Novel patient-reported outcomes (PROs) used in a pilot and feasibility study of a Cognitive Behavioral Coping Skills (CBCS) group intervention for patients with chronic hepatitis C

Effect of programmed nursing combined with cognitive behavioral intervention on clinical nursing effect and neurological function of patients with intracerebral hemorrhage

OBJECTIVE

To investigate the effect of programmed nursing combined with cognitive behavioral intervention on clinical efficacy and neurological function of patients with intracerebral hemorrhage (ICH).

METHODS

In this retrospective study, 96 patients with ICH admitted to our hospital were enrolled and divided into a programmed group and a joint group, with 48 cases in each group. Patients in the programmed group were treated with programmed nursing while those in the joint group were given cognitive behavior intervention based on programmed nursing, for 28 days. The Fugl-Meyer (FM) Assessment Scale was used to evaluate the motor function of patients, the Barthel index to analyze the activities of daily living (ADL), and the National Institutes of Health Stroke Scale (NIHSS) and Glasgow Outcome Scale (GOS) to assess the neurological function. The quality of life of patients was evaluated by the World Health Organization quality of life Brief Version (WHOQOL-BREF), and the nursing satisfaction of patients or their families was investigated by the self-made satisfaction scale. The incidence of adverse reactions during treatment was recorded and compared.

RESULTS

FM Assessment Scale and Barthel index did not differ significantly between the two groups before nursing (t_Fugl-Meyer =0.059, t_Barthel =0.033, both P>0.05); after nursing, the two scores increased in both groups, with higher scores in the joint group (t_Fugl-Meyer =3.331, t_Barthel =2.735, both P<0.05). Before nursing, there was no difference in NIHSS and GOS scores between the two groups (t_NIHSS =0.257, t_GOS =0.553, both P>0.05); after nursing, however, the NIHSS score decreased and the GOS score increased in both groups, with statistically significant differences between the two groups (t_NIHSS =5.158, t_GOS =5.303, both P<0.05). The total effective rate in the joint group was significantly higher than that in the programmed group (91.67% vs. 77.08%; χ²=4.511, P=0.034). No significant difference was observed in the World Health Organization Quality of Life Scale Brief Version (WHOQOL BREF) score between the two groups (t=0.049, P=0.960) before nursing; after nursing, the score increased significantly in both groups, with a significant difference between the two groups (t=15.970, P<0.001). The satisfaction was 95.83% in the joint group, which was higher than that of 83.33% in the programmed group (χ²=3.913, P=0.048). The joint group also had fewer adverse reactions than the programmed group (χ²=7.401, P=0.007).

CONCLUSION

Programmed nursing combined with cognitive behavioral intervention can improve the clinical efficacy of patients with ICH, improve limb motor ability, and reduce neurological deficits, with high safety.

Utilizing patient perception of group treatment in exploring medication adherence, social support, and quality of life outcomes in people who inject drugs with hepatitis C

People who inject drugs (PWID) have a high prevalence of hepatitis C virus (HCV). Group treatment is a practical option for addressing barriers to treatment in this population. Prior research on group treatment has resulted in mixed conclusions about its effectiveness in addressing barriers to treatment. A patient's perception of the group environment may help to explain this variability. This study sought to explore the association between indicators of group treatment environment and improved outcomes in HCV-infected PWID. This secondary analysis of a randomized controlled trial exploring different models of treatment for HCV in a PWID population consisted of 42 participants randomized to the group treatment branch of the trial. Independent variables consisted of group sessions attended and group climate constructs of engagement, conflict, and avoidance. Dependent variables consisted of medication adherence, social support, and health-related quality of life. The study implemented generalized estimating equations to assess associations with the outcomes at the end of treatment. Factors indicative of group treatment environment were related to medication adherence and other barriers to health for HCV-infected PWID: social support and health-related quality of life. Perceptions of conflict or avoidance were associated with worse outcomes, while increased session attendance was generally associated with better outcomes. The study attests to the importance of examining group environment factors during treatment interventions. Although preliminary, the study provides specific indicators of treatment success for HCV-infected PWID and practical implications to improve patients' health outcomes and better tailor treatment to the patient.

Update on global epidemiology of viral hepatitis and preventive strategies

Viral hepatitis is one of the major public health concerns around the world but until recently it has drawn little attention or funding from global health policymakers. Every year 1.4 million people die from viral hepatitis-related cirrhosis and liver cancer. However, the majority of the infected population are unaware of their condition. This population have significant obstacles to overcome such as lack of awareness, vulnerability, increased migration, disease stigma, discrimination, as well as poor health resources, conflict in policy development and program implementation. Despite implementing infection control measures over the last few decades eradication or significant disease reduction remains elusive. This study aims to present the current global prevalence status and examines potential elimination strategies. The information for this research were obtained through a systematic review, published scientific literatures, the official websites of various government organisations, international public health organisations and internationally recognised regulatory bodies over a period of 40 years between 1978 and 2018.