1
|
Miao X, Guo Y, Ding L, Xu X, Zhao K, Zhu H, Chen L, Chen Y, Zhu S, Xu Q. A dynamic online nomogram for predicting the heterogeneity trajectories of frailty among elderly gastric cancer survivors. Int J Nurs Stud 2024; 153:104716. [PMID: 38412776 DOI: 10.1016/j.ijnurstu.2024.104716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 12/30/2023] [Accepted: 02/02/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Frailty is very common among older people with gastric cancer and seriously affects their prognosis. The development of frailty is continuous and dynamic, increasing the difficulty and burden of care. OBJECTIVES The aims of this study were to delineate the developmental trajectory of frailty in older people with gastric cancer 1 year after surgery, identify heterogeneous frailty trajectories, and further explore their predictors to construct a nomogram for prediction. DESIGN We conducted a prospective longitudinal observation study. Clinical evaluation and data collection were performed at discharge, and at 1, 3, 6, and 12 months. SETTING AND PARTICIPANTS This study was conducted in a tertiary hospital and 381 gastric cancer patients over 60 years who underwent radical gastrectomy completed the 1-year follow-up. METHODS A growth mixture model (GMM) was used to delineate the frailty trajectories, and identify heterogeneous trajectories. A regression model was performed to determine their predictors and further construct a nomogram based on the predictors. Bootstrap with 1000 resamples was used for internal validation of nomogram, a receiver operating characteristic (ROC) curve to evaluate discrimination, calibration curves to evaluate calibration and decision curve analysis (DCA) to evaluate the clinical value. RESULTS GMM identified three classes of frailty trajectories: "frailty improving", "frailty persisting" and "frailty deteriorating". The latter two were referred to as heterogeneous frailty trajectories. Regression analysis showed 8 independent predictors of heterogeneous frailty trajectories and a nomogram was constructed based on these predictors. The area under ROC curve (AUC) of the nomogram was 0.731 (95 % CI = 0.679-0.781), the calibration curves demonstrated that probabilities predicted by the nomogram agreed well with the actual observation with a mean absolute error of 0.025, and the DCA of nomogram indicated that the net benefits were higher than that of the other eight single factors. CONCLUSIONS Older gastric cancer patients have heterogeneous frailty trajectories of poor prognosis during one-year postoperative survival. Therefore, early assessment to predict the occurrence of heterogeneous frailty trajectories is essential to improve the outcomes of elderly gastric cancer patients. Scientific and effective frailty interventions should be further explored in the future to improve the prognosis of older gastric cancer patients. CONTRIBUTION OF THE PAPER STATEMENTS This study constructed a static and dynamic online nomogram with good discrimination and calibration, which can help to screen high-risk patients, implement preoperative risk stratification easily and promote the rational allocation of medical resources greatly. REGISTRATION ClinicalTrials.gov (Number: NCT05982899). TWEETABLE ABSTRACT Our findings identified three frailty trajectories and constructed a nomogram to implement preoperative risk stratification and improve patient outcomes.
Collapse
Affiliation(s)
- Xueyi Miao
- School of Nursing, Nanjing Medical University, Nanjing 211166, China
| | - Yinning Guo
- School of Nursing, Nanjing Medical University, Nanjing 211166, China
| | - Lingyu Ding
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Xinyi Xu
- Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Kang Zhao
- School of Nursing, Nanjing Medical University, Nanjing 211166, China
| | - Hanfei Zhu
- School of Nursing, Nanjing Medical University, Nanjing 211166, China
| | - Li Chen
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Yimeng Chen
- School of Nursing, Nanjing Medical University, Nanjing 211166, China
| | - Shuqin Zhu
- School of Nursing, Nanjing Medical University, Nanjing 211166, China.
| | - Qin Xu
- School of Nursing, Nanjing Medical University, Nanjing 211166, China.
| |
Collapse
|
2
|
Yang J, Li YQ, Gong YL, Yan HL, Chen J, Liu LL, Wu J, Chu J. Benefit finding in individuals undergoing maintenance hemodialysis in Shanghai: a latent profile analysis. Front Psychol 2024; 15:1292175. [PMID: 38500646 PMCID: PMC10946449 DOI: 10.3389/fpsyg.2024.1292175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 02/07/2024] [Indexed: 03/20/2024] Open
Abstract
Objective This multi-center cross-sectional study aimed to delineate latent profiles of benefit finding (BF) in individuals undergoing maintenance hemodialysis (MHD) in Shanghai and examine associations between these BF profiles, social support, and coping style. Methods A total of 384 individuals undergoing MHD (mean age = 57.90, SD = 13.36) were assessed using the Benefit Finding Scale, Simplified Coping Style Questionnaire, and Perceived Social Support Scale. Latent profile analysis (LPA) identified distinct BF categories. Analysis of variance (ANOVA) evaluated the correlation between BF groups and demographic variables, while the relationship between BF, social support, and coping style was tested through correlation and multiple regression analyses. Results LPA identified three BF groups: rich BF (54.17%), moderate BF (41.14%), and poor BF (4.69%). Regression analyses indicated that positive coping and social support are protective factors for BF. Additionally, older age and heightened understanding of MHD correlated with higher BF levels. Conclusion The findings highlighted the importance of recognizing different BF profiles in individuals on MHD and working toward promoting BF levels in the rich BF and moderate BF groups, while helping the poor BF group to identify and address their challenges. Medical professionals should consider interventions tailored to individual psychological profiles to improve mental health and quality of life outcomes in this population.
Collapse
Affiliation(s)
- Jie Yang
- School of Nursing, Naval Medical University, Shanghai, China
| | - Yong-qi Li
- School of Nursing, Naval Medical University, Shanghai, China
| | - Yan-lin Gong
- School of Nursing, Naval Medical University, Shanghai, China
| | - Hong-li Yan
- School of Health Services Management, Southern Medical University, Guangzhou, China
| | - Jing Chen
- Department of Nephrology, Shanghai Chang Zheng Hospital, Shanghai, China
| | - Ling-ling Liu
- Department of Nephrology, Shanghai Chang Zheng Hospital, Shanghai, China
| | - Jing Wu
- School of Nursing, Naval Medical University, Shanghai, China
| | - Jing Chu
- School of Nursing, Naval Medical University, Shanghai, China
| |
Collapse
|
3
|
Cui Y, Yang T, Li R, Wang H, Jin S, Liu N, Liu X, Liu H, Zhang Y. Network structure of family function and self-management in patients with early chronic kidney disease amid the COVID-19 pandemic. Front Public Health 2023; 10:1073409. [PMID: 36703816 PMCID: PMC9871502 DOI: 10.3389/fpubh.2022.1073409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/23/2022] [Indexed: 01/11/2023] Open
Abstract
Background Family function plays a pivotal role in self-management among patients with early chronic kidney disease (CKD), which has been especially important during the COVID-19 pandemic. Previous studies have investigated the relationships between family function and self-management using total scores through self-report questionnaires while ignoring the different components in both family function and self-management. The specific objective of this study was to explore the network structure of family function and self-management at the component level. Methods A total of 360 patients with early CKD from three tertiary hospitals were enrolled in our cross-sectional survey from September to December 2021 in China. Components of family function were measured by the Family Adaptation Partnership Growth and Resolve Index, and components of self-management were measured by the Chronic Kidney Disease Self-management Instrument. Network analysis was used to establish the network structure. Results Edges across the community of family function and self-management were mainly positive. Edges between F3 "Growth" and M1 "Self-integration", F2 "Partnership" and M3 "Seeking social support," F5 "Resolve" and M3 "Seeking social support" were the strongest. F3 "Growth" had the greatest positive bridge expected influence of family function community (0.12), and M3 "Seeking social support" had the greatest positive bridge expected influence of self-management community (0.16). Conclusion We explored the potential pathways between different components of family function and self-management among patients with early CKD during the COVID-19 pandemic and found fine-grained relationships between them. The two nodes F3 "Growth" and M3 "Seeking social support" may provide a new idea from the perspective of family function for interventions to improve self-management.
Collapse
Affiliation(s)
- Yi Cui
- Department of Nursing, Air Force Medical University, Xi'an, China
| | - Tianqi Yang
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Rong Li
- Department of Nephrology, The First Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Hua Wang
- Department of Nephrology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Shasha Jin
- Department of Nephrology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Na Liu
- Department of Nursing, Air Force Medical University, Xi'an, China
| | - Xufeng Liu
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China,*Correspondence: Xufeng Liu ✉
| | - Hongbao Liu
- Department of Nephrology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China,Hongbao Liu ✉
| | - Yinling Zhang
- Department of Nursing, Air Force Medical University, Xi'an, China,Yinling Zhang ✉
| |
Collapse
|
4
|
Yuhuan Z, Pengyue Z, Dong C, Qichao N, Dong P, Anqi S, Hongbo J, Zhixin D. The association between academic stress, social support, and self-regulatory fatigue among nursing students: a cross-sectional study based on a structural equation modelling approach. BMC MEDICAL EDUCATION 2022; 22:789. [PMID: 36376814 PMCID: PMC9664672 DOI: 10.1186/s12909-022-03829-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Emphasizes the state of academic stress, social support, and self-regulatory fatigue on the physical and mental development of Chinese nursing students, the purpose of this study was to investigate the relationship between these variables and the mediating role of social support in academic stress and self-regulatory fatigue among a group of undergraduate nursing students in Heilongjiang Province, China, in order to provide a theoretical basis for working to reduce nursing students' self-regulatory fatigue. METHODS In this cross-sectional study, 1703 nursing students from various academic years completed the scales of social support, academic stress, and self-regulatory fatigue. In the end, there were 797 valid questionnaires, for a recovery rate of 46.80%. For statistical analysis, the independent t-test, Kruskal Wallis test, and Pearson correlation coefficient were used. In addition, we undertake analyses using structural equation modeling. RESULTS The bulk of nursing students, or 81.4%, are between the ages of 19 and 21. Eighty percent were females. The bulk (93.0%) was comprised of freshmen. Academic stress, social support, and self-regulatory fatigue had total scores of 111.28 ± 29.38, 37.87 ± 6.70, and 45.53 ± 5.55,respectively. Academic stress was correlated with social support and self-regulatory fatigue (all p < 0.001). Social support was an intermediate variable (p < 0.001), with an intermediate effect value of 0.122, representing 32.35% of the total effect. CONCLUSION Academic pressure is associated with an increase in self-regulatory fatigue, mediated by social support. Educational administrators should pay attention to the social support and resource supplement of nursing students, the adjustment and compensatory development of nursing students' physical and mental resources, the advancement of nursing students' internal resource adjustment, and the reduction of their self-regulatory fatigue.
Collapse
Affiliation(s)
- Zhang Yuhuan
- The Second Affiliated Hospital of Harbin Medical University, Student Department, Internship Researcher, 246 Xuefu Road, Heilongjiang Province Harbin, 150086 China
| | - Zheng Pengyue
- Heilongjiang University of Chinese Medicine, 24 Heping Road, Harbin, Heilongjiang Province 150040 China
| | - Chen Dong
- Heilongjiang Nursing College, Advanced Practice Nurse, Comprehensive Department of Nursing Education and Research, 209 Xuefu Road, Harbin, Heilongjiang Province 150086 China
| | - Niu Qichao
- Student Department, the Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Harbin, Heilongjiang Province 150086 China
| | - Pang Dong
- Department of Neurology, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Harbin, Heilongjiang Province 150086 China
| | - Song Anqi
- Student Department, the Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Harbin, Heilongjiang Province 150086 China
| | - Jiang Hongbo
- Student Department, the Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Harbin, Heilongjiang Province 150086 China
| | - Di Zhixin
- Department of Ultrasound Medicine, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Harbin, Heilongjiang Province 150086 China
| |
Collapse
|
5
|
Lyu W, Tanaka T, Son BK, Akishita M, Iijima K. Associations of multi-faceted factors and their combinations with frailty in Japanese community-dwelling older adults: Kashiwa Cohort Study. Arch Gerontol Geriatr 2022; 102:104734. [DOI: 10.1016/j.archger.2022.104734] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 04/29/2022] [Accepted: 05/11/2022] [Indexed: 12/31/2022]
|
6
|
Guo Y, Tian R, Ye P, Luo Y. Frailty in Older Patients Undergoing Hemodialysis and Its Association with All-Cause Mortality: A Prospective Cohort Study. Clin Interv Aging 2022; 17:265-275. [PMID: 35313671 PMCID: PMC8934156 DOI: 10.2147/cia.s357582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 03/04/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The study aimed to determine the prevalence and risk factors of frailty among a Chinese cohort of hemodialysis patients and to assess the degree to which frailty was associated with all-cause mortality. Participants and Methods We enrolled a group of older adults (≥60 years old) in a prospective cohort study of cognitive impairment in Chinese patients undergoing hemodialysis (registered in Clinical Trials.gov, ID: NCT03251573). We assessed the prevalence of frailty using Fried’s definition in the Cardiovascular Health Study, then we evaluated the associated risk factors of frailty using multivariate logistic regression analysis. Finally, we assessed the association of frailty and all-cause mortality with multivariable Cox proportional hazard regression analyses. Results The prevalence of frailty in these 204 enrolled hemodialysis patients was 72.1%. Patients with frailty were more inclined to have composite abnormal components that included poor physical functioning, exhaustion, low physical activity, and undernutrition. Multivariable logistic regression analysis suggested that increased age, female gender, history of diabetes, longer dialysis vintage, lower Kt/V, lower serum level of albumin concentrations, and increased serum iPTH concentrations were independently associated with frailty. Cox regression analysis indicated that frailty as a dichotomous construct was strongly associated with an increased risk of mortality (HR 6.092, 95% CI 1.886–19.677, P = 0.003) in unadjusted analyses. After adjusting (Model I = no adjusted; II = adjusted for age, gender; III = adjusted for age, gender, history of diabetes; IV = adjusted for all covariates associated at the p ≤ 0.10 level with death in unadjusted analyses, including age, history of diabetes, MoCA<26, single-pool Kt/V, and the levels of albumin and iPTH), the association was slightly affected but observed consistent as before. Conclusion Frailty is extremely common and is associated with serious clinical outcomes among older hemodialysis patients. Based on those clinical features of frailty, future studies should focus on exploring effective interventions aimed to prevent or attenuate frailty in the older hemodialysis population.
Collapse
Affiliation(s)
- Yidan Guo
- Division of Nephrology, Beijing Shijitan Hospital, Capital Medical University, Bejing, People’s Republic of China
| | - Ru Tian
- Division of Nephrology, Beijing Shijitan Hospital, Capital Medical University, Bejing, People’s Republic of China
| | - Pengpeng Ye
- Division of Injury Prevention and Mental Health National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Yang Luo
- Division of Nephrology, Beijing Shijitan Hospital, Capital Medical University, Bejing, People’s Republic of China
- Correspondence: Yang Luo, Email
| |
Collapse
|