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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Original article / research
Full Version
Effect of Intensive Nursing Care in Elderly Patients undergoing Video-assisted Thoracoscopic Lung Cancer Surgery: A Randomised Control Study
Correspondence Address :
Dr. Chunyong Su,
Chief Physician, Department of Division 1 of Thoracic Surgery, Handan Central Hospital, No. 20, Zhonghua South Street, Handan City, Hebei Province, China.
E-mail: SCY0622@sina.cn
Introduction: Lung Cancer (LC) is a prominent cause of death worldwide, with both non small cell and small cell types increasing in prevalence. Multiple therapeutic options such as chemotherapy, radiation, and surgery, including Video-assisted Thoracoscopic Surgery (VATS), have been developed, although postoperative complications remain a concern. Nursing care has been advocated as a means to mitigate these adverse effects. However, the actual association between nursing care and LC postoperative complications and outcomes remains unknown.
Aim: To assess the effects of Intensive Nursing Care (INC) on LC patients treated with VATS.
Materials and Methods: The present study was a randomised control study in which a total of 256 Non Small Cell Lung Cancer (NSCLC) patients over the age of 60 years who underwent VATS in the Division 1 of Thoracic Surgery at Handan Central Hospital between January 2021 and January 2023 were included. The participants were randomly allocated to different groups: an INC group (n=126) and a control group receiving normal care (n=130). Lung function, reported symptoms, hospitalisation duration, psychological wellbeing (anxiety and depression scores), and occurrence of postsurgery symptoms (pain, fatigue, insomnia, dyspnea, nausea/vomiting) were assessed. T-tests or Fisher’s-Exact tests were used to compare baseline and postsurgical variables between the INC and Normal Nursing Care (NNC) groups using IBM Statistical Package for Social Sciences (SPSS) version 26.0 software.
Results: The study population consisted of 53.1% females with an average age of 73.51±7.61 years, ranging from 60 to 85 years. INC significantly improved hospitalisation duration {Mean Difference (MD)=-1.9; 95% Confidence Interval (CI), -2.6 to -1.2; p-value <0.001}, the occurrence of postsurgery symptoms (p-value <0.001), and psychological states assessed by both the Self-rating Anxiety Scale (SRAS) (MD=-17.99; 95% CI, -18.63 to -17.35; p-value=0.001) and the Self-rating Depression Scale (SRDS) (MD= -9.04; 95% CI, -9.95 to -8.13; p-value=0.008) in comparison to NNC patients.
Conclusion: Given the global burden of LC, it is crucial to emphasise not only the development of treatments for this illness but also care regimens that alleviate complications associated with these therapies. In this study, INC as an alternative to routine nursing care in postsurgery recovery has proven to be more beneficial to patients by decreasing their hospitalisation stay, the occurrence of postsurgery symptoms, and by enhancing their mental state.
Mental state, Non small cell lung cancer, Self-rating anxiety scale, Self-rating depression scale
The LC is a prominent cause of mortality in China and globally, as reported by the Global Cancer Statistics 2018 (1),(2),(3),(4),(5). The occurrence of both NSCLC and SCLC has been steadily rising in recent decades and is projected to continue increasing in the future (6),(7),(8),(9). Several procedures have been developed to treat LC, including chemotherapy, radiation, and surgery, such as VATS (10),(11),(12),(13),(14). An increasing number of patients with NSCLC, at a precocious stage of the evolution of the disease, have taken advantage of surgical resection as a modality of treatment. Unfortunately, they have encountered several detrimental consequences, such as a significant occurrence of pulmonary problems in up to approximately 25% of patients after surgery (5). Nursing care as a model of clinical intervention has been proposed as an efficient method to mitigate these reactions in patients with LC (15),(16),(17),(18),(19),(20),(21),(22). Although limited clinical studies have explored the effects of nursing care on anxiety and depression relief and quality of life in general among perioperative patients with LC (5),(10), it is unclear the actual association between nursing care and LC postoperative morbidity and prognosis. The current study evaluates the impact of INC on lung function, symptom management, duration of hospitalisation and psychological wellbeing in LC patients undergoing VATS.
This randomised controlled study was conducted on 256 NSCLC patients who underwent VATS at the Thoracic Surgery Division 1 of Handan Central Hospital, Handan, Hebei, China from January 2021 to January 2023. The Hospital’s Committee of Medical Ethics approved this study (project N: 331522121), and all patients gave their written consent to participate.
Inclusion criteria: The criteria for inclusion were as follows: 1) Patients aged 60 years or older; 2) Patients without physical limitations who can comprehend and collaborate with healthcare professionals; 3) Patients who have indications for VATS 4) Patients who have received a confirmed diagnosis of LC based on postoperative pathology samples.
Exclusion criteria: The exclusion criteria were as follows: 1) Recent medical treatment involving chemotherapy or radiotherapy; 2) History of previous lung surgery; 3) Concomitant presence of additional tumours and/or serious co-morbidities such as cardiovascular, cerebrovascular, and pulmonary diseases; 4) Previous diagnosis of depression; 5) Incomplete medical records.
Study Procedure
The eligible patients were randomly allocated into groups using their hospitalisation numbers. The hospitalisation numbers were entered on an Excel spreadsheet, with number 1 representing NNC and number 2 representing INC. This random assignment divided them into two different groups: INC (n=126) and normal care (n=130) (Table/Fig 1). The NNC group received standard nursing care, which included monitoring vital signs and symptoms, dietary and wound management, adherence to anti-infection protocols, and other routine postsurgical treatments. In the intensive nursing group, additional measures such as early ambulation and respiratory training were initiated two hours after intervention, including exercises like abdominal breathing and effective cough training. Patients were also instructed in techniques such as deep relaxation breathing and music therapy to manage stress and anxiety.
Data regarding the basic features of the patients, their hospitalisation duration, and symptoms were directly acquired from their medical records. Vital indicators, including Heart Rate (HR), Mean Arterial Pressure (MAP), Oxygen Saturation (SpO2), Forced Expiratory Volume in one second (FEV1), and Forced Vital Capacity (FVC) were measured during their stay. The psychological wellbeing of the patients was also examined. Anxiety and depression levels were assessed using self-reported surveys SRDS and SRAS (23),(24). Each survey lists several items, with a score from 1 to 4 attributed according to the patient’s responses. The sum of each item’s score determines the level of anxiety or depression within specific ranges (normal, mild, moderate, severe) as provided by the scale. Additionally, the overall wellbeing of the patients was measured using the European Association for Research and Treatment of Cancer Quality of Life questionnaire (EORTC QoL-C30) (25),(26). This self-report questionnaire, translated into several languages and validated by numerous studies, was used in its Chinese version to assess the physical, cognitive, emotional, and social functioning of postoperative cancer patients. It consists of several modules subdivided into items with scoring similar to the SAS and SDS, ranging from 1 to 4 according to the surveyed responses.
Baseline and postsurgical variables were compared between the INC and NNC groups.
Statistical Analysis
The analysis was performed using IBM SPSS 26.0 software. When appropriate, data are expressed as mean±Standard Deviation (SD) or as a percentage. T-tests or Fisher’s-Exact tests were used to compare the intensive and NNC groups. A p-value of <0.05 was considered significant.
A cohort of 256 patients was selected and a group of nurses assessed them during the extent of their postsurgery hospitalisation. The study population consisted of 53.1% females with an average age of 73.51±7.61 years, ranging from 60 to 85 years old. The participants were assigned to two groups of nursing care, namely intensive: INC (n=126) and normal: NNC (n=130). A 54% of the INC group was female compared to 52.3% of the NNC group. The average age of the NNC group was 74.2±7.69, while the INC group had a lower mean age of 72.79±7.5. Adenocarcinomas were the most common pathological diagnosis among the NNC patients 71 (54.6%), but Squamous carcinoma 71 (56.3%) was more prevalent in INC patients. Hospitalisation duration was significantly reduced among the INC group, showing a mean difference of -1.9 (95% CI, -2.6 to -1.2; p<0.001) days compared to the NNC group (Table/Fig 2).
Furthermore, according to (Table/Fig 3), INC was found to alleviate symptoms and consequences more effectively than a routine nursing strategy (p-value <0.001). Patients’ overall quality of life was not significantly enhanced in the INC group. However, their average scores for both anxiety and depression were lower compared to the normal nursing group, with a MD of -17.99 (95% CI, -18.63 to -17.35; p-value=0.001) for anxiety and a MD of -9.04 (95% CI, -9.95 to -8.13; p-value=0.008) for depression (Table/Fig 4).
Despite the tremendous progress in treatment options for NSCLC, from chemotherapy to radiation, including surgery and VATS (10),(11),(12),(13),(14), LC remains the leading cause of cancer-related mortality, accounting for 18% of cancer deaths worldwide, and specifically in China, with approximately 733,300 deaths registered in 2022 (1),(2),(3),(4),(5). Therefore, it is crucial to develop appropriate care regimens or protocols to monitor these treatments, aiming to reduce the burden of this illness on both patients and the healthcare system. Recent clinical studies have suggested positive impacts of high-quality or individualised nursing care focused on patients’ mental and physical wellbeing (15),(16),(17),(18),(19),(20),(21),(22),(27).
The present study aimed to enhance understanding in that regard by investigating the effect of INC on the recovery of postoperative patients who benefited from VATS. Present study observations indicate that patients enrolled in the INC group experienced significantly shorter overall hospitalisation, fewer symptoms, and less anxiety and depression. However, their lung function (SpO2, FEV1, FVC) and their Quality of Life (assessed by the EORTC QOL-C30) did not significantly improve compared to those receiving NNC.
In this research, both the SRAS and SRDS were lower in the INC group compared to the NNC group. Additional research conducted by Wang M et al., Brocki BC et al., and dos Santos TD et al., respectively performed in China, Europe, and Albuquerque, have reported a positive impact of high-quality nursing on the level of psychological distress among NSLC patients [20-22]. Possible explanations for these results may be that the INC patients received more thorough and extensive treatment, which better equipped them to cope with the stress of recovery. They were provided with improved assistance and educated on stress management techniques such as breathing exercises and music therapy.
Although in this study, the Quality of Life of INC patients did not statistically improve (p-value=0.128) as opposed to the findings of Wang M et al., where their comprehensive approach group scored higher than the routine care group. The variations observed in the case of Wang M et al., may be attributed to the utilisation of a distinct questionnaire, namely the Dutch version of the World Health Organisation Quality of Life evaluation instrument WHOQoL-100, which incorporates different items and scoring methods (22).
Moreover, hospitalisation duration was shorter in the INC group. The reduction of symptoms might explain the shorter hospital stays among them. Present study observation follows disparity in hospitalisation similar trends presented by Zhao H et al., even though our average duration is -1.9 days, whereas their study reported -4.1 days (19). Early ambulation and the adoption of breathing exercises themselves could be the reason for these improvements in the hospitalisation of present study INC patients, as suggested by other studies (28),(29).
Limitation(s)
This research unfortunately presents some limitations. First, it incorporates data exclusively from a single hospital in China, which may limit the generalisability of present study findings. In addition, the emphasis on the immediate effects of nursing care may have overlooked long-term variables, such as survival rates. Finally, psychological assessment of the patients upon admission and again upon discharge would have allowed for a comparative and more in-depth analysis of the patients’ mental state progression during their hospitalisation.
The LC stands as a leading cause of illness and mortality both in China and globally. As a result, it is imperative to prioritise not only the development of therapies that specifically aim to reduce the burden of LC but also care regimens that alleviate its complications. This research found that patients who underwent VATS as LC therapy and were subjected to INC experienced reduced symptoms, shorter hospital stays, and lower scores for depression and anxiety compared to those who received NNC. The integration of psychological training within nursing curricula would therefore enhance nursing practice as a whole, and in this case, lessen the burden of LC surgery and recovery on both families and healthcare systems.
DOI: 10.7860/JCDR/2024/69530.19439
Date of Submission: Jan 11, 2024
Date of Peer Review: Feb 16, 2024
Date of Acceptance: Apr 20, 2024
Date of Publishing: May 01, 2024
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jan 11, 2024
• Manual Googling: Apr 11, 2024
• iThenticate Software: Apr 15, 2024 (4%)
ETYMOLOGY: Author Origin
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