Objective:To explore the health education needs of patients undergoing fecal microbiota transplantation (FMT) at different stages of treatment.Methods:A qualitative research method was employed and an interview guide based on timing theory was developed. Semi-structured interviews were conducted with patients treated for colorectal conditions with FMT at Tenth People's Hospital of Tongji University from August to October 2022. Data from the interviews were analyzed using thematic analysis.Results:A total of 19 patients aged 20 to 65 were interviewed, including seven males and 12 females. A total of five main themes and 15 subthemes were identified: health education demands during the diagnosis phase (basic information about FMT; knowledge about donor screening), health education demands during the preparation phase (alleviating discomfort caused by nasoenteric tubes; interpretation of examination reports), health education demands during the execution phase (dietary guidance during FMT; exercise guidance during FMT; medication and supplementary training guidance; management of adverse reactions), health education demands during the adaptation phase (consolidating treatment effects; knowledge related to FMT capsules; post-discharge follow-up content and methods; post-discharge precautions), long-term health education demands (diverse health education tools; individualized health education approaches; alleviating psychological anxiety) .Conclusions:Patients undergoing FMT have numerous concerns, and diverse health education needs throughout the treatment process. Healthcare professionals should adopt various health education strategies to address these needs.

Objective:To explore the health education needs of patients undergoing fecal microbiota transplantation (FMT) at different stages of treatment.Methods:A qualitative research method was employed and an interview guide based on timing theory was developed. Semi-structured interviews were conducted with patients treated for colorectal conditions with FMT at Tenth People's Hospital of Tongji University from August to October 2022. Data from the interviews were analyzed using thematic analysis.Results:A total of 19 patients aged 20 to 65 were interviewed, including seven males and 12 females. A total of five main themes and 15 subthemes were identified: health education demands during the diagnosis phase (basic information about FMT; knowledge about donor screening), health education demands during the preparation phase (alleviating discomfort caused by nasoenteric tubes; interpretation of examination reports), health education demands during the execution phase (dietary guidance during FMT; exercise guidance during FMT; medication and supplementary training guidance; management of adverse reactions), health education demands during the adaptation phase (consolidating treatment effects; knowledge related to FMT capsules; post-discharge follow-up content and methods; post-discharge precautions), long-term health education demands (diverse health education tools; individualized health education approaches; alleviating psychological anxiety) .Conclusions:Patients undergoing FMT have numerous concerns, and diverse health education needs throughout the treatment process. Healthcare professionals should adopt various health education strategies to address these needs.

Objective:To understand the frailty perception and coping experiences of elderly patients with hip fractures from the patients' perspective, providing insights for healthcare professionals on managing frailty.Methods:A purposive sampling method was used to select 12 elderly patients with hip fractures and frailty who were hospitalized at Tenth People's Hospital of Tongji University from September to October 2023. A phenomenological approach was adopted for this qualitative study, conducting semi-structured interviews to explore the patients' frailty perceptions and coping experiences. NVivo 11.0 software and Colaizzi's seven-step analysis method were used to organize and analyze the interview data.Results:The frailty perceptions of elderly hip fracture patients were categorized into four themes: multidimensional physiological challenges (e.g., aging of the body, nutritional imbalances, pain and sleep disturbances) ; limitations in daily life (e.g., mobility impairments, avoidance of social activities) ; heavy psychological burdens (e.g., uncertainty about the illness, low self-efficacy, feelings of guilt towards the family) ; insufficient social support (e.g., lack of age-friendly environments and limited medical policy coverage). The patients' coping strategies were grouped into two themes: active coping (e.g., self-encouragement, peer support, actively seeking relevant knowledge and guidance) ; passive coping (e.g., neglecting the situation) .Conclusions:Frailty brings multiple negative impacts on the physical, psychological, daily life and social aspects of elderly hip fracture patients; while most patients adopt a positive attitude towards frailty, some exhibit signs of emotional exhaustion and passivity. Medical staff should pay attention to the frailty perceptions of elderly hip fracture patients, identify related symptoms early, provide comprehensive support to alleviate the physical and psychological burden, and encourage patients to face frailty challenges optimistically, adopting proactive measures to slow its progression.

Objective:To extract and summarize the best available evidence on frailty management for elderly patients with hip fractures, providing a reference for developing clinically applicable management protocols.Methods:Following the "6S" evidence model, a systematic search was conducted across national and international databases and guideline websites for evidence on frailty management in elderly hip fracture patients, including guidelines, evidence summaries, systematic reviews, best practices, and expert consensus, with a search period from June 2018 to December 2023. Two researchers independently evaluated the quality of the literature, selecting studies that met inclusion criteria and extracting relevant evidence.Results:A total of 2 589 articles were identified, with 20 articles included: seven guidelines, two best practice standards, one evidence summary, seven expert consensus documents, and three systematic reviews. The best evidence was summarized across six domains: frailty screening, multidisciplinary collaboration, pain management, nutritional management, functional exercise, and discharge guidance, yielding 45 recommendations.Conclusions:The best evidence for frailty management in elderly patients with hip fractures summarized in this study offers valuable insights and scientific guidance for clinical healthcare providers. When applying this evidence, it is recommended to first adapt it to local contexts, considering factors such as institutional environment, healthcare policies, and patient preferences, before conducting implementation research on evidence translation.

Objective:To explore the journey map of patients with chronic constipation during fecal microbiota transplantation.Methods:This study adopted phenomenological methods. From October to December 2023, purposive sampling was used to select chronic constipation follow-up patients who underwent fecal microbiota transplantation at the Intestinal Microecology Center of Shanghai Tenth People's Hospital as respondents for semi-structured interviews. Colaizzi 7-step analysis method and NVivo 11.0 software were used for data analysis.Results:A total of 15 interviewees were interviewed. During fecal microbiota transplantation, the journey map of constipation patients included stages, mood changes, touchpoints, themes, emotional experiences and opportunities. The patient's experience and needs were summarized into three themes and ten sub-themes, including pre-transplant adaptation disorders to new environments (unfamiliarity and confusion-admission coordination disorders, anxiety and expectations-diverse complex emotions, puzzle and helplessness-asymmetric doctor and patient information), effectiveness-related psychological and social experiences in transplantation (attention and expectations-longing for positive efficacy, perception of benefits and risk avoidance, shame and inferiority-treatment stigmatization experience, questioning and despair-unrealized expectations, treatment resistance-sensitive economic burden), post-transplant transition dilemmas (inaccessible medical services-lack of continuous treatment and nursing, disease recurrence troubles) .Conclusions:This study visualizes the experiences and needs of constipation patients during microbiota transplantation through a patient journey map and identifies multidimensional issues and needs of patients. Clinical medical and nursing staff should pay attention to the needs of patients at different stages of the treatment process when formulating intervention programs to improve the quality of fecal microbiota transplantation nursing.

Objective To explore the dilemmas faced by surrogate decision-makers of severe stroke patients in treatment decision-making,and to provide a basis for developing decision support strategies.Methods From April to December 2023,through phenomenological qualitative research with 16 surrogate decision-makers with severe stroke patients from ICU of the department of neurology in a tertiary hospital in Jing'an District,Shanghai.semi-structured in-depth interviews were used to examine the perceptions of decision-making on surrogate.Data were analyzed via Braun's style of thematic analysis.Results 4 themes and 10 sub-themes were identified.Theme 1:negative emotional dilemmas(urgent decision-making leads to anxiety,fear,and unknown stroke trajectory increases the sense of uncertainty).Theme 2:supportive environment dilemmas(lack of information support delays decision-making;lack of family support increases decision-making stress;insufficient economic support increases the burden of decision-making).Theme 3:the dilemma of weighing the pros and cons(difficult trade-offs between risk and reward,tough decisions between reality and ethics,conflicting choices of life and dignity).Theme 4:preference management dilemmas(practical difficulties in adhering to patient preferences,impediments to decision-making due to unknown patient preferences).Conclusion Surrogate decision-makers of severe stroke patients face multiple decision-making dilemmas.Healthcare professionals should provide emotional support in multiple ways and comprehensive support to reduce the decision-making dilemmas experienced by surrogate decision-makers,as well as implement death education for surrogate decision-makers and promote advance care planning to reduce their decision-making stress.

Objective:To understand the frailty perception and coping experiences of elderly patients with hip fractures from the patients' perspective, providing insights for healthcare professionals on managing frailty.Methods:A purposive sampling method was used to select 12 elderly patients with hip fractures and frailty who were hospitalized at Tenth People's Hospital of Tongji University from September to October 2023. A phenomenological approach was adopted for this qualitative study, conducting semi-structured interviews to explore the patients' frailty perceptions and coping experiences. NVivo 11.0 software and Colaizzi's seven-step analysis method were used to organize and analyze the interview data.Results:The frailty perceptions of elderly hip fracture patients were categorized into four themes: multidimensional physiological challenges (e.g., aging of the body, nutritional imbalances, pain and sleep disturbances) ; limitations in daily life (e.g., mobility impairments, avoidance of social activities) ; heavy psychological burdens (e.g., uncertainty about the illness, low self-efficacy, feelings of guilt towards the family) ; insufficient social support (e.g., lack of age-friendly environments and limited medical policy coverage). The patients' coping strategies were grouped into two themes: active coping (e.g., self-encouragement, peer support, actively seeking relevant knowledge and guidance) ; passive coping (e.g., neglecting the situation) .Conclusions:Frailty brings multiple negative impacts on the physical, psychological, daily life and social aspects of elderly hip fracture patients; while most patients adopt a positive attitude towards frailty, some exhibit signs of emotional exhaustion and passivity. Medical staff should pay attention to the frailty perceptions of elderly hip fracture patients, identify related symptoms early, provide comprehensive support to alleviate the physical and psychological burden, and encourage patients to face frailty challenges optimistically, adopting proactive measures to slow its progression.

Objective:To extract and summarize the best available evidence on frailty management for elderly patients with hip fractures, providing a reference for developing clinically applicable management protocols.Methods:Following the "6S" evidence model, a systematic search was conducted across national and international databases and guideline websites for evidence on frailty management in elderly hip fracture patients, including guidelines, evidence summaries, systematic reviews, best practices, and expert consensus, with a search period from June 2018 to December 2023. Two researchers independently evaluated the quality of the literature, selecting studies that met inclusion criteria and extracting relevant evidence.Results:A total of 2 589 articles were identified, with 20 articles included: seven guidelines, two best practice standards, one evidence summary, seven expert consensus documents, and three systematic reviews. The best evidence was summarized across six domains: frailty screening, multidisciplinary collaboration, pain management, nutritional management, functional exercise, and discharge guidance, yielding 45 recommendations.Conclusions:The best evidence for frailty management in elderly patients with hip fractures summarized in this study offers valuable insights and scientific guidance for clinical healthcare providers. When applying this evidence, it is recommended to first adapt it to local contexts, considering factors such as institutional environment, healthcare policies, and patient preferences, before conducting implementation research on evidence translation.

BACKGROUND: Patients with mass-forming pancreatitis (MFP) or pancreatic ductal adenocarcinoma (PDAC) presented similar clinical symptoms, but required different treatment approaches and had different survival outcomes. This meta-analysis aimed to compare the diagnostic performance of contrast-enhanced ultrasound (CEUS) and contrast-enhanced computed tomography (CECT) in differentiating MFP from PDAC. METHODS: A literature search was performed in the PubMed, EMBASE (Ovid), Cochrane Library (CENTRAL), China National Knowledge Infrastructure (CNKI), Weipu (VIP), and WanFang databases to identify original studies published from inception to August 20, 2021. Studies reporting the diagnostic performances of CEUS and CECT for differentiating MFP from PDAC were included. The meta-analysis was performed with Stata 15.0 software. The outcomes included the pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR), and summary receiver operating characteristic (SROC) curves of CEUS and CECT. Meta-regression was conducted to investigate heterogeneity. Bayesian network meta-analysis was conducted to indirectly compare the overall diagnostic performance. RESULTS: Twenty-six studies with 2115 pancreatic masses were included. The pooled sensitivity and specificity of CEUS for MFP were 82% (95% confidence interval [CI], 73%-88%; I2  = 0.00%) and 95% (95% CI, 90%-97%; I2  = 63.44%), respectively; the overall +LR, -LR, and DOR values were 15.12 (95% CI, 7.61-30.01), 0.19 (95% CI, 0.13-0.29), and 78.91 (95% CI, 30.94-201.27), respectively; and the area under the SROC curve (AUC) was 0.90 (95% CI, 0.87-92). However, the overall sensitivity and specificity of CECT were 81% (95% CI, 75-85%; I2  = 66.37%) and 94% (95% CI, 90-96%; I2  = 74.87%); the overall +LR, -LR, and DOR values were 12.91 (95% CI, 7.86-21.20), 0.21 (95% CI, 0.16-0.27), and 62.53 (95% CI, 34.45-113.51), respectively; and, the SROC AUC was 0.92 (95% CI, 0.90-0.94). The overall diagnostic accuracy of CEUS was comparable to that of CECT for the differential diagnosis of MFP and PDAC (relative DOR 1.26, 95% CI [0.42-3.83], P  > 0.05). CONCLUSIONS CEUS and CECT have comparable diagnostic performance for differentiating MFP from PDAC, and should be considered as mutually complementary diagnostic tools for suspected focal pancreatic lesions.
Humans ; Contrast Media ; Bayes Theorem ; Tomography, X-Ray Computed/methods* ; Pancreatic Neoplasms/diagnostic imaging* ; Carcinoma, Pancreatic Ductal/diagnostic imaging* ; Sensitivity and Specificity ; Pancreatitis/diagnostic imaging* ; Ultrasonography/methods*

To improve the phenomenon of low participation and lack of innovation in education mode in general medical education elective courses, we have applied "creating significant learning experiences" to the design and implementation of medical general education curriculum, starting from six dimensions of learning including basic knowledge, application, synthesis, humanistic dimension, humanistic care, and learning to learn, setting learning goals, developing assessment tools and finally choosing teaching methods, thus forming a closed-loop teaching. And through the curriculum reform, collection of feedback and collation of data, the teaching activities designed according to this method fully meet and serve the teaching purposes, and assessment methods become more diverse and the content is more comprehensive, which reflects the multi-dimensional evaluation of the needs of general education.