RESUMO
ObjectiveTo investigate the identification of kidney Yang deficiency syndrome of patients with osteoporosis（OP）， and to form the clinical syndrome identification rules of traditional Chinese medicine（TCM）. MethodBasic information， etiology， clinical symptoms and other characteristics of 982 OP patients were included， and statistical tests were used to screen the variables associated with kidney Yang deficiency syndrome. Taking the decision tree as the base model， bootstrap aggregation algorithm（Bagging algorithm） was utilized to establish the classification model of kidney Yang deficiency syndrome in OP， generating numerous rules and removing redundancy. Combining least absolute shrinkage and selection operator（LASSO） regression to screen key rules and integrate them to construct an identification model， achieving the identification of kidney Yang deficiency syndrome in OP patients. ResultEighteen key identification rules were screened out， and of these， where 11 rules with regression coefficients>0 correlated positively with the kidney Yang deficiency syndrome， the rule with the highest coefficient was chilliness（present）&feverish sensation over the palm and sole（absent）. The other 7 rules with regression coefficients<0 correlated negatively with the syndrome， the rule with the lowest coefficient was reddish tongue（present）&diarrhea（absent）&deficiency of endowment（absent）. According to the regression coefficients of each key rule， variables with importance>0.2 were ranked as chilliness， reddish tongue， feverish sensation over the palm and sole， cold limbs， clear urine， diarrhea， deficiency of endowment， prolonged illness. The results of the partial dependence analysis of the identification model showed that compared to OP patients without chilliness， those with chilliness（present） had a 0.266 8 higher probability of being identified as having kidney Yang deficiency syndrome， indicating that this variable had the highest impact on identification of the syndrome. Similarly， compared to OP patients without reddish tongue， those with reddish tongue had a 0.141 9 lower probability of being identified as having kidney Yang deficiency syndrome， indicating that this variable had the highest impact on identifying non-kidney Yang deficiency syndrome. The accuracy， sensitivity， specificity and area under receiver operating characteristic curve（AUC） of the established kidney Yang deficiency syndrome identification model in the test set were 0.865 9， 0.853 7， 0.872 0 and 0.931 5， respectively. ConclusionA precise identification model of OP kidney Yang deficiency syndrome is conducted basing on the rule ensemble method of Bagging combining LASSO regression， and the screened key rules can explain the identification process of kidney Yang deficiency syndrome. In this research， according to the regression coefficients of rules， the importance and partial dependence of variables， combined with the thinking of TCM， the influence of patient characteristics on the identification of syndromes is described， so as to reveal the primary and secondary syndromes of identification and assist the clinical identification of kidney Yang deficiency syndrome.
RESUMO
Las enfermedades crónicas de parcial dependencia son aquellas en las cuales el individuo es capaz de favorecer el autocuidado, pero necesitan un cuidador que les proporcione apoyo, acompañamiento en el proceso de la enfermedad, ayuda para contribuir a su autocuidado y, de esta manera, cumplir con el régimen terapéutico. La labor del cuidador desencadena una interrupción en su cuidado que origina una disfunción en su calidad de vida, que debe ser evaluada para lograr su bienestar, teniendo en cuenta su responsabilidad a la hora de tomar decisiones frente al cuidado del familiar. El cuidar a un paciente con enfermedad crónica con parcial dependencia implica en este experimentar cambios en su vida cotidiana, relacionados con la transformación de roles, responsabilidades familiares, cambios en los estilos de vida y las relaciones de apoyo. El propósito de este artículo es proporcionar fundamentos teóricos que le permitan al profesional de enfermería reconocer que no sólo el paciente con enfermedad crónica requiere un cuidado, sino su cuidador, a fin de identificar oportunamente sus necesidades y desarrollar intervenciones que mejoren la calidad de vida del cuidador. Por tal motivo, se revisa la clasificación de las enfermedades crónicas según su dependencia; así como los conceptos de cuidador de personas con enfermedad crónica de parcial dependencia, calidad de vida y papel del profesional de enfermería en la calidad de vida de estos cuidadores...
The chronic partial-dependence diseases are those whereby the individual is capable of facilitating self-care, but needs a caregiver to provide them support, assistance in the disease process, help to contribute to their self-care and thus, fulfill the therapeutic regimen. The labor of the caregiver triggers an interruption in their care, leading to a dysfunction in the quality of life, which should be evaluated to ensure their welfare, taking into account the responsibility when making decisions compared to family care. Caring for a patient with chronic partial-dependence disease implies the experience of changes in their daily lives, related to the transformation of roles, responsibilities, changes in lifestyles and supportive relationship. The purpose of this review article is to provide theoretical foundations that allow nursing professionals to recognize not only the patient with chronic disease requires care, but also his caregiver in order to opportunely identify their needs and develop timely interventions to improve the life quality of both indeed. Therefore, there will be a thorough revision of the classification of chronic diseases according to their dependency, the concept of caregivers of people with chronic partial dependence disease, their quality of life, and the role of professional nursing in the care of these caregivers...
Na dependência crônica parcial o indivíduo é capaz de facilitar o auto-cuidado, mas precisa de um cuidador para prestar-lhe apoio no processo da doença, bem como ajuda o seu auto-cuidado e, assim, atender o seu regime terapêutico, o trabalho do cuidador implica uma interrupção nos seus cuidados, levando a uma disfunção na qualidade de vida, que deve ser avaliada para garantir seu bem-estar, tendo em conta a responsabilidade na tomada de decisões em relação com o cuidado da família. Cuidar de um paciente com dependência parcial crônica implica nele mudanças na sua vida quotidiana, relacionadas com a transformação dos papéis, responsabilidades, bem como no seu estilo de vida e relações de apoio. O objetivo desta revisão é fornecer fundamentos teóricos que permitam aos profissionais de enfermagem reconhecer que não só é o paciente quem tem necessidade de cuidados crônicos, mas também o seu cuidador, identificar as suas necessidades e desenvolver intervenções pontuais para melhorar a qualidade de vida do cuidador. Por esta razão, nós revisamos a classificação de doenças crônicas de acordo com suas dependências, os cuidadores de pessoas com dependência parcial crônica, qualidade de vida e o papel da enfermagem na qualidade de vida dessescuidadores...