ObjectiveTo investigate the status of exit-site care in patients undergoing peritoneal dialysis, and analyze the relationship between exit-site care practice and exit-site infection.MethodsThe patients undergoing peritoneal dialysis in Nanfang Hospital, Southern Medical University between January and October 2019 were recruited by convenience sampling method. The Exit-site Schaefer Scale was used to diagnose the occurrence of exit-site infection. According to the guidelines of the International Society of Peritoneal Dialysis and relevant research, a questionnaire was developed to investigate the status of exit-site care in all peritoneal dialysis patients. Logistic regression analysis was used to analyze the influence of care practice on exit-site infection.ResultsA total of 208 peritoneal dialysis patients were recruited. There were 39 patients with (totally 43 times of) exit-site infections, with an exit-site infection incidence of 0.06 episodes per patient-year. The main bacteria were Staphylococcus aureus (30.2%) and Pseudomonas aeruginosa (16.3%). Of the 39 infected patients, 8 (20.5%) had peritonitis and 3 (7.7%) had been infected more than once. The exit-site Schaefer score of the 208 patients was 3.14±2.75. Of the 208 patients, 204 (98.1%) had received training of exit-site care from nurses, 166 (79.8%) could wash their hands and wear masks as required, 196 (94.2%) covered dressings on the exit site, and 184 (88.5%) fixed catheters, but the application of antibiotic ointment did not follow the latest guidelines. The logistic regression analysis revealed that the history of redness and swelling at the exit site [odds ratio (OR)=7.926, 95% confidence interval (CI) (2.367, 26.535), P=0.001] and the history of traction-associated bleeding [OR=5.750, 95%CI (1.878, 17.610), P=0.002] were risk factors of exit-site infection.ConclusionsExit-site infection is common in peritonealdialysis patients. Most patients can perform the exit-site care as required, but the care content is yet to be updated. Nursing staff should improve the training content according to the latest guidelines, strengthen the exit-site assessment, follow-up, and retraining, treat the redness and swelling at the exit site timely, and tell the patients to pay attention to catheter fixation and avoiding excessive traction, to prevent the exit-site infection and the further development of peritonitis.
ObjectiveTo systematically review the factors for cognitive impairment in hypertensive patients. MethodsPubMed, Web of Science, Embase, Cochrane Library, Ovid, Scopus, EBSCO, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect studies on factors for cognitive impairment in hypertensive patients from inception to March 2023. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 and Stata 14.0 software. ResultsA total of 26 articles involving 13 464 patients were included. The results of meta-analysis showed that antihypertensive drug use (OR=0.22, 95%CI 0.09 to 0.59, P=0.002), blood pressure was well controlled (OR=0.48, 95%CI 0.37 to 0.623, P<0.001), and social support (OR=0.94, 95%CI 0.90 to 0.97, P<0.001) were protective factors for CI in hypertensive patients. And age (OR=1.17, 95%CI 1.12 to 1.22, P<0.001), age ≥60 (OR=2.10, 95%CI 1.71 to 2.57, P<0.001), female (OR=1.55, 95%CI 1.25 to 1.93, P<0.001), single (OR=2.39, 95%CI 1.89 to 3.03, P<0.001), smoking (OR=3.40, 95%CI 2.40 to 4.82, P < 0.001), educational level (<college） (OR=3.46, 95%CI 2.73 to 4.39, P<0.001), education years (≥12 years) (OR=2.10, 95%CI 1.43 to 3.07, P<0.001), diabetes (OR=2.82, 95%CI 2.22 to 3.58, P<0.001), hyperlipidemia (OR=1.48, 95%CI 1.10 to 2.00, P=0.01), total cholesterol (OR=1.11, 95%CI 1.01 to 1.22, P=0.02), CVHI anomalies (OR=6.24, 95%CI 3.75 to 10.37, P<0.001), sleep disorder (OR=2.92, 95%CI 1.93 to 4.42, P<0.001), systolic blood pressure (OR=1.04, 95%CI 1.02 to 1.06, P<0.001), orthostatic hypotension (OR=1.39, 95%CI 1.20 to 1.62, P<0.001, grade 2 hypertension (OR=2.62,95%CI 1.83 to 3.73, P<0.001), grade 3 hypertension (OR=3.15, 95%CI 1.90 to 5.22, P<0.001), stress history (OR=4.57, 95%CI 2.86 to 7.30, P<0.001) were all risk factors. ConclusionThe current evidence shows that there are many factors affecting the incidence of CI in hypertensive patients, and the assessment of the factors affecting the incidence of cognitive dysfunction in hypertensive patients should be more comprehensive in the future.
Objective To investigate the present status of anxiety and depression in patients through video electroencephalogram examination and analyze the influencing factors, providing a basis for clinical intervention. Methods A questionnaire survey was conducted on 177 patients at the Second Affiliated Hospital of Guangzhou Medical University using the general information and disease-related data questionnaire, the Self-Rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS). Results The SAS and SDS scores of the patients in this study were significantly higher than the domestic norms (P<0.01). The detection rates of anxiety and depressive moods were 18.08% and 32.77%, respectively. Logistic regression analysis showed that the risk factors for anxiety in these patients included disease duration, head discomfort, and the psychological burden of inducing experiments. The risk factors for depression included disease duration, head discomfort, and occupational factors. ConclusionPatients in this study generally exhibited anxiety and depressive moods. Their anxiety and depression are influenced by various factors. Targeted psychological interventions should be implemented to improve their mental health.
ObjectiveTo be aware of the current situation of nurses' protective consciousness on pulmonary tuberculosis in one of the top hospitals, and to discuss its influencing factors, in order to provide references for better improving nurses' tuberculosis protection consciousness.
MethodsBy using random sampling method, we selected the nurses who met the requirements to participate in the questionnaire investigation, between March and May 2014. According to the results, we evaluated their protective awareness on tuberculosis and its influencing factors.
ResultsWe delivered 320 questionairs and took back 316. Nurses with different age, length of nursing work, professional rank, job title, educational background, and tuberculosis prevention knowledge training status had significantly different scores (P < 0.05). The multiple linear regression analysis was carried out with total scores of tuberculosis prevention knowledge as dependent variable, and age, professional rank, length of nursing work, educational background and tuberculosis prevention knowledge training as independent variable. The results showed that age, educational background, and tuberculosis prevention knowledge training were influencing factors of tuberculosis prevention knowledge scores (P < 0.05).
ConclusionPulmonary tuberculosis prevention knowledge in nurses remains to be further promoted, and we should especially strengthen the prevention knowledge training for nurses with short working experience and low-degree education.
Objective To understand the quality of life of patients with acute mild to moderate ischemic stroke one year after stroke, analyze the factors affecting their quality of life, and provide a scientific basis for improving their health-related quality of life. Methods This study included patients who were diagnosed with acute mild to moderate ischemic stroke between March 2019 and March 2021 in four hospitals in Nanchang. Sociodemographic information and relevant clinical data were collected during hospitalization. The EQ-5D-5L questionnaire was administered to assess health-related quality of life one year after discharge. The Mann-Whitney U test (for two groups) and Kruskal-Wallis one-way ANOVA (for multiple groups) were used to analyze differences in utility scores among various factors. A Tobit regression model was built to investigate the factors influencing quality of life one-year post-stroke. Results A total of 1 181 patients participated in the study, including 791 males (66.98%) and 390 females (33.02%), with an average age of 63.7±10.9 years. Health-related quality of life data collected one year after the stroke revealed that 22.69% of patients experienced pain/discomfort, 17.27% suffered anxiety/depression, 15.66% had mobility issues, 10.33% had difficulties with daily activities, and 8.64% had trouble with self-care. Tobit regression results showed that age (β=?0.263, 95%CI ?0.327 to ?0.198), gender (β=?0.134, 95%CI ?0.189 to ?0.080), previous hypertension (β=?0.068, 95%CI ?0.120 to ?0.016), previous dyslipidemia (β=?0.068, 95%CI ?0.126 to ?0.011), admission NIHSS score (β=?0.158, 95%CI ?0.198 to ?0.118), and discharge mRS score (β=?0.193, 95%CI ?0.250 to ?0.136) were negatively associated with health utility values. Current employment status (β=0.141, 95%CI 0.102 to 0.181) and admission GCS score (β=0.209, 95%CI 0.142 to 0.276) were positively correlated with health utility values. Conclusion One year after an acute mild to moderate ischemic stroke, patients commonly face pain/discomfort and anxiety/depression. Factors affecting overall quality of life include age, sex, current employment status, previous hypertension, previous dyslipidemia, admission NIHSS score, admission GCS score, and discharge mRS score. Clinically, developing scientifically sound and reasonable rehabilitation plans post-discharge is crucial for improving long-term quality of life.
Objective
To investigate the factors influencing the medication adherence among patients with diabetes signing family doctor service contract in Beijing urban areas, and provide the basis for improving the level of medication adherence.
Methods
A total of 320 patients with diabetes from four community health service centers in Beijing urban areas were selected to answer the questionnaires using convenient sampling from June to September 2015. Univariate analysis and binary logistic regression were used for the influencing factors analysis.
Results
A total of 320 questionnaires were distributed, and 317 valid questionnaires were recovered, in which the rate of high medication adherence was 54.6%. The results of logistic regression showed that the main impact factors on medication adherence were age [odds ratio (OR)=1.918, P=0.011)], degree of education (OR=2.462, P=0.008), knowledge related to diabetes (OR=1.773, P=0.027), adopting of family doctor service or not (OR=2.521, P=0.029) and social function status (P=0.003).
Conclusions
The family doctor service team should implement the practice of the family doctor service to ensure that the contracted residents can make full use of the family doctor services; and strengthen the follow-up and interventions for patients less aged or with low degree of education. For those with poor social function, more attention should be paid to their self-health management behavior to improve the level of patients’ compliance. As a result, the levels of blood glucose will be well controlled to reduce possibilities of complications and improve their health status and quality of life.
ObjectiveTo investigate the fatigue of asthma patients, and to analyze its influencing factors, and provide a reference for clinical intervention.MethodsThe convenience sampling method was adopted to select asthma patients who were in clinic of the First Affiliated Hospital of Guangxi Medical University from November 2018 to March 2019. The patients’ lung function were measured. And questionnaires were conducted, including general data questionnaire, Chinese version of Checklist Individual Strength-Fatigue, Asthma Control Test, Chinese version of Self-rating Depression Scale. Relevant data were collected for multiple stepwise linear regression analysis.ResultsFinally, 120 patients were enrolled. The results of multiple stepwise linear regression analysis showed that age, education level, place of residence, time period of frequent asthma symptoms, degree of small airway obstruction, Asthma Control Test score and degree of depression were the influencing factors of fatigue in asthma patients (P≤0.05). Multivariate linear stepwise regression analysis showed that degree of small airway obstruction, degree of depression and time period of frequent asthma symptoms were the main influencing factors of fatigue in asthma patients, which could explain 51.8% of the variance of fatigue (ΔR2=0.518).ConclusionsThe incidence of fatigue in asthma patients is at a relatively high level. Medical staff should pay attention to the symptoms of fatigue in asthma patients. For asthma patients, it is recommended to strengthen standardized diagnosis and treatment, reduce the onset of symptoms at night and eliminate small airway obstruction. Psychological intervention methods are needed to improve patients’ depression, reduce fatigue symptoms, and improve quality of life.
ObjectiveTo investigate the influencing factors of serum NT-proBNP level in elderly patients with acute myocardial infarction (AMI) after PCI, and to analyze its predictive value for the short-term prognosis of patients. MethodsA total of 98 elderly patients with AMI in Zhengzhou central hospital from May 2020 to August 2022 were selected, all of whom underwent PCI. The level of serum NT-proBNP before and after PCI was detected. The level of serum NT-probNP after PCI was ≥125 pg/mL, and the level of serum NT-probNP after PCI was normal. Univariate analysis of the general data of the elevated NT-proBNP group and the normal group, Lasso regression model was used to screen the screening variables, and Logistic regression was used to analyze the influencing factors of serum NT-proBNP level in elderly AMI patients after PCI. The prognosis recovery of patients with different NT-proBNP and the level of NT-proBNP in patients with different prognosis were compared and analyzed. ROC curve was drawn to analyze the predictive value of NT-proBNP level in patients with short-term prognosis after PCI. ResultsLogistic regression analysis showed that the time from onset to PCI, age, left ventricular ejection fraction (LVEF), stroke, number of stents implanted, no recirculation and stent diameter were the influencing factors of serum NT-proBNP level in elderly AMI patients after PCI. The incidence of adverse cardiovascular events (MACE) was 21.43% (21/98) in 98 patients followed up 6 months after surgery, and the incidence of NT-proBNP increased group was 68.00% (17/25), which was significantly higher than that of normal group (5.48% (4/73) (P<0.05). The level of NT-proBNP in the group with MACE was significantly higher than that in the group without MACE (P<0.05). ROC curve showed that AUC was 0.813 (95%CI 0.721 to0.884), sensitivity and specificity were 80.95% and 79.22%, respectively, suggesting that serum NT-proBNP level after PCI had certain predictive value for short-term prognosis of patients. ConclusionSerum NT-proBNP level in elderly AMI patients after PCI has a good ability to predict the short-term prognosis of patients. Comprehensive consideration of the number of stents inserted, the presence of stroke, the presence of reflow and age and other factors to strengthen the monitoring of NT-proBNP level is helpful to prevent and control the occurrence of MACE, so as to improve the prognosis of patients.
Progressive ischemic stroke is one of the major diseases damaging the health of Chinese people. Its pathogenesis is complex and there are many influencing factors, but the treatment methods are limited. In recent years, the rapid development of neuroimaging and the results of various clinical trials have been reported in succession, which have made new progress in the clinical diagnosis and treatment of progressive ischemic stroke. This paper summarizes the progress of progressive ischemic stroke, introduces its pathogenesis (including increased intracranial pressure and reduced perfusion pressure, thrombosis progression, hemorrhagic transformation, cerebral edema, and inflammatory response), influencing factors, predictive indicators (including image indicators, biochemical indicators, and molecular biology indicators) and treatment (including admission to “stroke unit”, intravascular treatment, platelet aggregation inhibition treatment, anticoagulation treatment, and general treatment), to provide references for preventing the occurrence and development of progressive ischemic stroke, assessing the condition, guiding treatment and improving the prognosis.
ObjectivesTo investigate the status quo of follow-up services for patients with cervical spondylosis, to explore its influencing factors, and to provide reference for the follow-up management model after postoperative discharge of patients with cervical spondylosis.MethodsA total of 220 patients with cervical spondylosis were selected by using convenient sampling from October 2018 to May 2019, and the general information questionnaire and the follow-up service needs questionnaire were used for the investigation.ResultsThe score of follow-up service content requirement for patients with cervical spondylosis was 54.87±7.56, and the rehabilitation training instruction was the highest. Multiple linear regression analysis showed that the follow-up service content score was influenced by education level [non-standardized partial regression coefficient (b)=3.186, 95% confidence interval (CI) (2.490, 3.882), P<0.001], length of hospital stay [b=5.140, 95%CI (3.914, 6.365), P<0.001], Neck Disability Index [b=1.326, 95%CI (0.189, 2.463), P=0.022], and age [≥75 years as the reference, 45-59 years: b=3.766, 95%CI (0.671, 6.860), P=0.017; 60-74 years: b=4.081, 95%CI(0.849, 7.314), P=0.014]. The method of obtaining follow-up services was mainly based on outpatient follow-up (85.5%), telephone follow-up (50.5%), and established a follow-up service center (40.5%) for discharged patients. The executives were multidisciplinary teams (60.5%) and hospital-community integration teams (48.2%). There were 19.1% of discharged patients who were willing to pay for relevant follow-up services.ConclusionsPatients with postoperative cervical spondylosis have strong demand for post-discharge follow-up services, which are affected by many factors. Medical staff should pay attention to this and develop a personalized follow-up service plan according to patient characteristics to meet different discharged patients and improve the quality of medical services.
