Abstract
INTRODUCTION:
Urological disorders requiring laparoscopic intervention are increasingly common in modern medical practice.
AIM:
This study aimed to evaluate the effect of seamless intervention in the operating room combined with pain management on urological laparoscopic surgery efficiency.
MATERIALS AND METHODS:
A total of 100 patients undergoing urological laparoscopic surgery at our hospital from May 2022 to May 2024 were divided into 2 equal groups. The control group received conventional nursing, while the observation group received seamless intervention combined with pain management. Various comparisons were made, including pre- and postnursing anxiety (as assed via the Self-Rating Anxiety Scale [SAS]), depression (as evaluated using the Self-Rating Depression Scale [SDS]), and sleep quality (as measured with the Pittsburgh Sleep Quality Index [PSQI]) scores, pain levels (as assessed via the numeric rating scale [NRS]), surgical efficiency (turnover time, preparation time, and operative time), stress response indicators before and 24 hours after surgery, patient satisfaction, and complication rates.
RESULTS:
Postnursing, the SAS, SDS, and PSQI scores were lower in the observation group (P <0.01). The NRS scores on days 2 and 3 after surgery were also reduced in the observation group (P <0.01), as compared with the controls. Surgical efficiency (turnover time, preparation time, and operative time) was greater in the observation group (P <0.01). Stress response indicators 24 hours postsurgery were notably reduced in the observation group (P <0.01). The observation group had a higher satisfaction rate (P <0.001) and a lower incidence of complications (P = 0.09), as compared with the control group.
CONCLUSIONS:
Seamless intervention in the operating room combined with pain management significantly improves psychological state, sleep quality, pain relief, surgical efficiency, stress response, and patient satisfaction, as well as reduces complications in urological laparoscopic surgery patients.
Keywords: pain management, patient satisfaction, seamless intervention, surgical efficiency, urological laparoscopic surgery
INTRODUCTION
Urological disorders requiring laparoscopic intervention are increasingly common in modern medical practice, with recent epidemiological studies indicating a rising prevalence of numerous conditions, such as kidney stones, renal cysts, and urological tumors.1 Approximately 10% − 15% of the adult population will experience a urological condition requiring surgery during their lifetime, making efficient and effective surgical management a critical health care priority.2 Urological conditions are often associated with severe pain, urinary dysfunction, and significant worsening of quality of life (QoL). Patients frequently present with complications, such as infection, obstruction, and organ dysfunction, necessitating prompt surgical interventions.3 Laparoscopic surgery has emerged as the preferred treatment approach due to its minimally-invasive nature, reduced recovery time, and superior cosmetic outcomes, as compared with traditional open surgery.4 However, the management of perioperative pain and stress in urological laparoscopic surgery remains challenging. Research indicates that up to 60% of the patients experience moderate-to-severe postoperative pain, while approximately 40% report considerable preoperative anxiety.5 These factors can significantly impact surgical outcomes, recovery time, and patient satisfaction. Traditional nursing approaches have shown limitations in addressing these comprehensive care needs effectively.6 Recent literature has explored various interventions to improve surgical outcomes, but it mostly focuses on isolated aspects of care rather than an integrated approach.7
The concept of seamless intervention has gained notable attention in surgical care recently. Seamless intervention refers to providing continuous, coordinated care throughout the surgical process, eliminating gaps between treatment phases and health care providers.8 Integrating seamless nursing with the Roy adaptation model can enhance QoL of patients recovering from acute abdominal surgery.9 Pain recognition, assessment, and management are essential components of rehabilitation care. Evidence-based protocols for pain relief incorporate both pharmacological and nonpharmacological approaches to develop personalized, safe, and effective treatment plans.10 Simultaneously, systematic pain management has evolved from simple analgesic administration to comprehensive multimodal strategies involving both pharmacological and nonpharmacological interventions, with studies showing 40% improvement in patient satisfaction.11 However, the specific application of seamless intervention in the operating room combined with systematic pain management in urological laparoscopic surgery remains understudied. Our research addressed this gap by investigating an innovative approach integrating operating room seamless nursing intervention with comprehensive pain management. To evaluate its effectiveness in urological laparoscopic surgery, we conducted a comparative study involving 100 patients who underwent the procedure. The study examined multiple outcomes, including psychological states, sleep quality, pain levels, surgical efficiency, stress response, patient satisfaction, and complications.
AIM
This study aimed to evaluate the effect of seamless intervention in the operating room combined with pain management on urological laparoscopic surgery efficiency.
MATERIALS AND METHODS
Ethics All patients signed informed consent forms. This study was approved by the Ethics Committee of the Nanjing Drum Tower Hospital Group Suqian Hospital (2023068).
Research participants
The sample size was estimated with a method based on statistical efficiency, using G*Power software, version 3.1.9.7 (University of Düsseldorf, Düsseldorf, Germany). Taking into account the following parameters: power = 0.8, α = 0.05, effect size = 0.65, and number of groups = 2, the analysis indicated that the minimum required sample size for the study was 78 cases. Considering a 15% sample attrition rate, the number of participants was rounded up to 100 . Data of 100 patients who underwent laparoscopic urological surgery at the Nanjing Drum Tower Hospital Group Suqian Hospital from May 2022 to May 2024 were retrospectively collected. The patients were divided into 2 groups based on different nursing methods received, with 50 individuals in each group. No difference was found between the groups in terms of general data, indicating intergroup comparability.
Inclusion criteria involved patients with: 1) indications for urological surgery who received surgery at our hospital; 2) normal cognitive, linguistic, communication, hearing, and vision abilities; and 3) complete medical records.
Exclusion criteria comprised: 1) pregnant or breastfeeding women; 2 ) individuals with a history of alcohol or drug dependence; 3) individuals with coagulation disorders or severe organ dysfunction; 4) patients with immune system or infectious diseases; 5) individuals with severe disorders of consciousness combined with mental disorders or malignant tumors; and 6) patients with severe urinary system infections.
Intervention methods
The control group received conventional nursing. Prior to surgery, the patients were visited by specialist nurses and provided with information about the procedure, anesthesia, and key points of cooperation between the patients and the surgical team (surgeons, nurses, and anesthesiologists). After the patients were transferred to the operating room, their positions were adjusted, anesthesia was administered, and the surgical procedure was carried out by a surgeon, while closely monitoring patients' vital signs. Postoperatively, the patients were observed during recovery and transferred back to the department to the care of department nurses, with emphasis on postoperative observation.
The observation group received seamless intervention in the operating room combined with pain management. Several specific measures were taken.
The nursing team consisted of the head nurse, 1 chief nurse, 1 deputy chief nurse, 2 charge nurses, and 3 nursing staff members. The head nurse served as the team leader, ensuring that all members learn seamless intervention and pain management techniques.
Preoperatively, in addition to the routine visit and provision of surgery and anesthesia-related information, personalized psychological counseling was ensured to address patient anxiety and fear, providing specific reassurance and boosting the patient's confidence in the surgery. Based on individual situations, detailed pain management plans were developed, including preoperative preventive analgesia measures, such as the administration of appropriate analgesics or nonpharmacological pain management methods, to reduce patients' preoperative fear of pain and stress response during surgery.
In the operating room, the nursing team implemented a more refined seamless intervention. They assisted the anesthesiologist in adjusting the patient's position to ensure comfort and safety during anesthesia, using soft language and comforting touch to reduce the patient's nervousness. During surgery, in addition to closely monitoring vital signs, the nursing team paid special attention to the patient's pain responses, promptly adjusting anesthesia depth or supplementing it with local anesthesia as needed, aiming for a pain-free or minimally painful state throughout the surgery.
Postoperatively, the information regarding the patient's surgery, anesthesia type, and postoperative pain management plan was communicated to the team taking over the patient. A subsequent pain observation and assessment process was collaboratively developed, continuing pain management with a multimodal analgesic strategy that combined both pharmacological and nonpharmacological methods. Pain levels were assessed regularly, and analgesic doses were adjusted as needed. Early patient mobilization was encouraged to promote recovery and reduce complications associated with postoperative pain.
After the patient woke up, a detailed assessment of their pain experience was conducted, providing immediate pain relief measures and information on how to self-assess pain and use pain management tools. Pain management education for both the patient and their family members was provided, raising their awareness of this issue and encouraging active participation, thereby improving overall nursing care quality.
Observational indicators and evaluation criteria
Psychological state Pre- and postnursing anxiety and depression levels were assessed using the Self--Rating Anxiety Scale (SAS)12 and Self-Rating Depression Scale (SDS).13 The patients selected the corresponding options based on their own perceptions, and the total score was calculated to assess their levels of anxiety and depression. Lower values indicated better psychological status. The SAS consists of 20 items, each rated on a 4-point scale. The scoring standard is as follows: a score below 50 indicates no significant anxiety or a normal status; a score of 50-59 means mild anxiety; a score of 60-69 corresponds to moderate anxiety; and a score of 70 or above indicates severe anxiety. The SDS consists of 20 items, each rated on a 4 -point scale. A score below 53 corresponds to a normal status; a score of 53-62 indicates mild depression; a score of 63-72 means moderate depression; and a score above 72 translates to severe depression.
Sleep quality
The Pittsburgh Sleep Quality Index (PSQI)14 was adopted to evaluate the sleep quality of patients before and after nursing. The PSQI consists of 7 components, each scored from 0 to 3 . The total score ranges from 0 to 21 , with higher values indicating poorer sleep quality.
Pain assessment
Pain levels on the day of surgery, and at 2 and 3 days postsurgery were assessed using the numeric rating scale (NRS).15 The NRS uses a line or numerical sequence to classify pain into 11 levels, ranging from 0 to 10 . Higher scores indicate stronger pain.
Surgical efficiency
The efficiency of surgery was measured in terms of the turnover time for consecutive surgeries, preparation time, and operative time.
Stress response indicators
Pre- and postoperative 24-hour stress response indicators were compared between the groups. Blood pressure (both diastolic and systolic) and heart rate were measured using the Omron HEM-746C blood pressure monitor (OMRON Healthcare Group, Kyoto, Japan) before and 24 hours after surgery. Additionally, 5 ml of venous blood was collected from each patient, and after centrifugation at 3000 revolutions/min for 10 minutes, the serum was separated. Cortisol levels were measured using a radioimmunoassay (Xinyu Biotechnology, Shanghai, China), and norepinephrine levels were measured using high-performance liquid chromatography--electrochemical detection.
Patient satisfaction with nursing
Postnursing satisfaction was evaluated using a questionnaire form developed at our hospital. The scoring items included psychological counseling, preoperative education, nursing quality, patient position adjustment, and staff attitude, with each item scoring up to 20 points, for a total score of 100 points.
Complications
The occurrence of complications, including infection, vascular injury, and abdominal organ injury, was compared between the groups.
Statistical analysis
Data processing was performed using SPSS Statistics software, version 26.0 (IBM, Armonk, New York, United States). Quantitative data were presented as mean (SD). Independent sample t tests were used for comparisons between the groups, and paired t tests were employed for within-group comparisons. Categorical data were presented as frequency / percentage, and the χ2 test was applied for comparisons. For categorical data on complications, the Fisher exact test was employed. When multiple measurements were made on the same individual or object at different time points, repeated measures analysis of variance was applied if the data met the criteria of normal distribution or homogeneity of variance. Othersiwe, the Friedman test was used. A P value below 0.05 was considered significant.
RESULTS
General information In the control group, there were 38 men and 12 women. Their ages ranged from 19 to 73 years, with mean (SD) age of 49.7 (12.42) years. Surgery types included: 21 cases of renal stone extraction, 9 cases of renal cyst removal, 5 cases of nephrectomy, 4 cases of renal tumor resection, 7 cases of ureteroplasty, and 4 cases of other procedures. Ten patients haddiabetes and 15 had hypertension. In the observation group, there were 39 men and 11 women. Their age ranged from 20 to 78 years, with mean (SD) age of 49.82 (13.91) years. Surgery types included: 22 cases of renal stone extraction, 8 cases of renal cyst removal, 4 cases of nephrectomy, 9 cases of renal tumor resection, 3 cases of ureteroplasty, and 4 cases of other procedures. There were 13 patients with diabetes and 17 with hypertension. There were no differences in terms of general charactaristics between the 2 groups, indicating intergroup comparability TABLE 1.
TABLE 1.
General characteristics of the patients
| Parameter | Control group (n = 50) | Observation group (n = 50) | P value | |
|---|---|---|---|---|
| Sex | Men | 38 (76) | 39 (78) | 0.06 |
| Women | 12 (24) | 11 (22) | ||
| Age, y | 49.7 (12.42) | 49.82 (13.91) | 0.96 | |
| Body mass index, kg/m² | 22.49 (3.64) | 23.15 (3.45) | 0.35 | |
| Type of surgery | Renal stone extraction | 21 (42) | 22 (44) | 0.82 |
| Renal cyst removal | 9 (18) | 8 (16) | ||
| Nephrectomy | 5 (10) | 4 (8) | ||
| Renal tumor resection | 4 (8) | 9 (18) | ||
| Ureteroplasty | 7 (14) | 3 (6) | ||
| Other | 4 (8) | 4 (8) | ||
| Diabetes | Yes | 10 (20) | 13 (26) | 0.48 |
| No | 40 (80) | 37 (74) | ||
| Hypertension | Yes | 15 (30) | 17 (34) | 0.18 |
| No | 35 (70) | 33 (66) | ||
Data are presented as numbers (percentages) or mean (SD).
Psychological state
Before nursing, there was no difference in the SAS and SDS scores between the groups. After nursing, the SAS and SDS scores in both groups decreased, with the observation group showing lower scores than the controls ( P < 0.01; TABLE 2).
TABLE 2.
Comparison of the Self-Rating Anxiety Scale and Self-Rating Depression Scale scores between the groups
| Variable | Control group (n = 50) | Observation group (n = 50) | ||
|---|---|---|---|---|
| Before care | After care | Before care | After care | |
| SAS, points | 51.3(7.38) | 42.34(7.58)a | 51.72(4.73) | 40.82(4.61)a |
| SDS, points | 51.68(7.9) | 31.7(6.34)a | 51.92(4.58) | 35.06(2.68)a |
| P value | 0.8 | < 0.001 | 0.83 | < 0.001 |
Data are presented as mean (SD).
a A significant difference compared with precare values within the same group
Abbreviations: SAS, Self-Rating Anxiety Scale; SDS, Self-Rating Depression Scale
Sleep quality
Before nursing, there was no marked difference in the PSQI scores between the groups. After nursing, the PSQI scores in both groups decreased, with lower scores recorded in the observation group ( P < 0.01; TABLE 3).
TABLE 3.
Comparison of the Pittsburgh Sleep Quality Index scores between the groups
| Variable | Control group (n = 50) | Observation group (n = 50) |
|---|---|---|
| PSQI scores before care,points | 14.84(1.78) | 9.3(2.12)a |
| PSQI scores after care, points | 14.44(1.57) | 6.62(1.19)a |
| P value | 0.24 | < 0.001 |
Data are presented as mean (SD).
a A significant difference compared with precare values within the same group
Abbreviations: PSQI, Pittsburgh Sleep Quality Index
Pain assessment
On the day of surgery, both groups had similar NRS scores. On postoperative days 2 and 3, the NRS scores in both groups were lower than on the day of surgery, with the observation group demonstrating lower scores ( P < 0.01; TABLE 4).
TABLE 4.
Comparison of the numeric rating scale scores between the groups
| Parameter | Control group (n = 50) | Observation group (n = 50) | P value | |
|---|---|---|---|---|
| NRS score, points | Day 0 | 7.02 (0.71) | 7.04 (0.78) | 0.89 |
| Day 2 | 5.88(0.72)a | 4.74 (0.88)a | <0.001 | |
| Day 3 | 4.74(0.75)a | 2.5 (1.04)a | <0.001 | |
Data are presented as mean (SD).
a A significant difference compared with precare values within the same group
Abbreviations: NRS, numeric rating scale
Surgical efficiency
The turnover time for consecutive surgeries, preparation time, and operative time in the observation group were remarkably shorter than in the control group ( P < 0.01; TABLE 5).
TABLE 5.
Comparison of surgical efficiency between the groups
| Parameter | Control group (n = 50 ) | Observation group (n = 50) | P value |
|---|---|---|---|
| Turnover time for consecutive surgeries, min | 43.2 (9.62) | 30.86 (7.14) | <0.001 |
| Surgical preparation time, min | 44.96 (6.02) | 31.02 (4.09) | <0.001 |
| Operative time, min | 119.82 (22.78) | 103.38 (12.48) | <0.001 |
Data are presented as mean (SD).
Stress response
Preoperatively, no differences were noted in diastolic blood pressure, systolic blood pressure, heart rate, as well as cortisol and norepinephrine levels between the groups. At 24 hours postoperatively, all of the above parameters increased in both groups, but the observation group showed lower levels than the control group ( P < 0.01; TABLE 6).
TABLE 6.
Comparison of stress response indicators before and 24 hours after surgery between the groups
| Parameter | Control group (n = 50) | Observation group (n = 50) | P value | |
|---|---|---|---|---|
| Diastolic blood pressure, mm Hg | Preoperatively | 84.37 (2.19) | 84.55 (2.16) | 0.7 |
| 24 h posturgery | 96.85 (2.49)a | 89.51(2.25)a | <0.001 | |
| Systolic blood pressure, mm Hg | Preoperatively | 106.57 (4.77) | 106.53 (4.62) | 0.97 |
| 24 h posturgery | 126.9(6.8)a | 114.33 (5.08) a | <0.001 | |
| Heart rate, bpm | Preoperatively | 89.04 (2.43) | 89.34 (2.38) | 0.53 |
| 24 h posturgery | 109.04(5.65)a | 99.34 (3.39)a | <0.001 | |
| Cortisol, nmol/l | Preoperatively | 485.19 (66.46) | 485.78 (63.93) | 0.96 |
| 24 h posturgery | 589.69 (64.7)a | 509.88 (63.06)a | <0.001 | |
| Norepinephrine, μg/l | Preoperatively | 0.17 (0.05) | 0.18 (0.06) | 0.52 |
| 24 h posturgery | 0.63 (0.06)a | 0.42 (0.07)a | <0.001 | |
Data are presented as mean (SD).
a A significant difference compared with precare values within the same group
SI conversion factor: to convert norepinephrine to pmol/I, multiply by 5910
Patient satisfaction with nursing
The overall satisfaction score with the operating room nursing care in the observation group (mean [SD], 91.44 [3.68]) was noticeably higher than that in the control group (mean [SD], 81.2 [3.68]; P <0.001).
Complications
The total incidence of complications in the observation group was lower relative to the control group ( P = 0.09; TABLE 7).
TABLE 7.
Comparison of complication rates between the groups
| Complication | Control group (n = 50) | Observation group (n = 50) | P value |
|---|---|---|---|
| Infection | 4 (8) | 1 (2) | 0.36 |
| Vascular injury | 3 (6) | 1 (2) | 0.62 |
| Abdominal organ injury | 1 (2) | 0 | >0.99 |
| Total incidence rate | 8 (16) | 2 (4) | 0.09 |
Data are presented as numbers (percentages).
DISCUSSION
This study evaluated the impact of seamless intervention combined with pain management on the efficiency of urological laparoscopic surgery. By comparing the outcomes of the observation group, which received the integrated care approach, with those of the control group, which followed conventional care protocols, we noted significant improvements in various parameters, such as psychological state, sleep quality, pain management, surgical efficiency, and patient satisfaction.
Liu et al16 found that primary nursing intervention can improve patients' psychological well--being, as evidenced by the reduction in anxiety and depression scores postnursing (SAS, SDS) and the enhancement of sleep quality (PSQI). These outcomes align with our findings, highlighting the impact of seamless intervention combined with pain management on improving the efficiency of urological laparoscopic surgery. Specifically, it involves the integration of psychological support, pain management, preoperative preparation, and postoperative rehabilitation, which collectively help alleviate preoperative anxiety and enhance postoperative recovery. Meanwhile, this study contributes to the existing literature by examining the specific combination of seamless intervention and pain management within urological laparoscopic surgery, which had not been comprehensively explored before.17 Previous studies have primarily focused on the effects of either seamless intervention or pain management separately, but not their combined impact on surgical outcomes. 18,19 Our study addressed this gap by demonstrating that the integration of both approaches significantly enhances patient recovery in urological laparoscopic surgery, as evidenced by the improved psychological and physiological metrics.
One of our key findings is the marked reduction in postoperative pain levels and the improvement in surgical efficiency. These results align with existing research that suggests pain management protocols, especially multimodal analgesia, contribute to better surgical outcomes.20 However, our work demonstrates the value of an integrated care model that spans the entire perioperative period, emphasizing continuous patient care from preoperative psychological support to postoperative pain control. The observation group's considerably higher satisfaction scores further underscore the importance of addressing both physical and psychological aspects of patient care. Contrary to some earlier studies,21,22 our research shows a marked improvement in stress-related biomarkers, such as cortisol and norepinephrine levels, in the observation group. This discrepancy could be attributed to the more comprehensive nature of our intervention, which included tailored preoperative counseling, real-time intraoperative care, and robust postoperative pain management strategies.23 The observation group exhibited a lower incidence of postoperative complications, further highlighting clinical advantages of this integrated approach. While similar studies have demonstrated the effectiveness of seamless interventions in reducing complications in other types of surgery, 24 this work provided novel evidence specific to urological laparoscopic surgery, supporting its broader applicability.
CONCLUSIONS
Our findings suggest that the integrated approach of seamless intervention combined with pain management could set new standards for perioperative care in urological laparoscopic surgery. This research underscores the importance of considering the entire perioperative process rather than focusing solely on individual care aspects. The observed improvements in psychological and physiological parameters provide a compelling case for the adoption of this model, with significant implications for enhancing patient outcomes, reducing complications, and improving overall patient satisfaction. Future research could explore long-term effects of seamless intervention combined with pain management, particularly its impact on recovery time and QoL after surgery. Additionally, investigating the scalability of this integrated care model in other surgical disciplines could further expand its potential benefits to a wider range of patients. Future studies with larger sample sizes and multicenter designs are also warranted to confirm the generalizability of our findings.
Acknowledgments
ACKNOWLEDGMENTS
None.
Funding Statement
None.
CONTRIBUTIONS STATEMENTS
LG was involved in the study design and experimental studies. YS was responsible for the data analysis. LG and XL edited the manuscript. All authors read and approved the final version of the manuscript.
AI STATEMENT
Artificial intelligence was not used in the preparation of this manuscript.
HOW TO CITE
Liu X, Guan L, Shen Y. Impact of seamless intervention in the operating room combined with pain management on the efficiency of urological laparoscopic surgery. Wideochir Inne Tech Maloinwazyjne. 2025; 20: 445-450. doi:10.20452/wiitm.2025.17993
JOURNAL INFORMATION
Videosurgery and Other Miniinvasive Techniques is an official journal of the Videosurgery Foundation.
REFERENCES
- Practical relevance from urological guidelines. Krabbe L., Michel S., Krege S. Urologie. 2024;63:429-430. doi: 10.1007/s00120-024-02332-4. [DOI] [PubMed] [Google Scholar]
- Complications in urological surgery. Irani J., Legeais D., Madec F.X., et al. Prevention [in French]. Prog Urol. 2022;32:919-927. doi: 10.1016/j.purol.2022.08.011. [DOI] [PubMed] [Google Scholar]
- Obstructive uropathy - acute and chronic medical management. Yaxley J., Yaxley W. World J Nephrol. 2023;12:1-9. doi: 10.5527/wjn.v12.i1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Laparoscopic entry techniques: which should you prefer? Raimondo D., Raffone A., Travaglino A., et al. Int J Gynaecol Obstet. 2023;160:742-750. doi: 10.1002/ijgo.14412. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Effectiveness of perioperative low-dose esketamine infusion for postoperative pain management in pediatric urological surgery: a prospective clinical trial. Xie Y., Liang Z., Chen S., et al. BMC Anesthesiol. 2024;24 doi: 10.1186/s12871-024-02450-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Effect analysis of applying high-quality service model to surgical nursing. Chen L., Tu Q.M., Guo Z.D., et al. World J Clin Cases. 2024;12:3744-3751. doi: 10.12998/wjcc.v12.i19.3744. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Outcome4Medicine consensus group. Consensus recommendations on how to assess the quality of surgical interventions. Domenghino A., Walbert C., Birrer D.L., et al. Nat Med. 2023;29:811-822. doi: 10.1038/s41591-023-02237-3. [DOI] [PubMed] [Google Scholar]
- Effect of the whole seamless connection of nursing from WeChat interactive platform on stigma and quality of life in patients with urinary system cancer. Hao H., Yang X., Zhu H., et al. Digit Health. 2022;8 doi: 10.1177/20552076221102772. [DOI] [PMC free article] [PubMed] [Google Scholar]
- The effect of seamless nursing combined with Roy adaptive psychological nursing on self-efficacy and bad mood of patients after acute abdomen surgery. Nie C., Chen X., Wang L., et al. Medicine. 2023;102 doi: 10.1097/MD.0000000000032720. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Multimodal approach to pain management in veterinary rehabilitation. Ihrke A. Vet Clin North Am Small Anim Pract. 2023;53:731-742. doi: 10.1016/j.cvsm.2023.02.006. [DOI] [PubMed] [Google Scholar]
- Practice and factors associated with pediatrics pain management among nurses working in Bahir Dar city public hospitals: a mixed method study. Berihun B., Fentahun N., Asmare L., Yigzaw Z.A. PloS One. 2024;19 doi: 10.1371/journal.pone.0300853. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dunstan D.A., Scott N. BMC Psychiatry. Vol. 20. A; 2020. Norms for Zung's Self-rating Anxiety Scale. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Validation of the Zung self-rating depression scale (SDS) in older adults. Jokelainen J., Timonen M., Keinanen-Kiukaanniemi S., et al. Scand J Prim Health Care. 2019;37:353-357. doi: 10.1080/02813432.2019.1639923. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pittsburgh Sleep Quality Index (PSQI) responses are modulated by total sleep time and wake after sleep onset in healthy older adults. Zitser J., Allen I.E., Falgas N., et al. PloS One. 2022;17 doi: 10.1371/journal.pone.0270095. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Validity of the numeric rating scale as a measure of dyspnea. AG C.Gift, G Narsavage. Am J Crit Care. 1998;7:200-204. [PubMed] [Google Scholar]
- Analysis of primary nursing intervention for elderly patients with cancer pain on the improvement of potential risk and pain degree. Liu Y., Zhang Z., Gong Q., et al. Am J Transl Res. 2021;13:11890-11898. [PMC free article] [PubMed] [Google Scholar]
- Pain management and education for ambulatory surgery: a qualitative study of perioperative nurses. Nallani R., Fox C.C., Sykes K.J., et al. J Surg Res. 2021;260:419-427. doi: 10.1016/j.jss.2020.11.001. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Influence of seamless nursing model of humanistic care on nursing quality and blood infection risk of neurosurgical ICU patients and its correlation with APACHE II score. Liu F., Wang X. Front Public Health. 2022;10(944605) doi: 10.3389/fpubh.2022.944605. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Health care providers' experiences of pain management and attitudes towards digitally supported self--management interventions for chronic pain: a qualitative study. Varsi C., Ledel Solem I.K., Eide H., et al. BMC Health Serv Res. 2021;21 doi: 10.1186/s12913-021-06278-7. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pain can't be carved at the joints: defining function-based pain profiles and their relevance to chronic disease management in healthcare delivery design. Barron D.S., Saltoun K., Kiesow H., et al. BMC Medicine. 2024;22 doi: 10.1186/s12916-024-03807-z. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Influence of Psychological Nursing Procedure on Negative Emotion, Stress State, Quality of Life and Nursing Satisfaction in Patients with Lung Cancer Radical Operation. Yu Y., Xia Y., Fan X., et al. Front Surg. 2022;9 doi: 10.3389/fsurg.2022.899033. [DOI] [PMC free article] [PubMed] [Google Scholar]
- The effects of detailed nursing interventions on the safety and stress responses of tumor patients. Wang X., Yang W. Am J Transl Res. 2021;13:11375-11383. [PMC free article] [PubMed] [Google Scholar]
- Bridging the gap: evaluation of preoperative patients' education by comparing expectations and real-perioperative surgical experiences: a mixed-methods descriptive cross-sectional study. Ali Z., Ahsan Z., Liaqat N., Din I.U. BMC Health Serv Res. 2024;24 doi: 10.1186/s12913-024-11388-z. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Application effect of the principle of seamless management in nursing risk control of the department of gastrointestinal surgery. Lu L., Mao Y. Am J Transl Res. 2021;13:8031-8039. [PMC free article] [PubMed] [Google Scholar]