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Objective:To evaluate the trend and hotspots of the research on cognitive frailty in China and abroad through literature visualization analysis.Methods:Literature related to cognitive frailty were retrieved from the databases of CNKI, Wanfang, VIP and Web of Science from January 1, 2013 to August 31, 2022 with"cognitive frailty""cognitive decline"and"cognitive impairment"as retrieval terms. Based on the visualization software CiteSpace and VOSviewer, the network map analysis was conducted on the number of publications, journal distribution, country distribution and cooperation, institution distribution and cooperation and research hotspots.Results:A total of 2 500 literatures were retrieved, including 151 in Chinese and 2 349 in English. The number of publications showed an increasing trend with time. Among Chinese journals, Chin J Mod Nurs published the most literature (10 articles), while BMC Geriatr published the most literature (105 articles) in English journals. The top 5 countries in the number of English literature published were the United States (608 articles), the United Kingdom (295 articles), Italy (271 articles), China (252 articles) and Canada (195 articles). The top 5 institutions in the number of Chinese literature published were Fudan University (12 articles), Capital Medical University (10 articles), Zhengzhou University (7 articles), Central South University (5 articles) and Huazhong University of Science and Technology (5 articles). The National Center For Geriatrics Gerontology in Japan published the most English articles (74 articles). A total of 22 Chinese keywords and 44 English keywords were included. The nodes of the network analysis diagram were closely connected and highly centralized. The Chinese and English keywords“cognitive frailty”“elderly”and“frailty”were all in the core position. The Chinese emergent words were“cognitive frailty”“heart failure”“chronic disease”and“risk prediction”. The English burst terms were“cognitive frailty”“questionnaire”“cohort study”“social isolation”and“prevention”. Conclusions:The research popularity in the field of cognitive frailty is increasing year by year, and the number of articles published in English is higher than those in Chinese. At present, the main research focus is cognitive frailty, the elderly and frailty with great differences between China and abroad.
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Objective:To retrieve, evaluate and summarize the best evidence of exercise reversal intervention in the elderly with cognitive frailty, and to provide evidence for guiding exercise in elderly patients.Methods:This study was a summary of evidence-based nursing evidence. Based on the PIPOST (P: Population; I: Intervention; P: Professional; O: Outcome; S: Setting; T: Type of evidence) mode, the evidence of exercise reversal intervention in the elderly with cognitive frailty in 25 relevant guideline network and association websites, Chinese and foreign language comprehensive databases such as PubMed, CINAHL, Web of Science, Embase, Chinese Biomedical Database, China National Knowledge Internet and others were searched, extracted and integrated. The retrieval time was from January 1, 2013 to February 14, 2022.Results:A total of 22 articles were included, including 3 guidelines, 2 expert consensuses, 1 clinical decision-making, 1 evidence summary, 9 Meta analysis, and 6 randomized controlled trials. Finally, 28 pieces of the best evidence including 7 dimensions were namely formulate principles,overall assessment, exercise mode, exercise intensity, exercise time and frequency, exercise management, health guidance.Conclusions:This study summarized the best evidence of exercise intervention in the elderly with cognitive frailty, which are systematic, comprehensive, rigorous, and reliable. It can provide references for healthcare administrators to dynamically evaluate patients′cognitive frailty status, formulate personalized exercise programs, and standardize exercise guidance for patients, so as to delay or even reverse cognitive frailty.
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Under the diagnosis-related groups(DRG) prospective payment system, innovative health technologies with high costs and risks may be limited to some extent. How to balance the increase of health care cost and the development of innovative health technology is a difficult problem to be solved in the current reform. By studying the relatively mature payment systems of innovative health technologies in the world, the authors found that countries generally adopted additional payment or compensation to encourage the development of new technologies. But at the same time, a relatively perfect health technology assessment and payment management mechanism had been established to ensure the standardized operation of payment plan. These international advanced experience and practice could provide references for China′s innovative health technology payment strategy under the DRG payment system. It is suggested to establish a scientific and reasonable assessment mechanism of innovative health technology, create a special access channel for innovative health technology with limited short-term evidence, and gradually form a long-term incentive mechanism of innovative health technology in DRG payment system.
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BACKGROUND:Locking compression plate and dynamic hip screw are the two major extramedul ary fixations for the femoral intertrochanteric fractures, however, the comparison of the clinical efficacy between two methods is stil controversial. OBJECTIVE:To systematical y evaluate the clinical efficacy of locking compression plate versus dynamic hip screw in the treatment of femoral intertrochanteric fractures, and provide a theoretical basis for clinical application. METHODS:Authors searched for control ed studies on locking compression plate and dynamic hip screw in the treatment of femoral intertrochanteric fractures in PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP periodical database, Wanfang resource database, Chinese Biomedical Literature service systems published from January 1999 to April 2014. The inclusion and exclusion criteria were made, and the literature meeting the criteria was screened, and the methodological quality of the included studies was evaluated. Meta-analysis was carried out using the RevMan 5.2 software. RESULTS AND CONCLUSION:Ultimately 682 patients from 8 studies met the inclusion criteria, including 336 patients in the locking compression plate group and 346 patients in the dynamic hip screw group. Meta-analysis results showed that:there were no statistical y significant differences in operating time [MD=-12.07, 95%CI (-29.85, 5.71), P=0.18], peri-operative bleeding loss [MD=-15.01, 95%CI (-87.85, 57.83), P=0.69], post-operation drainage [MD=-13.62, 95%CI (-28.49, 1.26), P=0.07], ambulation time [MD=-0.14, 95%CI (-0.68, 0.41), P=0.63], length of hospitalization [MD=-0.74, 95%CI (-2.29, 0.82), P=0.35], bone union time [MD=-1.18, 95%CI (-2.78, 0.42), P=0.15] between locking compression plate and dynamic hip screw groups. The excellent and good rate of postoperative hip function reduction [OR=2.03, 95%CI (1.23, 3.36), P=0.006] was significantly higher in locking compression plate group than in the dynamic hip screw group. The incidence of coxa vara was lower in the locking compression plate group than in the dynamic hip screw group [OR=0.34, 95%CI (0.12, 0.96), P=0.04]. There were no significant differences in looseness, breakage, withdrawal of internal fixation [OR=1.20, 95%CI (0.59, 2.45), P=0.61] and the incidence of total complications [OR=0.55, 95%CI (0.24, 1.28), P=0.16] between locking compression plate and dynamic hip screw groups. However, the included studies have high possibility of selection bias and measurement bias, and wil affect proof strength of results. Therefore, more clinical randomized control ed studies with compact design are needed for verification.
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Objective To investigate the self-efficacy for the nursing activities of nurses in the operation room and explore the ways of improving the self-efficacy of nursing activities of nurses in the operation room.Methods 160 nnrses in the operation rooms of four hospitals in Binzhou city were chosen as the observation group.160 non-operation room nurses in these four hospitals were chosen as the control group.The self-efficacy of nursing activities questionnaires were used to survey the self-efficacy of nurses.According to the analysis of survey results,measures to improve the self-efficacy of nursing activities were discussed.Results The self-efficacy scores for 160 operation room nurses were lower than those non-operation room nurses.Among 5 dimensions,nursing skill was with the lowest score in 160 nurses who had been investigated.The difference of self-efficacy scores of care activities for nurses in operation rooms of different hospitals was significant.Conclusions Nursing activity in the operation room has its own specialty.The self-efficacy of nursing activities was lower than non-operation room nurses generally,especially in nursing skills.Improving leadership and working environment of nurses,giving positive social support and re-education programs are the scientific ways to improve self-efficacy of nursing activities in the operation room.