Objective:To develop a Knowledge-Attitude-Practice (KAP) Scale for Dietary Management During Hemodialysis and to test its reliability and validity.Methods:Based on the KAP theoretical framework, an initial version of the scale was developed through a literature review and expert consultations. A convenience sampling method was used to recruit hemodialysis patients from four hospitals in Suzhou in March 2024. Questionnaire item analysis and reliability and validity tests were conducted.Results:A total of 460 questionnaires were distributed and 438 valid responses were collected, with an effective response rate of 95.22%. The final scale included three dimensions (knowledge, attitude, and practice) with 34 items. Content validity at the scale level was 0.910, and the item level ranged from 0.800 to 1.000. Exploratory factor analysis extracted three common factors, with a cumulative variance contribution rate of 74.520%. Confirmatory factor analysis showed a good model fit. The total Cronbach's α coefficient of the scale was 0.971, and the Cronbach's αcoefficients for the three dimensions were 0.963, 0.933, and 0.934, respectively. The test-retest reliability coefficient was 0.839.Conclusions:The Knowledge-Attitude-Practice Scale for Dietary Management During Hemodialysis demonstrates good reliability and validity, making it a valuable tool for assessing the KAP level of dietary management in hemodialysis patients.

Objective:To develop a Knowledge-Attitude-Practice (KAP) Scale for Dietary Management During Hemodialysis and to test its reliability and validity.Methods:Based on the KAP theoretical framework, an initial version of the scale was developed through a literature review and expert consultations. A convenience sampling method was used to recruit hemodialysis patients from four hospitals in Suzhou in March 2024. Questionnaire item analysis and reliability and validity tests were conducted.Results:A total of 460 questionnaires were distributed and 438 valid responses were collected, with an effective response rate of 95.22%. The final scale included three dimensions (knowledge, attitude, and practice) with 34 items. Content validity at the scale level was 0.910, and the item level ranged from 0.800 to 1.000. Exploratory factor analysis extracted three common factors, with a cumulative variance contribution rate of 74.520%. Confirmatory factor analysis showed a good model fit. The total Cronbach's α coefficient of the scale was 0.971, and the Cronbach's αcoefficients for the three dimensions were 0.963, 0.933, and 0.934, respectively. The test-retest reliability coefficient was 0.839.Conclusions:The Knowledge-Attitude-Practice Scale for Dietary Management During Hemodialysis demonstrates good reliability and validity, making it a valuable tool for assessing the KAP level of dietary management in hemodialysis patients.

Objective:To understand the clinical application of diet management evidence during dialysis in maintenance hemodialysis (MHD) patients, analyze facilitators/barriers and develop intervention strategies, so as to provide reference for the conversion of evidence-based evidence into clinical practice.Methods:From January to February 2022, 131 persons related to diet management of MHD patients during dialysis were selected from Suzhou Hospital Affiliated to Nanjing Medical University (Suzhou Municipal Hospital) by convenience sampling, including 3 hemodialysis doctors, 7 hemodialysis nurses, and 121 MHD patients. We introduced 7 pieces of evidence of diet management for MHD patients during dialysis, developed 17 review indicators based on the evidence, and conducted a clinical status review. Based on the review results, we conducted an analysis of facilitators and barriers.Results:The clinical compliance rate of 17 review indicators ranged from 0 to 71.29%. The standardized scores of patients' diet management knowledge, beliefs, and behaviors were 26.00%, 61.88%, and 67.82%, respectively, while the standardized scores of medical and nursing diet management knowledge, beliefs, and behaviors were 42.20%, 68.00%, and 64.00%, respectively. The facilitators included the high validation importance and feasibility of each item in the evidence, the willingness of medical and nursing staff and patients to learn about diet management knowledge, the availability of ordering services in the cafeteria, the availability of a hemodialysis information system, and the pre dialysis evaluation and post dialysis evaluation stages. Barriers mainly included unclear explanation of evidence items, lack of practical details, lack of ways to learn diet management knowledge, single form of education channels, conflicts with patients' traditional dietary habits, difficulty in obtaining food that met the requirements of the conditions, lack of a comprehensive diet management process, lack of diet management teams, and lack of evaluation standards for diet management and lack of practical guidance.Conclusions:The evidence of diet management during dialysis in MHD patients has not yet been effectively translated into clinical practice. An evidence-based practice plan should be constructed based on the analysis of facilitators/barriers and intervention strategies to shorten the gap between clinical practice and evidence.

Objective:To retrieve, evaluate and summarize the relevant evidence of subcutaneous injection in patients to reduce pain at the injection site, so as to provide reference for clinical practice.Methods:According to the evidence pyramid "6S" model, all evidence on subcutaneous injection and injection site pain, including guidelines, expert consensus, summary of evidence, clinical decision, systematic review, etc were retrieved from domestic and international guideline networks and databases. The search period was from database establishment to October 2, 2022. The literature quality evaluation and evidence grading system of Joanna Briggs Institute (JBI) Evidence-based Health Care Center was used to evaluate the literature quality and classify the evidence level.Results:A total of 12 articles were included, including 2 expert consensus, 6 systematic reviews, 2 best evidence summaries and 2 clinical guidelines. A total of 21 pieces of best evidence were summarized from 8 aspects, including pre-subcutaneous injection assessment, injection site, injection needle, injection position, injection method, precautions, personnel training and health education.Conclusions:This study summarized a comprehensive and practical subcutaneous injection method. Clinical practitioners can use evidence to administer subcutaneous injection to patients, reduce pain and improve patients ′ comfort.

Objective Based on the liquid chromatography-tandem mass spectormetry (LC-MS/MS), to study the effects of Pogostemon cablin on serum metabolism of Guizhou miniature pigs， and to explore its pharmacological mechanism.MethodsNine healthy Guizhou miniature pigs were divided into two groups, namely Pogostemon cablin drug group (n=5) and control group (n=4). The pigs in Pogostemon cablin drug group were orally fed with traditional Chinese medicine formula granules, each 0.5 g per day, for consecutive 8 days, while those in control group were given normal feeding without additional treatment. After the feeding experiment, serum samples were collected and analyzed using the LC-MS/MS technology. The metabolomics data was annotated and compared with KEGG, HMDB and Lipidmaps databases. Bioinformatics analysis methods including partial least squares discriminant analysis (PLS-DA), intergroup clustering, differential metabolite analysis and functional enrichment were used to screen differential metabolic biomarkers and their possible metabolic pathways.Results Forty-four differential metabolites (P<0.05) were screened out from the 443 metabolites, eight differential metabolites were significantly up-regulated (P<0.01), namely cinnamoylglycine, N-benzyl-N-isopropyl-N'-[4-(trifluoromethoxy) phenyl]urea, hypotaurine, D-glucose 6-phosphate, cis-2-decenoic acid, 11(Z),14(Z)-eicosadienoic acid, prostaglandin A2 and 10-hydroxydecanoic acid, and three differential metabolites were significantly down-regulated (P<0.01), namely lysophosphatidyl choline 22:5, lysophosphatidic acid 22:6 and lysophosphatidic acid 22:5. The differential metabolites were mainly enriched in the metabolic pathways of alanine, aspartate and glutamate metabolism (MapID: map00250) and taurine and hypotaurine metabolism (MapID: map00430).Conclusion Pogostemon cablin can significantly affect the metabolism of lysophosphatidic acids in porcine, and relieve the disorder of amino acids metabolism and regulate the occurrence of inflammation by affecting the metabolic pathways of alanine, aspartate and glutamate metabolism and taurine and hypotaurine metabolism.