Assessment of Vietnamese nurse’s knowledge and practice regarding patient’s safety after coronary angiography or percutaneous coronary intervention

Original Research

Abstract

Background: Many clinical and paraclinical studies related to coronary artery disease have been done in Vietnam in recent years. However, there have been no studies on nurses’ knowledge and practice regarding patient care after coronary angiography (CAG) or percutaneous coronary intervention (PCI). This study was conducted to assess nurses' knowledge and practice on patient’s safety after CAG or PCI and its associated factors.

Methods: A descriptive cross-sectional study was conducted from December 2019 to June 2020 at the Department of Internal Cardiology, Interventional Cardiology, Intravascular Intervention, and Intensive care unit/Coronary care unit in three general and specialist hospitals in Ho Chi Minh city, Vietnam. 167 nurses who have taken care of patients after CAG or PCI were included in the study through using convenient sampling technique. A translated self-administered questionnaire was utilised. This self-reported survey achieved 100% response rate. Statistical analysis was performed by the Chi-square test (X2). Statistical significance level was at p<0.05 to determine factors related to nurses’ knowledge and practice. Prevalence ratio (PR) with 95% confidence interval (95% CI) were also used to measure the association.

Results: The study findings revealed that only 36% of the study sample had a good knowledge while 78% of them had a good practice on patient’s safety after CAG or PCI. There were association between educational level, working place with the knowledge (PR=1.87-1.92, p<0.01) and practice (PR=1.18-1.35, p<0.05) on patient’s safety after CAG or PCI among Vietnamese nurses. Besides those factors, the number of years working in cardiac specialty were also found to have an association with the practice. A moderately positive correlation between the knowledge and the practice towards patient‘s safety after CAG or PCI has been identified in this study (PR=1.27, 95% CI [1.09 – 1.47], p=0.005).

Conclusions: More than a half of the study sample had poor knowledge but performed good practice in some items of care for patients after CAG or PCI. There was positive association between the knowledge and practice about patient’s safety after CAG or PCI among Vietnamese registered nurses. Educational training programs for staffs working in coronary angiography or percutaneous coronary intervention is recommended to develop.

Graphical abstract

Evaluation of R-CHOP and R-CVP in the treatment of elderly patient with non-Hodgkin lymphoma

Original Research

Abstract

Introduction: Little information is available on the outcomes of R-CHOP (rituximab with cyclophosphamide, doxorubicin, vincristine and prednisone) and R-CVP (rituximab with cyclophosphamide, vincristine and prednisone) in treatment of the elderly patients with non-Hodgkin lymphoma (NHL), especially in Vietnam.

Material and methods: All patients were newly diagnosed with CD20-positive non-Hodgkin lymphoma (NHL) at Blood Transfusion and Hematology Hospital, Ho Chi Minh city (BTH) between 01/2013 and 01/2018 who were age 60 years or older at diagnosis. A retrospective analysis of these patients was perfomed.

Results: Twenty-one Vietnamese patients (6 males and 15 females) were identified and the median age was 68.9 (range 60-80). Most of patients have comorbidities and intermediate-risk. The most common sign was lymphadenopathy (over 95%). The proportion of diffuse large B cell lymphoma (DLBCL) was highest (71%). The percentage of patients reaching complete response (CR) after six cycle of chemotherapy was 76.2%. The median follow-up was 26 months, event-free survival (EFS) was 60% and overall survival (OS) was 75%. Adverse effects of rituximab were unremarkable, treatment-related mortality accounted for less than 10%. There was no difference in drug toxicity between two regimens.

Conclusions: R-CHOP, R-CVP yielded a good result and acceptable toxicity in treatment of elderly patients with non-Hodgkin lymphoma. In patients with known cardiac history, omission of anthracyclines is reasonable and R-CVP provides a competitive complete response rate.

Graphical abstract

Factors predicting physical and mental health-related quality of life among post-myocardial infarction patients: Bayesian model averaging analysis

Original Research

Abstract

Coronary artery disease was the cause of half of morbidity and mortality due to cardiovascular diseases in 2013. Myocardial infarction (MI) has been a common medical emergency with high mortality rate and complications unless it is early and appropriately treated. Health-related quality of life (HRQoL) has been popularly used in assessment of health state among coronary artery disease patients undergone both medical and surgical therapies. Bayesian model averaging approach statistically facilitated for identifying potential predictors of HRQoL among post-MI patients following up at University Medical Center, Ho Chi Minh City. The cross-sectional descriptive study was conducted on 146 participants diagnosed and treated with acute myocardial infarction from April 1st 2017 to June 30th 2017. The better HRQoL in physical component summary was associated with higher educational levels (coeff­icient=1.2) and weekly moderate – intensity physical activity (coeff­icient=0.002) but the contrast status for the female (coeff­icient =-3.7) in the fit model with R2= 0.24, BIC=-25.7 and posterior probability=11.7%. The good economic household (coeff­icient=9.8), more daily sitting time (coeff­icient =1.4) and weekly moderate – intensity physical activity (coeff­icient =0.004) predicted the increase of mental component summary score in the given model with R2= 0.08, BIC=-20.3 and posterior probability=25%. The post – MI patients experienced low physical health much more than mental health. The female and suitable physical activity should be concerned in the rehabilitation program as well as follow-up care during the discharge process.

Graphical abstract

Pursuing a targeted dream specialty and a research career: Opinions and observations from a fifth-year medical student’s perspective

Letter to Editor

Abstract

With our fast-pacing life, numerous learning and scientific sources and information are available and required for medical students to boost their skills since their early life to accommodate with the great knowledge they take. Medical students should re-elaborate what they studied and exploit knowledge clinically. A good doctor is a good observer, so eyes should be kept on while mentor managing patients in order to add more to our medical notions. A seed to become a great future doctor starts by searching for a specialty that fits your personality, to practice it as a volunteer, to gain its skills earlier. So when you graduate, you have more time to gain other learning experience. As long as you practice it, the more chance to become one of its experts. Managing your patient as a relative, not as a bag of money, is very important to be applied. Inability to diagnose a patient is not a shame, so never let a patient go home without referring him to another doctor who has more experience than you. Having a background in other medical specialties will help you recognize common signs of other related medical conditions that could lead you to refer him to right specialty doctor. Joining a research lab will keep you updated with new inventions, drugs, algorithms, and guidelines, which will help you become more acknowledged with medical problems that you were unaware of. Time management is the key to success as a researcher without affecting your daily life activities and study requirements.

Graphical abstract

The Incidence and Characteristics of Gastrointestinal Intolerance on Mechanically Ventilated Patients with Continuous versus Intermittent Feeding Method in The Intensive Care Unit: A Randomized Controlled Trial

Original Research

Abstract

Background: Enteral nutrition therapy via nasogastric tube can be administered through continuous or intermittent feeding methods for critically ill patients. However, there has not been existing consensus on the superiority of either method for mechanically ventilated patients due to insufficient evidence comparing the effectiveness of the two methods. The present study aimed to compare the impact of continuous versus intermittent feeding methods on gastrointestinal intolerance in mechanically ventilated patients.

Methods: 41 mechanically ventilated patients in the intensive care unit, University Medical Center, Ho Chi Minh City, Vietnam from 3/2017 to 5/2017 were enrolled in a randomized controlled trial. They were randomly and equally assigned to the two study groups and monitored for 4 consecutive days on incidence of gastrointestinal intolerance including high gastric residual volume, abdominal distention, diarrhea, and tube occlusion.

Results: There was statistically significant difference when comparing the gastric residual volumes between two groups with a median at 0.93ml (0.09-1.93) versus 11.61ml (7.61-17.28) (p < 0.001). The mean number of abdominal distention episodes in the continuous group was significantly lower than in the intermittent group (2.8 ± 2.66 versus 8.29 ± 5.1 episodes, respectively, p < 0.001). The diarrhea scores were not significantly different (p < 0.05) and there were no cases of occlusion recorded in the two groups.

Conclusions: Continuous feeding method offered less gastrointestinal intolerance than intermittent feeding method by reducing gastric residual volumes and limiting abdominal distention. The feeding method did not increase the risk of tube obstruction if it was flushed regularly.

Graphical abstract

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