Objective To investigate the development trajectories of kinesiophobia and their influencing factors in patients after total hip arthroplasty (THA). Methods Patients after THA from three tertiary hospitals in Wuhan from February to June 2023 were selected by convenience sampling method. The general situation questionnaire, Tampa Scale for Kinesiophobia, Self-Efficacy for Exercise Scale (SEE), Groningen Orthopaedic Social Support Scale, Generalized Anxiety Disorder, Patient Health Questionnaire, and Visual Analogue Scale (VAS) were distributed 1-2 d after surgery (T1), which were used again 1 week (T2), 1 month (T3), and 3 months (T4) after surgery, to evaluate the level of kinesiophobia and the physical and psychological conditions of the patients. The latent category growth model was used to classify the kinesiophobia trajectories of patients after THA, and the influencing factors of different categories of kinesiophobia trajectories were analyzed. Results A total of 263 patients after THA were included. The kinesiophobia trajectories of patients after THA were divided into four potential categories, including 29 cases in the C1 high kinesiophobia persistent group, 41 cases in the C2 medium kinesiophobia improvement group, 131 cases in the C3 low kinesiophobia improvement group, and 62 cases in the C4 no kinesiophobia group. Multicategorical logistic regression analysis showed that compared to the C4 no kinesiophobia group, the influencing factors for the kinesiophobia trajectory in THA patients to develop into the C1 high kinesiophobia persistent group were age [odds ratio (OR)=1.081, 95% confidence interval (CI) (1.025, 1.140)], chronic comorbidities [OR=6.471, 95%CI (1.831, 22.872)], the average SEE score at T1-T4 time points [OR=0.867, 95%CI (0.808, 0.931)], and the average VAS score at T1-T4 time points [OR=7.981, 95%CI (1.718, 37.074)], the influencing factors for the kinesiophobia trajectory to develop into the C2 medium kinesiophobia improvement group were age [OR=1.049, 95%CI (1.010, 1.089)], education level [OR=0.244, 95%CI (0.085, 0.703)], and the average VAS score at T1-T4 time points [OR=8.357, 95%CI (2.300, 30.368)], and the influencing factors for the kinesiophobia trajectory to develop into the C3 low kinesiophobia improvement group were the average SEE score [OR=0.871, 95%CI (0.825, 0.920)] and the average VAS score at T1-T4 time points [OR=4.167, 95%CI (1.544, 11.245)] . Conclusion Kinesiophobia in patients after THA presents different trajectories, and nurses should pay attention to the assessment and intervention of kinesiophobia in patients with advanced age, low education level, chronic diseases, low exercise self-efficacy, and high pain level.
Objective To investigate the risk factors of chronic obstructive pulmonary disease (COPD) combined with obstructive sleep apnea (OSA) and its relationship with apnea-hypopnea index (AHI). Methods Clinical data of 216 COPD patients with OSA were retrospectively chosen in the period from January 2016 to December 2019 in our hospital. All patients were divided into different groups according to with or without OSA and the clinical features of patients with and without OSA were compared. Multivariate analysis was used to analyze the influencing factors of COPD with OSA and the correlation between AHI and COPD with OSA was also evaluated. Results ① The age, body mass index (BMI), neck circumference, smoking index, forced expiratory volume in 1 second (FEV1), FEV1% predicted (FEV1pred), the ratio of FEV1 to the forced vital capacity of the lungs (FEV1/FVC), COPD assessment test (CAT) score, Epworth sleepiness scale (ESS) score, Charlson comorbidity index (CCI) score, sleep apnea clinical score (SACS) score and proportion of patients with essential hypertension in OSA group were significantly higher than non-OSA group (P<0.05). The course of disease and the proportion of severe COPD and GOLD grade 4 in OSA group were significantly less than non-OSA group (P<0.05). ② AHI was positively correlated with age, BMI, neck circumference, smoking index, FEV1%pred, FEV1%pred<50%, CAT score, ESS score, CCI score and SACS score (P<0.05); and negatively correlated with FEV1%pred<50% (P<0.05). ③ Multivariate analysis showed that BMI, FEV1%pred<50%, CAT score and ESS score were the independent factors of COPD patients with OSA (P<0.05). ④ The proportion of AHI<5 times/h in GOLD grade 4 was significantly higher than GOLD grade 1-3 (P<0.05). The proportion of AHI> 30 times/h in GOLD grade 4 was significantly lower than GOLD grade 1-3 (P<0.05). Conclusion The incidence of COPD with OSA was independently correlated with BMI, FEV1%pred, CAT score and ESS score; patients with severe COPD possess lower OSA risk.
Objective To observe the clinical characteristics of asthma patients with chronic duration stage combined with small airway dysfunction (SAD), and analyze the influencing factors of SAD and the cardiopulmonary function of such patients under exercise. Methods The patients with chronic duration of asthma admitted to Nanjing Affiliated Hospital of Traditional Chinese Medicine from July 2022 to April 2024 were divided into a SAD group and a non-SAD group according to the lung function results. Clinical data and relevant data of cardiopulmonary exercise test (CPET) were collected, the clinical data and cardiopulmonary function between the two groups were compared. The influencing factors of SAD were explored by multivariate logistic regression analysis. Results A total of 102 patients with chronic asthma duration, 59 (57.8%) in the SAD group and 43 (42.2%) in the non-SAD group were included. In the SAD group, age, body masss index, asthma duration were greater than those in the non-SAD group, and SAD score was lower than that in the non-SAD group; the proportion of patients with acute onset of asthma, history of smoking, allergic rhinitis, and asthma control test score were higher than those in the non-SAD group, the exhaled nitric oxide level of SAD group was higher than that in the non-SAD group, and the conventional lung function level was lower than that in the non-SAD group (P<0.05). CPET showed that the VE/VCO2 slope and CO2 equivalent in the SAD group were higher than those in the non-SAD group, and the peak kg oxygen uptake, peak heart rate, and respiratory reserve were lower than those in the non-SAD group, showing a statistically significant difference (P<0.05). Multivariate logistic analysis showed that age, increase of carbon dioxide equivalent at peak exercise, acute onset of asthma and allergic rhinitis were independent risk factors for SAD, and the increase of peak expiratory flow rate was the protective factor (P<0.05). Conclusions SAD in chronic persistent asthma is affected by various factors such as age, acute asthma attacks and history of allergic rhinitis. CPET indicates that patients with asthma who also have SAD have their cardiopulmonary function and aerobic capacity impaired to some extent.
Objective To review the influencing factors of medial patellofemoral ligament (MPFL) reconstruction for patellar dislocation. Methods The literature of MPFL reconstruction for patellar dislocation at home and abroad in recent years were summarized and analyzed. Results The influencing factors such as the location of the femoral insertion point, the tension and the fixed angle of the grafts, the dysplasia of the femoral trochlear before operation, the abnormal tuberositas tibiae-trochlear groove value, the high position of the patellar, and the tilting angle of the patellar, are all the factors affecting the effectiveness of MPLF reconstruction. Conclusion During MPFL reconstruction, the surgical techniques and elimination of other factors that caused patellar instability need to be focused in order to reduce the complications and operation failure.
ObjectiveTo analyze the influencing factors for postoperative thoracic drainage duration in patients with cavitary pulmonary tuberculosis and clinical nursing strategies. MethodsA retrospective analysis was conducted on the clinical data of patients with cavitary pulmonary tuberculosis who underwent surgical treatment in the Department of Thoracic Surgery at Public Health Clinical Center of Chengdu from December 2022 to December 2024. Patients with a drainage time ≤7 days were included in the recovery group, while those with a drainage time >7 days were included in the control group. Data on patients' preoperative Hamilton anxiety and depression scores, perioperative nursing conditions were collected, and factors affecting chest drainage time were analyzed. ResultsA total of 186 patients were included in this study, including 119 males and 67 females, with an average age of (36.10±15.20) years. The average chest drainage tube retention time was (10.59±9.24) days. Preoperative Hamilton anxiety and depression assessments showed that 47.31% (88/186) of patients were anxious, and 31.72% (59/186) were depressed. Multivariate analysis indicated that having a smoking history, undergoing open-chest surgery, prolonged postoperative use of analgesic pumps, preoperative anxiety, and depression were independent risk factors for chest drainage time >7 days (P<0.05); frequent coughing and longer average daily activity time postoperatively were protective factors for chest drainage time >7 days (P<0.05). ConclusionPatients undergoing surgery for pulmonary tuberculosis often experience anxiety and depression preoperatively. In the clinical nursing of patients with cavitary pulmonary tuberculosis, efforts should be made preoperatively to help patients adjust their anxious and depressed emotions, control smoking, and prefer minimally invasive surgery; postoperatively, reducing analgesic duration, increasing cough frequency, promoting effective coughing, and extending average daily activity time can effectively shorten the postoperative chest drainage time, facilitating the rapid recovery of patients after surgery for pulmonary tuberculosis.
Objective To analyze the clinicopathological characteristics of thymoma patients and the influencing factors for prognosis. Methods Thymoma patients who received treatment in Sichuan Cancer Hospital from March 2015 to March 2021 were collected. Clinical data of the patients were analyzed using Kaplan-Meier and Cox regression analyses. Results A total of 177 patients were included. There were 89 males and 88 females aged 17-88 (52.3±13.0) years, including 160 surgical patients and 17 non-surgical patients. There were 160 patients survived, 17 died of thymoma, and 5 had recurrence and metastasis. Overall, the 1-year, 3-year and 5-year progression-free survival rates were 94.4%, 88.7%, 88.1%, respectively; the 1-year, 3-year and 5-year overall survival rates were 94.9%, 91.5%, 91.0%, respectively. The Kaplan-Meier analysis showed that World Health Organization classification, clinical symptoms, Masaoka-Koga staging, treatment methods and surgery were statistically associated with progression-free survival; clinical symptoms, age, treatment methods and surgery were statistically associated with overall survival (P<0.05). Patients with younger age (P=0.018), without clinical symptoms (P=0.039), and with surgical treatment (P=0.004) had higher overall survival rates; those patients undergoing surgery had a higher progression-free survival rate (P=0.002). Conclusion Age, clinical symptoms and surgical treatment are independent factors influencing the prognosis of patients with thymoma.
Objective To observate the influencing factors on circuit life during continuous renal replacement therapy (CRRT) with regional citrate anticoagulation (RCA), so as to provide data support for further optimization of RCA anticoagulation strategy. MethodsPatients who underwent CRRT with RCA in West China Hospital of Sichuan University between March 2021 and April 2022 were retrospectively selected. Analyze the basic information of patients and the impact of relevant indicators before or within 12 hours of treatment on the circuit life. Results A total of 116 patients were included. Among the included patients, a total of 225 cases were treated with CRRT for 11 051.7 hours, the median circuit life was 57.0 (25.4, 72.0) h. 142 cases (63.1%) were terminated due to coagulation, the median circuit life was 30.3 (20.5, 52.8) h. The results of multivariate Cox regression analysis showed that pH value [hazard ratio (HR)=0.002, 95% confidence interval (CI) (0.0001, 0.127), P=0.003], the maximam postfilter ionized calcium [HR=0.039, 95%CI (0.004, 0.437), P=0.008], blood flow [HR=1.051, 95%CI (1.027, 1.075), P<0.001] and catheter dysfunction [HR=5.701, 95%CI (3.777, 8.605), P<0.001] were the four influential factors affected circuit life. Kaplan Meier survival curve showed that RCA had the best effect when the postfilter ionized calcium was in the range of 0.25 ~ 0.35 mmol/L. Conclusions During CRRT treatment of RCA, pH value, postfilter ionized calcium, blood flow and catheter function are the independent influencing factors of circuit life. The above parameters should be carefully monitored and optimized in the treatment process to minimize the risk of coagulation, prolong the circuit life and maintain the continuty of CRRT treatment. The postfilter ionized calcium was recommended to be maitained at 0.25-0.35mmol/L, pH value maintained above 7.38, blood flow no more than 145 mL/min and catheter maitained patency to ensure the adequate anticoagulation.
ObjectiveTo analyze the influencing factors of fear of cancer recurrence (FCR) and its correlation with social support and quality of life in patients with differentiated thyroid cancer (DTC) at 5 years after surgery. MethodsA total of 116 patients with DTC from West China Hospital, Sichuan University at 5 years after surgery were selected as the research objects. The patients were investigated using the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Social Support Rating Scale (SSRS) and the European Organization for Reasearch and Treatment of Cancer Quality of Life Questionnare-Core 30 (EORTC QLQ-C30, hereinafter referred to as QLQ-C30). The χ2 test or Fisher exact probability method were used for univariate analysis, and multivariate logistic regression analysis was used for influencing factor analysis. The diagnostic value of variables with significant influence on FCR in multivariate logistic regression was further studied by receiver operating characteristic (ROC) curve, and Pearson correlation analysis was finally adopted to analyze the relationship between FCR and social support and quality of life in patients with DTC at 5 years after operation. ResultsThe questionnaire survey showed that the FoP-Q-SF score of 116 patients with DTC at 5 years after surgery was (35.92±2.52) scores, of which 75 patients had FoP-Q-SF score ≥34 scores, 41 patients had FoP-Q-SF score <34 scores, and the FCR rate was 64.66% (75/116). Multivariate logistic regression showed that gender, family annual income, SSRS score and total QLQ-C30 score were the main factors of FCR in patients with DTC at 5 years after surgery (P<0.05). Further ROC curve diagnosis showed that the accuracy rate of diagnosis of FCR with SSRS score ≤47.5 scores was 70.70%, the total score of QLQ-C30 ≤617.225 scores was 69.02%. The accuracy rate of diagnosis of FCR was 66.03% when the annual income of family was less than 150 000 yuan. The accuracy of women’s diagnosis of FCR was 62.28%. Pearson correlation analysis showed that FoP-Q-SF score was negatively correlated with SSRS score and total score of QLQ-C30 in DTC patients at 5 years after operation (r=–0.629 6, P=0.000 1; r=–0.568 5, P=0.000 1). ConclusionsThe proportion of patients who have FCR at 5 years after DTC operation is high, and gender, family annual income, SSRS score and total score of QLQ-C30 are the influencing factors. Therefore, we can develop targeted management strategies to reduce patients’ FCR and improve their quality of life.
Objective To understand the incidence of frailty in maintenance hemodialysis (MHD) patients, and to explore the correlation and influencing factors of frailty in MHD patients, so as to provide some basis for the intervention of frailty in MHD patients. Methods Patients who underwent MHD in the Department of Nephrology of West China Hospital of Sichuan University from January to March 2021 were selected. Frail scale and Pittsburgh Sleep Quality Index (PSQI) were used for evaluation, and the influencing factors of frail in patients with MHD and its correlation with frail were analyzed. Results A total of 141 patients with MHD were included, including 57 cases without frailty (40.43%), 71 cases in early frailty (50.35%), and 13 cases in frailty (9.22%). 54 cases (38.30%) had very good sleep quality, 56 cases (39.72%) had good sleep quality, 24 cases (17.02%) had average sleep quality, and 7 cases (4.96%) had very poor sleep quality. The frailty of MHD patients was positively correlated with age (rs=0.265, P=0.002), PSQI (rs=0.235, P=0.005) and magnesium (rs=0.280, P=0.001). Logistic regression analysis showed that the influencing factors of MHD patients’ frailty were gender [odds ratio (OR) =4.321, 95%confidence interval (CI) (1.525, 12.243), P=0.006], PSQI [OR=1.110, 95%CI (1.009, 1.222), P=0.032], magnesium [OR=122.072, 95%CI (4.752, 3 135.528), P=0.004], hypertension [OR=0.112, 95%CI (0.023, 0.545), P=0.007] and other diseases [OR=0.102, 95%CI (0.019, 0.552), P=0.008]. Conclusions The incidence of frailty in MHD patients is high. Gender, PSQI, magnesium, hypertension and other diseases are the influencing factors of frailty in MHD patients, and there is a correlation between frailty and sleep. It is suggested that renal medical staff should pay more attention to the assessment of MHD frailty and sleep, and carry out multi-disciplinary personalized intervention to improve the quality of life of MHD patients.
Mild traumatic brain injury has a large number of patients in China. In recent years, studies have pointed out that the return to work is a key goal for rehabilitation, indicating that patients can start integrating into society again and resume normal work and life as soon as possible, which has a positive impact on their rehabilitation. This article summarizes the relevant factors that affect the return to work from four aspects: individual, disease, occupation, and social support, and introduces intervention measures such as follow-up and health education, neuromodulatory technology, symptom management, social support, cognitive and occupational rehabilitation, and multidisciplinary occupational rehabilitation, aiming to provide a reference for promoting the research and development of patients with mild traumatic brain injury returning to work in China.