BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential t...BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential to mitigate these adverse effects and enhance overall health outcomes in this population.AIM To evaluate the effects of exercise-cognitive dual-task training on frailty,cognitive function,psychological status,and quality of life in elderly patients with cognitive frailty and depression.METHODS A retrospective study was conducted on 130 patients with cognitive frailty and depression admitted between December 2021 and December 2023.Patients were divided into a control group receiving routine intervention and an observation group undergoing exercise-cognitive dual-task training in addition to routine care.Frailty,cognitive function,balance and gait,psychological status,and quality of life were assessed before and after the intervention.RESULTS After the intervention,the frailty score of the observation group was(5.32±0.69),lower than that of the control group(5.71±0.55).The Montreal cognitive assessment basic scale score in the observation group was(24.06±0.99),higher than the control group(23.43±1.40).The performance oriented mobility assessment score in the observation group was(21.81±1.24),higher than the control group(21.15±1.26).The self-efficacy in the observation group was(28.27±2.66),higher than the control group(30.05±2.66).The anxiety score in the hospital anxiety and depression scale(HADS)for the observation group was(5.86±0.68),lower than the control group(6.21±0.64).The depression score in the HADS for the observation group was(5.67±0.75),lower than the control group(6.27±0.92).Additionally,the scores for each dimension of the 36-item short form survey in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).CONCLUSION Exercise-cognitive dual-task training is beneficial for improving frailty,enhancing cognitive function,and improving psychological status and quality of life in elderly patients with cognitive frailty and depression.展开更多
Transferring patients with critical illnesses from general wards to intensive care units (ICUs) is a crucial and time-sensitive process. This article presents strategies for improving the efficiency of patient transfe...Transferring patients with critical illnesses from general wards to intensive care units (ICUs) is a crucial and time-sensitive process. This article presents strategies for improving the efficiency of patient transfers, particularly in hospitals where intensive care units are located in buildings separate from general wards. Patient transfers comprise several steps: physicians issue orders, relatives are notified, equipment is prepared, and medical staff coordinate. We identified three factors that influence transfer time: preparation time for bed transfer, time required for shift handovers, and time required for between-ward patient movement. Unfamiliarity with transfer routes and long elevator wait times were factors that also influenced transfer time. The following strategies were proposed: develop a standardized material checklist, design key notes for patient transfers, and optimize transfer routes. These strategies reduced transfer times by 40% to 43%. This study demonstrates that by addressing logistical challenges and streamlining relevant procedures, hospitals can enhance safety and quality of care during patient transfers.展开更多
Objective:Healthcare service satisfaction focuses not only on the patients but also on the overall quality and effectiveness of the care provided.This study aimed to explore the correlation between patients’perceptio...Objective:Healthcare service satisfaction focuses not only on the patients but also on the overall quality and effectiveness of the care provided.This study aimed to explore the correlation between patients’perceptions of empathy,patient satisfaction,and the quality of recovery in elderly patients undergoing postoperative care for lower extremity fractures under spinal anesthesia.Methods:In the present cross-sectional study,138 elderly patients who underwent surgery for lower extremity fracture and spinal anesthesia were selected for inclusion in the study.The questionnaire included demographic characteristics,the Jefferson Scale of Patient Perception of Physician Empathy,the Patient Satisfaction Scale,and the Postoperative Quality of Recovery Score.Multivariate regression was performed to evaluate the associations between patient-reported factors and satisfaction.Results:The overall average scores for patient perception of empathy,quality of recovery,and patient satisfaction were 20.30(1.18),110.11(8.26),and 156.86(5.44),respectively.There was a statistically significant positive correlation between patient quality of recovery and patient perception of empathy and patient satisfaction(p<0.01).Conclusions:This finding could also inform policymaking and the development of guidelines aimed at improving the quality of healthcare delivery.This study encouraged healthcare organizations and institutions to foster empathy in healthcare interactions,which may positively impact patient satisfaction and subsequent recovery outcomes,and patient-centered care.展开更多
Based on the perspective of caring,this study constructs a whole-cycle management programme for lymphoma patients,and systematically explores the pathway of patients’health management from diagnosis to recovery by in...Based on the perspective of caring,this study constructs a whole-cycle management programme for lymphoma patients,and systematically explores the pathway of patients’health management from diagnosis to recovery by integrating literature analysis,clinical practice research,and multidisciplinary experts’consensus.Focusing on the differentiated needs of patients,the study proposes a dual-track management framework of‘precise diagnosis and treatment standard’and‘humanistic care practice’,and innovatively designs a multidisciplinary collaborative mechanism,an information-based follow-up platform,and a social support network.Through the role of‘care consultant’,the programme connects the medical team with the individual needs of patients,strengthens treatment compliance and improves the quality of life,and provides a theoretical basis and practical reference for the optimization of the whole management mode of lymphoma patients.展开更多
Objective:To evaluate the practical application effect of nursing risk management in preventing falls among inpatients,and to provide a reference for optimizing clinical safety management strategies for inpatients.Met...Objective:To evaluate the practical application effect of nursing risk management in preventing falls among inpatients,and to provide a reference for optimizing clinical safety management strategies for inpatients.Methods:A total of 428 inpatients in our hospital from January 2021 to December 2023 were selected as the research objects.They were divided into a control group(218 cases)and a study group(210 cases)according to the nursing management method.The control group received routine fall prevention nursing,while the study group implemented systematic nursing risk management.The fall rate and post-fall injury rate during hospitalization were compared between the two groups.Results:The fall rate of the study group was significantly lower than that of the control group,and the difference was statistically significant(p<0.05).Conclusion:Nursing risk management can effectively reduce the fall rate and post-fall injury rate of inpatients through systematic risk identification,targeted intervention and continuous quality improvement.It also improves patients’awareness of fall prevention and nursing satisfaction,and promotes the improvement of nurses’risk management ability,which has important clinical promotion value.展开更多
BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing...BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing models is challenging due to the variety of diseases involved in gastrointestinal surgery and the com-plex factors contributing to patient stress responses.Moreover,stress responses are more severe in older adult patients.Therefore,precision medicine is required to improve the quality of nursing care and promote postoperative recovery in gastrointestinal surgery.and demonstrate nursing benefits through clinical practice.METHODS This randomized clinical trial first established an evidence-based nursing ERAS protocol in older adult patients based on literature related to perioperative nursing measures for gastrointestinal surgery stress response.Next,392 older adult patients who underwent gastrointestinal surgery and were admitted to our hospital between December 2021 and June 2023 were categorized into two groups to receive evidence-based(study group)or conventional(control group)ERAS nursing models,respectively.Intraoperative physiological parameters during surgery and postoperative recovery indicators were compared between the groups.RESULTS Among 64 domestic and international studies,the stress responses of older adult patients mainly included emotional anxiety,sleep disorders,gastrointestinal discomfort,physical weakness,pain,and swelling.The appropriate nursing interventions included comprehensive psychological counseling,pre-and postoperative nutritional support,temperature control,pain management,and rehabilitation training.Compared with the control group,the study group showed lower heart rate,mean arterial pressure,blood glucose level,and adrenaline level;shorter duration of drainage tube placement,time to first flatus,time to first ambulation,and postoperative hospital stay;lower anxiety scores on postoperative day 3;and lower incidences of postoperative infection,obstruction,poor wound healing,and gastrointestinal reactions were lower in the study group(all P<0.05).CONCLUSION The evidence-based nursing measures targeting stress responses based on the conventional ERAS nursing model resulted in stable intraoperative physiological parameters during surgery,promoted postoperative recovery,and reduced the incidence of complications.展开更多
BACKGROUND Empathetic psychological care improves mood and enhances the quality of life in critically ill patients.AIM To study the impact of combining 222-nm ultraviolet(UV)disinfection with empathetic psychological ...BACKGROUND Empathetic psychological care improves mood and enhances the quality of life in critically ill patients.AIM To study the impact of combining 222-nm ultraviolet(UV)disinfection with empathetic psychological care on emotional states,nosocomial infection rates,and quality of life in critically ill patients.METHODS A total of 202 critically ill patients admitted to Beijing Ditan Hospital(December 2023 to May 2024)were randomly assigned to control(Ctrl,n=101)or observation groups(Obs,n=101).The Ctrl group received 222-nm UV disinfection and routine care,while the Obs group received 222-nm UV disinfection with empathetic psychological care.Emotional states[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS)],hospital infection rates,quality of life(36-Item Short Form Health Survey),and patient satisfaction were evaluated.RESULTS At baseline,there were no significant differences in SAS and SDS scores between the groups(P>0.05).Following care,both groups demonstrated reductions in SAS and SDS scores,with the Obs group exhibiting a significantly greater reduction(P<0.05).The Obs group also experienced a significantly lower overall hospital infection rate(P<0.05).Similarly,while baseline 36-Item Short Form Health Survey scores did not differ significantly between the groups(P>0.05),post-care scores improved in both groups,with a greater improvement observed in the Obs group(P<0.05).Additionally,the Obs group reported higher patient satisfaction ratings(P<0.05).CONCLUSION The combination of 222-nm UV disinfection and empathetic psychological care improves emotional states,reduces hospital infection rates,enhances the quality of life,and increases patient satisfaction among critically ill patients.展开更多
Drug overdose is a common reason for emergency department admissions.Although pharmacobezoars due to drug overdose are rare,they can increase the length of hospital stay and risk of mortality.^([1]) Currently,no clear...Drug overdose is a common reason for emergency department admissions.Although pharmacobezoars due to drug overdose are rare,they can increase the length of hospital stay and risk of mortality.^([1]) Currently,no clear procedure for the management of gastric pharmacobezoars exists.We report a case of a patient with pharmacobezoars caused by high-dose oral drug poisoning.The patient recovered completely after gastroscopy,gastric lavage,and symptomatic treatments.展开更多
BACKGROUND Inflammatory bowel disease(IBD)is a global health burden that affects millions of individuals worldwide,necessitating extensive patient education.Large language models(LLMs)hold promise for addressing patie...BACKGROUND Inflammatory bowel disease(IBD)is a global health burden that affects millions of individuals worldwide,necessitating extensive patient education.Large language models(LLMs)hold promise for addressing patient information needs.However,LLM use to deliver accurate and comprehensible IBD-related medical information has yet to be thoroughly investigated.AIM To assess the utility of three LLMs(ChatGPT-4.0,Claude-3-Opus,and Gemini-1.5-Pro)as a reference point for patients with IBD.METHODS In this comparative study,two gastroenterology experts generated 15 IBD-related questions that reflected common patient concerns.These questions were used to evaluate the performance of the three LLMs.The answers provided by each model were independently assessed by three IBD-related medical experts using a Likert scale focusing on accuracy,comprehensibility,and correlation.Simultaneously,three patients were invited to evaluate the comprehensibility of their answers.Finally,a readability assessment was performed.RESULTS Overall,each of the LLMs achieved satisfactory levels of accuracy,comprehensibility,and completeness when answering IBD-related questions,although their performance varies.All of the investigated models demonstrated strengths in providing basic disease information such as IBD definition as well as its common symptoms and diagnostic methods.Nevertheless,when dealing with more complex medical advice,such as medication side effects,dietary adjustments,and complication risks,the quality of answers was inconsistent between the LLMs.Notably,Claude-3-Opus generated answers with better readability than the other two models.CONCLUSION LLMs have the potential as educational tools for patients with IBD;however,there are discrepancies between the models.Further optimization and the development of specialized models are necessary to ensure the accuracy and safety of the information provided.展开更多
BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU ad...BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU admissions are associated with increased morbidity and mortality and are an indicator of trauma service quality.Two different types of unplanned ICU admissions include upgrades(patients admitted to the floor then moved to the ICU)and bounce backs(patients admitted to the ICU,discharged to the floor,and then readmitted to the ICU).Previous studies have shown that geriatric trauma patients are at higher risk for unfavorable outcomes.AIM To analyze the characteristics,management and outcomes of trauma patients who had an unplanned ICU admission during their hospitalization.METHODS This institutional review board approved,retrospective cohort study examined 203 adult trauma patients with unplanned ICU admission at an urban level 1 trauma center over a six-year period(2017-2023).This included 134 upgrades and 69 bounce backs.Analyzed variables included:(1)Age;(2)Sex;(3)Comorbidities;(4)Mechanism of injury(MOI);(5)Injury severity score(ISS);(6)Glasgow Coma Scale(GCS);(7)Type of injury;(8)Transfusions;(9)Consultations;(10)Timing and reason for unplanned admission;(11)Intubations;(12)Surgical interventions;(13)ICU and hospital lengths of stay;and(14)Mortality.RESULTS Unplanned ICU admissions comprised 4.2%of total ICU admissions.Main MOI was falls.Mean age was 70.7 years,ISS was 12.8 and GCS was 13.9.Main injuries were traumatic brain injury(37.4%)and thoracic injury(21.7%),and main reason for unplanned ICU admission was respiratory complication(39.4%).The 47.3%underwent a surgical procedure and 46.8%were intubated.Average timing for unplanned ICU admission was 2.9 days.Bounce backs occurred half as often as upgrades,however had higher rates of transfusions(63.8%vs 40.3%,P=0.002),consultations(4.8 vs 3.0,P<0.001),intubations(63.8%vs 38.1%%,P=0.001),longer ICU lengths of stay(13.2 days vs 6.4 days,P<0.001)and hospital lengths of stay(26.7 days vs 13.0 days,P<0.001).Mortality was 25.6%among unplanned ICU admissions,31.9%among geriatric unplanned ICU admissions and 11.9%among all trauma ICU patients.CONCLUSION Unplanned ICU admissions constituted 4.2%of total ICU admissions.Respiratory complications were the main cause of unplanned ICU admissions.Bounce backs occurred half as often as upgrades,but were associated with worse outcomes.展开更多
The use of virtual reality to educate preoperative patients has a positive impact on nurses as well as patients undergoing treatment.It can help improve patient satisfaction and improve favorable outcomes by reducing ...The use of virtual reality to educate preoperative patients has a positive impact on nurses as well as patients undergoing treatment.It can help improve patient satisfaction and improve favorable outcomes by reducing patient anxiety and proving adequate knowledge about the procedure and possible outcomes to the patient.It also reduces burden on nursing staff and counsellors.Larger and more diverse cohort studies will help us understand the wider application of this tool on the patient population.It may be difficult to apply this tool on elderly patients with failing eyesight,multiple physical comorbidities.Also,there may be reduced acceptance of this modality by older nursing staff and practitioners who may prefer the traditional verbal version for counselling.We will benefit from a combined approach of using virtual reality apps with tradition one-on-one counselling to help alleviate patient concerns and improve patient and healthcare professional satisfaction.展开更多
BACKGROUND Traumatic injuries,such as falling,car accidents,and crushing mostly cause spinal fractures in young and middle-aged people,and>50%of them are thoracolumbar fractures.This kind of fracture is easily comb...BACKGROUND Traumatic injuries,such as falling,car accidents,and crushing mostly cause spinal fractures in young and middle-aged people,and>50%of them are thoracolumbar fractures.This kind of fracture is easily combined with serious injuries to peripheral nerves and soft tissues,which causes paralysis of the lower limbs if there is no timely rehabilitation treatment.Young patients with thoracolumbar fractures find it difficult to recover after the operation,and they are prone to depression,low self-esteem,and other negative emotions.AIM To investigate the association between anxiety,depression,and social stress in young patients with thoracolumbar spine fractures and the effect on rehabilitation outcomes.METHODS This study retrospectively analyzed 100 patients admitted to the orthopedic department of Honghui Hospital,Xi’an Jiaotong University who underwent thoracolumbar spine fracture surgery from January 2022 to June 2023.The general data of the patients were assessed with the Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),life events scale,and social support rating scale(SSRS)to identify the correlation between anxiety,depression scores,and social stress and social support.The Japanese Orthopedic Association(JOA)was utilized to evaluate the rehabilitation outcomes of the patients and to analyze the effects of anxiety and depression scores on rehabilitation.RESULTS According to the scores of HAMD and HAMA in all patients,the prevalence of depression in patients was 39%(39/100),and the prevalence of anxiety was 49%(49/100).Patients were categorized into non-depression(n=61)and depression(n=39),non-anxiety(n=51),and anxiety(n=49)groups.Statistically significant differences in gender,occupation,Pittsburgh Sleep Quality Index(PSQI)score,and monthly family income were observed between the non-depression and depression groups(P<0.05).A significant difference in occupation and PSQI score was found between the non-anxiety and anxiety groups.Both depression(r=0.207,P=0.038)and anxiety scores(r=0.473,P<0.001)were significantly and positively correlated with negative life events.The difference in negative life event scores as well as SSRS total and item scores was statist-ically significant between patients in the non-depression and depression groups(P<0.05).The difference between the non-anxiety and anxiety groups was statistically significant(P<0.05)in the negative life event scores as well as the total SSRS scores.Additionally,JOA scores were significantly lower in both anxious and depressed patients.CONCLUSION Young patients with thoracolumbar fractures are prone to anxiety and depression.Patients’anxiety and depression are closely associated with social pressure,which reduces the life pressure of young patients with thoracolumbar fractures,enhances social support,and improves the psychology of anxiety and depression.,which affects patients’recovery.展开更多
BACKGROUND Chronic hepatitis B often progresses silently toward hepatocellular carcinoma(HCC),a leading cause of mortality worldwide.Early detection of HCC is crucial,yet challenging.AIM To investigate the role of dyn...BACKGROUND Chronic hepatitis B often progresses silently toward hepatocellular carcinoma(HCC),a leading cause of mortality worldwide.Early detection of HCC is crucial,yet challenging.AIM To investigate the role of dynamic changes in alkaline phosphatase to prealbumin ratio(APR)in hepatitis B progression to HCC.METHODS Data from 4843 patients with hepatitis B(January 2015 to January 2024)were analyzed.HCC incidence rates in males and females were compared using the log-rank test.Data were evaluated using Kaplan–Meier analysis.The Linear Mixed-Effects Model was applied to track the fluctuation of APR levels over time.Furthermore,Joint Modeling of Longitudinal and Survival data was employed to investigate the temporal relationship between APR and HCC risk.RESULTS The incidence of HCC was higher in males.To ensure the model’s normality assumption,this study applied a logarithmic transformation to APR,yielding ratio.Ratio levels were higher in females(t=5.26,P<0.01).A 1-unit increase in ratio correlated with a 2.005-fold higher risk of HCC in males(95%CI:1.653-2.431)and a 2.273-fold higher risk in females(95%CI:1.620-3.190).CONCLUSION Males are more prone to HCC,while females have higher APR levels.Despite no baseline APR link,rising APR indicates a higher HCC risk.展开更多
Introduction: Diabetes remains a real public health problem today, due to its associated morbidity and mortality. It induces numerous metabolic, biochemical, hematological, and immunological changes, responsible for m...Introduction: Diabetes remains a real public health problem today, due to its associated morbidity and mortality. It induces numerous metabolic, biochemical, hematological, and immunological changes, responsible for multiple complications. The objective of this study was to characterize clinically and biologically type 2 diabetic patients followed at the National Center for Diabetology and Arterial Hypertension of the Central Hospital of Yaoundé. Method: This prospective, cross-sectional, and analytical study took place from April 5 to July 31, 2023 (4 months) on 100 diabetic patients of both sexes (61 women and 39 men), aged from 31 to 88 years. Body Mass Index, systolic and diastolic blood pressure, and cardiac frequency were measured on each of the patients. Subsequently, blood was collected from the patients for the determination of the complete blood count, HBA1c, lipid profile, serum albumin, TNF-α, and IL-6 levels. The data were analyzed using SPSS 17.0 software. Results: The age average of our population was 56.99 ± 11.51 years, the population was primarily female (61%) and primarily between the ages of 55 and 88. 67% of respondents were married. 59% went to secondary school. 73% of them lived in urban areas. 30% were obese and 40% were overweight, with an average BMI of 28.75 kg/m2. 76% of patients took oral antidiabetic medications. HbA1c level average was 8.65%, with 60% having readings above 6.5%. Low hemoglobin and hypochromia were among the abnormalities of red blood cells observed. Lipid profiles revealed low HDL-cholesterol and high triglycerides and cholesterol. Elevated levels of TNF-α and IL-6 indicated inflammation and cardiovascular risk. Conclusion: These results indicate the necessity of focused diabetic care and management on diabetic patients attending the central hospital of Yaoundé, Cameroon.展开更多
Introduction: In recent times, satisfaction studies have gained importance in the health sector as a way to monitor services and products. The main aim of this study was to explore patient satisfaction with pharmaceut...Introduction: In recent times, satisfaction studies have gained importance in the health sector as a way to monitor services and products. The main aim of this study was to explore patient satisfaction with pharmaceutical care provided in Nampula healthcare centers. Material and Methods: The study was conducted at the 25 de Setembro, 1˚ de Maio, and Muhala-Expansão healthcare centers in Nampula. The sample consisted of 381 patients, with 127 from each center, selected for accessibility. Data were collected through a questionnaire with an internal consistency of 0.816, calculated using McDonald’s total Omega (ωt). The analysis included frequencies, descriptive statistics (mean and standard deviation), and inferential statistics like Binary Logistic Regression. Results: Overall satisfaction was 3.62 ± 0.627 on a scale of 1 to 5, or 69.8%. The binary regression associated a higher education level with dissatisfaction (COR 0.204, 95% CI: −2.752 to −0.427) and living in Marrere (COR 0.083, 95% CI: -5.098 to 0.120) and Muahivir-Expansão (COR 0.589, 95% CI: −1.824 to 0.767) with dissatisfaction as well. Conclusion: Satisfaction was generally high, mainly influenced by the availability of medicines and medical supplies, and less by other factors such as healthcare center accessibility, facility quality, and relationships with pharmacy professionals. Although variables like sex, religion, age, marital status, profession, occupation, and the number of pharmacy visits in the last five years were not statistically significant for general satisfaction in this study, they should be considered in future studies as they are often linked to pharmaceutical satisfaction.展开更多
Introduction:With the aging population,more females will suffer from pelvic organ prolapse.Both urologists and gynecologists perform sacrocolpopexy,but there is no comparative study analyzing differences in provision ...Introduction:With the aging population,more females will suffer from pelvic organ prolapse.Both urologists and gynecologists perform sacrocolpopexy,but there is no comparative study analyzing differences in provision of care,outcomes,or patient population.We aimed to elucidate potential differences in demographics,outcomes,and minimally invasive surgery utilization for SCP performed by urology and gynecology.Methods:In our retrospective analysis,sacrocolpopexies were identified using the American College of Surgeons National Surgical Quality Improvement Project database from 2006–2020.Pearson’s chi-square test was performed to test trends in the utilization of MIS in five-year blocks.Frailty was calculated using the NSQIP modified frailty index and the revised surgical Risk Analysis Index.Univariate analysis was performed using Student’s t-test and Pearson’s chi-square to compare operative parameters,frailty,demographics,and outcomes.Results:We identified 8944 sacrocolpopexies.Gynecology performed 81%of cases while urology performed the remaining 19%(p<0.001).Between the specialties,there were no significant differences in outcomes,minor or major complications,or 30-day reoperations/hospital readmissions/mortality.However,urologists tended to care for patients who were older(65 vs.61 years,p<0.001)and frailer by both frailty indices(p<0.001).Conclusion:Case distributions have remained stable,with gynecologists four-fold more sacrocolpopexies,in keeping with the larger number of practicing gynecologists vs.urologists.There was no difference in 30-day outcomes between both specialties.However,urologists operated on older,more frail patients.展开更多
Objectives:This study aimed to generate a theoretical framework based on empirical data to explain the behavioral patterns closely related to young and middle-aged patients with lymphoma throughout the disease.Methods...Objectives:This study aimed to generate a theoretical framework based on empirical data to explain the behavioral patterns closely related to young and middle-aged patients with lymphoma throughout the disease.Methods:This study followed the classic grounded theory methodology,involving procedures such as theoretical sampling,substantive coding,theoretical coding,constant comparison,and memo writing and sorting.Multiple data types were used based on the principle of“all is data,”including 34 participants providing interview data along with observation notes and 40 relevant secondary texts from the“Lymphoma House”network platform and the“Lymphoma House 086”public account.Two autobiographical books written by lymphoma patients were also selected as data resources.Data collection and analysis were conducted in an iterative process until theoretical saturation was reached.The COREQ checklist was followed to report this study.Results:The main concern of middle-aged and young patients with lymphoma was identifiedas restoring normality,while managing uncertainty was the main behavioral pattern for restoring normality.Uncertainty consists of two interrelated types:inherent uncertainty of illness and perceived uncertainty of patients.Four strategies are used to manage uncertainty:reconstructing certainty,adaptive coping,defensive buffering,and compensatory changing.Managing uncertainty is influenced by disease characteristics and perceptions,social resources,and cultural concepts.The consequence of managing uncertainty is reaching a new normality.Conclusions:Pervasive uncertainty significantly affects the daily lives of young and middle-aged patients with lymphoma.Consequently,strategies for managing disease-related uncertainty to sustain normality are commonly observed in this population.This theoretical framework for addressing uncertainty can serve as a foundation for understanding and developing tailored interventions to manage uncertainty.Future research should focus on managing uncertainty to help patients restore normality.展开更多
BACKGROUND Hypertension is a common chronic disease in the elderly population,and its association with cognitive impairment has been increasingly recognized.Cognitive impairment,including mild cognitive impairment and...BACKGROUND Hypertension is a common chronic disease in the elderly population,and its association with cognitive impairment has been increasingly recognized.Cognitive impairment,including mild cognitive impairment and dementia,can significantly affect the quality of life and independence of elderly individuals.Therefore,identifying risk factors for cognitive impairment in elderly hypertensive patients is crucial for developing effective interventions and improving health outcomes.Nutritional status is one of the potential factors that may influence cognitive function in elderly hypertensive patients.Malnutrition or inadequate nutrition can lead to various health problems,including weakened immune system,increased susceptibility to infections,and impaired physical and mental function.Furthermore,poor nutritional status has been linked to increased risk of cognitive decline and dementia in various populations.In this observational study,we aimed to investigate the nutritional status of elderly hypertensive patients and its relationship to the occurrence of cognitive impairment.By collecting baseline data on general information,body composition,and clinical indicators,we hope to identify risk factors for cognitive impairment in this patient population.The results of this study are expected to provide more scientific basis for the health management of elderly patients with hypertension,particularly in terms of maintaining good nutritional status and reducing the risk of cognitive impairment.AIM To explore the differences between clinical data and cognitive function of elderly hypertensive patients with different nutritional status,analyze the internal relationship between nutritional statuses and cognitive impairment,and build a nomogram model for predicting nutritional status in elderly hypertensive patients.METHODS The present study retrospectively analyzed 200 elderly patients admitted to our hospital for a hypertension during the period July 1,2024 to September 30,2024 as study subjects,and the 200 patients were divided into a modeling cohort(140 patients)and a validation cohort(60 patients)according to the ratio of 7:3.The modeling cohort were divided into a malnutrition group(26 cases),a malnutrition risk group(42 cases),and a normal nutritional status group(72 cases)according to the patients’Mini-Nutritional Assessment Scale(MNA)scores,and the modeling cohort was divided into a hypertension combined with cognitive impairment group(34 cases)and a hypertension cognitively normal group(106 cases)according to the Montreal Cognitive Assessment Scale(MoCA)scores,and the validation cohort was divided into a hypertension combined with cognitive impairment group(14 cases)and hypertension cognitively normal group(46 cases).The study outcome was the occurrence of cognitive impairment in elderly hypertensive patients.Univariate and multivariate logistic regression was used to explore the relationship between the general information of the elderly hypertensive patients and the influence indicators and the occurrence of cognitive impairment,the roadmap prediction model was established and validated,the patient work receiver operating characteristic curve was used to evaluate the predictive efficacy of the model,the calibration curve was used to assess the consistency between the predicted events and the actual events,and the decision curve analysis was used to evaluate the validity of the model.Pearson correlation analysis was used to explore the relationship between nutrition-related indicators and MoCA scores.RESULTS In this research,the modeling cohort comprised 140 cases,while the verification cohort consisted of 60 cases,with no notable discrepancy in the data between the two groups.In the modeling cohort,there were significant differences in body mass index(BMI),albumin(ALB),hemoglobin(Hb)and homocysteine levels among the malnourished group,the malnourished risk group and the normal nutritional status group.The results of univariate and multivariate analysis showed that BMI[odds ratio(OR)=0.830,P=0.014],ALB(OR=0.860,P=0.028),Hb(OR=0.939,P=0.035)and MNA score(OR=0.640,P=0.000)were independent protective factors for patients without cognitive impairment,and alkaline phosphatase(ALP)(OR=1.074,P=0.000)was an independent risk factor for patients with cognitive impairment.In this study,the prediction nomogram tailored for cognitive deterioration in elderly patients with hypertension demonstrated robust predictive power and a close correspondence between predicted and observed outcomes.This model offers significant potential as a means to forestall cognitive decline in hypertensive elderly patients.ALP was negatively correlated with MoCA score,while BMI,MNA score,Hb and ALB were positively correlated with MoCA score.CONCLUSION BMI,MNA score,Hb and ALB were independent protective factors for cognitive impairment in elderly hypertensive patients and were positively correlated with MoCA score.ALP was an independent risk factor for cognitive impairment in elderly hypertensive patients and was negatively correlated with the MoCA score.The column line graph model established in the study has a good predictive value.展开更多
This study focuses on the management of maintenance hemodialysis(MHD)patients,with a specific emphasis on the practical application effect of the network information management model including its impact on patients’...This study focuses on the management of maintenance hemodialysis(MHD)patients,with a specific emphasis on the practical application effect of the network information management model including its impact on patients’compliance.A network information management model for MHD patients was constructed around three management schemes:“software reminders+follow-up guidance”,“dietary records+self-management reminders”,and“dialysis plan+precise weight management”.These schemes were respectively used to optimize anemia management,control the risk of hyperphosphatemia,and improve toxin clearance efficiency.A controlled experiment was conducted,with an experimental group and a control group set up for comparative practice.The results showed that the network information management model can effectively improve patients’anemia,help alleviate mineral metabolism disorders and the accumulation of small-molecule toxins,and exert a positive impact on patients’treatment compliance.展开更多
BACKGROUND Elobixibat reportedly improves bowel movements in patients with chronic constipation.However,its effect on bowel movements in elderly patients with chronic constipation in clinical settings has not been exa...BACKGROUND Elobixibat reportedly improves bowel movements in patients with chronic constipation.However,its effect on bowel movements in elderly patients with chronic constipation in clinical settings has not been examined.AIM To examine bowel movement frequency and stool form before and after elobixibat administration in elderly patients with chronic constipation at our clinic.METHODS A total of 10 mg elobixibat was administered to 35(<65 years old)patients and 45(≥65 years old)patients with chronic constipation.The frequency of bowel movements and stool forms,assessed using the Bristol Stool Form Scale(BSFS),were compared between the two groups 1 week before and after elobixibat administration.RESULTS In patients aged<65 years with chronic constipation,the pre-elobixibat frequency of bowel movements and BSFS scores were 2.167±0.732 and 2.286±0.742,respectively.After elobixibat administration,the frequency of bowel movements and BSFS scores improved to 2.389±0.502 and 3.995±0.566,respectively,showing a significant improvement in bowel movement status.In patients aged≥65 years with chronic constipation,the pre-elobixibat frequency of bowel movements and BSFS scores were 2.003±0.733 and 2.217±0.758,respectively.After elobixibat administration,the frequency of bowel movements and BSFS scores improved to 4.402±1.346 and 3.800±0.704,respectively,indicating an improvement in bowel movement status(P<0.001).No significant differences were observed in the frequency and improvement status of bowel movements or BSFS scores between patients with chronic constipation aged≥65 years and<65 years.Adverse events due to the administration of elobixibat occurred in 16 cases(20%).No significant differences were found in the incidence of adverse events between patients with chronic constipation aged<65 years(8 cases,22.9%)and those aged≥65 years(8 cases,17.8%).CONCLUSION Elobixibat is effective in improving bowel movement status in patients with chronic constipation.No significant differences were found in the improvement of bowel movement status or the incidence of adverse events between patients with chronic constipation aged<65 years and≥65 years,suggesting that the drug may be safely used in elderly patients.展开更多
文摘BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential to mitigate these adverse effects and enhance overall health outcomes in this population.AIM To evaluate the effects of exercise-cognitive dual-task training on frailty,cognitive function,psychological status,and quality of life in elderly patients with cognitive frailty and depression.METHODS A retrospective study was conducted on 130 patients with cognitive frailty and depression admitted between December 2021 and December 2023.Patients were divided into a control group receiving routine intervention and an observation group undergoing exercise-cognitive dual-task training in addition to routine care.Frailty,cognitive function,balance and gait,psychological status,and quality of life were assessed before and after the intervention.RESULTS After the intervention,the frailty score of the observation group was(5.32±0.69),lower than that of the control group(5.71±0.55).The Montreal cognitive assessment basic scale score in the observation group was(24.06±0.99),higher than the control group(23.43±1.40).The performance oriented mobility assessment score in the observation group was(21.81±1.24),higher than the control group(21.15±1.26).The self-efficacy in the observation group was(28.27±2.66),higher than the control group(30.05±2.66).The anxiety score in the hospital anxiety and depression scale(HADS)for the observation group was(5.86±0.68),lower than the control group(6.21±0.64).The depression score in the HADS for the observation group was(5.67±0.75),lower than the control group(6.27±0.92).Additionally,the scores for each dimension of the 36-item short form survey in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).CONCLUSION Exercise-cognitive dual-task training is beneficial for improving frailty,enhancing cognitive function,and improving psychological status and quality of life in elderly patients with cognitive frailty and depression.
文摘Transferring patients with critical illnesses from general wards to intensive care units (ICUs) is a crucial and time-sensitive process. This article presents strategies for improving the efficiency of patient transfers, particularly in hospitals where intensive care units are located in buildings separate from general wards. Patient transfers comprise several steps: physicians issue orders, relatives are notified, equipment is prepared, and medical staff coordinate. We identified three factors that influence transfer time: preparation time for bed transfer, time required for shift handovers, and time required for between-ward patient movement. Unfamiliarity with transfer routes and long elevator wait times were factors that also influenced transfer time. The following strategies were proposed: develop a standardized material checklist, design key notes for patient transfers, and optimize transfer routes. These strategies reduced transfer times by 40% to 43%. This study demonstrates that by addressing logistical challenges and streamlining relevant procedures, hospitals can enhance safety and quality of care during patient transfers.
文摘Objective:Healthcare service satisfaction focuses not only on the patients but also on the overall quality and effectiveness of the care provided.This study aimed to explore the correlation between patients’perceptions of empathy,patient satisfaction,and the quality of recovery in elderly patients undergoing postoperative care for lower extremity fractures under spinal anesthesia.Methods:In the present cross-sectional study,138 elderly patients who underwent surgery for lower extremity fracture and spinal anesthesia were selected for inclusion in the study.The questionnaire included demographic characteristics,the Jefferson Scale of Patient Perception of Physician Empathy,the Patient Satisfaction Scale,and the Postoperative Quality of Recovery Score.Multivariate regression was performed to evaluate the associations between patient-reported factors and satisfaction.Results:The overall average scores for patient perception of empathy,quality of recovery,and patient satisfaction were 20.30(1.18),110.11(8.26),and 156.86(5.44),respectively.There was a statistically significant positive correlation between patient quality of recovery and patient perception of empathy and patient satisfaction(p<0.01).Conclusions:This finding could also inform policymaking and the development of guidelines aimed at improving the quality of healthcare delivery.This study encouraged healthcare organizations and institutions to foster empathy in healthcare interactions,which may positively impact patient satisfaction and subsequent recovery outcomes,and patient-centered care.
文摘Based on the perspective of caring,this study constructs a whole-cycle management programme for lymphoma patients,and systematically explores the pathway of patients’health management from diagnosis to recovery by integrating literature analysis,clinical practice research,and multidisciplinary experts’consensus.Focusing on the differentiated needs of patients,the study proposes a dual-track management framework of‘precise diagnosis and treatment standard’and‘humanistic care practice’,and innovatively designs a multidisciplinary collaborative mechanism,an information-based follow-up platform,and a social support network.Through the role of‘care consultant’,the programme connects the medical team with the individual needs of patients,strengthens treatment compliance and improves the quality of life,and provides a theoretical basis and practical reference for the optimization of the whole management mode of lymphoma patients.
文摘Objective:To evaluate the practical application effect of nursing risk management in preventing falls among inpatients,and to provide a reference for optimizing clinical safety management strategies for inpatients.Methods:A total of 428 inpatients in our hospital from January 2021 to December 2023 were selected as the research objects.They were divided into a control group(218 cases)and a study group(210 cases)according to the nursing management method.The control group received routine fall prevention nursing,while the study group implemented systematic nursing risk management.The fall rate and post-fall injury rate during hospitalization were compared between the two groups.Results:The fall rate of the study group was significantly lower than that of the control group,and the difference was statistically significant(p<0.05).Conclusion:Nursing risk management can effectively reduce the fall rate and post-fall injury rate of inpatients through systematic risk identification,targeted intervention and continuous quality improvement.It also improves patients’awareness of fall prevention and nursing satisfaction,and promotes the improvement of nurses’risk management ability,which has important clinical promotion value.
文摘BACKGROUND Although the 2021 Chinese Clinical Practice Guidelines for Enhanced Recovery after Surgery(ERAS)provide recommendations for ERAS in gastrointestinal surgery,the clinical application of standard ERAS nursing models is challenging due to the variety of diseases involved in gastrointestinal surgery and the com-plex factors contributing to patient stress responses.Moreover,stress responses are more severe in older adult patients.Therefore,precision medicine is required to improve the quality of nursing care and promote postoperative recovery in gastrointestinal surgery.and demonstrate nursing benefits through clinical practice.METHODS This randomized clinical trial first established an evidence-based nursing ERAS protocol in older adult patients based on literature related to perioperative nursing measures for gastrointestinal surgery stress response.Next,392 older adult patients who underwent gastrointestinal surgery and were admitted to our hospital between December 2021 and June 2023 were categorized into two groups to receive evidence-based(study group)or conventional(control group)ERAS nursing models,respectively.Intraoperative physiological parameters during surgery and postoperative recovery indicators were compared between the groups.RESULTS Among 64 domestic and international studies,the stress responses of older adult patients mainly included emotional anxiety,sleep disorders,gastrointestinal discomfort,physical weakness,pain,and swelling.The appropriate nursing interventions included comprehensive psychological counseling,pre-and postoperative nutritional support,temperature control,pain management,and rehabilitation training.Compared with the control group,the study group showed lower heart rate,mean arterial pressure,blood glucose level,and adrenaline level;shorter duration of drainage tube placement,time to first flatus,time to first ambulation,and postoperative hospital stay;lower anxiety scores on postoperative day 3;and lower incidences of postoperative infection,obstruction,poor wound healing,and gastrointestinal reactions were lower in the study group(all P<0.05).CONCLUSION The evidence-based nursing measures targeting stress responses based on the conventional ERAS nursing model resulted in stable intraoperative physiological parameters during surgery,promoted postoperative recovery,and reduced the incidence of complications.
基金Supported by Beijing Ditan Hospital Affiliated to Capital Medical University“Sailing Plan”,No.DTQH-202405.
文摘BACKGROUND Empathetic psychological care improves mood and enhances the quality of life in critically ill patients.AIM To study the impact of combining 222-nm ultraviolet(UV)disinfection with empathetic psychological care on emotional states,nosocomial infection rates,and quality of life in critically ill patients.METHODS A total of 202 critically ill patients admitted to Beijing Ditan Hospital(December 2023 to May 2024)were randomly assigned to control(Ctrl,n=101)or observation groups(Obs,n=101).The Ctrl group received 222-nm UV disinfection and routine care,while the Obs group received 222-nm UV disinfection with empathetic psychological care.Emotional states[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS)],hospital infection rates,quality of life(36-Item Short Form Health Survey),and patient satisfaction were evaluated.RESULTS At baseline,there were no significant differences in SAS and SDS scores between the groups(P>0.05).Following care,both groups demonstrated reductions in SAS and SDS scores,with the Obs group exhibiting a significantly greater reduction(P<0.05).The Obs group also experienced a significantly lower overall hospital infection rate(P<0.05).Similarly,while baseline 36-Item Short Form Health Survey scores did not differ significantly between the groups(P>0.05),post-care scores improved in both groups,with a greater improvement observed in the Obs group(P<0.05).Additionally,the Obs group reported higher patient satisfaction ratings(P<0.05).CONCLUSION The combination of 222-nm UV disinfection and empathetic psychological care improves emotional states,reduces hospital infection rates,enhances the quality of life,and increases patient satisfaction among critically ill patients.
基金supported by the Tianjin Key Medical Discipline (Specialty) Construction Project (TJYXZDXK-007A)Beijing Union Medical Foundation-Rui E Emergency Medicine Research Funding (PUMF01010010-2024-18)。
文摘Drug overdose is a common reason for emergency department admissions.Although pharmacobezoars due to drug overdose are rare,they can increase the length of hospital stay and risk of mortality.^([1]) Currently,no clear procedure for the management of gastric pharmacobezoars exists.We report a case of a patient with pharmacobezoars caused by high-dose oral drug poisoning.The patient recovered completely after gastroscopy,gastric lavage,and symptomatic treatments.
基金Supported by the China Health Promotion Foundation Young Doctors'Research Foundation for Inflammatory Bowel Disease,the Taishan Scholars Program of Shandong Province,China,No.tsqn202306343National Natural Science Foundation of China,No.82270578.
文摘BACKGROUND Inflammatory bowel disease(IBD)is a global health burden that affects millions of individuals worldwide,necessitating extensive patient education.Large language models(LLMs)hold promise for addressing patient information needs.However,LLM use to deliver accurate and comprehensible IBD-related medical information has yet to be thoroughly investigated.AIM To assess the utility of three LLMs(ChatGPT-4.0,Claude-3-Opus,and Gemini-1.5-Pro)as a reference point for patients with IBD.METHODS In this comparative study,two gastroenterology experts generated 15 IBD-related questions that reflected common patient concerns.These questions were used to evaluate the performance of the three LLMs.The answers provided by each model were independently assessed by three IBD-related medical experts using a Likert scale focusing on accuracy,comprehensibility,and correlation.Simultaneously,three patients were invited to evaluate the comprehensibility of their answers.Finally,a readability assessment was performed.RESULTS Overall,each of the LLMs achieved satisfactory levels of accuracy,comprehensibility,and completeness when answering IBD-related questions,although their performance varies.All of the investigated models demonstrated strengths in providing basic disease information such as IBD definition as well as its common symptoms and diagnostic methods.Nevertheless,when dealing with more complex medical advice,such as medication side effects,dietary adjustments,and complication risks,the quality of answers was inconsistent between the LLMs.Notably,Claude-3-Opus generated answers with better readability than the other two models.CONCLUSION LLMs have the potential as educational tools for patients with IBD;however,there are discrepancies between the models.Further optimization and the development of specialized models are necessary to ensure the accuracy and safety of the information provided.
文摘BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU admissions are associated with increased morbidity and mortality and are an indicator of trauma service quality.Two different types of unplanned ICU admissions include upgrades(patients admitted to the floor then moved to the ICU)and bounce backs(patients admitted to the ICU,discharged to the floor,and then readmitted to the ICU).Previous studies have shown that geriatric trauma patients are at higher risk for unfavorable outcomes.AIM To analyze the characteristics,management and outcomes of trauma patients who had an unplanned ICU admission during their hospitalization.METHODS This institutional review board approved,retrospective cohort study examined 203 adult trauma patients with unplanned ICU admission at an urban level 1 trauma center over a six-year period(2017-2023).This included 134 upgrades and 69 bounce backs.Analyzed variables included:(1)Age;(2)Sex;(3)Comorbidities;(4)Mechanism of injury(MOI);(5)Injury severity score(ISS);(6)Glasgow Coma Scale(GCS);(7)Type of injury;(8)Transfusions;(9)Consultations;(10)Timing and reason for unplanned admission;(11)Intubations;(12)Surgical interventions;(13)ICU and hospital lengths of stay;and(14)Mortality.RESULTS Unplanned ICU admissions comprised 4.2%of total ICU admissions.Main MOI was falls.Mean age was 70.7 years,ISS was 12.8 and GCS was 13.9.Main injuries were traumatic brain injury(37.4%)and thoracic injury(21.7%),and main reason for unplanned ICU admission was respiratory complication(39.4%).The 47.3%underwent a surgical procedure and 46.8%were intubated.Average timing for unplanned ICU admission was 2.9 days.Bounce backs occurred half as often as upgrades,however had higher rates of transfusions(63.8%vs 40.3%,P=0.002),consultations(4.8 vs 3.0,P<0.001),intubations(63.8%vs 38.1%%,P=0.001),longer ICU lengths of stay(13.2 days vs 6.4 days,P<0.001)and hospital lengths of stay(26.7 days vs 13.0 days,P<0.001).Mortality was 25.6%among unplanned ICU admissions,31.9%among geriatric unplanned ICU admissions and 11.9%among all trauma ICU patients.CONCLUSION Unplanned ICU admissions constituted 4.2%of total ICU admissions.Respiratory complications were the main cause of unplanned ICU admissions.Bounce backs occurred half as often as upgrades,but were associated with worse outcomes.
文摘The use of virtual reality to educate preoperative patients has a positive impact on nurses as well as patients undergoing treatment.It can help improve patient satisfaction and improve favorable outcomes by reducing patient anxiety and proving adequate knowledge about the procedure and possible outcomes to the patient.It also reduces burden on nursing staff and counsellors.Larger and more diverse cohort studies will help us understand the wider application of this tool on the patient population.It may be difficult to apply this tool on elderly patients with failing eyesight,multiple physical comorbidities.Also,there may be reduced acceptance of this modality by older nursing staff and practitioners who may prefer the traditional verbal version for counselling.We will benefit from a combined approach of using virtual reality apps with tradition one-on-one counselling to help alleviate patient concerns and improve patient and healthcare professional satisfaction.
文摘BACKGROUND Traumatic injuries,such as falling,car accidents,and crushing mostly cause spinal fractures in young and middle-aged people,and>50%of them are thoracolumbar fractures.This kind of fracture is easily combined with serious injuries to peripheral nerves and soft tissues,which causes paralysis of the lower limbs if there is no timely rehabilitation treatment.Young patients with thoracolumbar fractures find it difficult to recover after the operation,and they are prone to depression,low self-esteem,and other negative emotions.AIM To investigate the association between anxiety,depression,and social stress in young patients with thoracolumbar spine fractures and the effect on rehabilitation outcomes.METHODS This study retrospectively analyzed 100 patients admitted to the orthopedic department of Honghui Hospital,Xi’an Jiaotong University who underwent thoracolumbar spine fracture surgery from January 2022 to June 2023.The general data of the patients were assessed with the Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),life events scale,and social support rating scale(SSRS)to identify the correlation between anxiety,depression scores,and social stress and social support.The Japanese Orthopedic Association(JOA)was utilized to evaluate the rehabilitation outcomes of the patients and to analyze the effects of anxiety and depression scores on rehabilitation.RESULTS According to the scores of HAMD and HAMA in all patients,the prevalence of depression in patients was 39%(39/100),and the prevalence of anxiety was 49%(49/100).Patients were categorized into non-depression(n=61)and depression(n=39),non-anxiety(n=51),and anxiety(n=49)groups.Statistically significant differences in gender,occupation,Pittsburgh Sleep Quality Index(PSQI)score,and monthly family income were observed between the non-depression and depression groups(P<0.05).A significant difference in occupation and PSQI score was found between the non-anxiety and anxiety groups.Both depression(r=0.207,P=0.038)and anxiety scores(r=0.473,P<0.001)were significantly and positively correlated with negative life events.The difference in negative life event scores as well as SSRS total and item scores was statist-ically significant between patients in the non-depression and depression groups(P<0.05).The difference between the non-anxiety and anxiety groups was statistically significant(P<0.05)in the negative life event scores as well as the total SSRS scores.Additionally,JOA scores were significantly lower in both anxious and depressed patients.CONCLUSION Young patients with thoracolumbar fractures are prone to anxiety and depression.Patients’anxiety and depression are closely associated with social pressure,which reduces the life pressure of young patients with thoracolumbar fractures,enhances social support,and improves the psychology of anxiety and depression.,which affects patients’recovery.
文摘BACKGROUND Chronic hepatitis B often progresses silently toward hepatocellular carcinoma(HCC),a leading cause of mortality worldwide.Early detection of HCC is crucial,yet challenging.AIM To investigate the role of dynamic changes in alkaline phosphatase to prealbumin ratio(APR)in hepatitis B progression to HCC.METHODS Data from 4843 patients with hepatitis B(January 2015 to January 2024)were analyzed.HCC incidence rates in males and females were compared using the log-rank test.Data were evaluated using Kaplan–Meier analysis.The Linear Mixed-Effects Model was applied to track the fluctuation of APR levels over time.Furthermore,Joint Modeling of Longitudinal and Survival data was employed to investigate the temporal relationship between APR and HCC risk.RESULTS The incidence of HCC was higher in males.To ensure the model’s normality assumption,this study applied a logarithmic transformation to APR,yielding ratio.Ratio levels were higher in females(t=5.26,P<0.01).A 1-unit increase in ratio correlated with a 2.005-fold higher risk of HCC in males(95%CI:1.653-2.431)and a 2.273-fold higher risk in females(95%CI:1.620-3.190).CONCLUSION Males are more prone to HCC,while females have higher APR levels.Despite no baseline APR link,rising APR indicates a higher HCC risk.
文摘Introduction: Diabetes remains a real public health problem today, due to its associated morbidity and mortality. It induces numerous metabolic, biochemical, hematological, and immunological changes, responsible for multiple complications. The objective of this study was to characterize clinically and biologically type 2 diabetic patients followed at the National Center for Diabetology and Arterial Hypertension of the Central Hospital of Yaoundé. Method: This prospective, cross-sectional, and analytical study took place from April 5 to July 31, 2023 (4 months) on 100 diabetic patients of both sexes (61 women and 39 men), aged from 31 to 88 years. Body Mass Index, systolic and diastolic blood pressure, and cardiac frequency were measured on each of the patients. Subsequently, blood was collected from the patients for the determination of the complete blood count, HBA1c, lipid profile, serum albumin, TNF-α, and IL-6 levels. The data were analyzed using SPSS 17.0 software. Results: The age average of our population was 56.99 ± 11.51 years, the population was primarily female (61%) and primarily between the ages of 55 and 88. 67% of respondents were married. 59% went to secondary school. 73% of them lived in urban areas. 30% were obese and 40% were overweight, with an average BMI of 28.75 kg/m2. 76% of patients took oral antidiabetic medications. HbA1c level average was 8.65%, with 60% having readings above 6.5%. Low hemoglobin and hypochromia were among the abnormalities of red blood cells observed. Lipid profiles revealed low HDL-cholesterol and high triglycerides and cholesterol. Elevated levels of TNF-α and IL-6 indicated inflammation and cardiovascular risk. Conclusion: These results indicate the necessity of focused diabetic care and management on diabetic patients attending the central hospital of Yaoundé, Cameroon.
文摘Introduction: In recent times, satisfaction studies have gained importance in the health sector as a way to monitor services and products. The main aim of this study was to explore patient satisfaction with pharmaceutical care provided in Nampula healthcare centers. Material and Methods: The study was conducted at the 25 de Setembro, 1˚ de Maio, and Muhala-Expansão healthcare centers in Nampula. The sample consisted of 381 patients, with 127 from each center, selected for accessibility. Data were collected through a questionnaire with an internal consistency of 0.816, calculated using McDonald’s total Omega (ωt). The analysis included frequencies, descriptive statistics (mean and standard deviation), and inferential statistics like Binary Logistic Regression. Results: Overall satisfaction was 3.62 ± 0.627 on a scale of 1 to 5, or 69.8%. The binary regression associated a higher education level with dissatisfaction (COR 0.204, 95% CI: −2.752 to −0.427) and living in Marrere (COR 0.083, 95% CI: -5.098 to 0.120) and Muahivir-Expansão (COR 0.589, 95% CI: −1.824 to 0.767) with dissatisfaction as well. Conclusion: Satisfaction was generally high, mainly influenced by the availability of medicines and medical supplies, and less by other factors such as healthcare center accessibility, facility quality, and relationships with pharmacy professionals. Although variables like sex, religion, age, marital status, profession, occupation, and the number of pharmacy visits in the last five years were not statistically significant for general satisfaction in this study, they should be considered in future studies as they are often linked to pharmaceutical satisfaction.
文摘Introduction:With the aging population,more females will suffer from pelvic organ prolapse.Both urologists and gynecologists perform sacrocolpopexy,but there is no comparative study analyzing differences in provision of care,outcomes,or patient population.We aimed to elucidate potential differences in demographics,outcomes,and minimally invasive surgery utilization for SCP performed by urology and gynecology.Methods:In our retrospective analysis,sacrocolpopexies were identified using the American College of Surgeons National Surgical Quality Improvement Project database from 2006–2020.Pearson’s chi-square test was performed to test trends in the utilization of MIS in five-year blocks.Frailty was calculated using the NSQIP modified frailty index and the revised surgical Risk Analysis Index.Univariate analysis was performed using Student’s t-test and Pearson’s chi-square to compare operative parameters,frailty,demographics,and outcomes.Results:We identified 8944 sacrocolpopexies.Gynecology performed 81%of cases while urology performed the remaining 19%(p<0.001).Between the specialties,there were no significant differences in outcomes,minor or major complications,or 30-day reoperations/hospital readmissions/mortality.However,urologists tended to care for patients who were older(65 vs.61 years,p<0.001)and frailer by both frailty indices(p<0.001).Conclusion:Case distributions have remained stable,with gynecologists four-fold more sacrocolpopexies,in keeping with the larger number of practicing gynecologists vs.urologists.There was no difference in 30-day outcomes between both specialties.However,urologists operated on older,more frail patients.
基金supported by the Postgraduate Supervision Fund within the School of Nursing at Fujian Medical University(No.110013)。
文摘Objectives:This study aimed to generate a theoretical framework based on empirical data to explain the behavioral patterns closely related to young and middle-aged patients with lymphoma throughout the disease.Methods:This study followed the classic grounded theory methodology,involving procedures such as theoretical sampling,substantive coding,theoretical coding,constant comparison,and memo writing and sorting.Multiple data types were used based on the principle of“all is data,”including 34 participants providing interview data along with observation notes and 40 relevant secondary texts from the“Lymphoma House”network platform and the“Lymphoma House 086”public account.Two autobiographical books written by lymphoma patients were also selected as data resources.Data collection and analysis were conducted in an iterative process until theoretical saturation was reached.The COREQ checklist was followed to report this study.Results:The main concern of middle-aged and young patients with lymphoma was identifiedas restoring normality,while managing uncertainty was the main behavioral pattern for restoring normality.Uncertainty consists of two interrelated types:inherent uncertainty of illness and perceived uncertainty of patients.Four strategies are used to manage uncertainty:reconstructing certainty,adaptive coping,defensive buffering,and compensatory changing.Managing uncertainty is influenced by disease characteristics and perceptions,social resources,and cultural concepts.The consequence of managing uncertainty is reaching a new normality.Conclusions:Pervasive uncertainty significantly affects the daily lives of young and middle-aged patients with lymphoma.Consequently,strategies for managing disease-related uncertainty to sustain normality are commonly observed in this population.This theoretical framework for addressing uncertainty can serve as a foundation for understanding and developing tailored interventions to manage uncertainty.Future research should focus on managing uncertainty to help patients restore normality.
基金Supported by the Wuxi Science and Technology Plan Project Plan,No.BJ21008.
文摘BACKGROUND Hypertension is a common chronic disease in the elderly population,and its association with cognitive impairment has been increasingly recognized.Cognitive impairment,including mild cognitive impairment and dementia,can significantly affect the quality of life and independence of elderly individuals.Therefore,identifying risk factors for cognitive impairment in elderly hypertensive patients is crucial for developing effective interventions and improving health outcomes.Nutritional status is one of the potential factors that may influence cognitive function in elderly hypertensive patients.Malnutrition or inadequate nutrition can lead to various health problems,including weakened immune system,increased susceptibility to infections,and impaired physical and mental function.Furthermore,poor nutritional status has been linked to increased risk of cognitive decline and dementia in various populations.In this observational study,we aimed to investigate the nutritional status of elderly hypertensive patients and its relationship to the occurrence of cognitive impairment.By collecting baseline data on general information,body composition,and clinical indicators,we hope to identify risk factors for cognitive impairment in this patient population.The results of this study are expected to provide more scientific basis for the health management of elderly patients with hypertension,particularly in terms of maintaining good nutritional status and reducing the risk of cognitive impairment.AIM To explore the differences between clinical data and cognitive function of elderly hypertensive patients with different nutritional status,analyze the internal relationship between nutritional statuses and cognitive impairment,and build a nomogram model for predicting nutritional status in elderly hypertensive patients.METHODS The present study retrospectively analyzed 200 elderly patients admitted to our hospital for a hypertension during the period July 1,2024 to September 30,2024 as study subjects,and the 200 patients were divided into a modeling cohort(140 patients)and a validation cohort(60 patients)according to the ratio of 7:3.The modeling cohort were divided into a malnutrition group(26 cases),a malnutrition risk group(42 cases),and a normal nutritional status group(72 cases)according to the patients’Mini-Nutritional Assessment Scale(MNA)scores,and the modeling cohort was divided into a hypertension combined with cognitive impairment group(34 cases)and a hypertension cognitively normal group(106 cases)according to the Montreal Cognitive Assessment Scale(MoCA)scores,and the validation cohort was divided into a hypertension combined with cognitive impairment group(14 cases)and hypertension cognitively normal group(46 cases).The study outcome was the occurrence of cognitive impairment in elderly hypertensive patients.Univariate and multivariate logistic regression was used to explore the relationship between the general information of the elderly hypertensive patients and the influence indicators and the occurrence of cognitive impairment,the roadmap prediction model was established and validated,the patient work receiver operating characteristic curve was used to evaluate the predictive efficacy of the model,the calibration curve was used to assess the consistency between the predicted events and the actual events,and the decision curve analysis was used to evaluate the validity of the model.Pearson correlation analysis was used to explore the relationship between nutrition-related indicators and MoCA scores.RESULTS In this research,the modeling cohort comprised 140 cases,while the verification cohort consisted of 60 cases,with no notable discrepancy in the data between the two groups.In the modeling cohort,there were significant differences in body mass index(BMI),albumin(ALB),hemoglobin(Hb)and homocysteine levels among the malnourished group,the malnourished risk group and the normal nutritional status group.The results of univariate and multivariate analysis showed that BMI[odds ratio(OR)=0.830,P=0.014],ALB(OR=0.860,P=0.028),Hb(OR=0.939,P=0.035)and MNA score(OR=0.640,P=0.000)were independent protective factors for patients without cognitive impairment,and alkaline phosphatase(ALP)(OR=1.074,P=0.000)was an independent risk factor for patients with cognitive impairment.In this study,the prediction nomogram tailored for cognitive deterioration in elderly patients with hypertension demonstrated robust predictive power and a close correspondence between predicted and observed outcomes.This model offers significant potential as a means to forestall cognitive decline in hypertensive elderly patients.ALP was negatively correlated with MoCA score,while BMI,MNA score,Hb and ALB were positively correlated with MoCA score.CONCLUSION BMI,MNA score,Hb and ALB were independent protective factors for cognitive impairment in elderly hypertensive patients and were positively correlated with MoCA score.ALP was an independent risk factor for cognitive impairment in elderly hypertensive patients and was negatively correlated with the MoCA score.The column line graph model established in the study has a good predictive value.
文摘This study focuses on the management of maintenance hemodialysis(MHD)patients,with a specific emphasis on the practical application effect of the network information management model including its impact on patients’compliance.A network information management model for MHD patients was constructed around three management schemes:“software reminders+follow-up guidance”,“dietary records+self-management reminders”,and“dialysis plan+precise weight management”.These schemes were respectively used to optimize anemia management,control the risk of hyperphosphatemia,and improve toxin clearance efficiency.A controlled experiment was conducted,with an experimental group and a control group set up for comparative practice.The results showed that the network information management model can effectively improve patients’anemia,help alleviate mineral metabolism disorders and the accumulation of small-molecule toxins,and exert a positive impact on patients’treatment compliance.
文摘BACKGROUND Elobixibat reportedly improves bowel movements in patients with chronic constipation.However,its effect on bowel movements in elderly patients with chronic constipation in clinical settings has not been examined.AIM To examine bowel movement frequency and stool form before and after elobixibat administration in elderly patients with chronic constipation at our clinic.METHODS A total of 10 mg elobixibat was administered to 35(<65 years old)patients and 45(≥65 years old)patients with chronic constipation.The frequency of bowel movements and stool forms,assessed using the Bristol Stool Form Scale(BSFS),were compared between the two groups 1 week before and after elobixibat administration.RESULTS In patients aged<65 years with chronic constipation,the pre-elobixibat frequency of bowel movements and BSFS scores were 2.167±0.732 and 2.286±0.742,respectively.After elobixibat administration,the frequency of bowel movements and BSFS scores improved to 2.389±0.502 and 3.995±0.566,respectively,showing a significant improvement in bowel movement status.In patients aged≥65 years with chronic constipation,the pre-elobixibat frequency of bowel movements and BSFS scores were 2.003±0.733 and 2.217±0.758,respectively.After elobixibat administration,the frequency of bowel movements and BSFS scores improved to 4.402±1.346 and 3.800±0.704,respectively,indicating an improvement in bowel movement status(P<0.001).No significant differences were observed in the frequency and improvement status of bowel movements or BSFS scores between patients with chronic constipation aged≥65 years and<65 years.Adverse events due to the administration of elobixibat occurred in 16 cases(20%).No significant differences were found in the incidence of adverse events between patients with chronic constipation aged<65 years(8 cases,22.9%)and those aged≥65 years(8 cases,17.8%).CONCLUSION Elobixibat is effective in improving bowel movement status in patients with chronic constipation.No significant differences were found in the improvement of bowel movement status or the incidence of adverse events between patients with chronic constipation aged<65 years and≥65 years,suggesting that the drug may be safely used in elderly patients.
