Predictive Model of Functional Exercise Compliance of Patients with Breast Cancer Based on Decision Tree.

Objective: Regular functional exercise can help recover the functions of upper limb for patients with breast cancer. By finding the influencing factors of functional exercise compliance and constructing a predictive model, patients with a poor functional exercise compliance can be better identified. This study aims to find out the factors influencing the functional exercise compliance of patients with breast cancer and build a predictive model based on decision tree. Methods: Convenience sampling was used at two tertiary hospitals in Shantou from August 2020 to March 2021. Data of patients with breast cancer patient was obtained from questionnaires and based on demographics, Constant-Murley Score, Functional Exercise Compliance Scale for Postoperative Breast Cancer Patients, Champion Health Belief Model Scale, Social Support Rating Scale, Disease Perception Questionnaire and Family Care Index Questionnaire. Possible influencing factors of functional exercise compliance were analyzed using correlation analysis as well as univariate and binary logistic regression analysis through SPSS v25, and a CHAID decision tree was used to construct a predictive model on training, validation and test sets via SPSS Modeler v18 at a ratio of 6:2:2. Prediction accuracy, sensitivity, specificity and AUC were used to analyze the efficacy of the predictive model. Results: A total of 227 valid samples were collected, of which 145 were assessed with a poor compliance (63.9%). According to a logistic regression analysis, perceived benefits, time after surgery and self-efficacy were influencing factors. The prediction accuracy, sensitivity, specificity and AUC of the predictive model, based on a CHAID decision tree analysis, were 70.73%, 57.1%, 77.8% and 0.81 respectively. Conclusion: The predictive model, based on a CHAID decision tree analysis, had a moderate predictive efficacy, which could be used as a clinical auxiliary tool for clinical nurses to predict patients' functional exercise compliance.

Prevention of unplanned endotracheal extubation in intensive care unit: An overview of systematic reviews.

AIMS: This study was performed to identify and summarize systematic reviews focusing on the prevention of unplanned endotracheal extubation in the intensive care unit. DESIGN: Overview of systematic reviews. METHODS: This overview was conducted according to the Preferred Reporting Items for Overviews of Systematic Reviews, including the harms checklist. A literature search of PubMed, the Cochrane Library, CINAH, Embase, Web of Science, SINOMED and PROSPERO was performed from January 1, 2005-June 1, 2021. A systematic review focusing on unplanned extubation was included, resulting in an evidence summary. RESULTS: Thirteen systematic reviews were included. A summary of evidence on unplanned endotracheal extubation was developed, and the main contents were risk factors, preventive measures and prognosis. The most important nursing measures were restraint, fixation of the tracheal tube, continuous quality improvement, psychological care and use of a root cause analysis for the occurrence of unplanned endotracheal extubation. CONCLUSIONS: This overview re-evaluated risk factors and preventive measures for unplanned endotracheal extubation in the intensive care unit, resulting in a summary of evidence for preventing unplanned endotracheal extubation and providing direction for future research. TRIAL REGISTRATION DETAILS: The study was registered on the PROSPERO website.

Status of cognitive frailty in elderly patients with chronic kidney disease and construction of a risk prediction model: a cross-sectional study.

OBJECTIVE: To investigate the risk factors of cognitive frailty in elderly patients with chronic kidney disease (CKD), and to establish an artificial neural network (ANN) model. DESIGN: A cross-sectional design. SETTING: Two tertiary hospitals in southern China. PARTICIPANTS: 425 elderly patients aged ≥60 years with CKD. METHODS: Data were collected via questionnaire investigation, anthropometric measurements, laboratory tests and electronic medical records. The 425 samples were randomly divided into a training set, test set and validation set at a ratio of 5:3:2. Variables were screened by univariate and multivariate logistic regression analyses, then an ANN model was constructed. The accuracy, specificity, sensitivity, receiver operating characteristic (ROC) curve and area under the ROC curve (AUC) were used to evaluate the predictive power of the model. RESULTS: Barthel Index (BI) score, albumin, education level, 15-item Geriatric Depression Scale score and Social Support Rating Scale score were the factors influencing the occurrence of cognitive frailty (p<0.05). Among them, BI score was the most important factor determining cognitive frailty, with an importance index of 0.30. The accuracy, specificity and sensitivity of the ANN model were 86.36%, 88.61% and 80.65%, respectively, and the AUC of the constructed ANN model was 0.913. CONCLUSION: The ANN model constructed in this study has good predictive ability, and can provide a reference tool for clinical nursing staff in the early prediction of cognitive frailty in a high-risk population.

Perceptions and experiences of nutritional management needs for patients with esophageal cancer during the peri-radiotherapy period: A qualitative study.

Objective: Malnutrition in patients with esophageal cancer is a major health problem. However, the information about the perceptions and experiences of nutritional management needs during the peri-radiotherapy period is lacking. This study aimed to understand the experiences of, and perspectives on, nutritional management needs of patients with esophageal cancer, family caregivers, doctors, and nurses â€‹so as to explore the influencing factors and coping strategies to meet nutritional management needs for patients with esophageal cancer during the peri-radiotherapy period. Methods: A qualitative study with purposive and theoretical sampling was used in this study. One-to-one and focus group interviews were held among patients, main family caregivers, doctors, and nurses in a tertiary general hospital and a tertiary cancer hospital in Shantou, south of China, from August to September in 2020. Data were analyzed using grounded theory by a three-level coding method. The reporting of this study adhered to the COREQ guidelines. Results: A total of 12 patients, 10 main family caregivers, 6 doctors, and 9 nurses were interviewed. According to the participants, the three main categories, "personal cognition," "family and social factors," and "nutritional management environment and system," were the main factors influencing nutritional management needs. "Lack of nutrition-related cognition," "effects of feeding-related symptom clusters," and "motivation" were the three major factors that constituted participants' personal cognition on nutritional management. "Dietary conditions in medical institutions," "nutritional management system in medical institutions," and "home nutritional care" were the main components of the nutritional management environment and system. The coping strategies included standardized nutritional training for staff, patients and caregivers, social support system, discharge preparation services, multidisciplinary nutritional management, and construction of the organization and management system. Conclusions: Malnutrition in patients with esophageal cancer who suffer from great diet pain during the peri-radiotherapy period has become a concerning health issue. It is still challenging and needs more nutritional research. The full identification of influencing factors for nutritional management needs and the proposal of coping strategies may help provide theoretical support and a practical basis for constructing a tumor nutritional management scheme to meet the needs of patients with esophageal cancer.

A qualitative study on the experience of empowerment from the perspectives of breast cancer survivors.

AIM: To describe the experience of empowerment for breast cancer survivors in order to increase quality of life after treatment. DESIGN: We adopted a qualitative design in this study. METHODS: A qualitative descriptive approach guided by interpretive description methodology as the theoretical framework was used in this study. Semi-structured group and individual interviews were conducted with eleven female Chinese breast cancer survivors (mean age 54.18 years, 100% female). RESULTS: Many survivors reported that they continued to experience disease-related discomfort from the physiological aspect, but they use multiple ways to improve quality of life. Breast cancer survivors experienced empowerment after treatment. Empowerment mainly required three components: a belief in good health, capability of self-management and acquisition of a good social support system.