Conceptual analysis of time perspective therapy GUO Yali, CHENG Menghua, XU Wen, GUO Jiayi, LI Haiting, WU Songmei, CAO Xiangyang, YANG Chaofan, QI Ran, CHEN Rui* Luoyang Orthopedic - Traumatologi
摘要 目的:系统评价现有良性前列腺增生病人术后尿失禁风险预测模型的性能和方法学质量,为医护人员选择合适的评估工具提供参考依据。方法:计算机检索PubMed、Web of Science、Cochrane Library、CINAHL、EMbase、万方数据库、维普数据库、中国生物医学文献数据库、中国知网等数据库中与良性前列腺增生病人术后尿失禁风险预测模型相关的文献,检索时限为建库至2026年1月15日。由2名研究人员独立完成文献筛选、资料提取,采用预测模型偏倚风险评估工具(PROBAST)对纳入研究的方法学偏倚和适用性进行质量评估。结果:共纳入16项研究,包含16个风险预测模型,模型的受试者工作特征(ROC)曲线下面积为0.610~0.943;模型最终纳入3~8个预测因子,高频预测因子包括前列腺体积、年龄、是否合并糖尿病、手术时间、膜性尿道长度以及体质指数。纳入文献中,仅2项研究同时进行了内部验证和外部验证,模型的整体适用性良好,但偏倚风险均较高。结论:现有预测模型多数缺乏完整设计,开发和验证仍处于发展阶段,模型质量有待改进,研究报告质量需进一步提升,未来模型开发应严格遵循个体预后与诊断多变量预测模型透明报告规范,优化研究设计,规范报告流程,以提高模型质量及临床实用价值。
摘要 目的:采用网状Meta分析方法系统评价不同心理干预方式对银屑病病人抑郁症状的干预效果,并进行排序,为临床制订个体化心理干预方案提供循证依据。方法:检索PubMed、EMbase、Cochrane Library、Web of Science、中国知网(CNKI)、万方数据库(WanFang Data)、维普数据库(VIP)及中国生物医学文献数据库(CBM)中有关心理干预改善银屑病病人抑郁症状的随机对照试验,检索时限为建库至2026年3月27日。采用Stata 17.0和RevMan 5.4软件进行网状Meta分析。结果:共纳入25篇RCT,涉及2541例病人、6种心理干预方法。网状Meta分析结果显示,与常规护理比较,情志护理[SMD=-1.14,95%CI(-1.63,-0.66)]、积极心理[SMD=-1.01,95%CI(-1.43,-0.58)]、积极心理+健康教育[SMD=-1.15,95%CI(-1.62,-0.67)]、积极心理+认知干预[SMD=-2.04,95%CI(-2.80,-1.28)]及认知干预[SMD=-0.79,95%CI(-1.25,-0.34)]均可有效改善银屑病病人抑郁症状。累积排序概率图下面积显示,积极心理+认知干预效果最佳。结论:现有证据提示,积极心理+认知干预可能是缓解银屑病病人抑郁的最佳干预,临床医护人员可优先考虑综合性心理干预方案,并结合病人病情、心理状态及可及性制订个体化干预策略。
摘要 目的:系统检索、评价、总结择期肝癌切除术病人预康复的最佳证据,构建规范化的临床管理方案。方法:采用PIPOST模式确立循证问题,遵循证据金字塔“5S”模型,系统检索中英文数据库及各专业学会网站等。2名研究者独立评价文献质量,结合循证专家意见,对符合标准的文献进行证据提取与总结。结果:共纳入22篇文献,汇总24条最佳证据,共9个主题,包括时机与适用人群、术前宣教、组建多学科团队、营养支持、运动管理、心理干预、血糖管理、血栓预防、中医治疗。结论:本研究总结择期肝癌切除术病人预康复管理的最佳证据内容科学、实用,可为医护人员开展预康复相关临床实践提供依据。
摘要 目的:系统评价肝移植受者术前衰弱的发生率及影响因素,为护理人员早期识别衰弱、实施干预措施提供参考。方法:计算机检索中国知网、万方数据库、维普数据库和中国生物医学文献服务系统、PubMed、Cochrane Library、Scopus、Web of Science、CINAHL、EMbase中关于肝移植受者术前衰弱发生率及影响因素的文献,检索时限为建库至2025年5月19日,采用Stata 18.0软件对肝移植受者术前衰弱发生率进行Meta分析。结果:共纳入22篇文献。肝移植受者术前衰弱总体发生率为30.0% [95%CI (25.3%, 35.0%)]。亚组分析结果显示,女性、采用非肝衰弱指数评估工具、亚洲地区、描述性研究的肝移植受者术前衰弱发生率更高。描述性分析显示,影响肝移植受者术前衰弱的因素包括年龄、性别、肝硬化病因、终末期肝病模型-血清钠(MELD-Na)评分、血清清蛋白、营养状况、躯体活动、抑郁等。结论:肝移植受者术前衰弱发生率较高,影响因素较多。护理人员应重视对肝移植受者术前衰弱的筛查,及早进行干预,预防或延缓衰弱的发生。
摘要 目的:系统评价与整合食管癌病人术后照护需求的质性研究。方法:计算机检索国内外数据库收录的有关食管癌病人术后照护需求的质性研究,检索时限为建库至2026年1月1日。采用澳大利亚乔安娜布里格斯研究所质性研究质量评价标准(2016)评价文献质量,通过汇集性整合方法进行结果整合。结果:共纳入17篇文献,提炼出了54个研究结果,归纳出10个类别,最终得出5个整合结果(消化道相关症状与饮食管理需求、心理支持需求、信息和自我管理需求、专业照护需求、社会支持需求)。结论:食管癌病人术后面临复杂的身心挑战和多层次的照护需求。医护人员应关注病人术后的真实体验,为其提供整体性和连续性的照护服务,制订精准、有效的干预措施,以提升病人术后的生活质量和康复效果。
摘要 目的:检索、评价并整合尿脓毒血症病人液体管理的最佳证据,为临床实践提供依据。方法:基于PIPOST模式构建循证问题,系统检索PubMed、Cochrane Library、CINAHL、中国知网、万方数据库、中国生物医学文献数据库、UpToDate及美国重症医学会、欧洲泌尿外科学会等网站中的相关文献,检索时限为建库至2026年3月31日。纳入指南、专家共识、系统评价/Meta分析、随机对照试验,由2名研究者独立进行文献筛选、质量评价和证据提取,并依据澳大利亚Joanna Briggs Institute(JBI)证据分级系统整合证据。结果:共纳入文献11篇,包括指南3篇、专家共识1篇、系统评价/Meta分析2篇及随机对照试验5篇,形成14条最佳证据,涵盖液体复苏时机与剂量、液体种类、液体反应性评估、液体治疗的时程化管理、液体过负荷防治及感染源的控制协同6个方面。结论:尿脓毒血症液体管理的直接高质量证据有限,临床医护人员应结合脓毒症液体治疗原则及尿源性感染特点,实施动态、个体化管理。
摘要 目的:检索、评价并汇总肩关节镜手术病人术中非计划低体温预防的最佳证据,为临床实践提供参考。方法:系统检索计算机决策支持系统、指南网站、专业协会网站及数据库中有关肩关节镜手术病人术中非计划低体温预防的文献,检索时限为建库至2026年3月31日。由2名研究者独立筛选文献、评价纳入文献的质量,并对符合质量标准的文献进行证据提取、翻译和整合。结果:共纳入13篇文献,包括临床决策2篇、指南4篇、专家共识1篇、系统评价6篇。从团队组成、评估与分级、术前干预措施、术中测量方式与频率、术中干预措施、术后干预措施和质量管理7个方面总结了30条证据。结论:总结的肩关节镜手术病人术中非计划低体温预防最佳证据可为临床护理实践提供循证依据。建议医护人员根据风险评估与分级结果,结合医疗机构资源条件及证据等级,选择性应用最佳证据,以降低肩关节镜手术病人术中非计划低体温发生率。
Application and barrier analysis of best evidence for nutritional support in patients with tuberculosis WANG Zhaobei, ZHANG Juan, ZHANG Jinglin, LU Zheng, WANG Fangjing, WANG Jiyan, TIAN Yuan, LU F
Evidence - based practice of microaspiration management in mechanically ventilated children in the surgical intensive care unit SHI Qianqian, SHI Ling*, KAN Yu, ZHANG Rui, ZHANG Qing, ZENG Yuqi, ZH
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Research progress on information concealment in cancer patients GAO Nana, CUI Siyuan, YANG Hui* *Corresponding Author YANG Hui, E-mail: yh15650022004@163.com Keywords cancer; information concealm
Research progress on frailty trajectories in older patients with chronic comorbidities LI Zhaoyang, JIN Kongjun* School of Medicine, Shaoxing University, Zhejiang 312000 China *Corresponding Auth
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Bibliometric analysis of appropriate traditional Chinese medicine technologies in the intervention of neonatal hyperbilirubinemia LU Xiaosu, ZHANG Lixia, JIANG Lin* Zhongda Hospital Southeast Univ
Construction and validation of a prediction model for postoperative stress ulcer in advanced-age patients with hip fracture LIU Zhebin, ZHANG Yi The Second Affiliated Hospital Zhejiang University
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Qualitative study on the information overload experience and influencing factors in stroke patients LIU Xun 1, TANG Qilan 2*, LIU Shuai 1, ZHANG Miao 1 1. School of Nursing and Health, Zhengzhou Un
Construction of a full-cycle journey map for tumor patients undergoing robotic surgery LI Zonghuan Tianjin Medical University Cancer Institute and Hospital/National Clinical Research Center for Can
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Application of a multidisciplinary digital care strategy in the rehabilitation nursing of patients after lung cancer surgery TU Minzhang, QIAO Min Tongji Hospital, Tongji Medical College, Huazhong
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Effect on the abdominal vibration cupping combined with thermosensitive moxibustion in preventing constipation in patients with spinal osteoporosis fractures DONG Man, LIU Li, ZHOU Yu Zhenjiang In
Path research on the empowerment of nursing micro-specialty construction through discipline-specific artificial intelligence large models LIU Yongbing, HOU Ping, DUAN Pei, TU Jiayuan School of Nur
Trend analysis of adverse events in central sterile supply departments of 44 medical institutions in Hainan province from 2022 to 2024 MA Chanjuan, WANG Wenjun, CAI Qiu, ZHOU Shuping* Hainan Gener