Background The purpose of this study was to investigate the effect of using telemedicine to improve the quality of life of parents of infants with congenital heart disease surgery after discharge. Methods A prospective randomized controlled study was conducted in a provincial hospital in China from November 2020 to April 2021 to compare the quality of life of parents of infants with congenital heart disease surgery after discharge between the WeChat follow-up group and the outpatient follow-up group. A total of 84 patients (42 in each group) and 168 parents (84 in each group) participated in this study. Results One month after discharge, the SAS and SDS scores of parents in the intervention group were significantly lower than those in the control group (P<0.05). Compared with the SAS and SDS scores at discharge, the scores of parents in the intervention group were significantly lower at one month after discharge (P<0.05), while the scores of parents in the control group were similar at one month after discharge (P>0.05). At discharge, in both the intervention group and the control group, the SAS and SDS scores of the mothers were higher than those of the fathers (P<0.05). One month after discharge, in the control group, the SAS and SDS scores of the mothers were higher than those of the fathers (P<0.05). One month after discharge, in the intervention group, the SAS and SDS scores of the mothers were similar to those of the fathers (P>0.05). The comparison of the SAS and SDS scores of parents with different education levels showed that in both the intervention group and control group, the lower the parents’ educational levels were, the higher their SAS and SDS scores were (P<0.05). One month after discharge, in the control group, the lower the parents’ education levels were, the higher their SAS and SDS scores (P<0.05). One month after discharge, in the intervention group, the SAS and SDS scores were similar among parents with different educational levels. The results of the WHOQOL-BREF scale showed that the scores of the physiological, psychological, social and environmental fields at one month after discharge in the intervention group were significantly higher than those in the control group (P<0.05). Conclusion Providing health education and medical support to the parents of infants with congenital heart disease surgery after discharge via telemedicine can effectively relieve the parents’ anxiety and depression and improve their quality of life.
Objective: To investigate the effect of WeChat follow-up management of infants who underwent ventricular septal defect (VSD) repair on parents' disease knowledge and quality of life.Methods: Participants were randomly assigned to an intervention group (n = 40) or a control group (n = 40). The intervention group was followed up with WeChat, while the control group was followed up using a traditional method. The disease knowledge, mental state, and quality of life of the two groups of parents were analyzed and compared.Results: During the 3-month follow-up period, the PedSQL (PedsQL family impact module) results showed that the overall score in the intervention group was significantly higher than that in the control group. The parents in the intervention group were better at managing "emotion control," "worry," and "family communication" than those in the control group. The results of the LKQCHD (Leuven congenital heart disease knowledge questionnaire) showed that the parents in the intervention group had a higher mastery of "basic knowledge and treatment of congenital heart disease," "related complications," and "postoperative rehabilitation" than those in the control group. Conclusion:Knowledge education and psychological counseling for parents of children who underwent VSD repair through WeChat follow-up management can effectively improve parents' knowledge, relieve their anxiety and sadness, and improve their quality of life. K E Y W O R D Sdisease knowledge, quality of life, VSD, WeChat | METHODSThis study was approved by the Ethics Committee of our university and followed the principles of the Helsinki Declaration. In addition, the parents of the patients signed informed consent forms before participating in the study. | SAMPLE SIZE CALCULATIONBased on the mean (group A = 70.03, group B = 63.95) and the standard deviation (7.80) of the total impact score in the presurvey, with α = .05, two-tailed and a power of 90%, the sample size of the two groups was 36, calculated by PASS 23.0. Considering a 10% drop rate, we included 40 samples in each group. | RESEARCH DESIGNThis study was a prospective randomized controlled study conducted at a provincial hospital in China. The inclusion criteria were as follows: (1) age <6 months; (2) a diagnosis of unrestricted VSD; (3) successful completed surgical treatment; (4) the parents were the primary caregivers; and (5) the parents had smartphones and could use the WeChat platform correctly. The exclusion criteria were as follows: (1) complications with other heart diseases requiring concurrent surgery; (2) other vital organ diseases; and (3) the parents refusing to participate in the study. Clinical data and family data of 80infants with VSD from January 2020 to September 2020 were collected. The patients' and parents' data are listed in Table 1.
Background During the COVID-19 pandemic, parents of infants having medical problem face challenges of insufficient medical resources at home. The purpose of this study was to investigate the effect of WeChat-based telehealth services on the preoperative follow-up of infants with congenital heart disease (CHD) during the COVID-19 pandemic. Methods This study retrospectively analyzed the medical records of 190 infants with CHD who underwent remote follow-up via WeChat from December 2019 to May 2020 in Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University. In addition, the psychological benefits of WeChat on the parents of these infants were analyzed. Results In total, 190 infants were involved in this study, including 72 cases of ventricular septal defects, 42 cases of patent ductus arteriosus, 55 cases of atrial septal defects, 3 cases of tetralogy of Fallot, 2 cases of endocardial cushion defects, 12 cases of pulmonary stenosis, 2 cases of total anomalous pulmonary venous connection and 2 cases of aortic arch constriction. During the follow-up period, 48 infants who received surgical indications were hospitalized in time for surgical treatment. It was recommended that 10 infants with respiratory tract infections be treated in local hospitals through the WeChat platform. We provided feeding guidance to 28 infants with dysplasia through the WeChat platform. The psychological evaluation results of parents showed that the median score and range of Self-Rating Depression Scale (SDS) scores were 42 and 32-58, respectively. Nine parents (4.7%) were clinically depressed, while the majority had mild depression. The median score and range of Self-Rating Anxiety Scale (SAS) scores were 44 and 31-59, respectively. Twenty parents (10.5%) had clinical anxiety, while the rest had mild anxiety. Conclusion During the COVID-19 pandemic, follow-up management and health services for infants with CHD prior to surgery through the WeChat platform were useful in identifying the state of an infants’ condition as well as in identifying and relieving care pressure, anxiety and depression in the parents.
This study investigated the neuroprotective effects of triptolide (TPL) in a rat model of cardiopulmonary bypass with deep hypothermia circulatory arrest (DHCA). Rats were randomly divided into six groups: control, sham, DHCA, and DHCA + TPL (100, 200, 300 μg/kg). Neurobehavioral functions were measured using the elevated plus-maze, Y-maze, and Morris water maze tests. Levels of inflammatory cytokines, oxidative stress indices, and brain neurotrophins were measured by ELISA. Microglial activation and cell death was measured by immunofluorescence staining and TUNEL assay, respectively. Finally, activation of the Nrf2 pathway and NF-κB were detected by western blot. The elevated plus-maze, Y-maze, and Morris water maze tests all showed that TPL mitigated anxiety-like behavior, working memory, spatial learning, and memory in DHCA rats. TPL inhibited inflammatory responses and oxidative stress, as well as increased brain neurotrophin levels in DHCA rats. Moreover, TPL attenuated microglia activation and cell death in DHCA rats. Finally, TPL activated the Nrf2 pathway and inhibited NF-κB activity in DHCA rats. These results demonstrated that TPL improved neurobehavioral functions, neuroinflammation, and oxidative stress in DHCA rats, which may be associated with the Nrf2 and NF-κB pathways.
Application value of nursing intervention combined with early nutritional support treatment in preventive stoma reversion of low rectal cancer was explored. Ninety-two cases of low rectal cancer patients undergoing preventive stoma reversion from January 2014 to December 2016 were retrospectively analyzed. All the patients had closed fistula 3 months after neostomy. Forty-four cases with routine nursing care were the control group; 48 cases with early nutritional support and nursing intervention were the experimental group. Nutritional status, psychological status, incidence of adverse reactions, wound infection rate, number of shaped and regular defecation were compared in the two groups. The levels of albumin, prealbumin and serum total protein in the experimental group were significantly higher than those in the control group after operation (P<0.05); the levels of albumin in the two groups after operation were significantly lower than those before operation (P<0.001). The SAS and SDS scores in the experimental group were significantly lower than those in the control group after operation (P<0.001); the SAS and SDS scores in the two groups after operation were significantly lower than those before operation (P<0.001). The number of abdominal pain, abdominal distention, diarrhea, incision infection and abdominal infection in the experimental group were less than those in the control group (P<0.05). The number of shaped and regular defecation cases in the experimental group was more than that in the control group (P<0.05). Nursing intervention combined with early nutritional support can improve the nutritional status, psychological anxiety-depression of the patients undergoing preventive stoma reversion, decrease the incidence of adverse reactions, and wound infection rate. It can also increase the shaped and regular defecation cases and is helpful for the recovery of intestinal function.
Objective: This study aimed to evaluate the effects of nasal high-frequency oscillatory ventilation (NHFOV) vs. nasal continuous positive airway pressure (NCPAP) on postextubation respiratory failure (PRF) in infants after congenital heart surgery (CHS).Method: Eighty infants underwent postoperative invasive mechanical ventilation for more than 12 h and planned extubation. The infants were randomized to undergo either NHFOV or NCPAP after extubation. Primary outcomes were the incidence of PRF and reintubation, the average PaCO2 level, the average oxygenation index (OI), and pulmonary recruitment in the early extubation phase. Secondary outcomes included the NCPAP/NHFOV time, length of hospital stay, treatment intolerance, signs of discomfort, pneumothorax, adverse hemodynamic effects, nasal trauma, and mortality.Results: Except for PaCO2 within 12 after extubation (39.3 ± 5.8 vs. 43.6 ± 7.3 mmHg, p = 0.05), there was no statistically significant difference for any of the primary outcome measure (PRF, reintubation within 12 h after extubation, oxygenation index within 12 h after extubation, or lung volumes on X-ray after extubation) or secondary outcome measures (duration of non-invasive ventilation, duration of hospital stay, ventilation intolerance, signs of discomfort, pneumothorax, nasal trauma, adverse hemodynamic effects, or death prior to discharge), p > 0.1 for each comparison.Conclusion: NHFOV therapy after extubation in infants after CHS was more efficient in improving CO2 cleaning than NCPAP therapy, but there was no difference in other outcomes (PRF, reintubation, oxygenation index, and pulmonary recruitment).
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