Global, regional and national burden of glaucoma from 1990 to 2021 and projections to 2050: a retrospective cross-sectional study

Mediating Role of Psychological Capital, Coping Styles Between Neurotic and Negative Experiences in Chinese Nurses' Second Victims: A Cross‐Sectional Study

ABSTRACT

Background

Nurses commonly experience negative experiences after experiencing a patient safety event, triggering a domino effect on the nurses themselves, subsequent patients, and healthcare organisations, thus requires urgent attention.

Aims

To explore the mediating role of psychological capital and coping styles between neurotic personality and negative experiences of nurses' second victims, and to provide theoretical guidance for nursing administrators to develop targeted strategies to mitigate negative experiences of nurses' second victims.

Methods

In June–July 2023, a general information questionnaire, a neurotic personality subscale, the Chinese version of the Second Victim Experience and Support Scale, the Nurses' Psychological Capital Questionnaire, and the Coping Styles Questionnaire were used to conduct an online survey of 213 nurses' second victims and structural equation modelling was constructed to clarify the relationship between these elements.

Results

Psychological capital and coping styles partially mediated the relationship between neurotic personality and negative experiences in the nurses' second victims, with a total indirect effect value of 0.203 and a total effect value of 0.303, for a mediating effect of 33.00%.

Conclusion

Neurotic personality and immature coping styles negatively predict the degree of negative experience, while psychological capital and mature coping styles positively predict the degree of negative experience. Psychological capital and coping styles play a partial mediating role between neurotic personality and negative experience.

Impact

After a patient safety incident, nursing managers can mitigate the negative experiences of nurses' second victims in patient safety incidents by reducing their neurotic personality tendencies, enhancing their level of psychological capital, and guiding them to adopt mature coping styles.

Patient or Public Contribution

No patient or public contribution.

A 6-month longitudinal and comparative study of corneal biomechanical properties after SMILE with two different optical zone sizes

by Yizhuo Gong, Xinmeng Wang, Mingkun Yu, Peipei Zu

To precisely evaluate the independent influence of two different optical zone (OZ) sizes (6.3 mm vs. 6.5 mm) on corneal biomechanical properties within 6 months after Small Incision Lenticule Extraction (SMILE) using multivariable-adjusted statistical models.

This retrospective study included myopic patients who underwent SMILE between 2022 and 2024. Patients were grouped into two groups based on the planned OZ: Group A (6.3 mm, 44 eyes) and Group B (6.5 mm, 54 eyes). Corneal biomechanical parameters were measured using the Corvis ST preoperatively and at 1, 3, and 6 months postoperatively. Linear Mixed Models (LMM) were used to assess the independent effect of OZ size, adjusting for key baseline covariates and accounting for inter-eye correlation by including a random intercept for patient identifier (ID).

A total of 98 eyes were analyzed. Baseline analysis revealed a significant imbalance between the groups, with Group A (6.3 mm OZ) having higher myopia and a greater corneal stromal ablation depth (both P  0.05), with the sole exception of Ambrosio Relational Thickness Horizontal (ARTH) (P = 0.012). In contrast, several preoperative covariates, particularly corneal stromal ablation depth and preoperative central corneal thickness, were identified as significant predictors of multiple postoperative biomechanical parameters.

The independent effect of a 0.2 mm difference in optical zone size on corneal biomechanical properties after SMILE appears to be limited. After comprehensive statistical adjustment, the results suggest that preoperative anatomical and surgical parameters, especially corneal stromal ablation depth, are the primary drivers of the postoperative biomechanical response, rather than the minor difference in OZ size itself. This study underscores the importance of confounder adjustment in refractive surgery research and suggests that maximizing the residual stromal bed may be more critical for maintaining corneal biomechanical integrity than fine-tuning the optical zone diameter.

Safety of penicillamine and trientine in the treatment of Wilson’s disease: An analysis of the FDA Adverse Event Reporting System (FAERS) database

by Wenlong Qian, Kou Xu, Shuo Li, Zhuo Zhang, Xiaoxiao Hou, Bingjie Min, Jia Ling, Xinyu Zhu, Hui Zhou, Wenjuan Xu, Wenming Yang, Shijian Cao, Yonghua Chen

Penicillamine(D-Penicillamine) and trientine are first-line therapies for Wilson’s Disease (WD), yet real-world data on their adverse events (AEs) remain scarce. We analyzed the FDA Adverse Event Reporting System (FAERS) to comprehensively assess the safety of penicillamine and trientine in WD treatment.

AEs for penicillamine and trientine (2004Q1–2024Q4) were analyzed using Proportional Reporting Ratio (PRR), Reporting Odds Ratio (ROR), and Bayesian Confidence Propagation Neural Network (BCPNN).

We found 1,452 and 760 AEs related to penicillamine and trientine, respectively. In all adverse event (AE) reports, the ratio of females to males was approximately 1.3, with the highest proportion of AE reports in the 21–30 age group, and the largest number of AE reports coming from the United States. Signal detection showed that the most commonly reported AEs for penicillamine and trientine were drug hypersensitivity and tremor, respectively, with the highest proportions in the SOC categories of immune system disorders and gastrointestinal disorders. The main AEs for both drugs involved condition aggravated, and identified potential safety signals requiring further validation for the two drugs, such as decreased bone density and brain atrophy for penicillamine, and memory impairment, oesophageal ulcer and starvation for trientine. In addition, we found that women were more likely to experience drug hypersensitivity in penicillamine adverse event reports, while men were more likely to experience cutis laxa.

This study reveals the characteristics of AEs and potential associated risks in the clinical application of penicillamine and trientine, emphasizing individualized medication and vigilant monitoring strategies to provide guidance for safe medication use.

Extrinsic or intrinsic motivation? The incentive mechanism to target rural outreach services into remote locations within the county medical community: a mixed-methods study

Study on the Construction of Infection Risk Prediction Model for Central Venous Catheterisation in PICU and Preventive Measures

ABSTRACT

Aim(s)

To analyse the risk factors for central venous catheter-related infections in Paediatric Intensive Care Unit (PICU) patients, construct a risk prediction model and propose preventive strategies to reduce infection rates and improve patient outcomes.

Design

A retrospective cohort study was conducted to identify risk factors and develop a predictive model for central venous catheter-associated infections in PICU patients.

Methods

Clinical data from 312 PICU patients with central venous catheters hospitalised between September 2020 and August 2022 were retrospectively analysed. Patients were divided into an infection group (55 cases) and a no-infection group (257 cases). Univariate analysis identified potential risk factors, and multivariate logistic regression was used to construct a predictive model. The model's performance was evaluated using Receiver Operating Characteristic (ROC) curves, calibration curves and decision curve analysis.

Results

The incidence of central venous catheter-related infections in PICU patients was 17.26%. Prolonged catheter retention and repeated catheterisation were identified as independent risk factors, while heparin sealing and increased frequency of auxiliary material changes were protective factors. The predictive model achieved an area under the curve (AUC) of 0.793, demonstrating good accuracy and clinical utility.

Conclusion

The risk prediction model for central venous catheter-associated infections in PICU patients is simple, accurate and clinically valuable. It supports early identification of high-risk patients and informs targeted preventive measures to reduce infection rates and improve patient outcomes.

Prevalence of Frailty and Its Impact on Quality of Life in Older Patients With Breast Cancer: A Prospective Cross‐Sectional Study

ABSTRACT

Aims

To evaluate the prevalence of frailty and its impact on quality of life (QoL) in older Chinese breast cancer (BC) patients, which have not been thoroughly reported in this population.

Design

A prospective multi-centre cross-sectional registry study.

Data Sources

Data were collected from Cancer Hospital of the Chinese Academy of Medical Sciences, Peking University Third Hospital and Beijing Chaoyang District San Huan Cancer Hospital between October 2021 and July 2023.

Methods

BC patients aged over 65 years were enrolled in this study. They completed three assessment scales including the FRAIL scale, Hospital Anxiety and Depression Scale (HADS) and European Organization for Research and Treatment of Cancer Quality of Life questionnaire Core 30 (EORTC QLQ-C30), to screen for frailty, related factors and QoL. Clinical and pathological data were also collected. Analysis of frailty and prefrailty risk factors was performed via logistic regression. A multivariable linear regression model was used to evaluate the mean differences in scores for each QoL domain between patients with different frailty statuses.

Results

A total of 946 patients were enrolled from three hospitals in Beijing between October 2021 and July 2023. Their median age was 69 years and 73.6% of them had early-stage breast cancer. Further, 37.2% of these patients had ≥ 1 comorbidity. The prevalence of frailty was 8.8% and frailty was more common in those with aged ≥ 75 years (22.3%), those with advanced tumours (15.6%), those with anxiety (31.3%) and those with depression (29.3%). More than half (57.2%) of the patients were prefrail. Regression analysis revealed that older age (odds ratio [OR] 1.12 [95% CI 1.07–1.17], p < 0.001), an advanced tumour (OR 2.27 [1.33–3.89], p = 0.003), anxiety (OR 2.74 [1.37–5.48], p = 0.004) and depression (OR 3.84 [1.97–7.49], p < 0.001) were significantly associated with frailty. After adjusting for other factors, different frailty states were shown to be independent influencing factors for QoL in both the functional and the symptom domains (all p < 0.05).

Conclusions

Our study provides data on the prevalence of frailty and prefrailty in older Chinese patients with BC. Both conditions are closely related to poor QoL. It is helpful for oncologist and clinical care to making intervention and better treatment decisions.

Reporting Method

The study adhered to the STROBE checklist.

Implications for the Profession and Patient Care

This study provides detailed data on the prevalence of frailty in older Chinese patients with BC and correlative factors. It suggests that clinical care should fully assess patients' frailty before making treatment decisions and provide early intervention for related factors.

Patient or Public Contribution

Patients participated in the implementation of the project (including the informed consent and questionnaire process). No other public contribution to this research.

Relevance to Clinical Practice

This study provides data on the prevalence of frailty in Chinese older BC patients and correlative factors. It indicates that clinicians should fully assess patients' frailty before making treatment decisions and provide early intervention for related factors.

Trial Registration

ChiCTR2200056070

Development and Validation of a New Nomogram for Predicting Early Neurological Deterioration in Young and Middle‐Aged Individuals With Stroke in the Neurocritical Care Unit

ABSTRACT

Objective

To analyse risk factors for early neurological damage in young and middle-aged stroke cases.

Methods

Totally 405 young and middle-aged stroke patients in the neurocritical care unit (NCU) were selected and divided into the developmental (260 patients) and validation (145 patients) sets. The 405 cases were also grouped based on whether early neurological deterioration (END) occurred. The influencing factors of END were analysed by logistic regression, followed by the construction of a nomogram for predicting the risk of END. The Bootstrap method was applied to internally verify the predictive value of the model, using validation set data.

Results

Age, type of stroke, diabetes, mechanical ventilation, pulse, initial National Institute of Health stroke scale (NIHSS), Barthel index (BI), haemoglobin, hypersensitive C-reactive protein (hs-CRP), triglyceride glucose (TyG) index and CONUT showed statistically significant differences (p < 0.05). Logistic regression analysis revealed type of stroke, initial NIHSS, CONUT, TyG index and hs-CRP were risk factors for END in young and middle-aged stroke cases (OR > 1, p < 0.05). The area under the curve (AUC) for the developmental set was 0.842, and internal validation results showed a C-index of 0.843; the AUC for the validation set was 0.843.

Conclusion

The nomogram constructed in this study has good predictive efficacy and can provide reference for early clinical prediction of END in young and middle-aged stroke cases.

Relevance to Clinical Practice

The importance of this research lies in shedding light on the significant impact of early neurological deterioration on the health outcomes of young and middle-aged stroke patients, particularly in the short term. To guide clinical workers to identify risk factors early and improve the prognosis of stroke patients.

Fall risk perception in older adults: A concept analysis

Abstract

Background

Fall prevention is crucial for older adults. Enhanced fall risk perception can encourage older adults to participate in fall prevention programs. However, there is still no unified definition of the concept of fall risk perception.

Objective

To explore the concept of fall risk perception in older adults.

Design

A concept analysis.

Data Sources

The literature was searched using online databases including PubMed, Cochrane Library, Embase, CINAHL Complete, PsycINFO, Web of Science, China National Knowledge Infrastructure, WangFang and SinoMed. Searches were also conducted in Chinese and English dictionaries. The literature dates from the establishment of the database to April 2023.

Methods

The methods of Walker and Avant were used to identify antecedents, attributes and consequences of the concept of “fall risk perception” in older adults.

Results

Eighteen publications were included eventually. The attributes were identified as: (1) dynamic change, with features of continuum and stage; (2) whether falls are taken seriously; (3) a self-assessment of the fall probability, which is driven by individual independence; and (4) involves multiple complex emotional responses. The antecedents were identified as: (1) demographic and disease factors; (2) psychological factors and (3) environmental factors. The consequences were identified as: (1) risk-taking behaviour; (2) risk compensation behaviour; (3) risk transfer behaviour; and (4) emotions.

Conclusion

A theoretical definition of fall risk perception was identified. A conceptual model was developed to demonstrate the theoretical relationships between antecedents, attributes and consequences. This is helpful for the development of relevant theories and the formulation of fall prevention measures based on fall risk perception as the intervention target.

Comment on: Fear of recurrence in postoperative lung cancer patients: Trajectories, influencing factors and impacts on quality of life

The cognitive appraisal path of stroke knowledge, coping traits, family functioning and stigma among stroke patients: A moderated parallel mediation model

Abstract

Aims

To establish a cognitive appraisal path model that examines the impact of stroke knowledge on stigma with the parallel mediating effects of negative and positive coping traits, as well as the moderating effects of family functioning.

Background

Stroke-related stigma, a ‘mixture’ of negative emotions involving internal criticism and external judgement, has been shown to impair patients' health outcomes. However, the specific factors underlying cognitive appraisals and their pathways remain unknown.

Design

A cross-sectional design.

Methods

The cross-sectional sample was from two stroke centres in China. Questionnaires were administered to collect sociodemographic data, stroke knowledge, coping traits, family functioning and stigma. Hierarchical regression models and the moderated parallel mediation model were constructed to analyse influencing pathways. The study adhered to the strengthening the reporting of observational studies in epidemiology guideline.

Results

All 144 samples reported stigma symptoms with a moderate-to-high standardising score. The best hierarchical regression model explains 55.5% of the variance in stigma. The parallel mediation model indicated that negative and positive coping traits co-mediating the association of stroke knowledge and stigma. After adding the family functioning as a moderator, the moderated parallel mediation model was confirmed with adequate fit indices.

Conclusion

Among the cognitive appraisal factors affecting stroke-related stigma, stroke knowledge reduces stigma by modifying coping traits, while poor family functioning may serve as an opposing moderator. Notably, when family support is insufficient, enhanced stroke knowledge might paradoxically exacerbate the stigma.

Relevance to Clinical Practice

This study contributes knowledge on transforming health education and emphasises the pivotal roles of clinical nursing practitioners. In similar global contexts, the study highlights integrating health education, psychological counselling and family support to advance systematic nursing practices.

Patient or Public Contribution

None.