Development and validation of the perceived symptom manageability scale among people living with the human immunodeficiency virus.

BACKGROUND: "Perceived Symptom Manageability (PSM)" is essential in symptom management among people living with HIV. As a standardized assessment instrument was lacking, we developed a PSM scale for people living with human immunodeficiency virus (PSM-HIV). METHODS: Data analysis was performed using the sample from HIV-designated medical institutions (N = 540). Psychometric testing, namely reliability and validity, is assessed by unidimensionality, internal consistency, exploratory and confirmatory factor analysis, and structural equation modeling. RESULTS: The final version of the PSM- HIV scale contained 15 items. This scale was submitted to a principal components analysis with varimax rotation, and three factors were obtained, explained by a total variance of 63.10%. The three factors were named Cognitive-Behavioral, Affective Interaction, and Self-Attitude. The results show that the scale had high reliability, Cronbach's α of the scale ranged from 0.71 to 0.92, and the Intraclass Correlation Coefficient was 0.88. The structural equation model supports a factor model with the acceptable fit (χ2/df (CMIN/DF) = 2.50, Root Mean square Residual (RMR) = 0.03, Goodness-of-Fit Index (GFI) = 0.93, Adjusted Goodness of Fit Index (AGFI) = 0.90, Normed Fit Index (NFI) = 0.93, Incremental Fit Index (IFI) = 0.96, Comparative Fit Index (CFI) = 0.96). The average variance extracted was 0.38 ∼ 0.59, and the composite reliability was 0.70 ∼ 0.91, indicating that the convergent validity of the scale is acceptable. Subjects with different stages of the disease reached significance(χ2 = 9.02; df = 2, P<0.05), meaning moderate Known-Groups Comparison Validation. CONCLUSIONS: The PSM-HIV scale is a valid instrument that measures overall attitude and belief about controlling or coping with HIV-relevant symptoms.

Effects of Perceived Social Support on Health-Related Quality of Life in Asymptomatic and Symptomatic People Living with HIV in China: A Cross-Sectional Study.

OBJECTIVE: Improving health-related quality of life (HRQOL) in people living with HIV (PLWH) is one of the critical goals of HIV prevention and control in the following decades, and perceived social support (PSS) has always exhibited a positive influence on patients' HRQOL. This study aims to describe the gap in social support in improving HRQOL between symptomatic and asymptomatic PLWH. METHODS: By analysing secondary data from an online survey, a multicenter, descriptive and crosssectional study was conducted. The correlation trend and differences between PSS and HRQOL among asymptomatic and symptomatic PLWH were determined. RESULTS: Information from 493 PLWH with ART medication was finally analyzed: 34.89% asymptomatic PLWH and 65.11% symptomatic PLWH. There were significant differences observed between the two groups in terms of family income (χ2 = 9.782, P = 0.021), HIV-positive duration (χ2 = 19.541, P < 0.001), stage of disease (χ2 = 9.617, P = 0.008), and comorbidities (χ2 = 26.119, P < 0.001). The mean score of HRQOL of PLWH for the whole domain of the questionnaire was 86.56 (SD = 15.95). In six domains of QOL and PSS, the asymptomatic group had better conditions than the symptomatic group. There was a linear association between PSS and HRQOL, not only in the symptomatic group but also asymptomatic population, after adjusting for potential confounding factors. When the level of PSS was between 60 and 80, the HRQOL of the symptomatic group was similar to that of the asymptomatic group. While the score of PSS exceeded 80, the HRQOL of the symptomatic group was less sensitive to the changes in PSS. The social and environmental status of HRQOL in PLWH was most strongly correlated with their PSS. CONCLUSION: The value of PSS on the HRQOL in PLWH is confirmed, especially for asymptomatic subjects. Healthcare providers need a complete understanding of the gap in social support between the asymptomatic and symptomatic populations. The comprehensive strategies, including symptom management, active treatment, and social support, should be more efficient for improving the overall health of symptomatic PLWH.

Awareness and practice of preventive measures among healthcare workers in medical institutions in Beijing during influenza season on the eve of COVID-19 epidemic: A cross-sectional survey.

BACKGROUND: Influenza is an acute respiratory infectious disease caused by the influenza virus, which poses a certain threat to humans due to its short incubation period, fast transmission and strong infectivity. OBJECTIVES: To evaluate the awareness and prevention behavior against influenza among healthcare workers on the eve of the coronavirus disease 2019 (COVID-19) epidemic in Beijing, China. MATERIAL AND METHODS: Using the cross-sectional research design based on the principle of convenience sampling, an online questionnaire survey on the knowledge of flu, vaccination, medical protection behavior, and flu medication was conducted between January and February 2020. Healthcare workers from different healthcare facilities and different job positions in Beijing participated in this survey. RESULTS: A total of 1910 healthcare workers from different medical institutions and jobs were included in the study. The mean age of the participants was 32.69 ±8.72 years (range: 18-64 years). There were significant differences in knowledge about clinical signs about flu and prevention approaches among different age groups, individuals with different work experience and job titles (χ2 = 8.903-32.839; p < 0.05). Personnel with different job positions and education levels differed only in the knowledge about clinical signs of flu and identification of high-risk populations. A multivariate logistic regression analysis revealed that age (odds ratio (OR) = 0.979, 95% confidence interval (95% CI): 0.966-0.992) and education level (OR = 0.736, 95% CI: 0.588-0.921) were risk factors for hand hygiene practices, whereas job position (OR = 1.757, 95% CI: 1.146-2.695) and awareness of high-risk populations (OR = 1.405, 95% CI: 1.096-1.800) were protective factors influencing hand hygiene practices (p < 0.05). The only factor influencing mask wearing was the education level (OR = 0.610, 95% CI: 0.450-0.828). CONCLUSION: The knowledge level and preventive behavior of healthcare workers before the outbreak of COVID-19 has been insufficient.

Benefits of an online multimodal nursing program among patients with peripherally inserted central catheter-related thrombosis.

Background: Asymptomatic peripherally inserted central catheter-related thrombosis (PICC-RT) is one of the most common and dangerous complications caused by peripherally inserted central catheter (PICC) insertion. A variety of factors might lead to huge psychological pressures on patients and markedly affect their quality of life. The aim of this study was to evaluate the benefits of an online multimodal nursing program on the quality of life and psychological resilience of asymptomatic PICC-RT patients with ovarian cancer. Methods: This was a prospective cohort study on patients with asymptomatic PICC-RT. Patients in the control group received routine nursing care, while patients in the intervention group obtained extra assistance through an online multimodal nursing program. Individual guidance, psychological support, and real-time consultation were provided to patients in the intervention group. All participants were followed for 3 months. The health-related quality of life and psychological resilience of patients were evaluated by using the 36-item Short Form Health Survey (SF-36) and Connor-Davidson Resilience Scale (CD-RISC), respectively. Results: Compared to baseline, most of the items in the SF-36 scores were significantly increased in both intervention and control groups after 3 months (all p < 0.05), except for the role emotional domain (p = 0.085 in control group). However, the SF-36 scores of the intervention group were significantly higher than those of the control group in All health domains, including physical functioning (p = 0.001), role physical (p = 0.004), bodily pain (p = 0.003), general health (p < 0.001), vitality (p < 0.001), social functioning (p < 0.001), role emotional (p = 0.002), mental health (p < 0.001) and health transition (p < 0.001). For CD-RISC scores, the mean value of the control group was 42.03 ± 4.42 at baseline and increased to 50.36 ± 4.70 after 3 months (p < 0.001), while the intervention group was 40.00 ± 6.61 at baseline and increased to 65.12 ± 5.21 after 3 months (p < 0.001). Moreover, the CD-RISC score in the intervention group was significantly higher than that in the control group after 3 months (p < 0.001). Conclusion: The application of an online multimodal nursing program could significantly improve the health-related quality of life and psychological resilience of asymptomatic PICC-RT patients. These findings provide evidence to support the necessity of an online multimodal nursing program in routine long-term follow-up, especially in the era of COVID-19.

Prevalence of Gynecological Related Symptoms and Quality of Life in Women Living with HIV/AIDS: a Secondary Analysis from an Online, Cross-Sectional Survey in China.

Objective: Our study aims to completely understand the experience of gynecological related symptoms (GRS) and the association between GRS and quality of life (QOL) among HIV-infected women in China. Design: A cross-sectional, multicenter survey. Setting: The HIV/AIDS designated medical institutions of seven regions in China. Participants: One hundred and fifty-three women with HIV infection. Primary and Secondary Outcome Measures: Primary outcome measures included the score of GRS and QOL from analysis sample. Results: Among 153 participants, 60.13% were asymptomatic, and 39.87% were symptomatic according to their self-report data. In the symptomatic group, 47.54% reported only one symptom, 18.03% reported 2 symptoms, others reported more than 3 symptoms. The most common symptoms were vaginal discharge (25.49%), followed by irregular period (18.95%), bad cramps (13.07%), vaginal odor (11.11%), and vaginal itching (10.46%). The mean score of QOL was 86.82 ± 15.53. The symptomatic group had higher score than the asymptomatic group on each domain of QOL. GRS were negatively correlated with QOL after adjustment for confounding factors. Correlation matrix of GRS and six domains of QOL demonstrated significant negative correlation with each domain of QOL, especially the most strongly negative correlation with physical function of participants. But the association between GRS and environmental domain was weaker. Conclusion: These findings present the multidimensionality of common gynecologic related symptoms and highlight the clinically meaningful associations between GRS and quality of life among women with HIV infection in China. There is an urgent need to take measures to increase vaginal care and education in advance, delivered by trusted health professionals.

Association between HIV duration and symptom distress among middle-aged and elderly people with HIV-infected in China: a cross-sectional study.

BACKGROUND: Debate has persisted regarding whether PLWH with longer HIV durations have lower levels of prevalence and severity of symptoms compared with their newly diagnosed counterparts. Whether and how the HIV duration impact the symptom distress among middle-aged and older PLWH has not been explored clearly. METHODS: The patients with HIV-infected aged more than 40 years old were included from seven designated medical institutions of seven regions in China. Outcome was the score of symptom distress. We used the multiple regression model to calculate adjusted Coefficient of Regression (ß) with 95% CI in this study. RESULTS: Among 210 participants (mean age 50.8 years; 71.0% male; 68.1% at asymptomatic stage) in the study, the median number of symptoms was 5. Of all symptoms reported, the most distressed symptoms were sleep disturbance (33.33%), followed by memory loss (31.90%), fatigue (26.67%), slow reactions (22.86%), and vision blur (21.90%). All participants were divided into four groups according to HIV duration, and the median of total score of symptom ditress among all participants was 0.1(0.0,0.9). Difference of total scores and clusters' scores of symptom distress among four HIV duration groups were statistically significant. 51 participants with 6-10 years HIV duration were more likely to be higher level of education, at asymptomatic stage and have higher CD4 + T cell count. After adjustment for gender, age, race, education, marital status, employment, family income, region, stage of disease and CD4 + T cell count, the score of symptom distress among participants with 6-10 years HIV duration had was higher with the extension of HIV duration. Specially in physical symptoms and psychological symptoms,participants with 6-10 years HIV duration reported the persisting worse burdensome. CONCLUSIONS: HIV duration with 6-10 yearsmay be a key period that the medical team needs to pay special attention to among middle-aged and elderly PLWH. There is a need to provide medical and psychosocial services targeting middle-aged and elderly PLWH according to their changing symptom distress. TRIAL REGISTRATION: Clinicaltrials.gov: ChiCTR2100046225. Registered 11 May 2021.

Effect of Psychological Intervention on Pelvic Floor Function and Psychological Outcomes After Hysterectomy.

Background: Hysterectomy is one of the most frequently performed operations worldwide. However, postoperative complications and body image changes may induce psychological distress after hysterectomy. The study aimed to evaluate the effect of psychological intervention on pelvic floor function and psychological outcomes following hysterectomy among patients with benign indications. Methods: Ninety-nine patients underwent hysterectomy were randomly divided into intervention group (n = 50) and control group (n = 49). Patients in the control group received routine postoperative nursing care, while extra psychological intervention was provided to patients in the intervention group, including psychological support, regular lectures and family support. After 6 months, patient's psychological statuses were assessed by Generalized Anxiety Disorder scale (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). The pelvic floor function of patients was evaluated using Pelvic Floor Impact Questionnaire (PFIQ-7) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Furthermore, the incidence of postoperative complications, including uracratia, pelvic organ prolapses, sexual dysfunction and chronic pelvic pain, was evaluated. Results: After 6-month intervention, the GAD-7 and PHQ-9 scores were significantly decreased in the intervention group (p < 0.001 and p = 0.018 respectively). Both scored were significantly lower than that in the control group (p < 0.001 and p < 0.001). Compared with control group, the incidence of uracratia, pelvic organ prolapse, sexual dysfunction and chronic pelvic pain for intervention group was significantly lower (p = 0.003, p = 0.027, p = 0.001, p = 0.002 respectively) and the pelvic floor muscle strength was significantly stronger (p = 0.001). Besides, the postoperative Urinary Incontinence Impact Questionnaire (UIQ-7), Pelvic Organ Prolapse Impact Questionnaire (POPIQ-7), and Colorectal-Anal Impact Questionnaire (CRAIQ-7) scores were significantly lower (p = 0.025, p = 0.04, p < 0.001) and PISQ-12 score was significantly higher in intervention group (p < 0.001). Conclusion: Psychological intervention could effectively improve the psychological condition of patients with hysterectomy, which may facilitate patients' postoperative recovery in pelvic floor function. These findings emphasized the necessity of psychological intervention in routine postoperative nursing care.

Bio-regeneration of different rich CO2 absorption solvent via microalgae cultivation.

As one of the most mature carbon capture technologies, thermal regeneration of rich CO2 absorption solvent is a crucial challenge due to its high energy consumption (typically in the range of 3-6 MJ/kg CO2). In this work, a concept of bio-regeneration was proposed using microalgae to convert bicarbonate (which is one of the dominant components in rich solution) into value-added biomass. To evaluate the performance of bio-regeneration, different rich solution (including NH4HCO3, KHCO3 and NaHCO3) were investigated. Experimental results indicated that NH4HCO3 could be a promising bicarbonate carrier for the proposed absorption-microalgae hybrid process, which had a higher biomass productivity (55.36 mg·L-1·d-1) compared to KHCO3 and NaHCO3 and carbon sequestration capacity could be up to 158.3 mg·L-1·d-1. Meanwhile, pH adjustment was an effective approach to further intensify the performance of hybrid process. As a result, bio-regeneration of solvents could be a promising alternative to the conventional thermal regeneration.

Postoperative Weight Loss Masks Metabolic Impacts of Periodontitis in Obese Rodents.

BACKGROUND: Postoperative weight loss (POWL) is expected to occur in combined models of obesity and periodontitis. This study explores the confounding effects of POWL on the impact of ligation-induced periodontitis on glucose and lipid metabolism in obese animals. METHODS: Combined mouse models of diet-induced obesity (DIO) and ligation-induced periodontitis (5- or 10-day ligation) were studied. Fasting serum glucose (FSG), fasting insulin (Fins), and lipids including triglyceride (TG), total cholesterol (TC), and low- and high-density lipoprotein cholesterol (HDLC), were detected via biochemistry and enzyme-linked immunosorbent assay. POWL and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. Analysis of covariance was performed to identify confounding effects of POWL. RESULTS: The obesity, periodontitis, and 10-day groups exhibited greater POWL than corresponding controls (P <0.01). Without considering POWL, conflicting results were found, including: 1) contradictory changes in HDLC caused by obesity or periodontitis; and 2) unequal levels of FSG, TC, and HDLC between days 5 and 10 in the sham-ligation controls. Moreover, upregulating effects of periodontitis were found only on TG in the DIO mice, whereas those on Fins, HOMA-IR, and HDLC were statistically veiled. After the confounding effects of POWL were filtered, periodontitis promoted increased levels of not only TG but also Fins, HOMA-IR, and HDLC in the DIO mice (P <0.05). CONCLUSIONS: When analyzing the interrelationship between obesity and periodontitis, the confounding effects of an imbalanced POWL should be considered. Otherwise, impact of periodontitis on metabolic dysregulation in obese animals may be underestimated.