RESUMO
PURPOSE: This study aimed to investigate the effects of glycaemic control and diabetes distress on frailty in older Chinese patients with diabetes, and to explore the mediating role of diabetes distress between glycaemic control and frailty. DESIGN: This is a descriptive, cross-sectional study. A total of 209 older patients with diabetes were recruited from a teaching hospital in Zhejiang Province. Data were collected from February to September 2022. METHODS: A self-designed questionnaire was used to collect demographic and disease-related data. The Fried Scale and Diabetes Distress Scale were employed to assess frailty and diabetes distress, respectively The bootstrap method was used to examine the mediating effects of diabetes distress on glycaemic control and frailty. The STROBE checklist was adhered to in the reporting of this study (see details in File S1). RESULTS: The findings indicated a positive correlation between the level of glycaemic control and frailty, as well as between diabetes distress and frailty. Furthermore, diabetes distress was found to play a complete mediating role between glycaemic control and frailty. CONCLUSIONS: The study findings highlight the relationship between glycaemic control, diabetes distress and frailty offering a valuable reference for enhancing the management of frailty in older patients with diabetes. RELEVANCE TO CLINICAL PRACTICE: This study emphasizes the significance of managing glycaemic control and diabetes distress in older patients with diabetes to prevent frailty, and may contribute for healthcare professionals to developing effective measures to improve the frailty of older diabetic patients in clinical settings. PATIENT OR PUBLIC CONTRIBUTION: This study was conducted with the participation of older patients with diabetes who contributed data by completing study questionnaires and undergoing physical assessments.
RESUMO
BACKGROUND: The Healthy Aging Brain Care Monitor Self-Report (HABC-M SR) is a tool to evaluate physical, mental and cognitive impairments. It has been validated in several countries for post-intensive care syndrome (PICS) assessment, but there is no Chinese version yet. AIM: The aim of this study is to translate and cross-cultural adapt HABC-M SR, and validate its psychological properties among Chinese ICU survivors. STUDY DESIGN: This is a cross-sectional study. the HABC-M SR was translated into Chinese and validated in intensive care unit survivors (n = 145). Measures of internal consistency, construct validity, concurrent validity, and content validity were evaluated. RESULTS: A 19-item Chinese version of HABC-M SR was yielded, with good reliability (Cronbach's α = 0.92) and validity (the variance was 64.4%, overall content validity was 0.91, and correlation coefficients were 0.62-0.90). CONCLUSIONS: The 19-item Chinese version HABC-M SR is a reliable and valid tool for PICS assessing and may be regarded as a standard measurement. RELEVANCE TO CLINICAL PRACTICE: The Chinese version HABC-M SR may help in selecting PICS high-risk survivors for ICU follow-up interventions. The HABC-M SR can also be regarded as a standard specific PICS measurement, thus promote the comparability between studies and transformation of the clinical evidence.
RESUMO
In this study, the Delphi method was used to develop evidence-based indicators of intensive care unit (ICU) nursing quality of care in China. Nursing quality indicators reflect elements of patient care that are directly affected by nursing practice. A comprehensive literature search identified 2,857 potentially relevant articles. From the 50 articles that were included in this study, researchers identified 38 commonly used nursing quality indicators. A panel of experts reduced these to 20, which were then subjected to two rounds of Delphi discussion by a different panel, and a final consensus was achieved. The 20 indicators were grouped into three dimensions: structure, process, and outcome (including adverse consequences). The agreement among the experts for the 20 indicators was high. These evidence-based nursing quality indicators provide for ease in data collection and a basis for clinical application and improvement in the quality of ICU nursing throughout China.
Assuntos
Enfermagem de Cuidados Críticos/normas , Unidades de Terapia Intensiva/normas , Recursos Humanos de Enfermagem Hospitalar/normas , Indicadores de Qualidade em Assistência à Saúde/normas , China , Técnica Delphi , Enfermagem Baseada em Evidências , Humanos , Papel do Profissional de EnfermagemRESUMO
AIMS AND OBJECTIVES: To establish evidence-based nursing-sensitive quality indicators for emergency nursing in China. BACKGROUND: China lacks nursing-sensitive quality indicators necessary for assessing the quality of emergency nursing and essential to nursing management. DESIGN: Prospective. METHODS: A literature search for relevant evidence-based studies was performed using several databases from January 2009-May 2014. Previously reported quality indicators were identified as appropriate for assessment by a panel of 40 experts in emergency medicine and nursing. Two successive rounds of Delphi surveys were conducted using questionnaires designed by the experts. Kendal's W coordination coefficients were calculated for indicator importance, rationality of calculation and feasibility of data collection. RESULTS: Thirty-three quality indicators were initially proposed for expert evaluation. After round 1 of expert discussion, Kendal's W coordination coefficients were .152 for importance, .092 for rationality and .141 for feasibility of data collection (all p < .001). Seven unsuitable items were discarded in round 1 and 11 discarded in round 2, which also added one new item. Finally, the experts reached consensus on 16 items established as appropriate nursing-sensitive quality indicators for emergency nursing care. CONCLUSION: Evidence-based nursing-sensitive quality indicators were established through a consensus of experts in emergency nursing and medicine. RELEVANCE TO CLINICAL PRACTICE: The current findings may provide a theoretical basis for establishing an emergency nursing quality database and improving the quality of emergency nursing care in China.
Assuntos
Enfermagem em Emergência/normas , Enfermagem Baseada em Evidências/normas , Indicadores de Qualidade em Assistência à Saúde/normas , China , Consenso , Técnica Delphi , Humanos , Estudos Prospectivos , Inquéritos e QuestionáriosRESUMO
AIMS AND OBJECTIVES: To develop nursing-sensitive quality indicators consistent with current medical practices in Chinese neonatal intensive care units. BACKGROUND: The development of nursing-sensitive quality indicators has become a top priority in nursing management. To the best of our knowledge, there has been no objective, scientific and sensitive evaluation of the quality of neonatal intensive care unit nursing in China. DESIGN: A modified Delphi technique was used to seek opinions from experts about what should be used and prioritised as indicators of quality care in neonatal intensive care unit nursing. METHODS: Based on a literature review, we identified 21 indicators of nursing-sensitive quality in the neonatal intensive care unit. Our group of 11 consultants chose 13 indicators to be discussed using the Delphi method. In October and November 2014, 39 neonatal intensive care unit experts in 18 tertiary hospitals spread across six provinces participated in two rounds of Delphi panels. RESULTS: Of the 13 indicators discussed, 11 were identified as indicators of nursing-sensitive quality in the neonatal intensive care unit: rate of nosocomial infections, rate of accidental endotracheal extubation, rate of errors in medication administration, rate of treatment for pain, rate of peripheral venous extravasation, rate of compliance with handwashing techniques, incidence of pressure ulcers, incidence of noise, the bed-to-care ratio, the proportion of nurses with greater than five years neonatal intensive care unit experience and incidence of retinopathy. CONCLUSIONS: The 11 neonatal intensive care unit nursing-sensitive indicators identified by the Delphi method integrated with basic Chinese practices provide a basis for nursing management and the monitoring of nursing quality. RELEVANCE TO CLINICAL PRACTICE: This study identified nursing-sensitive quality indicators for neonatal intensive care unit care that are suitable for current clinical practice in China.
Assuntos
Unidades de Terapia Intensiva Neonatal/normas , Terapia Intensiva Neonatal/normas , Papel do Profissional de Enfermagem , Recursos Humanos de Enfermagem Hospitalar/normas , Indicadores de Qualidade em Assistência à Saúde/normas , China , Infecção Hospitalar/prevenção & controle , Técnica Delphi , Humanos , Recém-NascidoRESUMO
BACKGROUND: Nursing-sensitive quality indicators comprise principles, procedures, and assessments to quantify the level of nursing quality in hospital departments. Although studies have demonstrated that quality indicators are essential for monitoring nursing practice in the operating room (OR), nursing quality in China is highly subjective and localised OR nursing-sensitive quality indicators are lacking. OBJECTIVE: This study aimed to establish scientific, objective and comprehensive nursing-sensitive quality indicators for the OR to evaluate and monitor OR nursing care quality in China. METHODS: Literature search for relevant evidence-based studies was performed using Cochrane, Medline, PubMed, Embase, and other databases, followed by literature review and group discussion by the expert panel. Two successive rounds of Delphi surveys were conducted using questionnaires completed by the expert panel to reach consensus and define nursing-sensitive quality indicators for the OR. RESULTS: Two rounds of Delphi surveys each had 100% questionnaire retrieval rate, with Kendall W coordination coefficients ranging from 0.096 to 0.263 (P<0.001). In round 1 of expert evaluation of 26 indicators, Kendall's W was 0.263 for importance, 0.126 for rationality, and 0.125 for feasibility of data collection (all P<0.001). After round 2, 23 items were established as OR nursing-sensitive quality indicators, including rates of work time wastage, surgery start-time delay, OR turnover time between surgeries, same-day surgery cancellation, and number of monthly surgeries in each OR; checking surgical patients, surgery site marking, allergy history, and antibiotics use 60min before incision; and also assessing expected surgical time, sterilisation indicator results, availability of surgical instruments and materials, and instrument count. CONCLUSIONS: Scientific, practical, and reliable OR nursing-sensitive quality indicators can be established based on evidence-based studies and expert consensus using the Delphi method. The quality indicators developed in this study may provide an objective and quantitative reference for evaluating nursing quality in Chinese ORs.
Assuntos
Enfermagem de Centro Cirúrgico , Salas Cirúrgicas , Indicadores de Qualidade em Assistência à Saúde , China , Técnica Delphi , Enfermagem Baseada em Evidências , HumanosRESUMO
BACKGROUND: In the postoperative period, patients mainly rely on caregivers, who experience their own physical and mental fatigue. Caregiver fatigue may affect patient outcomes. OBJECTIVES: This study explored the fatigue status and influencing factors of primary caregivers of patients after liver cancer surgery. METHODS: A baseline information questionnaire, the Fatigue Scale-14, and the Barthel Index were used to investigate the self-care ability and fatigue status of 191 primary caregivers of patients with hepatic carcinoma who had had surgery. FINDINGS: The postoperative hospitalization time and self-care level of patients, whether the primary caregiver had health insurance, subjective feelings of fatigue, the perception that health was affected, and the patients' desired level of postoperative care were correlated with the occurrence of primary caregiver fatigue.
Assuntos
Cuidadores , Fadiga , Neoplasias Hepáticas , Autocuidado , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , China , Cuidadores/psicologia , Neoplasias Hepáticas/cirurgia , Neoplasias Hepáticas/enfermagem , Adulto , Inquéritos e Questionários , Idoso , Período Pós-OperatórioRESUMO
This study aims to compare the effectiveness of video and paper materials used for teach-back education on the first insulin injection for patients with diabetes. The study enrolled 110 patients hospitalized for diabetes who had received education on their first insulin injection in the endocrinology department. The patients were divided into an intervention group (n = 55) and a control group (n = 55) using convenience sampling. Video materials were employed for the teach-back education of the intervention group, while paper materials were employed for the teach-back education of the control group. We compared cases who answered correctly to the common parts (selection and management of injection devices, selection and rotation of injection sites, proper use of injection angles and pinching, insulin storage, injection-related complications and their prevention, selection of the correct needle length, and safe disposal of needles after use) for the first time, the number of educational sessions and total education duration between the two groups and employed the "My View on Insulin" questionnaire to survey the two groups before and 28 days after the intervention. The intervention group had a shorter total education duration than the control group, a difference that was statistically significant (p < .001). The intervention group had more advantages over the control group in terms of rotation education at the injection site (p < .05). There was no statistically significant difference in the questionnaire scores between the two groups after the intervention (p > .05); however, both groups scored significantly higher than before the intervention, a difference that was statistically significant (p < .001). The teach-back method combined with video materials applied for educating patients on their first insulin injection could reduce the education duration by healthcare providers and improve the patients' psychological insulin resistance. The key to successfully teaching patients to self-administer insulin, and allowing them to master the steps involved, is to focus on "why" rather than "what" to do.
Assuntos
Diabetes Mellitus , Educação em Enfermagem , Compreensão , Humanos , Insulina , TecnologiaRESUMO
OBJECTIVES: This article aims to summarize a series of contingency management strategies of the Nursing Department in the centralized treatment of patients with coronavirus disease 2019 (COVID-19). METHODS: The strategies of the Nursing Department included an early warning for prevention and control, taking functions of vertically commanding and horizontally coordinating, and reasonably allocating nursing workforce, to facilitate centralized treatment work in the in-hospital fever clinic, isolation wards and ICU, and referral and admission of critical patients. Five special groups were established in charge of training and examination, management and supervision, psychological support, logistical support, and reporting and publicity, respectively. RESULTS: It was achieved that no deaths from critical patients and no medical staff, no other patients were infected. CONCLUSION: Through the implementation of these strategies, safe and efficient centralized treatment was ensured timely, orderly and sustainably.
RESUMO
INTRODUCTION: Cognitive behavioral therapy (CBT) has been shown to be effective in mitigating various psychosocial impacts from breast cancer. Long-term studies have yielded mixed findings on the outcome of CBT in breast cancer settings, especially with respect to quality of life (QOL) and the quantified degree of stress (QDS). EVIDENCE ACQUISITION: Medline, Cochrane, Embase, and Google Scholar databases were searched and randomized controlled trials relevant to the use of CBT and its variants in breast cancer patients were selected, and their pooled results meta-analyzed. EVIDENCE SYNTHESIS: Six studies qualified for inclusion in the meta-analysis. Results from the six pooled studies did not demonstrate that CBT improves QOL (standardized mean difference =-0.016, 95% CI=-0.898 to 0.866, P=0.972) or reduces QDS (standardized mean difference =-0.125, 95% CI=-0.268 to 0.017, P=0.084) for breast cancer survivors. However, interpretation of these results requires caution, given the small number of eligible studies, comprising a total of only 430 patients. Since the literature also includes trials of CBT combined with various other therapies, including hypnosis, exercise treatment, and stress management, with promising results in breast cancer settings, expanded clinical research is likely to demonstrate an overall benefit of CBT. CONCLUSIONS: Despite the meta-analysis fails to support the use of CBT to improve QOL or reduce stress for breast cancer survivors, CBT appears to be promising as a therapeutic intervention against many of the psychosocial impacts of breast cancer.
Assuntos
Neoplasias da Mama/psicologia , Terapia Cognitivo-Comportamental , Estresse Psicológico/terapia , Sobreviventes/psicologia , Idoso , Neoplasias da Mama/terapia , Terapia Combinada , Feminino , Humanos , Pessoa de Meia-Idade , Garantia da Qualidade dos Cuidados de Saúde , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Estresse Psicológico/etiologia , Estresse Psicológico/prevenção & controleRESUMO
Cordycepin, also termed 3'-deoxyadenosine, is a nucleoside analogue from Cordyceps sinensis and has been reported to demonstrate numerous biological and pharmacological properties. Our previous study illustrated that the anti-tumor effect of cordycepin may be associated with apoptosis. In the present study, the apoptotic effect of cordycepin on HepG2 cells was investigated using 4',6-diamidino-2-phenylindole, tetraethylbenzimidazolylcarbocyanine iodide and propidium iodide staining analysis and flow cytometry. The results showed that cordycepin exhibited the ability to inhibit HepG2 cells in a time- and dose-dependent manner when cells produced typical apoptotic morphological changes, including chromatin condensation, the accumulation of sub-G1 cells and change mitochondrial permeability. A potential mechanism for cordycepin-induced apoptosis of human liver cancer HepG2 cells may occur through the extrinsic signaling pathway mediated by the transmembrane Fas-associated with death domain protein. Apoptosis was also associated with Bcl-2 family protein regulation, leading to altered mitochondrial membrane permeability and resulting in the release of cytochrome c into the cytosol. The activation of the caspase cascade is responsible for the execution of apoptosis. In conclusion, cordycepin-induced apoptosis in HepG2 cells involved the extrinsic and intrinsic signaling pathway and was primarily regulated by the Bcl-2 family proteins.
RESUMO
OBJECTIVE: To investigate differential diagnoses value of ultra-rapid bedside measurement of brain natriuretic peptide (BNP) in patients with dyspnea. METHODS: Plasma BNP concentration were measured with immunofluorescence assay in 103 patients with dyspnea. Left ventricular ejection fraction (LVEF) and pulmonary capillary wedge pressure (PCWP) were determined by echocardiography and Swan-Ganz catheter in these patients on the same time, respectively. RESULTS: (1) Plasma BNP levels in the patients with heart failure were higher than those in the non-heart failure patients [(716 +/- 86 vs 46 +/- 7) ng/L, P < 0.01]. (2) The sensitivity, specificity and negative predictive values of Plasma BNP levels > or = 100 pg/ml for predicting heart failure were 95.2% (60/63), 93.0% (40/43) and 97.1% (100/103), respectively. (3) Plasma BNP levels were positively related to PCWP, and negatively related to LVEF (r = -0.56, both P < 0.01). CONCLUSION: Bedside BNP assay is sensitive and specific for diagnosing heart failure, and is useful in evaluating dyspnea in emergency care.