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Experience and caring needs of patients with psoriasis: A qualitative meta‐synthesis

Abstract

Background

As a chronic skin disease, psoriasis often affects the physical, psychological and social status of the patient, which in turn impacts on their experience of illness and needs. However, there is no review of qualitative research that integrates and analyses the experiences and needs of these three influences from a holistic perspective.

Methods

This review follows the ENTREQ guidelines. Six English databases (JBI, Cochrane Library, PubMed, PsyINFO, CINAHL and Embase) and three Chinese databases (CNKI, VIP and Wanfang) were searched from January 2012 to October 2022. Literature was included if it was relevant to the experience of illness and caring needs of patients with psoriasis. The JBI-QARI was used to rate the quality of included studies.

Results

Eleven studies were included in the meta-synthesis. Four analytical themes were identified for analysis: physical challenges, psychological discomfort, social phenomena and caring needs.

Conclusions

The combined physical, psychological and social effects of psoriasis and the consequent caring needs should be emphasised. Health professionals, including doctors and nurses, should be aware of the multiple changes in patients and their coping strategies, provide information about psoriasis, monitor and follow-up regularly over time and obtain feedback to inform further treatment and care so as to develop high-quality therapeutic interventions to help and guide patients with their coping strategies.

Relevance to Clinical Practice

These findings describe the physical, psychological and social experiences of illness and caring needs of patients with psoriasis. Healthcare professionals should be more aware of patients' easily overlooked psychological and social distress, providing prompt attention and recognition of patients' experiences and needs, offering relevant assistance and support and enhancing daily, regular follow-up to help them improve their understanding of and ability to manage their illness.

No Patient or Public Contribution

This is a meta-synthesis without direct patient involvement.

Analysing predictors of surgical site infections in patients undergoing emergency surgery for traumatic pulmonary haemorrhage

Abstract

Identifying predictors for surgical site infections (SSIs) after emergency surgical treatment for traumatic pulmonary haemorrhage (TPH) is crucial for improving patient outcomes. This study aims to ascertain these predictors. In this comprehensive retrospective study, conducted from January 2020 to December 2023 at our institution, 75 patients were analysed, including a case group of 25 patients with SSIs and a control group of 50 without SSIs post-TPH surgery. Inclusion criteria focused on patients aged 18 and above undergoing thoracotomy or minimally invasive thoracic surgery for TPH. Exclusion criteria included compromised immune systems, chronic pulmonary diseases, prior thoracic surgery or active infections at admission. We assessed several predictors: anaemia; operation time over 2 h; hospital stay over 5 days; intraoperative blood loss exceeding 500 mL; body mass index (BMI) ≥25 kg/m2; age ≥ 50 years; use of surgical drains; the presence of open wounds; diabetes mellitus and non-prophylactic antibiotic use. Statistical analysis involved univariate and multivariate logistic regression, using SPSS Version 27.0. Univariate analysis revealed significant associations between SSIs and surgical drain placement, diabetes mellitus, open wounds and non-prophylactic antibiotic use (p < 0.01). Multivariate analysis confirmed these factors as significant predictors of SSIs, with notable odds ratios. Other variables like anaemia, extended hospital stay, excessive intraoperative blood loss, older age and higher BMI did not significantly predict SSIs. Significant predictors for SSIs following TPH surgery include surgical drain placement, diabetes mellitus, open wounds and non-prophylactic antibiotic use. Identifying and managing these risks is crucial in clinical practice to reduce SSIs incidence and improve patient outcomes.

Construction of an instrument to enable the assessment of the risk of falls in older outpatients: A quantitative methodological study

Abstract

Objectives

To develop an instrument to facilitate the risk assessment of falls in older outpatients.

Design

A quantitative methodological study using the cross-sectional data.

Methods

This study enrolled 1988 older participants who underwent comprehensive geriatric assessment (CGA) in an outpatient clinic from May 2020 to November 2022. The history of any falls (≥1 falls in a year) and recurrent falls (≥2 falls in a year) were investigated. Potential risk factors of falls were selected by stepwise logistic regression, and a screening tool was constructed based on nomogram. The tool performance was compared with two reference tools (Fried Frailty Phenotype; CGA with 10 items, CGA-10) by using receiver operating curves, sensitivity (Sen), specificity (Spe), and area under the curve (AUC).

Results

Age, unintentional weight loss, depression measured by the Patient Health Questionnaire-2, muscle strength measured by the five times sit-to-stand test, and stand balance measured by semi- and full-tandem standing were the most important risk factors for falls. A fall risk screening tool was constructed with the six measurements (FRST-6). FRST-6 showed the best AUC (Sen, Spe) of 0.75 (Sen = 0.72, Spe = 0.69) for recurrent falls and 0.65 (Sen = 0.74, Spe = 0.48) for any falls. FRST-6 was comparable to CGA-10 and outperformed FFP in performance.

Conclusions

Age, depression, weight loss, gait, and balance were important risk factors of falls. The FRST-6 tool based on these factors showed acceptable performance in risk stratification.

Impact

Performing a multifactorial assessment in primary care clinics is urgent for falls prevention. The FRST-6 provides a simple and practical way for falls risk screening. With this tool, healthcare professionals can efficiently identify patients at risk of falling and make appropriate recommendations in resource-limited settings.

Patient or Public Contribution

No patient or public contribution was received, due to our study design.

Meta‐analysis of minimally invasive arthroscopy with sodium hyaluronate for wound healing of knee osteoarthritis treatment in the elderly

Abstract

Knee osteoarthritis (KOA) is not merely a medical condition—it is a prevalent and incapacitating ailment that significantly affects the quality of life for millions worldwide, especially as they age. The incidence of KOA increases year by year with increasing age. This study evaluated the therapeutic efficacy of combining arthroscopy with sodium hyaluronate (SH) in the treatment of wound healing of knee osteoarthritis (KOA) in elderly patients, with a focus on wound healing and overall joint function restoration. Randomized controlled trials (RCTs) evaluating the combination of arthroscopy and SH in geriatric KOA patients were identified through a systematic search of the scientific literature utilizing multiple databases and predefined search criteria. Ultimately, twelve investigations were included in the meta-analysis. Using Stata 15.1 software, data extraction and analysis were conducted using both fixed- and random-effects models, and a sensitivity analysis was conducted to assure the validity of the findings. Compared with arthroscopy alone, the combination of arthroscopy and SH significantly improved the efficiency rate, pain management (as measured by the Visual Analogue Scale), knee function (as measured by the Lysholm Knee Scoring Scale) and decreased levels of the pro-inflammatory cytokines IL-1 and IL-6. The meta-analysis revealed minimal heterogeneity between studies, and the sensitivity analysis validated the results' reliability. The incorporation of SH into arthroscopic procedures for elderly patients with KOA provides significant therapeutic benefits, including improved wound healing, reduced inflammation and enhanced joint function overall. These results support the use of this combined approach in the management of KOA in the elderly population and emphasize the need for additional research to optimize treatment protocols and comprehend long-term outcomes.

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