and other symptoms. Establishing its early diagnosis is difficult, which may lead to misdiagnosis. AIM To observe the effects of psychological guidance combined with evidence-based health intervention in patients with liver abscess treated with ultrasound. METHODS A total of 120 patients with bacterial liver abscess admitted to our hospital from May 2018 to February 2021 were selected and divided into groups according to their intervention plan. RESULTS After the intervention, Self-Rating Depression Scale, Self-Rating Anxiety Scale, Self-Perceived Burden Scale (SPBS), and quality of life scores (physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, mental health) were lower than before the intervention in the two groups. The observation group had lower negative sentiment, SPBS, and quality of life scores than the control group. In the observation group, 31 and 24 patients had good and general compliance, respectively, with a compliance rate of 91.67%, which was significantly higher than that in the control group. The observation group had significantly lower total incidence of incision infection, abdominal abscess, hemorrhage, and severe abdominal pain than the control group. CONCLUSION Three-dimensional psychological guidance combined with evidence-based health intervention in treating liver abscess can reduce patients’ burden and negative emotions, improve patient compliance and quality of life, and reduce complications.
Objective This study aimed to demonstrate and promote the skill of critical emancipatory reflection through reflecting on a nursing practice-based ethical issue about nurses’ paternalistic decision-making for patients. Meanwhile, critical awareness will be developed and the underlying issues of paternalism in nursing decision-making will be analyzed. Then, by applying the procedure, improvement in nursing decision-making practice will be expected. Methods Taylor’s model of emancipatory reflection with four steps, including construction, deconstruction, confrontation, and reconstruction, is utilized to guide the author’s reflection. Results Guided by the socialization theory, the author’s personal and professional socialization is seen to be associated with the formation of the value of paternalism. The theory of reflexivity is applied to unearth the related issues, including deeper personal value, work environment, as well as historical and cultural contexts. Moreover, the power derived from policy, work relationship, and nursing administration, which could induce paternalism in the author’s nursing decision-making practice, was critically debated using the hegemony theory. Finally, new insights into paternalism will be achieved, which enable change in terms of how to facilitate patients’ autonomous decision-making. Conclusions The process of refection makes it clear that respecting patients’ right and performing patient-centered caring are the bases to change the paternalism existing in the nursing decision-making practice currently. The reconstruction step assists the author in terms of how to value the patients’ autonomy and balance patients’ safety and choice, rather than being overprotective; carry out risk assessment, and search for strong evidence to counterbalance the positive and negative aspects of risk-taking; communicate with patients appropriately in a manner that they can comprehend; spend more time to explore patients’ preference and choice; make every effort to elevate the patients’ decision-making capacity; implement patient-centered care and shared decision-making in nursing practice; consult with other colleagues and obtain the required support when limitations or challenges exist; try to justify and avoid hidden paternalism behind policy or guidelines; deal with the power in hand well and fairly; and also positively face the powers that constrain the author.
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