Conectar
by Ping Guo, Yuwen Liu, Xiaomi Huang, Yanfang Zeng, Zhonglan Cai, Guang Tu
BackgroundAcute pulmonary edema is a severe clinical condition with high mortality. The anion gap, reflecting metabolic acid-base disturbances, is often elevated in critically ill patients. However, its relationship with outcomes in acute pulmonary edema remains unclear.
ObjectiveTo explore the association between admission anion gap levels and 28-day all-cause mortality in patients with acute pulmonary edema.
MethodsThis retrospective cohort study utilized data from the MIMIC-IV database (2008–2019) and included adult patients with acute pulmonary edema. Patients were categorized into quartiles based on anion gap levels. Cox regression models analyzed the relationship between anion gap and mortality, with restricted cubic spline (RCS) curves, Kaplan-Meier analysis, and subgroup analyses.
ResultsA total of 1094 patients were included. Univariate Cox regression showed a positive correlation between anion gap levels and 28-day mortality (HR = 1.13, 95%CI: 1.09–1.17, P P P Conclusion
Admission anion gap levels predict 28-day all-cause mortality in acute pulmonary edema patients, particularly in younger patients and those without renal disease. Clinically, anion gap monitoring should be emphasized, and individualized prognostic and treatment strategies should be developed with factors like age and renal status to improve outcomes.
This study aims to explore the trajectories and co-occurrence of perceived control and caregiver self-efficacy among patients with heart failure (HF) and their caregivers within 3 months post-discharge and identify associated risk factors.
A prospective cohort design.
A prospective cohort study was conducted from March to June 2024 in Tianjin, China. Information on perceived control and caregiver self-efficacy was collected 24 h before discharge, 2 weeks, 1 month, and 3 months after discharge. Group-Based Dual Trajectory Modelling (GBDTM) and logistic regression were used for analysis.
The study included 203 dyads of patients with HF and their caregivers (HF dyads). Perceived control identified three trajectories: low curve (15.3%), middle curve (57.1%) and high curve (27.6%). Caregiver self-efficacy demonstrated three trajectories: low curve (17.2%), middle curve (56.7%) and high stable (26.1%). GBDTM revealed nine co-occurrence patterns, with the highest proportion (36.7%) being ‘middle-curve group for perceived control and middle-curve group for caregiver self-efficacy’, and 16.7% being ‘high-curve group for perceived control and high-stable group for caregiver self-efficacy’. Age, gender, household income, NYHA class, symptom burden and psychological resilience were identified as risk factors for perceived control trajectories; marital status, regular exercise and psychological resilience were identified as risk factors for caregiver self-efficacy trajectories.
We identified distinct trajectories, co-occurrence patterns and risk factors of perceived control and caregiver self-efficacy among HF dyads. These findings help clinical nurses to better design and implement interventions, strengthening the comprehensive management and care outcomes for HF dyads.
These findings highlighted the interactive relationship between perceived control and caregiver self-efficacy trajectories, suggesting that interventions should boost both to improve personalised treatment plans and outcomes for HF dyads.
This study adhered to the STROBE checklist.
Patients and their caregivers contributed by participating in the study and completing the questionnaire.
The effect of prehabilitation on reducing the level of postoperative stress and facilitating recovery has been proven to be controversial in previous studies involving patients with cancer. This review contributes to the improvement of an intervention programme by qualitatively integrating the prehabilitation experiences of patients with cancer.
This review aimed to integrate the individual experiences of patients with cancer who had received prehabilitation interventions to identify the barriers and facilitators to implementation, which can be used to understand patients' adherence behaviours.
This was a qualitative evidence synthesis review.
Articles were systematically searched from inception to February 18, 2025, using four English databases and three Chinese databases. Keywords and Medical Subject Headings were used to identify potential studies written in both Chinese and English. This study was performed using the Joanna Briggs Institute qualitative systematic review methodology.
Twenty-five articles were included in this review. Guided by the Theoretical Domains Framework (TDF), eight synthesised findings were extracted, focusing on the representation of factors influencing the adherence of patients with cancer to prehabilitation, including the domains of knowledge (two facilitators), reinforcement (two facilitators), beliefs about consequences (two facilitators), beliefs about capabilities (two barriers), environmental context and resources (two barriers, one intervention preference factor), social influence (one facilitator, one intervention preference factor), emotion (one barrier, one facilitator) and behavioural regulation (one facilitators, two intervention preference factors).
Our findings indicate that the adherence to prehabilitation among patients with cancer is shaped by a dynamic interplay of determinants. Structured assessments, self-monitoring, tailored interventions and tele-prehabilitation can improve patients' self-efficacy, perceived benefits and access to resources, which in turn can facilitate their completion of prehabilitation.
This study deepens our understanding of behaviours related to adherence to prehabilitation among patients with cancer and provides valuable guidance for the formulation and optimisation of subsequent prehabilitation intervention programmes.
ENTREQ.
No patient or public contributions.
PROSPERO CRD: 42024553972
To examine the effects of depression on dyadic self-care in stroke patients and their caregivers, as well as the potential mediating role of self-efficacy in this relationship.
A multi-centre cross-sectional study design was employed.
From May to September 2022, stroke patients and their caregivers were recruited from China using a multi-centre stratified sampling method. Data analysis was conducted using a structural equation model based on the Actor-Partner Interdependence Model extended to include mediation. Depression in patients and caregivers was assessed using the Patient Health Questionnaire-9. The self-care self-efficacy scale was utilised to measure patient self-efficacy, while the caregiver self-efficacy in contributing to patient self-care scale was used for caregivers. Patient self-care was evaluated with the Self-Care of Stroke Inventory and caregiver contributions to self-care were assessed using the Caregiver Contributions to Self-Care of Stroke Inventory.
This study followed the STROBE checklist.
306 patient-caregiver dyads were enrolled. The direct effect between depression and dyadic self-care was not confirmed in stroke patients and their caregivers (p > 0.05). Patient self-efficacy had significant indirect actor effects on self-care maintenance (β = −0.173, p < 0.001), monitoring (β = −0.146, p < 0.001) and management (β = −0.186, p < 0.001). Caregiver self-efficacy had an indirect actor effect on caregiver contributions to self-care maintenance (β = −0.096, p < 0.001), monitoring (β = −0.073, p < 0.001) and management (β = −0.106, p < 0.001). The partner effect analysis showed caregiver self-efficacy plays a potential mediating role in the relationship between patient depression and caregiver contributions to self-care maintenance (β = −0.037, p = 0.036), monitoring (β = −0.028, p = 0.032) and management (β = −0.040, p = 0.036). Caregiver depression reduced caregiver self-efficacy, lowering patient self-care monitoring (β = −0.040, p = 0.004) and management (β = −0.047, p = 0.002) levels.
The findings indicate interactive effects between depression, self-efficacy and dyadic self-care among stroke patients and their caregivers. Therefore, the development of targeted dyadic interventions to address depression and enhance self-efficacy in both patients and caregivers should be considered.
To investigate the real-world experiences of nurses' using smart glasses to triage patients in an urgent care centre.
A parallel convergent mixed-method design.
We collected data through twelve in-depth interviews with nurses using the device and a survey. Recruitment continued until no new themes emerged. We coded the data using a deductive-thematic approach. Qualitative and survey data were coded and then mapped to the most dominant dimension of the sociotechnical framework. Both the qualitative and quantitative findings were triangulated within each dimension of the framework to gain a comprehensive understanding of user experiences.
Overall, nurses were satisfied with using smart glasses in urgent care and would recommend them to others. Nurses rated the device highly on ease of use, facilitation of training and development, nursing empowerment and communication. Qualitatively, nurses generally felt the device improved workflows and saved staff time. Conversely, technological challenges limited its use, and users questioned its sustainability if inadequate staffing could not be resolved.
Smart glasses enhanced urgent care practices by improving workflows, fostering staff communication, and empowering healthcare professionals, notably providing development opportunities for nurses. While smart glasses offered transformative benefits in the urgent care setting, challenges, including technological constraints and insufficient organisational support, were barriers to sustained integration.
These real-world insights encompass both the benefits and challenges of smart glass utilisation in the context of urgent care. The findings will help inform greater workflow optimisation and future technological developments. Moreover, by sharing these experiences, other healthcare institutions looking to implement smart glass technology can learn from the successes and barriers encountered, facilitating smoother adoption, and maximising the potential benefits for patient care.
COREQ checklist (consolidated criteria for reporting qualitative research).
No patient or public contribution.
The aim of this study was to explore the association between transition shocks and professional identity and the mediating roles of self-efficacy and resilience among Chinese novice nurses.
Novice nurses experience transition shock when they start their careers, which might lead to decreased professional identity and ultimately turnover. By contrast, self-efficacy and resilience are excellent psychological resources that may be associated with higher professional identity. It is unclear how transition shock affects professional identity by influencing these two internal resources.
A cross-sectional survey.
The STROBE guidelines were followed to report this study. Convenience sampling was used to recruit participants, and 252 novice nurses completed the Transition Shock of Novice Nurses Scale, the Professional Identity Assessment Scale, the General Self-Efficacy Scale and the Connor-Davidson Resilience Scale between April 2022 and May 2022. Influencing factors were primarily identified using independent-sample t-tests and a one-way ANOVA. Structural equation modelling was used to detect the mediating effects of self-efficacy and resilience.
Differences in novice nurses' levels of professional identity were found across age groups, hospitals and departments. Transition shock was negatively related to professional identity. Self-efficacy and resilience mediated the complete chain relationship between transition shock and professional identity.
To our knowledge, this study is the first to explore the mediating effect of self-efficacy and resilience on transition shock and professional identity. Higher transition shock may lead to lower professional identity by reducing self-efficacy and resilience.
Nursing managers ought to emphasise the significant role of psychological resources in the work adaptation process of novice nurses. It may be more effective to improve professional identity and maintain the stability of the health care system.
Nursing administrators working at seven preselected hospitals actively assisted us in the process of collecting self-report questionnaires from novice nurses, such as by booking appointments and providing access for questionnaire administration. In addition, the participants were actively involved in the data collection process.
This study investigates the therapeutic potential of Qingre Huoxue Decoction (QHD), a traditional Chinese herbal formulation, in promoting wound healing in an imiquimod-induced murine model of psoriasis. The research was driven by the need for effective wound healing strategies in psoriatic conditions, where conventional treatments often fall short. Employing a combination of in vivo and in vitro methodologies, we assessed the effects of QHD on key factors associated with wound healing. Our results showed that QHD treatment significantly reduced the expression of angiogenic proteins HIF-1α, FLT-1, and VEGF, and mitigated inflammatory responses, as evidenced by the decreased levels of pro-inflammatory cytokines and increased expression of IL-10. Furthermore, QHD enhanced the expression of genes essential for wound repair. In vitro assays with HUVECs corroborated the anti-angiogenic effects of QHD. Conclusively, the study highlights QHD's efficacy in enhancing wound healing in psoriatic conditions by modulating angiogenic and inflammatory pathways, presenting a novel therapeutic avenue in psoriasis wound management.
To explore the knowledge, attitudes and practice (KAP) status of preventing pressure injury among clinical nurses working in paediatric ICU, and to examine factors affecting nurses' KAP. A questionnaire survey was conducted among 1906 paediatric ICU nurses in 18 children's hospitals by convenience sampling method. The survey tools were self-designed general data questionnaire, KAP questionnaire for the prevention of pressure injury and the influencing factors were analysed. A total of 1906 valid questionnaires were collected. The scores of overall KPA, knowledge, attitudes, and practice were 101.24 ± 17.22, 20.62 ± 9.63, 54.93 ± 5.81and 25.67 ± 6.76, respectively. The results of multiple linear regression analysis showed that education background, professional title, age and specialist nurse were the main influencing factor of nurses' knowledge of preventing PI; education background and specialist nurse were the main influencing factors of nurses' attitudes of preventing PI; knowledge, attitudes and education background were the main influencing factors of nurses' practice of preventing PI. Paediatric ICU nurses have a positive attitude towards the prevention of PI, but their knowledge and practice need to be improved. According to different characteristics of nurses, nursing managers should carry out training on the knowledge of prevention of PI to establish a positive attitude, so as to drive the change of nursing practice and improve the nursing practice level of ICU nurses to prevent of PI.
Diabetic foot ulcer often leads to amputation, and both nutritional status and immune function have been associated with this process. We aimed to investigate the risk factors of diabetic ulcer-related amputation including the Controlling Nutritional Status score and neutrophil-to-lymphocyte ratio biomarker. We evaluated data from hospital in patients with diabetic foot ulcer, performing univariate and multivariate analyses to screen for high-risk factors and Kaplan–Meier analysis to correlate high-risk factors with amputation-free survival. Overall, 389 patients underwent 247 amputations over the follow-up period. After correction to relevant variables, we identified five independent risk factors for diabetic ulcer-related amputation: ulcer severity, ulcer site, peripheral arterial disease, neutrophil-to-lymphocyte ratio and nutritional status. Amputation-free survival was lower for the moderate-to-severe versus mild cases, for the plantar forefoot versus hindfoot location, for the concomitant peripheral artery disease versus without and in the high versus low neutrophil-to-lymphocyte ratio (all p < 0.01). The results showed that ulcer severity (p < 0.01), ulcer site (p < 0.01), peripheral artery disease (p < 0.01), neutrophil-to-lymphocyte ratio (p < 0.01) and Controlling Nutritional Status score (p < 0.05) were independent risk factors for amputation in diabetic foot ulcer patients and have predictive values for diabetic foot ulcer progression to amputation.
To compare the predictive ability and reliability of two pressure injury (PI) assessment tools, the Neonatal/Infant(N/I) Braden Q and Braden QD scale, in neonates. A prospective and cross-sectional study. This study was conducted in the neonatal intensive care unit (NICU) of a tertiary-level university hospital in China between April and June 2023. A total of 410 patients were included in this study. Risk assessment was performed with the N/I Braden Q scale, followed immediately with the Braden QD scale once daily. Risk assessment was terminated when the PI developed or the patient was discharged from the NICU or died. Each patient's final risk assessment was considered in the data analysis. The area under the curve (AUC) of the two scales was 0.879 and 0.857, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and Cronbach's α coefficient of the N/I Braden Q Scale scores were 0.844, 0.833, 0.30, 0.984 and 0.806, respectively. The Braden QD scale scores were 0.938, 0.733, 0.229, 0.993 and 0.727, respectively. Both scales are valid and reliable in predicting the risk of PI in the NICU. The N/I Braden Q Scale was better to distinguish patients at PI risk and not at PI risk than the Braden QD scale. The literature is limited on this topic. This study provides insight into the comparison of different pressure injury risk assessment scales. The findings of this study may guide nurses to choose a suitable tool to assess the risk of pressure injury in neonates.
FreshRSS 