Objective:This study aims to systematically evaluate the clinical efficacy and safety of diuretic therapy in patients with liver cirrhosis ascites.Method:60 patients with liver cirrhosis ascites diagnosed from January...Objective:This study aims to systematically evaluate the clinical efficacy and safety of diuretic therapy in patients with liver cirrhosis ascites.Method:60 patients with liver cirrhosis ascites diagnosed from January 2024 to May 2025 were prospectively included and randomly divided into a furosemide monotherapy group(20 cases),a spironolactone monotherapy group(20 cases),and a combination therapy group(20 cases).The intervention period is 28 days,and the main observation indicators include 24-hour urine output,changes in abdominal circumference,weight loss,serum electrolyte levels,renal function indicators,and incidence of adverse reactions.All study subjects received standardized dietary management and sodium restriction intervention(daily sodium intake<5 g).Result:The total effective rate(significant+effective)of the combination therapy group in reducing ascites was 95%(19/20),significantly higher than the 75%(15/20)of the furosemide group and the 70%(14/20)of the spironolactone group(p<0.01).On the 28th day of treatment,the mean urine output in the combination group was 2450±210 mL/d,which was higher than that in the monotherapy group(1850±195 mL/d in the furosemide group);Spironolactone group 1560±180 mL/d.The blood sodium levels of the three groups were maintained at 135-140 mmol/L,but the incidence of hypokalemia in the combination group(10%)was significantly lower than that in the furosemide group(35%).Conclusion:The combination of furosemide and spironolactone has a synergistic effect in the treatment of ascites in cirrhosis,with a 39.2%increase in diuretic effect and a reduction in the risk of electrolyte imbalance;Individualized dose adjustment combined with strict sodium restriction is the core strategy to ensure treatment safety.展开更多
Objective:Nurse-led virtual outpatient clinics are now a familiar component of healthcare delivery across many disciplines,including cancer care,or thopedics,rheumatology,and gastroenterology.However,establishing a nu...Objective:Nurse-led virtual outpatient clinics are now a familiar component of healthcare delivery across many disciplines,including cancer care,or thopedics,rheumatology,and gastroenterology.However,establishing a nurse-led vir tual clinic is challenging for nursing management,par ticularly regarding resources.We aimed to investigate nursing practices and processes and patient experiences in relation to vir tual outpatient clinics.Methods:This was a cross-sectional,descriptive study using mixed data collection methods.Patients(n=324)from 4 specialist clinics completed the Virtual Clinics Patient Satisfaction Questionnaire(VCSQ)survey.Five Nurse Specialists participated in a focus group interview.Results:Most participants(86.3%)reported being satisfied/very satisfied with the virtual clinics,particularly those that were nurse-led.Nurse specialists identified electronic health records(EHRs)and additional IT and administrative support as important for efficiency and effectiveness of the clinics.Conclusions:Nurse-led virtual clinics can be an effective and efficient way to provide care to patients.Nurse managers need to ensure supportive structures are in place,for example,dedicated administrators,IT support and infrastructure,education/training,and relevant policies/procedures.The success of nurse-led virtual services requires key infrastructure to support nursing staff and sustain this service.展开更多
BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery...BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery speed and quality of life.Effective prevention of anxiety and depression in elderly patients has become an urgent problem.AIM To investigate the trajectory of anxiety and depression levels in elderly patients after LIF,and the influencing factors.METHODS Random sampling was used to select 239 elderly patients who underwent LIF from January 2020 to December 2024 in Shenzhen Pingle Orthopedic Hospital.General information and surgery-related indices were recorded,and participants completed measures of psychological status,lumbar spine dysfunction,and quality of life.A latent class growth model was used to analyze the post-LIF trajectory of anxiety and depression levels,and unordered multi-categorical logistic regression was used to analyze the influencing factors.RESULTS Three trajectories of change in anxiety level were identified:Increasing anxiety(n=26,10.88%),decreasing anxiety(n=27,11.30%),and stable anxiety(n=186,77.82%).Likewise,three trajectories of change in depression level were identified:Increasing depression(n=30,12.55%),decreasing depression(n=26,10.88%),and stable depression(n=183,76.57%).Regression analysis showed that having no partner,female sex,elevated Oswestry dysfunction index(ODI)scores,and reduced 36-Item Short Form Health Survey scores all contributed to increased anxiety levels,whereas female sex,postoperative opioid use,and elevated ODI scores all contributed to increased depression levels.CONCLUSION During clinical observation,combining factors to predict anxiety and depression in post-LIF elderly patients enables timely intervention,quickens recovery,and enhances quality of life.展开更多
AIM:To investigate the association between functionaloutcomes and postoperative patient satisfaction 5y aftersmall incision lenticule extraction(SMILE)and femtosecondlaser-assisted in situ keratomileusis(FS-LASIK).MET...AIM:To investigate the association between functionaloutcomes and postoperative patient satisfaction 5y aftersmall incision lenticule extraction(SMILE)and femtosecondlaser-assisted in situ keratomileusis(FS-LASIK).METHODS:This is a cross-sectional study.Thepatients underwent basic ophthalmic examinations,axiallength measurement,wide-field fundus photography,andaccommodation function testing.Behavioral habits datawere collected using a self-administered questionnaire,andvisual symptoms were assessed with the Quality of Vision(QoV)questionnaire.Postoperative satisfaction was alsorecorded.RESULTS:Totally 410 subjects[820 eyes,160males(39.02%)and 250 females(60.98%)]who hadundergone SMILE or FS-LASIK 5y ago were enrolled.Themean(standard deviation,SD)age of all patients was29.83y(6.69).The mean(SD)preoperative manifest SEwas-5.80(2.04)diopters(D;range:-0.88 to-13.75).Patient satisfaction at 5y after undergoing SMILE or FSLASIKwas 91.70%.Patients were categorized into twogroups:dissatisfied group and satisfied group.Significantdifferences were observed between the two groups in termsof age(P=0.012),sex(P=0.021),preoperative degreeof myopia(P=0.049),postoperative visual symptoms(frequency,P=0.043;severity,P<0.001;bothersome,P=0.018),difficulty driving at night(P=0.001),andaccommodative amplitude(AMP,P=0.020).Multivariateanalysis confirmed that female sex(P=0.024),severityof visual symptoms(P=0.009),and difficulty driving atnight(P=0.006)were significantly associated with lowersatisfaction.The dissatisfied group showed higher rates ofstarbursts,double or multiple images,and high myopia,but lower age.The frequency,severity,and bothersome ofdistortion exhibited decreased with increasing age.CONCLUSION:Patient satisfaction 5y after SMILEand FS-LASIK is high and stable.Difficulty driving at night,sex,and severity of visual symptoms are important factorsinfluencing patient satisfaction.Special attention should bepaid to younger highly myopic female patients,particularlythose with starbursts and double or multiple images.It is crucial to monitor postoperative visual outcomesand provide patients with comprehensive preoperativecounseling to enhance long-term satisfaction.展开更多
Objective:To explore the impact of evidence-based predictive nursing intervention on psychological stress and physiological indicator stability of elderly cataract patients during the perioperative period(1 day before...Objective:To explore the impact of evidence-based predictive nursing intervention on psychological stress and physiological indicator stability of elderly cataract patients during the perioperative period(1 day before surgery to 1 day after surgery),and to provide a basis for optimizing clinical nursing plans for elderly cataract surgery.Methods:A retrospective selection of 90 elderly patients(aged≥60 years)who underwent cataract surgery in the Ophthalmology Department of our hospital from August 2024 to December 2024 was conducted.They were divided into an observation group(n=45)and a control group(n=45)using a random number table method.The control group received routine nursing for cataract surgery,while the observation group implemented evidence-based predictive nursing intervention(including the establishment of a multidisciplinary evidence-based team,hierarchical psychological intervention,perioperative environment optimization,intraoperative personalized cooperation,and video-based health education).Psychological stress indicators[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),General Self-Efficacy Scale(GSES)]on the 1st day before surgery and 1st day after surgery,and fluctuations of physiological indicators[Heart Rate(HR),Systolic Blood Pressure(SBP),Diastolic Blood Pressure(DBP)]on the 1st day before surgery and during surgery were compared between the two groups.Results:Before intervention,there were no statistically significant differences in SAS,SDS,GSES scores,HR,SBP,or DBP between the two groups(p>0.05);after intervention,the SAS score(33.62±5.72)and SDS score(32.14±4.86)of the observation group on the 1st day after surgery were significantly lower than those of the control group[(41.05±5.56),(43.59±4.75)],and the GSES score(31.15±3.28)was significantly higher than that of the control group(24.84±3.52)(all p<0.05);during surgery,the fluctuations of HR(74.0±6.0)beats/min,SBP(127.0±15.8)mmHg,and DBP(75.0±5.9)mmHg in the observation group were significantly smaller than those in the control group(all p<0.05).Conclusion:Evidence-based predictive nursing intervention can effectively alleviate anxiety and depression in elderly cataract patients during the perioperative period,improve self-efficacy,stabilize intraoperative physiological status,and enhance surgical cooperation,which is worthy of clinical promotion.展开更多
BACKGROUND Preoperative anxiety is a significant concern for patients,as it affects surgical outcomes,satisfaction,and pain perception.Although both anxiety and pain are common in surgical settings,their relationship ...BACKGROUND Preoperative anxiety is a significant concern for patients,as it affects surgical outcomes,satisfaction,and pain perception.Although both anxiety and pain are common in surgical settings,their relationship with personality traits has not been previously investigated in the Lebanese population.AIM To examine the prevalence of preoperative anxiety,pain perception,and personality traits among Lebanese surgical patients,and to assess the associations between these factors.METHODS A descriptive cross-sectional study was conducted between April 2024 and January 2025 across Lebanese hospitals.A total of 392 adult patients were recruited through convenience sampling.Data were collected using a questionnaire that included sociodemographic,clinical,and surgical variables,the Amsterdam Preoperative Anxiety and Information Scale for anxiety,the Visual Analog Scale and Numerical Pain Rating Scale for preoperative pain,and the Ten-Item Personality Inventory for personality traits.Ethical approval was obtained from the Institutional Review Boards of Makassed General Hospital and Hammoud University Medical Center.RESULTS Overall,25%of participants experienced preoperative anxiety,and 34.5%reported moderate pain.Personality assessment showed that the majority of participants had moderate extraversion(84.1%),moderate emotional stability(65.1%),high conscientiousness(61%),high agreeableness(54.1%),and moderate openness(49.2%).High conscientiousness was significantly associated with higher pain perception(P<0.05),while high emotional stability was associated with lower levels of anxiety(P<0.05).No significant association was found between preoperative anxiety and pain(P>0.05).CONCLUSION This study challenges the assumption that preoperative anxiety and pain are directly correlated and highlights the role of personality traits in shaping patient experience.These findings support the potential value of integrating psychological profiling into preoperative care and lay the groundwork for developing personalized interventions to improve patient-centered surgical outcomes.展开更多
We found the qualitative study by Xu et al.on how patients feel about laparoscopic incisions under enhanced recovery after surgery(ERAS)protocols to be very interesting.1 Xu et al.carried out a qualitative study on pa...We found the qualitative study by Xu et al.on how patients feel about laparoscopic incisions under enhanced recovery after surgery(ERAS)protocols to be very interesting.1 Xu et al.carried out a qualitative study on patient experience with laparoscopic incisions under an ERAS protocol to highlight the problem of psychosocial and aesthetic concerns,which are often overlooked when planning surgical operations.This study,which involved semistructured interviews with sixteen people,aimed to narrow perioperative education and the decision-making process for incision site selection,thus making the processes more focused on patient priorities.The study is based on a timely but under-researched subject area;however,it is possible to outline four possible areas of improvement that would allow the study to be more transparent and,at the same time,more applicable to clinical practice.展开更多
Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth...Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth interviews with patients and families,anchored by Interactive Patient Par ticipation Theory,to analyze 4 high-severity adverse drug events(ADE)cases.Cases were purposively sampled from 8 communities in China's National Adverse Event Monitor Center(2018-2023).Semi-structured interviews explored patient perspectives,with data analyzed via thematic coding and triangulation against clinical records.Results:Five interconnected themes emerged:(1)erosion of trust,(2)communication breakdowns,(3)information asymmetry,(4)environmental inadequacies,and(5)technological alienation.Notably,75% of participants had≤high school education,and 50% used≥7 medications daily,compounding ADE risks.Conclusions:We considered elements mentioned by theory,exploring trust,communication,information,and suppor t as the root causes.In addition,we added“adaptability to new technology”as an impor tant and necessary component.It is impor tant and necessary to analyze typical adverse drug events from the perspectives of patients.展开更多
Neurodegenerative disorders represent an increasingly pertinent public health crisis.As a greater proportion of the population ages,neurodegenerative disorders and other diseases of aging place undue burdens on patien...Neurodegenerative disorders represent an increasingly pertinent public health crisis.As a greater proportion of the population ages,neurodegenerative disorders and other diseases of aging place undue burdens on patients,caregivers,and healthcare workers.Alzheimer’s disease(AD)and Parkinson’s disease represent the two most common neurodegenerative disorders in the population,affecting over 65 million people,worldwide.展开更多
Background There is still limited data on predictive value of coronary computed tomography angiography(CCTA)–derived fractional flow reserve(CT-FFR) for long term outcomes. We examined the long-term prognostic value ...Background There is still limited data on predictive value of coronary computed tomography angiography(CCTA)–derived fractional flow reserve(CT-FFR) for long term outcomes. We examined the long-term prognostic value of CT-FFR combined with CCTA–defined atherosclerotic extent in diabetic patients with coronary artery disease(CAD).Methods A retrospective pooled analysis of individual patient data was performed. Deep-learning-based vessel-specific CTFFR was calculated. All patients enrolled were followed-up for at least 5 years. Predictive abilities for major adverse cardiac events(MACE) were compared among three models(model 1), constructed using clinical variables;model 2, model 1+CCTA–derived atherosclerotic extent(Leiden risk score);and model 3, model 2+CT-FFR.Results A total of 480 diabetic patients [median age, 61(55–66) years;52.9% men] were included. During a median follow-up time of 2197(2126–2355) days, 55 patients(11.5%) experienced MACE. In multivariate-adjusted Cox models, Leiden risk score(HR: 1.06;95% CI: 1.01–1.11;P = 0.013) and CT-FFR ≤ 0.80(HR: 6.54;95% CI: 3.18–13.45;P < 0.001) were the independent predictors. The discriminant ability was higher in model 2 than in model 1(C-index, 0.75 vs. 0.63;P < 0.001) and was further promoted by adding CT-FFR to model 3(C-index, 0.81 vs. 0.75;P = 0.002). Net reclassification improvement(NRI) was 0.19(P = 0.009) for model 2 beyond model 1. Of note, adding CT-FFR to model 3 also exhibited significantly improved reclassification compared with model 2(NRI = 0.14;P = 0.011).Conclusion In diabetic patients with CAD, CT-FFR provides robust and incremental prognostic information for predicting longterm outcomes. The combined model exhibits improved prediction abilities, which is beneficial for risk stratification.展开更多
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
The destruction of the skin barrier and the presence of necrotic tissue in large burns increase the risk of multiple infections,often leading to sepsis,bacteremia,and other complications.Infective endocarditis(IE)is a...The destruction of the skin barrier and the presence of necrotic tissue in large burns increase the risk of multiple infections,often leading to sepsis,bacteremia,and other complications.Infective endocarditis(IE)is a severe manifestation of organ damage,and if conservative medical treatment fails to control the infection,irreversible pathological changes may occur,including valvular redundancy.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 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
Objectives This systematic review aimed to identify effective and cost-effective digital health interventions to improve self-management behaviors,blood pressure control,and cardiovascular risk reduction.Methods A sea...Objectives This systematic review aimed to identify effective and cost-effective digital health interventions to improve self-management behaviors,blood pressure control,and cardiovascular risk reduction.Methods A search for randomized and non-randomized control trials of digital health interventions among patients with uncontrolled hypertension was conducted from the databases of Embase,PubMed,Scopus,CINAHL,Web of Science,PsycINFO,Thai Journal Online(ThaiJO),the Faculty of Nursing Mahidol University(FON-MU)Nursing Research Database,and gray literature.After conducting the literature screening,the authors completed data extraction,and the risk of bias was assessed using the Joanna Briggs Institute randomized controlled trial checklist and the Joanna Briggs Institute critical appraisal checklist for quasi-experimental studies.Results The study included 22 articles,comprising 30 to 4,118 patients with uncontrolled hypertension.This review classified and summarized the components of digital health interventions and their effects on hypertensive outcomes.It was found that the key elements of digital health interventions include health education,reminders,self-monitoring,feedback and consultation,and instrumental support.Moreover,approximately 81.81%(n=18)of the digital health interventions involved healthcare providers participating in feedback and consultation.Additionally,digital health interventions effectively improve hypertensive outcomes such as self-management behaviors,blood pressure control,and cardiovascular risk reduction,providing cost-effectiveness.Conclusion Based on the available literature,digital health interventions have been shown to effectively enhance behavioral,clinical,and economic outcomes for individuals with uncontrolled hypertension.Moreover,the combination of digital health interventions and healthcare providers’interventions can potentially help patients with uncontrolled hypertension improve adherence to self-management when compared to stand-alone digital health interventions.Digital health interventions to support self-management interventions should be developed for patients by healthcare providers.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
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
Patients with periodontal disease often require combined periodontal-orthodontic interventions to restore periodontal health,function,and aesthetics,ensuring both patient satisfaction and long-term stability.Managing ...Patients with periodontal disease often require combined periodontal-orthodontic interventions to restore periodontal health,function,and aesthetics,ensuring both patient satisfaction and long-term stability.Managing these patients involving orthodontic tooth movement can be particularly challenging due to compromised periodontal soft and hard tissues,especially in severe cases.Therefore,close collaboration between orthodontists and periodontists for comprehensive diagnosis and sequential treatment,along with diligent patient compliance throughout the entire process,is crucial for achieving favorable treatment outcomes.Moreover,long-term orthodontic retention and periodontal follow-up are essential to sustain treatment success.This expert consensus,informed by the latest clinical research and practical experience,addresses clinical considerations for orthodontic treatment of periodontal patients,delineating indications,objectives,procedures,and principles with the aim of providing clear and practical guidance for clinical practitioners.展开更多
Unplanned intensive care unit(ICU)admissions(UP-ICU)following initial general ward placement are associated with poor patient outcomes and represent a key quality indicator for healthcare facilities.Healthcare facilit...Unplanned intensive care unit(ICU)admissions(UP-ICU)following initial general ward placement are associated with poor patient outcomes and represent a key quality indicator for healthcare facilities.Healthcare facilities have employed numerous predictive models,such as physiological scores(e.g.,Acute Physiology and Chronic Health Evaluation II,Revised Trauma Score,and Mortality Probability Model II at 24 hours)and anatomical scores(Injury Severity Score and New Injury Severity Score),to identify high-risk patients.Although physiological scores frequently surpass anatomical scores in predicting mortality,their specificity for trauma patients is limited,and their clinical applicability may be limited.Initially proposed for ICU readmission prediction,the stability and workload index for the transfer score has demonstrated inconsistent validity.Machine learning offers a promising alternative.Several studies have shown that machine learning models,including those that use electronic health records(EHR)data,can more accurately predict trauma patients’deaths and admissions to the ICU than traditional scoring systems.These models identify unique predictors that are not captured by existing methods.However,challenges remain,including integration with EHR systems and data entry complexities.Critical care outreach programs and telemedicine can help reduce UP-ICU admissions;however,their effectiveness remains unclear because of costs and implementation challenges,respectively.Strategies to reduce UP-ICU admissions include improving triage systems,implementing evidence-based protocols for ICU patient management,and prioritizing prehospital intervention and stabilization to optimize the“golden hour”of trauma care.To improve patient outcomes and reduce the burden of UPICU admissions,further studies are required to validate and implement these strategies and refine machine learning models.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
文摘Objective:This study aims to systematically evaluate the clinical efficacy and safety of diuretic therapy in patients with liver cirrhosis ascites.Method:60 patients with liver cirrhosis ascites diagnosed from January 2024 to May 2025 were prospectively included and randomly divided into a furosemide monotherapy group(20 cases),a spironolactone monotherapy group(20 cases),and a combination therapy group(20 cases).The intervention period is 28 days,and the main observation indicators include 24-hour urine output,changes in abdominal circumference,weight loss,serum electrolyte levels,renal function indicators,and incidence of adverse reactions.All study subjects received standardized dietary management and sodium restriction intervention(daily sodium intake<5 g).Result:The total effective rate(significant+effective)of the combination therapy group in reducing ascites was 95%(19/20),significantly higher than the 75%(15/20)of the furosemide group and the 70%(14/20)of the spironolactone group(p<0.01).On the 28th day of treatment,the mean urine output in the combination group was 2450±210 mL/d,which was higher than that in the monotherapy group(1850±195 mL/d in the furosemide group);Spironolactone group 1560±180 mL/d.The blood sodium levels of the three groups were maintained at 135-140 mmol/L,but the incidence of hypokalemia in the combination group(10%)was significantly lower than that in the furosemide group(35%).Conclusion:The combination of furosemide and spironolactone has a synergistic effect in the treatment of ascites in cirrhosis,with a 39.2%increase in diuretic effect and a reduction in the risk of electrolyte imbalance;Individualized dose adjustment combined with strict sodium restriction is the core strategy to ensure treatment safety.
基金supported by Nursing and Midwifery Practice Development Unit(NMPDU),Dublin South,Kildare,and Wicklow,Nurses preparedness for end of life conversations(No.P210537)。
文摘Objective:Nurse-led virtual outpatient clinics are now a familiar component of healthcare delivery across many disciplines,including cancer care,or thopedics,rheumatology,and gastroenterology.However,establishing a nurse-led vir tual clinic is challenging for nursing management,par ticularly regarding resources.We aimed to investigate nursing practices and processes and patient experiences in relation to vir tual outpatient clinics.Methods:This was a cross-sectional,descriptive study using mixed data collection methods.Patients(n=324)from 4 specialist clinics completed the Virtual Clinics Patient Satisfaction Questionnaire(VCSQ)survey.Five Nurse Specialists participated in a focus group interview.Results:Most participants(86.3%)reported being satisfied/very satisfied with the virtual clinics,particularly those that were nurse-led.Nurse specialists identified electronic health records(EHRs)and additional IT and administrative support as important for efficiency and effectiveness of the clinics.Conclusions:Nurse-led virtual clinics can be an effective and efficient way to provide care to patients.Nurse managers need to ensure supportive structures are in place,for example,dedicated administrators,IT support and infrastructure,education/training,and relevant policies/procedures.The success of nurse-led virtual services requires key infrastructure to support nursing staff and sustain this service.
基金Supported by the Scientific Research Projects of the Health System in Pingshan District,No.2023122.
文摘BACKGROUND Lumbar interbody fusion(LIF)is the primary treatment for lumbar degenerative diseases.Elderly patients are prone to anxiety and depression after undergoing surgery,which affects their postoperative recovery speed and quality of life.Effective prevention of anxiety and depression in elderly patients has become an urgent problem.AIM To investigate the trajectory of anxiety and depression levels in elderly patients after LIF,and the influencing factors.METHODS Random sampling was used to select 239 elderly patients who underwent LIF from January 2020 to December 2024 in Shenzhen Pingle Orthopedic Hospital.General information and surgery-related indices were recorded,and participants completed measures of psychological status,lumbar spine dysfunction,and quality of life.A latent class growth model was used to analyze the post-LIF trajectory of anxiety and depression levels,and unordered multi-categorical logistic regression was used to analyze the influencing factors.RESULTS Three trajectories of change in anxiety level were identified:Increasing anxiety(n=26,10.88%),decreasing anxiety(n=27,11.30%),and stable anxiety(n=186,77.82%).Likewise,three trajectories of change in depression level were identified:Increasing depression(n=30,12.55%),decreasing depression(n=26,10.88%),and stable depression(n=183,76.57%).Regression analysis showed that having no partner,female sex,elevated Oswestry dysfunction index(ODI)scores,and reduced 36-Item Short Form Health Survey scores all contributed to increased anxiety levels,whereas female sex,postoperative opioid use,and elevated ODI scores all contributed to increased depression levels.CONCLUSION During clinical observation,combining factors to predict anxiety and depression in post-LIF elderly patients enables timely intervention,quickens recovery,and enhances quality of life.
基金Supported by Research and Transformation Application of Capital Clinical Diagnosis and Treatment Technology by Beijing Municipal Commission of Science and Technology(No.Z201100005520043).
文摘AIM:To investigate the association between functionaloutcomes and postoperative patient satisfaction 5y aftersmall incision lenticule extraction(SMILE)and femtosecondlaser-assisted in situ keratomileusis(FS-LASIK).METHODS:This is a cross-sectional study.Thepatients underwent basic ophthalmic examinations,axiallength measurement,wide-field fundus photography,andaccommodation function testing.Behavioral habits datawere collected using a self-administered questionnaire,andvisual symptoms were assessed with the Quality of Vision(QoV)questionnaire.Postoperative satisfaction was alsorecorded.RESULTS:Totally 410 subjects[820 eyes,160males(39.02%)and 250 females(60.98%)]who hadundergone SMILE or FS-LASIK 5y ago were enrolled.Themean(standard deviation,SD)age of all patients was29.83y(6.69).The mean(SD)preoperative manifest SEwas-5.80(2.04)diopters(D;range:-0.88 to-13.75).Patient satisfaction at 5y after undergoing SMILE or FSLASIKwas 91.70%.Patients were categorized into twogroups:dissatisfied group and satisfied group.Significantdifferences were observed between the two groups in termsof age(P=0.012),sex(P=0.021),preoperative degreeof myopia(P=0.049),postoperative visual symptoms(frequency,P=0.043;severity,P<0.001;bothersome,P=0.018),difficulty driving at night(P=0.001),andaccommodative amplitude(AMP,P=0.020).Multivariateanalysis confirmed that female sex(P=0.024),severityof visual symptoms(P=0.009),and difficulty driving atnight(P=0.006)were significantly associated with lowersatisfaction.The dissatisfied group showed higher rates ofstarbursts,double or multiple images,and high myopia,but lower age.The frequency,severity,and bothersome ofdistortion exhibited decreased with increasing age.CONCLUSION:Patient satisfaction 5y after SMILEand FS-LASIK is high and stable.Difficulty driving at night,sex,and severity of visual symptoms are important factorsinfluencing patient satisfaction.Special attention should bepaid to younger highly myopic female patients,particularlythose with starbursts and double or multiple images.It is crucial to monitor postoperative visual outcomesand provide patients with comprehensive preoperativecounseling to enhance long-term satisfaction.
基金Hospital Quality Management Research Fund Project of China Medical Quality Management Association(Project No.:YLZG202511)。
文摘Objective:To explore the impact of evidence-based predictive nursing intervention on psychological stress and physiological indicator stability of elderly cataract patients during the perioperative period(1 day before surgery to 1 day after surgery),and to provide a basis for optimizing clinical nursing plans for elderly cataract surgery.Methods:A retrospective selection of 90 elderly patients(aged≥60 years)who underwent cataract surgery in the Ophthalmology Department of our hospital from August 2024 to December 2024 was conducted.They were divided into an observation group(n=45)and a control group(n=45)using a random number table method.The control group received routine nursing for cataract surgery,while the observation group implemented evidence-based predictive nursing intervention(including the establishment of a multidisciplinary evidence-based team,hierarchical psychological intervention,perioperative environment optimization,intraoperative personalized cooperation,and video-based health education).Psychological stress indicators[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),General Self-Efficacy Scale(GSES)]on the 1st day before surgery and 1st day after surgery,and fluctuations of physiological indicators[Heart Rate(HR),Systolic Blood Pressure(SBP),Diastolic Blood Pressure(DBP)]on the 1st day before surgery and during surgery were compared between the two groups.Results:Before intervention,there were no statistically significant differences in SAS,SDS,GSES scores,HR,SBP,or DBP between the two groups(p>0.05);after intervention,the SAS score(33.62±5.72)and SDS score(32.14±4.86)of the observation group on the 1st day after surgery were significantly lower than those of the control group[(41.05±5.56),(43.59±4.75)],and the GSES score(31.15±3.28)was significantly higher than that of the control group(24.84±3.52)(all p<0.05);during surgery,the fluctuations of HR(74.0±6.0)beats/min,SBP(127.0±15.8)mmHg,and DBP(75.0±5.9)mmHg in the observation group were significantly smaller than those in the control group(all p<0.05).Conclusion:Evidence-based predictive nursing intervention can effectively alleviate anxiety and depression in elderly cataract patients during the perioperative period,improve self-efficacy,stabilize intraoperative physiological status,and enhance surgical cooperation,which is worthy of clinical promotion.
文摘BACKGROUND Preoperative anxiety is a significant concern for patients,as it affects surgical outcomes,satisfaction,and pain perception.Although both anxiety and pain are common in surgical settings,their relationship with personality traits has not been previously investigated in the Lebanese population.AIM To examine the prevalence of preoperative anxiety,pain perception,and personality traits among Lebanese surgical patients,and to assess the associations between these factors.METHODS A descriptive cross-sectional study was conducted between April 2024 and January 2025 across Lebanese hospitals.A total of 392 adult patients were recruited through convenience sampling.Data were collected using a questionnaire that included sociodemographic,clinical,and surgical variables,the Amsterdam Preoperative Anxiety and Information Scale for anxiety,the Visual Analog Scale and Numerical Pain Rating Scale for preoperative pain,and the Ten-Item Personality Inventory for personality traits.Ethical approval was obtained from the Institutional Review Boards of Makassed General Hospital and Hammoud University Medical Center.RESULTS Overall,25%of participants experienced preoperative anxiety,and 34.5%reported moderate pain.Personality assessment showed that the majority of participants had moderate extraversion(84.1%),moderate emotional stability(65.1%),high conscientiousness(61%),high agreeableness(54.1%),and moderate openness(49.2%).High conscientiousness was significantly associated with higher pain perception(P<0.05),while high emotional stability was associated with lower levels of anxiety(P<0.05).No significant association was found between preoperative anxiety and pain(P>0.05).CONCLUSION This study challenges the assumption that preoperative anxiety and pain are directly correlated and highlights the role of personality traits in shaping patient experience.These findings support the potential value of integrating psychological profiling into preoperative care and lay the groundwork for developing personalized interventions to improve patient-centered surgical outcomes.
文摘We found the qualitative study by Xu et al.on how patients feel about laparoscopic incisions under enhanced recovery after surgery(ERAS)protocols to be very interesting.1 Xu et al.carried out a qualitative study on patient experience with laparoscopic incisions under an ERAS protocol to highlight the problem of psychosocial and aesthetic concerns,which are often overlooked when planning surgical operations.This study,which involved semistructured interviews with sixteen people,aimed to narrow perioperative education and the decision-making process for incision site selection,thus making the processes more focused on patient priorities.The study is based on a timely but under-researched subject area;however,it is possible to outline four possible areas of improvement that would allow the study to be more transparent and,at the same time,more applicable to clinical practice.
基金supported by the Science and Technology Fund Project of Guizhou Health Commission(gzwkj2025-163)。
文摘Objective:To identify the root causes of typical adverse drug events through the lens of patient experiences proposing novel strategies to mitigate preventable harm.Methods:A qualitative case study leveraging in-depth interviews with patients and families,anchored by Interactive Patient Par ticipation Theory,to analyze 4 high-severity adverse drug events(ADE)cases.Cases were purposively sampled from 8 communities in China's National Adverse Event Monitor Center(2018-2023).Semi-structured interviews explored patient perspectives,with data analyzed via thematic coding and triangulation against clinical records.Results:Five interconnected themes emerged:(1)erosion of trust,(2)communication breakdowns,(3)information asymmetry,(4)environmental inadequacies,and(5)technological alienation.Notably,75% of participants had≤high school education,and 50% used≥7 medications daily,compounding ADE risks.Conclusions:We considered elements mentioned by theory,exploring trust,communication,information,and suppor t as the root causes.In addition,we added“adaptability to new technology”as an impor tant and necessary component.It is impor tant and necessary to analyze typical adverse drug events from the perspectives of patients.
基金supported by the Canadian Institutes of Health Research(DFD-181599)the National Institutes of Health(T32AG058527)to RJB and R0190106435 to VM.
文摘Neurodegenerative disorders represent an increasingly pertinent public health crisis.As a greater proportion of the population ages,neurodegenerative disorders and other diseases of aging place undue burdens on patients,caregivers,and healthcare workers.Alzheimer’s disease(AD)and Parkinson’s disease represent the two most common neurodegenerative disorders in the population,affecting over 65 million people,worldwide.
文摘Background There is still limited data on predictive value of coronary computed tomography angiography(CCTA)–derived fractional flow reserve(CT-FFR) for long term outcomes. We examined the long-term prognostic value of CT-FFR combined with CCTA–defined atherosclerotic extent in diabetic patients with coronary artery disease(CAD).Methods A retrospective pooled analysis of individual patient data was performed. Deep-learning-based vessel-specific CTFFR was calculated. All patients enrolled were followed-up for at least 5 years. Predictive abilities for major adverse cardiac events(MACE) were compared among three models(model 1), constructed using clinical variables;model 2, model 1+CCTA–derived atherosclerotic extent(Leiden risk score);and model 3, model 2+CT-FFR.Results A total of 480 diabetic patients [median age, 61(55–66) years;52.9% men] were included. During a median follow-up time of 2197(2126–2355) days, 55 patients(11.5%) experienced MACE. In multivariate-adjusted Cox models, Leiden risk score(HR: 1.06;95% CI: 1.01–1.11;P = 0.013) and CT-FFR ≤ 0.80(HR: 6.54;95% CI: 3.18–13.45;P < 0.001) were the independent predictors. The discriminant ability was higher in model 2 than in model 1(C-index, 0.75 vs. 0.63;P < 0.001) and was further promoted by adding CT-FFR to model 3(C-index, 0.81 vs. 0.75;P = 0.002). Net reclassification improvement(NRI) was 0.19(P = 0.009) for model 2 beyond model 1. Of note, adding CT-FFR to model 3 also exhibited significantly improved reclassification compared with model 2(NRI = 0.14;P = 0.011).Conclusion In diabetic patients with CAD, CT-FFR provides robust and incremental prognostic information for predicting longterm outcomes. The combined model exhibits improved prediction abilities, which is beneficial for risk stratification.
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The destruction of the skin barrier and the presence of necrotic tissue in large burns increase the risk of multiple infections,often leading to sepsis,bacteremia,and other complications.Infective endocarditis(IE)is a severe manifestation of organ damage,and if conservative medical treatment fails to control the infection,irreversible pathological changes may occur,including valvular redundancy.
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.
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the support provided by the 2D43 TW009883 D43 Post-Doctoral Program at the School of Nursing,University of Michigan,USA。
文摘Objectives This systematic review aimed to identify effective and cost-effective digital health interventions to improve self-management behaviors,blood pressure control,and cardiovascular risk reduction.Methods A search for randomized and non-randomized control trials of digital health interventions among patients with uncontrolled hypertension was conducted from the databases of Embase,PubMed,Scopus,CINAHL,Web of Science,PsycINFO,Thai Journal Online(ThaiJO),the Faculty of Nursing Mahidol University(FON-MU)Nursing Research Database,and gray literature.After conducting the literature screening,the authors completed data extraction,and the risk of bias was assessed using the Joanna Briggs Institute randomized controlled trial checklist and the Joanna Briggs Institute critical appraisal checklist for quasi-experimental studies.Results The study included 22 articles,comprising 30 to 4,118 patients with uncontrolled hypertension.This review classified and summarized the components of digital health interventions and their effects on hypertensive outcomes.It was found that the key elements of digital health interventions include health education,reminders,self-monitoring,feedback and consultation,and instrumental support.Moreover,approximately 81.81%(n=18)of the digital health interventions involved healthcare providers participating in feedback and consultation.Additionally,digital health interventions effectively improve hypertensive outcomes such as self-management behaviors,blood pressure control,and cardiovascular risk reduction,providing cost-effectiveness.Conclusion Based on the available literature,digital health interventions have been shown to effectively enhance behavioral,clinical,and economic outcomes for individuals with uncontrolled hypertension.Moreover,the combination of digital health interventions and healthcare providers’interventions can potentially help patients with uncontrolled hypertension improve adherence to self-management when compared to stand-alone digital health interventions.Digital health interventions to support self-management interventions should be developed for patients by healthcare providers.
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.
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 National Key R&D Program of China(2022YFC2504200)Chongqing Young and Middle-aged Medical Excellence Team ProjectJiangsu Province Key Research and Development Program(BE2022670)。
文摘Patients with periodontal disease often require combined periodontal-orthodontic interventions to restore periodontal health,function,and aesthetics,ensuring both patient satisfaction and long-term stability.Managing these patients involving orthodontic tooth movement can be particularly challenging due to compromised periodontal soft and hard tissues,especially in severe cases.Therefore,close collaboration between orthodontists and periodontists for comprehensive diagnosis and sequential treatment,along with diligent patient compliance throughout the entire process,is crucial for achieving favorable treatment outcomes.Moreover,long-term orthodontic retention and periodontal follow-up are essential to sustain treatment success.This expert consensus,informed by the latest clinical research and practical experience,addresses clinical considerations for orthodontic treatment of periodontal patients,delineating indications,objectives,procedures,and principles with the aim of providing clear and practical guidance for clinical practitioners.
文摘Unplanned intensive care unit(ICU)admissions(UP-ICU)following initial general ward placement are associated with poor patient outcomes and represent a key quality indicator for healthcare facilities.Healthcare facilities have employed numerous predictive models,such as physiological scores(e.g.,Acute Physiology and Chronic Health Evaluation II,Revised Trauma Score,and Mortality Probability Model II at 24 hours)and anatomical scores(Injury Severity Score and New Injury Severity Score),to identify high-risk patients.Although physiological scores frequently surpass anatomical scores in predicting mortality,their specificity for trauma patients is limited,and their clinical applicability may be limited.Initially proposed for ICU readmission prediction,the stability and workload index for the transfer score has demonstrated inconsistent validity.Machine learning offers a promising alternative.Several studies have shown that machine learning models,including those that use electronic health records(EHR)data,can more accurately predict trauma patients’deaths and admissions to the ICU than traditional scoring systems.These models identify unique predictors that are not captured by existing methods.However,challenges remain,including integration with EHR systems and data entry complexities.Critical care outreach programs and telemedicine can help reduce UP-ICU admissions;however,their effectiveness remains unclear because of costs and implementation challenges,respectively.Strategies to reduce UP-ICU admissions include improving triage systems,implementing evidence-based protocols for ICU patient management,and prioritizing prehospital intervention and stabilization to optimize the“golden hour”of trauma care.To improve patient outcomes and reduce the burden of UPICU admissions,further studies are required to validate and implement these strategies and refine machine learning models.
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.
