BACKGROUND Anxiety and depression are prevalent among patients with chronic heart failure(CHF)and can adversely contribute to treatment adherence and clinical outcomes.Poor fluid restriction adherence is a widespread ...BACKGROUND Anxiety and depression are prevalent among patients with chronic heart failure(CHF)and can adversely contribute to treatment adherence and clinical outcomes.Poor fluid restriction adherence is a widespread challenge in the management of CHF.To effectively manage disease progression and alleviate symptoms,it is crucial to identify key influencing factors to facilitate the implementation of targeted interventions.AIM To investigate the status of anxiety and depression among patients with CHF and determine the factors contributing to poor fluid restriction adherence.METHODS Three hundred CHF patients seeking medical treatment at The First Hospital of Hunan University of Traditional Chinese Medicine between June 2021 and June 2023 were included in the study.Questionnaires,including the Psychosomatic Symptom Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,and Fluid Restriction Adherence Questionnaire were administered to patients.Based on their anxiety and depression scores,patients were categorized into anxiety/depression and non-anxiety/depression groups,as well as fluid restriction adherence and fluid restriction non-adherence groups.General patient data were collected,and univariate and logistic regression analyses were conducted to determine the occurrence of depression and anxiety.Logistic regression analysis was used to identify independent factors influencing fluid restriction adherence.RESULTS Statistically significant differences in age,New York Heart Association(NYHA)grading,marital status,educational attainment,and family support were observed between depressed and non-depressed CHF patients(P<0.05).Age,NYHA grading,marital status,educational attainment,and family support were identified as factors influencing the development of depression.The anxiety and non-anxiety groups differed statistically in terms of gender,age,NYHA grading,smoking history,alcohol consumption history,monthly income,educational attainment,and family support(P<0.05).Gender,smoking,alcohol consumption,monthly income,and educational attainment affected anxiety in these patients.The fluid restriction adherence rate was 28.0%,and thirst sensation,anxiety,and depression were identified as independent influencing factors.CONCLUSION CHF patients are susceptible to anxiety and depression,with multiple associated influencing factors.Moreover,anxiety and depression are independent factors that can influence fluid restriction adherence in these patients.展开更多
BACKGROUND Mesalamine is the recommended first-line treatment for inducing and maintaining remission in mild-to-moderate ulcerative colitis(UC).However,adherence in real-world settings is frequently suboptimal.Encoura...BACKGROUND Mesalamine is the recommended first-line treatment for inducing and maintaining remission in mild-to-moderate ulcerative colitis(UC).However,adherence in real-world settings is frequently suboptimal.Encouraging collaborative patient-provider relationships may foster better adherence and patient outcomes.AIM To quantify the association between patient participation in treatment decisionmaking and adherence to oral mesalamine in UC.METHODS We conducted a 12-month,prospective,non-interventional cohort study at 113 gastroenterology practices in Germany.Eligible patients were aged≥18 years,had a confirmed UC diagnosis,had no prior mesalamine treatment,and provided informed consent.At the first visit,we collected data on demographics,clinical characteristics,patient preference for mesalamine formulation(tablets or granules),and disease knowledge.Self-reported adherence and disease activity were assessed at all visits.Correlation analyses and logistic regression were used to examine associations between adherence and various factors.RESULTS Of the 605 consecutively screened patients,520 were included in the study.The median age was 41 years(range:18-91),with a male-to-female ratio of 1.1:1.0.Approximately 75%of patients reported good adherence at each study visit.In correlation analyses,patient participation in treatment decision-making was significantly associated with better adherence across all visits(P=0.04).In the regression analysis at 12 months,this association was evident among patients who both preferred and received prolonged-release mesalamine granules(odds ratio=2.73,P=0.001).Patients reporting good adherence also experienced significant improvements in disease activity over 12 months(P<0.001).CONCLUSION Facilitating patient participation in treatment decisions and accommodating medication preferences may improve adherence to mesalamine.This may require additional effort but has the potential to improve long-term management of UC.展开更多
Objective: To assess antiretroviral therapy (ART) adherence rates and associated factors among people living with HIV in Vietnam. Methods: A cross-sectional study was conducted at the Hospital for Tropical Diseases, H...Objective: To assess antiretroviral therapy (ART) adherence rates and associated factors among people living with HIV in Vietnam. Methods: A cross-sectional study was conducted at the Hospital for Tropical Diseases, Ho Chi Minh City from June to August 2022. Data were collected from 347 people living with HIV using structured questionnaires assessing sociodemographics, substance use, drug side effects, treatment beliefs, treatment satisfaction, and depression. ART adherence was evaluated using a multi-method tool, including self-report, pill count, the Provider Interview Tool, and the Visual Analog Scale. Participants were classified as having high adherence only if they met all four criteria across these methods. Multivariable logistic regression was used to identify factors influencing adherence, with significance set at P<0.05. Results: High ART adherence was observed in 69.5% of the participants. Adherence was significantly lower among tobacco users (OR 0.49, 95% CI 0.30-0.83, P=0.007), those with higher depression scores (per 1-point increase) (OR 0.89, 95% CI 0.84-0.95, P<0.001), frequent substance users (OR 0.50, 95% CI 0.30-0.83, P=0.007), and those experiencing more severe drug side effects (per level increase) (OR 0.64, 95% CI 0.45-0.92, P=0.016). Participants able to afford treatment had nearly three times higher odds of adherence than those unable to pay (OR 2.85, 95% CI 1.48-5.47, P=0.002). Conclusions: ART adherence among people living with HIV in Vietnam remains suboptimal. Interventions should target substance use, drug side effects, financial barriers, and depression screening to improve adherence.展开更多
Objective: Regular cancer screening must be monitored to improve gastric cancer(GC) survival rates and maximize participation. This study examined adherence to regular GC screening over a 10-year period and identified...Objective: Regular cancer screening must be monitored to improve gastric cancer(GC) survival rates and maximize participation. This study examined adherence to regular GC screening over a 10-year period and identified the factors influencing adherence.Methods: This retrospective cohort study was conducted using data from the Korean National Cancer Screening Program(KNCSP) between 2011 and 2020. The total cohort comprised 400,113 adults aged 40 years who were newly eligible for and participated in GC screening in 2011. The participants were followed up for 10 years to assess their adherence to biennial screening recommendations. They were categorized into two groups: the nonregular screening(non-RS) group, which included individuals who did not participate in subsequent screenings, and the regular screening(RS) group, which included those who participated in at least one follow-up screening.Multiple logistic regression analyses were performed to identify the factors associated with adherence to regular GC screening.Results: Over 10 years, 59% of the participants completed at least four of the five recommended screenings,while 10% did not participate after their initial screening. Male participants had higher odds of non-adherence than females [adjusted odds ratio(aOR)=1.429, 95% confidence interval(95% CI): 1.394-1.464;P<0.001]. Nonadherence was more prevalent among self-employed individuals(aOR=1.208, P<0.001). Among males, those in the lowest income group were 1.267 times more likely to not undergo regular screening than those in the highest income group.Conclusions: Long-term adherence to regular GC screening in South Korea remains suboptimal.Socioeconomic disparities persist, highlighting the need for tailored interventions to improve adherence and enhance public health.展开更多
Objective:To investigate the impact of progressive effect nutritional care on uremia patients undergoing dialysis.Methods:A total of 101 uremia patients undergoing dialysis admitted from January 2024 to March 2025 wer...Objective:To investigate the impact of progressive effect nutritional care on uremia patients undergoing dialysis.Methods:A total of 101 uremia patients undergoing dialysis admitted from January 2024 to March 2025 were selected as the study subjects and divided into two groups by lottery method.The control group(55 cases)received routine care,while the observation group(56 cases)received a combination of routine care and progressive effect nutritional care.Results:After 4 weeks of care,the observation group demonstrated higher treatment adherence(P<0.05),better quality of life(P<0.05),and improved nutritional status(P<0.05)compared to the control group.Conclusion:Progressive effect nutritional care can significantly enhance treatment adherence,quality of life,and nutritional status in uremia patients undergoing dialysis.展开更多
BACKGROUND Current antiviral treatment for chronic hepatitis B can suppress viral replication and reduce the risk of cirrhosis and liver cancer.It requires lifelong daily medication,and long-term adherence is often ci...BACKGROUND Current antiviral treatment for chronic hepatitis B can suppress viral replication and reduce the risk of cirrhosis and liver cancer.It requires lifelong daily medication,and long-term adherence is often cited as a concern when initiating treatment.Hepatitis B treatment adherence in the context of the patient’s medical and life experiences remains underexplored.AIM To evaluate factors associated with adherence to hepatitis B oral antiviral treatment.METHODS A global online survey was administered anonymously to adults(aged 18 years or older)living with chronic hepatitis B.A subsample of 614 individuals who reported being on hepatitis B treatment was included in the analysis.Indices for treatment affordability,healthcare service acceptability,and individual physical,psychological,and emotional functioning were constructed(Cronbach’s alpha=0.71-0.83).Data analysis was conducted using Stata/BE 17.0.RESULTS Overall,81%of respondents reported high adherence to hepatitis B treatment.Lower adherence was observed among individuals who identified as African or African American(P=0.008).Among participants with low adherence,60%cited affordability as a challenge(P=0.068),53%identified healthcare service acceptability as a challenge(P=0.04),79%described physical functioning as a challenge(P=0.002),and 40.5%reported difficulties with psychological functioning(P=0.55).CONCLUSION Findings demonstrate high treatment adherence,although access to and acceptability of healthcare services,as well as an individual’s physical functioning challenges,appear to be related to low adherence.展开更多
Medication adherence in patients with schizophrenia is essential for managing symptoms,improving prognosis,and enhancing the quality of life.Despite the importance of adherence,it remains a global challenge.It is infl...Medication adherence in patients with schizophrenia is essential for managing symptoms,improving prognosis,and enhancing the quality of life.Despite the importance of adherence,it remains a global challenge.It is influenced by various factors,including symptom severity(e.g.,excitement and impulse control disorders),attitudes towards medication(e.g.,pharmacophobia),lack of social support,and the communication efficacy of healthcare teams.Regarding assessment tools,self-report questionnaires,such as the Morisky Scale,are common but subject to recall bias.Electronic monitoring devices(e.g.,Medication Event Monitoring System)and pharmacy refill data offer more objective measures of adherence,whereas biomarkers,such as blood drug concentration monitoring,show promise under specific conditions but require further validation.Long-acting injectable antipsychotic medications have shown greater adherence benefits than oral medications.Psychological interventions such as motivational interviewing and mindfulness training,along with multidisciplinary team efforts,including psychiatrists,pharmacists,and psychotherapists,can significantly improve patient outcomes.Future research should integrate innovative drug formulations(e.g.,long-acting,low-side-effect medications),digital health technologies(e.g.,medication reminder apps and wearable devices),and supportive policies(e.g.,community-based free medication services)as well as patient education to enhance disease awareness.However,the ethical and legal dilemmas(e.g.,balancing patient autonomy with involuntary medication)and privacy concerns in technological applications require further exploration.In conclusion,enhancing medication adherence in patients with schizophrenia requires a personalized,multifaceted approach,and collaborative efforts across various sectors to achieve optimal clinical results and social functioning.展开更多
This minireview focuses on psychological distress and treatment adherence-issues in patients with chronic hepatitis B(CHB).It begins by discussing the epidemiology and disease burden of CHB,and addresses the relations...This minireview focuses on psychological distress and treatment adherence-issues in patients with chronic hepatitis B(CHB).It begins by discussing the epidemiology and disease burden of CHB,and addresses the relationship between psychological distress and treatment adherence.Next,it delves into the current status and risk factors for psychological distress among patients with CHB,and explores the challenges and risk factors related to treatment adherence.Subsequently,it explores the development and implementation of integrated nursing strategies,including psychological interventions and support,self-efficacy enhancement strategies,social support-system optimization,personalized medical care,and technological innovation.Finally,it highlights the limitations of current interventions and clarifies future research priorities.This minireview aims to provide a comprehensive theoretical basis and practical guidance for improving treatment outcomes and quality of life of patients with CHB.In summary,we reveal that psychological distress significantly impacts treatment adherence in patients with CHB and that it is essential to adopt integrated nursing strategies to address these challenges.These findings highlight the need to consider the psychological states of individuals and develop targeted interventions to improve treatment outcomes.展开更多
Patients with cardiovascular disease rely on medication to achieve favorable longterm clinical results.Poor adherence has been linked to a relative increase in mortality of 50%-80%as well as higher health care costs.T...Patients with cardiovascular disease rely on medication to achieve favorable longterm clinical results.Poor adherence has been linked to a relative increase in mortality of 50%-80%as well as higher health care costs.This scoping review thus aimed to explore the evidence of the effects of mobile health care apps on medication adherence in patients with cardiovascular diseases.A comprehensive data search and extraction was done in line with the updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist.A total of 10 studies were included for the review.The mean pooled improvement in adherence was found to be 18%and the most effective tool was the digital therapeutics app discussed in Li et al’s study.Smartphones and apps enhance coronary artery disease management by promoting medication compliance.Challenges include data security and smartphone usage among the elderly.Tailored apps or voice assistants offer potential solutions.展开更多
BACKGROUND Post-procedural psychological disorders are frequently overlooked in elderly patients undergoing percutaneous coronary intervention(PCI),despite their potential impact on long-term cardiovascular outcomes.A...BACKGROUND Post-procedural psychological disorders are frequently overlooked in elderly patients undergoing percutaneous coronary intervention(PCI),despite their potential impact on long-term cardiovascular outcomes.AIM To evaluate the incidence and prognostic significance of post-PCI psychological disorders in elderly patients with heart failure,and to examine their association with medication adherence and major adverse cardiovascular events(MACE).METHODS This retrospective cohort study included 330 consecutive patients aged≥60 years with heart failure who underwent PCI between 2018 and 2021 at a single center,excluding those with prior psychiatric diagnoses.Psychological status within six months post-discharge was assessed using validated Chinese versions of the 9-item Patient Health Questionnaire and the 7-item Generalized Anxiety Disorder Scale,and medication adherence was measured by the 8-item Morisky Medication Adherence Scale(MMAS-8)scale.A subset of 145 patients with≥24 months of follow-up were analyzed for MACEs.Multivariate logistic regression and Kaplan-Meier survival analyses were performed.RESULTS Post-PCI psychological disorders were identified in 40%of patients,with anxiety(36%),depression(32%),and comorbid symptoms(22%)being most prevalent.Affected patients had lower MMAS-8 scores[median 5(IQR 4-6)vs 6(IQR 5-7),P=0.002]and a higher rate of low adherence(51.5%vs 30.3%,P<0.001).Among the 145 patients followed longitudinally,MACEs occurred in 17.9%,with 65.4%of events in those with psychological disorders.Psychological disorders(OR=2.66,95% CI:1.11-6.41,P=0.028)and low adherence(OR=2.77,95% CI:1.17-6.56,P=0.021)were independently associated with increased MACE risk.Kaplan-Meier analysis showed reduced MACE-free survival in patients with psychological disorders(HR=2.68,95%CI:1.25-5.73;log-rank P=0.008).CONCLUSION Post-PCI psychological disorders are common in elderly patients with heart failure and independently predict poorer adherence and worse cardiovascular outcomes.Routine psychological assessment and adherence interventions may improve prognosis in this vulnerable population.展开更多
Objectives This study aimed to evaluate the effectiveness of a Health Belief Model(HBM)-based electronic education program combined with individualized supervised exercise in improving exercise adherence and pregnancy...Objectives This study aimed to evaluate the effectiveness of a Health Belief Model(HBM)-based electronic education program combined with individualized supervised exercise in improving exercise adherence and pregnancy outcomes among women with gestational hypertension.Methods A randomized controlled trial was conducted from June 2024 to February 2025 at a tertiary hospital in Shenzhen,China.A total of 142 pregnant women diagnosed with gestational hypertension were randomly assigned to either an experimental group or a control group.The experimental group received routine antenatal care plus a 6-week HBM-based e-education intervention delivered via a mobile application and short messaging service(SMS)reminders,complemented by individualized in-person exercise guidance.The control group received routine antenatal care only.After the 6-week intervention,outcomes were assessed using the 6-min walk test,a disease knowledge and attitudes questionnaire,and the Pregnancy Exercise Self-Efficacy Scale.Primary outcomes included exercise adherence,blood pressure control,incidence of preeclampsia,and other pregnancy-related outcomes.Results A total of 129 participants completed the study(the intervention group[n=65],the control group[n=64]).At 6 weeks post-intervention,the experimental group demonstrated significantly greater improvements than the control group in exercise adherence,blood pressure control,preeclampsia incidence,disease-related knowledge and attitudes,and exercise self-efficacy(all P<0.05).Specifically,participants in the experimental group engaged in more frequent and longer-duration exercise sessions(P<0.05).Their blood pressure was maintained within a more stable and clinically optimal range(systolic:135.2±4.7 mmHg;diastolic:85.4±4.5 mmHg),which was significantly better than that of the control group(systolic:138.4±10.4 mmHg;diastolic:90.9±6.9 mmHg;P<0.05).The incidence of preeclampsia was also significantly lower in the experimental group(P<0.05).Additionally,scores for disease knowledge,attitudes,and exercise self-efficacy were higher in the experimental group(P<0.05).Within-group comparisons revealed that the experimental group showed significant improvements from baseline in exercise frequency,duration,total physical activity,and knowledge/attitude scores(P<0.05),whereas the control group showed no significant changes(P>0.05).Conclusion By embedding video-based education,real-time monitoring,and personalized support into routine prenatal care,this intervention facilitated positive behavioral changes in physical activity among pregnant women.The approach offers a scalable model for clinical nurses to delivering tailored remote exercise support for women with other pregnancy-related complications.展开更多
基金Huxiang TCM Physique Intervention Clinical Research Center,No.2023SK4061Traditional Chinese Medicine Research Project of Hunan Province,No.B2023065+4 种基金Hunan Province"14th Five-Year Plan"key specialty of TCM,No.[2023]4Hunan University of Chinese Medicine and Hospital Joint Foundation,No.2023XYLH019 and 2024XYLH365R&D Plan for Key Areas of Hunan Provincial Department of Science and Technology,No.2019SK2321Excellent Youth Program of Hunan Education Department,No.24B0346Hunan Provincial Natural Science Foundation for Young Scientists,No.2025JJ60626.
文摘BACKGROUND Anxiety and depression are prevalent among patients with chronic heart failure(CHF)and can adversely contribute to treatment adherence and clinical outcomes.Poor fluid restriction adherence is a widespread challenge in the management of CHF.To effectively manage disease progression and alleviate symptoms,it is crucial to identify key influencing factors to facilitate the implementation of targeted interventions.AIM To investigate the status of anxiety and depression among patients with CHF and determine the factors contributing to poor fluid restriction adherence.METHODS Three hundred CHF patients seeking medical treatment at The First Hospital of Hunan University of Traditional Chinese Medicine between June 2021 and June 2023 were included in the study.Questionnaires,including the Psychosomatic Symptom Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,and Fluid Restriction Adherence Questionnaire were administered to patients.Based on their anxiety and depression scores,patients were categorized into anxiety/depression and non-anxiety/depression groups,as well as fluid restriction adherence and fluid restriction non-adherence groups.General patient data were collected,and univariate and logistic regression analyses were conducted to determine the occurrence of depression and anxiety.Logistic regression analysis was used to identify independent factors influencing fluid restriction adherence.RESULTS Statistically significant differences in age,New York Heart Association(NYHA)grading,marital status,educational attainment,and family support were observed between depressed and non-depressed CHF patients(P<0.05).Age,NYHA grading,marital status,educational attainment,and family support were identified as factors influencing the development of depression.The anxiety and non-anxiety groups differed statistically in terms of gender,age,NYHA grading,smoking history,alcohol consumption history,monthly income,educational attainment,and family support(P<0.05).Gender,smoking,alcohol consumption,monthly income,and educational attainment affected anxiety in these patients.The fluid restriction adherence rate was 28.0%,and thirst sensation,anxiety,and depression were identified as independent influencing factors.CONCLUSION CHF patients are susceptible to anxiety and depression,with multiple associated influencing factors.Moreover,anxiety and depression are independent factors that can influence fluid restriction adherence in these patients.
文摘BACKGROUND Mesalamine is the recommended first-line treatment for inducing and maintaining remission in mild-to-moderate ulcerative colitis(UC).However,adherence in real-world settings is frequently suboptimal.Encouraging collaborative patient-provider relationships may foster better adherence and patient outcomes.AIM To quantify the association between patient participation in treatment decisionmaking and adherence to oral mesalamine in UC.METHODS We conducted a 12-month,prospective,non-interventional cohort study at 113 gastroenterology practices in Germany.Eligible patients were aged≥18 years,had a confirmed UC diagnosis,had no prior mesalamine treatment,and provided informed consent.At the first visit,we collected data on demographics,clinical characteristics,patient preference for mesalamine formulation(tablets or granules),and disease knowledge.Self-reported adherence and disease activity were assessed at all visits.Correlation analyses and logistic regression were used to examine associations between adherence and various factors.RESULTS Of the 605 consecutively screened patients,520 were included in the study.The median age was 41 years(range:18-91),with a male-to-female ratio of 1.1:1.0.Approximately 75%of patients reported good adherence at each study visit.In correlation analyses,patient participation in treatment decision-making was significantly associated with better adherence across all visits(P=0.04).In the regression analysis at 12 months,this association was evident among patients who both preferred and received prolonged-release mesalamine granules(odds ratio=2.73,P=0.001).Patients reporting good adherence also experienced significant improvements in disease activity over 12 months(P<0.001).CONCLUSION Facilitating patient participation in treatment decisions and accommodating medication preferences may improve adherence to mesalamine.This may require additional effort but has the potential to improve long-term management of UC.
文摘Objective: To assess antiretroviral therapy (ART) adherence rates and associated factors among people living with HIV in Vietnam. Methods: A cross-sectional study was conducted at the Hospital for Tropical Diseases, Ho Chi Minh City from June to August 2022. Data were collected from 347 people living with HIV using structured questionnaires assessing sociodemographics, substance use, drug side effects, treatment beliefs, treatment satisfaction, and depression. ART adherence was evaluated using a multi-method tool, including self-report, pill count, the Provider Interview Tool, and the Visual Analog Scale. Participants were classified as having high adherence only if they met all four criteria across these methods. Multivariable logistic regression was used to identify factors influencing adherence, with significance set at P<0.05. Results: High ART adherence was observed in 69.5% of the participants. Adherence was significantly lower among tobacco users (OR 0.49, 95% CI 0.30-0.83, P=0.007), those with higher depression scores (per 1-point increase) (OR 0.89, 95% CI 0.84-0.95, P<0.001), frequent substance users (OR 0.50, 95% CI 0.30-0.83, P=0.007), and those experiencing more severe drug side effects (per level increase) (OR 0.64, 95% CI 0.45-0.92, P=0.016). Participants able to afford treatment had nearly three times higher odds of adherence than those unable to pay (OR 2.85, 95% CI 1.48-5.47, P=0.002). Conclusions: ART adherence among people living with HIV in Vietnam remains suboptimal. Interventions should target substance use, drug side effects, financial barriers, and depression screening to improve adherence.
基金supported by the National R&D Program for Cancer Control through the National Cancer Center funded by the Ministry of Health & Welfare, Republic of Korea (No. HA21C0225)。
文摘Objective: Regular cancer screening must be monitored to improve gastric cancer(GC) survival rates and maximize participation. This study examined adherence to regular GC screening over a 10-year period and identified the factors influencing adherence.Methods: This retrospective cohort study was conducted using data from the Korean National Cancer Screening Program(KNCSP) between 2011 and 2020. The total cohort comprised 400,113 adults aged 40 years who were newly eligible for and participated in GC screening in 2011. The participants were followed up for 10 years to assess their adherence to biennial screening recommendations. They were categorized into two groups: the nonregular screening(non-RS) group, which included individuals who did not participate in subsequent screenings, and the regular screening(RS) group, which included those who participated in at least one follow-up screening.Multiple logistic regression analyses were performed to identify the factors associated with adherence to regular GC screening.Results: Over 10 years, 59% of the participants completed at least four of the five recommended screenings,while 10% did not participate after their initial screening. Male participants had higher odds of non-adherence than females [adjusted odds ratio(aOR)=1.429, 95% confidence interval(95% CI): 1.394-1.464;P<0.001]. Nonadherence was more prevalent among self-employed individuals(aOR=1.208, P<0.001). Among males, those in the lowest income group were 1.267 times more likely to not undergo regular screening than those in the highest income group.Conclusions: Long-term adherence to regular GC screening in South Korea remains suboptimal.Socioeconomic disparities persist, highlighting the need for tailored interventions to improve adherence and enhance public health.
文摘Objective:To investigate the impact of progressive effect nutritional care on uremia patients undergoing dialysis.Methods:A total of 101 uremia patients undergoing dialysis admitted from January 2024 to March 2025 were selected as the study subjects and divided into two groups by lottery method.The control group(55 cases)received routine care,while the observation group(56 cases)received a combination of routine care and progressive effect nutritional care.Results:After 4 weeks of care,the observation group demonstrated higher treatment adherence(P<0.05),better quality of life(P<0.05),and improved nutritional status(P<0.05)compared to the control group.Conclusion:Progressive effect nutritional care can significantly enhance treatment adherence,quality of life,and nutritional status in uremia patients undergoing dialysis.
文摘BACKGROUND Current antiviral treatment for chronic hepatitis B can suppress viral replication and reduce the risk of cirrhosis and liver cancer.It requires lifelong daily medication,and long-term adherence is often cited as a concern when initiating treatment.Hepatitis B treatment adherence in the context of the patient’s medical and life experiences remains underexplored.AIM To evaluate factors associated with adherence to hepatitis B oral antiviral treatment.METHODS A global online survey was administered anonymously to adults(aged 18 years or older)living with chronic hepatitis B.A subsample of 614 individuals who reported being on hepatitis B treatment was included in the analysis.Indices for treatment affordability,healthcare service acceptability,and individual physical,psychological,and emotional functioning were constructed(Cronbach’s alpha=0.71-0.83).Data analysis was conducted using Stata/BE 17.0.RESULTS Overall,81%of respondents reported high adherence to hepatitis B treatment.Lower adherence was observed among individuals who identified as African or African American(P=0.008).Among participants with low adherence,60%cited affordability as a challenge(P=0.068),53%identified healthcare service acceptability as a challenge(P=0.04),79%described physical functioning as a challenge(P=0.002),and 40.5%reported difficulties with psychological functioning(P=0.55).CONCLUSION Findings demonstrate high treatment adherence,although access to and acceptability of healthcare services,as well as an individual’s physical functioning challenges,appear to be related to low adherence.
文摘Medication adherence in patients with schizophrenia is essential for managing symptoms,improving prognosis,and enhancing the quality of life.Despite the importance of adherence,it remains a global challenge.It is influenced by various factors,including symptom severity(e.g.,excitement and impulse control disorders),attitudes towards medication(e.g.,pharmacophobia),lack of social support,and the communication efficacy of healthcare teams.Regarding assessment tools,self-report questionnaires,such as the Morisky Scale,are common but subject to recall bias.Electronic monitoring devices(e.g.,Medication Event Monitoring System)and pharmacy refill data offer more objective measures of adherence,whereas biomarkers,such as blood drug concentration monitoring,show promise under specific conditions but require further validation.Long-acting injectable antipsychotic medications have shown greater adherence benefits than oral medications.Psychological interventions such as motivational interviewing and mindfulness training,along with multidisciplinary team efforts,including psychiatrists,pharmacists,and psychotherapists,can significantly improve patient outcomes.Future research should integrate innovative drug formulations(e.g.,long-acting,low-side-effect medications),digital health technologies(e.g.,medication reminder apps and wearable devices),and supportive policies(e.g.,community-based free medication services)as well as patient education to enhance disease awareness.However,the ethical and legal dilemmas(e.g.,balancing patient autonomy with involuntary medication)and privacy concerns in technological applications require further exploration.In conclusion,enhancing medication adherence in patients with schizophrenia requires a personalized,multifaceted approach,and collaborative efforts across various sectors to achieve optimal clinical results and social functioning.
文摘This minireview focuses on psychological distress and treatment adherence-issues in patients with chronic hepatitis B(CHB).It begins by discussing the epidemiology and disease burden of CHB,and addresses the relationship between psychological distress and treatment adherence.Next,it delves into the current status and risk factors for psychological distress among patients with CHB,and explores the challenges and risk factors related to treatment adherence.Subsequently,it explores the development and implementation of integrated nursing strategies,including psychological interventions and support,self-efficacy enhancement strategies,social support-system optimization,personalized medical care,and technological innovation.Finally,it highlights the limitations of current interventions and clarifies future research priorities.This minireview aims to provide a comprehensive theoretical basis and practical guidance for improving treatment outcomes and quality of life of patients with CHB.In summary,we reveal that psychological distress significantly impacts treatment adherence in patients with CHB and that it is essential to adopt integrated nursing strategies to address these challenges.These findings highlight the need to consider the psychological states of individuals and develop targeted interventions to improve treatment outcomes.
文摘Patients with cardiovascular disease rely on medication to achieve favorable longterm clinical results.Poor adherence has been linked to a relative increase in mortality of 50%-80%as well as higher health care costs.This scoping review thus aimed to explore the evidence of the effects of mobile health care apps on medication adherence in patients with cardiovascular diseases.A comprehensive data search and extraction was done in line with the updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist.A total of 10 studies were included for the review.The mean pooled improvement in adherence was found to be 18%and the most effective tool was the digital therapeutics app discussed in Li et al’s study.Smartphones and apps enhance coronary artery disease management by promoting medication compliance.Challenges include data security and smartphone usage among the elderly.Tailored apps or voice assistants offer potential solutions.
文摘BACKGROUND Post-procedural psychological disorders are frequently overlooked in elderly patients undergoing percutaneous coronary intervention(PCI),despite their potential impact on long-term cardiovascular outcomes.AIM To evaluate the incidence and prognostic significance of post-PCI psychological disorders in elderly patients with heart failure,and to examine their association with medication adherence and major adverse cardiovascular events(MACE).METHODS This retrospective cohort study included 330 consecutive patients aged≥60 years with heart failure who underwent PCI between 2018 and 2021 at a single center,excluding those with prior psychiatric diagnoses.Psychological status within six months post-discharge was assessed using validated Chinese versions of the 9-item Patient Health Questionnaire and the 7-item Generalized Anxiety Disorder Scale,and medication adherence was measured by the 8-item Morisky Medication Adherence Scale(MMAS-8)scale.A subset of 145 patients with≥24 months of follow-up were analyzed for MACEs.Multivariate logistic regression and Kaplan-Meier survival analyses were performed.RESULTS Post-PCI psychological disorders were identified in 40%of patients,with anxiety(36%),depression(32%),and comorbid symptoms(22%)being most prevalent.Affected patients had lower MMAS-8 scores[median 5(IQR 4-6)vs 6(IQR 5-7),P=0.002]and a higher rate of low adherence(51.5%vs 30.3%,P<0.001).Among the 145 patients followed longitudinally,MACEs occurred in 17.9%,with 65.4%of events in those with psychological disorders.Psychological disorders(OR=2.66,95% CI:1.11-6.41,P=0.028)and low adherence(OR=2.77,95% CI:1.17-6.56,P=0.021)were independently associated with increased MACE risk.Kaplan-Meier analysis showed reduced MACE-free survival in patients with psychological disorders(HR=2.68,95%CI:1.25-5.73;log-rank P=0.008).CONCLUSION Post-PCI psychological disorders are common in elderly patients with heart failure and independently predict poorer adherence and worse cardiovascular outcomes.Routine psychological assessment and adherence interventions may improve prognosis in this vulnerable population.
基金supported by the Guangdong Basic and Applied Basic Research Foundation(2025A1515011703).
文摘Objectives This study aimed to evaluate the effectiveness of a Health Belief Model(HBM)-based electronic education program combined with individualized supervised exercise in improving exercise adherence and pregnancy outcomes among women with gestational hypertension.Methods A randomized controlled trial was conducted from June 2024 to February 2025 at a tertiary hospital in Shenzhen,China.A total of 142 pregnant women diagnosed with gestational hypertension were randomly assigned to either an experimental group or a control group.The experimental group received routine antenatal care plus a 6-week HBM-based e-education intervention delivered via a mobile application and short messaging service(SMS)reminders,complemented by individualized in-person exercise guidance.The control group received routine antenatal care only.After the 6-week intervention,outcomes were assessed using the 6-min walk test,a disease knowledge and attitudes questionnaire,and the Pregnancy Exercise Self-Efficacy Scale.Primary outcomes included exercise adherence,blood pressure control,incidence of preeclampsia,and other pregnancy-related outcomes.Results A total of 129 participants completed the study(the intervention group[n=65],the control group[n=64]).At 6 weeks post-intervention,the experimental group demonstrated significantly greater improvements than the control group in exercise adherence,blood pressure control,preeclampsia incidence,disease-related knowledge and attitudes,and exercise self-efficacy(all P<0.05).Specifically,participants in the experimental group engaged in more frequent and longer-duration exercise sessions(P<0.05).Their blood pressure was maintained within a more stable and clinically optimal range(systolic:135.2±4.7 mmHg;diastolic:85.4±4.5 mmHg),which was significantly better than that of the control group(systolic:138.4±10.4 mmHg;diastolic:90.9±6.9 mmHg;P<0.05).The incidence of preeclampsia was also significantly lower in the experimental group(P<0.05).Additionally,scores for disease knowledge,attitudes,and exercise self-efficacy were higher in the experimental group(P<0.05).Within-group comparisons revealed that the experimental group showed significant improvements from baseline in exercise frequency,duration,total physical activity,and knowledge/attitude scores(P<0.05),whereas the control group showed no significant changes(P>0.05).Conclusion By embedding video-based education,real-time monitoring,and personalized support into routine prenatal care,this intervention facilitated positive behavioral changes in physical activity among pregnant women.The approach offers a scalable model for clinical nurses to delivering tailored remote exercise support for women with other pregnancy-related complications.
