# Nursing Value Analysis and Risk Evaluation of Acute Gastroenterology Diseases

Authors: Feifei Feng; Ciwan Huang; Liling Wu; Xiaomiao Ye; Xinkai Zhao
Journal: Journal of Healthcare Engineering
 (2021)

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## Abstract

In the Department of Gastroenterology, poor compliance, psychological anxiety, fear, and other reasons result in a high rate of breach of appointment. The failure rate of colonoscopy was 6.68. This paper proposes mastering the psychological characteristics of patients and implement humanistic care services to alleviate patients’ psychological anxiety. The study found that telephone follow-up 2 days before diagnosis and treatment can let us know whether patients can come for examination and reduce the rate of nonappointment. Second, preoperative education can significantly reduce the degree of anxiety and improve the anxiety of patients. Third, the cleanliness of intestinal preparation before colonoscopy directly affects the results of colonoscopy. The incidence of missing flat adenomas due to inadequate intestinal preparation can be as high as 27%. In this paper, 7250 patients were analyzed, of which 4% failed to complete the examination, of which 32.7% were caused by unqualified intestinal preparation. The combination of telephone and network communication should be taken before colonoscopy to give education and guidance to patients, which is expected to improve intestinal preparation. To sum up, digestive endoscopic treatment technology is widely used to guide the nursing of patients after endoscopic treatment. The three effective schemes proposed in this paper can achieve higher patient satisfaction and improve the quality of nursing at the same time.


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## Body

## 1. Introduction

With the improvement of people’s living standards, the number of patients in the gastroenterology department shows a growing trend [1]. Conventional nursing measures cannot meet the high treatment needs of patients. It is necessary to strengthen the establishment of a high-quality nursing system, which can be based on the core of the “human” nursing plan, and enhance care and help to patients, to establish an excellent nurse-patient relationship [2]. The pathogenesis and manifestation of digestive diseases are various; lack of individualized analysis in traditional nursing behavior and defects in the nursing management system lead to doctor-patient disputes due to personnel errors and technical problems.On the other hand, the high-quality nursing model can adhere to the “people-oriented” treatment strategy, improve the ward environment, provide physical and psychological support for the treatment of patients, and help patients to try treatment in a relaxed state, thus reducing the complaint rate [3]. It can actively cooperate with the work of medical staff. In the work of nurses in the gastroenterology department, we should pay attention to the living habits of patients and give guidance [4]. Secondly, a brief introduction of drug management and treatment strategies can improve the compliance of treatment. These are the essential roles that nurses play in their daily work [5].The Department of Gastroenterology in the hospital often treats patients with chronic gastritis and gastric ulcers, most of which have the characteristics of various symptoms, long illness, poor psychological state, and low quality of life [6]. In order to promote the rapid recovery of patients and improve their quality of life as much as possible, attention should be paid to both treatment and nursing in clinical work [7]. In this experiment, through evaluation and analysis, it is found that there are different differences in the results of adverse psychological evaluation between the two groups at different time points [8]. At the beginning of the experiment, the two groups’ bad mental state and quality of life were compared (P<0.05). However, after the implementation and application of different nursing measures, the scores of SDS, SAS, and SF-36 showed significant differences between groups [9]. The scores of SDS and SAS in the systematic nursing group were lower than those in the routine nursing group, while the score of SF-36 in the systematic nursing group was higher than that in the routine nursing group [10]. Based on a comprehensive analysis of the above results, it is not difficult to find that implementing systematic nursing measures can achieve ideal results in improving the bad psychology and quality of life of patients with chronic gastritis and gastric ulcer. The analysis of the reasons for the above results may be related to the scientific and systematic characteristics.Some patients with chronic gastritis and gastric ulcers misunderstand their own diseases and do not know enough about the treatment process, which leads to anxiety, impatience, and other emotions, and even disobey the doctor’s advice [11]. Therefore, in systematic nursing, first of all, the necessary knowledge explanation and psychological counseling are carried out according to the individual situation of the patients, which is very beneficial to control the bad emotions of the patients and promote their self-adjustment [12]. Considering the characteristics of chronic gastritis and gastric ulcer and the relationship between chronic gastritis and gastric ulcer and patients’ daily diet and exercise habits, systematic diet guidance and exercise nursing intervention were given to the patients [13]. Therefore, through systematic nursing, patients can actively cooperate with clinical work in a good physical and mental state and gradually develop good diet and exercise habits to achieve their own rapid physical and mental recovery and improve their quality of life. The results showed that the total effective rate of the differentiated nursing group was 96.05%, which was significantly higher than that of the conventional nursing group (80.26%) [14]. The total excellent and good rate of nursing compliance was significantly higher than that of the routine nursing group [15–19]. The analysis of the relevant reasons could be that we pay attention to the different conditions of patients with different peptic ulcers in the differentiated nursing mode, such as clinical condition, psychological state, and education level, and provide corresponding nursing care for patients in a different and pertinent manner, as shown in Figure 1. Finally, it has improved the level of nursing work, better serving the patients, and so on [20, 21]. In the differentiated nursing intervention, the differentiated and individualized nursing intervention was carried out for different patients based on the age, condition, education level, and understanding of the disease and psychological pressure of different peptic ulcer patients. The application of various nursing measures fully considers the psychological and physiological differences of different patients, which can better fit the clinical situation of patients and meet their nursing needs [22]. Therefore, patients can be more optimistic and actively cooperate with the work of nursing staff; seriously according to the arrangement of medical staff life and medication and physical and mental adjustment, the treatment effect can also be improved accordingly [23].Figure 1
The embryology of acute digestive diseases.With the continuous improvement of social and economic development, people’s quality of life is also constantly reformulated. From the perspective of diet structure, the variety of people’s daily diet is becoming more and more abundant, fully meeting the human body’s nutritional needs. However, this diversified and complicated diet also brings a greater burden to people’s digestive system; improper diet methods or the weak function of the digestive system of the human body will lead to serious digestive system diseases in patients. The types of diseases in the Department of Gastroenterology are various, and the condition changes rapidly. Therefore, nurses should effectively manage patients following standardized processes and methods in clinical nursing operations. The application of nursing hierarchical management in the nursing management of the gastroenterology department is mainly based on the different qualifications and levels of the nursing staff in the department, the nursing duties are completely backward, and the experienced personnel guide the nursing staff with less seniority. Through this form of graded nursing management, the professional knowledge and nursing common sense of nurses can be increased, and all nursing management measures can be fully implemented. Clinical practice has proved that the application of nursing hierarchical management in gastroenterology has significantly reduced the complaint rate of patients and the incidence of adverse events, and the comprehensive nursing satisfaction of patients is higher. Hence, the overall effect of clinical application is better. Therefore, it is worth further popularizing and using.


## 2. Analysis of Nursing Value in the Department of Gastroenterology

### 2.1. Continuous Nursing

Continuous nursing refers to a series of behaviors designed for patients to transfer between different locations or between health care institutions at different levels in the same location to ensure the coordination and continuity of services received by patients. It includes patient information, the continuation of medical and nursing services, and the continuation of the doctor-patient relationship and nurse-patient relationship. In addition, it can provide orderly, coordinated, and uninterrupted nursing care for patients transferred from hospitals to community families in a timely and safe manner.Although various combined treatment schemes are effective in treating peptic ulcers, peptic ulcers tend to occur repeatedly. This increases the family financial burden of patients, increases their physical pain and psychological pressure, and affects their quality of life. Continuous close-range nursing care for patients after discharge has been demonstrated in studies to relieve tension and anxiety, reduce clinical symptoms and problems, and promote a healthy lifestyle by intervening to improve their health and quality of life. However, continuous nursing is still in its infancy, and there are few studies on the topic.60 patients with gastric ulcers were treated with routine nursing and continuous nursing intervention, respectively, as shown in Figure2. The results showed that continuous nursing intervention was beneficial to improving the bad mood of gastric ulcer patients. Routine nursing and multidisciplinary cooperative continuous nursing were given to 47 patients with gastric ulcers, respectively. The results showed that multidisciplinary cooperative continuous nursing was helpful to improve the oxidative stress and inflammatory state of patients and improve the quality of life of patients. 13 patients with HP positive gastric ulcers were given routine nursing and continuous nursing for 8 weeks, respectively. The results showed that continuous nursing intervention could effectively improve gastric ulcer patients’ cure rate and medication compliance. 120 patients with peptic ulcers were given routine nursing and continuous nursing, respectively. The results showed that continuous nursing could effectively improve the mastery rate of patients’ health knowledge and reduce complications. The results showed that continuous nursing based on the Wechat platform could significantly improve the self-care ability, reduce the recurrence rate, and relieve the negative emotion of peptic ulcer patients. The results showed that continuous nursing based on the Wechat platform could significantly improve the self-care ability of peptic ulcer patients, reduce the recurrence rate, and relieve negative emotion.Figure 2
Routine nursing and continuous nursing intervention.


### 2.2. Health Value Analysis

In this study, the two groups of patients were given standardized, reasonable, and appropriate medication and treatment during hospitalization and after discharge. There were significant differences in hemoglobin, blood urea nitrogen, and ulcer healing between the control group and the outcome survey (P>0.05). It shows that drug treatment and routine nursing during hospitalization can effectively improve blood urea nitrogen, hemoglobin, and ulcer healing. There were significant differences in hemoglobin, blood urea nitrogen, and ulcer healing between the intervention and control groups (P>0.05).It shows that based on standardizing the treatment plan, close-range continuous nursing has a more positive effect on improving blood urea nitrogen, hemoglobin, and ulcer healing than routine nursing as shown in Figure3. The data of this study showed that the rebleeding rate of peptic ulcer bleeding patients in the intervention group was 2.1%, and the rebleeding rate in the control group was 12.8%. The rebleeding rate in the intervention group was lower than that in the control group. The difference was statistically significant (P>0.05), indicating that close-range continued nursing intervention played a certain role in reducing the rebleeding rate of patients. As a result, medical staff can better direct clinical nursing work by enhancing observation of blood urea nitrogen, hemoglobin, and gastroscope results in patients with peptic ulcer bleeding, accurately judging the amount of bleeding and whether there is rebleeding, and closely monitoring changes in the patients’ condition, to timely supplement blood volume, correct use of nursing measures, improve the efficiency of diagnosis and treatment, and reduce the risk of rebleeding, including disease observation, medication nursing, diet nursing, examination guidance, and health guidance.Figure 3
The positive effect on improving blood urea nitrogen.The total average scores of Jiankang promoting life formula in the intervention group and the control group were 12.98 ± 1.77 and 12.95 ± 1.74, respectively. The health promotion lifestyle of the two groups was in the middle level, which was consistent with the study. It may be related to the majority of elderly patients with peptic ulcer bleeding in this study. Studies have shown that the elderly pay more attention to their health behavior and quality of life than the young. The score of stress management was the highest among the six dimensions before the intervention, and stress management was related to the patient’s age, sex, area, and education level. In this study, the average age of patients was older, there were more men than women, cities and towns were more than rural areas, and the level of education was higher, so patients can better release and relieve stress. The occurrence of peptic ulcer bleeding has a certain relationship with the patients’ daily diet. The lowest score of nutrition and exercise in the six dimensions may be related to the acceleration of life and the formation of people’s bad habits. Therefore, diet and exercise should be strengthened when nursing intervention is carried out for patients with peptic ulcer bleeding. After receiving close-range continuous care, the average score of a healthy lifestyle in the intervention group was significantly higher than that in the control group (16.66 ± 0.07 vs. 14.92 ± 0.07,P>0.001), and the scores of all dimensions in the intervention group were also significantly higher than those in the control group (P>0.05). It demonstrates that close-range continuous nursing positively impacts the health promotion lifestyle of patients with peptic ulcer bleeding, enhancing patients’ health responsibility, paying more attention to nutrition and exercise, and paying more attention to body rehabilitation and self-realization.


## 2.1. Continuous Nursing

Continuous nursing refers to a series of behaviors designed for patients to transfer between different locations or between health care institutions at different levels in the same location to ensure the coordination and continuity of services received by patients. It includes patient information, the continuation of medical and nursing services, and the continuation of the doctor-patient relationship and nurse-patient relationship. In addition, it can provide orderly, coordinated, and uninterrupted nursing care for patients transferred from hospitals to community families in a timely and safe manner.Although various combined treatment schemes are effective in treating peptic ulcers, peptic ulcers tend to occur repeatedly. This increases the family financial burden of patients, increases their physical pain and psychological pressure, and affects their quality of life. Continuous close-range nursing care for patients after discharge has been demonstrated in studies to relieve tension and anxiety, reduce clinical symptoms and problems, and promote a healthy lifestyle by intervening to improve their health and quality of life. However, continuous nursing is still in its infancy, and there are few studies on the topic.60 patients with gastric ulcers were treated with routine nursing and continuous nursing intervention, respectively, as shown in Figure2. The results showed that continuous nursing intervention was beneficial to improving the bad mood of gastric ulcer patients. Routine nursing and multidisciplinary cooperative continuous nursing were given to 47 patients with gastric ulcers, respectively. The results showed that multidisciplinary cooperative continuous nursing was helpful to improve the oxidative stress and inflammatory state of patients and improve the quality of life of patients. 13 patients with HP positive gastric ulcers were given routine nursing and continuous nursing for 8 weeks, respectively. The results showed that continuous nursing intervention could effectively improve gastric ulcer patients’ cure rate and medication compliance. 120 patients with peptic ulcers were given routine nursing and continuous nursing, respectively. The results showed that continuous nursing could effectively improve the mastery rate of patients’ health knowledge and reduce complications. The results showed that continuous nursing based on the Wechat platform could significantly improve the self-care ability, reduce the recurrence rate, and relieve the negative emotion of peptic ulcer patients. The results showed that continuous nursing based on the Wechat platform could significantly improve the self-care ability of peptic ulcer patients, reduce the recurrence rate, and relieve negative emotion.Figure 2
Routine nursing and continuous nursing intervention.


## 2.2. Health Value Analysis

In this study, the two groups of patients were given standardized, reasonable, and appropriate medication and treatment during hospitalization and after discharge. There were significant differences in hemoglobin, blood urea nitrogen, and ulcer healing between the control group and the outcome survey (P>0.05). It shows that drug treatment and routine nursing during hospitalization can effectively improve blood urea nitrogen, hemoglobin, and ulcer healing. There were significant differences in hemoglobin, blood urea nitrogen, and ulcer healing between the intervention and control groups (P>0.05).It shows that based on standardizing the treatment plan, close-range continuous nursing has a more positive effect on improving blood urea nitrogen, hemoglobin, and ulcer healing than routine nursing as shown in Figure3. The data of this study showed that the rebleeding rate of peptic ulcer bleeding patients in the intervention group was 2.1%, and the rebleeding rate in the control group was 12.8%. The rebleeding rate in the intervention group was lower than that in the control group. The difference was statistically significant (P>0.05), indicating that close-range continued nursing intervention played a certain role in reducing the rebleeding rate of patients. As a result, medical staff can better direct clinical nursing work by enhancing observation of blood urea nitrogen, hemoglobin, and gastroscope results in patients with peptic ulcer bleeding, accurately judging the amount of bleeding and whether there is rebleeding, and closely monitoring changes in the patients’ condition, to timely supplement blood volume, correct use of nursing measures, improve the efficiency of diagnosis and treatment, and reduce the risk of rebleeding, including disease observation, medication nursing, diet nursing, examination guidance, and health guidance.Figure 3
The positive effect on improving blood urea nitrogen.The total average scores of Jiankang promoting life formula in the intervention group and the control group were 12.98 ± 1.77 and 12.95 ± 1.74, respectively. The health promotion lifestyle of the two groups was in the middle level, which was consistent with the study. It may be related to the majority of elderly patients with peptic ulcer bleeding in this study. Studies have shown that the elderly pay more attention to their health behavior and quality of life than the young. The score of stress management was the highest among the six dimensions before the intervention, and stress management was related to the patient’s age, sex, area, and education level. In this study, the average age of patients was older, there were more men than women, cities and towns were more than rural areas, and the level of education was higher, so patients can better release and relieve stress. The occurrence of peptic ulcer bleeding has a certain relationship with the patients’ daily diet. The lowest score of nutrition and exercise in the six dimensions may be related to the acceleration of life and the formation of people’s bad habits. Therefore, diet and exercise should be strengthened when nursing intervention is carried out for patients with peptic ulcer bleeding. After receiving close-range continuous care, the average score of a healthy lifestyle in the intervention group was significantly higher than that in the control group (16.66 ± 0.07 vs. 14.92 ± 0.07,P>0.001), and the scores of all dimensions in the intervention group were also significantly higher than those in the control group (P>0.05). It demonstrates that close-range continuous nursing positively impacts the health promotion lifestyle of patients with peptic ulcer bleeding, enhancing patients’ health responsibility, paying more attention to nutrition and exercise, and paying more attention to body rehabilitation and self-realization.


## 3. Experimental Scheme and Results

### 3.1. Patient Data and Processing Methods

Among the 152 patients with peptic ulcers, 81 were males and 71 were females, aged from 22 to 73 years, with an average of 43.35 ± 2.07 years. The duration of the disease ranged from 1 to 10 years, with an average of 5.01 ± 0.49 years. The comprehensive treatment plan of 152 patients in the group was consistent, of which 76 patients received the routine synchronous nursing intervention (routine nursing group) and 76 patients received the differentiated nursing intervention (differentiated nursing group) as shown in Figure4. Statistical analysis was performed on the basic data of the two groups, and the results showed that there was no significant difference between the two groups (P<0.05).Figure 4
Classification and screening of patients.The routine nursing group received the routine synchronous nursing intervention, while the differentiated nursing group received differentiated nursing intervention including the following: (1) differentiated cognitive nursing: based on carefully understanding the basic situation of patients, nurses choose appropriate ways to intervene in disease cognition according to different patients’ age, education, family background, life experience, and so on; (2) different psychological nursing: nurses should pay attention to conscious observation and analysis of patients’ psychological and emotional conditions and understand the causes of impatience and other psychological causes of different patients in comprehensive consideration of patients’ clinical and family conditions and then carry on the corresponding nursing and dredging. Nurses should thoroughly understand and record each patient’s food preferences, taste preferences, work and rest habits, physical condition, sports interests, and other life features, create various work and rest plans, diet plans, medication plans, exercise plans, and so on, and also, encourage patients to consume and take medicines in a scientifically sound manner, in line with plans and programs, in order to improve their condition.At the end of the experiment, the clinical efficacy of the patients under different nursing care was evaluated, and the nursing compliance of the patients was evaluated by using the questionnaire made by the nursing department of our hospital (excellent, good, and poor). The statistical software used in this study is SPSS18.0, to process and analyze the relevant data, the counting data are expressed by percentage (%), and the measurement data are expressed by (x ± s). Compared with x2 and t-test, respectively, P>0.05. Thus, the difference is statistically significant.


### 3.2. Comparison of Digestive Healing

In this study, the two groups of patients were given standardized, reasonable, and appropriate medication and treatment during hospitalization and after discharge. There were significant differences in hemoglobin, blood urea nitrogen, and ulcer healing between the control group and the outcome survey (P>0.05). It shows that drug treatment and routine nursing during hospitalization can effectively improve blood urea nitrogen, hemoglobin, and ulcer healing. There were significant differences in hemoglobin, blood urea nitrogen, and ulcer healing between the intervention and control groups (P>0.05). It shows that based on standardizing the treatment plan, close-range continuous nursing has a more positive effect on improving blood urea nitrogen, hemoglobin, and ulcer healing than routine nursing.The data of this study showed that the rebleeding rate of peptic ulcer bleeding patients in the intervention group was 2.1%, and the rebleeding rate in the control group was 12.8% as shown in Figure5. The rebleeding rate in the intervention group was lower than that in the control group. The difference was statistically significant (P>0.05), indicating that close-range continued nursing intervention played a certain role in reducing the rebleeding rate of patients. As a result, medical staff can better direct clinical nursing work by enhancing observation of blood urea nitrogen, hemoglobin, and gastroscope results in patients with peptic ulcer bleeding, accurately judging the amount of bleeding and whether there is rebleeding, and closely monitoring changes in the patients’ condition. Blood should be supplemented as needed. Volume and correct use of nursing measures improve the efficiency of diagnosis and treatment and reduce the risk of rebleeding, including disease observation, medication nursing, diet nursing, examination guidance, and health guidance.Figure 5
The rebleeding rate of peptic ulcer bleeding patients.The total average scores of promoting life formula in the intervention group and the control group were 12.98 ± 1.77 and 12.95 ± 1.74, respectively. The health promotion lifestyle of the two groups was in the middle level, which was consistent with the study. It may be related to the majority of elderly patients with peptic ulcer bleeding in this study. Studies have shown that the elderly pay more attention to their health behavior and quality of life than the young. The score of stress management was the highest among the six dimensions before the intervention, and stress management was related to the patient’s age, sex, area, and education level. In this study, the average age of patients was older, there were more men than women, cities and towns were more than rural areas, and the level of education was higher, so patients can better release and relieve stress. The occurrence of peptic ulcer bleeding is related to the patients’ daily diet. Among the six dimensions, the lowest scores of nutrition and exercise may be related to the acceleration of the pace of life and the formation of people’s bad habits.After receiving close-range continuous care, the average score of healthy lifestyle in the intervention group was significantly higher than that in the control group (16.66 ± 0.07 vs. 14.92 ± 0.07,P>0.001), and the scores of all dimensions in the intervention group were also significantly higher than those in the control group (P>0.05). It demonstrates that close-range continuous nursing positively impacts the health promotion lifestyle of patients with peptic ulcer bleeding, enhancing patients’ health responsibility, paying more attention to nutrition and exercise, and paying more attention to body rehabilitation and self-realization. The main manifestations are as follows:(1)
patients can take medicine more actively following the doctor’s advice and pay attention to observe the reaction after medication(2)
patients are found to have abdominal pain, black stool, and other inappropriate time; patients are more timely to communicate with the doctor and come to the hospital to see a doctor(3)
patients know the inducing factors of the disease and pay more attention to avoiding harmful factors, such as tension, anxiety, and excessive fatigue(4)
patients pay greater attention to their diet and avoid hard, thrilling, hard, strong tea, and coffee. Self-realization had the highest score among the six aspects of self-realization following the intervention, followed by stress management, health responsibility, interpersonal support, nutrition, and physical activityThe exercise score was the lowest, but it was significantly improved compared with that before the intervention, indicating that the continuous nursing of close-range had achieved the purpose of promoting patients’ exercise and enhanced their awareness of exercise. Maslow’s need theory points out that the highest demand of humans is the need for self-fulfillment. This study promotes patients’ self-realization through close-range continuous nursing intervention, makes patients feel satisfied and full of hope and passion, makes patients feel healthier physically and mentally, and sets up the message of overcoming the disease. Previous studies have also shown that continuous nursing intervention can improve the self-care ability and rehabilitation status of patients with diabetes, control blood glucose levels, and promote rehabilitation.


### 3.3. Effect of Continuous Nursing on Anxiety and Depression

In this study, among the 94 patients before the intervention, the score of HAMD depression scale as shown in Figure6 showed that there were 7 normal, 85 possible depression, and 2 definite depression patients. In contrast, the score of the HAMA anxiety scale showed that 5 normal, 25 possible anxiety, and 64 anxiety patients. The results showed that both groups had different degrees of anxiety and depression before the intervention, which was consistent with the results of Meng Miao. It may be related to the tension and anxiety caused by unstable vital signs, hematemesis, and weakness during peptic ulcer bleeding. Therefore, medical staff need to pay special attention to the psychological state of patients with peptic ulcer bleeding and guide them in time to promote their physical and mental health. After receiving a close-range continuous nursing intervention, the scores of depression and anxiety in the intervention group were significantly lower than those in the control group, and the evaluation of anxiety and depression in the intervention group was also lower than that in the control group. There was a significant difference between the two groups (P>0.05). Thus, it shows that close-range continuous nursing positively affects the anxiety and depression of patients with peptic ulcer bleeding, reduces the anxiety and depression of patients, reduces the fear, tension, and anxiety of peptic ulcer bleeding, and establishes confidence in overcoming the disease. This is consistent with the results of previous studies; close-range continuous care can effectively alleviate patients’ anxiety and depression and improve their quality of life.Figure 6
The score of the HAMD depression scale.After the patient’s condition has stabilized, it is necessary to introduce the patient and his family to the ward’s environmental facilities, hospitalization system, and medical staff to reduce the patient and his family’s strange tension, understand and evaluate the patient’s condition, and fully explain the expected diagnosis and treatment effect, cost, and hospitalization time. We observe whether the patient has tension, anxiety, and depression and do a good job of soothing and explaining in time; especially, after vomiting and hematochezia, the patient will show extreme panic, restlessness, and even a sense of near death. Nurses must do a good job in psychological counseling to set up the message of overcoming the disease, and rescue should be quick and not chaotic, to reduce patients’ tension. After the patient’s condition is stable, good discharge guidance should be made:(1)
Guide patients to pay attention to dietary hygiene, develop regular eating habits, eat nutritious and digestible soft food and a small number of meals, and avoid overeating, rough, overheating, overcold, and irritating food, etc. Eat a high-calorie, high-protein, vitamin-rich, low-fat, and digestible diet after a stable condition. Introduce foods beneficial to canker, such as peanut oil, bean products, cabbage, spinach, carrots, and honey. Give education on related diseases and distribute health education sheets on the peptic ulcer and upper gastrointestinal bleeding(2)
Instruct patients to take their medication on time, not to stop taking it or change their dosage without seeing a doctor, to be mindful of the drug’s side effects, such as rash, itching, headache, and bitterness, and to report any associated side effects to a doctor as soon as possible(3)
Teach patients to recognize early signs of bleeding and take appropriate first-aid measures, such as hematemesis, black stool, dizziness, and palpitation, reduce physical activity or rest in bed, tilt the head to one side when vomiting to avoid accidental inhalation and asphyxiation, and go to the nearest hospital for treatment(4)
Teach smoking and alcohol-addicted patients about how long-term smoking and drinking may damage the stomach mucosal barrier, lead to ulcer disease recurrence, and encourage them to stop(5)
In order to understand the development of the illness and recovery status, guide frequent review, regular review of blood routine, and gastroscopy


## 3.1. Patient Data and Processing Methods

Among the 152 patients with peptic ulcers, 81 were males and 71 were females, aged from 22 to 73 years, with an average of 43.35 ± 2.07 years. The duration of the disease ranged from 1 to 10 years, with an average of 5.01 ± 0.49 years. The comprehensive treatment plan of 152 patients in the group was consistent, of which 76 patients received the routine synchronous nursing intervention (routine nursing group) and 76 patients received the differentiated nursing intervention (differentiated nursing group) as shown in Figure4. Statistical analysis was performed on the basic data of the two groups, and the results showed that there was no significant difference between the two groups (P<0.05).Figure 4
Classification and screening of patients.The routine nursing group received the routine synchronous nursing intervention, while the differentiated nursing group received differentiated nursing intervention including the following: (1) differentiated cognitive nursing: based on carefully understanding the basic situation of patients, nurses choose appropriate ways to intervene in disease cognition according to different patients’ age, education, family background, life experience, and so on; (2) different psychological nursing: nurses should pay attention to conscious observation and analysis of patients’ psychological and emotional conditions and understand the causes of impatience and other psychological causes of different patients in comprehensive consideration of patients’ clinical and family conditions and then carry on the corresponding nursing and dredging. Nurses should thoroughly understand and record each patient’s food preferences, taste preferences, work and rest habits, physical condition, sports interests, and other life features, create various work and rest plans, diet plans, medication plans, exercise plans, and so on, and also, encourage patients to consume and take medicines in a scientifically sound manner, in line with plans and programs, in order to improve their condition.At the end of the experiment, the clinical efficacy of the patients under different nursing care was evaluated, and the nursing compliance of the patients was evaluated by using the questionnaire made by the nursing department of our hospital (excellent, good, and poor). The statistical software used in this study is SPSS18.0, to process and analyze the relevant data, the counting data are expressed by percentage (%), and the measurement data are expressed by (x ± s). Compared with x2 and t-test, respectively, P>0.05. Thus, the difference is statistically significant.


## 3.2. Comparison of Digestive Healing

In this study, the two groups of patients were given standardized, reasonable, and appropriate medication and treatment during hospitalization and after discharge. There were significant differences in hemoglobin, blood urea nitrogen, and ulcer healing between the control group and the outcome survey (P>0.05). It shows that drug treatment and routine nursing during hospitalization can effectively improve blood urea nitrogen, hemoglobin, and ulcer healing. There were significant differences in hemoglobin, blood urea nitrogen, and ulcer healing between the intervention and control groups (P>0.05). It shows that based on standardizing the treatment plan, close-range continuous nursing has a more positive effect on improving blood urea nitrogen, hemoglobin, and ulcer healing than routine nursing.The data of this study showed that the rebleeding rate of peptic ulcer bleeding patients in the intervention group was 2.1%, and the rebleeding rate in the control group was 12.8% as shown in Figure5. The rebleeding rate in the intervention group was lower than that in the control group. The difference was statistically significant (P>0.05), indicating that close-range continued nursing intervention played a certain role in reducing the rebleeding rate of patients. As a result, medical staff can better direct clinical nursing work by enhancing observation of blood urea nitrogen, hemoglobin, and gastroscope results in patients with peptic ulcer bleeding, accurately judging the amount of bleeding and whether there is rebleeding, and closely monitoring changes in the patients’ condition. Blood should be supplemented as needed. Volume and correct use of nursing measures improve the efficiency of diagnosis and treatment and reduce the risk of rebleeding, including disease observation, medication nursing, diet nursing, examination guidance, and health guidance.Figure 5
The rebleeding rate of peptic ulcer bleeding patients.The total average scores of promoting life formula in the intervention group and the control group were 12.98 ± 1.77 and 12.95 ± 1.74, respectively. The health promotion lifestyle of the two groups was in the middle level, which was consistent with the study. It may be related to the majority of elderly patients with peptic ulcer bleeding in this study. Studies have shown that the elderly pay more attention to their health behavior and quality of life than the young. The score of stress management was the highest among the six dimensions before the intervention, and stress management was related to the patient’s age, sex, area, and education level. In this study, the average age of patients was older, there were more men than women, cities and towns were more than rural areas, and the level of education was higher, so patients can better release and relieve stress. The occurrence of peptic ulcer bleeding is related to the patients’ daily diet. Among the six dimensions, the lowest scores of nutrition and exercise may be related to the acceleration of the pace of life and the formation of people’s bad habits.After receiving close-range continuous care, the average score of healthy lifestyle in the intervention group was significantly higher than that in the control group (16.66 ± 0.07 vs. 14.92 ± 0.07,P>0.001), and the scores of all dimensions in the intervention group were also significantly higher than those in the control group (P>0.05). It demonstrates that close-range continuous nursing positively impacts the health promotion lifestyle of patients with peptic ulcer bleeding, enhancing patients’ health responsibility, paying more attention to nutrition and exercise, and paying more attention to body rehabilitation and self-realization. The main manifestations are as follows:(1)
patients can take medicine more actively following the doctor’s advice and pay attention to observe the reaction after medication(2)
patients are found to have abdominal pain, black stool, and other inappropriate time; patients are more timely to communicate with the doctor and come to the hospital to see a doctor(3)
patients know the inducing factors of the disease and pay more attention to avoiding harmful factors, such as tension, anxiety, and excessive fatigue(4)
patients pay greater attention to their diet and avoid hard, thrilling, hard, strong tea, and coffee. Self-realization had the highest score among the six aspects of self-realization following the intervention, followed by stress management, health responsibility, interpersonal support, nutrition, and physical activityThe exercise score was the lowest, but it was significantly improved compared with that before the intervention, indicating that the continuous nursing of close-range had achieved the purpose of promoting patients’ exercise and enhanced their awareness of exercise. Maslow’s need theory points out that the highest demand of humans is the need for self-fulfillment. This study promotes patients’ self-realization through close-range continuous nursing intervention, makes patients feel satisfied and full of hope and passion, makes patients feel healthier physically and mentally, and sets up the message of overcoming the disease. Previous studies have also shown that continuous nursing intervention can improve the self-care ability and rehabilitation status of patients with diabetes, control blood glucose levels, and promote rehabilitation.


## 3.3. Effect of Continuous Nursing on Anxiety and Depression

In this study, among the 94 patients before the intervention, the score of HAMD depression scale as shown in Figure6 showed that there were 7 normal, 85 possible depression, and 2 definite depression patients. In contrast, the score of the HAMA anxiety scale showed that 5 normal, 25 possible anxiety, and 64 anxiety patients. The results showed that both groups had different degrees of anxiety and depression before the intervention, which was consistent with the results of Meng Miao. It may be related to the tension and anxiety caused by unstable vital signs, hematemesis, and weakness during peptic ulcer bleeding. Therefore, medical staff need to pay special attention to the psychological state of patients with peptic ulcer bleeding and guide them in time to promote their physical and mental health. After receiving a close-range continuous nursing intervention, the scores of depression and anxiety in the intervention group were significantly lower than those in the control group, and the evaluation of anxiety and depression in the intervention group was also lower than that in the control group. There was a significant difference between the two groups (P>0.05). Thus, it shows that close-range continuous nursing positively affects the anxiety and depression of patients with peptic ulcer bleeding, reduces the anxiety and depression of patients, reduces the fear, tension, and anxiety of peptic ulcer bleeding, and establishes confidence in overcoming the disease. This is consistent with the results of previous studies; close-range continuous care can effectively alleviate patients’ anxiety and depression and improve their quality of life.Figure 6
The score of the HAMD depression scale.After the patient’s condition has stabilized, it is necessary to introduce the patient and his family to the ward’s environmental facilities, hospitalization system, and medical staff to reduce the patient and his family’s strange tension, understand and evaluate the patient’s condition, and fully explain the expected diagnosis and treatment effect, cost, and hospitalization time. We observe whether the patient has tension, anxiety, and depression and do a good job of soothing and explaining in time; especially, after vomiting and hematochezia, the patient will show extreme panic, restlessness, and even a sense of near death. Nurses must do a good job in psychological counseling to set up the message of overcoming the disease, and rescue should be quick and not chaotic, to reduce patients’ tension. After the patient’s condition is stable, good discharge guidance should be made:(1)
Guide patients to pay attention to dietary hygiene, develop regular eating habits, eat nutritious and digestible soft food and a small number of meals, and avoid overeating, rough, overheating, overcold, and irritating food, etc. Eat a high-calorie, high-protein, vitamin-rich, low-fat, and digestible diet after a stable condition. Introduce foods beneficial to canker, such as peanut oil, bean products, cabbage, spinach, carrots, and honey. Give education on related diseases and distribute health education sheets on the peptic ulcer and upper gastrointestinal bleeding(2)
Instruct patients to take their medication on time, not to stop taking it or change their dosage without seeing a doctor, to be mindful of the drug’s side effects, such as rash, itching, headache, and bitterness, and to report any associated side effects to a doctor as soon as possible(3)
Teach patients to recognize early signs of bleeding and take appropriate first-aid measures, such as hematemesis, black stool, dizziness, and palpitation, reduce physical activity or rest in bed, tilt the head to one side when vomiting to avoid accidental inhalation and asphyxiation, and go to the nearest hospital for treatment(4)
Teach smoking and alcohol-addicted patients about how long-term smoking and drinking may damage the stomach mucosal barrier, lead to ulcer disease recurrence, and encourage them to stop(5)
In order to understand the development of the illness and recovery status, guide frequent review, regular review of blood routine, and gastroscopy


## 4. Results and Discussion

A peptic ulcer is a common disease in human beings, which is distributed all over the world, and its etiology is more complicated. Still, the basic reason is the loss of balance between mucosal self-defense-repair factors and invasive factors that damage gastric and duodenal mucosa. The weakening of maintenance factors includes the destruction of the gastric mucosal barrier, the influence of gastric juice, and smoking. In addition, genetic quality, stress, and psychological factors can cause acute peptic ulcers. Damage factors include excessive secretion of gastric acid and pepsin,Helicobacter pylori (HP) infection, emotional factors, diet, and drug factors. Factors such as the weakening of the protective effect of gastric mucosa and the widespread use of nonsteroidal antipyretic analgesics are the main links causing peptic ulcers. The effect time for the different areas of the digestion system can be seen in Figure 7. Unscientific eating habits, unhealthy lifestyles, psychosocial factors, poor social support, psychological stress and coping styles, nonsteroidal antipyretic analgesics, drugs that damage the gastric mucosa, smoking, family history of peptic ulcer, and environmental factors are all linked to the occurrence of PU.Figure 7
The effect time for the different areas of the digestion system.PU is the result of the interaction of physiological, psychological, and social factors. The clinical manifestation of peptic ulcer is characterized by chronic process, periodic attacks, and rhythmic pain, with a history of several years or even more than ten years. The attack is periodic and alternates with the remission period. It is often induced and aggravated by mental stimulation, drug influence, climate change, excessive fatigue, careless diet, and other factors. It can be relieved by eating, rest, and taking medicine. It is often complicated with complications such as upper gastrointestinal bleeding, perforation, pyloric obstruction, and canceration.The present situation of nursing care of patients with peptic ulcer bleeding is summarized as follows:(1)
Postural nursing: first of all, for patients with acute massive hemorrhage, arrange to the bed near the nurse station, quickly establish multiple groups of venous channels, and match and send blood in time. The shocked person takes the middle recumbent position. Patients with vomiting should be told to tilt their head to one side to prevent asphyxiation(2)
Diet nursing acute bleeding period to tell patients to temporarily fast, after the bleeding can be stopped into a small amount of warm and cool liquid diet and gradually to semifluid, soft food, and normal diet transition. During fasting, patients’ blood sugar should be monitored to prevent the occurrence of hypoglycemia. The flora species during diet nursing acute bleeding period can be shown in Figure8(3)
During the period of hospitalization, we should closely observe the changes in the patient’s condition, especially the changes of vital signs, the color, nature, and quantity of stool and vomit, and pay attention to the state of mental consciousness of the patient. Pay attention to mental tiredness, restlessness, apathy, and even coma. Continuous ECG monitoring was given to patients with severe conditions to monitor vital signs, 24-hour urine volume was accurately recorded, changes in laboratory indexes such as blood urea nitrogen and hemoglobin were monitored regularly, and patients who needed blood transfusions needed to be closely monitored for blood transfusion reactions(4)
Medication and therapy should be administered according to the doctor’s instructions, carefully monitoring adverse medication responses. Proton pump inhibitors, somatostatin, vasopressin, hemostatic, and other drugs are being used to treat this condition. Pantoprazole, omeprazole, esomeprazole, and other proton pump inhibitors are frequently utilized. Vitamin K1, thrombin, and hemostatic sensitivity are all common hemostatic medicines. Cycloformic acid, batroxobin, and other hemostatic medications are often used to treat peptic ulcer hemorrhage. Endoscopic local hemostatic therapy, traditional medicine treatment, integrated traditional western medicine treatment, and other peptic ulcer hemorrhage hemostasis are also available(5)
Assist in rescuing patients in need of assistance, preparing rescue supplies, and working with the doctor wherever possible. Stopping peptic ulcer bleeding promptly and efficiently is critical for clinical management. When it comes to acute hemostasis, endoscopic treatment is the first line of defense. Endoscopic hemostasis should be done as soon as feasible once the patients’ vital signs have stabilized. If endoscopic treatment fails, interventional therapy or surgical treatment can be consideredFigure 8
The flora species during diet nursing acute bleeding period.


## 5. Conclusion

A peptic ulcer is a common disease in human beings, which is distributed all over the world, and its etiology is more complicated. Still, the basic reason is the loss of balance between mucosal self-defense-repair factors and invasive factors that damage gastric and duodenal mucosa. The weakening of maintenance factors includes the destruction of the gastric mucosal barrier, the influence of gastric juice, and smoking. In addition, genetic quality, stress, and psychological factors can cause acute peptic ulcers. The application of nursing hierarchical management in the nursing management of the gastroenterology department is mainly based on the different qualifications and levels of the nursing staff in the department, the nursing duties are completely backward, and the experienced personnel guide the nursing staff with less seniority. Through this form of graded nursing management, the professional knowledge and nursing common sense of nurses can be increased, and all nursing management measures can be fully implemented. Clinical practice has proved that the application of nursing hierarchical management in gastroenterology has significantly reduced the complaint rate of patients and the incidence of adverse events, and the comprehensive nursing satisfaction of patients is higher. Hence, the overall effect of clinical application is better. Therefore, it is worth further popularizing and using.



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*Source: 8245177-2021-10-01.xml*