Disease trajectory research in critical illness: applications, examples, and prospects / 中华危重病急救医学

Trajectories refer to the motion paths followed by objects in space. Disease trajectories, which depict the evolution of disease processes over time, are significantly important for assessing diseases, formulating treatment strategies, and predicting prognosis. Critical illness is one of the leading causes of death. With advances in critical care medicine, there is increasing focus on the occurrence and development of critical illnesses. Understanding the development trajectory of critical illness is helpful to promote the early identification, intervention, and treatment of high-risk patients, avoid prolongation of the course of disease, reduce the risk of multiple organ failure, and provide important reference for the development of targeted prevention and intervention strategies, thereby reducing the incidence and mortality of critical illness. In recent years, various trajectory modeling methods have been applied to the study of critical illness. These include, but are not limited to, latent growth curve modeling (LGCM), growth mixture modeling (GMM), group-based trajectory modeling (GBTM), latent transition analysis (LTA), and latent class analysis (LCA). The aim of this article is to review the definition of disease trajectories, the methods used in trajectory modeling, and their applications and future prospects in critical illness research.

Construction of self-management intervention program for breast cancer patients undergoing chemotherapy based on chronic disease trajectory model / 中国实用护理杂志

Objective:To construct a self-management intervention program for patients with adenocarcinoma chemotherapy based on chronic disease trajectory model, and to provide reference for clinical nursing intervention.Methods:From October 2021 to June 2022, a research team was established. Based on the chronic disease trajectory model and self-management theory, through preliminary quantitative research, literature review and semi-structured interview, the first draft of the intervention plan was prepared. 24 experts were selected for two rounds of Delphi expert correspondence consultation to determine the self-management intervention plan for breast cancer patients undergoing chemotherapy based on the trajectory model of chronic disease.Results:The effective questionnaire recovery rates of the two rounds of expert letter consultation were 100%, and the coefficient of expert authority degree was 0.805 and 0.863, respectively. The mean values of importance were 4.21- 4.96 and 4.46 - 5.00, the coefficients of variation were 0.00 - 0.19 and 0.00-0.17, and the Kendall concordant coefficients were 0.123 and 0.149 ( both P<0.01). Finally, the self-management intervention scheme for breast cancer chemotherapy patients based on the trajectory model of chronic disease was constructed, including 3 first-level indicators, 6 second-level indicators and 27 third-level indicators. Conclusions:The self-management intervention program for patients with adenocarcinoma chemotherapy based on chronic disease trajectory model constructed in this study can provide a certain reference for clinical nurses to carry out targeted self-management interventions.