Development and Validation of a Risk Prediction Model to Predict Postextubation Dysphagia in Elderly Patients After Endotracheal Intubation Under General Anesthesia: A Single-Center Cross-Sectional Study.

At present, the incidence and risk factors for dysphagia after extubation in elderly inpatients are still unclear, and we aimed to develop and validate a risk prediction model that prospectively identifies high-risk patients to reduce the occurrence rate of dysphagia. The 469 patients recruited were randomly divided into modeling and validation groups in a 7:3 ratio. In the modeling group, the postextubation dysphagia (PED) risk factors were analyzed, and a risk prediction model was established. In the validation group, the model was validated and evaluated. The model was constructed based on the risk factors determined by a binary logistic regression analysis. The discrimination ability of the model was evaluated by the receiver operating characteristic (ROC) curve. The calibration curve and Hosmer‒Lemeshow test were performed to evaluate the model's calibration ability. The clinical utility of the risk prediction model was analyzed by decision curve analysis (DCA). The results showed that the incidence of PED was 15.99%, and age, duration of indwelling gastric tube, difficult endotracheal intubation, atomization after extubation, anesthesia risk level and frailty assessment were identified as important risk factors. The model was validated to have favorable discrimination, calibration ability and clinical utility. It has a certain extension value and clinical applicability, providing a feasible reference for preventing the occurrence of PED.

Family burden and psychological distress among Chinese caregivers of elderly people with dementia: a moderated mediation model.

BACKGROUND: Although the Stress-Coping Model (SCM) has been widely used to explain the coping process of individuals facing stressful situations, its applicability to caregivers of elderly people with dementia (PwD) in China needs to be further investigated. Furthermore, the role of external resources in caregivers stress coping is not yet clear. Therefore, our study aimed to investigated the mediating and moderating mechanisms between family burden and psychological distress in PwD caregivers based on the SCM. METHODS: A cross-sectional study, with 193 pairs of PwD and caregivers completed the self-designed questionnaire, Family Burden Scale of Disease, Kessler Psychological Distress Scale, General Self-Efficacy Scale, Simplified Coping Style Question, The Family Adaptation and Cohesion Evaluation Scales II-CV and Social Support Rating Scale. Partial least squares-structural equation modeling (PLS-SEM) analyzed the mediating and moderating effects. RESULTS: Family burden positively correlated with psychological distress; the chain mediation effects of self-efficacy and positive coping between family burden and psychological distress was significant; the interaction term (family function_positive coping) did not but (social support_positive coping) had a significant positive impact on psychological distress. CONCLUSIONS: The findings provides a practical basis for the use of SCM in informal caregivers of elderly PwD, assists understanding the mechanism of the relationship between family burden and psychological distress. And it supplies new perspectives for reducing the negative psychological health status and a theoretical basis for designing interventions for caregivers.

The impact of family burden on the psychological distress of informal caregivers for older adults living with dementia: The role of internal and external coping resources.

OBJECTIVES: Numerous studies have demonstrated that informal caregivers of people living with dementia (PLWD) have serious adverse psychological problems, but little research has been done on the role of integrating caregivers' various coping resources in reducing psychological effects. Therefore, the current study aimed to investigate the impact of caregivers' internal (self-efficacy and positive coping) and external coping resources (family function and social support) on the family burden and psychological distress. METHODS: A cross-sectional study, and a self-designed questionnaire, Family Burden Scale of Disease, Kessler Psychological Distress Scale, General Self-Efficacy Scale, Simplified Coping Style Question, The Family Adaptation, Partnership, Growth, Affection, Resolve Scale and Social Support Rating Scale were completed by 193 pairs of PLWD and caregivers. Partial least squares-structural equation modeling (PLS-SEM) was used to analyze the mediating effects of coping resources. RESULTS: Self-efficacy, positive coping, family function, and social support respectively mediated the relationship between family burden and psychological distress (ß = 0.402, ß = 0.059, ß = -0.111, ß = 0.053; P < 0.05). Besides, the serial mediation effects of self-efficacy and positive coping, family function and social support were also significant (ß = 0.104, ß = 0.045; P < 0.05). CONCLUSIONS: This study confirmed the mediating role of internal and external coping resources between family burden and psychological distress in caregivers of older PLWD, providing a theoretical basis for promoting the,mental health of caregivers.

Self-Perceived Burden as a Mediator Between Perceived Partner Responsiveness and Fertility Intentions in Women With Inflammatory Bowel Disease.

This study investigates the role of self-perceived burden as a mediating factor in the association between perceived partner responsiveness and fertility intentions in women of reproductive age diagnosed with inflammatory bowel disease. A sample of 366 female inflammatory bowel disease patients from Changsha, China, was recruited using convenience sampling. Participants completed assessments, including the Impact of Perceived Partner Responsiveness Scale, Self-Perceived Burden Scale, Fertility Intentions Questionnaire, and a demographic questionnaire. Results indicated a moderate-to-low level of fertility intentions (mean score: 5.33 ± 2.21), with corresponding moderate levels of self-perceived burden (mean score: 30.01 ± 10.02) and perceived partner responsiveness (mean score: 52.80 ± 17.03). Positive correlations were observed between perceived partner responsiveness and fertility intentions and negative correlations between self-perceived burden and fertility intentions. The relationship between perceived partner responsiveness and fertility intentions was found to be partially mediated by self-perceived burden. These findings highlight the significance of perceived partner responsiveness and self-perceived burden in shaping fertility intentions among women with inflammatory bowel disease.

Association between the patients' symptom burden and their family caregivers' benefit finding in non-small cell lung cancer receiving combined chemotherapy.

PURPOSE: The aim of the study is to explore the relationship between the patients' symptom burden and their family caregivers' benefit finding in non-small cell lung cancer (NSCLC) receiving combined chemotherapy. METHODS: A cross-sectional study on 181 NSCLC patients receiving combined chemotherapy and their family caregivers was conducted at two comprehensive hospitals from December 2021 to August 2022 in China. The patients completed the self-designed questionnaire, The Chinese Version of M.D. Anderson Symptom Inventory (MDASI) and Lung Cancer Module of the M.D. Anderson Symptom Inventory (MDASI-LC), while caregivers completed the self-designed questionnaire, Benefit Finding Scale (BFS). RESULTS: The mean symptom burden score of NSCLC patients receiving combined chemotherapy was 71.55 (SD = 22.19), and the median score of fatigue was 6 (IQR, 4, 7). Fatigue was the most severe symptom. The mean benefit finding score of family caregivers was 56.09 (SD = 16.25). Among the dimensions of the benefit finding scale, the personal growth dimension scored the highest. The mean score of personal growth dimension was 18.31 (SD = 5.47). The scores of symptom burden of NSCLC patients and the benefit finding of family caregivers were significantly different in patients' clinical data: stage of tumor, tumor metastasis, duration of illness, self-care ability, leukocyte count (WBC), blood platelet (PLT), hemoglobin content (Hb), Na+ concentration, and K+ concentration (P < 0.05). The symptom burden of NSCLC patients with combined chemotherapy was adversely correlated with the benefit finding of family caregivers (r = - 0.609 ~ - 0.151, P < 0.05). CONCLUSIONS: The symptom burden of patients is adversely correlated with the benefit finding of family caregivers in NSCLC receiving combined chemotherapy; the lighter the symptom burden of patients, the higher the benefit finding of family caregivers. Therefore, appropriate nursing measures should be taken for fatigue, lack of appetite, and other symptoms. A variety of ways should be taken to promote family caregivers to participate in patient symptom management, so as to achieve the goal of reducing the burden of patients' symptoms and improving the level of family caregivers' benefit finding.