Living well or not? Quality of life of parental living liver donors: A cross-sectional study.

AIM: The aim of this study was to gain comprehensive insight into the quality of life of parental living liver donors after liver donation. BACKGROUND: Several studies reported good quality of life of living liver donors with the SF-36 scale. Care demand from the recipient and responsibility of being parent might make a difference in parental donors' personal experienced quality of life after transplantation surgery. METHODS: It is a cross-sectional study. The parental donors' demographics, clinical data and post-donation complications were obtained. Quality of life was assessed using the Medical Outcomes Study SF-36 and the Quality of Life Scale of Living Organ Donors-Common Module. PATIENT OR PUBLIC CONTRIBUTION: The enrolled participants were contacted by electronic questionnaires and telephonic interview. RESULTS: A total of 345 parental donors were included, with recruited period ranging from 3 to 85 months post-donation. 8.1% of donors had post-operative complications, mostly classified as Clavien grade II. Donors' general quality of life was higher than the Chinese general norm. Issues related to surgical incision, fatigue, worries about income and personal health, effects on work capability, increased medical expenses and difficult reimbursement and suspected donation decision were the prominent problems among donors. Mother-son relationship (OR = 1.87) and equal or less than 2 years after donation (OR = 3.08) were the influencing factors for poor physical quality of life, while unmarried status (e.g. divorced or widowed) was found negatively associated with mental quality of life (adjusted OR = 3.61). CONCLUSIONS: General health among parental donors is good but those female, unmarried and near post-donation might in low life quality. Incision, fatigue, finance, reimbursement and donation decision are prominent problems. RELEVANCE TO CLINICAL PRACTICE: Post-donation care of living donors should cover social and financial domain besides physical and mental dimension. Providing follow-up care and counselling is necessary to ensure their life quality.

The Application of Computer Technology to Clinical Practice Guideline Implementation: A Scoping Review.

Implementation of clinical practice guidelines (CPG) is a complex and challenging task. Computer technology, including artificial intelligence (AI), has been explored to promote the CPG implementation. This study has reviewed the main domains where computer technology and AI has been applied to CPG implementation. PubMed, Embase, Web of science, the Cochrane Library, China National Knowledge Infrastructure database, WanFang DATA, VIP database, and China Biology Medicine disc database were searched from inception to December 2021. Studies involving the utilization of computer technology and AI to promote the implementation of CPGs were eligible for review. A total of 10429 published articles were identified, 117 met the inclusion criteria. 21 (17.9%) focused on the utilization of AI techniques to classify or extract the relative content of CPGs, such as recommendation sentence, condition-action sentences. 47 (40.2%) focused on the utilization of computer technology to represent guideline knowledge to make it understandable by computer. 15 (12.8%) focused on the utilization of AI techniques to verify the relative content of CPGs, such as conciliation of multiple single-disease guidelines for comorbid patients. 34 (29.1%) focused on the utilization of AI techniques to integrate guideline knowledge into different resources, such as clinical decision support systems. We conclude that the application of computer technology and AI to CPG implementation mainly concentrated on the guideline content classification and extraction, guideline knowledge representation, guideline knowledge verification, and guideline knowledge integration. The AI methods used for guideline content classification and extraction were pattern-based algorithm and machine learning. In guideline knowledge representation, guideline knowledge verification, and guideline knowledge integration, computer techniques of knowledge representation were the most used.

[A Health Education Program for Home Emergency Management of Acute Complications of Diabetes in the Elderly].

Objective To establish a health education program for home emergency management of acute complications of diabetes in the elderly.Methods The program was drafted by literature review and panel discussion.The final draft was formed after two rounds of correspondence from 13 experts.Results The recovery rate of the two rounds of expert correspondence was 100%,and the expert authority coefficient was 0.98.The Kendall's harmony coefficients of the two rounds of correspondence were 0.263 and 0.212 respectively(both P<0.001).The established health education program included indicators of three categories:early stage of acute complications of diabetes at home(understanding the inducing factors),emergency warning(quick and early identification in case of emergency),and emergency treatment at home.Conclusion The contents of the health education program are systematic and reliable and meet the needs of health education for home emergency management of the elderly with diabetes.

"Jolly fat" or "sad fat": a systematic review and meta-analysis of the association between obesity and depression among community-dwelling older adults.

OBJECTIVE: To review the evidence and explore the association between obesity and depression in community-dwelling older adults. METHODS: We searched 6 electronic databases from inception to November 28, 2019. Observational studies investigating the association between obesity and depression among community-dwelling older adults aged 60 years or older were included. Two reviewers independently screened the studies, extracted the data and assessed the quality of the studies. The eligible studies were meta-analysed using the Comprehensive Meta-analysis Version 3.0. RESULTS: Among the 16,059 studies identified from these databases, 19 studies meeting the inclusion criteria were included, of which 14 were meta-analysed. Meta-analyses showed that older adults who were overweight (pooled odds ratio: 0.847, 95% CI:0.789-0.908, p < 0.001) or obesity (pooled odds ratio: 0.795, 95% CI:0.658-0.960, p = 0.017) - assessed using the body mass index - were significantly less likely to be depressed than their counterparts with a normal weight. No significant association between obesity (as measured via waist circumference) and depression was detected (pooled odds ratio: 0.722, 95% CI:0.465-1.119, p = 0.145) in this group population. The subgroup analyses demonstrated that both female and male older adults with overweight/obesity were significantly less likely to have depression. CONCLUSIONS: The "jolly fat" hypothesis is deemed to be applicable among community-dwelling older adults. Older adults might, therefore, be encouraged to increase their body weight above the normal level to be mentally healthy. Monitoring intentional weight loss among older adults should be reinforced for public health strategies.

Understanding professionals' perspectives and experiences of elder self-neglect: A systematic review and meta-synthesis of qualitative studies.

PURPOSE: To systematically review and synthesize the findings on various professionals' perspectives of elder self-neglect (ESN) and/or their experiences with ESN. DESIGN: A systematic qualitative review was used. METHODS: Primary qualitative studies published either in English or Chinese until August 2020 were systematically searched in the following databases: PubMed, Web of Science, Embase, CINAHL Plus, PsycINFO, Wanfang Data, and China National Knowledge Infrastructure (CNKI). FINDINGS: Eleven studies were included. Five subthemes including retaining a sense of normalcy/identity, service refusal, isolation, contributing factors in ESN, and manifestations and consequences of ESN were included in the overarching theme of ESN features. Another two subthemes, emotional and ethical dilemmas in caring for self-neglecters and management strategies, were included under the second overarching theme of complicated experiences managing cases of ESN. CONCLUSIONS: This qualitative synthesis provides a deep and comprehensive insight into professionals' perspectives and experiences of self-neglect in older adults. Understanding professionals' perspectives of ESN can help with the knowledge and theory development pertinent to this particular phenomenon. CLINICAL RELEVANCE: Findings are valuable in informing the provision of funds and structural, informational, and emotional support systems development for professionals managing ESN cases. Establishing a strong link between ESN case management and improved outcomes in older self-neglecters is essential to establish a definite need for the provision of support, resource, and stardardized guidelines for these professionals.

Global nursing research activity from 2009 to 2020: A bibliometric analysis.

AIM: Bibliometric analysis of the nursing literature can provide insights into the current state and dynamics of the nursing profession. This study aimed to assess global nursing-related research activity from 2009 to 2020. METHOD: The corpus of nursing papers was harvested from the Web of Science Core Collection database. The bibliometric indicators and VOSviewer mapping of the retrieved papers were presented. RESULTS: The search found 109,782 papers, and 39.0% of papers reported funded studies. Publication numbers were increasing. The USA was the most prolific country in literature production and international collaboration in nursing studies. International cooperation in nursing research was dominated by developed regions. Among the 20 most cited articles, 75% were published in first quartile journals, and review papers received a higher number of citations than original research articles. Author keyword analysis identified 'quality of life', 'mental health', 'nursing students' education' and 'adolescent' as common nursing focus topics. CONCLUSIONS: The publication trend of nursing papers was positive. However, several problems were associated with nursing research activity, including low research funding, regionally centred research activity and inactivity of developing regions in terms of international collaborations, which need to be addressed by policy makers, nursing managers and scholars.

Immortal time bias exaggerates the effect of metformin on the risk of gastric cancer: A meta-analysis.

High heterogeneity has been reported among epidemiological studies exploring the relationship between metformin and the risk of gastric cancer. Immortal time bias might be one of the vital factors causing heterogeneity because of its widespread existence in pharmacological observational studies and it could severely exaggerate the drug's effectiveness. Immortal time bias could occur in an observational study if exposure status is determined based on a measurement or event that occurs after baseline. In this study, we aimed to assess whether immortal time bias is responsible for the false assumption that metformin reduces the risk of gastric cancer. We searched PubMed, Embase, Web of Science and Cochrane Library databases for relevant studies from the inception to August 9, 2020. The strength of the relationship was assessed using pooled relative risks (RRs) with corresponding 95% confidence intervals (95% CIs). Statistical analyses were carried out using a random-effects model. Pooled RR from 6 cohort studies with immortal time bias found a clear 33% reduced risk associated with metformin use (RR = 0.67, 95% CI = 0.59, 0.77; P < 0.001; I2 = 48.5%). However, pooled RR from 8 cohort studies without immortal time bias indicated no association between the use of metformin and gastric cancer risk (RR = 0.95, 95% CI = 0.85, 1.05; P = 0.317; I2 = 64.5%). From a univariate meta-regression model, the presence of immortal time bias was associated with a significant reduction of 29% in the effect estimate of metformin on gastric cancer risk (ratio of RR = 0.71, 95% CI = 0.58, 0.86; P = 0.002). This meta-analysis indicates that metformin use has no protective effect on gastric cancer risk. The relationship between metformin use and gastric cancer risk has been exaggerated as a result of the presence of immortal time bias. Further studies are required to confirm the results by controlling for immortal time bias based on appropriate study designs and statistical methods.

A systematic review of self-neglect and its risk factors among community-dwelling older adults.

OBJECTIVES: To systematically review published evidence on self-neglect (SN) and its risk factors among community-dwelling older adults. METHOD: A comprehensive literature search was conducted in PubMed, Embase, CINAHL Plus, PsycINFO, and Scopus for studies that were published in English from inception to 8 April 2020. Grey database was also included to ensure a thorough search. The study quality was assessed by two reviewers independently using the Newcastle-Ottawa Scale or the checklist suggested by the Agency for Healthcare Research and Quality. RESULTS: A total of 19 studies was included in this review. Various tools were used to assess SN among the available studies. The prevalence rates of SN among community-dwelling older adults ranged from 18.4% to 29.1%. The risk factors of SN identified by these studies involved sociodemographic characteristics (male gender, older age, low economic status, ethnicity, lower educational level, marital status, and lower number of children), health-related characteristics (cognitive impairment, lower level of physical function, nutritional status, higher number of medical comorbidities, and pain), psychological characteristics (depression), and social context characteristics (living alone, lower social networks and social engagement, lower neighborhood cohesion, and neighborhood disorder). CONCLUSION: SN is a common and under-recognized phenomenon among community-dwelling older adults. Our review provides healthcare professionals with an insight into SN and its risk factors. More studies are required to test the potency of each independent risk factor to deepen our understanding of this particular phenomenon.

The association between obesity and chronic pain among community-dwelling older adults: a systematic review and meta-analysis.

OBJECTIVES: To systematically review studies and explore the association between obesity and chronic pain among community-dwelling older adults. METHODS: A comprehensive literature search was conducted in 9 databases and the Pubmed search engine from their inception to March 19, 2020. Studies that investigated the associations between overweight/obesity and chronic pain among older people were obtained. Comprehensive Meta-analysis was used to meta-analyze the eligible studies. RESULTS: Totally 14 studies with 40,999 participants were included in this review, and 8 of these studies were meta-analyzed. The meta-analyses showed that both overweight (pooled OR = 1.166, 95% CI: 1.104-1.232, p < 0.01) and obesity (pooled OR = 1.786, 95% CI: 1.530-2.085, p < 0.01) had significant associations with chronic pain among older adults. CONCLUSIONS: Overweight and obesity are both associated with chronic pain among older adults. It is suggested that body weight control strategies might be incorporated into the pain management program for older adults with obesity.

An exploration of how developers use qualitative evidence: content analysis and critical appraisal of guidelines.

BACKGROUND: Clinical practice guidelines have become increasingly widely used to guide quality improvement of clinical practice. Qualitative research may be a useful way to improve the quality and implementation of guidelines. The methodology for qualitative evidence used in guidelines development is worthy of further research. METHODS: A comprehensive search was made of WHO, NICE, SIGN, NGC, RNAO, PubMed, Embase, Web of Science, CNKI, Wanfang, CBM, and VIP from January 1, 2011 to February 25, 2020. Guidelines which met IOM criteria and were focused on clinical questions using qualitative research or qualitative evidence, were included. Four authors extracted significant information and entered this onto data extraction forms. The Appraisal of Guidelines for Research and Evaluation (AGREE II) tool was used to evaluate the guidelines' quality. The data were analyzed using SPSS version 17.0 and R version 3.3.2. RESULTS: Sixty four guidelines were identified. The overall quality of the guidelines was high (almost over 60%). Domain 1 (Scope and Purpose) was ranked the highest with a median score of 83% (IQ 78-83). Domain 2 (Stakeholder involvement) and Domain 5 (Applicability) were ranked the lowest with median scores of 67% (IQ 67-78) and 67% (IQ 63-73) respectively. 20% guidelines used qualitative research to identify clinical questions. 86% guidelines used qualitative evidence to support recommendations (mainly based on primary studies, a few on qualitative evidence synthesis). 19% guidelines applied qualitative evidence when considering facilitators and barriers to recommendations' implementation. 52% guideline developers evaluated the quality of the primary qualitative research study using the CASP tool or NICE checklist for qualitative studies. No guidelines evaluated the quality of qualitative evidence synthesis to formulate recommendations. 17% guidelines presented the level of qualitative research using the grade criteria of evidence and recommendation in different forms such as I, III, IV, very low. 28% guidelines described the grades of the recommendations supported by qualitative and quantitative evidence. No guidelines described the grade of recommendations only supported by qualitative evidence. CONCLUSIONS: The majority of the included guidelines were high-quality. Qualitative evidence was mainly used to identify clinical questions, support recommendations, and consider facilitators and barriers to implementation of recommendations'. However, more attention needs to be paid to the methodology. For example, no experts proficient in qualitative research were involved in guideline development groups, no assessment of the quality of qualitative evidence synthesis was included and there was lack of details reported on the level of qualitative evidence or grade of recommendations.

Cross-cultural adaptation and psychometric assessment of the statement format Decisional Conflict Scale for Mandarin version.

BACKGROUND: The statement format of the Decisional Conflict Scale (sf-DCS) is designed and widely used to assess patients' state of uncertainty during health related decision making. As yet no Mandarin version of the sf-DCS has been produced. This study aims to produce the first Mandarin version of the sf-DCS and test its validity and reliability in mainland China. METHODS: The translation and cross-cultural adaptation of the original English version of the sf-DCS into Mandarin was carried out in accordance with previously published guidelines. The psychometric properties of sf-DCS were assessed in two hypothesized decision-making contexts through online surveys. RESULTS: In the online survey designed to test scale validity and reliability, 437 people responded to the influenza immunization survey and 238 responded to the breast cancer screening survey. The results confirm that the Mandarin version of sf-DCS has good criteria validity and the exploratory factor analysis suggested a fitted revised five factors model by removing three items. Respondents who were "unsure" about their decisions/intentions, had read less information, and reported lower self-perceived prior knowledge level scored higher on sf-DCS. The Cronbach's alpha for the sf-DCS total score was 0.963 and that for each subscale ranged from 0.784 to 0.937 in both decision making contexts, and the test-retest correlation coefficient was 0.528. CONCLUSIONS: The Mandarin version of sf-DCS has good criteria validity and its internal consistency is satisfactory. Our analysis suggests a refinement of the original sf-DCS's factor structure is needed.

Variation in nurse self-reported practice of managing chest tubes: A cross-sectional study.

AIMS AND OBJECTIVES: To reveal nurses' self-reported practice of managing chest tubes and to define decision-makers for these practices. BACKGROUND: No consensus exists regarding ideal chest-tube management strategy, and there are wide variations of practice based on local policies and individual preferences, rather than standardised evidence-based protocols. DESIGN: This article describes a cross-sectional study. METHODS: Questionnaires were emailed to 31 hospitals in Tianjin, and the sample consisted of 296 clinical nurses whose work included nursing management of chest drains. The questionnaire, which was prepared by the authors of this research, consisted of three sections, including a total of 22 questions that asked for demographic information, answers regarding nursing management that reflected the practice they actually performed and who the decision-makers were regarding eight chest-drain management procedures. McNemar's test was used to analyse the data. RESULTS: The results indicated that most respondents thought that it was necessary to manipulate chest tubes to remove clots impeding unobstructed drainage (91.2%). Most respondents indicated that dressings would be changed when the dressing was dysfunctional. At the same time, more than half of respondents approved of changing dressings routinely, and the frequency of changing dressings varied. When drainage was employed for pleural effusion and for a pneumothorax, 64.6% and 94.5% of respondents, respectively, considered that underwater seal-drainage bottles should be changed routinely, and the frequency of changing bottles both varied. The results indicated that nurses were the primary decision-makers in the replacement of chest tubes, manipulation of chest tubes and monitoring of drainage fluid. CONCLUSIONS: There was considerable variation in respondents' self-reported clinical nursing practice regarding management of chest drains. The rationale on which respondents' practices were based also varied greatly. This study indicated that nurses were the primary decision-makers for three of eight procedures regarding management of chest drains, which reflects that clinical nurses' decision-making power regarding management of chest drains was weak. RELEVANCE TO CLINICAL PRACTICE: This study describes the nurse-reported practices of Chinese nurses from Tianjin, including changing and selecting dressing types, manipulating chest tubes, clamping drains and replacing drainage bottles, and the study defines who the decision-makers were for these interventions. By focusing on nurses' self-report of behaviours in managing chest drains (actual nursing practice vs. nursing knowledge), this article also relates the literature to the research findings and denotes the gaps in knowledge for future research.

Educational intervention for metabolic bone disease in patients with chronic kidney disease: a systematic review and meta-analysis.

Metabolic bone disease (MBD) is a common complication of chronic kidney disease (CKD). The currently accepted international guidelines for treatment of CKD-MBD has been published, unfortunately adequate control of serum markers of disorder, especially hyperphosphatemia, is poorly achieved. Whether educational intervention is an effective way for improving CKD-MBD remains controversial. A systematic review of educational intervention versus routine care to improve patients with CKD-MBD was conducted. All randomized controlled trials (RCTs) and quasi-RCTs examining the efficacy of educational intervention to improve patients with CKD-MBD were included. We performed a comprehensive search of several databases and sources to identify eligible trials. In addition, we searched unpublished studies by tracking the SIGLE (System for Information on Grey Literature) database. Finally, 8 RCTs and 2 quasi-RCTs containing 775 participants were included in our systematic review. The result of our study revealed that the educational intervention to patients with CKD-MBD led to an improvement of the serum phosphorus and calcium by phosphate product. Educational intervention is a beneficial supplement method in improving CKD-MBD and putting off deterioration of the disease.

Valuation of the cultural adaptation and psychometric properties of the Chinese version of the hidden curriculum evaluation scale in nursing education.

BACKGROUND: The hidden curriculum in baccalaureate nursing programs is a means of moral education. Evaluation of the curriculum by students and faculty can increase awareness of its characteristics, which could be useful for planning and further development. OBJECTIVES: This study's aim was to translate the Hidden Curriculum Evaluation Scale in Nursing Education (HCES-N) to Chinese, adapt the scale to the Chinese culture and evaluate its validity and reliability in a sample of undergraduate nursing students. DESIGN: Psychometric assessment of a tool using two cross-sectional surveys. SETTINGS: University-based schools of nursing in seven provinces and cities of China. PARTICIPANTS: Undergraduate nursing students in a baccalaureate program. METHODS: The English version of the HCES-N was translated to Chinese using the Brislin translation model. The test-retest, internal consistency and split-half reliabilities of the HCES-N were examined in a sample of 1016 undergraduate nursing students. Exploratory factor analysis and confirmatory factor analysis were conducted to examine the scale's content validity. RESULTS: The exploratory factor analysis of the final 44-item HCES-N revealed three common factors and a cumulative variance contribution rate of 73.535%. The results of the confirmatory factor analysis showed that the final 44-item, 3-factor model was adequate for the s cale's structure (Chi-square/df = 6.59, RMSEA = 0.074, SRMR = 0.040, CFI = 0.911 and TLI = 0.905). The results confirmed that the Chinese version of HCES-N had good internal consistency (Cronbach α = 0.945); the scale's split-half-reliability was 0.794 and its test-retest reliability after two weeks was 0.894. CONCLUSION: The Chinese version of the HCES-N has good reliability and validity and it can be used to assess the hidden curriculum in baccalaureate nursing programs.

Effectiveness of a nurse-led intensive educational programme on chronic kidney failure patients with hyperphosphataemia: randomised controlled trial.

AIMS AND OBJECTIVES: To prospectively evaluate the effects of a nurse-led educational intervention on the management of hyperphosphataemia as well as knowledge of phosphate among patients with end-stage renal disease. BACKGROUND: Haemodialysis and phosphate binder therapy are the major methods used to reduce the phosphate level in dialysis patients. However, patient education related to hyperphosphataemia, diet and phosphate binders may be another important factor associated with the success of the control of the hyperphosphataemia. DESIGN: This prospective randomised controlled trial was conducted during the period from June 2009-March 2011 at the HD units of two hospitals in Tianjin, China. METHODS: A total of 80 participants were randomly assigned to experimental group (n=40) and control group (n=40). Participants in the experimental group received the nurse-led intensive educational programme, including individualised education and educational session about diet and medicine regimes, etc., while participants in the control group received the routine guidance. RESULTS: There were statistically significant differences between the study groups in decline in serum phosphorus and calcium-phosphorus product levels and improvement in patients' general knowledge three months postintervention, and these differences sustained until the end of the study. Increased serum calcium level was observed both in the experimental group and in the control group, but there was no significant difference between groups. No statistical significance was found regarding serum albumin level between the groups. No significant difference in the serum parathyroid hormone level was found between the groups by month 6. CONCLUSIONS: Nurse-led intensive educational programme plays an important role in the control of hyperphosphataemia among patients with end-stage renal disease. RELEVANCE TO CLINICAL PRACTICE: Chronic kidney failure patients with hyperphosphataemia are more likely to benefit from nurse-led intensive educational programmes.

A systematic review of the factors significantly influencing the quality of life of living liver donors.

Objectives: This systematic review aimed to synthesize the literature on factors influencing the quality of life in living liver donors post-donation and to provide a reference for developing targeted interventions in clinical practice. Methods: A systematic search guided by the PRISMA 2020 approach was performed on specific databases: PubMed, EMBASE, CINHAL with full text, Web of Science, and ProQuest Dissertations & Theses databases. Peer-reviewed articles published in English from inception to October 2022 covering cross-sectional studies and longitudinal studies on factors affecting the quality of life of living liver donors after donation were included in this systematic review. The methodological quality of the studies was examined using a modified version of the National Institutes of Health Quality Assessment Tool. Results: A total of 6,576 studies were retrieved, and 16 eligible studies were finally included. Four types of independent influencing factors: sociodemographic (gender, donor age, education, ethnicity, and marital status), donation-related (length of hospital stay and number of hospitalizations/hospital visits related to donation surgery, recipient outcome, time from donation, complications, donation decision, ambivalence about donating, donor-recipient relationship), health-related (body mass index and pre-donation physical symptoms), and psychosocial (pre-donation physical and mental score, household income, anxiety, depression), were extracted from the included studies. Several studies consistently identified old age, recipient death, recent donation, postoperative complications experienced by donors, and donor concerns about their well-being as negative influencing factors on physical function. Female donors, low education levels, longer hospital stays, and/or more hospital visits due to donation, poor recipient outcome, recent donation, pre-donation concerns regarding their well-being, and first-degree relative and spouse/partner donors were reported in several studies as negative predictors for psychological status. Factors affecting social function were considered by only two included articles. Conclusions: The quality of life of living liver donors could be affected by both donation surgery and psychosocial factors. Based on the above-influencing factors, clinical nurses can develop targeted interventions to improve the quality of life of living liver donors.

Quality of life, anxiety and depression symptoms in living related kidney donors: a cross­sectional study.

OBJECTIVES: Few studies have examined the quality of life of living kidney donors in mainland China. The data on anxiety and depression of living kidney donors was also scant. This study aimed to investigate quality of life, anxiety, and depression and identify their influencing factors among living kidney donors in mainland China. METHODS: A cross-sectional study included 122 living kidney donors from a kidney transplantation center in China. The abbreviated World Health Organization Quality of Life questionnaire, Generalized Anxiety Disorder 2-item and Patient Health Questionnaire 2-item were used to assess the quality of life, anxiety and depression symptoms, respectively. RESULTS: Our study found that the physical related quality of life of our donors was poorer than that of the domestic general population. Among 122 donors, 43.4% and 29.5% of them were found to have anxiety and depression symptoms, respectively. Poor health condition of recipient was identified as not only negative factors affecting all domains of quality of life, but also closely related to anxiety and depression of kidney donors. Donors with proteinuria were more likely to have a poor psychological, social related quality of life, as well as anxiety and depression symptoms. CONCLUSIONS: Living kidney donation has an impact on the physical and mental health of donors. Both the physical and mental health of living kidney donors should not be ignored. More attention and support should be given to donors with proteinuria and donors whose relative recipient suffering poor health condition.

Prevalence and factors associated with depression and anxiety in living liver donors: A systematic review and meta-analysis.

OBJECTIVE: This study aimed to systematically review the prevalence and factors associated with depression and anxiety in living liver donors after liver transplantation. METHODS: Five English language electronic databases and four Chinese language electronic databases were searched from inception to February 2023. Two investigators independently extracted the data and assessed the study quality. The pooled prevalence was calculated using STATA software (version 14.0). We performed a narrative review to summarize the factors associated with depression and anxiety in living liver donors after liver transplantation. The protocol of this study was registered with the International Prospective Register of Systematic Reviews (PROSPERO) database, registration number: CRD42021290071. RESULTS: This study included 39 articles involving 18,577 participants. The pooled prevalence was 6.3% [95% confidence interval (CI) (4.1-8.9%)] for depression in living liver donors, and 10.0% [95% CI (4.0-18.1%)] for anxiety. Prevalence of clinically significant depressive or anxiety symptoms was higher (15.7% and 17.4%) compared with disorders (2.7% and 2.2%). The prevalence of depression and anxiety was highest within 3 months post-donation. Specifically, female donors, serious postoperative complications, and recipients' poor health/death have been reported as factors having a negative influence on depression and anxiety. CONCLUSIONS: Collected evidence showed that the overall prevalence of depression or anxiety of living liver donors was high. Therefore, early detection and timely treatment of psychological disorders are crucial to promote positive psychiatric health outcomes and ensure the quality of life of living liver donors.

Balance Function in Patients With COPD: A Systematic Review of Measurement Properties.

To conduct an overview, evaluation, and synthesis of measurement properties of instruments assessing balance of COPD patients. Electronic searches were performed in Web of Science, Scopus, Embase, PubMed, CINAHL, PsycINFO, WanFang, and China National Knowledge Infrastructure databases up to the end of April 2021. Two reviewers independently evaluated the methodological quality using the Consensus-based Standards for the Selection of Health Status Measurement Instrument checklist, and rated the overall quality level of evidence was graded based upon a modified Grades of Recommendation, Assessment, Development, and Evaluation approach. Finally, 12 instruments were included. The Berg Balance Scale and the Timed Up and Go test were the most frequently used tools to evaluate balance. None of 12 instruments provide any information regarding cross-cultural validation or criterion validation. High-quality studies exploring measurement properties with a focus on the criterion validity and cross-cultural validity of balance measurements in COPD patients are warranted.

Instruments to assess self-neglect among older adults: A systematic review of measurement properties.

OBJECTIVE: To critically appraise, compare, and summarize the measurement properties of existing instruments that assess self-neglect among older adults. METHODS: Eight electronic databases (PubMed, Scopus, Embase, CINAHL Plus with Full Text, Web of Science, PsycINFO, China National Knowledge Infrastructure, and WanFang Data) were searched from their inception to September 6, 2020. The methodological qualities of the included studies on measurement properties were assessed by using the COnsensus-based Standards for selection of health Measurement INstruments (COSMIN) methodology for systematic reviews of Patient-Reported Outcome Measures (PROMs). RESULTS: Among the 1184 studies identified, 47 full-text studies were assessed further for their eligibilities. A total of 8 studies were eventually included. The methodological quality of content validity for relevance, comprehensiveness, and comprehensibility of all instruments in this review was doubtful or inadequate. The methodological quality of structural validities in the majority of the studies were very good, while the quality of hypothesis testing for construct validity was doubtful. The internal consistency was assessed by calculating Cronbach's alpha coefficient in all studies. Some measurement properties (e.g., cross-cultural validity/measurement invariance, measurement error, and responsiveness) were not assessed in the reviewed studies. CONCLUSIONS: This systematic review provides a comprehensive overview of the measurement properties of elder self-neglect instruments. Among the eight instruments identified, none of them demonstrate better properties than any other. Future studies are suggested to use COSMIN methodology as guideline to examine the measurement properties of the developed instruments. Instruments with rigid measurement properties are urgently needed to assess self-neglect among older adults to provide the necessary and valuable information on this particular phenomenon.