Development of the self-management scale for urolithiasis patients with indwelling double-J tube.

PURPOSE: To develop a specific self-management scale applicable to patients with indwelling double-J tube in urolithiasis, and to test its reliability and validity. METHODS: The construction and validation of our scale involved three stages. First, an initial version of the questionnaire was formed through literature analysis, group discussions, semi-structured interviews, and the Delphi method. Second, a pre-survey was conducted with 20 urolithiasis patients with indwelling double-J stent placement to test their understanding of the initial questionnaire items and its acceptability. Finally, a formal survey of 234 patients with indwelling double-J tube for urolithiasis was conducted, and the scale was tested for reliability and validity. RESULTS: After the three stages, a specific self-management scale for urolithiasis patients with indwelling double-J tube was developed, consisting of 30 items across five dimensions with a cumulative contribution rate of 52.541%. The content validity index for item level ranged from 0.8 to 1, and the content validity index for the questionnaire level was 0.93. The correlation between each item and its dimension was > 0.4. The Cronbach's alpha coefficient for the overall questionnaire was 0.910, and the Cronbach's alpha coefficients for each dimension ranged from 0.672 to 0.865. The split-half reliability of the overall questionnaire was 0.864, and the split-half reliabilities for each dimension ranged from 0.659 to 0.827. The test-retest reliability of the overall questionnaire was 0.840, and the test-retest reliabilities for each dimension ranged from 0.674 to 0.818. CONCLUSION: The specific self-management scale for urolithiasis patients with indwelling double-J tube has good reliability and validity, and it is a reliable and effective tool for evaluating and assessing the self-management level of patients with indwelling double-J tube in urolithiasis.

Different Hydrogen Bond Changes Driven by Surface Segregation Behavior of Imidazolium-Based Ionic Liquid Mixture at the Liquid-Vacuum Interface.

In this work, molecular dynamics (MD) simulations were carried out to study the behaviors of a binary ionic liquid (IL) mixture consisting of equimolar [C2C1Im][BF4] and [C4C1Im][BF4], as well as two corresponding pure ILs, at the liquid-vacuum interface. Our simulation results show that the competition of nonpolar interactions between different alkyl chains of two cations results in an obvious surface segregation behavior of the IL mixture at the interface, indicating an enhanced aggregation of the [C4C1Im]+ cations but a weakened aggregation of the [C2C1Im]+ cations at the outermost surface. More interestingly, different hydrogen bond (HB) changes between two imidazolium cations at the interface can be driven by such surface segregation behavior, where the [C2C1Im]+ cations rather than the [C4C1Im]+ ones have more and stronger HBs with the [BF4]- anions by comparison with the corresponding pure ILs at the interface. Meanwhile, it is interesting to find that such a stronger HB would lower the rotations of the imidazolium rings of interfacial [C2C1Im]+ cations. By contrast, the [C4C1Im]+ cations at the outermost surface rotate faster owing to their weaker HB. In addition, the orientation analysis uncovers that there is a major decrease for the orderliness of interfacial [C2C1Im]+ cations, but a minor decrease for that of interfacial [C4C1Im]+ cations, from the pure IL to the IL mixture. Such distinct results are closely related to the surface segregation between the [C2C1Im]+ and [C4C1Im]+ cations in the IL mixture and their interfacial HB properties. Thus, our simulation results afford a deep insight into the surface segregation effect on the HB behavior of the imidazolium-based IL mixture at liquid-vacuum interface.

Cognitive-behavioural therapy effectiveness for fear of cancer recurrence: systematic review and meta-analysis.

OBJECTIVE: Fear of cancer recurrence is one of the psychological distresses for patients with cancer and cancer survivors, which poses a physical and psychological threat. There is scant evidence on the effectiveness of cognitive-behavioural therapy in reducing fear of cancer recurrence. Therefore, we conducted a systematic review and meta-analysis to assess the effectiveness of cognitive-behavioural therapy for fear of cancer recurrence. METHOD: The review was reported according to Preferred Reporting Items for Systematic Review and Meta-analyses statement. Seven databases were systematically searched from inception to 31 March 2023. Randomised controlled trials implementing cognitive-behavioural therapy interventions and studies reporting fear of cancer recurrence were included. The methodological quality of included studies was assessed using the Cochrane Risk of Bias Tool 2. RESULTS: A total of 32 randomised controlled trials involving 1515 cancer survivors and 1845 patients with cancer undergoing treatment were included. The meta-analysis indicated a significant effect of cognitive-behavioural therapy on fear of cancer recurrence in patients with cancer and cancer survivors compared with controls (g=-0.65; 95% CI=-0.86, -0.44; p<0.001). The results of the overall risk of bias indicated some concerns in 4 studies and a high risk in 28 studies. CONCLUSION: The study indicated the effectiveness of cognitive-behavioural therapy intervention for fear of cancer recurrence in patients with cancer and cancer survivors, which should inform future clinical practice of interventions for the treatment of fear of cancer recurrence. PROSPERO REGISTRATION NUMBER: CRD42023404948.

Self-management in young and middle-aged patients with hypertension: a systematic review and meta-synthesis of qualitative studies.

BACKGROUND: There has been a sharp increase in the prevalence of hypertension in young and middle-aged people at high risk of the disease. Despite the fact that good self-management can be effective in controlling blood pressure, patients do not perform well in this area, resulting in poor blood pressure control. It is therefore particularly important to gain a thorough understanding of patients' attitudes to self-management and the factors that influence them. The aim of this study was to synthesise the qualitative research on attitudes, motivations and challenges of self-management in young and middle-aged hypertensive patients, to analyse the synthesised results using the COM-B model and to propose appropriate improvement actions. METHODS: From the time of construction until May 2023, the system searched PubMed, Web of Science, ProQuest, Embase, MEDLINE, CINAHL, PsyCINFO and CNKI databases. The analyses were carried out using a thematic synthesis approach to summarise the key findings. The findings were then mapped and analysed using the COM-B model. RESULTS: A total of 11 studies were included, involving 250 patients between the ages of 18 and 64. Four themes with ten sub-themes were identified: Poor disease recognition (low disease perception, fuzzy disease knowledge); Barriers to doctor-patient interactions (short communication time, unmet knowledge needs, incomplete guidance for disease management); Living in a hostile environment (heavy workload, lack of companionship, ignorance of families); Expectations for a healthy body (responsibility of family roles, witness the cruelty of illness). Analysis of the composite results based on the COM-B model showed that low disease perceptions, barriers to doctor-patient interactions and life circumstances with enemies on all sides were the main challenges faced by young and middle-aged hypertensive patients, whereas the expectation of a healthy body was a motivation to promote self-management of blood pressure in patients. CONCLUSIONS: This study shows that family responsibilities are a particular motivator for self-management in young and middle-aged hypertensive patients. In response to the problems they face, we believe that meeting patients' knowledge needs, improving healthcare professionals' communication skills and valuing the role of community hospitals are effective ways to promote patient self-management. In the future, telemedicine, mobile healthcare and intelligent monitoring devices will provide a solution to reduce the burden on medical resources. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018100810.

Effectiveness of Cognitive Behavioral Therapy on Fear of Cancer Recurrence in Breast Cancer: A Systematic Review and Meta-analysis.

BACKGROUND: Fear of cancer recurrence is one of the psychological distresses that seriously affects the quality of life of breast cancer patients. However, the evidence for cognitive behavioral therapy on fear of cancer recurrence in breast cancer is limited. OBJECTIVE: The aim of this study was to evaluate the effectiveness of cognitive behavioral therapy in reducing breast cancer patients' fear of cancer recurrence. METHODS: Seven databases were searched for randomized controlled studies on cognitive behavioral therapy for fear of cancer recurrence in cancer patients from the inception of the database to April 30, 2023, with no language restrictions. Meta-analysis was performed using Stata MP 17. The Cochrane Risk of Bias Tool version 2 was used to assess the quality of the included studies. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation method. RESULTS: This review includes a total of 13 randomized controlled trials with 1447 breast cancer patients and survivors. When compared with controls, meta-analysis revealed that cognitive behavioral therapy significantly reduced the fear of cancer recurrence (g = -0.44; 95% confidence interval, -0.75 to -0.13; P < .001), whereas subgroup analysis revealed that only mindfulness-based cognitive therapy was significant. The overall risk of bias was high. The Grading of Recommendations, Assessment, Development and Evaluation assessment showed a low overall quality of evidence. CONCLUSIONS: Cognitive behavioral therapy may be effective in reducing fear of cancer recurrence in breast cancer patients, and mindfulness-based cognitive therapy is particularly worthy of implementation. IMPLICATIONS FOR PRACTICE: Mindfulness-based cognitive therapy may be used as an additional strategy to help manage breast cancer patients' fears of cancer recurrence.

Geriatric nutritional risk index independently predicts delirium in older patients in intensive care units: A multicenter cohort study.

BACKGROUND: Malnutrition is associated with clinical outcomes in several diseases. However, the role of malnutrition in the risk of delirium in elderly patients in intensive care units (ICU) remains unclear. This study aimed to elucidate the association between the Geriatric Nutritional Risk Index (GNRI) and the risk of delirium in elderly patients in the ICU. METHODS: Elderly patients from the Medical Information Mart for Intensive Care IV (MIMIC-IV) and the eICU Collaborative Research Database (eICU-CRD) were included in this study, totaling 11,310 and 5,627, respectively. All subjects were stratified according to their GNRI score: those with no nutritional risk (GNRI > 98), mild nutritional risk (92 ≤ GNRI ≤ 98), moderate nutritional risk (82 ≤ GNRI ≤ 92), and severe nutritional risk (GNRI < 82). The primary outcome was delirium. RESULTS: The GNRI in MIMIC-IV and eICU-CRD were 93.82 (84.88, 101.26) and 83.39 (75.95, 89.35), respectively. Compared to the cohort without nutritional risk, there was an increased risk of delirium in patients with mild nutritional risk (OR: 1.39, 95 % CI: 1.23-1.58), moderate nutritional risk (OR: 1.72, 95 % CI: 1.52-1.95), and severe nutritional risk (OR: 2.07, 95 % CI: 1.79-2.39). Inclusion of the GNRI score in the multivariate models improved the prediction of delirium. Similar results were found in the eICU-CRD database. CONCLUSIONS: Nutritional assessment using the GNRI may be an independent predictor of the development of delirium in elderly patients in the ICU. The addition of the GNRI score to the delirium prediction model improves its predictive accuracy.

Effects of balance training on balance and fall efficacy in patients with Osteoporosis: A systematic review and meta-analysis with trial sequential analysis.

OBJECTIVE: To appraise research evidence on the effects of balance training on balance and fall efficacy in patients with osteoporosis. METHODS: Six electronic databases were searched from inception of the database to 1 August 2022, with no language restrictions, and randomized controlled trials of balance training in patients with osteoporosis were included in this meta-analysis. Two authors independently screened and reviewed the articles and assessed the methodological quality using the Cochrane risk-of-bias tools. Trial sequential analysis was conducted. RESULTS: A total of 10 randomized controlled trials with 684 patients were included. Three of the studies that were included had low risk of bias, 5 had moderate risk of bias, and 2 had high risk of bias. A meta-analysis demonstrated that balance training improves dynamic balance measured using the Timed Up and Go Test (mean difference (MD) = -1.86, 95% CI (-2.69, -1.02), Z = 4.38, p < 0.0001) and the Berg Balance Scale (MD = 5.31, 95% CI (0.65, 9.96), Z = 2.23, p < 0.03), static balance measured using One-Leg Standing Time (MD = 4.10, 95% CI (2.19, 6.01), Z = 4.21, p < 0.0001), and fall efficacy measured using the Falls Efficacy Scale International (MD = -4.60, 95% CI (-6.33, -2.87), Z = 5.20, p < 0.00001) were also significantly improved. Trial sequential analysis showed reliable evidence of the effects of balance training on dynamic and static balance improvement. The conclusions of this review are supported by the statistical and clinical significance of all outcomes in the meta-analysis, based on the advised minimal clinically significant differences and minimum detectable changes. CONCLUSION: Balance training may be effective in improving balance ability and reducing fear of falling in patients with osteoporosis.