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Telephone-based telepsychiatry consultations: a qualitative exploration of psychiatrists experiences in Oman

Por: Al-Mahrouqi · T. · Al-Alawi · K. · Al-Sabahi · F. · Al-Harrasi · A. · Al-Sinawi · H. · Al-Balushi · N. · Al-Shekaili · M. · Al-Alawi · M.
Objectives

The utilisation of tele-mental health services has the potential to address challenges in mental health services within the Eastern Mediterranean Region. However, the adoption of tele-mental health in Oman remains limited. Therefore, this study aimed to explore the experiences of psychiatrists with telephone consultations, offering valuable insights to advance the field of telepsychiatry.

Design

This is a qualitative exploratory study. The analysis of the data involved the application of manifest content analysis.

Setting

The semi-structured interviews were conducted with the psychiatrists at Al Masarra Hospital.

Participants

A total of 10 semi-structured interviews were conducted.

Results

The study reveals that psychiatrists encounter communication challenges in telephone consultations, such as the absence of visual cues, confirming patient identity, conducting comprehensive assessments and effectively communicating with younger patients who may lack developed social skills or patients with specific health conditions. Infrastructure limitations, such as outdated medical records, lack of electronic prescriptions and limited availability of child/adolescent psychiatric medications, further restrict the effectiveness of telepsychiatry consultations. In contrast, telephone appointments offer convenience and flexibility for psychiatrists, allowing them to manage non-clinical responsibilities and provide focused consultations tailored to individual needs. In addition, it benefits patients by improving appointment adherence, diminishing stigma and financial savings compared with in-person consultations.

Conclusions

Tele-mental health has emerged as a promising avenue for enhancing mental healthcare services in Oman. Addressing psychiatrists’ challenges is crucial to further developing and strengthening these services.

Risk factors for medical adhesive-related skin injury at the site of peripherally inserted central venous catheter placement in patients with cancer: a single-centre prospective study from China

Por: Qi · M. · Qin · Y. · Meng · S. · Feng · N. · Meng · Y.
Objectives

This study aims to explore the incidence of, and risk factors for medical adhesive-related skin injury (MARSI) at peripherally inserted central venous catheter (PICC) sites in patients with cancer.

Design

A prospective observational cohort study was conducted at a tertiary hospital in Shenzhen, China.

Setting

This was a single-centre study conducted in a tertiary hospital in Shenzhen, China.

Participants

A total of 340 patients with cancer and PICC placement from January 2022 to June 2023 were selected using a convenience sampling method.

Methods

Factors potentially associated with PICC-related MARSI (PICC-MARSI) were recorded, including patient demographics, and catheter placement and maintenance. Patients were divided into MARSI and non-MARSI groups. Univariate analysis was performed to screen for associated variables, and logistic regression analysis was used to identify independent risk factors for PICC-MARSI.

Results

Of all 340 patients enrolled, 33 (9.7%) developed PICC-MARSI, including skin tear (8, 24.2%), tension injury (5, 15.2%), irritant contact dermatitis (10, 30.3%), allergic dermatitis (7, 21.2%) and maceration (3, 9.1%). Multivariable analysis showed that age (OR=1.058, p=0.001, 95% CI 1.023–1.094), wet skin (OR=4.873, p=0.003, 95% CI 1.728–13.742), dry skin (OR=6.247, p

Conclusions

Proper catheter maintenance and appropriate dressing selection are crucial for the prevention of this condition.

Family resilience, patient‐reported symptoms in young stroke dyads: The effect of caregiver readiness and social support

Abstract

Aims and Objectives

To investigate empirically the direct effect and potential mechanism of family resilience on patient-reported outcomes among young stroke dyads in China.

Background

Young patients with stroke have been becoming an important public health issue. According to relevant theories and previous studies, we found that family resilience might play an important role in patient's symptoms. However, it is less clear about the specific relationship and potential mechanisms of these two variables.

Design

We used a prospective cross-sectional design.

Methods

A multi-item questionnaire was used to assess the constructs of interest. Researchers progressively constructed and validated conditional process models. The PROCESS macro was used to verify the research hypotheses.

Results

A total of 560 questionnaires were collected in this study. We found that family resilience of stroke patients and their spouses had a direct effect on the physical, psychological and social aspects of patient-reported symptoms. We further revealed that caregiver preparedness partially mediated the relationship between family resilience and patient's symptoms in stroke patient-spouse dyads, while perceived social support moderated the relationship between caregiver preparedness and patient's symptoms. Finally, we observed that the impact of caregiver readiness and social support on patients' symptoms predominantly manifested in physical and physiological outcomes.

Conclusions

Our research provides evidence about the positive impact of family resilience on patient-reported symptoms in young stroke dyads. Meanwhile, it further revealed how caregiver preparedness and perceived social support may play out in the relationship.

Practice Implications

Our research introduces a novel perspective and pathway to enhance short-term recovery outcomes for patients. It also furnishes clinicians and nurses with evidence to guide the implementation of interventions aimed at improving patient health outcomes and facilitating smoother transitions from the hospital to home.

Impact

What problem did the study address?

Families play a crucial role in a patient's recovery process from illness, with family resilience serving as an important force for families to overcome adversity. However, the impact on patient symptoms and the underlying mechanisms of this relationship are uncertain. Empirical research is required to validate these aspects.

What were the main findings?

Family resilience has a positive impact on the physical, psychological and social aspects of patient-reported symptoms in young stroke dyads. Both the actor effect and partner effect are supported. The impact of caregiver readiness and social support on patient-reported symptoms is primarily observed in physical and physiological outcomes.

Where and on whom will the research have an impact?

This study offers a novel approach to enhance the short-term recovery of stroke patients. The researchers believe that the findings of this study will play an even more significant role during patients' transition from the hospital to home.

Reporting Method

This study followed the STROBE statement of cross-sectional studies.

Patient or Public Contribution

The study was conducted by patients, their spouses, healthcare professionals and the research team.

The effectiveness of interventions to reduce cancer‐related stigma: An integrative review

Abstract

Aims

The clinical significance of cancer-related stigma on patients' well-being has been widely established. Stigma can be perceived and internalised by cancer patients or implemented by the general population and healthcare workers. Various interventions have been carried out to reduce cancer-related stigma, but their effectiveness is not well-understood. This review aims to synthesise evidence on the effectiveness of interventions to reduce cancer-related stigma.

Design

An integrative review.

Methods

This integrative review combined both qualitative and quantitative studies and followed five steps to identify problems, search for the literature, appraise the literature quality, analyse data, and present data. Mixed Methods Appraisal Tool (version 2018) was applied to evaluate the quality of the included studies.

Data Sources

Databases included Web of Science, MEDLINE, SpringerLink, Wiley Online Journals, Cochrane Library, ScienceDirect, OVID, and China National Knowledge Infrastructure (from the inception of each database to 30 April 2021).

Results

Eighteen quantitative, six qualitative, and five mixed-methods studies were included in this review. Cultural factors should be considered when conducting interventions to reduce cancer-related stigma. For cancer patients, multi-component interventions have demonstrated a positive effect on their perceived stigma. For general population, interactive interventions show promise to reduce their implemented stigma towards cancer patients. For healthcare workers, there is a paucity of studies to reduce their implemented stigma. Existing studies reported inconclusive evidence, partially due to the lack of a robust study design with an adequate sample size.

Conclusions

Multi-component and interactive interventions show promise to relieve cancer-related stigma. More methodologically robust studies should be conducted in different cultures to elucidate the most appropriate interventions for different populations to reduce cancer-related stigma.

Implication for the Profession and Patient Care

These findings will facilitate healthcare workers to design and implement interventions to reduce cancer-related stigma, thus improving the quality of life for cancer patients.

Patient and Public Contribution

No patient and public contribution.

Factors associated with the intrinsic capacity in older adults: A scoping review

Abstract

Introduction

In 2015, the term ‘intrinsic capacity’ (IC) was proposed by the World Health Organisation to promote healthy aging. However, the factors associated with IC are still discrepant and uncertain.

Aim

We aim to synthesise the factors connected with IC.

Methods

This scoping review followed the five-stage framework of Arksey and O'Malley and was reported using PRISMA-ScR guidelines.

Results

In all, 29 articles were included. IC of older adults is associated with demographic characteristics, socioeconomic factors, disease conditions, behavioural factors, and biomarkers. Age, sex, marital status, occupation status, education, income/wealth, chronic diseases, hypertension, diabetes, disability, smoking status, alcohol consumption, and physical activity were emerged as important factors related to the IC of older adults.

Conclusions

This review shows that IC is related to multiple factors. Understanding these factors can provide the healthcare personnel with the theoretical basis for intervening and managing IC in older adults.

Relevance to Clinical Practice

The influencing factors identified in the review help to guide older adults to maintain their own intrinsic capacity, thereby promoting their health and well-being. The modifiable factors also provide evidence for healthcare personnel to develop targeted intervention strategies to delay IC decline.

No Patient or Public Contribution

As this is a scoping review, no patient or public contributions are required.

Meta‐analysis on the impact of immune senescence: Unravelling the interplay in cutaneous wound healing and lung cancer progression

Abstract

The primary objective of this meta-analysis was to provide the comprehensive understanding of the intricate correlation that existed between immune senescence and its effects on the advancement of lung cancer as well as recovery of cutaneous wounds. By conducting this systematic review of six rigorous studies utilizing databases such as PubMed and Web of Science, this research examined the multitude of facets pertaining to immune aging and consequences it bear on the health outcomes. The incorporated studies encompassed wide range of geographical and methodological viewpoints, with the specific emphasis on non-small-cell lung cancer and diverse scenarios related to wound recovery. This analysis synthesized discoveries regarding therapeutic responses, cellular and molecular mechanisms and impact of lifestyle factors on immune senescence. The findings suggested that immune senescence has substantial impact on the effectiveness of treatments for lung cancer and cutaneous wounds healing process; therefore, targeted therapies and holistic approaches may be able to mitigate these effects. By following the revised PRISMA guidelines, this meta-analysis guarantee thorough and ethically sound methodology for amalgamating pre-existing literature. The study concluded by emphasizing the critical nature of comprehending immune senescence in the context of clinical practice and proposed avenues for further investigation to enhance health results among the elderly.

Comparison of the risk of postoperative wound infection in patients with rectal cancer by laparoscopic versus open Hartmann's surgery

Abstract

Traditional Hartmann surgery is used when the patient is in an acute case where it might not be safe to carry out a one-stage intestinal anastomosis. Laparoscopy has been extensively applied in the treatment of large intestine, which can significantly improve both short- and long-term outcomes. While randomized, controlled studies and reviews have shown that laparoscopy is superior to that of open-access colectomy, the impact of Hartmann's surgery on postoperative site infections has not been studied. The purpose of this study is to summarize the existing evidence to show that laparoscopy is better than open operation in the area of injury. Methods The Embase, PubMed and Cochrane Libraries were searched from the moment the database was created until November 2023. For binary results, the odds ratio was estimated, and a weighted average of consecutive results was calculated. Our findings indicate that there is a lower risk for SSIs after laparoscopic approach surgery than an open-access procedure (OR, 0.26; 95% CI, 0.10, 0.69, p = 0.006); Laparoscopy was associated with a reduction in the risk of dying after surgery (OR, 0.50; 95% CI, 0.30, 0.84, p = 0.009); The operation time was not significantly different in open and laparoscope (MD, 12.23; 95% CI, −5.63, 30.09, p = 0.18); laparoscopy was used to lower the incidence of SSI after surgery and to lower the mortality rate after surgery than by open-access surgery. However, the time of operation did not differ significantly among the two methods. However, further controlled trials will need to be carried out to verify the results.

Evaluating the effectiveness of proactive perioperative nursing strategies on the prevention of surgical site infections and the enhancement of skin healing in paediatric abdominal surgery

Abstract

The present study aimed to investigate the comparative efficacy of proactive perioperative nursing interventions versus conventional perioperative nursing care in improving wound healing, reducing the incidence of surgical site infections (SSIs) and enhancing patient satisfaction among paediatric patients undergoing elective open abdominal surgery. A total of 100 paediatric patients were enrolled in a randomised controlled trial at our hospital between January 2021 and December 2022. Inclusion criteria were patients aged <18 years who met the requirements for surgical intervention and had no contraindications to surgery or anaesthesia. Patients were randomly assigned to either an observation group receiving proactive perioperative nursing care, or a control group subjected to conventional care. Primary outcome measures included surgical incision healing grades (A, B, C), infection rates confirmed by bacterial culture within 30 days post-surgery, patient satisfaction scores and length of hospital stay. Comprehensive statistical analyses were performed using IBM's SPSS software (version 27.0). Both groups demonstrated statistically similar baseline demographics and surgical parameters. However, the observation group showed significant improvement in wound healing outcomes (Grade A) and decreased incidence of complications (Grade C) and infections compared to the control group (P < 0.05). Patient satisfaction was significantly higher in the observation group, with 80% of patients reporting satisfaction as opposed to 20% in the control group (p < 0.05). The distribution of pathogenic bacteria in SSIs predominantly included Escherichia coli (E. coli), Pseudomonas aeruginosa, Enterococcus spp., Staphylococcus aureus and Klebsiella pneumoniae. Proactive perioperative nursing interventions demonstrate considerable benefits in improving wound healing, reducing surgical site infection rates and enhancing patient satisfaction in elective open abdominal surgery settings. However, these results require validation through large-scale trials.

Effect of intra‐wound vancomycin on the surgical site wound infection after spinal surgery: A meta‐analysis

Abstract

The topical application of the vancomycin in spine surgery is an effective method of reducing the incidence of postsurgical infections. However, there are differences in the prophylactic strategies used for various spinal surgeries. Therefore, the primary aim of this meta-analysis was to evaluate the effectiveness of the application of the intra-wound vancomycin during spine surgery. For this purpose, 100 studies were identified through different databases and search engines with various search terms such as ‘intrawound vancomycin in surgery’, ‘intrawound applications of vancomycin’, ‘vancomycin in surgery’, ‘intraoperative vancomycin’, ‘vancomycin spinal surgeries’, ‘treating surgical site infections in spinal surgeries using vancomycin’, ‘spinal surgery’, ‘vancomycin in spinal surgery’, ‘spine surgery’, ‘topical vancomycin’ and ‘local vancomycin’. Furthermore, the identified studies were reviewed thoroughly and finally, 19 studies were selected for meta-analysis. The selected studies were included based on the inclusion criteria and data was extracted from the selected studies. The pool of the statistically significant studies was further analysed using the ‘meta’ package of R version 4.3.2. The analysed data resulted in statistically significant results with a p-value <0.001 and the heterogeneity at 50% suggesting that the meta-analysis results may be significant in supporting the application of vancomycin at surgical sites to reduce the surgical site infections and eventually improve the postoperative conditions by reducing the long hospital stays.

Fruquintinib plus oxaliplatin combined with S-1 (SOX) as neoadjuvant therapy for locally advanced gastric cancer (GC) or gastro-oesophageal junction adenocarcinoma (GEJ): a multicentre, phase II, single-arm, open-label clinical trial (FRUTINEOGA) protocol

Por: Wu · L. · Yan · H. · Qin · Y. · Huang · M. · Wang · T. · Jin · Q. · Wei · W.
Introduction

Curing locally advanced gastric cancer (GC) or gastro-oesophageal junction adenocarcinoma (GEJ) with surgery alone is challenging. Neoadjuvant chemotherapy (NCT) has become the standard treatment for patients with locally advanced GC/GEJ, and SOX is the most common neoadjuvant regimen in China. The generally good tolerability in patients and fruquintinib’s low potential for drug–drug interaction suggest that it may be highly suitable for combinations with other antineoplastic therapies. A combination of fruquintinib, S-1 and oxaliplatin can be a promising neoadjuvant treatment for locally advanced GC/GEJ. In this phase II study, we aim to investigate the efficacy and toxicity of fruquintinib plus SOX as neoadjuvant treatment for locally advanced GC/GEJ.

Methods and analysis

The FRUTINEOGA trial is a prospective, multicentre, phase II, single-arm, open-label clinical trial that will enrol 54 patients. Eligible patients will be registered, enrolled and receive 2–4 cycles of fruquintinib plus SOX, after which surgery will be performed and tumour regression will be evaluated. The primary endpoint is the pathological remission rate, and the secondary endpoints are disease-free survival, overall survival, objective response rate, major pathological response rate and R0 resection rate.

Ethics and dissemination

Written informed consent will be required from all patients enrolled, and it will be provided by them. The study protocol received approval from the independent ethical review committee of Guangxi Medical University Cancer Hospital, Wuming Hospital of Guangxi Medical University and Wuzhou Red Cross Hospital, Wuzhou Gongren Hospital (approval number: CS2021(96)). We will submit the finalised paper for publication on completing the analyses. This study will provide valuable insights to clinicians regarding the safety and efficacy of incorporating fruquintinib into SOX as neoadjuvant treatment for locally advanced GC/GEJ. The findings have the potential to inform future research proposals and may guide the use of fruquintinib in the neoadjuvant setting for locally advanced GC/GEJ.

Trial registration number

NCT05122091.

Insight into Private General Physicians Practices: an Exploratory Qualitative Study in a Rural District of Pakistan

Por: Akber Pradhan · N. · Zaidi · T. W. · Siddiqi · S.
Objective

The study aimed to assess private general physicians’(GPs) healthcare practices, identifying perceived malpractices, the support they receive, and barriers they experience in providing healthcare services.

Design

Qualitative exploratory study.

Setting

Rural district, Thatta in Province of Sindh, Pakistan.

Participants

15 GPs.

Results

Our results include increased motivation among GPs for continued professional development, the high influence of pharmaceutical companies on providers’ prescribing practices, perceived malpractices by GPs, and the prevalence of quackery and ineffective regulatory mechanisms for private GPs in a rural district.

Conclusion

Our findings have implications for the capacity building of GPs by academic institutions, enforcement of regulatory measures by the authorities, and the introduction of measures to curb practices by unqualified practitioners. Finally, more research will be needed to further understand the perceptions of GPs, their needs and the service delivery interventions that will enhance the quality of care they provide.

Which aspects of patient experience are the 'moment of truth in the healthcare context: a multicentre cross-sectional study in China

Por: Chen · X. · Yuan · J. · Zhao · W. · Qin · W. · Gao · J. · Zhang · Y.
Objective

This study aimed to examine the differential magnitude of associations between specific dimensions of patient experience and overall patient satisfaction.

Design

A descriptive, cross-sectional design was used to collect patient experience and overall satisfaction data.

Setting

Participants were recruited at one tertiary general hospital, one tertiary specialised hospital, and one secondary hospital in Shanghai, China. These three institutes represent the main kinds of hospitals in the Chinese healthcare system.

Participants

1532 inpatients were recruited, and 1469 were included. The inclusion criteria were as follows: (1) having received inpatient service for at least 2 days; (2) able to understand the questions in the questionnaires; and (3) aged>18 years old. Patients who had impaired cognitive function and completed the questionnaires with missing information were excluded.

Primary and secondary outcome measure

Patient experience was measured using the Inpatient Experience with Nursing Care Scale, which is widely used in the China. The overall patient satisfaction was measured with 10-point response option.

Results

The LASSO (least absolute shrinkage and selection operator) regression results showed that as the penalty factor () = 0.0162, age, marriage status, financial status, length of hospital stay and numbers of previous of hospitalisation and six dimensions of nursing care remained in the model. As increases to 0.1862, only four patient experience variables, potentially the most influential on patient satisfaction, remained in the model. Patient experience with emotional support was the most significant dimension explaining patient satisfaction (β=0.1564), the second most significant dimension was admission and discharge management (β=0.1562), and the third was monitoring and coping with the progress of diseases (β=0.0613).

Conclusion

Patient experience with emotional support, admission and discharge management, monitoring and coping with the progress of diseases, and information and education are the most significant dimensions explaining patient satisfaction.

Study protocol for a prediction model for mild cognitive impairment in older adults with diabetes mellitus and construction of a nurse-led screening system: a prospective observational study

Por: Miao · W. · Lu · Y. · Xv · H. · Zheng · C. · Yang · W. · Qian · X. · Chen · J. · Geng · G.
Introduction

With an increasing number of older adults in China, the number of people with cognitive impairment is also increasing. To decrease the risk of dementia, it is necessary to timely detect mild cognitive impairment (MCI), which is the preliminary stage of dementia. The prevalence of MCI is relatively high among older adults with diabetes mellitus (DM); however, no effective screening strategy has been designed for this population. This study will construct a nurse-led screening system to detect MCI in community-dwelling older adults with DM in a timely manner.

Methods and analysis

A total of 642 participants with DM will be recruited (n=449 for development, n=193 for validation). The participants will be divided into MCI and none-MCI groups. The candidate predictors will include demographic variables, lifestyle factors, history of diseases, physical examinations, laboratory tests and neuropsychological tests. Univariate analysis, least absolute shrinkage and selection operator regression screening, and multivariate logistic regression analysis will be conducted to identify the outcome indicators. Based on the multivariate logistic regression equation, we will develop a traditional model as a comparison criterion for the machine learning models. The Hosmer-Lemeshow goodness-of-fit test and calibration curve will be used to evaluate the calibration. Sensitivity, specificity, area under the curves and clinical decision curve analysis will be performed for all models. We will report the sensitivity, specificity, area under the curve and decision curve analysis of the validation dataset. A prediction model with better performance will be adopted to form the nurse-led screening system.

Ethics and dissemination

This prospective study has received institutional approval of the Medical Ethics Committee of Qidong Hospital of TCM (QDSZYY-LL-20220621). Study results will be disseminated through conference presentations, Chinese Clinical Trial Registry and publication.

Trial registration number

ChiCTR2200062855.

Quantitative assessments of retinal macular structure among rural-dwelling older adults in China: a population-based, cross-sectional, optical coherence tomography study

Por: Zhang · Q. · Zhang · C. · Wang · Y. · Cong · L. · Liu · K. · Xu · Z. · Jiang · C. · Zhou · W. · Zhang · C. · Dong · Y. · Feng · J. · Qiu · C. · Du · Y.
Objectives

To quantitatively assess and compare retinal macular structures of rural-dwelling older adults in China using two different optical coherence tomography (OCT) scanners and to examine their associations with demographic, lifestyle, clinical and ocular factors.

Design, setting and participants

This population-based, cross-sectional study included 971 participants (age ≥60 years) derived from the Multimodal Interventions to Delay Dementia and Disability in Rural China study. We collected data on demographics, lifestyle factors, clinical conditions (eg, cardiovascular disease (CVD)) and ocular factors (eg, visual acuity and spherical equivalent). We used two models of spectral-domain OCT to measure macular parameters in nine Early Treatment Diabetic Retinopathy Study subfields. Data were analysed using the multiple general linear models.

Results

Spectralis OCT demonstrated higher macular thickness but a lower macular volume than Primus 200 OCT (p

Conclusions

Macular thickness and volume assessed by Spectralis and Primus 200 OCT scanners differ. Older age and female sex are associated with lower macular thickness and volume. Macular parameters are associated with education, CVD and spherical equivalent.

Trial registeration number

MIND-China study (ChiCTR1800017758).

Pivotal relationship between heavy metal, PM2.5 exposures and tuberculosis in Bangladeshi children: protocol paper of a case-control study

Por: Haque · R. · Hanson · M. · Shariful Islam · M. · Akter · N. · Moniruzzaman · M. · Alam · M. J. · Kamruzzaman · M. · Rahman · M. · Chisti · M. J. · Raqib · R. · Rahman · S. M.
Introduction

Air pollution is a global issue that poses a significant threat to public health. Children, due to their developing physiology, are particularly susceptible to the inhalation of environmental pollutants. Exposure can trigger immune modulation and organ damage, increasing susceptibility to respiratory diseases. Therefore, we aim to examine the association between heavy metal and particulate matter exposure with tuberculosis in children.

Methods and analysis

As a case–control study, we will include children diagnosed with pulmonary tuberculosis (n=60) and matched healthy controls (n=80) recruited from the same communities in Dhaka, Bangladesh. Exposure data for both cases and controls will be collected by a trained field team conducting home visits. They will administer an exposure questionnaire, measure child anthropometry, collect blood and household dust samples and instal 48-hour air quality monitors. The blood samples will be analysed by inductively coupled plasma mass spectrometry for serum heavy metal concentrations (lead, cadmium, arsenic, mercury and chromium), as a representative marker of exposure, and the presence of inflammatory biomarkers. Descriptive and inferential statistics, including independent samples t-tests, analysis of variance and conditional regression analysis, will be used to quantify heavy metal and particulate matter exposure status in tuberculosis cases compared with healthy controls, while accounting for potential confounders. Dust samples and air quality results will be analysed to understand household sources of heavy metal and particulate matter exposure. To test the study hypothesis, there is a positive association between exposure and tuberculosis diseases, we will also measure the accumulated effect of simultaneous exposures using Bayesian statistical modelling.

Ethics and dissemination

This study has been approved by International Centre for Diarrhoeal Disease Research, Bangladesh’s Institutional Review Board (PR-22030). The study findings will be disseminated at conferences and published in peer-reviewed journals.

Contribution of non‐socioeconomic factors to healthy quality of life in socioeconomically deprived patients with advanced gastrointestinal cancer: Measuring attributable fraction

Abstract

Background

The quality of life of patients with advanced gastrointestinal cancer is seriously impaired, and socioeconomic deprivation often has a serious impact on their quality of life. However, little is known about the relative contribution of non-socioeconomic factors to the quality of life of patients with advanced gastrointestinal cancer with socioeconomic deprivation.

Aim

This study aims to investigate the situation and predictors of quality of life of patients with socioeconomic deprivation and evaluate the independent effects of some non-socioeconomic factors.

Design

A retrospective study based on cross-sectional design.

Methods

Data were obtained from 1075 patients with advanced gastrointestinal cancer who received family palliative treatment in the hospice ward of Zhongnan Hospital of Wuhan University from March 2010 to October 2020, including demographic and clinical questionnaires, Karnofsky Performance Status scale and Cancer Pain and Quality of Life Questionnaire of Chinese Cancer Patients.

Results

The quality of life of patients with advanced gastrointestinal cancer with socioeconomic deprivation is impaired and is affected by gait, self-care ability, abdominal distension, nutritional status, weight loss, constipation and posture. Improvement in six of these factors—gait, self-care ability, abdominal distension, nutritional status, weight loss and posture—has an independent positive impact on the development of a healthy quality of life for patients.

Conclusions

Gait, self-care ability, abdominal distension, nutritional status, weight loss and posture are important determinants of healthy quality of life in patients with advanced gastrointestinal cancer with socioeconomic deprivation, and early identification and strength management of these non-socioeconomic factors may neutralize the negative impact of socioeconomic factors on the quality of life.

Implications for Practice

This study provides new ideas and intervention entry points for global nurses in practice innovations to improve the quality of life of socioeconomically deprived patients with advanced gastrointestinal cancer. It enables them to focus on the effectiveness of non-socioeconomic factors in the development and implementation of targeted care plans for patients with advanced gastrointestinal cancer experiencing socioeconomic deprivation globally.

Reporting Method

This study was reported in strict compliance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline.

Patient or Public Contribution

No patient or public contribution.

Readiness for hospital discharge and its association with post‐discharge outcomes among oesophageal cancer patients after oesophagectomy: A prospective observational study

Abstract

Aim

To examine the level and influencing factors of discharge readiness among patients with oesophageal cancer following oesophagectomy and to explore its association with post-discharge outcomes (post-discharge coping difficulty and unplanned readmission).

Background

Oesophageal cancer is common and usually treated via oesophagectomy in China. The assessment of patient's discharge readiness gradually attracts attention as patients tend to be discharged more quickly.

Design

Prospective observational study. The STROBE statement was followed.

Methods

In total, 154 participants with oesophageal cancer after oesophagectomy were recruited in a tertiary cancer centre in Southern China from July 2019 to January 2020. The participants completed a demographic and disease-related questionnaire, the Quality of Discharge Teaching Scale and Readiness for Hospital Discharge Scale before discharge. Post-discharge outcomes were investigated on the 21st day (post-discharge coping difficulty) and 30th day (unplanned readmission) after discharge separately. Multiple linear regressions were used for statistical analysis.

Results

The mean scores of discharge readiness and quality of discharge teaching were (154.02 ± 31.58) and (138.20 ± 24.20) respectively. The quality of discharge teaching, self-care ability, dysphagia and primary caregiver mainly influenced patient's discharge readiness and explained 63.0% of the variance. The low discharge readiness could predict more risk of post-discharge coping difficulty (r = −0.729, p < 0.01) and unplanned readmission (t = −2.721, p < 0.01).

Conclusions

Discharge readiness among patients with oesophageal cancer following oesophagectomy is influenced by various factors, especially the quality of discharge teaching. A high discharge readiness corresponds to good post-discharge outcomes.

Implications for the Profession and Patient Care

Healthcare professionals should improve the discharge readiness by constructing high-quality discharge teaching, cultivating patients' self-care ability, mobilizing family participation and alleviating dysphagia to decrease adverse post-discharge outcomes among patients with oesophageal cancer.

Patients or Public Contribution

Patients with oesophageal cancer after oesophagectomy who met the inclusion criteria were recruited.

Interventions to address parenting stress among caregivers of children with chronic diseases: An umbrella review

Abstract

Background

Caregivers of children with chronic diseases suffer from great parenting pressure, which directly affects the treatment and rehabilitation of children, reduces the quality of life of caregivers and damages family functioning. Existing reviews have not systematically summarized and evaluated interventions for parenting stress in caregivers of children with chronic diseases.

Data Sources

Embase, PubMed, Web of Science, OVID, CNKI, CBM, Wan Fang and Cochrane Library were searched for eligible reviews in November 2021 and October 2022.

Methods

Two reviewers independently screened titles and abstracts, reviewed full texts of articles for eligibility, and appraised the quality of reviews using JBI. The quality of the evidence was assessed using GRADE. Findings are reported in accordance with PRISMA checklist. Narrative summaries grouped findings by intervention types.

Results

Out of 2632 records, we included 21 systematic reviews for a synthesis. Interventions for parenting stress in children with chronic diseases were divided into seven categories. Cognitive behavioural interventions, psychosocial interventions, child behavioural and/or developmental parent interventions and synthesized interventions have shown high-level evidence in reducing parenting stress for caregivers of children with chronic diseases. Furthermore, outcome measures and intervention protocols were highly heterogeneous across interventions.

Conclusions

This umbrella review suggest that reducing the parenting stress of caregivers of children with chronic diseases can directly target caregivers' parenting stress through cognitive behavioural interventions/psychosocial interventions and/or provide guidance to parents on the behavioural and developmental problems of children with chronic diseases. A more standardized approach to outcome measures is essential to assess efficacy and compare interventions across studies.

Relevance to Clinical Practice

The findings provide information and evidence for reducing parenting stress among caregivers of children with chronic diseases to guide the development of comprehensive intervention strategies.

Patient or Public Contribution

Patient or public contribution does not apply to this study.

Best practices for managing malodorous and infected wounds in advanced cervical cancer

Abstract

This cross-sectional study was conducted to examine the most effective strategies for managing malodorous and infected wounds in patients who have been diagnosed with advanced cervical cancer. The research was conducted in Liupanshui, China. The study specifically examined demographic profiles, wound characteristics and effectiveness of wound management approaches. The study incorporated the heterogeneous sample of 289 participants who fulfilled the inclusion criteria. Data collection was conducted via structured questionnaires and medical record evaluations. Descriptive statistics and statistical analyses, such as regression analysis, were utilized to evaluate demographic attributes, wound profiles and effects of different approaches to wound management. The findings unveiled the heterogeneous demographic composition of patients, encompassing differences in socioeconomic standing, educational attainment and age. A wide range of wound characteristics were observed, as 65.7% of lesions during the acute phase with diameter between 2 and 5 centimetres, while 41.5% of lesions had this range. The most prevalent types of infections were those caused by fungi (48.4%), followed by bacterial infections lacking resistance (38.1%). A moderate degree of odour intensity was prevalent, affecting 45.0% of the cases. With maximal odour reduction of 80%, a mean healing time of 25 days and patient satisfaction rating of 4.5 out of 5, Negative Pressure Wound Therapy demonstrated itself to be the most efficacious treatment method. Additional approaches, such as photodynamic therapy and topical antibiotic therapy, demonstrated significant effectiveness, as evidenced by odour reductions of 70% and 75%, respectively, and patient satisfaction ratings of 4.3 and 4.2. Thus, the study determined challenges associated with management of malodorous and infected lesions among patients with advanced cervical cancer. The results underscored the significance of individualized care approaches, drew attention to efficacious wound management techniques and identified critical determinants that impacted patient recuperation. The findings of this study hold potential for advancing palliative care for individuals diagnosed with advanced cervical cancer.

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