Objective:To explore risk factors of skin pruritus in peritoneal dialysis patients and the effect of individualized care intervention, to provide guidance for clinical practice.Methods:The total of 87 patients with peritoneal dialysis who were followed-up with pruritus in the Beijing Anzhen Hospital from January 2017 to June 2020 were selected. The Visual Analogue Scale (VAS) was used to evaluate the degree of pruritus, and the patients were divided into two groups: mild-to-moderate skin pruritus group (VAS≤6 points) and severe skin pruritus group (VAS>6 points). The risk factors of severe skin pruritus were analyzed by single factor and multivariate Logistic regression. The improvement of skin pruritus after 3 months of individualized nursing intervention was observed.Results:Among the 87 patients, the mild-to-moderate skin pruritus group and the severe skin pruritus group accounted for 64.4%(56/87) and 35.6%(31/87), respectively. Single factor analysis showed that the age, prevalence of diabetes, serum albumin, serum phosphorus, intact parathyroid hormone and C-reactive protein levels were (61.8 ± 11.5) years old, 33.3%(19/56), (36.3 ± 5.3) g/L, (1.6 ± 0.5) mmol/L, 328.4(144.9, 494.5) ng/L, 2.8(0.6, 8.3) ng/L in the mild-to-moderate skin pruritus group, and (67.0 ± 9.2) years old, 61.1%(19/31), (33.9 ± 4.8) g/L, (1.9 ± 0.3) mmol/L, 397.0(300.0,758.6) ng/L, 7.2(2.6, 17.2) mg/L in the severe skin pruritus group, the differences were significant between the two groups ( t values were -2.17, 2.14, -2.32, Z values were -2.28, -2.90, χ 2 value was 6.07, P<0.05). Logistic multivariate regression analysis showed that low albumin, high blood phosphorus and high C-reactive protein were independent risk factors for severe skin pruritus in peritoneal dialysis patients ( P<0.05). After 3 months of individualized care,18.4% (16/87) patients had complete remission,19.5% (17/87) patients significantly relieved, 55.2% (48/87) relieved, 6.9% (6/87) were ineffective, and the total response rate was 93.1%(81/87). Conclusions:More than one-third of peritoneal dialysis patients with pruritus are severe. Lower serum albumin, higher serum phosphorus and higher C-reactive protein are independent risk factors for severe pruritus in peritoneal dialysis patients. Individualized care can effectively improve pruritus in peritoneal dialysis patients.

Objective:To evaluate the reliability of several formulae for estimating the quantity of glucose absorption of peritoneal dialysate (GA).Methods:Forty-four patients receiving continuous ambulatory peritoneal dialysis (CAPD) were enrolled in this study. The quantities of GA obtained from actual measurement and estimation were compared to judge whether there was statistical difference between them.Results:The GA quantities estimated by Grodstein formula, Bodnar formula, K/DOQI formula, empirical method A (based on 60% absorption rate) and empirical method B (based on 50% absorption rate in daytime and 80% absorption rate in night) were as follows: 81.3 (64.2, 118.0) g, (97.8±19.7) g, (94.1±25.8) g, 87.1 (76.2, 109.0) g and (89.5±16.0) g, respectively; the actually measured GA quantity was [94.2 (77.5, 111.6)] g. Wilcoxon signed rank test of paired samples showed that only the results of Bodnar formula and K/DOQI formula did not present statistical differences from actually measured result.Conclusion:It can be considered to use Bodnar formula and K/DOQI formula to roughly estimate the GA quantity of CAPD patients, but to accurately understand the individual GA value, actual measurement is still required.

Objective:To systematically review the medical decision-making for children with autism spectrum disorder (ASD) from the perspective of caregivers.Methods:It was a systematic review. Using search terms as “Autism”“loneliness disorder”“autism spectrum disorder”“parents”“caregiver”“medical decision making”, etc., qualitative studies on medical decision-making of ASD caregivers in the databases of PubMed, Web of Science, Cochrane Library, Embase, Scopus, CNKI.com, Wanfang Database, VIP database, and Chinese Biomedical Literature database were searched. The search was conducted from the inception of the databases to July 31, 2022, and the data was organized from August 1 to September 1, 2022. The literature quality was evaluated by two researchers according to the quality evaluation criteria for qualitative research at the Centre for Evidence-based Health Care, Joanna Briggs Institute, Australia. Pooled integration method was used to integrate the study results and evaluate the medical decision-making of children with ASD from the perspective of caregivers.Results:Seventeen studies were included, with two studies rated as quality grade A and fifteen studies rated as quality grade B. A total of 36 research findings were extracted. These findings were grouped into ten new categories based on similarities, which were further synthesized into three overarching results: the symptom-driven medical decision-making process, delays in medical decision-making due to individual, family, and societal factors, and the influence of personal experiences and multiple external pressures on medical decision-making.Conclusion:The factors that lead to the delay or promotion of medical decision of caregivers of children with ASD are complicated, and comprehensive intervention measures should be taken at individual, family and social levels to promote early medical diagnosis and intervention of the children with ASD.