ObjectiveTo investigate the status of exit-site care in patients undergoing peritoneal dialysis, and analyze the relationship between exit-site care practice and exit-site infection.MethodsThe patients undergoing peritoneal dialysis in Nanfang Hospital, Southern Medical University between January and October 2019 were recruited by convenience sampling method. The Exit-site Schaefer Scale was used to diagnose the occurrence of exit-site infection. According to the guidelines of the International Society of Peritoneal Dialysis and relevant research, a questionnaire was developed to investigate the status of exit-site care in all peritoneal dialysis patients. Logistic regression analysis was used to analyze the influence of care practice on exit-site infection.ResultsA total of 208 peritoneal dialysis patients were recruited. There were 39 patients with (totally 43 times of) exit-site infections, with an exit-site infection incidence of 0.06 episodes per patient-year. The main bacteria were Staphylococcus aureus (30.2%) and Pseudomonas aeruginosa (16.3%). Of the 39 infected patients, 8 (20.5%) had peritonitis and 3 (7.7%) had been infected more than once. The exit-site Schaefer score of the 208 patients was 3.14±2.75. Of the 208 patients, 204 (98.1%) had received training of exit-site care from nurses, 166 (79.8%) could wash their hands and wear masks as required, 196 (94.2%) covered dressings on the exit site, and 184 (88.5%) fixed catheters, but the application of antibiotic ointment did not follow the latest guidelines. The logistic regression analysis revealed that the history of redness and swelling at the exit site [odds ratio (OR)=7.926, 95% confidence interval (CI) (2.367, 26.535), P=0.001] and the history of traction-associated bleeding [OR=5.750, 95%CI (1.878, 17.610), P=0.002] were risk factors of exit-site infection.ConclusionsExit-site infection is common in peritonealdialysis patients. Most patients can perform the exit-site care as required, but the care content is yet to be updated. Nursing staff should improve the training content according to the latest guidelines, strengthen the exit-site assessment, follow-up, and retraining, treat the redness and swelling at the exit site timely, and tell the patients to pay attention to catheter fixation and avoiding excessive traction, to prevent the exit-site infection and the further development of peritonitis.
ObjectiveTo identify the risk factors of postoperative recurrence and survival for patients with hepatocellular carcinoma within Milan criteria following liver resection. MethodsData of 267 patients with hepatocellular carcinoma within Milan criteria who received liver resection between 2007 and 2013 in our hospital were retrospectively analyzed. ResultsAmong the 267 patients, 123 patients suffered from recurrence and 51 patients died. The mean time to recurrence were (16.9±14.5) months (2.7-75.1 months), whereas the mean time to death were (27.5±16.4) months (6.1-75.4 months). The recurrence-free survival rates in 1-, 3-, and 5-year after operation was 76.8%, 56.3%, and 47.6%, respectively; whereas the overall survival rates in 1-, 3-, and 5-year after operation was 96.6%, 82.5%, and 74.5%, respectively. Multivariate analyses suggested the tumor differentiation, microvascular invasion, and multiple tumors were independent risk factors for postoperative recurrence; whereas the tumor differentiation, positive preoperative HBV-DNA load, and preoperative neutrophil-to-lymphocyte ratio adversely influenced the postoperative survival. ConclusionsFor patients with hepatocellular carcinoma within Milan criteria after liver resection, the tumor differentiation, microvascular invasion, and multiple tumors contribute to postoperative recurrence; whereas the tumor differentiation, positive preoperative HBV-DNA load, and preoperative neutrophil-to-lymphocyte ratio adversely influence the postoperative survival.
ObjectiveTo systematically review the incidence and influencing factors of early enteral nutritional feeding interruptions in critically ill patients. MethodsThe PubMed, Web of Science, Embase, Cochrane Library, CNKI, WanFang Data and CBM databases were electronically searched to collect observational studies on the early enteral nutritional feeding interruptions in critically ill patients from inception to January 2, 2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 17.0 software. ResultsA total of 12 studies including 1 121 patients were included. Meta-analysis showed that the incidence of early enteral nutritional feeding interruptions in critically ill patients was 75.0% (95%CI 64.0% to 84.0%). Influenced by feeding intolerance, airway management, tube problems, radiological examination, and endoscopy, surgery and so on, interruptions of early enteral nutritional feeding frequently occur in critically ill patients. ConclusionCurrent evidence shows that early enteral feeding interruptions in critically ill patients are affected by many factors, and the incidence is high. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the indoor influencing factors of asthma in Chinese children. MethodsThe CNKI, WanFang Data, VIP, PubMed, Cochrane Library, and ScienceDirect databases were electronically searched to collect cross-sectional studies on the indoor influencing factors of asthma in Chinese children from inception to November 2021. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies; then, meta-analysis was performed using Stata 16.0 software. ResultsA total of 29 cross-sectional studies were included, and 11 influencing factors were analyzed by meta-analysis. The results of the meta-analysis showed that redecoration (OR=1.57, 95%CI 1.37 to 1.79, P<0.01), environmental tobacco smoke (OR=1.59, 95%CI 1.34 to 1.88, P<0.01), cooking oil fume (OR=1.98, 95%CI 1.20 to 3.25, P<0.01), mold and water damage (OR=1.49, 95%CI 1.09 to 2.02, P<0.01), mold (OR=2.01, 95%CI 1.40 to 2.90, P<0.01), water damage (OR=1.72, 95%CI 1.44 to 2.06, P<0.01), moldy odor (OR=1.38, 95%CI 1.22 to 1.56, P<0.01), indoor humidity (OR=1.50, 95%CI 1.18 to 1.91, P<0.01), furry pets (OR=1.55, 95%CI 1.39 to 1.72, P<0.01) and cockroach (OR=1.63, 95%CI 1.24 to 2.14, P<0.01) were risk factors for asthma in Chinese children, while burning incense had no association with the occurrence of asthma in children. ConclusionCurrent evidence indicates that redecoration, environmental tobacco smoke, cooking oil fume, mold and water damage, mold, water damage, moldy odor, indoor humidity, furry pets, and cockroaches are influencing factors of asthma in Chinese children. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectivesTo investigate the present status of clinical nurses' attitude towards patient safety and its influencing factors.MethodsA total of 2 290 clinical nurses in 10 large general hospitals in Anhui Province were investigated by general data and patient safety attitude questionnaire (SAQ).ResultsThe total score of the nurse's patient safety attitude was 112.57±11.83, in which the 6 dimension scores arranged from high to low were management recognition, working conditions, job satisfaction, team cooperation, safety climate, and pressure perception. Nurses who were female, marriage, college degrees, head nurse, and receivded patient safety education had higher total scores.ConclusionsScores of nurses of tertiary 3A hospitals in Anhui Province are overall above average. The influencing factors of nurses’ safety attitude are gender, marital status, education level, length of service, whether being head nurse, and whether being received safety education.
Objective To explore maternal health services utilization in rural areas in Rongchang County, and to analyze the influencing factors. Methods Seven hundred pregnant women were enrolled by stratified cluster sampling. The data was analyzed in SAS 8.2. Results Ninety-five percent of pregnant women had an antenatal examination, 69.3% had it for 5 times or more, and 75.4% received checking in the earlier stage of pregnancy; 98.3% were delivered in hospital, 26.3% had postpartum visit 3 times or more, and 16.7% had been systematically managed. The main influencing factors of systematic management rate were family yearly income before pregnancy whether or not the patient participated in the new rural cooperative medical scheme, and the number of pregnancies. Conclusion The maternal systematic management rate in the county has yet to be improved. Health education to improve prenatal care and postnatal visit status should be strengthened, and women should be guided to participate in the new rural cooperative medical scheme.
Objectives To study the characteristics and influencing factors of sleep disorder in patients with epilepsy. Methods One hundred and eighty-four patients with epilepsy who were admitted to the outpatient department and the epilepsy center in the Second Affiliated Hospital of Zhejiang University from October 2016 to October 2017 were enrolled. Their clinical data were collected in detail and their sleep related scales were evaluated. Sleep related assessment tools: Chinese version of the Pittsburgh sleep quality index scale (PSQI), the Epworth sleepiness scale (ESS), Berlin Questionnaire (BQ), Quality Of Life In People With Epilepsy-31 (QOLIE-31), Beck Anxiety Inventory (BAI) and Beck Depression Inventory(BDI). Results Among the 184 cases of patients with epilepsy, 100 cases were male (54.3%), 84 cases were female (45.7%), 35 cases (19.0%) had sleep disorders, 89 cases (48.4%) with poor quality of life, 23 cases (12.5%) with anxiety, 47 cases (25.5%) with depression, 59 cases (32.1%) had daytime sleepiness, and 30 cases (16.3%) with OSAS. there were statistically significant differences in age, history of hypertension, seizure frequency, quality of life , anxiety and depression in epilepsy patients with sleep disorder compared those without sleep disorder (P<0.05). The seizure frequency, quality of life, anxiety and depression were analyzed by logistic regression analysis, suggesting that seizure frequency (P=0.011) and depression (P<0.001) are independent risk factors of sleep disorders. Conclusions Epileptic patients with sleep disorder have higher frequency of seizures, poorer quality of life, and are more likely to be associated with anxiety and depression, and the frequency and depression are independent risk factors of sleep disorder in patients with epilepsy.
ObjectiveTo investigate the knowledge of hypoglycemia in patients with type 2 diabetes mellitus, analyze its influential factors, and explore the measure of hypoglycemia education. MethodsA questionnaire survey was conducted with a sample of 5 961 patients with type 2 diabetes mellitus from 144 hospitals in China between April and July 2010. The investigation contents included patients' demographic data and the knowledge of hypoglycemia. ResultsThe score of the knowledge of hypoglycemia was 62.71±10.34 and the status was medium. Multiple stepwise regression analysis showed that degree of education, duration of diabetes mellitus, periodic inspection, education about diabetic complications, times of hypoglycemia were influencing factors for the knowledge of hypoglycemia (P<0.05). ConclusionThe status of the knowledge of hypoglycemia is not optimistic. Educators should pay attention to the characteristics of patients and provide a safe regiment for controlling blood sugar with a comprehensive introduction of hypoglycemia.
ObjectiveTo systematically review the risk factors associated with sleep disorders in ICU patients.MethodsWe searched The Cochrane Library, PubMed, EMbase, Web of Science, CNKI, Wanfang Data, VIP and CBM databases to collect cohort studies, case-control studies and cross-sectional studies on the risk factors associated with sleep disorders in ICU patients from inception to October, 2018. Two reviewers independently screened literature, extracted data and evaluated the bias risk of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 9 articles were included, with a total of 1 068 patients, including 12 risk factors. The results of meta-analysis showed that the combined effect of equipment noise (OR=0.42, 95%CI 0.26 to 0.68, P=0.000 4), patients’ talk (OR=0.53, 95%CI 0.42 to 0.66, P<0.000 01), patients’ noise (OR=0.39, 95%CI 0.21 to 0.74, P=0.004), light (OR=0.29, 95%CI 0.18 to 0.45, P<0.000 01), night treatment (OR=0.36, 95%CI 0.26 to 0.50, P<0.000 01), diseases and drug effects (OR=0.17,95%CI 0.08 to 0.36, P<0.000 01), pain (OR=0.37, 95%CI 0.17 to 0.82, P=0.01), comfort changes (OR=0.34,95%CI 0.17 to 0.67,P=0.002), anxiety (OR=0.31,95%CI 0.12 to 0.78, P=0.01), visit time (OR=0.72, 95%CI 0.53 to 0.98, P=0.04), economic burden (OR=0.63, 95%CI 0.48 to 0.82, P=0.000 5) were statistically significant risk factors for sleep disorders in ICU patients.ConclusionCurrent evidence shows that the risk factors for sleep disorders in ICU patients are environmental factors (talking voices of nurses, patient noise, and light), treatment factors (night treatment), disease factors (disease itself and drug effects, pain,) and psychological factors (visiting time, economic burden). Due to the limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusions.
Objective To understand the quality of life of patients with acute mild to moderate ischemic stroke one year after stroke, analyze the factors affecting their quality of life, and provide a scientific basis for improving their health-related quality of life. Methods This study included patients who were diagnosed with acute mild to moderate ischemic stroke between March 2019 and March 2021 in four hospitals in Nanchang. Sociodemographic information and relevant clinical data were collected during hospitalization. The EQ-5D-5L questionnaire was administered to assess health-related quality of life one year after discharge. The Mann-Whitney U test (for two groups) and Kruskal-Wallis one-way ANOVA (for multiple groups) were used to analyze differences in utility scores among various factors. A Tobit regression model was built to investigate the factors influencing quality of life one-year post-stroke. Results A total of 1 181 patients participated in the study, including 791 males (66.98%) and 390 females (33.02%), with an average age of 63.7±10.9 years. Health-related quality of life data collected one year after the stroke revealed that 22.69% of patients experienced pain/discomfort, 17.27% suffered anxiety/depression, 15.66% had mobility issues, 10.33% had difficulties with daily activities, and 8.64% had trouble with self-care. Tobit regression results showed that age (β=−0.263, 95%CI −0.327 to −0.198), gender (β=−0.134, 95%CI −0.189 to −0.080), previous hypertension (β=−0.068, 95%CI −0.120 to −0.016), previous dyslipidemia (β=−0.068, 95%CI −0.126 to −0.011), admission NIHSS score (β=−0.158, 95%CI −0.198 to −0.118), and discharge mRS score (β=−0.193, 95%CI −0.250 to −0.136) were negatively associated with health utility values. Current employment status (β=0.141, 95%CI 0.102 to 0.181) and admission GCS score (β=0.209, 95%CI 0.142 to 0.276) were positively correlated with health utility values. Conclusion One year after an acute mild to moderate ischemic stroke, patients commonly face pain/discomfort and anxiety/depression. Factors affecting overall quality of life include age, sex, current employment status, previous hypertension, previous dyslipidemia, admission NIHSS score, admission GCS score, and discharge mRS score. Clinically, developing scientifically sound and reasonable rehabilitation plans post-discharge is crucial for improving long-term quality of life.