The experiences of family resilience in patients with permanent colostomy and their spouses: A dyadic qualitative study.

PURPOSE: With the prolonged survival time of patients with permanent colostomy for colorectal cancer, they and their spouses face tremendous pressure and development dilemmas that can easily lead to family adaptation crises. This qualitative study amid to explore the dyadic experiences of family resilience among Chinese patients with permanent colostomy and their spouses. METHODS: A phenomenological research method was adopted. Semi-structured, in-depth, face-to-face interviews with 10 dyads of patients with permanent colostomy and their spouses were recruited through purposive sampling from a public tertiary hospital in China from March 2023 to July 2023.The Dyadic interview analysis and Colaizzi methods were used to analyze the interview data. RESULTS: Three themes and nine subthemes were developed. (1) family crisis and dichotomous coping with stress-family crisis and coping pressure caused by enterostomy; (2) Adjustment and adaptation within the family-Joint adjustment and adaptation within the couple's family; and (3) integration and utilization of multi-dimensional social external resources (micro-level, meso-level, and macro-level). CONCLUSIONS: Couples living with permanent colostomy often undergo a complex emotional journey, experiencing varied levels of individual stress as they navigate social interactions and daily activities, which can contribute to a decline in family adaptation. With the help of the perspective of family advantage, health practitioners should pay attention to the evaluation of individual factors and family environmental resources, to fully mobilize advantage resources and give effective interventions to improve the family and social adaptation level of patients and their spouses.

Serum HMGB1 Serves as a Novel Laboratory Indicator Reflecting Disease Activity and Treatment Response in Ankylosing Spondylitis Patients.

Objective. High mobility group box 1 (HMGB1) is a late inflammatory factor participating in the pathogenesis of various autoimmune and inflammatory diseases. In the current study, we analyzed the association between serum levels of HMGB1 and clinical features of AS patients before and during treatment. Methods. Serum HMGB1 was detected in 147 AS patients and 61 healthy controls using ELISA. We evaluated the association between HMGB1 and extra-articular manifestations as well as disease severity indices. Among these AS patients, 41 patients received close follow-up at 1, 3, and 6 months after treatment. This group comprised 25 patients treated with anti-TNF-α biologics and 16 patients receiving oral NSAIDs plus sulfasalazine. Results. The serum HMGB1 of AS patients was significantly higher than in healthy controls and positively correlated with BASDAI, BASFI, ASDAS-ESR, ASDAS-CRP, ESR, and CRP, but not with HLA-B27, anterior uveitis, and recurrent diarrhea. There was no significant difference between patients with radiographic damage of hip joints and those without. We observed that serum HMGB1 paralleled disease activity after treatment. Conclusion. Serum level of HMGB1 is higher in AS patients, and to some extent, HMGB1 can reflect the activity of AS and be used as a laboratory indicator to reflect the therapeutic response.