Risk prediction models of mortality after hip fracture surgery in older individuals: a systematic review.

OBJECTIVE: This study aimed to critically assess existing risk prediction models for postoperative mortality in older individuals with hip fractures, with the objective of offering substantive insights for their clinical application. DESIGN: A comprehensive search was conducted across prominent databases, including PubMed, Embase, Cochrane Library, SinoMed, CNKI, VIP, and Wanfang, spanning original articles in both Chinese and English up until 1 December 2023. Two researchers independently extracted pertinent research characteristics, such as predictors, model performance metrics, and modeling methodologies. Additionally, the bias risk and applicability of the incorporated risk prediction models were systematically evaluated using the Prediction Model Risk of Bias Assessment Tool (PROBAST). RESULTS: Within the purview of this investigation, a total of 21 studies were identified, constituting 21 original risk prediction models. The discriminatory capacity of the included risk prediction models, as denoted by the minimum and maximum areas under the subject operating characteristic curve, ranged from 0.710 to 0.964. Noteworthy predictors, recurrent across various models, included age, sex, comorbidities, and nutritional status. However, among the models assessed through the PROBAST framework, only one was deemed to exhibit a low risk of bias. Beyond this assessment, the principal limitations observed in risk prediction models pertain to deficiencies in data analysis, encompassing insufficient sample size and suboptimal handling of missing data. CONCLUSION: Subsequent research endeavors should adopt more stringent experimental designs and employ advanced statistical methodologies in the construction of risk prediction models. Moreover, large-scale external validation studies are warranted to rigorously assess the generalizability and clinical utility of existing models, thereby enhancing their relevance as valuable clinical references.

Global research trends of immunosenescence: A bibliometric study.

Background: Immunosenescence, an age-related deficit in immunity, associated with multiple disorders and making the successful aging a challenge. Although nearly 4000 articles have been published, only few review articles have summarized the research status. In order to better understand the most recent advances, hotspots and development trends in immunosenescence, it is very necessary to conduct a comprehensive bibliometric analysis. Hence, commonly used bibliometric analysis software CiteSpace and VOSviewer were employed to conduct a quantitative analysis and critical evaluation of publications in this study. Methods: Immunosenescence publications were screened from the Web of Science Core Collection (WoSCC). Microsoft Excel 2021, CiteSpace 5.8.R3, and VOSviewer 1.6.17 were used for bibliometric study. Results: A total of 3875 publications were retrieved from WoSCC. After screening by document type (article or review) (352 publications were excluded) and language of English (85 were excluded), 3438 studies were finally used for bibliometric analysis. The literature on immunosenescence had been continuously growing since 1991, and by 2020 it has skyrocketed 312 publications from 240 in 2019. USA (1111 publications, 35.01%) was the leading country of publications, followed by ITALY (379, 11.94%) and ENGLAND (366, 11.53%). Of the authors, Pawelec G from the Tubingen University of GERMANY contributed the greatest articles (93 publications). All the keywords could be divided into five clusters, and additional potent visualization bursts revealed that "gut microbiota," "health," "dysfunction," and "nivolumab" were the active hotspots presently. Conclusion: Based on the current data, we firstly concluded that there will be a dramatically rising publications on immunosenescence, and research teams from USA or GERMANY might be the best chooses for collaboration. Moreover, We particularly emphasized the development potential of mechanism and intervening strateges like "gut microbiota" and "nivolumab" in immunosenescence. We hope to provide new ideas for promoting the basic research and clinical application of immunosenescence.

Symptom clusters among breast cancer patients in relation to chemotherapy cycles: a longitudinal study.

PURPOSE: The aim of this study was to identify symptom clusters in breast cancer patients undergoing adjuvant chemotherapy. METHODS: A prospective longitudinal study was conducted. And a sample of 620 breast cancer patients receiving adjuvant chemotherapy was recruited using convenience sampling from May 20, 2020, to March 31, 2021. Data were collected eight times: the first chemotherapy cycle (T1) to the eighth cycle of chemotherapy (T8). Exploratory factor analysis was used to explore the composition of symptom clusters. RESULTS: Symptoms with an incidence of less than 20% were deleted and the remaining symptoms were included in the factor analysis. Three common factors were extracted in T1, including gastrointestinal symptom cluster, emotional and psychological symptom cluster, and menopausal symptom cluster. Five common factors were extracted from T2 to T7, including gastrointestinal symptom cluster, emotional and psychological symptom cluster, neurological symptom cluster, menopausal symptom cluster, and self-image disorder symptom cluster. Four common factors were extracted at T8, including gastrointestinal symptom cluster, emotional and psychological symptom cluster, neurological symptom cluster, and menopausal symptom cluster. CONCLUSION: Breast cancer patients undergoing adjuvant chemotherapy experience multiple symptoms and different symptom clusters in different chemotherapy cycles. It is a benefit for health care providers to better understand and care for breast cancer patients. It will also help such women to manage concurrent symptoms ahead to promote their quality of life.

Discovering Traditional Chinese Medicine (TCM) Formulas for Complex Diseases Based on a Combination of Reverse Systematic Pharmacology and TCM Meridian Tropism Theory: Taking COVID-19 as an Example.

OBJECTIVE: Infections and death have been a part of our daily lives since the COVID-2019 pandemic outbreak in 2019, and the societal and economic consequences have lingered for an unanticipated duration. Novel and effective treatments are still desperately needed around the world to combat the infection. Here, we discovered a novel traditional Chinese medicine formula (TCMF) to potentially combat COVID-19 through reverse systematic pharmacology (disease → targets → TCMF → disease). METHODS: Combining Integrative network pharmacology and the traditional Chinese medicine (TCM) theory, a TCMF for COVID-19 was identified. In silico physiological interactions between herbs and disease hub targets were validated by molecular docking and dynamics simulation. RESULTS: Based on disease-related gene/pathway targets and a combination of reverse pharmacology and TCM meridian tropism theory, a COVID-19-associated herb database was constructed. A new TCMF, including Gancao, Baitouweng, Congbai, and Diyu (GBCD), was discovered for anti-COVID-19 therapy. The KEGG and GO analyses of 49 intersecting genes suggested that GBCD could combat COVID-19 through antiviral, antiinflammation, immunoregulation, and cytoprotection activities. Moreover, these possible effects were validated through docking and MD simulation. CONCLUSIONS: To the best of our knowledge, this study is the first to combine reverse pharmacology and meridian tropism theories for TCMF development, and a novel herbal combination, GBCD, was discovered for anti-COVID-19 therapy.

Investigation on risk factors of chronic diseases among community residents: A study based on health management systems supported by Mobile phones.

AIM: To explore the physical and mental health status of community residents and to identify the risk factors of chronic diseases. DESIGN: A cross-sectional, descriptive correlational study was conducted. METHODS: A total of 579 participants were recruited from 15 communities in Tianjin. The demographic information sheet, 7-item Generalized Anxiety Disorder scale (GAD-7) and Patient Health Questionnaire (PHQ-9) were used. Data collection was undertaken based on the health management system on mobile phones from April to May 2019. RESULTS: Eighty-four participants of the total number of surveyed were with chronic disease. The incidence of depression and anxiety in participants was 44.2% and 41.3%. Logistic regression analysis showed that age (OR = 4.905, 95%CI: 2.619-9.187), religious belief (OR = 0.445, 95%CI: 1.510-11.181) and working condition (OR = 0.161, 95%CI: 0.299-0.664) entered the regression equation. Old age is a risk factor for chronic diseases. No religious belief and working condition are protective factors for chronic diseases.

How about trust in physician-patient relationship? A concept analysis of physicians' perspectives.

OBJECTIVE: Trust is an essential part of the physician-patient relationship. Yet physicians' perspectives in physician-patient trust has always been ignored, and the concept has not yet been clearly defined and analyzed. This study explores the conceptual understanding of physicians' trust in patients in the context of healthcare and clinical practice and provides a theoretical frameworks foundation for practitioners and researchers. METHODS: Seven databases were systematically searched for relevant studies, including Pubmed, CINAHL, ScienceDirect, Web of Science, CNKI, Wanfang and Weipu. Walker and Avant's approach to concept analysis was performed to extract the concept attributes, antecedents, consequences, and define empirical referents. RESULTS: Of the 8028 articles identified, 43 met the inclusion criteria. Five core attributes were identified: (a) Interaction and support; (b) Confidence and expectation in building trust; (c) Motivation for medical treatment; (d) Socially and medically epistemic competence of patients; (e) Self-reported accuracy. Antecedents were divided into a physician-patient relationship and the social context of medicine. Consequences included treatment outcomes, patient outcomes, and treatment efficiency for physicians and patients. CONCLUSIONS: Our findings offer insights into refining the concept of trust. By collaborating across healthcare trusts, we can contribute to the development of theoretical models and empirical research. This concept analysis serves as a foundation to develop instruments to measure the concept and highlight the need to design a qualitative study and enhancement strategy for physician trust in patients. PRACTICE IMPLICATIONS: Trust in Physicians' perspectives is an essential part of the physician-patient relationship. Establishing and strengthening physicians' trust in patients is significant to healthcare and clinical practice. Concept analysis of physicians' trust in patients will give policymakers a more evident concept and understanding of the importance of the trust improvement strategy and guide healthcare managers to improve theoretical development.

Relationships among social support, coping style, self-stigma, and quality of life in patients with diabetic foot ulcer: A multicentre, cross-sectional study.

Patients with diabetic foot ulcer have a significantly lower quality of life. Quality of life could be connected to other psychological or social processes. The purpose of this study was to examine the relationships between social support, decision regret, self-stigma, and quality of life in patients with diabetic foot ulcers. The sample of the study consisted of 229 diabetic foot ulcer patients. Data were collected from September 2019 to March 2020. The demographic and clinical information, the Stigma Scale for Chronic Illness, Medical Coping Scale, Social Support Scale, and Quality of Life scale were used to assess the quality life for diabetic foot ulcer. Pearson correlation coefficient and structural equation modelling were used for data analysis. The quality of life was negatively correlated with self-stigma, positively correlated with social support, giving up coping, and not significantly correlated with confrontation coping and avoidance coping. Self-stigma has significant indirect effects on quality of life through social support and coping style. Further clinical intervention strategies for decreasing self-stigma as well as strengthening social support and positive coping styles are needed to inform diabetic foot ulcer patients, thus improving their quality of life.

Associated factors of professional identity among nursing undergraduates during COVID-19: A cross-sectional study.

OBJECTIVES: Professional identity plays an important role in the long-term development of nurses, and it will change when public health emergency occurs. The objective of this study is to investigate the factors associated with the professional identity of nursing undergraduates in the epidemic of COVID-19. METHODS: A cross-sectional survey design with convenience sampling was used. A total of 3,875 nursing undergraduates were recruited from seven universities across China from March to April 2020. A general information questionnaire was used to collect students' information, and the Professional Identity Questionnaire for Nurse Students was used to survey their professional identity during the early and later stages of the first wave of the COVID-19 epidemic. RESULTS: The score of professional identity in the later stage (59.49 ± 12.41) was higher than that in the early stage (56.96 ± 12.61). The stepwise regression indicated that several factors were associated with professional identity, including gender, residential area, major, impact of the epidemic on intention to work after graduation, reasons for choosing nursing major and students' scores of professional identity in early stage. CONCLUSIONS: Nursing educators can utilize the positive impact of responding to public health emergencies to increase the professional identity of students. Meanwhile, educators should give those students with lower professional identity more targeted education to cultivate their professional identity after the occurrence of public health emergencies.

Evaluation index system of education quality for nursing professional degree postgraduate using the analytic hierarchy process.

ABSTRACT: Nursing is an inseparable job with the healthy life of human beings. High-level nursing talents have a greater influence on patients. It is the future trend for schools to train Nursing Professional Degree Postgraduate, and the evaluation of their education quality is the top priority.To construct the education quality evaluation index system of Nursing Professional Degree Postgraduate and to determine the weight of each indicator.Firstly, the indicators of the evaluation index system of education quality were identified from the literature review. Meanwhile, the Delphi questionnaire was designed and 13 experts evaluated and rated the indictors who were invited to conduct two rounds of the questionnaire. The weights associated with the factors were determined using the analytic hierarchy process and percentage methods, Finally, we developed the evaluation index system of education quality for a postgraduate nursing professional degree.The evaluation system consisted of 4 first-level indicators, 17 second-level indicators, and 71 third-level indicators. According to the weights computed by analytic hierarchy process, first-level indicators are ranked as "Input quality" (0.1273), "Process quality" (0.3111), "Output quality" (0.0846), "Development quality" (0.4770). Among the secondary indicators, experts pay the most attention to career development (0.3180). The top three indicators of third-level indicators are workplace (0.2385), matching degree between personal expectations and job opportunities (0.1272), and promotion opportunities (0.0795).The quality index system of nursing postgraduate education is scientific and reliable, and the weight distribution is reasonable. It is an effective tool for evaluating the quality of nursing graduate education.

Effects of patient decision aids in patients with type 2 diabetes mellitus: A systematic review and meta-analysis.

AIMS: This study aimed to systematically evaluate the effectiveness of patient decision aids on knowledge, decisional conflict and decisional self-efficacy outcomes in patients with diabetes. METHODS: A comprehensive database search was performed using the Web of Science, Cochrane Library, PubMed, Embase, PsycINFO (Ovid), CINAHL (EBASCO), CNKI, VIP, Wan Fang Database and the Ottawa Decision Aid Library Inventory (http://decisionaid.ohri.ca/index.html) from inception to 13 October 2019. Two reviewers independently searched databases, screened articles, extracted data and evaluated the risk bias of included studies. Then Rev Man 5.3 software was adopted for statistical analysis. RESULTS: Ten articles containing 1,452 people with diabetes were selected. The results of meta-analysis showed that patient decision aids had a positive effect on reducing decisional conflict and improving decisional self-efficacy among patients with type 2 diabetes. Meanwhile, this article also revealed that patient decision aids have beneficial short-term effects on improving knowledge, but there was no significant long-term effect. CONCLUSION: Patient decision aids are capable of becoming support tools to improve shared decision making. Further implementation studies are required to transform patient decision aids tools into clinical practice.

Chinese version of the clinical supervision self-assessment tool: Assessment of reliability and validity.

BACKGROUND: Cultivating the professional knowledge and professional identity of nursing students is important for nursing education. The degree of professional identity of nursing students will directly affect their career options and work performance after graduation. Clinical practice is a learning process of combining the knowledge and the practical techniques of nursing. It is the important way to cultivate the students' comprehensive ability, professional attitude and professional emotion. Effective clinical supervision during the clinical practice plays an important role in guaranteeing clinial practice quality and cultivating professional nursing students. Active teaching supervision is helpful to achieve the expected learning effect. Therefore, it is vital to evaluate the clinical supervision ability of the clinical nursing teachers. However, there is no special assessment instrument available in China. OBJECTIVES: To assess the validity and reliability of the Chinese version of the modified Clinical Supervision Self-Assessment Tool (mCAST). DESIGN: A cross sectional survey design with a convenience sample was used in this study. This cross-sectional psychometric instrumental study determined the reliability and validity of the Chinese version of the modified Clinical Supervision Self-Assessment Tool (mCAST). SETTINGS: Twelve hospitals in Tianjin, China. PARTICIPANTS: A total of 350 registered nurses who perform teaching tasks in clinical practice were recruited. METHODS: The Chinese version of the mCSAT was translated and tested by obtaining the authorization of the developer of the mCAST using Brislin's model (that is, translation, back translation, cultural adaptation and pilot study). A total of 350 registered nurses who perform teaching tasks in clinical practice were recruited by convenience sampling for the assessment of construct validity using exploratory factor analysis (EFA). Moreover, item analysis, internal correlation coefficients, Cronbach's alpha coefficients, test-retest realibility and split-half reliability were conducted to test the psychometric properties of the Chinese version of the mCSAT. RESULTS: The Chinese version of the mCSAT contained 2 subscales, namely, mCSAT-Knowledge and mCSAT-Skills. Exploratory factor analysis of the knowledge and skills subscales explained 63.26% and 63.60% of the total variances, respectively. The mCSAT-Knowledge subscale contains 3 dimensions, namely, evaluating learning (10 items), facilitating learning (9 items) and problem solving (10 items); the mCSAT-Skills subscale contains 3 dimensions, namely, evaluating learning (10 items), facilitating learning (9 items) and problem solving (10 items). The Cronbach's α coefficients of the mCSAT-Knowledge and mCSAT-Skills subscales were both 0.95. The split-half reliability of the mCSAT-Knowledge and mCSAT-Skills subscales were 0.88 and 0.89, respectively. CONCLUSION: The Chinese version of the mCSAT was reliable and valid in the evaluation of the knowledge and skills for the clinical supervision of registered nurses. Further validation of the Chinese version of the mCSAT requires a more representative and larger sample. Also, the confirmatory factor analysis should be conducted in future study.

Health Risk Assessment Indicators for the Left-Behind Elderly in Rural China: A Delphi Study.

In China, many young and middle-aged rural residents move to urban areas each year. The rural elderly are left behind. The number of the rural left-behind elderly is increasing with urbanization, but it is unclear which indicators can be used to assess their health condition. The health risk assessment index system was developed to improve the health level of the rural left-behind elderly. A two-round web-based Delphi process was used to organize the recommendations from fifteen Chinese experts in geriatrics, health management, social psychology who participated in this study. Meaningfulness, importance, modifiability, and comprehensive value of the health risk assessment indicators in the index system were evaluated. The effective recovery rates of the two-round Delphi were 86.67% and 92.31%, respectively. The judgement coefficient and the authority coefficient were 0.87 and 0.82, respectively. The expert familiarity was 0.76. Ultimately, the health risk assessment index system for the rural left-behind elderly consisted of five first-level indicators, thirteen second-level indicators, and sixty-six third-level indicators. The final indicators can be used to evaluate the health of the rural left-behind elderly and provide the basis for additional health risk interventions.

Short report: relationships among resilience, social support, coping style and posttraumatic growth in hematopoietic stem cell transplantation caregivers.

Posttraumatic growth has become a focus of concern in cancer caregivers, but a few studies have explored relationships among resilience, social support, coping style, and posttraumatic growth, especially in hematopoietic stem cell transplantation caregivers. A descriptive cross-sectional survey was conducted. Three hundred and fourteen participants completed questionnaires consisting of demographics, Posttraumatic Growth Inventory, Perceived Social Support Scale, Connor-Davidson Resilience Scale 10 and Coping Style Questionnaire. Pearson correlation analyses revealed that posttraumatic growth was positively associated with resilience, social support, and positive coping style, while, passive coping style was negatively associated with posttraumatic growth. At the same time, structural equation modeling analyses showed that resilience mediated the relationship between positive coping style and posttraumatic growth. Positive coping style and resilience played completely intermediary role between social support and posttraumatic growth.