Abstract
Objective: To explore the effect of hospital, community and home care model on the nursing effect and quality of life of patients with benign prostatic hyperplasia (BPH) undergoing transurethral resection. Methods: As a prospective study, 89 patients with transurethral resection of BPH were randomly divided into two groups by different nursing methods: a research group and a control group. The control group (n=41) received regular nursing, and the research group (n=48) received hospital, community and home care intervention. Both nursing methods were performed from patients’ admission to discharge. The changes of psychological status (measured by Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD)), self-care ability (measured by Exercise of Self-care Agency Scale (ESCA)) and quality of life (measured by Benign Prostatic Hyperplasia Quality of Life Scale (BPH-QLS)), the incidence of postoperative complications and nursing satisfaction of patients before and after intervention were compared between the two groups. Results: After nursing, the HAMA and HAMD scores in the research group were lower than those in the control group; the ESCA score and BPH-QLS score were higher than those in the control group (P<0.05); the incidence of complications in the research group was lower than that in the control group (P<0.05); the nursing satisfaction in the research group was higher than that in the control group (P<0.05). Conclusion: The intervention of hospital, community and family care nursing model for patients with transurethral resection of BPH can reduce the occurrence of complications, significantly improve their psychological status and self-care ability, thus improving the quality of life and nursing satisfaction of patients.
Keywords: Transurethral resection of benign prostatic hyperplasia, hospital, community and home care, psychological status, self-care ability, quality of life
Introduction
Benign prostatic hyperplasia (BPH) is a common benign disease that causes micturition disorders in middle-aged and elderly men, which is mainly characterized by clinical symptoms such as prostatic enlargement, lower urinary tract symptoms and bladder outlet obstruction. It not only affects the physical health of patients, but also seriously affects their quality of life [1]. Transurethral resection of the prostate is currently the most commonly used method for endourological treatment of benign prostatic hyperplasia, with the advantages of less trauma, significant effect, rapid recovery, and short hospital stay. It is known as the “Gold standard” for the treatment of benign prostatic hyperplasia in recent years [2]. However, surgery is by no means traumatic. Effective as it is, surgery is actually a “double-edged sword”. If the intervention is inappropriate after surgery, it is likely to cause a series of complications such as secondary bleeding, urinary incontinence, urinary tract infection, retrograde ejaculation and urethral stricture [3]. Moreover, some patients are prone to negative emotions. They worry about the effect of surgery and postoperative recovery, which may reduce their compliance, influence the therapeutic effect, and then reduce their quality of life [4]. Based on the serious condition, some studies have suggested that intensive nursing intervention plays an important role in improving the psychological status of patients and reducing the occurrence of complications [5].
Routine care is mostly conducted in hospitals and focuses more on physical discomfort only. It rarely exerts psychological intervention for patients, and it is often disconnected from the integrated health management of community and family and patients cannot receive long-term professional care and guidance after discharge. Indeed, the patients barely know anything about disease management [6]. In recent years, because of its effects in nursing, the hospital, community and home care model has been gradually applied in the clinical nursing of various diseases [7]. As the continuation of out-of-hospital care, the hospital, community and home care model ensure that patients can be properly cared in their daily life to promote faster recovery of the disease [8]. However, there are few reports on the application of this model in patients undergoing transurethral resection of benign prostatic hyperplasia. In this study, we reported the application and effect of the care model in patients undergoing transurethral resection of benign prostatic hyperplasia.
Materials and methods
General information
As a prospective study, 89 patients with transurethral resection of benign prostatic hyperplasia admitted to our hospital between March 2019 and February 2020 were selected and randomized into two groups: a research group and a control group. A total of 41 patients in the control group received routine care, and 48 patients in the research group received the hospital, community and home care. This study complied with the relevant standards of the Medical Ethics Committee of the hospital.
Inclusion criteria
All patients were treated in accordance with the diagnostic criteria of benign prostatic hyperplasia in the “Chinese Guidelines for the Diagnosis and Treatment of Urological Diseases”, and were diagnosed by cystoscopy, MRI, CT, blood extraction and other methods [9]. Their blood pressure, blood glucose, blood lipids and other indicators were controlled at normal levels before surgery. All indications of patients conform to those of transurethral resection of benign prostatic hyperplasia without history of surgical contraindications. All patients were given general anesthesia during the operation. All patients and their families signed the informed consent form for the study. Exclusion criteria: patients had history of previous prostate, bladder, urethral surgery, abnormal coagulation function and abnormal immune function; patients had cancer, organic diseases such as heart, lung, cerebrovascular disease; patients had abnormal mental cognition or lack capacity in daily life; patients had neurogenic bladder, urethral obstructive diseases caused by cerebrovascular disease, lumbar trauma, diabetes or other reasons; patients lived alone; patients had previous psychiatric history such as depression, anxiety or bipolar disorder; patients had long-term abuse of psychotropic drugs; patients were disabled.
Methods
Control group
Routine care and health education were given to patients on admission into the hospital. Procedures of hospitalization were introduced to the patients, such as examination, treatment, medication, payment, etc. During hospitalization, preoperative visit was performed. The importance and necessity of surgical treatment were explained to the patients. The operating room, surgical process, postoperative recovery process and late maintenance were also briefly introduced to them. Their psychological status was recorded and evaluated during the communication with the patients. If the patients had large mood swings, hypnotic and sedative drugs could be given as appropriate to help the patients cope with the operation in a good physical and mental state. Pay close attention to the changes of blood pressure, body temperature and other vital signs after operation. Instructions on diet, medicine and rehabilitation training were given to the patients. Before discharge, the patients were informed of guidance in their daily activities and in the prevention of complications. The whole nursing was conducted from their admission to discharge. After discharge, the patients would perform self-care and disease management for themselves. The routine care guidance and return visit after discharge were conducted by telephone for 6 months.
Research group
Based on the nursing measures in the control group, hospital, community and home care was added in the research group: (1) hospital care: a) A care group was established which consisted of one head nurse with five responsible nurses. The head nurse was responsible for supervision and guidance, and each responsible nurse covered for 8 to 10 patients. b) A good nurse-patient relationship was built up through fully communicating with patients during every visit. Psychological counseling was implemented according to the patient’s educational level, social status, economic status though communication, encouragement and other means to meet the psychological needs of patients who wanted to be understood as much as possible, so that patients would naturally unfold their inner emotions, and nurses could deal with them in time. It helped patients maintain a stable and optimistic attitude to surgery and subsequent treatment. c) Preoperative and postoperative examination of relevant biological indicators and prevention of complications were carried out in the hospital. Informed patients of the possible complications and the causes, and immediately notify the medical staff once the relevant symptoms occur. d) Instructed the patients to carry out rehabilitation training to contract perineum and anus, focus on the strength of perineal muscles and the part around anus during practice. Each practice lasted for 5-10 seconds with 10-15 times/group. When the patients master the skills, increase the training time and intensity according to their own conditions, and change their positions at the same time. In addition, during micturition, patients were instructed to control the micturition speed and the times of controlling urinary flow, so as to relieve the symptoms of urinary incontinence. e) Before discharge, patients were given a community review manual to record the community feedback, and meanwhile, the review requirements, review time, diet and mood management, medication guidance, common complications and other contents were prepared on the manual for later checking. WeChat groups for patients and their families were also established to facilitate communication. (2) Community care: The patients were instructed to do the reexamination in the community 1 month and 3 months after discharge and the results were recorded in detail on the reexamination manual for comparison. If the examination results were unremarkable, self-care could be implemented normally. If the results were remarkable, the attending physician would guide the patients to do self-care and they would decide whether patients needed to return to the hospital for reexamination. Meanwhile, the community carried out a health education symposium once a week. Before the symposium, the self-care conditions such as diet and rehabilitation training in the daily life of patients were examined. Those patients with poor self-care ability were emphatically supervised by more instructions and communication through WeChat or phone calls. During the symposium, knowledge of related diseases, precautions and targeted guidance would be instilled to the patients, thus deepening the patients’ understanding of diseases and enhancing their awareness of self-care. Besides, psychological counseling was performed according to the patients’ psychological status. More concerns and care were also expressed to the patients. (3) Home care: Family members were also responsible for patients’ care. We communicated with the family members through Wechat, allowed them to actively participate in the daily activity arrangement of patients, advised them to do the supervision over patients’ rehabilitation training, encourage the patients to maintain a positive attitude and good mood and feel the care and love from their family. Supervised the patients to quit smoking and alcohol, asked them to avoid strenuous exercise, eat more coarse grains, fruits and vegetables, drink water on time to promote defecation, avoid straining to defecate so as to prevent increased intra-abdominal pressure which may squeeze the prostate and cause secondary bleeding. The nursing process continued for 6 months.
Outcome measures
Main outcome measures
(1) Psychological stat-us: Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA) were used before nursing (on the 2nd day after admission) and after nursing (on the 2nd day after the end of nursing intervention) [10,11]. HAMD consists of 24 items including depressive mood, suicide, feelings of guilt, etc., of which 14 items take 0-4 rating method, 10 items apply 0-2 score method. Eight points and below indicates normal psychological state; 8-20 points indicates possible depression; 21-35 points indicates definite depression, and >35 points indicates severe depression. The HAMA contains 14 items such as anxious mood, tension, insomnia, intellectual and so on, and 0-4 rating method was used in the scale with 7 points or below indicating normal psychological state, 7-13 points indicating possible anxiety, 14-20 points indicating definite anxiety, 21-29 points indicating obvious anxiety, and >29 points indicating severe anxiety. (2) Self-care ability: Self-care ability was evaluated by the Exercise of Self-care Agency Scale (ESCA) before nursing (2nd day after admission) and after nursing (2nd day after the end of nursing intervention), which contains 4 dimensions and 43 items, namely self-concept (8 items), self-competence (6 items), self-care skills (12 items), and health knowledge (17 items), and a 0-4 scoring method was used, with higher scores indicating better self-care ability [12]. (3) Quality of life: It was assessed by Benign Prostatic Hyperplasia Quality of Life Scale (BPH-QLS) before and after care [13]. The scale contains 5 dimensions and 74 items, which are disease dimension (27 items), physical dimension (16 items), psychological dimension (10 items), social dimension (13 items) and satisfaction dimension (8 items). The 1 to 5 grading method was applied. D66 was the forward item and the remaining 73 were the reverse item, with higher scores indicating better quality of life.
Secondary outcome measures
(1) Complications: The incidence of postoperative complications was recorded, including perioperative bleeding, urinary tract infection, urinary incontinence, fluid leakage, and transurethral resection syndrome. (2) Nursing satisfaction: 6 months after discharge, the self-made satisfaction questionnaire was used to count the patients’ satisfaction with nursing work. The questionnaire included nursing content, nursing skills, communication skills, nursing attitude, etc. By 0-4 grading method, the full score was 100 points, and the score was divided into 5 grades, which were very satisfied (≥90 points), satisfied (80-89 points), fairly satisfied (70-79 points), dissatisfied (60-69 points), and very dissatisfied (<60 points). Satisfaction equals (very satisfied cases + satisfied cases)/n × 100%.
Statistical analysis
SPSS 23.0 software was used. Measurement data were expressed as (x̅ ± sd); independent sample t test was applied for comparison between groups; paired sample t test was utilized for comparison in the same group before and after nursing; count data were expressed as percentage and plotted by χ2 test. P<0.05 was considered statistically significant.
Result
Comparison of general information between two groups
There was no significant difference in age, disease duration, prostate weight, prostate volume, and marital status between two groups (all P>0.05), but they are comparable. See Table 1.
Table 1.
Comparison of general information between two groups (x̅ ± sd)
| Group | Control group (n=41) | Research group (n=48) | t/χ2 | P |
|---|---|---|---|---|
| Age (years) | 63.1±8.2 | 62.8±8.1 | t=0.173 | 0.863 |
| Course of disease (years) | 5.51±2.08 | 6.08±2.19 | t=1.252 | 0.214 |
| Prostate weight (g) | 35.22±6.28 | 34.92±6.01 | t=0.230 | 0.819 |
| Prostate volume (cm3) | 94.28±15.20 | 96.51±16.27 | t=0.664 | 0.508 |
| Marital status (n) | χ2=0.583 | 0.747 | ||
| Married | 33 | 36 | ||
| Divorced | 2 | 2 | ||
| Widowed | 6 | 10 |
Comparison of psychological status between two groups
After nursing, the HAMA and HAMD scores of patients in both groups decreased, and scores of the research group was lower than those of the control group (all P<0.001). It suggested that the hospital, community and home care model was effective on the improvement of psychological status of patients undergoing transurethral resection of benign prostatic hyperplasia. See Table 2 and Figure 1.
Table 2.
Comparison of HAMA and HAMD scores between two groups (x̅ ± sd, scores)
| Group | Control group (n=41) | Research group (n=48) | t | P |
|---|---|---|---|---|
| HAMA | ||||
| Before nursing | 12.01±1.94 | 11.77±1.90 | 0.588 | 0.558 |
| After nursing | 6.60±1.02*** | 5.15±0.81*** | 7.472 | <0.001 |
| HAMD | ||||
| Before nursing | 18.38±2.62 | 18.81±2.88 | 0.732 | 0.466 |
| After nursing | 7.92±1.17*** | 6.47±1.01*** | 6.276 | <0.001 |
Note: Compared with that before nursing;
P<0.001.
HAMA: Hamilton Anxiety Rating Scale; HAMD: Hamilton Depression Rating Scale.
Figure 1.
Comparison of HAMA and HAMD scores between two groups. A: HAMA score; B: HAMD score. Compared with that before nursing, ***P<0.001; compared with that after nursing, ###P<0.001. HAMA: Hamilton Anxiety Rating Scale; HAMD: Hamilton Depression Rating Scale.
Comparison of self-care ability between two groups
After nursing, ESCA scores increased in both groups, and scores were higher in the research group than in the control group (all P<0.001). It represented that the hospital, community and home care model played positive role in the improvement of self-care ability of patients undergoing transurethral resection of benign prostatic hyperplasia. See Table 3 and Figure 2.
Table 3.
Comparison of ESCA scores between two groups (x̅ ± sd, scores)
| Group | Control group (n=41) | Research group (n=48) | t | P |
|---|---|---|---|---|
| Self-concept | ||||
| Before nursing | 11.18±2.38 | 10.74±2.02 | 0.944 | 0.348 |
| After nursing | 21.71±3.56*** | 25.85±3.78*** | 5.289 | <0.001 |
| Self-care responsibility | ||||
| Before nursing | 10.42±2.08 | 11.16±2.30 | 1.581 | 0.117 |
| After nursing | 15.23±2.79*** | 18.59±3.04*** | 5.397 | <0.001 |
| Self-competence | ||||
| Before nursing | 22.21±3.95 | 21.88±3.73 | 0.405 | 0.686 |
| After nursing | 35.82±4.81*** | 40.19±5.19*** | 4.094 | <0.001 |
| Health knowledge | ||||
| Before nursing | 28.24±4.03 | 29.39±4.11 | 1.328 | 0.188 |
| After nursing | 45.95±5.61*** | 51.96±6.32*** | 4.707 | <0.001 |
Note: Compared with that before nursing;
P<0.001.
ESCA: Exercise of Self-care Agency Scale.
Figure 2.
Comparison of ESCA score between two groups. A: Self-concept score; B: Self-responsibility score; C: Self-competence score; D: Health knowledge score. Compared with that before nursing, ***P<0.001; compared with that after nursing, ###P<0.001. ESCA: Exercise of Self-care Agency Scale.
Comparison of quality of life between two groups
After nursing, BPH-QLS scores increased in both groups, and scores were higher in the research group than in the control group (all P<0.001). It indicated that the hospital, community and home care model was effective on the improvement of quality of life in patients undergoing transurethral resection of benign prostatic hyperplasia. See Table 4 and Figure 3.
Table 4.
Comparison of BPH-QLS scores between two groups (x̅ ± sd, scores)
| Group | Control group (n=41) | Research group (n=48) | t | P |
|---|---|---|---|---|
| Disease dimension | ||||
| Before nursing | 41.60±5.72 | 43.01±5.89 | 1.141 | 0.257 |
| After nursing | 92.41±9.46*** | 115.04±17.63*** | 7.360 | <0.001 |
| Physical dimension | ||||
| Before nursing | 32.51±4.31 | 33.37±4.56 | 0.909 | 0.366 |
| After nursing | 61.06±7.25*** | 70.32±7.99*** | 5.686 | <0.001 |
| Psychological dimension | ||||
| Before nursing | 21.60±3.58 | 20.94±3.45 | 0.884 | 0.379 |
| After nursing | 33.52±4.49*** | 38.67±4.89*** | 5.141 | <0.001 |
| Social dimension | ||||
| Before nursing | 29.48±3.98 | 30.50±4.02 | 1.199 | 0.234 |
| After nursing | 48.18±5.63*** | 55.17±6.16*** | 5.550 | <0.001 |
| Satisfaction rate | ||||
| Before nursing | 24.81±3.59 | 23.78±3.41 | 1.386 | 0.169 |
| After nursing | 30.57±4.05*** | 35.25±4.71*** | 4.980 | <0.001 |
Note: Compared with that before nursing;
P<0.001.
BPH-QLS: Benign Prostatic Hyperplasia Quality of Life Scale.
Figure 3.
Comparison of BPH-QLS scores between two groups. A: Scores on disease; B: Scores on physiological dimension; C: Scores on psychological dimension; D: Scores on social dimension; E: Scores on satisfaction. Compared with that before nursing, *** P<0.001; compared with that after nursing, ###P<0.001. BPH-QLS: Benign Prostatic Hyperplasia Quality of Life Scale.
Comparison of incidence of complications between two groups
The incidence of complications in the research group was lower than that in control group, and the difference had statistical significance (P<0.05). It showed the hospital, community and home care could alleviate the complication rate to a certain extent. See Table 5.
Table 5.
Comparison of incidence of complication between two groups (n, %)
| Group | Control group (n=41) | Research group (n=48) | χ2 | P |
|---|---|---|---|---|
| Perioperative bleeding | 2 (4.88) | 1 (2.08) | 0.019 | 0.890 |
| Urinary tract infection | 2 (4.88) | 0 (0.00) | 0.689 | 0.406 |
| Urinary incontinence | 3 (7.32) | 1 (2.08) | 0.455 | 0.500 |
| Fluid leakage | 1 (2.44) | 0 (0.00) | 0.006 | 0.937 |
| Transurethral resection syndrome | 1 (2.44) | 1 (2.08) | 0.000 | 1.000 |
| Total incidence | 9 (21.95) | 3 (6.25) | 4.673 | 0.031 |
Comparison of satisfaction rate with nursing work between two groups
The nursing satisfaction in the research group was higher than that in the control group, and the difference was statistically significant (P<0.05). It suggested that the hospital, community and home care was more easily recognized by patients for nursing work. See Table 6.
Table 6.
Comparison of satisfaction rate between two groups (n, %)
| Group | Control group (n=41) | Research group (n=48) | χ2 | P |
|---|---|---|---|---|
| Very satisfied | 21 (51.22) | 32 (66.67) | 2.190 | 0.139 |
| Satisfied | 12 (29.27) | 14 (29.17) | ||
| Fairly satisfied | 6 (14.63) | 1 (2.08) | ||
| Dissatisfied | 1 (2.44) | 1 (2.08) | ||
| Very dissatisfied | 1 (2.44) | 0 (0.00) | ||
| Satisfaction rate | 33 (80.49) | 46 (95.83) | 5.221 | 0.022 |
Discussion
The main issue of benign prostatic hyperplasia is progressive worsening of the micturition disorders, which results in a decreased quality of life of patients. If the urination is frequent, patients dare not drink water, and even reduce participation in daily activities. It will also affect the sleep quality of patients with a history of nocturia, leading to diurnal fatigue and lack of energy [14]. With the increase of patients’ dependence on their family members, it is easy to develop depression, anxiety and other adverse emotions, which further aggravates clinical symptoms and forms a vicious cycle [15]. With the development of biopsychosocial model in medicine, the correlation of patients’ psychology and physiology has been paid attention in recent years. Many clinical experiments have demonstrated that the occurrence, development of diseases and the maintenance of health are not only related to biological factors and physical treatment. Social factors and psychological treatment are also rather pivotal. Strengthening the treatment of symptoms caused by psychological and social factors is more conducive to the outcome of diseases [16].
It has to be mentioned that since most patients with benign prostatic hyperplasia are the elderly and have poor self-care ability, there are many problems in disease management after discharge and the level of self-care ability is closely related to the prognosis of the disease [17]. Although surgery can deal with the obstruction in patients, due to the complicated features of the prostate such as the rich vascular plexus, internal and external sphincter of the prostate and other anatomical characteristics, symptoms of urination stimulation may not be improved in a short term after surgery, which will effect urination or sexual function and ultimately influence quality of life of patients [18]. Therefore, nursing interventions in daily life is quite necessary in improving patients’ self-care ability and health.
The hospital, community and home care model, as a type of continuous care model, mainly aims at making patients return to the community or family as well as receiving professional care after discharge. Rising in recent years, this nursing model meets the needs of patients for continuous care. It compensates for the disadvantages such as inadequate ability of family caregivers and simple regular follow-up in hospitals, so that hospitals, communities, and families can better integrate with each other and provide normative and professional rehabilitation guidance for patients. It helps patients promote disease rehabilitation and improve their quality of life [19]. Shi Lihong and other scholars applied hospital, community and home care in patients with stoma after ileal cystectomy and found that this nursing model can effectively improve stoma adaptability, reduce renal function injury, prevent stoma-related complications and improve patients’ quality of life [20]. It has been pointed out that continuous care can significantly improve the psychological flexibility and mental capacity of elderly patients with benign prostatic hyperplasia after transurethral resection, help patients cope with the disease and promote the postoperative rehabilitation [21]. However, there are still few clinical studies on the application of the hospital, community and home care for patients with benign prostatic hyperplasia. The results of this study showed that after care, the improvement of psychological status, self-care ability and quality of life of patients in the research group were superior to those in the control group, and the incidence rate of complications in the research group was lower than that in the control group. It suggests that the hospital, community and home care model is definitely effective in reducing the risk of complications, avoiding the adverse emotions of patients and improving the self-care ability of patients in daily life, thus improving their quality of life.
During the hospitalization, the instruction on the patient’s diet can avoid vasodilatation caused by food stimulation, prevent prostatic congestion from being larger which aggravates urethral obstruction, or cause constipation and other symptoms. Meanwhile, instructing the patient to do functional exercise will promote anal muscle contraction, blood circulation, reduce edema and adhesion, improve urinary incontinence, enhance and restore local muscle strength. However, most patients have poor postoperative adaptability. Although they have good compliance in the hospital, they may not follow the guidance after discharge. They will be less focused on the diet, medication, rehabilitation exercise and other healthy lifestyles. They might be less determined, which brings postoperative complications without any significant improvement on rehabilitation. Then, they may hold doubts about the effect of surgery and show a sense of helplessness and depression [22]. The negative emotions can disturb the autonomic nervous system through neurotransmitter transmission, resulting in increased excitability of sympathetic nerves around the pelvic floor muscle and external urethral sphincter, which causes urethral hypertension and aggravates dysuria [23]. The hospital, community and home care model unites community and family for mutual assistance. It helps to supervise and instruct patients, educate them with self-care knowledge, carry out behavioral guidance, improve patients’ understanding of the disease and establish the scientific health concept. At the same time, it can also effectively and consciously change patients’ unhealthy lifestyles, relieves patients’ anxiety, depression and other emotions, encourage and help them actively involved in daily activities, which is quite significant for complication control [24,25]. In addition, the study investigated patient satisfaction with care and found that the hospital, community and home care was also more easily recognized by patients than routine care, which also confirmed that this model could meet the needs of patients for continuous care. However, since this model has not been popularized in urology and this study is limited with small sample size, the effects of this model need to be verified in the future.
In summary, the hospital, community and home care for patients undergoing transurethral resection of benign prostatic hyperplasia can significantly improve patients’ psychological status, self-care ability, reduce the occurrence of complications, thus improving patients’ quality of life and their satisfaction with nursing work.
Disclosure of conflict of interest
None.
References
- 1.Foo KT. What is a disease? What is the disease clinical benign prostatic hyperplasia (bph)? World J Urol. 2019;37:1293–1296. doi: 10.1007/s00345-019-02691-0. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Abt D, Hechelhammer L, Müllhaupt G, Markart S, Güsewell S, Kessler TM, Schmid HP, Engeler DS, Mordasini L. Comparison of prostatic artery embolisation (pae) versus transurethral resection of the prostate (turp) for benign prostatic hyperplasia: randomised, open label, non-inferiority trial. BMJ. 2018;361:2338. doi: 10.1136/bmj.k2338. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Sun F, Sun X, Shi Q, Zhai Y. Transurethral procedures in the treatment of benign prostatic hyperplasia: a systematic review and meta-analysis of effectiveness and complications. Medicine (Baltimore) 2018;97:13360. doi: 10.1097/MD.0000000000013360. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Erkoc M, Otunctemur A, Besiroglu H, Altunrende F. Evaluation of quality of life in patients undergoing surgery for benign prostatic hyperplasia. Aging Male. 2018;21:238–242. doi: 10.1080/13685538.2018.1433654. [DOI] [PubMed] [Google Scholar]
- 5.Robert G, De LA Taille A, Descazeaud A. Epidemiology of benign prostatic hyperplasia. Prog Urol. 2018;28:803–812. doi: 10.1016/j.purol.2018.08.005. [DOI] [PubMed] [Google Scholar]
- 6.Magistro G, Stief CG, Gratzke C. Prostatic urethral lift versus transurethral resection of the prostate (turp) Curr Urol Rep. 2017;18:82. doi: 10.1007/s11934-017-0725-4. [DOI] [PubMed] [Google Scholar]
- 7.Kapp S, Miller C, Santamaria N. The quality of life of people who have chronic wounds and who self-treat. J Clin Nurs. 2018;27:182–192. doi: 10.1111/jocn.13870. [DOI] [PubMed] [Google Scholar]
- 8.Gong FH, Tang SH. Internet intervention system for elderly hypertensive patients based on hospital community family edge network and personal medical resources optimization. J Med Syst. 2020;44:95. doi: 10.1007/s10916-020-01554-1. [DOI] [PubMed] [Google Scholar]
- 9.Na YQ, Sun G. Chinese guidelines for the diagnosis and treatment of urological diseases. In: Na YQ, Sun G, editors. Beijing: People’s Health Publ House; 2009. pp. 166–199. [Google Scholar]
- 10.Vaccarino Al, Evans KR, Sills TL, Kalali AH. Symptoms of anxiety in depression: assessment of item performance of the hamilton anxiety rating scale in patients with depression. Depress Anxiety. 2008;25:1006–1013. doi: 10.1002/da.20435. [DOI] [PubMed] [Google Scholar]
- 11.Dunstan DA, Scott N, Todd AK. Screening for anxiety and depression: reassessing the utility of the zung scales. BMC Psychiatry. 2017;17:329. doi: 10.1186/s12888-017-1489-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 12.Guo LN, Zhao J, Li LF, Zhu YR, Liu K, Liu YJ. Chinese version-multi-center reliability and validity analysis and verification of self-care ability scale for the elderly. Mod Prev Med. 2018;45:7–11. [Google Scholar]
- 13.Otaola-Arca H, Álvarez-Ardura M, Molina-Escudero R, Fernández MI, Páez-Borda Á. A prospective randomized study comparing bipolar plasmakinetic transurethral resection of the prostate and monopolar transurethral resection of the prostate for the treatment of benign prostatic hyperplasia: efficacy, sexual function, quality of life, and complications. Int Braz J Urol. 2021;47:131–144. doi: 10.1590/S1677-5538.IBJU.2019.0766. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.Gilling P, Barber N, Bidair M, Anderson P, Sutton M, Aho T, Kramolowsky E, Thomas A, Cowan B, Kaufman RP Jr, Trainer A, Arther A, Badlani G, Plante M, Desai M, Doumanian L, Te Ae, Deguenther M, Roehrborn C. Water: a double-blind, randomized, controlled trial of aquablation (®) vs transurethral resection of the prostate in benign prostatic hyperplasia. J Urol. 2018;199:1252–1261. doi: 10.1016/j.juro.2017.12.065. [DOI] [PubMed] [Google Scholar]
- 15.Ray AF, Powell J, Speakman MJ, Longford NT, Dasgupta R, Bryant T, Modi S, Dyer J, Harris M, Carolan-Rees G, Hacking N. Efficacy and safety of prostate artery embolization for benign prostatic hyperplasia: an observational study and propensity-matched comparison with transurethral resection of the prostate (the uk-rope study) BJU Int. 2018;122:270–282. doi: 10.1111/bju.14249. [DOI] [PubMed] [Google Scholar]
- 16.Wada N, Kikuchi D, Tateoka J, Abe N, Banjo H, Tsuchida M, Hori J, Tamaki G, Kita M, Kakizaki H. Long-term symptomatic outcome after transurethral resection of the prostate: a urodynamics-based assessment. Int J Urol. 2019;26:1071–1075. doi: 10.1111/iju.14104. [DOI] [PubMed] [Google Scholar]
- 17.Patel NH, Uppaluri N, Iorga M, Schulman A, Bloom JB, Phillips J, Fullerton S, Konno S, Choudhury M, Eshghi M. Device malfunctions and complications associated with benign prostatic hyperplasia surgery: review of the manufacturer and user facility device experience database. J Endourol. 2019;33:448–454. doi: 10.1089/end.2019.0067. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18.Jiang YL, Qian LJ. Transurethral resection of the prostate versus prostatic artery embolization in the treatment of benign prostatic hyperplasia: a meta-analysis. BMC Urol. 2019;19:11. doi: 10.1186/s12894-019-0440-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 19.Gong C. Self-management behavior and quality of life improvement of diabetic patients under the “hospital-community-family” trinity nursing model. Nurs Sci. 2020;9:203–208. [Google Scholar]
- 20.Shi LH, Wang LY, Tang M. Effect of hospital, community and home continuous careon quality of life and renal function of postoperative patients with ileal bladder stoma. J Qilu Nurs. 2020;26:49–52. [Google Scholar]
- 21.Su LH. Effect of continuous nursing care on mental resilience after transurethral resection of prostate hyperplasia in elderly patients. Chin J Health Psychol. 2019;27:49–52. [Google Scholar]
- 22.Madersbacher S, Sampson N, Culig Z. Pathophysiology of benign prostatic hyperplasia and benign prostatic enlargement: a mini-review. Gerontology. 2019;65:458–464. doi: 10.1159/000496289. [DOI] [PubMed] [Google Scholar]
- 23.Wen YJ, Liu JP, Lu L, Zhang JX, Han L. Study on the application of the integrated information management model of general hospital, community and home. J Nurs Train. 2017;32:2001–2004. [Google Scholar]
- 24.Ding RX, Dai LF. Effect of “hospital-community-family” continuous care on stroke patients with limb dysfunction. J Bengbu Med Coll. 2017;42:1003–1005. [Google Scholar]
- 25.Guo X, Gu X, Jiang J, Li H, Duan R, Zhang Y, Sun L, Bao Z, Shen J, Chen F. A hospital-community-family-based telehealth program for patients with chronic heart failure: single-arm, prospective feasibility study. JMIR Mhealth Uhealth. 2019;7:13229. doi: 10.2196/13229. [DOI] [PMC free article] [PubMed] [Google Scholar]