Relationships Between Chemotherapy-Related Cognitive Impairment, Self-Care Ability, and Quality of Life in Breast Cancer Survivors: A Cross-Sectional Study.

OBJECTIVES: It is not clear how chemotherapy-related cognitive impairment and self-care ability affect the quality of life of women with breast cancer. The purpose of this study was to explore the relationships between chemotherapy-related cognitive impairment, self-care ability, and quality of life in breast cancer patients, and test whether self-care ability plays a mediating role in the association between cognitive impairment and quality of life. METHODS: This study was a cross-sectional study, conducted in China in 2022. Self-reported scales were used to assess cognitive function, self-care ability, and quality of life. Data were analyzed using descriptive statistics, spearman correlation analysis and hierarchical multiple regression analyses, the SPSS Process program was used to explore the mediating effect of self-care ability. RESULTS: A total of 218 participants were investigated, and approximately 79.3% of patients experienced mild chemotherapy-related cognitive impairment, the mean quality of life score was 59.96 ± 14.15, and the mean self-care ability score was 107.4 ± 24.09. Significant correlations among cognitive impairment, self-care ability, and quality of life were observed (P < .05). Additionally, self-care ability played a partial mediating role between cognitive impairment and quality of life (P < .05), accounting for 24.3% and 22.3%, respectively. CONCLUSIONS: Chemotherapy-related cognitive impairment and self-care ability are factors affecting the quality of life of breast cancer survivors. Self-care ability mediates the relationship between cognitive impairment and quality of life. Enhancing patients' self-care ability can improve the quality of life of patients with cognitive impairment. IMPLICATIONS FOR NURSING PRACTICE: In the future, oncology nurses should not only pay attention to the severity of cognitive impairment, but also assess the level of patients' self-care ability, provide relevant medical and healthcare guidance, train self-management behavior and strengthen self-care ability by integrating multidisciplinary forces to improve the quality of life of breast cancer patients effectively.

Application of intelligent nursing system based on big data in maintenance hemodialysis patients.

Maintenance hemodialysis (MHD) is one of the most important renal replacement therapies for patients with end-stage renal disease. However, long-term and frequent treatment not only damages the physiological functions of patients but also leads to serious economic burdens and mental stress. This can easily cause a series of psychological disorders in patients, resulting in severe rejection and fear of MHD. To reduce patient resistance and improve the quality of life of MHD, this article built an intelligent nursing system based on big data and then used the constructed intelligent nursing system to research MHD. Through experiments, it has been found that compared to self-efficacy intervention, intelligent nursing systems can control the concurrent rate of MHD patients below 14 %, and self-efficacy intervention methods can control the concurrent rate of MHD patients above 13 %. Moreover, using intelligent nursing systems can improve the ability of MHD patients to self-care. At the same time, before the use of intelligent nursing systems, the nursing satisfaction of MHD patients also varied greatly, with the overall satisfaction rate after use being 70 % higher than before. Using intelligent nursing systems can improve the satisfaction of MHD patients with nursing outcomes.

Effects of a step-by-step inpatient rehabilitation program on self-care ability and quality of life in patients with acute cerebral infarction following intravascular stent implantation: a prospective cohort study.

Objective: This study aims to evaluate the influence of a step-by-step inpatient rehabilitation program (SIRP) on the self-care capability and quality of life of patients who have undergone intravascular stent implantation to treat large vessel occlusion during acute cerebral infarction (ACI). Methods: This study included a cohort of 90 patients with ACI who received intravascular stent implantations at a tertiary hospital in the Third Affiliated Hospital of Anhui Medical University from January 2020 to February 2024. The patients were followed up for at least 3 months. Cohort grouping was based on the type of nursing care each patient received. The observation group participated in SIRP along with receiving routine nursing care, whereas the control group received only routine nursing care. Key outcome measures included the Barthel index, the National Institute of Health Stroke Scale (NIHSS) score, the incidence of complications, length of hospital stay, and 36-item short-form survey (SF-36) scores. These parameters were compared between the two groups. Results: At the time of admission, there were no significant differences in demographic data, NIHSS score, Barthel index, or SF-36 scores between the observation and control groups (all p > 0.05). However, at 3 months postoperatively, the observation group showed significant improvements, with higher average scores in the Barthel index (62.49 ± 7.32 vs. 53.16 ± 4.37, p < 0.001) and SF-36 scores (502.33 ± 14.28 vs. 417.64 ± 9.65, p < 0.001). Additionally, this group had significantly lower NIHSS scores (3.38 ± 1.19 vs. 10.24 ± 2.10, p < 0.001), fewer complications (3 vs. 15, p = 0.002), and shorter hospital stays (12.40 ± 1.68 vs. 15.56 ± 1.87, p < 0.001). Conclusion: Implementing SIRP notably enhanced self-care capabilities and overall quality of life, while also reducing complication rates and the length of hospital stays for patients with ACI who underwent intravascular stent implantation. This underscores the potential benefits of incorporating structured rehabilitation programs in the treatment and recovery processes of such patients.

Relationship between social support and self-care ability among patients with breast cancer during rehabilitation: The multiple mediating roles of resilience and depression.

AIMS: To identify the multiple mediating effects of resilience and depression between social support and self-care ability among patients with breast cancer during rehabilitation to provide reference for developing and implementing targeted interventions. DESIGN: A cross-sectional study reported according to the STROBE checklist. METHODS: A convenience sample of 320 patients with breast cancer during rehabilitation was recruited from one hospital in China. Data were collected from April to August 2022 using a self-report questionnaire, including the demographic and clinical information, Appraisal of Self-Care Agency Scale-Revised, Multidimensional Scale of Perceived Social Support, Connor-Davidson Resilience Scale-10 item, and Patient Health Questionnaire-9. The mediation analysis was conducted using the SPSS Process macro. RESULTS: Self-care ability was positively associated with social support (ß = .229) and resilience (ß = .290), and negatively associated with depression (ß = -.208). The relationship between social support and self-care ability was mediated by resilience and depression, respectively, and together in serial. The multiple mediating effects accounted for 34.0% of the total effect of social support on self-care ability. CONCLUSION: Our findings identify resilience and depression as multiple mediators between social support and self-care ability and highlight the important roles of social support, resilience and depression in improving self-care ability. RELEVANCE TO CLINICAL PRACTICE: Healthcare providers should pay great attention to the underlying mechanisms of how social support affects patients' self-care ability during breast cancer rehabilitation. Integrated intervention programmes targeted at enhancing social support, building resilience and alleviating depression might be beneficial to the improvement of self-care ability. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. REPORTING METHOD: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies was applied to report the results.

Designing and validating of a questionnaire measuring perceived self-care ability (PSCA) in chronic stroke patients at home.

BACKGROUND: Patients with a stroke often cannot care for themselves after hospital discharge. Assessment of their self-care ability is the first step in planning post-discharge home care. This study aimed to design and validate a measure of perceived self-care ability (PSCA) in stroke patients. METHODS: A sequential-exploratory mixed method was conducted in Tehran, Iran, in 2020-2021. The qualitative phase involved in-depth semi-structured interviews with 12 participants. Transcripts were content analyzed. The results guided the development of 81 items. psychometric properties such as face validity (Impact Score > 1.5), content validity ratio (CVR > 0.63), content validity index (Item Content Validity Index: ICVI > 0.78, Scale Content Validity Index/Average: SCVI/Ave > 0.8) and Kappa value (Kappa > 0.7), internal consistency (Cronbach's alpha > 0.7), relative reliability (ICC: inter class correlation coefficient), absolute reliability (Standard Error of Measurement: SEM and Minimal Detectable Changes: MDC), convergent validity (Correlation Coefficient between 0.4-0.7), interpretability, responsiveness, feasibility, and ceiling and floor effects were assessed. RESULTS: Content analysis of the qualitative interviews yielded 5 major categories and 9 subcategories that reflected "Perceptual stability", "Cognitive fluctuations", "Sensory, Motor and Physical health"," The subjective nature" and "The dynamic nature" of PSCA. Results of face and content validity reduced the number of items to 32, capturing three dimensions of PSCA in chronic stroke patients; these dimensions included perceptual ability, threatened health status, and sensory, motor, and cognitive ability. The findings supported the reliability and validity of the measure. CONCLUSIONS: The PSCA questionnaire was developed and validated within the Iranian culture. It is useful in assessing the self-care of patients with stroke and in informing practice.

[Application and Effect of Patient Portal System in the Remote Management of Chronic Diseases for Older Adults With Coronary Heart Disease]. / æ‚£è€ é—¨æˆ·ç³»ç»Ÿåœ¨è€å¹´å† å¿ƒç— æ ¢ç— è¿œç¨‹ç®¡ç†ä¸­çš„åº”ç”¨åŠæ•ˆæžœ.

Objective: To investigate the application of personal health record (PHR) and chronic disease management platform established on the basis of patient portal system (PPS) in managing older adults with coronary heart disease and to examine the effect on patients' self-care ability, coping mode, and quality of life. Methods: A total of 532 elderly patients with coronary heart disease were included in the study. All the participants enrolled were admitted to a tertiary-care hospital between January 2019 and June 2021. They were randomly assigned to the study group (269 cases) and the control group (263 cases). Patients in the control group were discharged with the routine discharge procedures and received the routine follow-up care. On the other hand, patients in the study group were discharged and followed up through the PHR and chronic disease management platform established on the basis of PPS. After 6 months, 12 months, and 18 months of patient management, the Exercise of Self-Care Agency (ESCA) Scale, Medical Coping Modes Questionnaire (MCMQ) and Seattle Angina Questionnaire (SAQ) were used to evaluate the patients' self-care ability, coping mode, and quality of life, respectively. The patient management effects of the two groups were analyzed. Results: Before the management programs started, there was no statistically significant difference in the scores for the scales between the two groups of patients. After 6 months, 12 months, and 18 months of patient management, the ESCA scores of both groups were higher than those before patient management started (P<0.05). Facing scores in the MCMQ of both groups were higher than those before patient management started (P<0.05), while the scores for avoidance and yielding were lower than those before patient management started (P<0.05). The SAQ scores of both groups were higher than those before patient management started (P<0.05). After 6 months, 12 months and 18 months of patient management, the ESCA scores of the study group were always higher compared with those of the control group (P<0.05). The facing score of the study group was higher, while the scores for avoidance and yielding were lower compared with those of the control group (P<0.05). The SAQ scores of the study group were higher compared with those of the control group (P<0.05). The medication compliance rate in the study group (83.27%) was higher than that in the control group (69.96%) (P<0.05). The incidence of adverse cardiovascular events in the study group (4.09%) was lower than that in the control group (10.27%) (P<0.05). The average times of emergency treatment and readmission in the study group were lower compared with those of the control group (P<0.05). The patient satisfaction score of the study group was higher compared with that of the control group (P<0.05). Conclusion: The PHR and chronic disease management platform established on the basis of PPS can increase the convenient access to medical care among elderly patients with coronary heart disease, which is conducive to improving their self-care ability, coping mode, and quality of life. In addition, the patient management effect is good.

Whole-process case management effects on mental state and self-care ability in patients with liver cancer.

BACKGROUND: Regarding the incidence of malignant tumors in China, the incidence of liver cancer ranks fourth, second only to lung, gastric, and esophageal cancers. The case fatality rate ranks third after lung and cervical cancer. In a previous study, the whole-process management model was applied to patients with breast cancer, which effectively reduced their negative emotions and improved treatment adherence and nursing satisfaction. AIM: To explore Mental state and self-care ability in patients with liver cancer: effects of whole-process case management. METHODS: In this single-center, randomized, controlled study, 60 randomly selected patients with liver cancer who had been admitted to our hospital from January 2021 to January 2022 were randomly divided into an observation group (n = 30), who received whole-process case management on the basis of routine nursing measures, and a control group (n = 30), who were given routine nursing measures. We compared differences between the two groups in terms of anxiety, depression, the level of hope, self-care ability, symptom distress, sleep quality, and quality of life. RESULTS: Post-intervention, Hamilton anxiety scale, Hamilton depression scale, memory symptom assessment scale, and Pittsburgh sleep quality index scores in both groups were lower than those pre-intervention, and the observation group had lower scores than the control group (P < 0.05). Herth hope index, self-care ability assessment scale-revision in Chinese, and quality of life measurement scale for patients with liver cancer scores in both groups were higher than those pre-intervention, with higher scores in the observation group compared with the control group (P < 0.05). CONCLUSION: Whole-process case management can effectively reduce anxiety and depression in patients with liver cancer, alleviate symptoms and problems, and improve the level of hope, self-care ability, sleep quality, and quality of life, as well as provide feasible nursing alternatives for patients with liver cancer.

Effectiveness of continuity of care after robot-assisted laparoscopic adrenalectomy under ambulatory mode: a single-center intervention study.

To investigate the effectiveness of continuity of care after robot-assisted adrenal tumor resection under ambulatory mode. Patients who underwent robot-assisted laparoscopic adrenalectomy (RALA) in the ambulatory surgery department and urology department of our hospital from January 2022 to January 2023 were selected as study subjects. Among them, 50 patients in the Department of Urology as the control group were given routine care. The 50 patients in the ambulatory surgery department as the observation group were given continuity of care on the basis of routine care. Observation indexes include: wound healing, blood pressure, blood potassium, renal function impairment, self-care ability in daily life, medication compliance, follow-up rate, and patient satisfaction. There were no remarkable discrepancies between the two groups in terms of demographic data and basic preoperative conditions of the patients. Compared with the control group, the observation group significantly improved the patients' wound healing, postoperative blood pressure and blood potassium and kidney function (P value all < 0.05). Compared with the control group, the observation group significantly improved postoperative patients' ADL scores, follow-up rates within three months after surgery, and patient satisfaction scores (P value all < 0.05). For patients receiving ambulatory mode robot-assisted laparoscopic adrenalectomy, continuity of care can effectively reduce postoperative complications, improve patients' postoperative self-care ability in daily life, medication compliance and follow-up rate, and improve patient satisfaction, which is worthy of promotion and application by nursing workers.

Self-Care Ability and Life Quality of Cured Leprosy Patients: The Mediating Effects of Social Support.

OBJECTIVES: The study explores the relationship between social support, self-care ability, and life quality of cured leprosy patients (CLPs), aiming to develop strategies to enhance their overall well-being. METHODS: From July to December 2021, we investigated the social support, self-care ability, and life quality of CLPs through three scales and analyzed the correlation between them. In addition, structural estimation modeling (SEM) was employed to analyze their correlation. RESULTS: A total of 9245 CLPs were recruited, with a male-to-female ratio of 2.19:1, and 94.04% of cured patients was 60 years or above, with predominantly home-cured patients. The scores of WHOQOL-BREF, SSRS, and ESCA were (51.39 ± 9.89), (31.87 ± 8.76), and (100.95 ± 19.75), respectively. The results indicate a poorer quality of life and social support for CLPs compared to the general population in China. Furthermore, the home group had higher scores on these scales than the leprosarium group. The correlation analysis showed significant interactions between life quality, social support, self-care ability, and various domains (p < 0.05). SEM results revealed that the direct effect of self-care ability on life quality was 0.13, and the indirect effect on quality of life through social support was 0.08. The mediating effect of social support accounted for 22.86% of the total effect in the home group. In the leprosarium group, the effect of self-care ability on quality of life was 0.14. CONCLUSIONS: Most CLPs in Jiangsu Province are concentrated in the central region, with a high disease burden. We found that CLPs have a poorer life quality than the general population, with the leprosarium group being worse than the home group. The government and society should pay more attention to and support these cured patients.

Nivel de conocimientos y capacidad para el autocuidado en personas en tratamiento con hemodiálisis y su relación con la calidad de vida / Level of knowledge and self-care capacity in individuals undergoing hemodialysis and its relationship with quality of life

Introducción:Determinar el grado de conocimientos que tie-nen los pacientes en hemodiálisis sobre su enfermedad y trata-miento, valorar su capacidad para hacerse el autocuidado y su relación con la calidad de vida relacionada con la salud.Material y Método: Se realizó un estudio descriptivo y trans-versal en dos unidades de diálisis. Se estudiaron 31 pacien-tes en hemodiálisis con edad media de 67,2±14 años (71% hombres). Se estudió nivel de conocimientos sobre la enfermedad y tra-tamiento, capacidad de autocuidado y calidad de vida (lámi-nas COOP/WONCA). Se recogieron, además, variables socio-demográficas, clínicas, comorbilidad y grado de dependencia.Resultados: El 9,7% de los pacientes eran laboralmente acti-vos. El 16,1% no tenía formación, 38,7% básica, 32,3% secun-daria y 12,9% universitaria. El 61% tenía un grado de conoci-mientos alto sobre su enfermedad y tratamiento, el 32% medio y el 7% bajo.El 52 % de los pacientes mostraron alta capacidad para el au-tocuidado y el 48% media. El 3,2% de los pacientes presentaba dependencia severa, moderada el 22,6%, leve el 6,5%, siendo autónomos el 67,7%.La puntuación media en el cuestionario de calidad de vida fue de 24,06±6,5 puntos.Encontramos relación significativa entre el grado de conocimien-tos con edad (0,384, p<0,05) y nivel formativo (0,464, p<0,01).Conclusiones: Los pacientes presentan un alto nivel de cono-cimiento sobre su enfermedad y tratamiento, alto grado de autonomía y capacitación para el autocuidado, siendo los más jóvenes y con mayor nivel formativo, los que muestran mejores resultados, sin que estas variables tengan relación con la cali-dad de vida (AU)

Introduction:To determine the level of knowledge that hemodialysis patients have about their disease and treatment, assess their ability for self-care, and examine its relationship with health-related quality of life.Material and Method:A descriptive, cross-sectional study was conducted in two dialysis units. Thirty-one hemodialysis patients were studied, with a mean age of 67.2±14 years (71% male). The study assessed the level of knowledge about the disease and treatment, self-care ability, and quality of life (using COOP/WONCA charts). Additionally, sociodemographic, clinical, comorbidity, and dependence variables were collected.Results: 9.7% of the patients were employed. 16.1% had no formal education, 38.7% had basic education, 32.3% had secondary education, and 12.9% had a university education. 61% had a high level of knowledge about their disease and treatment, 32% had a moderate level, and 7% had a low level.52% of the patients demonstrated a high capacity for self-care, while 48% showed a moderate capacity. 3.2% of the patients exhibited severe dependence, 22.6% moderate dependence, 6.5% mild dependence, and 67.7% were autonomous. The average score on the quality-of-life questionnaire was 24.06±6.5 points. A significant relationship was found between the level of knowledge and age (0.384; p<0.05) and educational level (0.464; p<0.01).Conclusions: Patients exhibit a high level of knowledge about their disease and treatment, along with a high degree of autonomy and self-care capabilities. Younger patients and those with higher education levels show better results, although these variables do not appear to be directly related to quality of life (AU)

A randomized controlled study on systematic nursing care based on health empowerment theory and its effect on the self-care and functional abilities of patients with spinal fractures.

OBJECTIVE: In this study, we aimed to explore the effectiveness of systematic nursing care based on health empowerment theory on the self-care and functional abilities of patients with spinal fractures. METHODS: We selected a total of 50 patients with spinal fractures from our hospital and randomly divided them into the control group and the observation group, with 25 patients in each group. Patients in the control group received conventional nursing care, while those in the observation group received systematic nursing care grounded in the health empowerment theory. We recorded and compared the self-care ability, functional ability, knowledge about the condition, and pain scores of patients in the two groups before and after the nursing intervention. RESULTS: There was no significant difference in the baseline characteristics between the two groups (P > 0.05), and there was no significant difference in self-care ability, functional ability, knowledge about the condition, or the visual analog scale (VAS) score between the two groups before treatment (P > 0.05). After treatment, outcomes in the observation group in terms of self-care ability, functional ability, and knowledge about the condition were significantly better than those in the control group (P < 0.05), while the VAS score in the observation group was significantly lower than that in the control group (P < 0.05). CONCLUSION: Compared with conventional nursing care, patients with spinal fractures who received systematic nursing inputs based on health empowerment theory reported significant improvements in pain, self-care, functional ability, and knowledge of the condition, and this is an approach that is worthy of promotion in clinical use.

[Testing Effectiveness of Localized Cognitive Stimulation Training With Musical Rhythm Courses Among Older People in Day Care Centers: A Pilot Study].

BACKGROUND: Staff caregivers of day care centers provide many activities for older people. However, there is a lack of a systematic curriculum based on Taiwanese culture to improve cognitive function, self-care ability, and depressive mood status in these individuals. PURPOSE: This study was designed to test the effectiveness of a series of localized cognitive stimulation training courses implemented by direct caregivers and aimed at improving cognitive function, self-care ability, and depressive mood in older people at day care centers. METHODS: This cluster-randomized controlled trial research was conducted over a four-month period. The participants were randomly assigned to the experimental, comparison, or control groups based on their day care center affiliation. The experimental group received a series of localized cognitive stimulation training sessions with musical rhythm courses from day care center direct caregivers. The cognitive function, self-care ability, and depression mood state of the three groups were then tested. RESULTS: The experimental group reported statistically significant changes in average scores for attention, feeding, and depressive mood. After controlling for time and degree of participation in activities, the comparison group reported a lower average score for cognitive function at timepoint 3. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The results of this study support caregivers at day care centers implementing a series of localized cognitive stimulation training course interventions to prevent declines in activities of daily living and cognitive function and ameliorate depressive mood in older adults. In the future, a larger sample size should be used to improve the effectiveness of the intervention.

A randomized control study: The effectiveness of multimedia education on self-care and quality of life in patients with enterostomy.

Colorectal cancer is typically treated through surgery, and self-care skills play a crucial role in disease adaptation and quality of life improvement. Therefore, this study aimed to investigate the effectiveness of a multimedia patient education intervention on enhancing the self-care and quality of life among patients with a postoperative stoma as well as on establishing an easy-to-use ostomy self-care skills assessment. The sample comprised 108 patients with new ostomies who were randomly assigned to two groups. Data were collected from June 2018 to March 2019. The conventional education service program group received individual education in the hospital environment, consisting of four 3-h sessions delivered over 4 consecutive days. The multimedia group viewed a multimedia educational program using a laptop. Data were collected at baseline and 3 months after the intervention using a demographic questionnaire, an ostomy self-care ability scale and the Stoma Quality of Life Scale. Before the intervention, there were no significant differences in self-care ability and quality of life scores between the two groups (p = 0.764 and p = 0.466, respectively). However, 3 months after the intervention, the group that received the multimedia software intervention showed significantly higher self-care ability and quality of life scores compared to the group that received conventional education services (p < 0.001). When a set threshold is reached, self-care ability and a good quality of life can be met. The threshold value of the ostomy self-care skill scale was determined to be 20 points, resulting in a sensitivity of 77.8% and a specificity of 75.5%. The results indicate that the multimedia education program enhanced home self-care ability and quality of life among patients with enterostomy.

Effect of the physical rehabilitation program based on self-care ability in patients with acute ischemic stroke: a quasi-experimental study.

Introduction: It is the most practical goal of limb rehabilitation for stroke patients to make the upper limb, trunk, and lower limb joints link together as a whole and restore the ability to self-care. However, many previous studies focused on the single joint or single muscle group movement of stroke patients and did not integrate self-care ability training into the whole process of rehabilitation, which lacks accuracy, integrity, and systematization. Methods: A quasi-experimental study was conducted in a tertiary hospital. Eligible patients were recruited according to the inclusion criteria and exclusion criteria and then divided into an experimental group (n = 80) and a control group (n = 80) by the medical district. The control group received the routine physical rehabilitation intervention. The experimental group adopted the physical rehabilitation program based on self-care ability led by the nurses specializing in stroke rehabilitation to carry out the multi-joint coordinated exercise based on the control group. The training time and frequency were the same in both groups (45 min per session, one session per day for three consecutive months). The primary outcome was myodynamia. Secondary outcomes were the modified Barthel Index (MBI) and Stroke Specific Quality of Life Scale (SS-QOL). The primary and secondary outcomes were assessed before the intervention and at 1 and 3 months of intervention. In this study, the TREND checklist was followed for non-randomized controlled trials. Results: A total of 160 participants completed the study. The physical rehabilitation program based on self-care ability was better than the routine rehabilitation program. With the prolongation of intervention time, all outcomes improved gradually in the experimental group (P < 0.05), and the myodynamia of lower limbs recovered faster than that of upper limbs. In the control group, the myodynamia of the affected limb was not significantly improved (P > 0.05), with only a small increase in MBI and SS-QOL scores (P < 0.05). Conclusion: The physical rehabilitation program based on self-care ability after stroke was beneficial for acute ischemic stroke patients and improved the patient's myodynamia, quality of life, and self-care ability within the third month.

Analysis of factors associated with 6MWD among older patients with chronic heart failure.

OBJECTIVES: To study the factors that influence the 6-minute walking distance (6MWD) among older patients with chronic heart failure. METHODS: This was a single-center, retrospective, observational study. A total of 123 patients from the First Affiliated Hospital of Nanjing Medical University was selected. The factors associated with the 6MWD were analyzed using Pearson correlation analysis and multivariate linear regression. RESULTS: The 6MWD of older patients was negatively correlated with age, fall risk, nutritional score, frailty, and depression but was positively correlated with educational level, fall efficacy, self-care ability, and plasma albumin. The results of independent variable multiple linear regression analysis showed that age (ß = -0.098), fall risk (ß = -0.262), fall efficacy (ß = 0.011), self-care ability (ß = -0.021), nutrition (ß = -0.405), frailty (ß = -0.653), and plasma albumin (ß = 0.127) influenced the 6MWD. CONCLUSIONS: The 6MWD of older patients with chronic heart failure was related to age, self-care ability, fall risk, nutrition, frailty, and depression.

Pilot testing the impact of an aerobic exercise plus rehabilitation training on respiratory function in older adults with COPD.

Chronic obstructive pulmonary disease (COPD) is a chronic intractable lung disease. To investigate the therapeutic effect, older adult patients were subjected to aerobic exercise and respiratory rehabilitation (diaphragmatic breathing) for six months. At the end of six-month intervention, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), 6-minute walking distance (6 MWD), and patient activation measure scores increased; St. George's respiratory questionnaire scores and disease impact score decreased; and PaCO2 and PaO2 were significantly improved in both groups, particularly in the experimental group. In addition, FEV1, FEV1/FVC, 6 MWD, blood gas levels, quality of life, and self-care ability in the experimental group were significantly improved compared with those in the control group, and the improvements were significantly greater in male, younger, and less diseased patients. Our study demonstrated that aerobic exercise combined with diaphragmatic breathing significantly improves respiratory function and quality of life in older adult patients.

The use of nurse-led care intervention to improve self-care abilities subsequently decreasing readmission in multimorbid hospitalized patients: A quasi-experimental study in a real-world setting.

AIM: Nurse-led care aims to optimize the discharge preparation with a focus on increasing patients' independency and self-care abilities. This study compared patients' improvements of self-care abilities and frequency of readmission rate between nurse-led care and regular nursing care within the acute hospital setting. DESIGN: A quasi-experimental design within a real-world setting was used for this work. METHODS: We included a pool of 2501 patients from a control group (medically stable in usual care) and 420 patients from an intervention group (nurse-led care). After propensity score matching, the study cohort consisted of 612 patients. RESULTS: From admission to discharge, nurse-led care patients showed superior improvements of total self-care abilities compared to usual care patients. In particular, we found improvements in the following categories: mobility, grooming and excretion. Patients with nurse-led care were furthermore less frequently readmitted to hospital compared with the control group patients. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Value of internet of things-based diagnosis-treatment model in improving the quality of medical services during COVID-19 outbreak.

OBJECTIVE: To demonstrate the value of Internet of things (IoT)-based diagnosis-treatment model in improving medical service quality during the novel coronavirus pneumonia (COVID-19) outbreak. METHODS: In this retrospective analysis, 483 patients with chronic diseases treated between January 2020 and March 2021 were selected and grouped as follows based on different intervention methods: a research group (the Res group) with 229 patients that were given IoT-based diagnosis and treatment, and a control group (the Con group) with 254 patients that were treated with routine diagnosis and treatment. The qualified rate of medical records, the missing rate of medical records, and the incidence of doctor-patient disputes were compared between the two groups. In addition, investigations were made regarding patients' daily living ability, psychological state, health behavior, self-care ability, quality of life, as well as treatment satisfaction. RESULTS: There was no difference in the qualified rate of medical records between the Res group and the Con group (P>0.05), but the missing rate of medical records and the incidence of doctor-patient disputes were lower in the Res group (both P<0.05). An obviously improved living ability was observed in both groups after the treatment (both P<0.05), with no statistical significance between groups (P>0.05). Besides, the Res group presented lower scores of SAS and SDS but higher scores of SRAHP, ES-CA and SF-36 than the Con group after treatment (all P<0.05). Finally, according to the satisfaction survey, more patients in the Res group were very satisfied but fewer cases were dissatisfied with the medical service they received as compared with the Con group (both P<0.05). CONCLUSIONS: The IoT-based diagnosis-treatment model can effectively improve the quality of medical services and patients' self-care ability, which is extremely important and promising for addressing the current medical limitations during the COVID-19 epidemic.

Factor analysis of the Chinese version of the Self-care Ability Scale for the Elderly: A multi-centre cross-cultural validation study.

AIM: This study aimed to explore and confirm the factor structure and item distribution of the Chinese version of Self-care Ability Scale for the Elderly among older Chinese people. METHODS: A cluster random sampling method was used to collect 2856 older people from five different cities of China from July 2018 to July 2019. A questionnaire comprised of socio-demographic information and the Chinese version of the Self-care Ability Scale for the Elderly was administered, and SPSS 21.0 and Mplus 7.4 were used for analyses. RESULTS: Participants were aged 60 to 92 years, with a mean age of 71.52 (SD = 7.68) years. In the Exploratory Factor Analysis, the three-factor structure and item distribution of the Chinese version of the Self-care Ability Scale for the Elderly were verified to be better than other options. The factor loadings varied from 0.428 to 0.800, and the communality values ranged from 0.426 to 0.792. The modified model showed a good fit in the Confirmatory Factor Analysis. CONCLUSION: The Chinese version of the Self-care Ability Scale for the Elderly has a clear three-factor structure and a good item distribution. It serves as a convenient and accurate assessment tool to assess the self-care ability of older Chinese people.

Everyday challenges following hospital discharge. A multi-method study identifying and describing areas of concern for patients during the first month after colorectal cancer surgery.

AIM: Identify and describe areas of concern focusing on day-to-day variations during the first month after surgery for patients recovering from colorectal cancer surgery. DESIGN: A multi-method design was applied using diaries and interviews. METHOD: Data was collected using semi-structured diaries kept 1 month after surgery by seven patients recovering from colorectal cancer surgery. Also, face-to-face interviews were conducted 1 month after surgery. Data from the diaries constituted a framework for the following directed content analysis of interviews. FINDINGS: Low levels of pain were experienced but caused reduced mobility and tiredness. Practical matters in daily living were restricted, while social life could be hampered by a frequent need to defecate. Appetite and consequently the ability to eat and drink was the most prominent concern, due to changes in taste and ability to tolerate food. Worries were mainly related to changes in bowel movements. No Patient or Public Contribution.