Association between physical activity and health-related quality of life in middle-aged and elderly individuals with musculoskeletal disorders: Findings from a national cross-sectional study in Korea

by Jung Hyun Lee, Il Yun, Chung-Mo Nam, Suk-Yong Jang, Eun-Cheol Park

Purpose

This study aimed to identify the association between physical activity and health-related quality of life (HRQoL) in middle-aged and elderly individuals with musculoskeletal disorders.

Methods

This study used data from the 2016–2020 Korea National Health and Nutrition Examination Survey (KNHANES). We included only those over 40 years of age diagnosed with one or more of the following: osteoarthritis, rheumatism, and osteoporosis. In total, 4,731 participants (783 men and 3,948 women) were included as the study population. Multiple logistic regression analysis was performed to examine the association between physical activity and HRQoL.

Results

In the case of middle-aged and elderly individuals with musculoskeletal disorders, the likelihood of HRQoL worsening was significantly lower for those who regularly engaged in physical activity compared with that of those who did not engage in physical activity at all (men: OR 0.58, 95% CI 0.37–0.90; women: OR 0.64, 95% CI 0.53–0.79). Stratified analysis by the type and intensity of physical activity revealed that the possibility of poor HRQoL was lowest when leisure-related moderate-intensity physical activities were performed (men: OR 0.44, 95% CI 0.22–0.89; Women: OR 0.50, 95% CI 0.36–0.69).

Conclusions

Our findings suggest that engaging in regular physical activity contributes to preventing exacerbation of HRQoL, even if the individual suffers from musculoskeletal disorders. It is necessary to provide an appropriate type and intensity of physical activity in consideration of the patients’ pain and severity.

Overview of the role of different conservative interventions as first-line treatment in the management of urinary incontinence in women

Commentary on: Todhunter-Brown A, Hazelton C, Campbell P, Elders A, Hagen S, McClurg D. Conservative interventions for treating urinary incontinence in women: an Overview of Cochrane systematic reviews. Cochrane Database Syst Rev. 2022 Sep 2;9(9):CD012337. doi: 10.1002/14651858.CD012337.pub2.

Implications for practice and research

Pelvic floor muscle training is an effective conservative treatment option for managing all types of urinary incontinence (UI) in women in isolation or combined with other measures and should be considered first-line treatment in women with UI.

Further research is needed on long-term outcomes of conservative interventions and their impact on quality of life.

Context

Urinary incontinence (UI) is a highly prevalent condition affecting nearly 25% of women, especially in older age groups.1 It is characterised by involuntary leakage of urine and can have a significant impact on quality of life, leading to psychological distress and placing a financial burden...

Perceived organisation support would buffer the impact of work frustration on burn-out among intensive care unit nurses

Commentary on: Yanbei R, Dongdong M, Yun L, Ning W, Fengping Q. Does perceived organization support moderate the relationships between work frustration and burnout among intensive care unit nurses? A cross-sectional survey. BMC Nurs. 2023 Jan 23;22(1):22. doi: 10.1186/s12912-023-01180-5.

Commentary

Implications for practice and research

Providing intensive care unit (ICU) nurses with organisational supports by showcasing that the organisation cares about their well-being, gives importance to their opinions, is proud of their achievements will decrease their work frustration.

Future research and auditing of programmes and events to monitor organisational support to ICU nurses in reduction of work frustration and burn-out. Such monitoring systems could translate into better patient outcome.

Context

The psychological strain of caring for very ill patients causes significant mental stress for all ICU healthcare professionals. When stress is prolonged, it might eventually cause burn-out and deterioration of patient...

The correlation between transcutaneous oxygen pressure (TcPO2) and forward‐looking infrared (FLIR) thermography in the evaluation of lower extremity perfusion according to angiosome

Abstract

The increased peripheral arterial disease (PAD) incidence associated with aging and increased incidence of cardiovascular conditions underscores the significance of assessing lower limb perfusion. This study aims to report on the correlation and utility of two novel non-invasive instruments: transcutaneous oxygen pressure (TcPO₂) and forward-looking infrared (FLIR) thermography. A total of 68 patients diagnosed with diabetic foot ulcer and PAD who underwent vascular studies at a single institution between March 2022 and March 2023 were included. Cases with revascularization indications were treated by a cardiologist. Following the procedure, ambient TcPO₂ and FLIR thermography were recorded on postoperative days 1, 7, 14, 21 and 28. In impaired limbs, TcPO₂ was 12.3 ± 2 mmHg and FLIR thermography was 28.7 ± 0.9°C. TcPO₂ (p = 0.002), FLIR thermography (p = 0.015) and ankle–brachial index (p = 0.047) values significantly reduced with greater vascular obstruction severity. Revascularization (n = 39) significantly improved TcPO₂ (12.5 ± 1.7 to 19.1 ± 2.2 mmHg, p = 0.011) and FLIR (28.8 ± 1.8 to 32.6 ± 1.6°C; p = 0.018), especially in severe impaired angiosomes. TcPO₂ significantly increased immediately post-procedure, then gradually, whereas the FLIR thermography values plateaued from day 1 to 28 post-procedure. In conclusion, FLIR thermography is a viable non-invasive tool for evaluating lower limb perfusion based on angiosomes, comparable with TcPO₂.

Collaborative practice in type 2 diabetes management in a developing country: A qualitative study of perceptions and attitudes of key stakeholders

Abstract

Aims and objectives

To explore collaborative practice and perceptions and attitudes of key stakeholders on collaboration in type 2 diabetes management in a tertiary care setting.

Background

Understanding collaborative practice in diabetes care in developing countries helps to design and provide patient-centred and cost-effective care.

Design

An exploratory qualitative study.

Methods

Interviews were undertaken with 30 patients and 18 health professionals and policymakers. Thematic data analysis was undertaken to explore collaborative practice and examine participant perspectives on collaboration in diabetes management. We compared the findings with D'Amour's Collaboration Framework to determine the level of collaboration.

Results

Most participants reported a lack of collaborative practice in diabetes management, while they appreciated its importance in improving care. Perceptions varied with respect to what constituted collaborative practice. Three themes were identified: (1) perspectives of key stakeholders on current practice of collaboration; (2) impediments to collaborative practice; (3) strategies to improve collaborative practice. Analyses of the themes using D'Amour's Collaboration Framework indicated a low level of collaboration among physicians, nurses, pharmacists and policymakers, which was attributed to workload and time pressures on health professionals, power dynamics and lack of role clarity of all actors in collaborative action. Participants commented on the need to improve collaboration by establishing strong leadership and governance at different healthcare structure levels, which is committed to coordinating collaboration and developing collaborative frameworks and policies that guide collaborative undertaking.

Conclusions

Perceived shortcomings of collaboration were attributed to inadequate resources, power dynamics, a lack of strong team functioning and policies. Participants' positive perceptions provide an opportunity to improve collaborative practice through incorporation of collaborative frameworks and policies.

Relevance to Clinical Practice

The findings in this study inform development of tailored and patient-centred diabetes care in tertiary care settings in sub-Saharan Africa.

Reporting Method

The study was reported in accordance with the COREQ checklist.

Patient or Public Contribution

Patients or the public were not involved in the design, analysis or interpretation of the data in this study. However, patients and healthcare providers participated in pilot interviews, which helped refine the interview guides. The summary of the findings of the study was also discussed with patients and healthcare providers, where they provided feedback.

Promoting holistic approaches to management of violence in the ED—a response to Ramacciati ()

Journal of Clinical Nursing, Volume 32, Issue 19-20, Page 6771-6772, October 2023.

Cut‐off scores of the Depression Anxiety Stress Scale‐8: Implications for improving the management of chronic pain

Abstract

Aim

Mental distress, non-specific symptoms of depression and anxiety, is common in chronic pelvic pain (CPP). It contributes to poor recovery. Women's health nurses operate in multidisciplinary teams to facilitate the assessment and treatment of CPP. However, valid cut-off points for identifying highly distressed patients are lacking, entailing a gap in CPP management.

Design

This instrumental cross-sectional study identified a statistically derived cut-off score for the Depression Anxiety Stress Scale-8 (DASS-8) among 214 Australian women with CPP (mean age = 33.3, SD = 12.4, range = 13–71 years).

Methods

Receiver operator characteristic curve, decision trees and K-means clustering techniques were used to examine the predictive capacity of the DASS-8 for psychiatric comorbidity, pain severity, any medication intake, analgesic intake and sexual abuse. The study is prepared according to the STROBE checklist.

Results

Cut-off points resulting from the analysis were ordered ascendingly. The median (13.0) was chosen as an optimal cut-off score for predicting key outcomes. Women with DASS-8 scores below 15.5 had higher analgesic intake.

Conclusion

CPP women with a DASS-8 score above 13.0 express greater pain severity, psychiatric comorbidity and polypharmacy. Thus, they may be a specific target for nursing interventions dedicated to alleviating pain through the management of associated co-morbidities.

Implications for patient care

At a cut-off point of 13.0, the DASS-8 may be a practical instrument for recommending a thorough clinician-based examination for psychiatric comorbidity to facilitate adequate CPP management. It may be useful for evaluating patients' response to nursing pain management efforts. Replications of the study in different populations/countries are warranted.

¿Qué autocuidados se recomiendan a las enfermeras en los procesos de duelo?

Objetivo principal: Determinar qué autocuidados son recomendables, en los procesos de duelo, para las enfermeras. Metodología: Lectura crítica del artículo seleccionado, evaluado con la parrilla de preguntas CASPe, con los criterios propuestos por Arnau y Sala para revisiones narrativas y con The Literature Review Checklist de Leite et al. Resultados principales: Según el sistema GRADE, hablamos, en general, de Moderada Calidad de la Evidencia. Conclusión principal: Tras la lectura crítica y junto a la literatura revisada, vemos a cualquiera de las intervenciones de autocuidado propuestas por McAdam como recomendable. Aun así se hacen precisos más estudios que aporten mayor grado de evidencia en intervenciones concretas.

SCAMPER. Creatividad en cuidados de Salud

Introducción: El método SCAMPER es considerado como fácil y directo en el estímulo del pensamiento creativo y resolución de dificultades, pudiendo ser útil su aplicación en Cuidados de Salud y Prácticas Basadas en Evidencia. Desarrollo: SCAMPER engloba siete técnicas, (S) sustituir, (C) combinar, (A) adaptar, (M) modificar, (P) poner en otro uso, (E) eliminar y (R) reorganizar o revertir, que representan a preguntas que accionarán el ingenio para mejorar algo que ya existe, resolver un problema o encontrar una oportunidad. Ha sido un método muy popular en la gestión de empresas y en educación. Son escasos los ejemplos en el ámbito de cuidados de salud.  Conclusión: El campo de aplicación de SCAMPER se intuye ilimitado, haciéndolo universal. Demuestra ser efectivo debido a su practicidad, sencillez y flexibilidad. Con respecto a los Cuidados de Salud se ve necesario objetivar su posible utilidad, así como su aplicabilidad en todas las dimensiones de la Enfermería.

¿Es beneficiosa la terapia con sanguijuelas en el alivio de la congestión venosa?

Objetivo principal: Valorar si la terapia con sanguijuelas, es beneficiosa en el alivio de la congestión venosa. Metodología: Lectura crítica con CARE. Resultados principales: Nivel de evidencia bajo, según GRADE. Conclusión principal: A pesar de la falta de evidencia, con-cluimos que la terapia con sanguijuelas, mejora la congestión venosa en heridas.

¿La miel puede reducir los síntomas de la tos aguda en niños?

Objetivo principal: Evaluar la efectividad de la miel para la tos aguda en niños. Metodología: Lectura crítica con CASPe y Prisma 2. Pro-cedimientos metodológicos estándar esperados por Cochrane. Resultados principales: Nivel de evidencia baja. Conclusión principal: A pesar de la falta de evidencia plausible,la miel puede reducir la tos aguda en niños, frente a la no utilización de otro producto, tomándo-se como una recomendación favorable pero no concluyente, siendo mayor el beneficio obtenido que el perjuicio.

¿El chicle mejora la función intestinal tras la cesárea?

Objetivo principal: Valorar si masticar chicle, tras una cesárea, mejora la función intestinal. Metodología: Lectura crítica con CASPe y Prisma 2. Resultados principales: Nivel de evidencia baja, según GRADE. Conclusión principal: A pesar de una falta de evidencia plausible, concluimos que masticar chicle, mejora la recuperación temprana de la función intestinal.

¿Es preferible “Atar el pelo” ante cortes en la cabeza?

Artículo en alemán de divulgación científica, cuyo objetivo es dar a conocer la técnica de aposición con pelo para laceraciones tipo scalp (Arrancamiento accidental, total o parcial, del cuero cabelludo), que consiste en el acercamiento de los bordes de la herida mediante el enrollado de haces de pelo colindante y su aseguramiento con pegamento tisular; así como reflejar las ventajas de este método frente a las suturas convencionales y a las grapas. Se trata de una reseña en la sección de “foco de formación” o “foco educativo” de una revista médica [fragmento de texto].