Application of a nurse-led multidisciplinary health problem assessment tool on patients undergoing peritoneal dialysis at home: A cross-sectional study.

OBJECTIVE: To identify and analyze the most prominent problems of peritoneal dialysis (PD) patients by applying a nurse-led multidisciplinary health problem assessment tool. METHODS: 170 PD patients were recruited from the PD center of the First Affiliated Hospital of GuangXi Medical University from January 2019 to June 2019, and their information was collected from July 2019 to June 2020 through telephone interviews, Wechat interviews, outpatient visits, and home visits; their health problems were classified and analyzed with regard to physiological, psychosocial, health-related behavior, and environment categories based on the Omaha Problem Classification System, and their knowledge, behavior, and status related to these problems were evaluated by the Omaha Knowledge-Behavior-Status Scale. RESULTS: 165 of the eligible patients completed the follow-up, and their ten most prominent health problems were "Income", "Social contact", "Pain", "Neuro-musculo-skeletal function", "Digestion-hydration" and "Edema", "Nutrition", "Physical activity", "Fluid and diet restriction", and "Symptom management". As for the Knowledge-Behavior-Status scale, they got the lowest scores in knowledge of "Symptom management", behavior of "Fluid and diet restriction" and Status of "Nutrition", while they scored the best in knowledge of "Nutrition" and "Edema", behavior of "Income" and "Pain", and Status of "Pain" and "Edema". CONCLUSION: The multidisciplinary problem assessment tool based on the Omaha Problem Classification System serves as an effective and instructive tool to identify the prominent health problems of PD patients and provides a basis for the development of subsequent targeted interventions.

A Longitudinal Study of Trajectories and Factors Influencing Patient-Reported Outcomes in Chronic Obstructive Pulmonary Disease.

Purpose: To explore the trajectory of patient-reported outcomes and the factors influencing them in patients with COPD. Patients and Methods: The study population, 236 patients with stable COPD who attended the outpatient clinic of the Department of Respiratory and Critical Care Medicine in a tertiary care hospital in Nanning City between October 2020 and November 2021, answered the modified patient-reported outcome scale for COPD (mCOPD-PRO). Patient-reported outcomes were investigated at the time of the patient's outpatient visit (T1), 1 month after the visit (T2), 3 months after the visit (T3), and 6 months after the visit (T4). Latent class growth modeling was used to determine the number and shape of trajectories, and multinomial logistic regression analysis were used to explore influence factors of each class. Results: COPD patients' reported outcome trajectories were classified into 3 categories: health low-level group (14.80%), health risk group (54.70%), and good health group (30.50%). Logistic regression analysis showed that gender, BMI, smoking history, number of comorbidities, whether it was their first visit, and lung function classification were influential factors in patients' reported outcome trajectories (P<0.05). Female, obese, had a history of smoking, number of comorbid diseases >3, first diagnosis, and lung function class IV had a higher probability of entering the healthy low-level group. Conclusion: COPD patients have poor self-reported health levels during the first 6 months after the outpatient visit, and there is group heterogeneity in patient-reported outcome trajectories; medical staff should give patients specific nursing interventions based on their current development of COPD, self-reported changes, and other relevant influencing factors.

Health Priorities in Chronic Obstructive Pulmonary Disease Patients with Multimorbidity: A Qualitative Study.

Purpose: To explore the health priorities of patients with multimorbidity in COPD and the factors as to why their condition is prioritized. Methods: This qualitative study was conducted from February to April 2022 at a hospital in China. A specially selected sample of 18 patients completed a general information sheet and face-to-face interviews. The Colaizzi method was used to analyze the data. Results: Participants reported their experience which fell into three themes: disease burden, health perception and views of others. In addition, participants explained that health knowledge from short videos on mobile apps influenced them, which in turn influenced their ranking. Conclusion: Our findings suggested that health priorities of patients with multimorbidity in COPD manifest differently. Specifically, our findings suggested that patients' health priorities are most influenced by disease burden, health perception, and the opinions of those around them. Nursing staff should fully understand each patients'own perspectives and provide them with personalized support.

Identification of Symptom Clusters and Their Influencing Factors in Subgroups of Chinese Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease.

CONTEXT: Limited studies have identified symptom clusters (SCs) and their risk factors and the relationships with inflammatory biomarkers in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). OBJECTIVES: In this study, we aimed to investigate SCs in patients with AECOPD and explore their influencing factors and relationships with inflammatory biomarkers. METHODS: Data were collected with sociodemographic and disease information questionnaires, and symptoms were measured with the revised Memorial Symptom Assessment Scale. SCs were extracted through exploratory factor analysis. Logistic regression analysis was conducted to explore the risk factors of SCs. RESULTS: A total of 151 patients were recruited. Two SCs, namely, emotional and respiratory functional SCs, were identified. Logistic regression analysis showed that individuals with high C-reactive protein level, Charlson Comorbidity Index score, and high modified Medical Research Council Dyspnea Scale score were more likely to belong to the high-severity symptom subgroup than to the low-severity symptom group in the emotional SC. The patients with a low body mass index and without or lax inhaled drug therapy exhibited highly prominent predictors of membership in the high-severity symptom group of the respiratory functional SC. CONCLUSION: Symptoms experienced by patients with AECOPD were grouped into specific clusters. Targeted interventions should be performed based on SCs, and influencing factors and biological mechanisms should be considered when providing individualized approaches and interventions.

(18)FDG-PET/CT for detection of mediastinal nodal metastasis in non-small cell lung cancer: a meta-analysis.

BACKGROUND: We performed a meta-analysis to evaluate the role of (18)F-fluorodeoxyglucos -e positron emission tomography/computed tomography ((18)FDG-PET/CT) in detecting mediastinal nodal metastasis in patients with non-small cell lung cancer (NSCLC). METHODS: Studies about (18)FDG-PET/CT for detecting mediastinal nodal metastasis in patient with NSCLC were systematically searched in the MEDLINE, EMBASE, and EBM Review databases from January 1, 2000 to July 26, 2011. A software called "Meta-Disc" was used to obtain pooled estimates of sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR), respectively. We also calculated summary receiver operating characteristic (SROC) curves, and the Q* index. RESULTS: 20 articles fulfilled all inclusion criteria (3028 eligible patients). The pooled sensitivity, and specificity with 95% confidence interval for PET/CT on a per-patient analysis were 0.719 (0.683-0.753), and 0.898 (0.882-0.912). Corresponding values for PET/CT on a per-nodal-station analysis were 0.610 (0.582-0.636), 0.924 (0.918-0.930). The Q* index estimates under SROC were 0.8464 and 0.8067, respectively. CONCLUSIONS: (18)FDG-PET/CT had more specificity but less sensitivity for mediastinal nodal metastasis in patients with NSCLC.