OBJECTIVES: End stage renal disease (ESRD) is a major disease that seriously threatens the health of young people, and kidney transplantation is an effective treatment method to improve its prognosis.Young ESRD patients at a critical stage of life development often face significant physical and psychological challenges while waiting for kidney transplantation. Their psychological state directly affects treatment compliance and transplantation outcomes.This study aims to explore the psychological experiences of young patients with end stage renal disease during the waiting period for kidney transplantation, and provide a reference for formulating relevant psychological intervention measures. METHODS: A descriptive qualitative research design was adopted. Using purposive sampling, 20 young ESRD patients awaiting for kidney transplantation at the Transplantation Center of Xiangya Third Hospital, Central South University, from June to August 2024, were recruited. Based on the socio-ecological systems theory, a semi-structured interview outline was developed, and directed content analysis was applied to analyze the interview data. RESULTS: According to the results of qualitative interviews, 3 themes and 9 sub-themes were summarized as follows: Microsystem (disease pain experience, anxiety during transplantation waiting period, cognitive differentiation and coping differences), mesosystem (imbalance of family roles and dependent guilt, physician-patient trust dynamics, ambivalence toward peer support), and macrosystem (decision-making powerlessness caused by information asymmetry, sociocultural stigma and public bias, institutional dependence and passive behavior). CONCLUSIONS Young ESRD patients experience complex psychological experiences during the waiting period for kidney transplantation. Healthcare providers should explore corresponding intervention measures based on patients' psychological status to improve their waiting period experience and promote both physical and mental health.
Humans ; Kidney Transplantation/psychology* ; Kidney Failure, Chronic/surgery* ; Qualitative Research ; Female ; Male ; Adult ; Adaptation, Psychological ; Waiting Lists ; Young Adult ; Adolescent ; Anxiety/psychology*

Objective To investigate the effect of dietary intake on the childbirth outcomes of primipara women with full-term labor analgesia. Methods A total of 400 primipara women with full-term labor analgesia were randomly divided into observation group and control group. The observation group received intake management and individualized dietary guidance, while the control group ate and drank according to their own wishes. The childbirth quality, the incidence of vomiting, the use of oxytocin due to uterine atony, the rate of intrapartum fever, the rate of perineal incision, the rate of cesarean section, the rate of vaginal assisted delivery, and the rate of postpartum hemorrhage were compared between the two groups. The duration of the first stage of labor, the duration of the second stage of labor, the duration of labor analgesia, and the amount of postpartum hemorrhage within 2 hours were also compared. Neonatal Apgar score, random blood glucose, umbilical artery blood pH value, umbilical artery blood lactic acid (Lac) value, the incidence of neonatal asphyxia, the incidence of neonatal fever, and the incidence of neonatal hypoglycemia were compared between the two groups. Results The observation group had lower incidences of vomiting, oxytocin use rate due to uterine atony, intrapartum fever rate, perineal incision rate, transferring cesarean section rate, and vaginal assisted delivery compared to the control group(P < 0.05). The observation group had lower rates of postpartum hemorrhage, shorter duration of the first and second stages of labor, shorter duration of labor analgesia, and less postpartum hemorrhage within 2 hours compared to the control group, and the incidences of neonatal hyperglycemia and hypoglycemia in the observation group were lower than those in the control group (P < 0.05). There were no statistically significant differences in umbilical artery blood pH value, Lac value, neonatal Apgar score, random blood glucose, neonatal asphyxia rate, and neonatal fever rate between the two groups (P>0.05). Conclusion Intake management and individualized dietary guidance during labor can reduce the incidence of uterine atony, shorten the duration of labor, decrease the incidence of dystocia, reduce postpartum hemorrhage within 2 hours and decrease the incidence of neonatal glucose abnormality.

Objective:To identify the risk factors for intrapartum fever during labor analgesia and establish the prediction model.Methods:The medical records from pregnant women with intrapartum fever during labor analgesia were retrospectively analyzed. According to whether the highest body temperature ≥38 ℃, the parturients were divided into intrapartum fever group and non-fever group. The general data from patients, duration of hospital stay before labor, induced labor, prenatal hemoglobin concentration, body msaa index (BMI) during pregnancy, artificial rupture of membranes in the incubation period, frequency of vaginal examination and etc. were collected. The risk factors of which P values were less than 0.05 would enter the logistic regression analysis to stratify intrapartum fever-related risk factors, and the weighted score regression prediction model was established. Hosmer-Lemshow Test was used to assess the fit of the model, and the receiver operating characteristic curve was drawn to evaluate the model. The nomogram was drawn for visually presenting the regression model. The clinical calibration curve, decision curve analysis and clinical impact curve were drawn to assess the created prediction model. Results:There were 99 parturients developed fever during labor analgesia, with an incidence of 34.7%. The results of logistic regression analysis showed that duration of hospital stay before labor, prenatal hemoglobin concentrations, BMI during pregnancy, induced labor, artificial rupture of membranes in the incubation period and frequency of vaginal examination were the independent risk factors for intrapartum fever during labor analgesia. The area under the receiver operating characteristic curve was 0.943, 95% confidence interval was 0.916-0.969, the sensitivity was 86.9%, the specificity was 88.6%, and the Youden index was 0.755. The prediction model of the line chart was assessed by Hosmer-Lemshow, P=0.898. Conclusions:Duration of hospital stay before labor, hemoglobin concentrations, BMI during pregnancy, induced labor, artificial rupture of membranes in the incubation period and frequency of vaginal examination are independent risk factors for intrapartum fever during labor analgesia in parturients, and the risk prediction model developed can effectively predict the occurrence of intrapartum fever during labor analgesia.

OBJECTIVES: Patients from different social environments and cultural backgrounds have different nursing needs. If nurses ignore the cultural differences of patients, it is easy to lead to the strained nurse-patient relationship, affect the nursing effect and cause harm to patients. Critical cultural competence (CCC) can help nurses to meet the nursing needs of patients from different cultural backgrounds, which is beneficial to building a harmonious nurse-patient relationship and improving the quality of nursing. Almutairi, et al designed the Critical Cultural Competence Scale (CCCS) which can be used to evaluate accurately nurses' CCC. No studies have reported the development of a critical cultural competence measurement tool for nurses or the introduction of foreign scales in China. This study aims to conduct Chinese and cross-cultural debugging and test the reliability of the English version of the CCCS in order to form CCCS suitable for Chinese cultural background and provide an effective evaluation tool for investigating the current situation of clinical nurses' CCC. METHODS: This study used Brislin's back-translation model to translate and back-translation the English version of CCCS. The Chinese version of CCCS was then created through cross-cultural debugging by expert consultation and a pre-survey with a sample size of 30 clinical nurses. From August to October 2019, 580 clinical nurses were surveyed using a whole group sampling method. The participants were randomly divided into 2 groups with a 7꞉3 ratio. One group (n=406) was used for exploratory factor analysis and reliability analysis, while the other group (n=174) was used for confirmatory factor analysis. Six experts used the scale-level content validity index (S-CVI) and the item-level content validity index (I-CVI) to assess content validity. In the exploratory factor analysis, items were screened using the critical ratio method, and were tested using the KMO (Kalser-Meyer-Olkin) index, Bartlett's sphericity test, and principal component analysis. In the confirmatory factor analysis, average variance extracted (AVE), goodness of fit index (GFI), adjusted goodness of fit index (AGFI), and root mean square error of approximation (RMSEA) were used to assess the degree of fit of the constructed model. For the total scale and the 4 subscales, the Cronbach's α coefficient, split-half reliability, and retest reliability were used to assess the scale's reliability. RESULTS: The S-CVI was 0.930, while the I-CVI ranged from 0.833 to 0.944. For all items, the critical ratio exceeded 3, and the difference between the high and low subgroups was statistically significant (P<0.05). Exploratory factor analysis revealed critical knowledge subscale had a KMO value of 0.676, with the total scale and other 3 subscales all having a KMO value >0.8 and a chi-square value of 814.32 to 12 442.45 for the Bartlett's spherical test, with degree of freedom ranging from 21 to 136 (P<0.001), indicating that all items were suitable for factor analysis. The principal component analysis showed that 17, 12, 7, and 7 items were extracted from the 4 subscales, with 4, 3, 2, and 2 components whose eigenvalues were more than 1, and the cumulative variance contribution was 66.0%, 54.3%, 56.6%, and 70.2%, respectively. The confirmatory factor analysis showed that the AVE of the 4 subscales were 0.637, 0.499, 0.560, and 0.565, GFI was 0.904, AGFI was 0.863, and RMSEA was 0.076. The Cronbach's α coefficient for the total scale and subscales ranged from 0.811 to 0.878, the split-half reliability ranged from 0.707 to 0.842, and the retest reliability was 0.827. CONCLUSIONS The Chinese version of the CCCS has good reliability and validity, and it can be used as a valid assessment tool for clinical nurses' critical cultural competence in China.
Humans ; Cultural Competency ; Reproducibility of Results ; Psychometrics/methods* ; Factor Analysis, Statistical ; China

Objective To investigate the cytogenetic and clinical features of acute myeloid leukemia (AML) with CD7 positive. Methods Among 788 AML patients in the First Affiliated Hospital of USTC from January 2008 to December 2012, a total of 140 AML patients with CD7 positive were enrolled, and their clinical and cytogenetic characteristics were analyzed respectively. Results According to French-American-British (FAB) classification systems, M5[47.1 % (66/140)] and M2[27.1 % (38/140)] were often detected in 140 AML patients with CD7 positive. The positive rate of CD7 in M0patients [(60.9±13.2) %] was the highest, followed by (53.1±29.5) % in M1patient. Karyotype analysis showed that 72 (51.4 %) AML patients with CD7 positive had unfavorable karyotypes. Thirty-one (22.1 %) AML patients with CD7 positive simultaneously showed the expressions of lymphoid antigens. Clinically, some AML patients with CD7 positive was accompanied by hyperleukocytosis [75.0 % (105/140)] (white blood count ≥20×109/L) and hepatosplenomegaly [82.1 % (115/140)]. The proportion of elder patients (above 65 years old) and complete remission rate of AML with CD7 positive were lower than those of AML with CD7 negative [25.7 % (36/140) vs. 39.4 % (255/648);12.1 % (17/140) vs. 24.7 % (160/648), respectively], and there were statistical differences (χ 2＝ 8.62, P＝0.03; χ 2＝ 9.70, P＝ 0.01, respectively). Conclusion AML patients with CD7 positive have specific cytogenetic and clinical characteristics, and poor prognosis.

Objective To explore the methods for quality management and continuous improvement of nursing care quality in the orthopedic demonstration ward by taking the hospital accreditation as an opportunity. Methods From July 2012 to June 2013, the continuous care quality improvement in the ward was carried out to find out the problems with PDCA (plan, do, check, action) cycle method, including enhancing the function of orthopedic nursing quality management groups, conducting all-staff training and improving the knowing rate by referring to the standards of hospital assessment standards. Results After the performance of whole-process quality management, the percentage of indexes assessed at level A, B and C was increased from 42.2%to 50.0%, 17.2%to 14.7%and 40.2%to 35.3%, respectively. The score of nurses' responsibility accreditation was increased from 92 to 95. The rates of patient and nursing staff satisfaction were increased from 91.8%to 98.9%and 92.57%to 97.7%, respectively. Conclusion In accordance with the standards for hospital accreditation, the continuous improvement of nursing quality in the orthopedic demonstration wards can improve the specialist care of orthopedic care, improve patients' and nurses' satisfaction, thus making the daily work more scientific and standardized.

Objective To determine the coagulation status as well as circulating levels of complement and inflammation markers in patients with chronic urticaria (CU) during acute attack and in remission,and to estimate the relationship of coagulant and anticoagulant factors as well as fibrinolytic markers with the development of chronic urticaira.Methods This study included 40 patients with CU (22 during acute attack and 18 in remission) and 40 healthy blood donors from the Guangzhou Blood Center.Venous blood samples were obtained from these subjects,and enzyme-linked immunosorbent assay (ELISA) was performed to measure the plasma levels of prothrombin fragrnent 1 +2 (F1 +2),tissue factor (TF),thrombomodulin (TM),high molecular weight kininogen (HMWK),tissue-type plasminogen activator (t-PA),C5a and serum levels of C3,C4,antistreptolysin O antibodies (ASO),rheumatoid factor (RF) and C-reactive protein (CRP).Erythrocyte sedimentation rate (ESR) was also determined in these patients.Comparisons of these parameters were carried out by using t test,and the correlation of these factors with CU was evaluated by using Spearman correlation coefficient.Results Compared with the healthy controls,the patients with CU showed significantly higher plasma levels of F1+2 and HMWK (both P ＜ 0.01),but lower levels of TF,TM and t-PA (all P ＜ 0.01).The plasma levels of F1 +2,HMWK,t-PA were significantly correlated with the symptom scores in patients with CU (r =0.81,P ＜ 0.01; r =-0.39,P ＜ 0.05; r =0.35,P ＜ 0.05).A significant increase was observed in the plasma concentration of F1 +2 in patients during acute attack compared with those in remission (P ＜ 0.01),whereas no significant differences were noted in the plasma levels of TF,TM,HMWK,t-PA,C5a,serum levels of C3,C4,ASO,RF and CRP or ESR between the two groups of patients (all P ＞ 0.05).Conclusions It seems that coagulation,anti-coagulation and fibrinolysis are all involved in the development of urticaria.There is an obvious difference in the plasma level of prothrombin F1 +2 between patients with CU during acute attack and in remission,suggesting that coagulation factors play a certain role in the initiation and progression of CU.

Objective To explore the application effect of “high quality nursing service demonstration project” in nursing management .Methods This study was a non-experimental design using data analysis method.The total of 262 clinical nurses and 10 000 patients with their permission were included in this research.The Nurses Job Satisfaction Scale (NJSS), Chinese Nurse Job Stressors Questionnaire (CNJSQ), and Self-Rating Anxiety Scale ( SAS ) were collected from the nurses whereas Patient Satisfaction Questionnaire ( PSQ) was collected from the patients at pre and post of the administration of the “high quality nursing service demonstration project”.Results After carried out the “Quality care demonstration project”, the patient satisfaction increased from 84.2%to 95.6%.There was significant difference (χ2 =2.14,P<0.05).Positive evaluation was above 90%.Nurse job satisfaction scores, wages, benefits, rewards approach, the relationship between colleagues, work nature, desire to communicate were significantly improved (t =2.99,2.18,3.24, 2.44,2.41,2.25, respectively;P<0.05).Nurse job stress scores, nursing profession and work issues, time allocation and workload issues , working conditions and equipment problems , patient care problems caused by stress were significantly reduced (t=2.65,3.17,1.75,3.36, respectively;P<0.05).After the intervention, the mean score of positive assessment of SAS , negative assessment of SAS and the total score were significantly decreased (t=1.15,1.73,1.24, respectively;P<0.05).Conclusions Evidence from the study suggests the meaningful effectiveness of the “Quality care demonstration project” and there is a strong need of continuous promotion based on the research outcomes .

OBJECTIVE: To evaluate 3 published questionnaires for screening diabetes for rural samples in China. METHODS: Three screening questionnaires (Finnish Diabetes Risk Score, Danish Diabetes Risk Score, and Chinese Diabetes Risk Score) were selected through literature review, and were employed in a rural community sample in Wangcheng, Changsha. RESULTS: Sensitivity of these risk scores was 63.72%, 56.64% and 82.30%; the specificity was 79.75%, 62.64% and 46.90%. The area under the receiver operating characteristic curve (AUC) was 0.78 (95% CI: 0.73-0.83), 0.65 (95% CI: 0.60-0.70) and 0.68 (95% CI: 0.63-0.73). CONCLUSION The 3 screening questionnaires show a lower validity than originally described when applied to rural samples in the study. Difference in population characteristics is a possible reason. F-DRS is better than the other two, suggesting that F-DRS is more suitable for diabetes screening in China rural areas.
Aged ; China ; Diabetes Mellitus, Type 2 ; prevention & control ; Female ; Humans ; Male ; Mass Screening ; methods ; Middle Aged ; Reproducibility of Results ; Rural Population ; Sampling Studies ; Sensitivity and Specificity ; Surveys and Questionnaires

OBJECTIVE To give an overview of our hospital′s actual infection situation and provide scientific data for nosocomial infection management.METHODS With a cross-sectional study,the infection rate was investigated.RESULTS The infection rate was 2.39%,and the most common infection site was lower respiratory tract(50.00%);the department of neurosurgory was with the highest infection rate;the risk factors for NI included: respiratory ventilator,tracheotomy,blood vessel catheter and indwelling catheter.CONCLUSIONS The departments with the higher infection rate should be given enhancing surveillance.Cleaning and antisepsis of environment,procedures of aseptico skills,compliance of washing hands and antibiotics management should be strengthened.