摘要：
Aim To explore and explain the mechanisms that influence surface acting in nursing students with different characteristics.
To explore and explain the mechanisms that influence surface acting in nursing students with different characteristics.
Background Nurses are now expected to deliver patient-centered care which necessitates the emotional labor. Surface acting, a form of emotional labor, can lead to negative outcomes. Given that nursing students are the backbone of the future nursing profession, there is an urgent need to investigate their surface acting tendencies and identify potential factors for early intervention.
Nurses are now expected to deliver patient-centered care which necessitates the emotional labor. Surface acting, a form of emotional labor, can lead to negative outcomes. Given that nursing students are the backbone of the future nursing profession, there is an urgent need to investigate their surface acting tendencies and identify potential factors for early intervention.
Design A cross-sectional study.
A cross-sectional study.
Methods This study was surveyed in a vocational college in Gansu, China. Participants completed the general information questionnaire, Bem Sex Role Inventory, Professional Identity Questionnaire of Nursing Students and Surface Acting Scale. K-means cluster analysis was performed, followed by random forest algorithm and SHapley Additive exPlanations based on Python program.
This study was surveyed in a vocational college in Gansu, China. Participants completed the general information questionnaire, Bem Sex Role Inventory, Professional Identity Questionnaire of Nursing Students and Surface Acting Scale. K-means cluster analysis was performed, followed by random forest algorithm and SHapley Additive exPlanations based on Python program.
Results A total of 1241 nursing students from vocational college were investigated and were clustered into 4 groups. The five dimensions of professional identity had higher feature importance in all four groups, with professional self-image having the highest feature importance in Cluster 3. Professional self-image and understanding retention benefits and turnover risks were negative predictors of surface acting in all four groups. Social comparison and self-reflection, independence of career choice and social modeling regarding nursing profession were positively correlated with surface acting in specific groups. In Cluster 1, there exists a positive correlation between professional self-image and the constructs of social comparison and self-reflection; as well as a negative correlation between maternal education and understanding of retention benefits and turnover risks.
A total of 1241 nursing students from vocational college were investigated and were clustered into 4 groups. The five dimensions of professional identity had higher feature importance in all four groups, with professional self-image having the highest feature importance in Cluster 3. Professional self-image and understanding retention benefits and turnover risks were negative predictors of surface acting in all four groups. Social comparison and self-reflection, independence of career choice and social modeling regarding nursing profession were positively correlated with surface acting in specific groups. In Cluster 1, there exists a positive correlation between professional self-image and the constructs of social comparison and self-reflection; as well as a negative correlation between maternal education and understanding of retention benefits and turnover risks.
Conclusions Professional identity significantly influences surface acting behaviors among nursing students, with professional self-image serving as a key negative predictor. Positive family conditions, access to educational resources, parental literacy, masculine or feminine gender roles and first-year nursing students, these traits have implications when dimensions of professional identity are used to predict surface acting behaviors.
Professional identity significantly influences surface acting behaviors among nursing students, with professional self-image serving as a key negative predictor. Positive family conditions, access to educational resources, parental literacy, masculine or feminine gender roles and first-year nursing students, these traits have implications when dimensions of professional identity are used to predict surface acting behaviors.
作者：
Liang, Cong;Huang, Xinlin;Pu, Yucui;Zhang, Pei;Wang, Rong
期刊：
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES,2025年34(1):108104 ISSN：1052-3057
通讯作者：
Rong Wang
作者机构：
[Zhang, Pei; Liang, Cong] School of Nursing, University of South China, Heng Yang, 421001, China;[Liang, Cong] Yellow River Centre Hospital of the Yellow River Conservancy Commission, Zheng Zhou, 450000, China. Electronic address: 983849974@qq.com;[Huang, Xinlin] The Hong Kong Polytechnic University, Hong Kong, China;[Pu, Yucui] Chongqing Preschool Education College, Chong Qing, China;[Wang, Rong] School of Nursing, University of South China, Heng Yang, 421001, China. Electronic address: wwrr77@163.com
通讯机构：
[Rong Wang] S;School of Nursing, University of South China, Heng Yang, 421001, China
关键词：
Genome-wide association study;Mendelian randomization;Stroke;Walking pace
摘要：
Background Walking pace (WP), a simple physiological indicator, has been found to be strongly associated with a variety of health outcomes in recent years. Among them, the relationship between walking pace and stroke is of particular interest. Given the high morbidity, disability and mortality associated with stroke, identifying modifiable indicators of health, such as walking pace, could help in stroke prevention strategies. However, the causal relationship between WP and stroke risk remains unclear. This study aims to determine the causal relationship between walking pace and risk of stroke using a two-sample Mendelian randomization approach in a European-ancestry population.
Walking pace (WP), a simple physiological indicator, has been found to be strongly associated with a variety of health outcomes in recent years. Among them, the relationship between walking pace and stroke is of particular interest. Given the high morbidity, disability and mortality associated with stroke, identifying modifiable indicators of health, such as walking pace, could help in stroke prevention strategies. However, the causal relationship between WP and stroke risk remains unclear. This study aims to determine the causal relationship between walking pace and risk of stroke using a two-sample Mendelian randomization approach in a European-ancestry population.
Methods In order to evaluate the potential for a causal relationship between WP and stroke in people of European heritage, a two-sample Mendelian randomization (MR) study was carried out. Statistics about the association of single nucleotide polymorphisms (SNPs) with stroke were taken from FinnGen (R8) (n = 284,040), while the UK Biobank genome-wide association studies (GWAS) provided the summary data on the association of SNPs with WP (n = 459,915). The inverse-variance weighted (IVW) method was utilised as the primary strategy to examine the causal connection between WP and stroke. Additionally, complementary analyses were conducted using the MR-Egger and weighted median. In order to identify the potential directional pleiotropy and heterogeneity, the MR-Egger intercept test, the MR-PRESSO test, and Cochran's Q statistic were all carried out. This connection was evaluated using OR with 95% confidence intervals (CIs).
In order to evaluate the potential for a causal relationship between WP and stroke in people of European heritage, a two-sample Mendelian randomization (MR) study was carried out. Statistics about the association of single nucleotide polymorphisms (SNPs) with stroke were taken from FinnGen (R8) (n = 284,040), while the UK Biobank genome-wide association studies (GWAS) provided the summary data on the association of SNPs with WP (n = 459,915). The inverse-variance weighted (IVW) method was utilised as the primary strategy to examine the causal connection between WP and stroke. Additionally, complementary analyses were conducted using the MR-Egger and weighted median. In order to identify the potential directional pleiotropy and heterogeneity, the MR-Egger intercept test, the MR-PRESSO test, and Cochran's Q statistic were all carried out. This connection was evaluated using OR with 95% confidence intervals (CIs).
Results A total of 48 SNPs were identified as valid instrumental variables in our two-sample MR analysis. The result showed that a slower walking pace is associated with a higher risk of stroke (OR = 0.573; 95% CI, 0.383-0.858, P = 0.007). The “leave-one-out” analysis demonstrated that the absence of a single SNP did not affect the robustness of our results. The MR-Egger intercept test indicated that genetic pleiotropy did not introduce bias into the results [intercept = −2.9E−03, SE = 0.008, P = 0.719] and Cochran's Q test revealed no heterogeneity. Therefore, the sensitivity analyses yielded comparable results. Consequently, the results of the sensitivity analyses were consistent.
A total of 48 SNPs were identified as valid instrumental variables in our two-sample MR analysis. The result showed that a slower walking pace is associated with a higher risk of stroke (OR = 0.573; 95% CI, 0.383-0.858, P = 0.007). The “leave-one-out” analysis demonstrated that the absence of a single SNP did not affect the robustness of our results. The MR-Egger intercept test indicated that genetic pleiotropy did not introduce bias into the results [intercept = −2.9E−03, SE = 0.008, P = 0.719] and Cochran's Q test revealed no heterogeneity. Therefore, the sensitivity analyses yielded comparable results. Consequently, the results of the sensitivity analyses were consistent.
Conclusion Our MR study revealed that WP is inversely associated with risk of stroke. These results provided evidence that slower WP causally increased the risk of stroke, recommending that patients with lower WP should have a prompt physical examination and targeted interventions to reduce their risk of stroke and enhance their quality of life.
Our MR study revealed that WP is inversely associated with risk of stroke. These results provided evidence that slower WP causally increased the risk of stroke, recommending that patients with lower WP should have a prompt physical examination and targeted interventions to reduce their risk of stroke and enhance their quality of life.
摘要：
China is experiencing an increasingly serious aging population. Cognitive function is an important factor and guarantee for the quality of life of older people. Therefore, to achieve healthy aging, this study aimed to examine the sequential multiple mediating effects of indoor ventilation frequency and cognitive function on anxiety and self-rated health in the Chinese older people population. Using the 2018 China Longitudinal Health and Longevity Survey (CLHLS) dataset, we finally selected 10,372 Chinese seniors over the age of 65. First, we describe the basic socio-demographic information of the sample population. Second, Spearman correlation analysis was used to determine whether there was a correlation between indoor ventilation frequency, anxiety, self-rated health, and cognitive function among Chinese older people. Finally, the SPSS macro process program was used to complete the sequence multiple mediation analysis. Indoor ventilation frequency, anxiety, self-rated health and cognitive function were significantly correlated (p < 0.01). Indoor ventilation frequency not only has a direct positive impact on the cognitive function of older people (effect = 0.1427; Standard error = 0.0201; 95%CI: LL = 0.1034, UL = 0.1821), but also indirectly affected cognitive function through three pathways: independent mediation of anxiety (effect = 0.0078; Standard error = 0.0021; 95%CI: LL = 0.0041, UL = 0.0121), independent mediating effect of self-rated health (effect = 0.0154; Standard error = 0.0030; 95%CI: LL = 0.0098, UL = 0.0215), and the chain mediating effect between anxiety and self-rated health (effect = 0.0046; Standard error = 0.0009; 95%CI: LL = 0.0029, UL = 0.0065). All projects are self-reported and some results may be biased. In the future, it may be more inspiring to explore more detailed and specific effects of indoor air quality on cognitive function in older people. Studies have shown that indoor ventilation frequency can improve cognitive function by reducing anxiety and improving self-rated health in older people Chinese. Encouraging older adults to increase the frequency of indoor ventilation will benefit their mental health and cognitive function. This study provides empirical evidence for the association between indoor ventilation frequency and cognitive function in older people Chinese adults. We used nationally representative data to investigate the relationship between indoor ventilation frequency and cognitive function and further explored the mediating role of anxiety and self-rated health in Chinese older adults. Indoor ventilation frequency can not only directly affect cognitive function in older people, but also indirectly affect cognitive function through anxiety and self-rated health. Anxiety and self-rated health have a series of mediating effects between indoor ventilation frequency and cognitive function.
摘要：
BACKGROUND: To investigate the association between indoor ventilation frequency and symptoms of depression and anxiety in older persons. METHODS: A binary logistic regression model was used to analyze the effects of indoor ventilation frequency on depression and anxiety by using data from the 2018 Chinese longitudinal healthy longevity survey (CLHLS). RESULTS: A total of 9,690 older persons with an average age of (83.20 ± 11.27) years were included, including 4,458 males (46.0%) and 5,232 females (54.0%). The average score of indoor ventilation frequency was (6.06 ± 1.98) points, including 770 people (7.9%) with low frequency, 3,066 people (31.6%) with medium frequency, and 5,854 people (60.4%) with high frequency. 842 (8.7%) had symptoms of depression and 204 (2.1%) had symptoms of anxiety. Compared with the older persons with low indoor ventilation frequency, the older persons with higher ventilation frequency had a lower incidence of depression (OR(95%CI) = 1.92 (1.50 ∼ 2.46), 1.51 (1.27 ∼ 1.79); P < 0.001). However indoor ventilation frequency was not associated with anxiety symptoms. CONCLUSION: Indoor ventilation frequency is related to depressive symptoms in older persons. Communities and families should pay more attention to indoor ventilation and intervene in time to promote and improve the mental health of older persons.
期刊：
Journal of Orthopaedic Surgery and Research,2025年20(1):1-8 ISSN：1749-799X
通讯作者：
Zhou, YH;Huang, HY
作者机构：
[He, Yulian; Liu, Bo; Tang, Wen; Yuan, Runzhi] Univ South China, Affiliated Hosp 1, Dept Orthoped Ctr, Hengyang Med Sch, Hengyang City 421001, Hunan Prov, Peoples R China.;[Wang, Yiqi] Univ South China, Sch Nursing, Hengyang City 421001, Hunan Prov, Peoples R China.;[Zhou, Yanhui] Univ South China, Affiliated Hosp 1, Hengyang Med Sch, Nursing Dept, 69 Chuanshan Rd, Hengyang City 421001, Hunan Prov, Peoples R China.;[Huang, Huayong; Huang, HY] Univ South China, Affiliated Hosp 1, Dept Emergency Med Ctr, Hengyang Med Sch, 69 Chuanshan Rd, Hengyang City 421001, Hunan Prov, Peoples R China.
通讯机构：
[Huang, HY ; Zhou, YH ] U;Univ South China, Affiliated Hosp 1, Hengyang Med Sch, Nursing Dept, 69 Chuanshan Rd, Hengyang City 421001, Hunan Prov, Peoples R China.;Univ South China, Affiliated Hosp 1, Dept Emergency Med Ctr, Hengyang Med Sch, 69 Chuanshan Rd, Hengyang City 421001, Hunan Prov, Peoples R China.
关键词：
Early rehabilitation;Hospital stay;Postoperative complications;Elderly patients;Hip fracture;A prospective cohort study
摘要：
Hip fractures in the elderly are a major global public health concern, with incidence projected to rise as populations age. Rehabilitation is critical to recovery after hip fracture surgery, but the ideal timing for initiation remains uncertain. While early rehabilitation, within 48 h post-surgery, is associated with better outcomes, its specific impact on hospital stay duration and postoperative complications is not yet conclusively established. This study aims to evaluate the effects of initiating rehabilitation within 48 h after hip fracture surgery on hospital length of stay and postoperative complications, compared to rehabilitation started one-week post-surgery in elderly patients. It is hypothesized that early rehabilitation will significantly reduce hospital stays and decrease the rate of postoperative complications. In this prospective cohort study, patients aged 65 and older are divided into early rehabilitation (within 48 h) and delayed rehabilitation (after one week) groups. Data will be collected using electronic medical records (EMR), standardized clinical tools (Barthel Index, Timed Up and Go), and patient-reported outcome measures (SF-36, EQ-5D). Statistical analyses will include t-tests and chi-square tests for outcome comparison, with multiple regression adjusting for potential confounders such as age, gender, and comorbidities. This study addresses a gap in current research by comparing early versus delayed rehabilitation for elderly hip fracture patients. The findings will contribute to the development of evidence-based rehabilitation protocols aimed at optimizing recovery, reducing complications, and improving the efficient use of medical resources.
摘要：
Background Anxiety is a common and significant problem in patients who need to undergo colonoscopy. However, the question of which non-pharmacological intervention is the best strategy to reduce anxiety in patients undergoing colonoscopy remains unanswered.
Anxiety is a common and significant problem in patients who need to undergo colonoscopy. However, the question of which non-pharmacological intervention is the best strategy to reduce anxiety in patients undergoing colonoscopy remains unanswered.
Objectives To evaluate and rank the effectiveness of various non-pharmacological interventions for reducing anxiety in patients undergoing colonoscopy in order to identify the most effective strategies.
To evaluate and rank the effectiveness of various non-pharmacological interventions for reducing anxiety in patients undergoing colonoscopy in order to identify the most effective strategies.
Methods We searched PubMed, Cochrane Library, Embase, Web of Science, and Medline for randomized controlled trials published from the database construction to March 2024. The primary outcome was the difference between pre- and post-intervention anxiety means. A network meta-analysis was conducted utilizing the “gemtc” package based on R4.3.0.
We searched PubMed, Cochrane Library, Embase, Web of Science, and Medline for randomized controlled trials published from the database construction to March 2024. The primary outcome was the difference between pre- and post-intervention anxiety means. A network meta-analysis was conducted utilizing the “gemtc” package based on R4.3.0.
Results The analysis encompassed 24 randomized controlled trials, incorporating 2525 participants and evaluating 9 non-pharmacological interventions. All non-pharmacological interventions reduced anxiety in patients undergoing colonoscopy compared to standard care, with music intervention (SMD = -0.52, 95 %CI (−0.84,-0.20)), audiovisual distraction (SMD = -0.54, 95 %CI(−0.96,-0.12)), video information (SMD = -1.47, 95 %CI(−2.03,-0.90)), individual education (SMD = -1.72, 95 %CI(−2.76,-0.70)), and electroacupuncture (SMD = -1.12, 95 %CI(−2.10,-0.13)) having statistically significant effects. SUCRA ranking identified the priority of individual education (SUCRA: 92.5 %) and video information (SUCRA: 87.7 %). Meta-regression and sensitivity analysis further demonstrated the stability of the evidence. The certainty of the evidence was mostly rated as medium to low.
The analysis encompassed 24 randomized controlled trials, incorporating 2525 participants and evaluating 9 non-pharmacological interventions. All non-pharmacological interventions reduced anxiety in patients undergoing colonoscopy compared to standard care, with music intervention (SMD = -0.52, 95 %CI (−0.84,-0.20)), audiovisual distraction (SMD = -0.54, 95 %CI(−0.96,-0.12)), video information (SMD = -1.47, 95 %CI(−2.03,-0.90)), individual education (SMD = -1.72, 95 %CI(−2.76,-0.70)), and electroacupuncture (SMD = -1.12, 95 %CI(−2.10,-0.13)) having statistically significant effects. SUCRA ranking identified the priority of individual education (SUCRA: 92.5 %) and video information (SUCRA: 87.7 %). Meta-regression and sensitivity analysis further demonstrated the stability of the evidence. The certainty of the evidence was mostly rated as medium to low.
Conclusion This review highlights the superior effects of individual education and video information in reducing anxiety in patients undergoing colonoscopy. The findings of our review could provide clinical decision-makers and healthcare practitioners, such as doctors and nurses, with evidence-based practices for selecting interventions to reduce anxiety in patients undergoing colonoscopy.
This review highlights the superior effects of individual education and video information in reducing anxiety in patients undergoing colonoscopy. The findings of our review could provide clinical decision-makers and healthcare practitioners, such as doctors and nurses, with evidence-based practices for selecting interventions to reduce anxiety in patients undergoing colonoscopy.
摘要：
Hypertrophic scarring (HS) is a fibrotic skin disorder characterized by excessive deposition of extracellular matrix (ECM), leading to symptoms such as pain, itching, and skin contraction. HS can also result in restricted joint mobility and cosmetic deformities, imposing psychological and economic burdens on patients. Additionally, it increases wound care costs, and currently, no ideal treatment options exist. Therefore, HS is not only a clinical care issue but also a societal problem, with significant challenges related to its management and prevention. In this study, a custom-made cepharanthine ointment was applied to a rabbit ear scar model to investigate its effects on morphology, histology, and protein expression in HS. Additionally, the mechanism underlying the effect of cepharanthine on affected fibroblasts and the expression of ECM proteins was explored in vitro models of fibrosis. Animal experiments demonstrated that cepharanthine significantly reduced the tissue scar hypertrophy index and collagen content, improved the arrangement of fibroblasts, and inhibited ECM production. Cellular experiments indicated that cepharanthine effectively downregulated key proteins in the TGF-β/SMAD pathway, decreased ECM protein expression, and suppressed fibroblast proliferation and migration. Cepharanthine can prevent HS by reducing ECM deposition through the TGF-β/SMAD signalling pathway.
作者机构：
[You, Jia-Chun; Xu, Chao-Yue; Li, Shu-Lin; Huang, YJ; Huang, Yan-Jin; He, Zhi-Qing] Univ South China, Sch Nursing, Hengyang Med Sch, Hengyang, Hunan, Peoples R China.;[Zou, Ping] Nipissing Univ, Sch Nursing, North Bay, ON, Canada.;[Chen, Xi] Hong Kong Polytech Univ, Sch Nursing, Hong Kong, Peoples R China.
通讯机构：
[Huang, YJ ] U;Univ South China, Sch Nursing, Hengyang Med Sch, Hengyang, Hunan, Peoples R China.
摘要：
INTRODUCTION: Stroke presents a considerable burden not only to patients but also to their families and society at large. In many instances, stroke patients opt for home rehabilitation, relying on family caregivers for daily assistance. This dynamic significantly influences the physiological, psychological and social well-being of these caregivers. Despite its importance, the phenomenon of self-regulatory fatigue (SRF) among family caregivers has received insufficient attention in the literature. Therefore, the objective of this study is to investigate the levels of SRF, the characteristics of associated symptoms and the trajectories of symptom change experienced by family caregivers of stroke patients. METHODS AND ANALYSIS: This research employs a mixed-methods approach, combining a cross-sectional study with a prospective longitudinal quantitative and qualitative design. The Chinese version of the SRF Scale and the Chinese version of Patient-Reported Outcomes Measurement Information System profile-29 are used to assess SRF, psychological and physiological symptoms, and related functional outcomes among family caregivers of stroke patients. Latent class growth analysis will be employed to model the heterogeneous developmental trajectories of SRF-related symptoms among family caregivers of stroke patients. Reflexive thematic analysis will be employed to analyse, organise and summarise qualitative data, to identify the experiences and management needs related to SRF among family caregivers during home care. Through this comprehensive mixed-methods approach, the study aims to: investigate the levels of SRF experienced by family caregivers of stroke patients, identify patterns and trajectories of related symptoms. The integration of cross-sectional and longitudinal data allows for a thorough examination of both immediate and long-term aspects of caregiver experiences, providing valuable insights into the complex dynamics of SRF in this population. ETHICS AND DISSEMINATION: The study protocol was approved by the Medical Ethics Committee of the University of South China (approval number 2023-NHHL-051). Data collection was authorised by the ethics committees of the First Affiliated Hospital, Second Affiliated Hospital and Nanhua Affiliated Hospital of the University of South China. The results of this study will be disseminated through publication in pertinent peer-reviewed journals, presentation at local and international conferences, and communication with all relevant stakeholders. TRIAL REGISTRATION NUMBER: ChiCTR2400082717.
摘要：
Chlamydia trachomatis Pgp3 protein-induced immunoprotection is effective but incomplete, which requires the suitable adjuvants to enhance its immune response. Within this context, Hepatitis B core virus-like particles (HBc-VLP) emerge as nanoscale protein particles capable of incorporating either endogenous or exogenous antigens or epitopes. In this study, HBc-Pgp3 chimeric protein was accomplished by integrating the identified dominant epitope of the Pgp3 protein into the major immunodominant region of a truncated HBc-VLP, which was realized in the pET28a (+) vector and expressed via the E. coli BL21 expression system. The efficacious expression and purification of the recombinant HBc-Pgp3 facilitated a tripartite immunization regimen in mice. The immunological assessment encompassed the measurement of IgG antibody and cytokine levels through ELISA, alongside flow cytometric analysis of the CD4+ Th1 cell-mediated immune responses within the murine spleen. Comparative analysis revealed that the HBc-Pgp3-vaccinated mice demonstrated superior IgG antibody titers and subtypes relative to the controls. Moreover, the HBc-Pgp3 formulation was instrumental in augmenting IFN-γ production, enhancing the efficiency of Chlamydia muridarum clearance post-challenge, and severity of hydrosalpinx within the lower genital tract. Collectively, these findings illuminate the potential of the novel HBc-Pgp3 chimeric construct as an innovative vaccine candidate, offering augmented immunoprotection against chlamydial infection.
Chlamydia trachomatis Pgp3 protein-induced immunoprotection is effective but incomplete, which requires the suitable adjuvants to enhance its immune response. Within this context, Hepatitis B core virus-like particles (HBc-VLP) emerge as nanoscale protein particles capable of incorporating either endogenous or exogenous antigens or epitopes. In this study, HBc-Pgp3 chimeric protein was accomplished by integrating the identified dominant epitope of the Pgp3 protein into the major immunodominant region of a truncated HBc-VLP, which was realized in the pET28a (+) vector and expressed via the E. coli BL21 expression system. The efficacious expression and purification of the recombinant HBc-Pgp3 facilitated a tripartite immunization regimen in mice. The immunological assessment encompassed the measurement of IgG antibody and cytokine levels through ELISA, alongside flow cytometric analysis of the CD4+ Th1 cell-mediated immune responses within the murine spleen. Comparative analysis revealed that the HBc-Pgp3-vaccinated mice demonstrated superior IgG antibody titers and subtypes relative to the controls. Moreover, the HBc-Pgp3 formulation was instrumental in augmenting IFN-γ production, enhancing the efficiency of Chlamydia muridarum clearance post-challenge, and severity of hydrosalpinx within the lower genital tract. Collectively, these findings illuminate the potential of the novel HBc-Pgp3 chimeric construct as an innovative vaccine candidate, offering augmented immunoprotection against chlamydial infection.
期刊：
Archives of Gerontology and Geriatrics,2025年128:105622 ISSN：0167-4943
通讯作者：
Xinhong Yin
作者机构：
[Zhang, Hongtao; Zhou, Yutong; She, Keyi; Gao, Yue; Chen, Yao; Zhang, Wen] School of Nursing, University of South China, Hengyang, Hunan, PR China;[Zhou, Li; Jiang, Dandan] The Second Hospital, University of South China, Hengyang, Hunan, PR China;[Yin, Xinhong] School of Nursing, University of South China, Hengyang, Hunan, PR China. Electronic address: 466844009@qq.com
通讯机构：
[Xinhong Yin] S;School of Nursing, University of South China, Hengyang, Hunan, PR China
摘要：
Introduction Frailty is a geriatric syndrome that is highly susceptible to adverse health outcomes and is a major burden that exacerbates society's medical care. By investigating the frailty trajectory within the older demographic and initially recognizing its clinical outcomes, we will have more tactics to manage the at-risk population.
Frailty is a geriatric syndrome that is highly susceptible to adverse health outcomes and is a major burden that exacerbates society's medical care. By investigating the frailty trajectory within the older demographic and initially recognizing its clinical outcomes, we will have more tactics to manage the at-risk population.
Methods We executed a systematic review of trajectory studies elucidating the connection between frailty and adverse outcomes among older individuals (≥ 65 years) and explored articles published in English and Chinese from the inception of the database until Jun 30, 2024, in PubMed, Web of Science, Embase, The Cochrane Library, CINAHL, Scopus, CNKI, China Online Journals, VIP Information, and SinoMed.
We executed a systematic review of trajectory studies elucidating the connection between frailty and adverse outcomes among older individuals (≥ 65 years) and explored articles published in English and Chinese from the inception of the database until Jun 30, 2024, in PubMed, Web of Science, Embase, The Cochrane Library, CINAHL, Scopus, CNKI, China Online Journals, VIP Information, and SinoMed.
Results The database survey unearthed 3522 articles, of which 21 were deemed eligible. The majority incorporated distinct assessment tools and statistical methodologies to classify frailty trajectories into three groups. Although these frailty trajectories produced inconsistent clinical outcomes, they did reveal trends in the frailty status of older adults.
The database survey unearthed 3522 articles, of which 21 were deemed eligible. The majority incorporated distinct assessment tools and statistical methodologies to classify frailty trajectories into three groups. Although these frailty trajectories produced inconsistent clinical outcomes, they did reveal trends in the frailty status of older adults.
Conclusion The link between frailty trajectories and adverse outcome is a multifaceted and complex process that is currently understudied. More comprehensive and in-depth longitudinal studies should be conducted to explore the mechanism of interaction between the two to obstruct the progression of the frailty trajectory and bolster support for interventions.
The link between frailty trajectories and adverse outcome is a multifaceted and complex process that is currently understudied. More comprehensive and in-depth longitudinal studies should be conducted to explore the mechanism of interaction between the two to obstruct the progression of the frailty trajectory and bolster support for interventions.
摘要：
Purpose The study aimed to identify the profiles of psychological flexibility in patients with cervical cancer and how self-perceived burden networked to different psychological flexibility profiles.
The study aimed to identify the profiles of psychological flexibility in patients with cervical cancer and how self-perceived burden networked to different psychological flexibility profiles.
Methods The Personalized Psychological Flexibility Index and the Self-Perceived Burden for Cancer Patients were used to measure psychological flexibility and self-perceived burden in patients from the “Be Resilient to Cancer” project. Latent profile analysis was used to identify profiles and computer-simulated network analysis was conducted to determine if self-perceived burden networked to any of the psychological flexibility profiles.
The Personalized Psychological Flexibility Index and the Self-Perceived Burden for Cancer Patients were used to measure psychological flexibility and self-perceived burden in patients from the “Be Resilient to Cancer” project. Latent profile analysis was used to identify profiles and computer-simulated network analysis was conducted to determine if self-perceived burden networked to any of the psychological flexibility profiles.
Results A total of 325 patients with cervical cancer were recruited in this study. Mean age was 42.26 years, the majority were married (71%) and 75.4% had early stage disease (I or II). Three profiles of psychological flexibility were identified: moderate avoidance-low acceptance/harnessing (34.8%), high avoidance-moderate acceptance/harnessing (36.9%), low avoidance and high acceptance/harnessing (28.3%). Furthermore, “worrying about damaging family relationships” and “feeling guilty about affecting family's life plans” were the most bridge symptoms as well as the targeted intervention symptoms for alleviating and aggravating the self-perceived burden respectively.
A total of 325 patients with cervical cancer were recruited in this study. Mean age was 42.26 years, the majority were married (71%) and 75.4% had early stage disease (I or II). Three profiles of psychological flexibility were identified: moderate avoidance-low acceptance/harnessing (34.8%), high avoidance-moderate acceptance/harnessing (36.9%), low avoidance and high acceptance/harnessing (28.3%). Furthermore, “worrying about damaging family relationships” and “feeling guilty about affecting family's life plans” were the most bridge symptoms as well as the targeted intervention symptoms for alleviating and aggravating the self-perceived burden respectively.
Conclusion Three patterns of psychological flexibility were recognized with two symptoms might be targeted to improve the self-perceived burden in women with cervical cancer.
Three patterns of psychological flexibility were recognized with two symptoms might be targeted to improve the self-perceived burden in women with cervical cancer.
作者机构：
[Peng, Tong; Huang, Li-Li; Yue, Qian-Qian; Feng, Ge-Hui; Tang, Tian; Zeng, Ying; Meng, Xin-Ru; Zhao, Ke-Hao; Huang, Hui-Lin; Sun, Ying-Xue] Univ South China, Sch Nursing, Hengyang Med Sch, Dept Int & Humanist Nursing,Hunan Sci Popularizat, Hengyang, Hunan, Peoples R China.;[Zeng, Ying] Univ South China, Hengyang Sch Med, Canc Res Inst, Hunan Prov Key Lab Tumor Cellular & Mol Pathol, Hengyang, Peoples R China.
通讯机构：
[Zeng, Y ] U;Univ South China, Sch Nursing, Hengyang Med Sch, Dept Int & Humanist Nursing,Hunan Sci Popularizat, Hengyang, Hunan, Peoples R China.;Univ South China, Hengyang Sch Med, Canc Res Inst, Hunan Prov Key Lab Tumor Cellular & Mol Pathol, Hengyang, Peoples R China.
关键词：
Colonoscopy;Anxiety;Influencing factors;Mental health
摘要：
Background Anxiety in patients undergoing colonoscopy may also result in adverse effects, including altered vital signs such as elevated heart rate and blood pressure, exacerbation of symptoms like bloating and gastrointestinal discomfort, a decline in cooperation and satisfaction, and even colonoscopy failure. However, limited studies have explored the level of anxiety, factors that influence it, and its specific causes. Methods A cross-sectional study was conducted, recruiting 825 patients undergoing colonoscopy in Hunan Province between January and July 2023 using stratified sampling. The Spielberger State-Trait Anxiety Inventory (STAI), a self-designed demographic characteristics questionnaire, and a colonoscopy patient anxiety influencing factor questionnaire were used. The data were analyzed in SPSS (version 26) using Mann-Whitney U, Kruskal-Wallis, and multiple regression analysis tests. Results The final study included 825 participants, of whom 19.8% exhibited mild anxiety, 37.0% exhibited moderate anxiety, and 43.2% exhibited severe anxiety. The results indicated that insomnia (beta=-0.080, p = 0.013), no comorbidities (beta=-0.147, p < 0.001), not smoking or drinking (beta=-0.158, p < 0.001), and poor health (moderate: beta=-0.183, p < 0.001; poor: beta=-0.164, p < 0.001) were negatively associated with anxiety levels. In contrast, marital status (beta = 0.177, p < 0.001), education level (beta = 0.204, p < 0.001), age (beta = 0.114, p = 0.007), medical insurance (Basic Medical Insurance for Urban Residents beta = 0.204, p < 0.001; Commercial medical insurance: beta = 0.112, p < 0.001), care provided by relatives (beta = 0.102, p = 0.002), diarrhoea (beta = 0.089, p = 0.005), occupation (farmers: beta = 0.099, p = 0.009; self-employed: beta = 0.082, p = 0.014), and paternal upbringing (beta = 0.067, p = 0.034) were positively correlated with anxiety. Several factors had a greater impact on the anxiety level of the patients: education level (beta = 0.204), health status (moderate: beta=-0.183; not good: beta=-0.164), and marital status (beta = 0.177). It probably because higher education levels may increase awareness of potential risks associated with colonoscopy, contributing to greater anxiety. The five common reasons for anxiety included the presence of bloody faeces, enemas, need for further treatment, lack of timely feedback from the physician, lack of an accurate diagnosis. Conclusion The level of anxiety experienced by patients during the colonoscopy phase was more severe and should be alleviated with targeted interventions based on the cause of anxiety, such as pre-procedural counseling, patient education materials, and enhanced communication with healthcare providers.
摘要：
This research seeks to thoroughly examine the present state and research hotspots in Mendelian randomization (MR) in osteoporosis (OP)-related fields, providing a reference for future research directions in this area. Following an exhaustive search of the Web of Science Core Collection database, our analysis utilized citation statistics for osteoporosis studies conducted from January 1, 2007, through March 15, 2024. Bibliometric and visual analyses were conducted using two online analysis systems, CiteSpace and VOSviewer. The analysis included a variety of dimensions, including the distribution of citations, authorship, published journals, year of publication, countries, co-occurrence keywords and keyword clustering. From 2007 to 2024, the number of publications in MR in OP-related fields showed an overall increased. High-impact publications and leading contributors were primarily from China, followed by the USA and England. The journal with the largest number of publications in MR in OP-related fields is the Journal of Bone and Mineral Research. Risk factor research, genome-wide associations, meta-analysis, fractures, and gene loci were the main research hotspots. Interdisciplinary integration, MR research combined with data from clinical trials and observational studies, represents the future development trend. Research on MR in OP-related fields has mainly been conducted in China, the USA, and England. The research hotspots were aimed at exploring the causative between risk factors and OP. Future studies are likely to center on multidisciplinary integration.
期刊：
International Journal of Medical Informatics,2025年195:105738 ISSN：1386-5056
通讯作者：
Hu, Li;Zeng, GQ
作者机构：
[Zeng, Mi; Wang, Manyi; Hu, Li; Zeng, Guqing; Li, Zhuolan; Wu, Jingjing; Zeng, Qingqing] Univ South China, Hengyang Med Sch, Sch Nursing, 28 Changsheng Rd West, Hengyang 421001, Hunan, Peoples R China.;[Zeng, Mi; Wang, Manyi; Zeng, Guqing; Li, Zhuolan; Wu, Jingjing; Hu, Li] Univ South China, Sch Enterprise Cooperat Innovat & Entrepreneurship, Hunan Lantern Med Technol Co Ltd, Hengyang, Peoples R China.;[Gui, Sijie] Univ South China, Affiliated Hosp 1, Dept Orthoped & Trauma, Hengyang, Peoples R China.;[Zeng, Qingqing] Army Med Univ, Affiliated Hosp 1, Hosp Chinese Peoples Liberat Army 958, Jiangbei Campus,29 Jianxindong St, Chongqing 400038, Peoples R China.;[Miao, Wanyu] Chongqing Univ Technol, Coll Comp Sci & Engn, Chongqing, Peoples R China.
通讯机构：
[Hu, L; Zeng, GQ ] U;Univ South China, Hengyang Med Sch, Sch Nursing, 28 Changsheng Rd West, Hengyang 421001, Hunan, Peoples R China.
关键词：
Hip fractures;Re-fracture;Automatic machine learning;Prediction models
摘要：
Objective The aim of study was to construct a postoperative re-fracture prediction model for elderly hip fracture patients using an automated machine learning algorithm to provide a basis for early identification of patients with high risk of re-fracture occurrence.
The aim of study was to construct a postoperative re-fracture prediction model for elderly hip fracture patients using an automated machine learning algorithm to provide a basis for early identification of patients with high risk of re-fracture occurrence.
Methods Clinical data were collected and subjected to univariate and multivariate analyses to determine the independent risk factors affecting postoperative re-fracture of hip fracture in the elderly. The collected data were divided into training and validation sets in a ratio of 7:3, AutoGluon was applied to construct LightGBMXT, LightGBM, RandomForestGini, RandomForestEntr, CatBoost, NeuralNetFastAI, XGBoost, NeuralNetTorch, LightGBMLarge and WeightedEnsemble_L2 prediction models, and the constructed models were evaluated using evaluation indicators. The models were externally validated and the model with the best prediction performance was selected.
Clinical data were collected and subjected to univariate and multivariate analyses to determine the independent risk factors affecting postoperative re-fracture of hip fracture in the elderly. The collected data were divided into training and validation sets in a ratio of 7:3, AutoGluon was applied to construct LightGBMXT, LightGBM, RandomForestGini, RandomForestEntr, CatBoost, NeuralNetFastAI, XGBoost, NeuralNetTorch, LightGBMLarge and WeightedEnsemble_L2 prediction models, and the constructed models were evaluated using evaluation indicators. The models were externally validated and the model with the best prediction performance was selected.
Results The incidence of postoperative re-fracture was about 11.7%, and age, comorbid diabetes mellitus, comorbid osteoporosis, rehabilitation exercise status, and preoperative total protein level were considered as independent risk factors. The top three models in terms of AUC values in the training set were WeightedEnsemble_L2 (0.9671), XGBoost (0.9636), and LightGBM (0.9626), the WeightedEnsemble_L2 (0.9759) was best in the external validation. Based on the AUC and other evaluation indicators, WeightedEnsemble_L2 was considered the model with the best prediction performance.
The incidence of postoperative re-fracture was about 11.7%, and age, comorbid diabetes mellitus, comorbid osteoporosis, rehabilitation exercise status, and preoperative total protein level were considered as independent risk factors. The top three models in terms of AUC values in the training set were WeightedEnsemble_L2 (0.9671), XGBoost (0.9636), and LightGBM (0.9626), the WeightedEnsemble_L2 (0.9759) was best in the external validation. Based on the AUC and other evaluation indicators, WeightedEnsemble_L2 was considered the model with the best prediction performance.
Conclusion The constructed model is highly generalizable and applicable, and can be used as an effective tool for healthcare professionals to assess and manage patients’ risk of re-fracture.
The constructed model is highly generalizable and applicable, and can be used as an effective tool for healthcare professionals to assess and manage patients’ risk of re-fracture.
作者机构：
[Su, Yinhua; Li, Zhongyu; Su, YH; Li, ZY; Guo, Yu; Yu, Huixi; Li, Hanbing; Shangguan, Fuliang; Liu, Hui] Hengyang Med Sch, Univ South China, Sch Nursing, Hengyang, Hunan, Peoples R China.;[Liu, Fen] Univ South China, Affliated Hosp 1, Hengyang, Hunan, Peoples R China.
通讯机构：
[Su, YH; Li, ZY ] H;Hengyang Med Sch, Univ South China, Sch Nursing, Hengyang, Hunan, Peoples R China.
摘要：
Background Time-restricted eating (TRE) manages weight effectively, but choosing how long and what time window remain debatable. Although an 8:00 a.m. to 16:00 p.m. time frame is reported to show positive results in most weight loss trial, its safety and efficacy in overweight and obese women with polycystic ovary syndrome (PCOS) is uncertain. This randomized controlled trial is conducted to evaluate the safety and efficacy of TRE in specific populations. Objective This study aims to assess the 6-month effects of TRE on weight change, metabolic improvement, reproductive recovery, and health-related quality of life in overweight and obese women with polycystic ovary syndrome (PCOS), compared to those who did not receive TRE. Methods This randomized controlled trial will enroll 96 overweight and obese women with polycystic ovary syndrome (PCOS), who will be randomly assigned to either a TRE group (with an eating window from 8:00 a.m. to 16:00 p.m.) or a control group (without eating time restrictions), with 49 participants in each group. Evaluators and data analysts will remain blinded to group allocation throughout the study. The primary outcomes, including changes in weight and body mass index (BMI), will be assessed weekly. Secondary outcomes, encompassing alterations in sex hormones, metabolic parameters, body composition, sleep quality, quality of life, anxiety, and depression, will be evaluated monthly. Compliance and safety will be continuously monitored throughout the study. Additionally, a 6-month follow-up will be conducted at the end of the trial to assess the long-term effects of TRE. Statistical analysis will include the Anderson-Darling test for normality, T-test/Wilcoxon test based on distribution, mixed-effects models for assessing time/group effects, Cox model for time-to-event analysis, repeated ANOVA for change analysis, and sensitivity analysis. All tests will be conducted using appropriate software, with a significance level set at P<0.05. Missing data will be imputed. Discussion The purpose of this study protocol is to further evaluate the effects of TRE in overweight and obese women with PCOS through a randomized controlled trial (RCT). Findings from this study are expected to provide new dietary intervention strategies for overweight and obese PCOS participants. Ethics and dissemination This study has received ethics approval from the Medical Ethics Committee of the University of South China (Number: NHHL027). Participants are included after signing informed consent. Results will be submitted for publication in peer-reviewed journals. Trail registration Trail registration number: ChiCTR2400086815.
作者机构：
[Wang, Jiani] Univ South China, Sch Nursing, Hengyang 421001, Peoples R China.;[Rao, Qin] Univ South China, Changsha Cent Hosp, Dept Pulm TB, Changsha 410004, Peoples R China.;[Zhou, Lan] Univ South China, Dept Drug Resistant TB, Changsha Cent Hosp, Changsha 410004, Peoples R China.;[Xiang, Lingling] Univ South China, Dept Extrapulm TB, Changsha Cent Hosp, Changsha 410004, Peoples R China.;[Xi, Mingxia; Xi, MX] Univ South China, Dept Nursing, Changsha Cent Hosp, Changsha 410004, Peoples R China.
通讯机构：
[Xi, MX ] U;Univ South China, Dept Nursing, Changsha Cent Hosp, Changsha 410004, Peoples R China.
关键词：
Continuing care services;Cross-sectional study;Need survey;Pulmonary tuberculosis
摘要：
OBJECTIVE: To understand the relationship between the need for continuing care services and influencing factors, social support, readiness for discharge among discharged pulmonary tuberculosis (PTB) patients. METHODS: A cross-sectional study was conducted among 170 patients from a database of discharged patients with PTB from September 2023 to January 2024. A demographic and disease characteristics questionnaire, continuing care services basic modality questionnaire, continuing care services need questionnaire, the Social Support Rating Scale (SSRS), and the Readiness for Hospital Discharge Scale (RHDS) were used for this investigation. Univariate analysis and multiple linear regression analysis were used to analyze the associated factors. RESULTS: The mean total score for the need for continuing care services among patients with PTB discharged from the hospital was (121.61±22.98). The dimension with the highest score was health education guidance need. Compared to the the original hospital medical personnel, the primary source of care information after discharge was the local medical institutions was statistically significant and negatively correlated with continuing care service need (P=0.005). Social support was positively associated with need for continuing care services (P=0.042). CONCLUSION: Discharged PTB patients had a high degree of continuing care service need. Factors influencing the need for continuing care services are the primary source of care information after discharge was the local medical institutions, the social support. Medical staff need to provide targeted continuing care services based on relevant influencing factors to meet the discharge needs of patients.
关键词：
Fear of cancer recurrence;Meaning in life;Experiential avoidance;Death anxiety;Serial mediation model
摘要：
This study aims to investigate the association between fear of cancer recurrence (FCR) and death anxiety (DA) among Chinese cancer patients, while considering the mediating effects of experiential avoidance (EA) and meaning in life (MIL). From February to June 2023, convenience sampling was used to select newly diagnosed cancer patients in a tertiary Cancer Hospital in Chinese Hunan Province as the survey objects. A total of 436 cancer patients completed the Fear of Cancer Recurrence Inventory, the Meaning in Life Questionnaire, the Acceptance and Action Questionnaire-II, and the Templer’s death anxiety scale. Descriptive analysis and Pearson correlation analysis were conducted using SPSS 28.0 software. Serial mediation analysis was performed by Hayes’ PROCESS macro. Gender, age, educational level, marital status, residence, occupation, per capita monthly household income, tumor type, and cancer stage were controlled in the model. The results revealed that fear of cancer recurrence had a significant direct effect on death anxiety (Effect = 0.075, 95% CI: 0.064 to 0.087). Additionally, three indirect pathways were identified: (1) through experiential avoidance (Effect = 0.037, 95% CI: 0.026 to 0.049), (2) through meaning in life (Effect = 0.022, 95% CI: 0.014 to 0.031), and (3) through the serial mediators involving meaning in life and experiential avoidance (Effect = 0.016, 95% CI: 0.010 to 0.023). The total indirect effect of the three mediation paths was 63.56%. Fear of cancer recurrence is a significant psychological distress experienced by cancer patients, which not only directly contributes to death anxiety but also may triggers changes, such as experiential avoidance and meaning in life. Ultimately, this comprehensive psychological distress leads to death anxiety.
关键词：
Death anxiety;Meaning in life;Experiential avoidance;Cancer patients;Mediation effect
摘要：
Death anxiety is thought to cause a range of mental disorders among cancer patients, which may affect their mental health and even quality of life. This study sought to investigate experiential avoidance, meaning in life, and death anxiety among Chinese cancer patients and then explore the relationship between these 3 variables. A total of 300 cancer patients recruited from a tertiary cancer hospital participated in this study from October to December 2021. A cross-sectional survey was conducted using a demographic and clinical characteristics questionnaire, the Acceptance and Action Questionnaire II, the Meaning in Life Questionnaire, and Templer’s Death Anxiety Scale. Correlation analysis, hierarchical regression analysis, and mediating effect analysis were used to analyze the relationship among experiential avoidance, meaning in life (including 2 dimensions: presence of meaning and search for meaning), and death anxiety. A total of 315 questionnaires were distributed, and 300 valid questionnaires were returned, resulting in a valid response rate of 95.2%. Experiential avoidance (r = 0.552, p < 0.01) was moderately positively correlated with death anxiety. Presence of meaning (r = − 0.400, p < 0.01) was moderately negatively correlated with death anxiety, while search for meaning (r = − 0.151, p < 0.01) was weakly negatively correlated with death anxiety. Regression analysis showed that experiential avoidance (β = 0.464) and presence of meaning (β = −0.228) were predictors of death anxiety. Mediating effect analysis revealed that presence of meaning either completely or partially mediated the effect of experiential avoidance and death anxiety, and the indirect effect accounted for 14.52% of the total effect. Overall, experiential avoidance predicts death anxiety in cancer patients, and meaning in life can mediate this effect. The results of this study provide a new path for studying the mechanism of death anxiety and suggest a more positive and promising strategy for its management.
作者机构：
[Su, Yinhua; Li, Zhongyu; Liang, Yingni; Shen, Jiayu; Su, YH; Li, ZY; Yu, Huixi; Li, Hanbing; Shangguan, Fuliang] Univ South China, Sch Nursing, Hengyang, Hunan, Peoples R China.;[Dong, Weilei] Univ South China, Affiliated Hosp 1, Dept Obstet, Hengyang, Hunan, Peoples R China.
通讯机构：
[Su, YH; Li, ZY ] U;Univ South China, Sch Nursing, Hengyang, Hunan, Peoples R China.
关键词：
Diabetes in pregnancy;Fetal medicine;Meta-Analysis;Protocols & guidelines;Risk Factors
摘要：
INTRODUCTION: Women with gestational diabetes mellitus (GDM) are more likely to give birth to large for gestational age (LGA) infants, due to abnormalities in glucose metabolism during pregnancy. Although previous studies have explored the risk factors for LGA delivery in GDM women, the results are quite different and still lack of unified understanding. OBJECTIVE: To explore the elements linked to LGA delivery in GDM women, and thus provide a reference for medical staff to formulate relevant clinical interventions. METHODS AND ANALYSIS: Systematic search of seven electronic databases (PubMed, Scopus, Cochrane Library, Web of Science, EMBASE, OVID and CINAHL) will be undertaken between the inception of the database to 1 August 2024. Quantitative studies published in English and focused on the risk factors for LGA delivery in GDM women will be included. Two researchers will independently screen the literature and any disagreements will be resolved by a third-party researcher. Joanna Briggs's Institutional Critical Appraisal Tools will be used for the quality assessment of included studies. RevMan V.5.4 software will be used for data processing and summarising. To ensure the reliability and stability of the results, Q test and I(2) test will be used to identify the heterogeneity between studies, while subgroup analysis and sensitivity analysis will be performed based on study quality. ETHICS AND DISSEMINATION: This systematic review and meta-analysis will be based on published literature, and the findings will be published in a peer-reviewed journal and presented at major conferences focused on clinical nursing. PROSPERO REGISTRATION NUMBER: CRD42024559013.
作者机构：
[Guo, Sixuan; Liao, Li; Liu, Yaqing; Zhang, Longhan; Luo, An; Wang, Manyi; Liao, L; Liu, Xun] Univ South China, Sch Nursing, Hengyang, Hunan, Peoples R China.;[Li, Xiaoyun] Univ South China, Sch Comp, Hengyang, Hunan, Peoples R China.;[Wei, Xingyu] Guangzhou Univ Chinese Med, Clin Med Coll Acupuncture Moxibust & Rehabil, Guangzhou, Guangdong, Peoples R China.;[Sun, Yuanhong] Univ South China, Hengyang Med Sch, Hengyang, Hunan, Peoples R China.
通讯机构：
[Liao, L ] U;Univ South China, Sch Nursing, Hengyang, Hunan, Peoples R China.
摘要：
OBJECTIVE: This systematic review and meta-analysis aimed to evaluate the prevalence of frailty and pre-frailty in older adults with diabetes; and to identify the risk factors associated with frailty in this population. DESIGN: Systematic review and meta-analysis. PARTICIPANTS: 24,332 people aged 60 years and older with diabetes. METHODS: Six databases were searched (PubMed, Embase, the Cochrane Library, Web of Science, China Knowledge Resource Integrated Database, and Chinese Biomedical Database) up to 15 January 2024. Random effects models were used in instances of significant heterogeneity. Subgroup analysis and meta-regression were conducted to identify the potential source of heterogeneity. The Agency for Healthcare Research and Quality (AHRQ) and the Newcastle-Ottawa Scale (NOS) were applied to assess the quality of included studies. RESULTS: 3,195 abstracts were screened, and 39 full-text studies were included. In 39 studies with 24,332 older people with diabetes, the pooled prevalence of frailty among older adults with diabetes was 30.0% (95% CI: 23.6%-36.7%). Among the twenty-one studies involving 7,922 older people with diabetes, the pooled prevalence of pre-frailty was 45.1% (95% CI: 38.5%-51.8%). The following risk factors were associated with frailty among older adults with diabetes: older age (OR = 1.08, 95% CI: 1.04-1.13, p<0.05), high HbA1c (OR = 2.14, 95% CI: 1.30-3.50, p<0.001), and less exercise (OR = 3.11, 95% CI: 1.36-7.12, p<0.001). CONCLUSIONS: This suggests that clinical care providers should be vigilant in identifying frailty and risk factors of frailty while screening for and intervening in older adults with diabetes. However, there are not enough studies to identify comprehensive risk factors of frailty in older adults with diabetes. TRIAL REGISTRATION: PROSPERO registration number: CRD42023470933.
