1.Mediating effect of psychological stress between sleep disorder and fatigue in patients with acute coronary syndrome undergoing PCI
Wenyue SUN ; Shan JIANG ; Ting QI ; Ping YANG ; Jing GUO ; Jingru LIU
Chinese Journal of Modern Nursing 2025;31(30):4164-4169
Objective:To investigate the mediating effect of psychological stress between sleep disorder and fatigue in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) .Methods:Convenience sampling was used to select 305 ACS patients with PCI from August to September 2024 in China-Japan Union Hospital of Jilin University. General Information Questionnaire, Multidimensional Fatigue Inventory-20 (MFI-20), Symptom Checklist 90 (SCL-90), and Pittsburgh Sleep Quality Index (PSQI) were used to survey the patients at discharge, and one month after discharge.Results:The MFI-20, SCL-90, and PSQI scores at discharge of 305 patients with PCI for ACS were (59.27±18.33), (141.09±49.08), and (10.72±4.95), respectively. The MFI-20, SCL-90, and PSQI scores at one month after discharge were (55.58±19.28), (134.08±44.29), and (9.17±5.20), respectively. Mediating effect analysis showed that at discharge, the direct effect of sleep disorder on fatigue was 0.403, the mediating effect was 0.216, and the total effect was 0.619, with the mediating effect accounting for 34.89% of the total effect. One month after discharge, the direct effect of sleep disorder on fatigue was 0.385, the mediating effect was 0.355, and the total effect was 0.740, with the mediating effect accounting for 47.97% of the total effect.Conclusions:Psychological stress plays a mediating role between sleep disorder and fatigue at different time points in ACS patients undergoing PCI. Clinical attention should be paid to sleep disorders and psychological stress of ACS patients undergoing PCI, so as to improve their fatigue.
2.Analysis of fatigue status and its influencing factors in acute coronary syndrome patients after PCI
Wenyue SUN ; Jingru LIU ; Ping YANG ; Haiyan SANG ; Yu LU ; Chunyan HAO ; Zhe AN
Chinese Journal of Modern Nursing 2025;31(9):1223-1226
Objective:To explore the fatigue status and its influencing factors in acute coronary syndrome (ACS) patients after percutaneous coronary intervention (PCI) .Methods:This study is a cross-sectional study. A convenient sampling method was used to select 98 ACS patients who underwent PCI in the Department of Cardiology at China-Japan Union Hospital of Jilin University in February 2024. A general data questionnaire and the Multidimensional Fatigue Inventory-20 (MFI-20) were used to investigate the patients.Results:The total score of MFI-20 for the 98 ACS patients post-PCI was (57.38±15.14). Multiple linear regression analysis showed that hypertension was influencing factor of fatigue in ACS patients after PCI ( P<0.05) . Conclusions:The fatigue level of ACS patients after PCI is at a moderate level. The degree of fatigue is influenced by hypertension. Clinical targeted nursing measures should be implemented to alleviate the fatigue of the patients.
3.Guide on Methodological Standards in Pharmacoepidemiology(2nd edition)and their series interpretation(9):research report standards and results visualization
Jingru CHENG ; Ruina CHEN ; Jiarui LI ; Shaowen TANG ; Feng SUN ; Siyan ZHAN
Chinese Journal of Pharmacoepidemiology 2025;34(9):1004-1016
Standardized research reporting is crucial for the translation of pharmacoepidemiology research findings,and visual reporting can significantly enhance the clarity,understandability,and transparency of research results.Based on the Guide on Methodological Standards in Pharmacoepidemiology(2nd edition),this article systematically explains the key points for writing each component of a research report(including title,abstract,introduction,research methods,research results,discussion and conclusions,acknowledgments,conflict of interest statement,and references).This article also summarizes recognized international and domestic standards for pharmacoepidemiology research reporting,providing a reference for researchers.Furthermore,real-world cases will be used to demonstrate common forms of visualized reports and their interpretation methods.Finally,it further explores strategies for communicating research results.This study aims to provide pharmacoepidemiology researchers with detailed guidance on visually presenting research results and writing high-quality research reports,thereby enhancing the integrity and impact of their research.
4.Randomized controlled trial of enhanced cognitive behavioral therapy for chronic insomnia with comorbid anxiety/depression
Xin LUO ; Jingru LI ; Jingfang LU ; Fangmei GE ; Jie ZHANG ; Jing ZHANG ; Wanqi SUN ; Wenqing ZHAO ; Binbin SHI ; Chengmei YUAN
Chinese Journal of Psychiatry 2025;58(3):202-210
Objective:To compare the effects of standard cognitive behavioral therapy for insomnia (CBT-I) and enhanced cognitive behavioral therapy for insomnia(CBT-I Plus) in patients with chronic insomnia disorder comorbid anxiety or depressive symptoms.Methods:This prospective study included 148 patients with chronic insomnia disorder and anxiety/depression symptoms who were treated at the Sleep Disorder clinic of Shanghai Mental Health Center between July 2020 and August 2023. Participants (56 males, 92 females; aged 18-65 years, mean age 35.08±10.30 years) were randomly assigned in a 1∶2 ratio to the CBT-I group ( n=54) or CBT-I Plus group ( n=94). The CBT-I Plus group received additional treatments targeting anxiety and depressive symptoms. Treatment lasted 8 weeks, with assessment conducted at baseline, weeks 2, 4, and 8. Depression severity was measured using the 17-item Hamilton Depression Rating Scale (HAMD 17), anxiety severity with the Hamilton Anxiety Scale (HAMA), and sleep quality with the Pittsburgh Sleep Quality Index (PSQI). Paired sample t-tests were used to evaluate within-group changes, repeated-measures ANOVA compared treatment effects between groups, and ANCOVA was employed to adjust for confounding variables. Results:Significant reductions in PSQI, HAMD 17, and HAMA scores were observed in both groups after treatment: CBT-I group: PSQI ((14.15±2.54) vs. (7.50±3.35), t=13.25), HAMD 17 ((14.70±4.09) vs. (7.40±4.61), t=9.33), and HAMA ((14.94±4.11) vs. (5.56±3.67), t=12.38) (all P<0.001).CBT-I Plus group: PSQI ((14.87±3.01) vs. (7.19±3.86), t=18.75), HAMD 17 ((16.84±3.91) vs. (6.84±4.79), t=17.42), and HAMA ((15.57±3.93) vs. (6.10±4.57), t=18.39) (all P<0.001). After adjusting for HAMD 17 scores and medication use, no statistically significant between-group differences were observed in changes in PSQI, HAMD 17, and HAMA scores ( P>0.05). A significant time-by-group interaction was found for the PSQI daytime dysfunction subscale ( F=4.87, P<0.01). Conclusion:Both CBT-I and CBT-I Plus improve sleep and emotional symptoms in patients with chronic insomnia disorder and comorbid anxiety/depression symptoms. However, CBT-I Plus has no significant advantages over standard CBT-I. Further studies are needed to refine the timing and content of interventions.
5.Analysis of fatigue status and its influencing factors in acute coronary syndrome patients after PCI
Wenyue SUN ; Jingru LIU ; Ping YANG ; Haiyan SANG ; Yu LU ; Chunyan HAO ; Zhe AN
Chinese Journal of Modern Nursing 2025;31(9):1223-1226
Objective:To explore the fatigue status and its influencing factors in acute coronary syndrome (ACS) patients after percutaneous coronary intervention (PCI) .Methods:This study is a cross-sectional study. A convenient sampling method was used to select 98 ACS patients who underwent PCI in the Department of Cardiology at China-Japan Union Hospital of Jilin University in February 2024. A general data questionnaire and the Multidimensional Fatigue Inventory-20 (MFI-20) were used to investigate the patients.Results:The total score of MFI-20 for the 98 ACS patients post-PCI was (57.38±15.14). Multiple linear regression analysis showed that hypertension was influencing factor of fatigue in ACS patients after PCI ( P<0.05) . Conclusions:The fatigue level of ACS patients after PCI is at a moderate level. The degree of fatigue is influenced by hypertension. Clinical targeted nursing measures should be implemented to alleviate the fatigue of the patients.
6.Guide on Methodological Standards in Pharmacoepidemiology(2nd edition)and their series interpretation(9):research report standards and results visualization
Jingru CHENG ; Ruina CHEN ; Jiarui LI ; Shaowen TANG ; Feng SUN ; Siyan ZHAN
Chinese Journal of Pharmacoepidemiology 2025;34(9):1004-1016
Standardized research reporting is crucial for the translation of pharmacoepidemiology research findings,and visual reporting can significantly enhance the clarity,understandability,and transparency of research results.Based on the Guide on Methodological Standards in Pharmacoepidemiology(2nd edition),this article systematically explains the key points for writing each component of a research report(including title,abstract,introduction,research methods,research results,discussion and conclusions,acknowledgments,conflict of interest statement,and references).This article also summarizes recognized international and domestic standards for pharmacoepidemiology research reporting,providing a reference for researchers.Furthermore,real-world cases will be used to demonstrate common forms of visualized reports and their interpretation methods.Finally,it further explores strategies for communicating research results.This study aims to provide pharmacoepidemiology researchers with detailed guidance on visually presenting research results and writing high-quality research reports,thereby enhancing the integrity and impact of their research.
7.Mediating effect of psychological stress between sleep disorder and fatigue in patients with acute coronary syndrome undergoing PCI
Wenyue SUN ; Shan JIANG ; Ting QI ; Ping YANG ; Jing GUO ; Jingru LIU
Chinese Journal of Modern Nursing 2025;31(30):4164-4169
Objective:To investigate the mediating effect of psychological stress between sleep disorder and fatigue in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) .Methods:Convenience sampling was used to select 305 ACS patients with PCI from August to September 2024 in China-Japan Union Hospital of Jilin University. General Information Questionnaire, Multidimensional Fatigue Inventory-20 (MFI-20), Symptom Checklist 90 (SCL-90), and Pittsburgh Sleep Quality Index (PSQI) were used to survey the patients at discharge, and one month after discharge.Results:The MFI-20, SCL-90, and PSQI scores at discharge of 305 patients with PCI for ACS were (59.27±18.33), (141.09±49.08), and (10.72±4.95), respectively. The MFI-20, SCL-90, and PSQI scores at one month after discharge were (55.58±19.28), (134.08±44.29), and (9.17±5.20), respectively. Mediating effect analysis showed that at discharge, the direct effect of sleep disorder on fatigue was 0.403, the mediating effect was 0.216, and the total effect was 0.619, with the mediating effect accounting for 34.89% of the total effect. One month after discharge, the direct effect of sleep disorder on fatigue was 0.385, the mediating effect was 0.355, and the total effect was 0.740, with the mediating effect accounting for 47.97% of the total effect.Conclusions:Psychological stress plays a mediating role between sleep disorder and fatigue at different time points in ACS patients undergoing PCI. Clinical attention should be paid to sleep disorders and psychological stress of ACS patients undergoing PCI, so as to improve their fatigue.
8.Randomized controlled trial of enhanced cognitive behavioral therapy for chronic insomnia with comorbid anxiety/depression
Xin LUO ; Jingru LI ; Jingfang LU ; Fangmei GE ; Jie ZHANG ; Jing ZHANG ; Wanqi SUN ; Wenqing ZHAO ; Binbin SHI ; Chengmei YUAN
Chinese Journal of Psychiatry 2025;58(3):202-210
Objective:To compare the effects of standard cognitive behavioral therapy for insomnia (CBT-I) and enhanced cognitive behavioral therapy for insomnia(CBT-I Plus) in patients with chronic insomnia disorder comorbid anxiety or depressive symptoms.Methods:This prospective study included 148 patients with chronic insomnia disorder and anxiety/depression symptoms who were treated at the Sleep Disorder clinic of Shanghai Mental Health Center between July 2020 and August 2023. Participants (56 males, 92 females; aged 18-65 years, mean age 35.08±10.30 years) were randomly assigned in a 1∶2 ratio to the CBT-I group ( n=54) or CBT-I Plus group ( n=94). The CBT-I Plus group received additional treatments targeting anxiety and depressive symptoms. Treatment lasted 8 weeks, with assessment conducted at baseline, weeks 2, 4, and 8. Depression severity was measured using the 17-item Hamilton Depression Rating Scale (HAMD 17), anxiety severity with the Hamilton Anxiety Scale (HAMA), and sleep quality with the Pittsburgh Sleep Quality Index (PSQI). Paired sample t-tests were used to evaluate within-group changes, repeated-measures ANOVA compared treatment effects between groups, and ANCOVA was employed to adjust for confounding variables. Results:Significant reductions in PSQI, HAMD 17, and HAMA scores were observed in both groups after treatment: CBT-I group: PSQI ((14.15±2.54) vs. (7.50±3.35), t=13.25), HAMD 17 ((14.70±4.09) vs. (7.40±4.61), t=9.33), and HAMA ((14.94±4.11) vs. (5.56±3.67), t=12.38) (all P<0.001).CBT-I Plus group: PSQI ((14.87±3.01) vs. (7.19±3.86), t=18.75), HAMD 17 ((16.84±3.91) vs. (6.84±4.79), t=17.42), and HAMA ((15.57±3.93) vs. (6.10±4.57), t=18.39) (all P<0.001). After adjusting for HAMD 17 scores and medication use, no statistically significant between-group differences were observed in changes in PSQI, HAMD 17, and HAMA scores ( P>0.05). A significant time-by-group interaction was found for the PSQI daytime dysfunction subscale ( F=4.87, P<0.01). Conclusion:Both CBT-I and CBT-I Plus improve sleep and emotional symptoms in patients with chronic insomnia disorder and comorbid anxiety/depression symptoms. However, CBT-I Plus has no significant advantages over standard CBT-I. Further studies are needed to refine the timing and content of interventions.
9.Sleep quality and influencing factors of mariners during ocean voyages
Zhanying SUN ; Xueyang GAN ; Qingqing SU ; Jingru CHEN ; Yuan GAO
Journal of Environmental and Occupational Medicine 2024;41(8):892-897
Background The average sleep quality of mariners during ocean voyages is notably worse than that of the general populace, and the incidence of sleep disorders among them is higher. Sleep disorders closely associate with fatigue and cognitive decline, increasing error and accident rates, and are a major safety hazard in marine navigation. At present, research on factors influencing the sleep quality of mariners during ocean voyages in China is limited and needs further investigation. Objective To investigate the sleep quality of mariners during ocean voyages and analyze its influencing factors, in order to provide reference for constructing sleep intervention plans and mitigating their sleep disorders. Methods Using convenience cluster sampling, a questionnaire survey was carried out in 408 crew members of a fleet who returned from a voyage on March 21, 2024. The questionnaires included a general information questionnaire, Pittsburgh Sleep Quality Index (PSQI) , and Self Rating Anxiety Scale (SAS), and the data were analyzed by SPSS 26.0 software. Results A total of 399 valid questionnaires were collected, with an effective recovery rate of 97.8%. The mean score of PSQI for the mariners during ocean voyages was (6.41±2.44), with 33.6% (134/399) of the mariners reporting sleep disorders. The PSQI scores varied by family structures (t=2.235, P=0.031), labor types (F=3.789, P=0.023), noise exposure (F=53.218, P<0.001), dietary patterns (F=63.311, P<0.001), exercise habits (F=16.416, P<0.001), and anxiety states (t=5.963,P<0.001). The results of linear regression showed that incomplete family structure (β=0.102, P=0.010), noise exposure (β=0.323, P<0.001), and anxiety (β=0.117, P=0.006) positively associated with the total score of PSQI, while dietary patterns (β=-0.331, P<0.001) and exercise habits (β=-0.147, P<0.001) negatively associated with the total PSQI score, and the 5 variables jointly explained 38.9% of the total variation in the PSQI score (F=37.159, P<0.01). Conclusion The sleep quality of mariners during ocean voyages is relatively low and the incidence of sleep disorders is relatively high, which is jointly influenced by factors such as family structure, noise exposure, dietary habits, exercise habits, and anxiety.
10.Construction of risk prediction model of heart failure in patients with coronary heart disease based on LASSO regression
Yikang XU ; Jingru MA ; Yang YANG ; Lei LIU ; Zhifeng ZHANG ; Siqi SUN ; Manman LI ; Kaiwen ZHAN
China Modern Doctor 2024;62(28):1-5,46
Objective To analyze the risk factors of heart failure in patients with coronary heart disease(CHD),and to construct and verify a nomogram prediction model for the risk of heart failure in patients with CHD.Methods The clinical data of 453 patients with CHD who were hospitalized in the Second Affiliated Hospital of Shenyang Medical College from January to December 2022 were retrospectively analyzed,including 278 patients with CHD combined with heart failure and 175 patients without heart failure.The patients were divided into training group(318 cases)and validation group(135 cases)according to the ratio of 7:3.R software was applied to perform LASSO regression to screen the risk factors,and Logistic regression to establish a prediction model and construct a nomogram.The calibration curve and receiver operating characteristic(ROC)curve were used to evaluate the calibration and discrimination of the model.Results LASSO regression analysis ultimately screened five risk factors from 22 variables,and Logistic regression results showed that age,smoking,history of myocardial infarction,New York Heart Association(NYHA)cardiac function class Ⅳ,and left ventricular ejection fraction(LVEF)were all independent risk factors for heart failure in CHD patients(P<0.05).The model formula was Z=-2.927+0.045 × age+0.886 × smoking+0.808 × history of myocardial infarction-2.829 × NYHA cardiac function class Ⅳ+0.037×LVFF.Internal validation of the model showed that area under the curve was 0.727(95%CI:0.588-0.752),the sensitivity was 40.4%,the specificity was 84.3%,and the Youden index was 0.247.According to the calibration curve,the predicted value of the calibration curve was highly consistent with the actual value,and the Brier score was 0.106.Conclusion The risk prediction model for heart failure in patients with CHD based on LASSO regression has good discrimination and prediction efficiency,which can be used as an evaluation tool for medical staff to predict the risk of patients.

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