Objective:To construct and validate a depression risk prediction model for middle-aged and elderly patients with diabetes.Methods:Data were extracted from the fifth wave (2020) of the China Health and Retirement Longitudinal Study (CHARLS). A total of 900 diabetic patients were identified, and after excluding those with missing data or invalid questionnaires, 769 patients were included in the analysis. Patients were randomly divided into a training set and a validation set in a 7∶3 ratio. Univariate analysis and logistic regression analysis were performed to screen the optimal predictors of depression in diabetic patients, and a nomogram model was developed. The predictive performance of the model was assessed by the area under the receiver operating characteristic curve ( AUC). Model calibration and accuracy were evaluated using bootstrap resampling, calibration plots, and the Hosmer-Lemeshow test. The clinical utility was further assessed by decision curve analysis (DCA) and clinical impact curves (CIC) . Results:Among the 769 patients, 366 (47.59%) had depression. Logistic regression analysis showed that place of residence, pain, difficulty in toileting, difficulty in bathing, sleep duration, physical exercise, life satisfaction, and children's satisfaction were independent predictors of depression in diabetic patients. A nomogram was constructed based on these variables, yielding an AUC of 0.775. At the optimal cutoff value of 0.557, the model demonstrated a sensitivity of 59.1% and a specificity of 84.8%, indicating good discriminative ability. The Hosmer-Lemeshow test showed (χ 2=15.821, P=0.105), suggesting good agreement between predicted and observed outcomes. In the validation set, the AUC was 0.778, with Hosmer-Lemeshow (χ 2=8.557, P=0.575). DCA and CIC indicated favorable clinical applicability of the model. Conclusions:The depression risk prediction model constructed in this study demonstrated good predictive performance. It can assist clinicians in early identification of high-risk individuals with diabetes and provide a theoretical basis for targeted interventions.

Objective:To construct and validate a depression risk prediction model for middle-aged and elderly patients with diabetes.Methods:Data were extracted from the fifth wave (2020) of the China Health and Retirement Longitudinal Study (CHARLS). A total of 900 diabetic patients were identified, and after excluding those with missing data or invalid questionnaires, 769 patients were included in the analysis. Patients were randomly divided into a training set and a validation set in a 7∶3 ratio. Univariate analysis and logistic regression analysis were performed to screen the optimal predictors of depression in diabetic patients, and a nomogram model was developed. The predictive performance of the model was assessed by the area under the receiver operating characteristic curve ( AUC). Model calibration and accuracy were evaluated using bootstrap resampling, calibration plots, and the Hosmer-Lemeshow test. The clinical utility was further assessed by decision curve analysis (DCA) and clinical impact curves (CIC) . Results:Among the 769 patients, 366 (47.59%) had depression. Logistic regression analysis showed that place of residence, pain, difficulty in toileting, difficulty in bathing, sleep duration, physical exercise, life satisfaction, and children's satisfaction were independent predictors of depression in diabetic patients. A nomogram was constructed based on these variables, yielding an AUC of 0.775. At the optimal cutoff value of 0.557, the model demonstrated a sensitivity of 59.1% and a specificity of 84.8%, indicating good discriminative ability. The Hosmer-Lemeshow test showed (χ 2=15.821, P=0.105), suggesting good agreement between predicted and observed outcomes. In the validation set, the AUC was 0.778, with Hosmer-Lemeshow (χ 2=8.557, P=0.575). DCA and CIC indicated favorable clinical applicability of the model. Conclusions:The depression risk prediction model constructed in this study demonstrated good predictive performance. It can assist clinicians in early identification of high-risk individuals with diabetes and provide a theoretical basis for targeted interventions.

Objective:To evaluate the item properties and applicability of the eHealth Literacy Scale in Web 3.0 context (eHLS-Web 3.0) among diabetic patients by applying classical test theory (CTT) and item response theory (IRT) to provide a new effective tool for assessing the level of eHealth literacy among diabetic patients.Methods:A cross-sectional study design was adopted and 230 diabetic patients from the inpatient endocrinology department of the Affiliated Yantai Yuhuangding Hospital of Qingdao University were selected by convenience sampling from November 2022 to May 2023 and were surveyed by using the self-general information questionnaire and eHLS-Web 3.0. The correlation coefficient method, Cronbach α coefficient, Guttman split-half reliability coefficient, and structural validity in CCT were used, and discriminant validity, convergent validity, and Samejima Graded Response model in IRT were used to evaluate the scale items. Results:The CTT results showed that Cronbach α coefficient for the eHLS-Web 3.0 was 0.973, the Guttman split-half reliability coefficient was 0.894, and the correlation coefficient between the items and the total score of the scale ranged from 0.708 to 0.845 (all P<0.01). Exploratory factor analysis extracted three common factors with a cumulative variance contribution rate of 76.75%, and the confirmatory factor analysis model had a good fit. The reliability of each dimension combination was >0.60, and the average variance extracted was >0.50. The square root of the average variance extracted from each dimension (0.817, 0.875, 0.845) was greater than the correlation coefficient between this dimension and other dimensions (0.742, 0.763, 0.715). The IRT results showed that the discrimination parameter of all the items ranged from 2.174 to 4.054, the difficulty coefficients increased with the increase of the level (- 2.471 - 2.187), and the average information content of all the items ranged from 1.217 to 2.609. Conclusions:The eHLS-Web 3.0 has good characteristics among diabetic patients as tested by CTT and IRT, and can be used as an effective tool to assess the eHealth literacy level of diabetic patients in China.

Objective:To explore the effect of intervention plan based on a shared decision-making model on the diabetes knowledge, self-efficacy, self-management behavior, and blood glucose level of patients with diabetic ketosis.Methods:From November 2019 to March 2020, a total of 212 patients with diabetic ketosis who were admitted to the Endocrinology Department of a ClassⅢGrade A hospital in Yantai were recruited by convenience sampling. Among them, 104 patients admitted from July to October 2019 were involved into the control group, and 108 patients for the experimental group. The control group was given regular health education, and the experimental group was given the education based on the shared decision-making model. The changes of diabetes knowledge, diabetes management self-efficacy, self-management behavior, fasting blood glucose (FBG) , 2-hour postprandial blood glucose (2hPG) , glycosylated hemoglobin value (HbA1c) in two groups were compared before intervention, 3 months and 6 months after intervention.Results:3 months and 6 months after the intervention, the scores of diabetes knowledge with 85 (89.3, 70.0) and 88 (71.3, 92) , diabetes self-efficacy with 77.5 (70.0, 88.0) and 79.2 (63.8, 92.4) , self-management behavior with [64.5 (55.8, 74.8) ] and [62.5 (53.9, 74.2) ]in the experimental group were significantly higher than those of the control group ( P<0.05) . The level of FBG, 2hPG, and HbA1c of the experimental group were lower than those of the control group, and the differences were statistically significant ( P<0.05) . There was no significant difference in the recurrent cases of ketosis between the two groups within 6 months ( P>0.05) . Conclusions:The self-management intervention based on the shared decision-making model as the starting point may improve the level of diabetes knowledge, diabetes management self-efficacy and self-management behavior and stabilize the level of blood glucose of patients with diabetic acidosis.

Among the staff of Beijing Chao-Yang Hospital, Capital Medical University, who received the inactivated SARS-CoV-2 vaccine on January 30 in 2021, 28 recipients were selected for this research. Samples for nucleic acid tests were collected from the surface of the recipients′ both hands before and after vaccination. The hemostatic stickers used after the inoculation were also collected for nucleic acid tests. The nucleic acid tests of the samples collected from the surface of both hands of the 28 recipients before vaccination were all negative. After vaccination, the nucleic acid tests of the samples collected from the surface of both hands of recipients were positive in 3 cases, and suspicious in 8 cases, with a positive rate of 10.7%. A total of 25 hemostatic stickers used were collected, 24 of them had positive nucleic acid tests, and the rest one had suspicious nucleic acid test result, with a positive rate of 96%. The hemostatic stickers used after the inoculation have the risk of nucleic acid contamination.

Among the staff of Beijing Chao-Yang Hospital, Capital Medical University, who received the inactivated SARS-CoV-2 vaccine on January 30 in 2021, 28 recipients were selected for this research. Samples for nucleic acid tests were collected from the surface of the recipients′ both hands before and after vaccination. The hemostatic stickers used after the inoculation were also collected for nucleic acid tests. The nucleic acid tests of the samples collected from the surface of both hands of the 28 recipients before vaccination were all negative. After vaccination, the nucleic acid tests of the samples collected from the surface of both hands of recipients were positive in 3 cases, and suspicious in 8 cases, with a positive rate of 10.7%. A total of 25 hemostatic stickers used were collected, 24 of them had positive nucleic acid tests, and the rest one had suspicious nucleic acid test result, with a positive rate of 96%. The hemostatic stickers used after the inoculation have the risk of nucleic acid contamination.

Objective:To translate Pediatric Quality of Life Inventory TM 3.2 Diabetes Module (PedsQL TM 3.2-DM) for children and adolescents into Chinese and analyze the reliability and validity of it. Methods:Following the principle of Brislin translation, the source scale was translated by 2 supervisor nurses with master's degrees and the scale was back translated by 2 nursing experts with overseas study experience. The semantic adjustment of the scale was carried out by pre-surveys. By the convenient sampling method, a total of 175 children and adolescents with diabetes who were treated in Department of Endocrinology and Department of Pediatrics in ClassⅢ Grade A hospitals in Yantai and Qingdao from March to August 2019 were investigated and 175 effective scales were finally included to analyze the reliability and validity of the revised scale in children and adolescents with diabetes.Results:The Chinese version of PedsQL TM 3.2-DM had 33 items in total, including 4 dimensions such as disease-related symptoms, treatment compliance, disease-caused worry and communication. The Cronbach's α coefficient of Chinese version of PedsQL TM 3.2-DM was 0.927 and that of 4 dimensions were respectively 0.885, 0.910, 0.828 and 0.798. After assessment by panel of experts, the content validity index of Chinese version of PedsQL TM 3.2-DM was 0.97 and the content validity index of every item was from 0.80 to 1.00. A total of 4 common factors were extracted by exploratory factor analysis and the cumulative variance contribution rate was 59.539%. In addition, the factor loading of each item on its common factor was over 0.4. Conclusions:The Chinese version of PedsQL TM 3.2-DM has good reliability and validity, which can be used as a simple tool for self-assessment of quality of life in children aged from 8 to 19 years with diabetes.

ObjectiveTo explore the effects of companion support on insulin pump therapy in adolescents with type 1 diabetes.Methods A total of 60 patients were randomly divided into experimental group and control group,30 cases respectively. Patients in control group were given routine education,while patients in experimental group received additional intervention of companion support. Changes of blood glucose,the occurrence of negative events during the use of insulin pump and standardized usage of insulin pump were compared between two groups. Blood glucose before sleep in one random day was recorded and the fluctuation of blood glucose was compared between two groups.Results After six months,fasting and postprandial blood glucose,glycated hemoglobin and the occurrence of negative events during the use of insulin pump in experimental group were significantly lower than those in control group (P<0.05). The waveform stability at one random day before sleep of experimental group was better than that of control group.Conclusions Companion support plays curial roles in controlling blood glucose, improves the standardization of insulin pump operation and effectively reduces the negative events in adolescents with type 1 diabetes undergoing temporary insulin pump therapy.

Objective To explore the effects of health education based on health belief model in elderly patients with 0 grade diabetic foot. Methods Elderly patients with 0 grade diabetic foot of endocrinology ward were selected by convenience sampling in Yantai Yuhuangding Hospital of Shandong Province as subjects form 1st January to 31st March 2014. Patients were divided into observation group (n=49) and control group (n=51) with the random number table. On the end of the study, there were 47 patients in observation group and 42 in control group. Patients of both groups all received the same treatment and knowledge education during hospitalization. After discharge, monthly telephone follow-up was carried out for patients in control group along with answering questions, while health education based on health belief model was applied for patients in observation group. The glucose and TG control condition, self-care behavior and foot situation were compared between two groups. Results Six months and three years after intervention, the fasting plasma glucose (FPG), plasma glucose two hours after glucose load (2hPG), glycosylated hemoglobin (HbA1c), triglyceride (TG) of patients in observation group were lower than those in control group with significant differences (P< 0.05). Three years after intervention, the diabetes self-care behavior of patients in observation group was significantly better than that in control group (P<0.05); the situation of ulcer/infection, deformity, blister/callosum, xerosis cutis/chapped skin, pain/twitch of lower limbs and anaesthesia in the foot of patients in observation group was better than those in control group with significant differences (P<0.05). Conclusions The health education based on health belief model for elderly patients with 0 grade diabetic foot can make the effects of glucose control and blood lipid control lasting and stable. Besides, the self-care ability of diabetic foot of patients improves by knowledge learning again and again and correcting unhealthy life styles so as to reduce the risk of infection, ulcer, thanatosis and amputation.

Objective To construct a scientific and feasible evaluation indicator system of health education effect of our country′s hospitalized patients with diabetes. Methods On the basis of literature review and semi-structured interview combined with group discussion, alternative index system were determined,and then the Delphi method were used for two round consultation with 30 diabetes experts to finally determine indicator evaluation system. Results Positive coefficient of the two rounds consultation were 86.7% (26/30) and 100.0% (26/26) respectively, experts′ authority coefficient was 0.889,and the Kendall W coefficients of concordance were 0.447,0.369 and 0.302 respectively (P<0.01). The evaluation indicator system of health education effect was consisted of 6 fisrt-level indicators, 24 second-level indicators and 55 third-level indicators. Conclusions The evaluation indicator system of health education effect is reliable and scientific, which can provide objective and quantitative standards for health education effect of hospitalized patients with diabetes in our country.