1.Establishment of evaluation indicators of nutrition care ability for oral feeding by caregivers of patients with post-stroke dysphagia
Yingji QIAN ; Hong TANG ; Liting WANG ; Hongyan CHENG ; Li YOU ; Li LI
Modern Clinical Nursing 2024;23(11):16-23
Objective To establish evaluation indicators of nutrition care ability for carrying out oral feeding by caregivers of patients with post-stroke dysphagia (PSD) so as to provide references for nursing staff in evaluation of the nutritional care ability of caregivers and for the targeted health education. Methods Based on the caregiver skill model proposed by Farran et al,literature review and analysis,semi-structured interview,Delphi expert inquiry,analysis with the Analytic Hierarchy Process and pre-survey were conducted to establish a pool of evaluation indicators for nutrition care ability in carrying out oral feeding by caregivers of patients with PSD and to determine the weights of indicators. Results The two rounds of inquiry questionnaires achieved effective response rates of 90.00% and 100.00%,respectively. The expert authority coefficients were at 0.869 and 0.910,and the coefficients of variation ranged 0.035 to 0.162 and 0.025 to 0.078 for the first and second rounds. The Kendall coordination coefficients were between 0.205 and 0.276 for the first round and between 0.278 and 0.364 for the second round (P<0.01). Based on expert consultations,the evaluation indicators were finalised,comprising 6 primary indicators and 38 secondary indicators,with consistency coefficients of each level indicator is less than 0.05. The primary indicators consisted of the knowledge of oral feeding nutrition care,attitude of oral feeding nutrition care,care skills,personal qualities of the caregiver,management of own emotions,and management of family and social resources. Conclusion The evaluation indicators for nutrition care ability to carry out oral feeding by caregivers of patients with PSD has been established. They are scientifically sound and rational,with strong practicality,and are able to provide a reference for nursing staff in evaluation of the nutrition care ability of caregivers and the health education.
2.Establishment of evaluation indicators of nutrition care ability for oral feeding by caregivers of patients with post-stroke dysphagia
Yingji QIAN ; Hong TANG ; Liting WANG ; Hongyan CHENG ; Li YOU ; Li LI
Modern Clinical Nursing 2024;23(11):16-23
Objective To establish evaluation indicators of nutrition care ability for carrying out oral feeding by caregivers of patients with post-stroke dysphagia (PSD) so as to provide references for nursing staff in evaluation of the nutritional care ability of caregivers and for the targeted health education. Methods Based on the caregiver skill model proposed by Farran et al,literature review and analysis,semi-structured interview,Delphi expert inquiry,analysis with the Analytic Hierarchy Process and pre-survey were conducted to establish a pool of evaluation indicators for nutrition care ability in carrying out oral feeding by caregivers of patients with PSD and to determine the weights of indicators. Results The two rounds of inquiry questionnaires achieved effective response rates of 90.00% and 100.00%,respectively. The expert authority coefficients were at 0.869 and 0.910,and the coefficients of variation ranged 0.035 to 0.162 and 0.025 to 0.078 for the first and second rounds. The Kendall coordination coefficients were between 0.205 and 0.276 for the first round and between 0.278 and 0.364 for the second round (P<0.01). Based on expert consultations,the evaluation indicators were finalised,comprising 6 primary indicators and 38 secondary indicators,with consistency coefficients of each level indicator is less than 0.05. The primary indicators consisted of the knowledge of oral feeding nutrition care,attitude of oral feeding nutrition care,care skills,personal qualities of the caregiver,management of own emotions,and management of family and social resources. Conclusion The evaluation indicators for nutrition care ability to carry out oral feeding by caregivers of patients with PSD has been established. They are scientifically sound and rational,with strong practicality,and are able to provide a reference for nursing staff in evaluation of the nutrition care ability of caregivers and the health education.
3.Discussion of the 8 th edition of AJCC/UICC staging system from the clinical stage Ⅲ nasopharyngeal carcinoma
Yingji HONG ; Mei LI ; Zhining YANG ; Yajie XUE ; Xiaoying GAO ; Zhixiong LIN
Chinese Journal of Radiation Oncology 2020;29(10):822-826
Objective:To evaluate the 8 th edition of AJCC/UICC staging system for stage Ⅲ nasopharyngeal carcinoma (NPC) by the survival analysis. All patients were treated with intensity-modulated radiotherapy (IMRT). Methods:Among 1351 treatment-na?ve NPC patients who received radiotherapy/chemoradiotherapy in our hospital from December 2008 to October 2014, 742 and 784 cases were classified as clinical stage Ⅲ based on the criteria of the 7 th and 8 th edition of AJCC/UICC staging systems, respectively. These patients were classified into three subgroups according to the 7 th and 8 th edition of AJCC/UICC staging systems: T 3N 0-1 as G 1( n=226, n=245), T 1-2N 2 as G 2( n=180, n=187) and T 3N 2 as G 3( n=336, n=352). The 5-year overall survival (OS), progression-free survival (PFS), distant metastasis-free survival (DMFS) and local-regional recurrence-free survival (LRRFS) were analyzed with Kaplan- Meier method. The differences among different groups were evaluated by log-rank test. Results:There were 93.6% patients evaluated by the 8 th AJCC/UICC staging system remained the same cohort with those by the 7 th AJCC/UICC staging system. The 5-year OS, PFS, DMFS and LRRFS of the 8 th and 7 th staging systems were 84.8% and 85.4%, 76.2% and 77.0%, 80.4% and 81.3%, 89.8% and 90.6%, respectively (all P>0.05). The OS, PFS or DMFS significantly differed among three subgroups classified by the 8 th staging system (all P<0.001). In addition, statistical significance was observed between G 1 and G 2, and between G 1 and G 3(both P<0.05), whereas no statistical significance was noted between G 2 and G 3( P=0.183, 0.310, 0.248). Conclusions:The distribution features and clinical endpoints of clinical stage Ⅲ defined by the 8 th AJCC/UICC staging system are similar to those defined by the 7 th AJCC/UICC staging system. The distribution of survival risk significantly differs among different subgroups. N 2 plays a major role in assessing the survival risk of patients with stage Ⅲ NPC. In the era of IMRT plus chemotherapy, the effect of local tumors on clinical prognosis has been diminished. The 8 th AJCC/UICC staging system remains to be further improved.

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