Implementation of early prophylaxis for deep-vein thrombosis in intracerebral hemorrhage patients: an observational study from the Chinese Stroke Center Alliance.

BACKGROUND: There is substantial evidence to support the use of several methods for preventing deep-vein thrombosis (DVT) following intracerebral hemorrhage (ICH). However, the extent to which these measures are implemented in clinical practice and the factors influencing patients' receipt of preventive measures remain unclear. Therefore, we aimed to evaluate the rate of the early implementation of DVT prophylaxis and the factors associated with its success in patients with ICH. METHODS: This study enrolled 49,950 patients with spontaneous ICH from the Chinese Stroke Center Alliance (CSCA) between August 2015 and July 2019. Early DVT prophylaxis implementation was defined as an intervention occurring within 48 h after admission. Univariate and multivariate logistic regression analyses were conducted to identify the rate and factors associated with the implementation of early prophylaxis for DVT in patients with ICH. RESULTS: Among the 49,950 ICH patients, the rate of early DVT prophylaxis implementation was 49.9%, the rate of early mobilization implementation was 29.49%, and that of pharmacological prophylaxis was 2.02%. Factors associated with an increased likelihood of early DVT prophylaxis being administered in the multivariable model included receiving early rehabilitation therapy (odds ratio [OR], 2.531); admission to stroke unit (OR 2.231); admission to intensive care unit (OR 1.975); being located in central (OR 1.879) or eastern regions (OR 1.529); having a history of chronic obstructive pulmonary disease (OR 1.292), ischemic stroke (OR 1.245), coronary heart disease or myocardial infarction (OR 1.2); taking antihypertensive drugs (OR 1.136); and having a higher Glasgow Coma Scale (GCS) score (OR 1.045). Conversely, being male (OR 0.936), being hospitalized in tertiary hospitals (OR 0.778), and having a previous intracranial hemorrhage (OR 0.733) were associated with a lower likelihood of early DVT prophylaxis being administered in patients with ICH. CONCLUSIONS: The implementation rate of early DVT prophylaxis among Chinese patients with ICH was subpar, with pharmacological prophylaxis showing the lowest prevalence. Various controllable factors exerted an impact on the implementation of early DVT prophylaxis in this population.

Development and validation of the parental health literacy scale for children with asthma (PHLSCA).

OBJECTIVE: This study aimed to develop and validate an instrument to assess the health literacy of parents of children with asthma in a Chinese context. METHODS: The preliminary Parental Health Literacy Scale for Children with Asthma (PHLSCA) was developed based on a literature review and refined to 45 items through two rounds of expert consultation using the Delphi method. A total of 481 parents of children with asthma were recruited from seven hospitals across four provinces in China between February and April 2019. Principal component analysis (PCA) and confirmatory factor analysis were conducted to evaluate the structural and construct validity of the scale. RESULTS: The development and validation processes led to a 38 items scale comprising three subscales, namely: Health Knowledge (11 items), Health Skills (19 items) and Health Behavior (8 items). The scale demonstrated good reliability, with an internal consistency of Cronbach's α = 0.956 and a split-half reliability of r = 0.887 (p < 0.01). The Item Content Validity Index (I-CVI) ranged from 0.81 to 1.00, and the Scale-CVI was 0.842. The correlation coefficients and factor analysis results indicated good construct validity, with the factors explaining 59.33% to 62.90% of the variance in each subscale. CONCLUSIONS: The final version of the questionnaire (PHLSCA) has been demonstrated to be a valid and reliable tool for assessing the health literacy of parents of Chinese children with asthma.

Effectiveness of decision aids on critically ill patients' outcomes and family members' knowledge, anxiety, depression and decisional conflict: A systematic review and meta-analysis.

BACKGROUND: Decision aids (DAs) have been proposed to support patients and families with disease information processing and decision-making, but their effectiveness for critically ill patients and their families is incompletely understood. AIM: To systematically synthesize evidence on the effectiveness of the DAs on the prognosis of critically ill patients and knowledge, anxiety, depression and decisional conflict of their family members. STUDY DESIGN: Systematic review and meta-analysis. We conducted a systematic search of literature using PubMed, Embase, Cochrane Library, Web of Science, Cumulative Index to Nursing and Allied Health Literature database, Scopus, PsycNet, CNKI and Wanfang Database from the inception of the databases until May 2023 to identify randomized clinical trials (RCTs) describing DAs interventions targeted at adult intensive care unit (ICU) patients or their families. We also searched grey literature in four databases: Chinese Clinical Trials Registry, Chinese Cochrane Center, Open Grey and GreyNet International. RESULTS: Seven RCTs were included in the review. Meta-analysis identified longer hospital length of stay (LOS) among all patients compared with usual care (mean difference [MD] = 5.64 days, 95% confidence interval, CI [0.29, 10.98], p = .04), but not in surviving patients (MD = 2.09 days, 95% CI [-3.70, 7.89], p = .48). However, there was no evidence of an effect of DAs on hospital mortality (RR = 1.25, 95% CI [0.92, 1.70], p = .15), ICU LOS (MD = 3.77 days, 95% CI [-0.17, 7.70], p = .06) and length of mechanical ventilation (MD = 0.88 days, 95% CI [-2.22, 3.97], p = .58). DAs led to a statistically significant improvement in family members' knowledge (standard mean difference = 0.84, 95% CI [0.12, 1.56], p = .02). We found no significant effect of DAs on anxiety, depression, post-traumatic stress disorder, decisional conflict and quality of communication of family members. CONCLUSIONS: This review provides effective evidence that DAs can potentially improve the knowledge level of family members while prolonging the hospital LOS among critically ill patients. RELEVANCE TO CLINICAL PRACTICE: Well-designed large-scale studies with DAs tailored to the individuals' preferences and existing cultural values are warranted.

Development and validation of the family management scale for children with asthma (FMSCA).

Objective: This study aims to develop and validate the Family Management Scale for Children with Asthma (FMSCA) in China context. Methods: Based on the Family Management Style Framework (FMSF) model, an original 89 items were generated from literature review and interviews with 15 caregivers of children with asthma. The preliminary scale was refined to 82 items through two rounds of experts' evaluation and a pilot study, then administered to 329 caregivers of children with asthma for testing between April and July 2013. Item analysis and exploratory factor analysis were performed to screen the items, reliability and validity analysis were tested using psychometric techniques (internal consistency, split-half reliability, test-retest reliability, content validity, and construct validity). Confirmatory factor analysis was adopted to further evaluate the construct validity of the scale in an additional 600 children with asthma and their parents from August 2014 to December 2015. Results: A final 57-item FMSCA from 8 subscales (children identity, view of condition, management mindset, parental mutuality, parenting philosophy, management approach, family focus, and future expectation) were generated. The excellent internal consistency (Cronbach's α = 0.918), very good split-half reliability (r = 0.802, p < 0.01) and test-retest reliability (r = 0.857, p < 0.01) indicate a satisfactory reliability of the FMSCA. The Item Content Validity Index (I-CVI) of the scale ranged 0.8 3 ～1.00, Scale Content Validity Index (S-CVI) was 0.807, indicating a good content validity. Construct validity was established by accepted correlation coefficient of item-to-subscale (r range = 0.513-0.865, P < 0.01), intersubscale (r range = 0.195-0.604, p < 0.01), and subscale-to-total (r range = 0.408-0.876, p < 0.01), respectively. Additionally, the factors accounted for 51.586%∼74.063% of the variance in each subscale, confirmatory factor analysis indicated the confirmatory model fitted data well and the scale had adequate construct validity. Conclusions: The study demonstrates FMSCA can serve as a valid and reliable measure of family management level for Chinese children with asthma.

Evidence-based nursing outputs and hot spot analysis of the last 5 years in mainland China: Results of a bibliometric analysis.

BACKGROUND: Evidence-based nursing has been highlighted and highly developed in recent decades in mainland China. Nevertheless, little is known about its overall development. AIMS: To gain insights on the overall development of evidence-based nursing in the most recent 5 years and to inform future evidence-based nursing research in mainland China. METHOD: Four Chinese and four English databases were searched with the search terms "evidence-based practice," "nurse or nursing," and "China or Chinese" from 2012 to 2016. Bibliometric and co-word cluster analysis were conducted with the final included publications. RESULTS: A total of 9036 papers published by 13 808 authors in 606 journals were included. Publication numbers were increasing. None of the top ten journals publishing evidence-based nursing papers were core nursing journals. The research hot spots on evidence-based nursing in the recent five years were cardiovascular disease, mental health, and complication prevention. However, little attention has been paid to education for evidence-based nursing. CONCLUSION: Evidence-based nursing has penetrated into various nursing branches in mainland China and become a well-recognized and relatively mature research domain. More importance should be attached to the study design, methodological, and reporting quality of evidence-based nursing projects.

The Hotspots Analysis of Education and Management of Childhood Asthma Based on Cluster Analysis Method.

By the use of SPSS software and computer programs, this paper gives a co-word clustering analysis of the articles on education and management of childhood asthma worldwide published in the Web of Science before September 2018. Correlation and dissimilarity matrix and hierarchical clustering were constructed. Finally, 66 high-frequency keywords of 6147 papers were included, 9 hotspots in this field emerged by cluster analysis, which could provide some valuable information of hot research on this field.