1.Visual analysis of status quo of hemodialysis care research at home and abroad over past 10 years
Chinese Journal of Modern Nursing 2018;24(36):4366-4371
Objective To understand and explore the status quo, hotspots and trends of hemodialysis care research at home and abroad over the past 10 years and to provide a theoretical basis for China's hemodialysis care research.Methods The literatures on hemodialysis care published at home and abroad from 2008 to 2017 were selected from Web of Science, CNKI and Wanfang databases. The number, regional distribution, status quo and hotspots of the publications over the past 10 years were analyzed with CiteSpaceV. Results The number of publications on hemodialysis care abroad from 2008 and 2017 grew sustainably, while there were less papers on core journals at home and no significant changes were found in the number. The US took the leading role in hemodialysis care globally, with the most articles. Most of the papers published at home were attributed to nursing schools, and Guangdong Province preponderated significantly in the number. Hot topics abroad included outcome, vascular access, complication and humanistic psychology. Hot topics at home were similar to the ones abroad and mainly included quality care and training. Both researchers at home and abroad paid attention to evidence-based nursing. The research fronts abroad were psychological experience and formulation of standards, while the researchers at home focus on self-efficacy.Conclusions Compared with the research abroad, there is still room for the development of hemodialysis care research in China. We deepen our research by referring to hot topics and research fronts abroad as well as China's local situations and find that the major directions for China's hemodialysis care research is outcome, children, humanity, self-efficacy and training.
2.A study of influencing factors about fertility motivation in female patients with chronic kidney disease based on grounded theory
Pei DUAN ; Guilan LYU ; Fang LIU
Chinese Journal of Practical Nursing 2022;38(18):1395-1399
Objective:To investigate the infuencing factors of fertility motivation in patients with chronic kidney disease (CKD).Methods:The 21 female patients with CKD in the Eastern Theater General Hospital from November 2019 to November 2020 were selected by objective sampling method. The data were collected by semi-structured interview, recording and writing on-site notes, and the subjects were extracted by Strass and Corbin′s grounded theory data analysis method.Results:The core category is "the formation of patients′ reproductive motivation". A theoretical model including four main categories of patient characteristics, disease coping style, subjective norms and perceived behavioral control was constructed. Patients′ characteristics are dynamic factors, subjective norms are situational factors, perceptual behavior control is protective factors, and patients′ disease coping style is regulatory factors.Conclusion:This study explored the influencing factors of fertility motivation in CKD patients from the perspective of patients, aiming to provide theoretical basis for the formulation and implementation of intervention measures.
3.Analysis of risk factors for intradialytic hypotension in elderly maintenance hemodialysis patients
Hunan CAO ; Yuxiu LIU ; Rui FAN ; Ling KONG ; Fang WANG ; Guilan LYU
Chinese Journal of Nephrology 2023;39(2):101-111
Objective:To analyze the risk factors for the occurrence of intradialytic hypotension (IDH) in elderly maintenance hemodialysis (MHD) patients based on longitudinal multidimensional data.Methods:This was a single-center, retrospective observational study. Data of MHD patients were retrospectively analyzed from April 3, 2017 to December 31, 2021 in the blood purification center of National Clinical Research Center for Kidney Diseases, General Hospital of Eastern Theater Command. IDH defined by the Kidney Disease Outcomes Quality Initiative was used as outcome indicator. Generalized estimating equations were used for univariate and multivariate regression analysis. The importance of each factor on the occurrence of IDH was evaluated by chi-square statistic minus degrees of freedom, and sensitivity analysis was performed by 5-fold interpolation of missing data.Results:A total of 156 elderly patients were enrolled, 91(58.3%) of whom were male, and 2 681 dialysis data recordings were included. The incidence of IDH from 2017 to 2021 fluctuated from 8.3% to 13.2%, with an average incidence of 11.0% by 2021. The results of multivariate regression showed pre-dialysis systolic pressure of 140-159 mmHg (1 mmHg=0.133 kPa, 90-139 mmHg as reference: OR=0.482, 95% CI 0.273-0.851, P=0.012), pre-dialysis diastolic pressure ≥ 90 mmHg (60-89 mmHg as reference, 90-99 mmHg: OR=4.081, 95% CI 2.132-7.809, P < 0.001; ≥ 100 mmHg: OR=8.547, 95% CI 3.233-22.597, P < 0.001), albumin (34-48 as reference, < 34 g/L: OR=2.677, 95% CI 1.592-4.502, P < 0.001; > 48 g/L: OR=2.692, 95% CI 1.102-6.577, P=0.030), C-reactive protein ≥ 8 mg/L (< 8 mg/L as reference: OR=1.787, 95% CI 1.216-2.628, P=0.003), hemodiafiltration as the dialysis mode (hemodialysis as the reference: OR=2.256, 95% CI 1.395-3.648, P=0.001), actual ultrafiltration volume/dry body mass (per 1% increase, OR=1.539, 95% CI 1.139-2.080, P=0.005), and ultrafiltration rate (per 100 ml/h increase, OR=1.641, 95% CI 1.389-1.939, P < 0.001) were independently associated with the occurrence of IDH. Contribution analysis showed that the top three factors related to IDH were ultrafiltration rate ( χ 2- df=32.798), pre-dialysis diastolic pressure ( χ 2- df=20.757) and albumin ( χ 2- df=19.971). The sensitivity analysis showed that the regression results were robust. Conclusions:The risk factors of IDH in elderly MHD patients are increasing ultrafiltration rate, higher pre-dialysis diastolic pressure(≥ 90 mmHg), lower albumin (< 34 g/L), HDF, higher c-reactive protein(≥ 8 mg/L) and increasing actual ultrafiltration volume/dry body mass. Higher pre-dialysis systolic pressure (140-159 mmHg) is a protective factor.
4.Summary of the best evidence for neuropathic pain nursing intervention in patients with spinal cord injury
Yanhui WAN ; Guilan LYU ; Ke WANG ; Wenjuan DU ; Fang LIU ; Aiqin ZHANG
Chinese Journal of Practical Nursing 2021;37(32):2511-2515
Objective:To summarize and evaluate the domestic and foreign evidence on the intervention and management of neuropathic pain in patients with spinal cord injury, so as to provide evidence-based basis for clinical nursing staff.Methods:According to "6S" evidence model of evidence pyramid, computer evidence retrieval was carried out. Expert consensus and evidence summary quality assessment used the corresponding evaluation criteria of JBI evidence-based Health Care Centers (2016), while evidence-based guidelines quality used AGREE Ⅱinstrument, and high quality evidence was extracted.Results:A total of 6 articles, including 5 guidelines and 1 expert consensus, were included in this study. A total of 22 pieces of evidence were extracted, including the assessment, intervention measures, feedback, education and nursing model of neuropathic pain in patients with spinal cord injury.Conclusion:This study summarizes the evidence for the intervention and management of pathologic pain in spinal cord injury, which can provide scientific basis for clinical nursing staff. As the evidence summarized in this study comes from many countries, sufficient evaluation of clinical environment and other related factors should be conducted before application to promote the quality of nursing.
5. Research progress of pregnancy management in patients with lupus nephritis
Pei DUAN ; Xia SONG ; Guilan LYU
Chinese Journal of Practical Nursing 2019;35(15):1192-1196
Based on the latest research results at home and abroad, this paper firstly elaborated the interaction mechanism between pregnancy and lupus nephritis, then pointed out the importance and research progress of pregnancy management, next introduced the content and deficiency of the management in patient with lupus nephritis.And on this basis, it gives some advices on the development and research of pregnancy management in patients with lupus nephritis in order to provide a reference for effective improvement of adverse pregnancy outcomes and the realization the pregnancy safety in patients with lupus nephritis.