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To rigorously examine the association between catheterisation duration and urinary tract infections among geriatric patients with hip fractures.
Retrospective cohort study.
We analysed data from 872 patients aged 60 years and older, treated at a tertiary care hospital between January 2022 and May 2023. To address missing data, we employed multiple imputations using chained equations (50 iterations). A comprehensive set of statistical methods, including multivariate logistic regression, generalised additive models, and smooth curve fitting techniques, was applied to investigate variable relationships. Additionally, we used a two-piecewise binary logistic regression model to further elucidate nonlinear associations.
The cohort included 296 males and 576 females, with an overall urinary tract infection prevalence of 25.3%. Multivariate smooth spline analysis revealed a nonlinear relationship between catheterisation duration and urinary tract infection. This finding suggested that the risk of urinary tract infection increased by 2.8% for every 10-h increase with an indwelling duration < 106 h. However, the risk no longer significantly increased with an indwelling duration of ≥ 106 h. Sensitivity and interaction analyses confirmed the robustness of these results.
This study identified an inverse L-shaped relationship between catheterisation duration and urinary tract infection. Given the potential for confounding, further investigations are necessary to validate these findings and explore their implications for clinical practice.
Nurses should prioritise early catheter removal protocols to mitigate infection risk, coupled with enhanced surveillance within the first 106 h after insertion.
Adhered to STROBE guidelines for observational studies.
No public Contribution. Patients contributed through data collected from the Hospital Information System, which was used for analysis.
Many studies have identified the negative psychological impact of in vitro fertilisation and embryo transfer (IVF-ET) on couples with infertility, but there remains a paucity of research clarifying both positive and negative effects within the context of Chinese culture.
To explore the dynamic psychosocial experiences and underlying mechanisms of couples in the whole process of IVF-ET, and to construct a theoretical framework that elucidates this phenomenon within the context of Chinese social-culture.
A grounded theory study.
Guided by constructivist grounded theory methodology, semi-structured face-to-face interviews were conducted in the reproductive medicine outpatient department of a tertiary-level hospital located in northwest China between January and October 2023. Purposive and theoretical sampling methods were used to recruit couples undergoing IVF-ET. Data were analysed through three iterative steps: initial coding, focused coding, and theoretical coding, utilising constant comparative methods and reflective memo-writing. The study is reported using the COREQ checklist.
Theoretical saturation was achieved after interviewing 22 couples. The substantive theory was synthesised into one core category: ‘forward or backward’, which captured the ambivalent psychosocial experiences of couples undergoing IVF-ET within the context of Chinese culture. This theory described three overarching stages: making the decision, undergoing the treatment, and facing the result, with each stage linked to specific promoting and hindering factors.
This study establishes a theoretical foundation for further implementation of comprehensive reproductive health management within the Chinese sociocultural context. It is crucial for healthcare providers and policymakers to focus on the dyad of couples undergoing IVF-ET, pay attention to both negatively and positively psychosocial fluctuations, and enhance both medical care and sociocultural support systems accordingly.
No patient or public contribution.
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