Objective To analyze risk factors for sleep disorders in patients with chronic heart failure(CHF)and construct a nomogram prediction model.Methods Using simple random sampling,306 hospital-ized CHF patients meeting inclusion criteria were enrolled from four Grade A tertiary hospitals in Guangxi Zhuang Autonomous Region(two in Nanning,one each in Yulin and Guilin)between March 2023 and March 2024.LASSO regression analysis was initially employed for variable screening,followed by logistic regression to identify predictive variables for constructing the nomogram model.Model validation and performance evalua-tion were conducted using receiver operating characteristic(ROC)curves,calibration curves,and clinical decision curves,with internal validation performed through Bootstrap resampling(1 000 iterations).Results The incidence of sleep disorders among the 306 patients was 57.5%(176/306).Logistic regression analysis identified eight independent risk factors for sleep disorders in CHF patients(P＜0.05):age,education level,monthly house-hold income per capita,NYHA cardiac function classification,number of comorbidities,triglyceride levels,ano-rexia,and anxiety.The model demonstrated good discrimination for the AUC of 0.91(95%CI:0.77-0.88)and calibration consistency.Conclusion The prediction model established in this study shows good predictive performance,serving as a valuable reference for healthcare providers to early identify sleep disorders and im-plement preventive care strategies in patients with CHF.

Objective:To investigate the current situation of kinesiophobia in patients after heart valve replacement surgery and to analyze its influencing factors, and to provide reference for the intervention research of patients with cardiophobia after cardiac valve replacement.Methods:Using cross-sectional survey method and convenient sampling method, 109 patients who underwent cardiac valve replacement surgery in department of cardiothoracic and vascular surgery of Guangxi Zhuang Autonomous Region People′s Hospital from March 2021 to January 2022 were selected as the study subjects. The patients were surveyed with the general questionnaire, Tampa Scale of Kinesiophobia and Visual Analogue Scale.Results:After heart valve replacement, the score of Tampa Scale of Kinesiophobia was (46.90 ± 9.30) points. The score of Visual Analogue Scale was (5.83 ± 1.01) points. The score of Tampa Scale of Kinesiophobia was positively correlated with the score of Visual Analogue Scale ( r=0.46, P<0.01). Multiple linear regression analysis showed that patient′s age, cardiac function level, left ventricular ejection fraction, pain were the main influencing factors of Kinesiophobia ( t values were -2.37-4.34, all P<0.05). Conclusions:Medical staff should understand and accurately assess the status of patient′s kinesiophobia after heart valve replacement surgery, identify high-risk groups of kinesiophobia, and take targeted nursing measures to effectively alleviate postoperative pain, thereby reducing the incidence of kinesiophobia in patients, helping patients to carry out early functional exercise, and prorroting physical recovery.

Objective To measure the prevalence and analyzed associated factors of medical adhesive-related skin injuries (MARSI) at PICC insertion site in patients with hematologic malignancies. Methods A cross- sectional observational study lasting two weeks was carried out in Department of Hematology. Skin assessment data and photographs of skin were collected during PICC maintenances by the same investigator. The related information was got out from the medical record. The observed skin injuries were classified by the dermatologist and PICC specialized nurse together. MARSI prevalence was calculated. The associated factors were analyzed statistically. Results All of the 153 patients with hematologic malignancies were included. The prevalence of total MARSI at PICC insertion site was 33.99%(52/153), including mechanical skin injury (22.87%,35/153), contact dermatitis (CD) ( 9.80%,15/153), moisture-associated skin damage (0.65%,1/153), folliculitis(0.65%,1/153), respectively. Multivariate analysis identified two independent risk factors for mechanical skin injury including age≥50 years old, P=0.016, odds ratio (OR)=5.919, 95%CI 1.389-25.220 and non-specialist nurses in PICC maintenance, P=0.013, OR=8.333,95%CI 1.566-44.360. History of skin allergies (P=0.000,OR=12.333,95%CI 3.669-41.454) and arsenic trioxide infusion through PICC(P=0.003,OR=4.565,95%CI 1.661-12.547) were associated with CD. Conclusions MARSI at PICC insertion site is a prevalent event in the patients with hematologic malignancies. Epidemiological data and independent risk factors are presented in our study, which provide a basis for future study in this area.