Conectar
by Yao-Yao Mao, Ke Zhang, Dan-Dan Zhao, Jia-Wei Cui, Zhan-Dong Lin, Cong-Yue Zhang, Yue-Min Nan
BackgroundClinical practice commonly uses the Yi-qi Huo-xue formula (YQHX), a traditional Chinese herbal medicine comprising eight herbal components, to treat liver fibrosis resulting from various etiologies. Nevertheless, this formula’s specific active constituents and underlying mechanisms of action remain to be fully elucidated.
MethodsThe drug components of YQHX and potential targets for liver fibrosis were identified via the screening of the various databases. Qualitative and quantitative identification of chemical components of drug-containing serum by Ultra Performance Liquid Chromatography (UPLC).Liver fibrosis was induced in mice through the intraperitoneal injection of carbon tetrachloride, followed by oral administration of YQHX. RNA-Seq quantified transcriptomic profiles in liver tissue.The degree of liver fibrosis was assessed via histopathology staining, the transcription and expression of relevant proteins were analyzed. Primary cells were isolated for in vitro experiments to validate the influence of YQHX on the associated signaling pathways.
ResultsNetwork pharmacology identified IL-1β, IL-6, and TNF-α as potential targets for YQHX in treating liver fibrosis.The UPLC detected multiple potential active components. In vivo experiments showed that YQHX reduced serum AST and ALT levels in liver fibrosis-induced mice, decreased liverIL-1β, IL-6, and TNF-α levels, and improved liver fibrosis.The results of transcriptomics suggest that YQHX can reduce the expression of “collagen-activated signaling pathway,” “MyD88-dependent toll-like receptor signaling pathway,” “fibrinolysis” and “toll-like receptor 4 signaling pathway”. Furthermore, YQHX reduced the aggregation of M1 macrophages in the portal area and the deposition of α-SMA. Primary bone marrow-derived cells successfully transformed into M1 macrophages after induction, and YQHX reduced the levels of IL-1β, IL-6, and TNF-α in the supernatant of M1 macrophage culture and decreased the activation of primary hepatic stellate cells indirectly co-cultured with the supernatant. Interestingly, TLR4 agonists weakened this inhibitory effect. Both in vitro and in vivo experiments demonstrated that YQHX could inhibit the expression of the TLR4/TRAF6/MyD88 pathway in M1 macrophages.
ConclusionWe reveal here the molecular mechanism and signaling pathway of YQHX in treating liver fibrosis by utilizing network pharmacology in conjunction with in vivo and in vitro experiments. The findings offer insights that may advance the clinical application of YQHX.
Tobacco use causes approximately 8 million deaths worldwide each year. Against the backdrop of a rapidly expanding game market, there is growing potential to develop tailored gaming interventions for smoking cessation. This study protocol describes the development of a personalised Serious Game Applet based on an integrated TTM–PMT–HAPA framework (Transtheoretical Model, Protection Motivation Theory, Health Action Process Approach) and evaluates its effectiveness compared with conventionalShort Messaging Service (SMS) -based smoking cessation interventions.
Design: The study comprises two phases. The first involves developing the Serious Game Applet using the TTM–PMT–HAPA theoretical framework. The second phase consists of a multicentre, two-arm, single-blind cluster randomised controlled trial, which will enrol 1320 eligible smokers from various enterprises. Enterprises will be randomised to either the Serious Game Applet group or the SMS push control group. Eligible participants include daily smokers aged 18–45 years, working in non-tobacco-related enterprises, with exhaled carbon monoxide levels ≥6 ppm.
Outcomes: Primary outcomes are smoking abstinence rates at 3 and 6 months. Secondary outcomes include abstinence rates at 1, 2 and 9 months; point-prevalence cessation rates at 1, 2, 3, 6 and 9 months; changes in cigarette consumption; stage transitions in smoking cessation; nicotine dependence scores and withdrawal symptoms. The trial will be conducted as a field study targeting smartphone users across three cities in Fujian Province, China.
This study has been approved by the Biomedical Research Ethics Committee of Fujian Medical University (Approval No. 127, 2024). Results will be disseminated through peer-reviewed journals and academic conferences.
ChiCTR2400088105.
by Pei-Chi Su, Hui-Fen Mao, Wen-Chen Cheng
BackgroundThe Health Enhancement Lifestyle Profile - Taiwan Version (HELP-T) assesses the lifestyle profiles of the older adults through participation in activities across seven domains: exercise, diet, social and productive activities, leisure, activities of daily living, stress management and spiritual participation, and other health behaviors. This study aimed to develop a short form of HELP-T (HELP-T-SF) to reduce assessment time and evaluate its psychometric properties.
MethodsThis three-phase study comprised item reduction using archival data (2012–2013), field testing (n = 223; 2023), and psychometric evaluation (n = 117; 2024) among community-dwelling older adults. Data collection included the HELP-T-SF, original HELP-T, WHO-5 Well-Being Index, and quality-of-life questions. Analysis employed classical test theory.
ResultsThe finalized HELP-T-SF, consisting of 20 items. Internal consistency for the total score was Cronbach’s α = 0.78 (95% CI: 0.54 to 0.89); test–retest reliability over 7–14 days was ICC (3,1) = 0.78 (95% CI: 0.54 to 0.89); correlation with the long form was r = 0.75 (95% CI: 0.56 to 0.86). Convergent validity showed moderate correlations with well-being and quality of life. The short form reduced assessment time to 10–15 minutes.
ConclusionsThe HELP-T-SF is a valid tool for assessing lifestyle profiles in community-dwelling older adults, assisting practitioners in lifestyle medicine for understanding older adults’s lifestyle profile, setting client-centered goals and designing personalized lifestyle interventions.
Current prediction models for disease progression to AIDS in people living with HIV primarily rely on traditional statistical methods. This study aimed to develop and compare four machine learning models and to create a clinically applicable nomogram for identifying risk factors associated with AIDS progression.
A retrospective cohort study conducted from January 2013 to December 2022.
Yining City, Xinjiang, China.
Newly diagnosed HIV-infected patients (aged 18–60 years) who received antiretroviral therapy and had not progressed to AIDS at baseline.
Progression from HIV infection to AIDS, as defined by the Chinese Center for Disease Control and Prevention criteria.
Among the 2305 patients included, 652 progressed to AIDS. The cohort was predominantly male, with a mean baseline CD4 cell count of 384 cells/μL. Four machine learning models—Support Vector Machine, Random Forest, Logistic Regression and Extreme Gradient Boosting (XGBoost)—were developed. The XGBoost model demonstrated the best predictive performance (area under the curve, AUC: 0.877). Univariate and multivariate analyses identified WHO clinical stages, CD4 cell count, HIV transmission route, platelet count and haemoglobin level as significant predictors. The developed nomogram achieved an AUC of 0.840. Its calibration curve, after bias correction, showed good agreement with the ideal curve, and decision curve analysis indicated potential clinical utility.
In this cohort, the XGBoost model showed superior performance for predicting AIDS progression. The proposed nomogram may serve as a practical tool to facilitate rapid risk assessment in similar clinical settings. These findings suggest that enhanced monitoring and regular follow-up might be beneficial for patients with low CD4 counts for timely intervention and to improve outcomes.
This study aimed to investigate the trajectory patterns and influencing factors of sleep quality and verify the bidirectional association between physical activity and sleep quality during pregnancy.
This was a prospective longitudinal study.
The study was conducted at the obstetric clinic in a tertiary maternity hospital in Zhejiang Province, mainland China.
A total of 645 pregnant women were selected through simple random sampling and completed follow-up assessments during the first, second and third trimesters of pregnancy from January to December 2024.
The desired data were collected using the Pittsburgh Sleep Quality Index and the International Physical Activity Questionnaire Short Form. Latent class growth analysis was applied to identify sleep quality trajectories, multiple logistic regression was used to determine the influencing factors, and cross-lagged panel analysis was used to explore the bidirectional association between sleep quality and physical activity.
Three distinct sleep quality trajectories were identified: the constantly poor sleep quality group (21.40%), the constantly decreasing sleep quality group (50.70%) and the constantly good sleep quality group (27.90%). Multiple logistic regression analyses indicated that being underweight (OR=3.013, 95% CI: 1.308 to 6.942) and having insufficient physical activity levels during the first (OR=3.346, 95% CI: 2.009 to 5.573) and second phases (OR=37.515, 95% CI: 20.215 to 69.620) were associated with an increased risk of exhibiting a consistently declining pattern. Being underweight (OR=2.679, 95% CI: 1.041 to 6.893), passive smoking (OR=11.433, 95% CI: 2.220 to 58.883) and having insufficient physical activity levels during the first (OR=12.624, 95% CI: 6.285 to 25.356) and second phases (OR=23.773, 95% CI: 11.745 to 48.118) were associated with an increased risk of exhibiting a consistently poor pattern. Additionally, results from the cross-lagged panel analysis revealed a bidirectional association between sleep quality and physical activity.
This study demonstrates heterogeneity in changes in sleep quality among pregnant women. Interventions aimed at promoting maternal and infant health during pregnancy should consider both sleep quality and physical activity. Earlier interventions are associated with better outcomes.
ChiCTR2300078952.
by Jinghui Xie, Haofang Guan, Maohui Liu, Weijun Ding
BackgroundCurrent obesity treatments include behavioral interventions, pharmacotherapy and surgery. Recently, the combination of ‘medicinal food’ products such as the plant Crataegus pinnatifida and its interaction with the gut microbiota has shown promise as an alternative therapeutic strategy to treat obesity.
MethodsWe obtained secondary metabolites (SMs) of obesity-related gut microbiota and Crataegus pinnatifida from gutMGene database and NAPSS database. bioinformatics analysis was used to elucidate key target and signaling pathways, whereas molecular docking (MD), molecular dynamics simulation and quantum chemical calculations identified crucial SMs involved in these pathways. The toxicity and physicochemical properties of these SMs were also assessed.
ResultsPhosphoinositide-3-kinase regulatory subunit 1 (PIK3R1), a key mediator in the phosphoinositide 3-kinase (PI3K)/ Protein Kinase B (Akt) pathway that is crucial for regulating insulin signaling and adipogenesis, emerged as the central hub within the PPI network. Strong binders to PIK3R1 were predicted to be quercetin, kaempferol and naringenin chalcone, suggesting their potential as therapeutic agents to treat obesity.
ConclusionThe synergistic combination of Crataegus pinnatifida and the obesity-related gut microbiota holds promise as a novel therapeutic strategy for obesity by targeting PIK3R1 and modulating the PI3K/Akt signaling pathway. Further experimental validation is necessary to confirm these findings.
Post-chronic pancreatitis (CP) diabetes mellitus (PPDM-C) is a distinct form of diabetes, in which complex pathogenesis hampers adequate glycaemic control. This study aimed to identify risk factors for poor glycaemic status in PPDM-C to guide clinical management.
Cross-sectional study.
Shanghai, China.
Between January 2018 and March 2023, 1677 patients with CP were enrolled in the CP database of the National Clinical Research Center. After application of strict exclusion criteria, 302 patients diagnosed with PPDM-C were included in the study.
The primary outcome was glycaemic control. The secondary outcomes were factors that affect glycaemic control among patients with PPDM-C.
This retrospective study was conducted in patients with PPDM-C. Poor glycaemic status was defined as a glycated haemoglobin A1c level of >7% at admission. Patients were stratified into those with and without diabetes treatment. Multivariate logistic regression was performed to identify risk factors. The area under the curve (AUC) analysis was used to evaluate the predictive efficacy of these risk factors.
A total of 302 patients with PPDM-C were analysed. Poor glycaemic status was observed in 72.6% (61/84) of patients without diabetes treatment and 52.8% (115/218) of those with diabetes treatment. For those without diabetes treatment, a history of acute pancreatitis (AP) attacks (OR: 4.838, p=0.014) and smoking (1–20 pack-years, OR: 4.418; >20 pack-years, OR: 9.989; p0.001). In patients with diabetes treatment, AP attack history (OR: 5.640, p20 pack-years, OR: 11.395; p
Patients with PPDM-C in China exhibited a high prevalence of poor glycaemic status. Smoking and a history of AP attacks were significantly associated with an increased risk of poor glycaemic control. The early identification of patients with PPDM-C at elevated risk of poor glycaemic control may facilitate timely and optimised management of glycaemia.
Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are high-risk factors for dementia. We developed a cognitive measurement tool for screening SCD and MCI in community-dwelling elderly individuals.
This study investigated the feasibility of using the Brief Elderly Cognitive Screening Inventory (BECSI) as a screening measure for MCI and SCD in community elderly.
A cross-sectional validation study.
The study included 1642 community-dwelling older adults aged ≥60 years.
The Cronbach’s α and split-half coefficients were calculated to test its reliability. The BECSI scores of the normal control group, SCD group and MCI group were compared. The internal consistency analysis, correlation analysis with the neuropsychiatric inventory (NPI) and core neuropsychological test (CNT) were conducted. The screening efficacy of BECSI was verified by receiver operating characteristic curve.
BECSI was a self-report questionnaire. Its Cronbach’s α coefficient and split-half coefficient were respectively 0.923 and 0.888. The correlation coefficients between the total score and individual items ranged from 0.185 to 0.813, and were also significantly correlated with NPI and CNT. Statistically significant differences were observed among the three groups in the total scores. The areas under the curves for distinguishing SCD from normal cognitive and MCI from SCD are 0.835 and 0.889, respectively, with the optimal cut-off points of 12.5 and 16.5.
BECSI is quick and easy to administer, and can be used as a feasible and useful measure for screening SCD and MCI in community-dwelling older adults.
by Xing Chen, Zhixiong Zhang, Jiwei Xiang, Ruliu Xiong, Xingmao Zhou
BackgroundSoft tissue and other extraosseous sarcomas (STSES) are rare malignant tumors originating from mesenchymal tissues with complex etiologies. A systematic analysis of global burden trends is urgently needed.
MethodsUtilizing the Global Burden of Disease (GBD) 2021 database, we assessed STSES incidence, mortality, disability-adjusted life years (DALYs), age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR) across regions and countries from 1990 to 2021, stratified by sociodemographic index (SDI). Spatiotemporal models, Joinpoint regression (to calculate average annual percentage changes, AAPC), and decomposition analysis were employed to evaluate the impacts of population growth, aging, and epidemiological factors on disease burden.
ResultsIn 2021, there were 96,201 new STSES cases globally, resulting in 50,203 deaths and 1.678 million DALYs. While age-standardized rates (per 100,000 person-years) showed declining trends (AAPC for ASIR = −0.13, ASMR = −0.60, ASDR = − 0.94), absolute burden increased by 77.97% due to population growth. Males exhibited consistently higher burden than females, with incidence peaking at 55–74 years. Notably, young females (10–29 years) transiently surpassed males in DALYs. Significant regional disparities emerged: High-SDI regions (e.g., Western Europe) demonstrated lower ASMR attributable to advanced diagnostics and treatment, whereas low-SDI regions (e.g., Uganda, ASMR = 1.96/100,000) faced poorer prognoses due to healthcare deficiencies. SDI exhibited a nonlinear association with disease burden—middle-SDI regions (0.4–0.8) showed rising ASIR, potentially linked to industrial pollution and improved diagnostic capabilities. These findings underscore the critical need for context-specific prevention and resource allocation strategies to address the evolving global STSES burden.
ConclusionsThe global STSES burden is predominantly driven by population growth, necessitating targeted prevention strategies addressing occupational exposures in males and subtype-specific risks among young females. While high-SDI regions demonstrate mortality reduction through precision oncology, low-SDI regions require urgent improvements in healthcare accessibility to mitigate survival disparities. Persistent regional heterogeneity underscores the imperative for international collaboration to standardize diagnostic protocols and ensure equitable resource allocation. These insights emphasize the need for stratified surveillance systems and translational research to optimize context-specific intervention frameworks.
This study aimed to assess the global, regional and national burden of non-rheumatic degenerative mitral valve disease (nrDMVD) from 1990 to 2021 using data from the global burden of disease (GBD) Study 2021, focusing on trends in incidence, prevalence, mortality and disability-adjusted life-years (DALYs). The analysis evaluated disparities by age, sex and sociodemographic index (SDI).
This was a systematic analysis leveraging GBD 2021 data and employing decomposition and frontier analyses to quantify the contributions of ageing, population growth and epidemiological transitions. Age-standardised rates (ASRs) and absolute case numbers were analysed across 204 countries and territories.
Global, regional and national data spanning 1990 to 2021, stratified by SDI quintiles (low to high), 21 GBD regions and age-sex groups.
Individuals diagnosed with nrDMVD, with data representing global populations categorised by age, sex and SDI.
Primary outcomes included incidence, prevalence, mortality and DALYs. Secondary outcomes encompassed age-standardised rates (ASR) (age-standardised incidence rate (ASIR), age-standardised prevalence rate (ASPR), age-standardised mortality rate (ASMR) and age-standardised DALYs rate (ASDR)) and temporal trends.
In 2021, there were 15.49 million prevalent cases (ASPR: 182.13 per 100 000 population) and 36 843 deaths (ASMR: 0.46 per 100 000 population) globally. From 1990 to 2021, ASRs for prevalence, mortality and DALYs declined significantly (estimated annual percentage change range: –0.17% to –0.31%), while absolute case numbers increased by 85% due to population ageing. High-SDI regions exhibited the highest ASIR (28.49 per 100 000) and ASPR (364.24 per 100 000), while low-SDI regions showed underdiagnosis. Sex disparities were pronounced, with higher ASIR (16.13 vs 11.38) and ASPR (385.09 vs 241.64) in females. Projections to 2050 indicated continued ASR declines, yet rising absolute cases. Frontier analysis identified Serbia, Georgia and high-SDI countries (eg, the Netherlands) as having the largest gaps between actual and achievable disease burden.
Despite declining ASRs, nrDMVD remains a critical global health challenge, driven by ageing populations and regional inequalities. Targeted interventions addressing gender disparities, ageing-related healthcare and resource allocation in low-SDI regions are urgently needed to mitigate future burdens.
The purpose of this study was to analyse the speech-language pathology (SLP) literature from 2012 to 2022 and evaluate authorship trends and factors associated with gender disparities.
Authorship across journals published by the American Speech-Language-Hearing Association (ASHA) was evaluated. Outcomes collected from each article included the gender of the first and senior authors, author department affiliations, study type, reported funding source and the country of origin. Three sets of linear regression models were explored to determine the probability of male first authorship, of male senior authorship, and of a study being funded.
A total of 2754 articles were identified for inclusion. The majority of the literature was authored by females, with 77% of first authors and 68% of senior authors being female. Studies with a male senior author were shown to be 4.05–4.67 times more likely to have a male first author than with a female senior author. Male senior authors were over-represented relative to their proportion of ASHA membership compared with female senior authors. Male authorship was associated with certain subtopics, including voice, stuttering and motor speech. Funding probability decreased for all authors regardless of gender between 2012 and 2022.
Implicit gender bias and societal gender stereotypes lead to a greater number of women in the field of SLP; the same biases and stereotypes often limit the research productivity and academic leadership potential of women in the field. Addressing these biases and stereotypes is vital to move towards gender equity in the field.
Many studies have identified the negative psychological impact of in vitro fertilisation and embryo transfer (IVF-ET) on couples with infertility, but there remains a paucity of research clarifying both positive and negative effects within the context of Chinese culture.
To explore the dynamic psychosocial experiences and underlying mechanisms of couples in the whole process of IVF-ET, and to construct a theoretical framework that elucidates this phenomenon within the context of Chinese social-culture.
A grounded theory study.
Guided by constructivist grounded theory methodology, semi-structured face-to-face interviews were conducted in the reproductive medicine outpatient department of a tertiary-level hospital located in northwest China between January and October 2023. Purposive and theoretical sampling methods were used to recruit couples undergoing IVF-ET. Data were analysed through three iterative steps: initial coding, focused coding, and theoretical coding, utilising constant comparative methods and reflective memo-writing. The study is reported using the COREQ checklist.
Theoretical saturation was achieved after interviewing 22 couples. The substantive theory was synthesised into one core category: ‘forward or backward’, which captured the ambivalent psychosocial experiences of couples undergoing IVF-ET within the context of Chinese culture. This theory described three overarching stages: making the decision, undergoing the treatment, and facing the result, with each stage linked to specific promoting and hindering factors.
This study establishes a theoretical foundation for further implementation of comprehensive reproductive health management within the Chinese sociocultural context. It is crucial for healthcare providers and policymakers to focus on the dyad of couples undergoing IVF-ET, pay attention to both negatively and positively psychosocial fluctuations, and enhance both medical care and sociocultural support systems accordingly.
No patient or public contribution.
To determine nursing costs for intensive care unit (ICU) patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), assess the correlation with diagnosis-related group (DRG) payments and identify cost determinants.
Prospective, descriptive and quantitative study.
From January to December 2022, we selected ICU patients with AECOPD and used time-driven activity-based costing method to calculate the overall nursing costs. We examined the cost recovery rate, correlations between nursing costs and DRG Relative Weight, and factors influencing nursing costs using nonparametric tests, Spearman's rank correlation and quantile regression.
The median nursing charge was US$1001.88, the median nursing cost was US$678.51, and the average cost recovery rate was 68.39%. Nursing costs correlated with the DRG Relative Weight but not with payments. Length of stay, oxygen therapy mode and noninvasive ventilator use days impacted costs.
Nursing costs exceeded charges, with a moderate cost recovery rate. DRG payments do not fully reflect nursing cost variations.
Our findings indicate the need to enhance the reimbursement system for nursing costs and to manage ICU nursing expenses by addressing the determinants of these costs.
The authors adhered to the EQUATOR network guidelines STROBE to report observational cross-sectional studies.
Sífilis enfermedad de difícil diagnóstico, en los albores del siglo XX, provocó un pánico social en España. Objetivo desvelar los avances en el tratamiento de la sífilis y descubrir la política sanitaria de lucha antivenérea, entre 1900 y 1953. Metodología a través del método heurístico se efectuó un análisis documental meticuloso tanto en fuentes directas como indirectas. Resultados, hacer frente al mal venéreo-sifilítico fue prioritario para las autoridades sanitarias españolas, debido al impacto de esta patología en el desarrollo económico del país. Por tanto, el descubrimiento casual en 1928, del Penicilium notatum supuso una revolución en el tratamiento de la sífilis. Sin embargo, las autoridades sanitarias preocupadas por la morbilidad de esta patología en plena Guerra Civil Española, impulsaron novedosos proyectos de salud pública, los cuales fueron un hito histórico. Conclusión gracias a la creación del cuerpo de Enfermeras Profesionales Visitadoras, el paciente sifilítico fue tratado de forma holística, confidencial y gratuita, hecho que asociado a las campañas de promoción de hábitos higiene sexual y educación sexual antivenérea que desarrollaron, logró que la tasa de mortalidad de la sífilis disminuyese. Luego, la lucha antivenérea ejecutada por estas enfermeras comunitarias, también puede ser considerada una bala mágica contra la sífilis.
This review aims to explore factors influencing family resilience in families providing care for patients with cancer and to provide suggestions for future research directions.
Six electronic databases were searched including Web of Science, CINAHL, EMBASE, PsycINFO, PubMed and CNKI from their inception to December 2023. The article reference lists were also manually searched. The Mixed Method Appraisal Tool was used to assess the included studies in this review. The 27-item checklist Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed to report this review.
Twenty-one studies from six online databases reported that either individual or family factors have effects on family resilience and were described into five clusters on the basis of the Walsh model of family resilience, including demographic and clinical factors, personal strengths and resources, family stressors, family resilient coping processes and family resilient adaptation outcomes.
Family resilience in cancer families plays a pivotal role in coping with family stressors and facilitating positive outcomes through domains of coping. Future researches need to explore factors related to family resilience from dyadic perspectives and to establish multidisciplinary intervention strategies for developing levels of family resilience in cancer families.
PROSPERO: CRD42024535349
To investigate the prevalence of anxiety and depression symptoms in intensive care unit (ICU) patients with cardiovascular disease (CVD) and to explore which elements are risk factors for the development of anxiety and depression symptoms.
A cross-sectional study.
A total of 1028 ICU patients with CVD were enrolled in this cross-sectional study. Logistic regression was used to assess risk factors and associations between anxiety and depression symptoms, and mediation analysis was used to explore the effect of risk factors on the association between anxiety and depression symptoms. Reporting of the study followed the STROBE checklist.
The results showed that among ICU patients with CVD, 38.1% had anxiety symptoms, 28.7% had depression symptoms and 19.3% had both anxiety and depression symptoms, and there was a significant association between anxiety and depression symptoms. We also identified female gender, hypertension, hyperlipidemia and cardiac function class IV as independent risk factors for anxiety and depression symptoms. Importantly, these factors also mediated the association between anxiety and depression symptoms, emphasising their role in the psychological well-being of this patient group.
ICU patients with CVD were prone to anxiety and depression symptoms. Female gender, hypertension, hyperlipidemia and cardiac function class IV were identified as independent risk factors that also served as mediators in the relationship between anxiety and depression symptoms. Especially, cardiac function class IV emerged as a critical factor in this association.
It is imperative for critical care professionals to recognize the elevated risk of depression and anxiety among ICU patients with severe CVD, especially those with cardiac function class IV, hypertension, hyperlipidemia and females. Proactive and supportive measures are essential for this vulnerable group during their ICU stay to safeguard their mental health and prevent negative outcomes.
No Patient or Public Contribution.
Vicarious trauma can significantly affect the physical and mental health of nurses, as well as their ability to provide quality of care. However, the concept of vicarious trauma has received limited attention and remains controversial in the nursing context.
The purpose of this study was to clarify and define the concept of vicarious trauma as it pertains to the nursing context.
The Schwartz and Kim's three-stage hybrid concept analysis method was used to define the concept. In the theoretical phase, PubMed, CINAHL, OVID, Medline, Embase, Web of Science, Scopus, ProQuest, PsycINFO, CNKI database, VIP database and Wanfang database were used using keywords “nurs*”and “vicarious trauma*”, resulting in a total of 25 papers. In the fieldwork phase, we conducted participatory observations in three hospitals and semi-structured in-depth interviews with 18 clinical nurses from seven cities. In the analysis phase, the results of the previous two phases were integrated to develop a comprehensive concept of vicarious trauma in nursing.
Based on the results of the theoretical and field phases, we propose the concept of vicarious trauma in nursing as follows: vicarious trauma is a psychological trauma impacting nurses' cognitive schema which they may experience in clinical settings or on social media, resulting from deeply empathize with the physical or emotional trauma of patients, family, or colleagues, such as patients' physical injuries or death, family's grieving feelings and colleagues' received threats and attacks. Positively, vicarious trauma can transform into vicarious post-trauma growth through repositioning and connection, nourishing nurses and promoting their personal and professional development.
The concept of vicarious trauma in nursing is multidimensional and holistic. This study clarifies the concept of vicarious trauma in nursing using the hybrid concept analysis, providing a framework for future research and practice on vicarious trauma in the nursing field.
Nurses contributed to the conduct of the study by participating in the data collection via interviews.
FreshRSS 