目的系统评价老年慢性病共病患者的药物自我管理体验。方法检索PubMed、Cochrane Library,Web of Science、Embase、CINAHL、CNKI、万方、维普及中国生物医学文献服务系统数据库,检索时限为建库至2024年4月22日,依据2020版澳大利亚JBI...目的系统评价老年慢性病共病患者的药物自我管理体验。方法检索PubMed、Cochrane Library,Web of Science、Embase、CINAHL、CNKI、万方、维普及中国生物医学文献服务系统数据库,检索时限为建库至2024年4月22日,依据2020版澳大利亚JBI循证卫生保健中心质性研究质量评价标准对文献质量进行评价,采用meta分析整合结果。结果共纳入20篇文献,提炼出54个研究结果,整合为13个类别,归纳为4个整合结果:面临的挑战和困难、药物自我管理策略、心理和情绪状态、应对心理和情绪的方法及策略。结论老年共病患者的药物自我管理体验复杂而关键。医护人员需协助患者掌握自我管理策略、调整心理状态,以应对药物管理任务,促使其积极接受现实并建立健康生活方式。展开更多
Background: For patients with severe neck angulation (SNA), hemodynamic and clinical outcomes following endovascular aneurysm repair (EVAR) are still unclear. This study aimed to explore the influence of SNA on hemody...Background: For patients with severe neck angulation (SNA), hemodynamic and clinical outcomes following endovascular aneurysm repair (EVAR) are still unclear. This study aimed to explore the influence of SNA on hemodynamic and clinical outcomes following EVAR.Methods: This study included a hemodynamic analysis and a retrospective cohort study from West China Hospital of Sichuan University between January 2011 and December 2020. The Cox regression model, inverse probability of treatment weighting (IPTW) analysis, sensitivity analysis, and subgroup analysis were applied. Primary outcome was type IA endoleak (T1AEL).Results: In this hemodynamic analysis, nine non-severe neck angulation (nSNA) and 16 SNA idealized models were constructed. We found a significant difference in drag force between SNA and nSNA models (7.016 ± 2.579 Nvs. 4.283 ± 1.460 N,P = 0.008), and proximal neck angles were significantly associated with the magnitude of drag force (F = 0.082 ×α-0.006 ×β + 2.818, α: 95% confidence interval [CI] 0.070-0.094;P = 0.001;β: 95% CI -0.019 to 0.007;P = 0.319). In our cohort study, 514 nSNA patients (71.5 ± 8.5 years;459 males) and 208 SNA patients (72.5 ± 7.8 years;135 males) were included, with a median follow-up duration of 34 months (16-63 months). All baseline characteristics were well balanced after IPTW matching. We found that SNA was associated with a significant risk of adverse limb event (hazard ratio [HR] 2.18, 95% CI 1.09-3.12), yet was not associated with T1AEL, overall survival, or reintervention. In patients without proximal or distal additional procedures (DAP), subgroup analyses suggested a significant risk of T1AEL (Proximal: HR 5.25, 95% CI 1.51-18.23;Distal: HR 5.07, 95% CI 1.60-16.07) and adverse limb event (Proximal: HR 2.27, 95% CI 1.01-5.07;Distal: HR 2.91, 95% CI 1.30-6.54) in SNA patients. However, no noticeable difference was observed in patients with proximal or DAP.Conclusions: SNA has a critical influence on hemodynamic and clinical outcomes following EVAR. Appropriate additional procedures may be of great benefit to SNA patients.展开更多
文摘目的系统评价老年慢性病共病患者的药物自我管理体验。方法检索PubMed、Cochrane Library,Web of Science、Embase、CINAHL、CNKI、万方、维普及中国生物医学文献服务系统数据库,检索时限为建库至2024年4月22日,依据2020版澳大利亚JBI循证卫生保健中心质性研究质量评价标准对文献质量进行评价,采用meta分析整合结果。结果共纳入20篇文献,提炼出54个研究结果,整合为13个类别,归纳为4个整合结果:面临的挑战和困难、药物自我管理策略、心理和情绪状态、应对心理和情绪的方法及策略。结论老年共病患者的药物自我管理体验复杂而关键。医护人员需协助患者掌握自我管理策略、调整心理状态,以应对药物管理任务,促使其积极接受现实并建立健康生活方式。
基金National Natural Science Foundation of China(Nos. 81770471 and 12072214)Post-Doctor Research Project, West China Hospital, Sichuan University(No. 2021HXBH012)
文摘Background: For patients with severe neck angulation (SNA), hemodynamic and clinical outcomes following endovascular aneurysm repair (EVAR) are still unclear. This study aimed to explore the influence of SNA on hemodynamic and clinical outcomes following EVAR.Methods: This study included a hemodynamic analysis and a retrospective cohort study from West China Hospital of Sichuan University between January 2011 and December 2020. The Cox regression model, inverse probability of treatment weighting (IPTW) analysis, sensitivity analysis, and subgroup analysis were applied. Primary outcome was type IA endoleak (T1AEL).Results: In this hemodynamic analysis, nine non-severe neck angulation (nSNA) and 16 SNA idealized models were constructed. We found a significant difference in drag force between SNA and nSNA models (7.016 ± 2.579 Nvs. 4.283 ± 1.460 N,P = 0.008), and proximal neck angles were significantly associated with the magnitude of drag force (F = 0.082 ×α-0.006 ×β + 2.818, α: 95% confidence interval [CI] 0.070-0.094;P = 0.001;β: 95% CI -0.019 to 0.007;P = 0.319). In our cohort study, 514 nSNA patients (71.5 ± 8.5 years;459 males) and 208 SNA patients (72.5 ± 7.8 years;135 males) were included, with a median follow-up duration of 34 months (16-63 months). All baseline characteristics were well balanced after IPTW matching. We found that SNA was associated with a significant risk of adverse limb event (hazard ratio [HR] 2.18, 95% CI 1.09-3.12), yet was not associated with T1AEL, overall survival, or reintervention. In patients without proximal or distal additional procedures (DAP), subgroup analyses suggested a significant risk of T1AEL (Proximal: HR 5.25, 95% CI 1.51-18.23;Distal: HR 5.07, 95% CI 1.60-16.07) and adverse limb event (Proximal: HR 2.27, 95% CI 1.01-5.07;Distal: HR 2.91, 95% CI 1.30-6.54) in SNA patients. However, no noticeable difference was observed in patients with proximal or DAP.Conclusions: SNA has a critical influence on hemodynamic and clinical outcomes following EVAR. Appropriate additional procedures may be of great benefit to SNA patients.
