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To evaluate the effectiveness of nurse-led care (NLC) in patients with rheumatoid arthritis on disease activity, physical function, fatigue, satisfaction, pain, and quality of life.
Rheumatoid arthritis is a chronic autoimmune disease, which may not respond to insufficient rheumatology care capacity and workforce shortage. NLC is a care delivery model that can help address this shortage and improve disease management.
Systematic review and meta-analysis.
Nine databases were independently searched by two reviewers for eligible studies. Randomised controlled studies evaluating the effects of NLC on disease activity, physical function, fatigue, satisfaction, and other outcomes were included. The cochrane risk of bias tool was used to assess the risk of bias.
A total of nine studies involving 1447 participants were included. The pooled results indicated that no significant difference in disease activity was found at 0.5 years of follow-up (SMD: −0.33, 95% CI [−0.70, 0.04]), and a significant difference was seen in favour of NLC at 1 year (SMD: −0.35, 95% CI [−0.48, −0.10]), and 2 years (SMD: −0.29, 95% CI [−0.48, −0.10]). Moreover, no significant difference was found in fatigue and satisfaction at 0.5 years of follow-up, whereas differences in favour of NLC were seen at 1 year. In addition, no significant difference was found in physical function, pain, and quality of life.
This review indicated that NLC was not inferior to other types of care, and even had a better positive impact on disease activity, fatigue, and satisfaction for patients with rheumatoid arthritis.
Our study demonstrates that NLC is an effective approach to managing rheumatoid arthritis and recommends medical practitioners be well-versed in its importance.
Patients or public members were not directly involved in this study.
ClinicalTrials.gov identifier: CRD42022355963
To compare the predictive properties of the Jackson/Cubbin scale and Waterlow scales in intensive care unit patients. A multi-centre study. This study was conducted between April 2021 and February 2023 in 72 intensive care units of 38 tertiary hospitals in Gansu Province, China. All adults admitted to the intensive care unit for 24 hours or more without pressure injury on admission were screened using the Waterlow scale and Jackson/Cubbin scales in intensive care. Additionally, the negative predictive value, positive predictive value, sensitivity, specificity and receiver operating characteristic curve with area under the curve of the Waterlow scale and Cubbin/Jackson scales were determined. The participant population for this study included 6203 patients. Predictive properties for the Jackson/Cubbin scales and Waterlow scales, respectively, were as follows: Cut-off scores, 28 versus 22; AUC, 0.859 versus 0.64; sensitivity, 92.4% versus 51.9%; specificity, 67.26% versus 71.46%; positive predictive value, 35% versus 23%; negative predictive value, 99.9% versus 99.1%. Both Waterlow scales and Jackson/Cubbin scales could predict pressure injury risk for patients in the intensive care unit. However, the Jackson/Cubbin scale demonstrated superior predictive properties than the Waterlow scale.
Deep tissue injuries (DTIs) are a serious type of pressure injuries that mainly occur at the bony prominences and can develop rapidly, making prevention and treatment more difficult. Although consistent research efforts have been made over the years, the cellular and molecular mechanisms contributing to the development of DTIs remain unclear. More recently, ferroptosis, a novel regulatory cell death (RCD) type, has been identified that is morphological, biochemical and genetic criteria distinct from apoptosis, autophagy and other known cell death pathways. Ferroptosis is characterized by iron overload, iron-dependent lipid peroxidation and shrunken mitochondria. We also note that some of the pathological features of DTI are known to be key features of the ferroptosis pathway. Numerous studies have confirmed that ferroptosis may be involved in chronic wounds, including DTIs. Here, we elaborate on the basic pathological features of ferroptosis. We also present the evidence that ferroptosis is involved in the pathology of DTIs and highlight a future perspective on this emerging field, desiring to provide more possibilities for the prevention and treatment of DTIs.
FreshRSS 