Adherence with oral nutritional supplements and influencing factors in postoperative patients with digestive tract tumors: a cross-sectional study.

OBJECTIVE: This study aims to use structural equation modeling to explore the pathways and effect sizes of factors influencing the adherence of postoperative patients with digestive tract tumor to oral nutritional supplements, providing a theoretical basis for future nursing intervention measures. METHODS: A total of 300 postoperative patients with digestive tract tumor within 30 days after surgery were conveniently sampled. Surveys were conducted using a General Information Questionnaire, Morisky Medication Adherence Scale, Digestive System Tumor Patient Nutrition Knowledge-Attitude-Behavior Questionnaire, Multidimensional Social Perception Scale, Beliefs about Medical Questionnaire, and General Self-Efficacy Scale. Structural equation modeling was employed to analyze the factors and pathways affecting adherence with oral nutritional supplements. RESULTS: The adherence score of postoperative patients with digestive tract tumor to oral nutritional supplements was 1.61 ± 1.38. The structural equation model had a good fit (χ2/df = 2.685, GFI = 0.930, CFI = 0.913, AGFI = 0.887, IFI = 0.915, and RMSEA = 0.075). Nutrition knowledge, social support, medication beliefs, and self-efficacy were found to be factors influencing adherence with oral nutritional supplements in postoperative patients with digestive tract tumor, with total effects of 0.539, 0.264, 0.215, and 0.180, respectively. Nutrition knowledge indirectly affected adherence through self-efficacy and medication beliefs, while social support indirectly affected adherence through self-efficacy. CONCLUSION: Adherence with oral nutritional supplements in postoperative patients with digestive tract tumor is at a low level. Improving social support, enhancing patients nutrition knowledge, increasing self-efficacy, and strengthening medication beliefs are effective ways to improve patient adherence.

Compliance with oral nutritional supplements and its influencing factors in postoperative patients with digestive tract tumors: a cross-sectional study.

BACKGROUND: Oral nutritional supplements are one of the preferred methods of nutritional support for postoperative patients. This study aims to investigate the current status of oral nutritional supplements compliance in postoperative patients with digestive tract tumors and its influencing factors. METHODS: Convenience sampling was employed to select 242 patients who underwent surgery for digestive tract tumors at a tertiary hospital in Shanghai from October 2022 to July 2023 as the study subjects. Data following a normal distribution were analyzed using independent sample t-tests, ANOVA single-factor analysis, Pearson correlation analysis, and multiple linear regression analysis to determine the factors influencing compliance with oral nutritional supplements. RESULTS: A total of 252 questionnaires were distributed, with 10 invalid questionnaires excluded, resulting in an effective questionnaire rate of 96.03%. The compliance score for oral nutritional supplements in postoperative patients with digestive tract tumors was (2.40 ± 1.45), General Self-efficacy Scale (GSES) score was (24.72 ± 4.86), Multidimensional Scale of Perceived Social Support Scale (MSPSS) score was (58.67 ± 11.09), and Belief about Medicines Questionnaire Scale (BMQ) score was (0.17 ± 2.78). Multiple linear regression analysis revealed that age, adverse reactions, educational level, self-efficacy, medication beliefs, and social support were factors influencing compliance with oral nutritional supplements in postoperative patients with digestive tract tumors (P < 0.05). CONCLUSION: Our study revealed that the compliance to oral nutritional supplements among postoperative patients with digestive tract tumors was at a moderate level and was closely associated with age, educational level, adverse reactions to oral nutritional supplements, medication beliefs, social support, and self-efficacy. Nursing staff should conduct nursing assessments based on the specific circumstances of patients and their families, provide personalized health education management plans based on the patients' educational level, enhance patients' nutrition knowledge, improve patient self-efficacy, and enhance social support for patients, while further improving patient nutrition management.

A review on the removal of Cl(-I) with high concentration from industrial wastewater: Approaches and mechanisms.

Large quantities of wastewaters containing high concentrations of Cl(-I) can be generated in several industries when chloride-containing materials and additive agents are employed. Because Cl(-I) is unavailable to microorganisms, physicochemical methods are generally used for the removal of Cl(-I); however, as the most stable form of chlorine under aqueous conditions, Cl(-I) in wastewaters is difficult to remove to achieve low residual concentrations through common physicochemical methods. This paper provides new insights into traditional precipitation, oxidation, ion exchange and physical separation methods, as well as newly developed approaches, for Cl(-I) removal from various industrial wastewaters through analysis of the mechanisms, applicable conditions, optimum parameters, and method advantages and disadvantages. Moreover, the developmental trends and potential improvements to these approaches are also presented. Currently, precipitation is the most common and efficient Cl(-I) removal method, for which ultraviolet (UV) light is regarded as an effective means of improvement. Additionally, advanced oxidation processes (AOPs), where Cl(-I) can be oxidized to generate Cl radicals, Cl2- radicals, Cl2 gas, etc., show great promise for Cl(-I) removal. This review provides a theoretical foundation for the effective treatment and for the secondary utilization of industrial wastewaters containing Cl(-I).

Photo-induced dissolution of Bi2O3 during photocatalysis reactions: Mechanisms and inhibition method.

Photo-induced dissolution greatly limits the application of Bi2O3 photocatalyst in water treatment. In this study, mechanisms for the photo-induced dissolution of Bi2O3 were proposed. (1) Under UV light, h+ forms and diffuses through Bi2O3. (2) The h+, which reaches the surface of Bi2O3 and can be regarded as a monatomic oxygen ion (OS-), is weakly bonded to the crystal lattice. (3) Two OS- combine and the generated (O-O)2- ionic group is oxidized by h+, resulting in the release of O2 and dissolution of Bi2O3. However, modification of Bi2O3 using polyaniline (PANI) greatly inhibits Bi2O3 dissolution under UV. Under the PANI to Bi2O3 mass ratio of 1.5%, the concentration of produced Bi3+ significantly decreased from 2.02 to 0.27 mg/m2 with a high methylene blue (MB) degradation efficiency of 98.3%, thanks to the separation of h+ from VB-Bi2O3 to HOMO-PANI. This study provided the theoretical foundation for the modification and application of Bi2O3 in water treatment.

UV-Improved Removal of Chloride Ions from Strongly Acidic Wastewater Using Bi2O3: Efficiency Enhancement and Mechanisms.

Strongly acidic wastewater generated from nonferrous metal smelting industries can be recycled as sulfuric acid after the contaminants have been removed, and among which, Cl- is rather difficult to remove. Although previous studies showed that Cl- can be removed from acidic Zn electrolyte by Bi2O3, this method still suffers from low efficiency when being employed for strongly acidic wastewater recycling. Otherwise, very high Bi2O3 dosage and H2SO4 concentration are required, leading to the need for improvement. In this study, UV irradiation was employed to improve the removal, and it was found that Cl- removal efficiency was substantially enhanced from 63.9 to 98.3%, the optimum Bi2O3/Cl- mole ratio was lowered from 1.5:1 to 0.5:1, and to achieve the maximum removal efficiency, the required H2SO4 concentration was lowered from 70 to 40 g/L. The mechanisms were also elaborated. First, Bi2O3 dissolves under the function of UV and H+, and the produced Bi3+ combines with H2O and Cl- to form BiOCl. Then, Bi2O3/BiOCl transforms into BiOCl(h+)/Bi2O3(e-) under UV irradiation, and the generated h+ oxidizes Cl- to Cl•. Finally, Cl• reacts with Bi2O3/e- to produce BiOCl. This study offered a theoretical foundation for the improvement of Cl- removal from strongly acidic wastewater.

Removal of Chloride Ions from Strongly Acidic Wastewater Using Cu(0)/Cu(II): Efficiency Enhancement by UV Irradiation and the Mechanism for Chloride Ions Removal.

Strongly acidic wastewater, which is usually generated from nonferrous metal smelting industries, has the ability to be recycled as sulfuric acid. Before this wastewater is recycled, the removal of chloride ions is necessary to improve the quality of the recycled sulfuric acid. At present, the widely used method to remove chloride ions from acidic wastewater in the form of CuCl precipitate has several disadvantages, including low removal efficiency, high temperature, long treatment time, and high dosage of Cu(II). This study proposed an improved new method of removing Cl(-I) using Cu(0)/Cu(II) under UV irradiation, and the mechanism was investigated. The Cl(-I) concentration was lowered to below 50 mg/L at a Cu(II) dosage of 1200 mg/L. Under UV irradiation, ligand-to-metal charge transfer takes place, thereby resulting in the formation of Cl•. Next, CuCl precipitates form through the reaction between Cu(0) and Cl• and produce h+/•OH under UV irradiation, which can oxidize Cl(-I) to Cl•. Simultaneously, Cl2 gas also forms directly from Cl•. This study offered a theoretical foundation for the application of UV irradiation for the enhanced removal of chloride ions from strongly acidic wastewater.