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Objective:To investigate the mediating effect of hope on resilience and post traumatic growth (PTG) in patients with refractory secondary hyperparathyroidism (rSHPT).Methods:It was convenient to select rSHPT patients and non-refractory SHPT patients who received maintenance hemodialysis treatment in China-Japan Friendship Hospital from September 2018 to September 2021. Totally 495 patients with rSHPT and 1 295 patients with mild secondary hyperparathyroidism (SHPT) were surveyed by the Chinese Version of The Herth Hope Scale, the Chinese version of the Connor-Davidson Resilience Scale and the Post Traumatic Growth Rating Scale (PTGI). After matching according to the 1∶1 Propensity Score Matching (PSM), 436 cases were set in each of the two groups. The differences of hope, resilience and PTG scores between the two groups were compared. Pearson correlation analysis was used to analyze the correlation between hope, resilience and total score of PTG in rSHPT group. Regression analysis and SPSS Process mediation Model 4 were used to test the mediating effect of hope on resilience and PTG.Results:The hope score (32.16 ± 4.15), psychological resilience score (61.22 ± 14.38), and the PTG score (52.34 ± 18.92) of rSHPT patients was significantly lower than 33.41 ± 2.97 ( t=-5.72, P<0.05), 63.19 ± 7.25 ( t=-2.77, P<0.05), 57.95 ± 10.07 ( t=-6.34, P<0.05) of SHPT patients. There was a positive correlation between hope, resilience and PTG score ( r=0.671, 0.488, 0.523, all P<0.01). Regression analysis showed that resilience could positively predict PTG ( β=0.518, P<0.01). Psychological resilience positively predicted hope ( β=0.188, P<0.01). Resilience ( β=0.204, P =0.002) and hope ( β=1.442, P<0.01) could positively predict PTG. Hope played a partial mediating role in the relationship between resilience and PTG, and the mediating effect accounted for 60.23%. Conclusions:rSHPT patients generally had lower levels of hope, resilience and PTG. Resilience can affect PTG directly or indirectly through hope. Medical staff should improve the resilience and hope level of patients with rSHPT through positive psychological intervention measures, so as to enhance the positive promoting effect of psychological resilience on PTG.
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Objective:To determine the spiritual needs of shrinking man syndrome (SMS) in young and middle-aged patients, and to provide reference for determining targeted intervention plans.Methods:From May to July, 2021, 14 young and middle-aged patients with SMS who received hyperparathyroidism thermal ablation in the Interventional Medicine Department of China-Japan Friendship Hospital were selected by purpose sampling method. Qualitative research phenomenology was used to conduct semi-structured in-depth interviews, and the interview data were analyzed by Colaizzi 7-step analysis method.Results:There were 4 themes and 14 sub-themes: "understanding and self-acceptance of illness" (attribution to illness; disease uncertainty; acceptance and illness), "need for social support" (love and respect; connection and companionship; family support; medical support; patient support), "life value and sense of meaning" (life meaning and goal; self-esteem; religious belief), "self-actualization and transcendence" (hope for improvement; eager for miracles; realize your value).Conclusions:Medical staff should pay attention to the spiritual needs of young and middle-aged patients with SMS, and specifically meet their spiritual needs during diagnosis, treatment, nursing and follow-up, so as to improve the patients′ sense of life meaning and value, and help them to better survive with disease and return to society.
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Objective:To develop the Chinese version of measuring change in restriction of salt (sodium ) in diet in hypertensives(MCRSDH), and to test its reliability and validity.Methods:Authorization was obtained from the original authors of MCRSDH.Cross-cultural revision of the MCRSDH was conducted according to the guidelines from November 2020 to January 2021.Totally 700 patients with hypertension were recruited through convenience sampling from 4 community health service centers in 2 main urban districts of Changsha and investigated by the Chinese version of MCRSDH.Reliability and validity of the scale were assessed.Results:The correlation coefficient between each item and the total score ranged from 0.327-0.799 and 0.468-0.893 in MCRSDH initiation (MCRSDH-INIT)and MCRSDH sustenance(MCRSDH-SUST) respectively.The item of content validity index(I-CVI) of each item ranged from 0.802 to 1.000, and the scale of content validity index(S-CVI) was 0.914.Four factors were extracted by exploratory factor analysis(EFA)and could explain 68.511% of the total variance for MCRSDH-INIT.Three factors were extracted by EFA and could explain 76.558% of the total variance for MCRSDH-SUST.Values of factor loading ranged from 0.541 to 0.926 for MCRSDH-INIT, and from 0.586 to 0.888 for MCRSDH-SUST.The Confirmatory factor analysis indicated that χ 2/ df=1.732, GFI=0.902, CFI=0.945, RMSEA=0.046, NFI=0.931, TLI=0.936 for initiation model and χ 2/ df=1.248, GFI=0.937, CFI=0.971, RMSEA=0.018, NFI=0.943, TLI=0.937 for sustenance model.The cronbach's α coefficient of the scale was 0.901 and the test-retest reliability was 0.917. Conclusion:The Chinese version of the MCRSDH is reliable and valid, and can be used as a tool to MCRSDH in China.
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Objective@#To evaluate the safety, feasibility, and efficacy of microwave ablation (MWA) for the treatment of primaryhyperparathyroidism (PHPT). @*Materials and Methods@#This study enrolled 67 PHPT patients (22 men, 45 women; mean age, 56.0 ± 16.3 years; range, 18–83 years) from January 2015 to December 2018. The laboratory data, including the serum intact parathyroid hormone (iPTH),calcium, phosphorus, and alkaline phosphatase (ALP) levels, were evaluated before MWA and again 2 hours, 1 day, 7 days, 1month, 3 months, 6 months, 12 months, 18 months, and 24 months after. @*Results@#Complete ablation was achieved with all 72 hyperplastic parathyroid glands found on the 67 patients enrolled, 64 ofwhom were treated in one session and 3 were treated over two sessions. The technical success rate was 100%. The medianfollow-up time was 13.6 months (range, 10.0–31.1 months). The clinical success rate was 89.4%. The volume reduction ratewas 79.4% at 6 months. Compared to pre-MWA, the serum iPTH, calcium, phosphorus, and ALP levels had significantlyimproved 6 months post-MWA (iPTH, 157.3 pg/mL vs. 39.2 pg/mL; calcium, 2.75 ± 0.25 mmol/L vs. 2.34 ± 0.15 mmol/L;phosphorus, 0.86 ± 0.20 mmol/L vs. 1.12 ± 0.22 mmol/L; ALP, 79 U/L vs. 54 U/L, respectively; all, p < 0.01). Hoarseness wasa major complication in 4 patients (6.0%), but it improved spontaneously within 2–3 months. @*Conclusion@#MWA is safe, feasible, and effective for the treatment of PHPT.
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Objective To evaluate the efficacy of disinfection and isolation measures in a hospital that received and treated the first case of imported Middle East respiratory syndrome(MERS)in China.Methods The first MERS case in China was admitted in the negative pressure room of the intensive care unit in a hospital on May 28,2015,a series of disinfection and isolation measures were taken for controlling and preventing MERS coronavirus (MERS-CoV)infection.Results One case of MERS confirmed by Guangdong Provincial Center for Disease Control and Pre-vention (CDC)and Chinese CDC were admitted in a hospital at 2:30 of May 28,2015,throat swabs and blood specimens of patients were detected as positive for MERS-CoV by real-time polymerase chain reaction.On the 3rd day,8th day,2 week after admission,and on June 21 ,throat swabs,blood,stool,and sputum specimen culture were negative respectively;before patient’s discharge,throat swabs,sputum,blood,and stool specimen culture were all negative for consecutive two times,there was no fever for 10 consecutive days,clinical symptoms were im-proved,patient finally recovered and was discharged on June 26.Detection of MERS-CoV were all negative for nasal swabs,throat swabs,and blood specimens from all health care workers (HCWs)participated in the treatment for MERS;all HCWs were performed physical examination from June 26 to July 10,none of them felt discomfort, there was no infection occurred among them.On the 7th,13th day of admission,and following terminal disinfec-tion,specimens of environment and object surface were taken and performed detection of MERS-CoV,all were negative.Conclusion Strict implementation of disinfection and isolation measures can effectively cut off the routes of MERS-CoV transmission and protect the safety of HCWs.