Journal of Multidisciplinary Healthcare最新文献

Background: Sepsis-induced coagulopathy (SIC) is a critical determinant of organ dysfunction and mortality in patients with sepsis. While research in this field is rapidly expanding, a comprehensive, quantitative analysis of its knowledge landscape is lacking. This study aims to conduct a bibliometric analysis to delineate the global research status, identify thematic hotspots, and reveal emerging frontiers in the field of SIC from 2000 to 2024.

Methods: We retrieved publications related to SIC from the Web of Science Core Collection (WoSCC), with the final search conducted on May 27, 2025. Only original English-language 'Articles' were included. Bibliometric analysis and knowledge mapping were performed using VOSviewer (v1.6.18) and CiteSpace (v6.2.R6) to analyze countries, authors, journals, co-cited references, and keywords.

Results: A total of 1715 publications were included. The annual publication volume showed an exponential growth trend, particularly after 2020. The United States was the leading country in publication output (471 articles, 27.5%), and Critical Care Medicine was the most productive journal (106 articles). The PROWESS trial published by Bernard GR et al (2001) was the most co-cited foundational document with 4,188 co-citations. Keyword analysis identified four major research clusters: (1) Pathophysiological Mechanisms and Endothelial Injury, (2) Diagnostic Biomarkers and Prognostic Assessment, (3) Anticoagulant Therapy and Clinical Management, and (4) Immunothrombosis and Neutrophil Extracellular Traps (NETs).

Conclusion: Over the past two decades, research on SIC has evolved from exploring fundamental coagulation pathways to investigating the intricate mechanisms of immunothrombosis. Current research hotspots focus on endothelial injury, NETs, and the development of precise diagnostic and therapeutic strategies. This analysis provides a quantitative map of the knowledge structure and emerging trends in the SIC field, offering a valuable reference for future research priorities.

Background: A common challenge in health education for older surgical patients is poor memory, which hinders the processing of health information. Structured educational materials have been shown to be effective in improving information retention, but there remains a paucity of materials specifically designed to address the cognitive and sensory characteristics of older adults.

Objective: To evaluate the effect of an adapted education booklet based on cognitive load theory and older adults' preferences on the memory of health information in older surgical adults experiencing benign prostatic hyperplasia (BPH).

Methods: A randomized controlled trial was conducted at a tertiary hospital from January to February 2025. Sixty-four older adults scheduled for BPH surgery were randomly divided into an intervention group (n=32, using an adapted education booklet) and a control group (n=32, using conventional education materials). Both groups received standard perioperative education. Health information recall was evaluated using a standardized questionnaire on the day before discharge. Secondary outcomes included satisfaction with nursing care and the nurse's support for the booklet.

Results: There were no differences between the two groups in terms of age, body mass index, educational attainment, monthly personal income, and length of hospital stay. Adults in the intervention group demonstrated superior recall of health information and nursing satisfaction compared to the control group (P < 0.001). Over 85% of nurses believed that the booklet did not increase their workload, improved nurse-adult communication, and expressed support for its clinical application.

Conclusion: Adapting an education booklet based on cognitive load theory and older adult preferences can significantly improve health information recall and satisfaction among older adults experiencing BPH. High acceptance among nurses suggests that this intervention has potential for clinical application. This simple, easy-to-administer, and inexpensive method of patient education could be extended to other areas of geriatric surgical education.

Introduction: Chronic disease is a considerable public health concern in Saudi Arabia, as it affects the healthcare system and requires innovative healthcare solutions. Virtual Home Health Care (VHHC) has emerged as a promising approach in managing chronic diseases. This study aims to analyze the effectiveness of VHHC in managing chronic diseases from patients' perspectives in Saudi Arabia.

Methods: This study used a cross-sectional design and a convenience sample of 517 patients with chronic diseases from various regions of Saudi Arabia (Eastern, Western, Central, Southern, and Northern Regions) who are current or former VHHC users were participated. An online, self-administered questionnaire was employed to gather patients' demographic information, chronic disease status, experiences with VHHC, and evaluations of VHHC's effectiveness.

Results: The study revealed that the age group of 25 to 35 years represents the largest segment (39.5%) of participants, with 70% being female. The majority of participants (60.9%) held a bachelor's degree. Additionally, half of the participants (57.4%) have had a chronic illness for more than five years. Overall, respondents held a relatively positive opinion (weighted mean of 3.89 ± 0.710) of VHHC's effectiveness. Also, the results showed that disease duration and education level are significant predictors of VHHC effectiveness, according to the regression analysis, with disease duration exerting the greatest influence (B = 0.134, p = 0.034).

Conclusion: Virtual home healthcare is a convenient experience for most participants, who are mostly satisfied with such services. However, some areas still need more improvement, which requires tailored strategies and initiatives to enhance health literacy, which is a significant predictor of effectiveness in the current study among patients with chronic diseases among patients with chronic diseases.

Purpose: Chronic heart failure (CHF) impairs heart function and affects patients' well-being, while cardiac rehabilitation (CR) improves outcomes. In this cross-sectional survey, we assessed knowledge, attitudes, and practices (KAP) related to CR in patients with CHF and their family caregivers.

Patients and methods: A cross-sectional survey was conducted at Heping Hospital, affiliated with Changzhi Medical College, from July 1 to October 10, 2024. Data were collected using questionnaires that included demographic information and evaluations of KAP scores. A total of 500 questionnaires were distributed to eligible participants.

Results: Of the 500 questionnaires distributed, 492 valid responses were obtained, yielding a response rate of 98.4%. Among the respondents, 277 (56.3%) were patients, with 191 (38.8%) aged 60 or older. The mean knowledge, attitude, and practice scores were 6.90 ± 5.63 (range: 0-30), 33.43 ± 3.31 (range: 9-45), and 28.01 ± 4.46 (range: 8-40), respectively. Multivariate logistic regression analysis identified several factors associated with proactive practice: knowledge score (OR = 1.114, 95% CI: [1.053, 1.179]), college degree (OR = 3.089, 95% CI: [1.054, 9.053]), absence of medical insurance (OR = 6.762, 95% CI: [3.597, 12.713]), no family history of heart issues (OR = 4.414, 95% CI: [2.351, 8.288]), and non-participation in CR (OR = 0.206, 95% CI: [0.087, 0.489]). The SEM results showed that knowledge directly affected attitude (β = 0.321, p < 0.001) and practice (β = 0.285, p = 0.004), and attitude directly affected practice (β = 0.217, p < 0.001). Additionally, knowledge indirectly affected practice through attitude (β = 0.355, p < 0.001).

Conclusion: Patients with CHF and their families showed insufficient knowledge but positive attitudes and proactive practices regarding CR. Targeted educational interventions are recommended to improve knowledge, particularly for younger patients and those without prior CR training, to enhance rehabilitation effectiveness.

Objective: To explore diabetes specialist nurses' perceptions of traditional Chinese medicine, their clinical practice experiences, and feedback on the teaching model.

Methods: The study conducted semi-structured qualitative interviews with 21 diabetes specialist nurses who were trained in traditional Chinese medicine nursing, using purposeful sampling. Data were analyzed using traditional content analysis. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist for qualitative research was used.

Results: Three themes were distilled: A layer-by-layer deepening of traditional Chinese medicine perception, clinical practice experience of traditional Chinese medicine nursing in diabetes and feedback on teaching traditional Chinese medicine clinical practice to diabetes specialist nurses.

Conclusion: The province's diabetes specialist nurse base training program, integrating Chinese and Western medicine, has enhanced the knowledge of traditional Chinese medicine nursing among specialist nurses and is highly regarded for its clinical practice experience. It also promotes the dissemination of traditional Chinese medicine culture. However, further optimization, such as extending the duration of clinical practical training in traditional Chinese medicine nursing for diabetes, is needed to meet the demand for high-quality training of diabetes specialist nursing personnel integrating Chinese and Western medicine.

Purpose: This study aimed to develop and assess the impact of a pharmacist-led, technology-supported venous thromboembolism (VTE) management program on improving VTE prophylaxis and incidence in patients undergoing orthopaedic surgery.

Patients and methods: This was a retrospective, observational study with a pre-post design conducted in the trauma and joint ward of the Orthopaedic Department of a tertiary hospital in Chongqing, China. Surgical patients were included from the period before (December 2022 to May 2023) and after (June to November 2023) the implementation of pharmacist-led VTE management program (PL-VTEMP), in which pharmacists conducted standardized VTE risk verification and proactive medication monitoring. Primary endpoints included VTE incidence and prophylactic pharmacotherapy rate. Multivariable logistic regression was used to adjust for potential confounders, along with an E-value analysis to assess robustness to unmeasured confounding.

Results: In total, 651 participants were included (322 in the pre-program group and 329 in the post-program group). Following the implementation of pharmacist-led VTE management program, the incidence of VTE decreased significantly (7.8% vs 2.7%, p = 0.004) and the proportion of patients receiving pharmacological prophylaxis increased significantly among high-risk patients in the post-program group (51.6% vs 33.9%, p < 0.01). The pharmacist-led VTE management program was identified as a protective factor for VTE prevention in multivariate regression model (OR 0.223, 95% confidence interval [CI] 0.093-0.535). Despite the average duration of drug prophylaxis not significantly increased to match guideline recommendations (7.18 days vs 6.80 days, p > 0.05), the proportion of patients receiving oral sequential anticoagulants had risen (29.4% vs 2.3%, p < 0.001). No significant differences were observed in the incidence of bleeding.

Conclusion: This study demonstrated the benefits of pharmacist-led VTE management program as thromboprophylaxis in patients undergoing orthopaedic surgery. Clinical pharmacists have the potential to be core members of the VTE management team.

Background: Osteoporosis is a progressive bone condition characterized by the erosion of bone mineral density and weakening of bones. A vast volume of clinical research experimental data on osteoporosis has been published in the last 12 years. These studies are mainly focused on clinical observations, animal experiments, and investigations into pathways and targets. However, this information remains disjointed with scarce systematic reviews and comprehensive analyses.

Material and methods: The Web of Science Core Collection (WoSCC) and PubMed databases were utilized to retrieve relevant osteoporosis literature. Publication volume, journal, authors, keywords, countries, and institutions were bibliometrically and visually analyzed using Citespace 6.3.R3 software, Microsoft Excel 2019, and VOSviewer 1.6.18.0.

Results: There have been 10,343 published reviews and research articles on osteoporosis by 45,966 researchers from 9,462 institutions across 102 countries or regions. Annual publications have been on the rise, particularly in the last few years. The United States, Japan, and China are among the nations involved in this research area. Guangzhou University of Chinese Medicine, and Soochow University are prominent research institutions. Osteoporosis International journal had the most publications and the most cited. Cooper Cyrus was the leading author with a significant volume of publications, while Kanis Ja was noted for having a substantial number of co-citations. An analysis of keywords showed that bone-mineral density, postmenopausal women, and fracture had higher frequencies, leading to thirteen clusters.

Conclusion: Recent research hotspots in osteoporosis are centered on accurate diagnosis, understanding the disease's pathogenesis, and developing effective, scientific prevention and treatment strategies.

This review systematically analyzes the current status and characteristics of caregiver empowerment interventions for post-stroke incontinence (PSI) globally, with a focus on Chinese and international practices. Key research dimensions include: the types, manifestations, and impacts of caregiver burden; the classification and implementation features of empowerment intervention models; the effectiveness of evidence-based empowerment nursing strategies; and emerging development trends in this field. The findings reveal that PSI caregivers commonly face multi-dimensional burdens, which significantly impair their quality of life and long-term caregiving sustainability. Empowerment-oriented nursing interventions have shown consistent positive effects in improving caregivers' care competence, reducing care-related stress, and enhancing the quality of PSI care. However, three critical limitations persist: the absence of unified standardized intervention protocols, large variability in the selection and application of caregiver/patient assessment tools, and insufficient long-term outcome evaluations. Future research should prioritize three directions: developing personalized intervention frameworks tailored to caregiver burden types and patient incontinence severity; constructing integrated multidisciplinary collaboration models; and promoting the application of digital health tools to address time/geographic barriers. Additionally, greater attention should be paid to strengthening caregivers' mental health support systems and optimizing social assistance mechanisms. This review provides a solid theoretical basis and practical strategic references for guiding subsequent research on PSI caregiver empowerment and promoting the translation of research findings into clinical and community practice.

Objective: This study assesses the safety and precision of percutaneous vertebroplasty (PVP) for thoracolumbar osteoporotic fractures using 3D printing and intraoperative CT guidance.

Methods: This retrospective cohort study included 100 patients with thoracolumbar osteoporotic fractures who underwent PVP from January 2020 to December 2022. Preoperative CT scans were used to create 3D printed models for surgical planning and simulation. Intraoperative CT was employed post-needle insertion and pre-cement injection for accuracy verification. Outcomes were measured using the visual analog scale (VAS) for pain, Oswestry disability index (ODI) for functionality, and assessments of vertebral height and kyphotic angle. Complications recorded included cement leakage, nerve injury, and adjacent vertebral fracture. Subgroup analysis was performed to compare outcomes between thoracolumbar and lumbar fractures.

Results: Average operation time was 35.6 ± 8.4 minutes, and fluoroscopy time was 12.3 ± 3.7 seconds. Intraoperative CT confirmed precise needle placement, with no occurrences of cement leakage or nerve injury. VAS scores improved from 8.2 ± 1.5 preoperatively to 2.1 ± 0.9 postoperatively, and ODI scores from 72.3 ± 9.8% to 18.4 ± 6.7%. Subgroup analysis showed no significant differences in clinical or radiographic outcomes between thoracolumbar and lumbar groups, although a higher cement volume was used in lumbar vertebrae (3.6 vs 2.8 mL, p<0.001). There was significant post-surgical restoration and maintenance of vertebral height and kyphotic angle, with no adjacent vertebral fractures reported.

Conclusion: PVP using 3D printing and intraoperative CT for thoracolumbar osteoporotic vertebral fractures is safe, accurate, and effective in pain relief, functional improvement, and vertebral morphology restoration. The 3D models enhance surgical planning, while intraoperative CT provides real-time feedback for needle and cement placement.

Purpose: This study assessed attitudes and perception of medicine, dental, pharmacy and nursing students toward their first interprofessional education (IPE), compared interprofessional attitudes scores with demographic characteristics, and evaluated session feedback to identify areas for improvements.

Methods: A mixed method study was conducted among healthcare students participating in an introductory IPE session. The interprofessional attitudes Scale (IPAS) was administered pre-session to evaluate baseline attitudes. Post-session, quantitative feedback was collected and analyzed using non-parametric tests (Mann-Whitney U, Kruskal-Wallis). Quantitative data were obtained through structured discussions with nine facilitators (Medicine/Dentistry/Pharmacy), recorded and analyzed until thematic saturation was reached.

Results: Among 218 respondents (Dentistry 30%, Nursing 25.3%, Medicine 22.6%, Pharmacy 21.2%), 88% had no prior IPE exposure. Median IPAS scores were positive (IQR-5), with significant variations by discipline, cumulative GPA, and academic year (p<0.001). Post session, the "community-Centeredness" domain showed significant improvement (p<0.001). Student feedback (n=131) yielded median satisfactory scores of 52 (IQR 48-55), with prior IPE exposure influencing perceptions (p<0.05). Facilitators acknowledged IPE's value but identified key areas for enhancement: pre-session team-building to improve engagement, structured facilitator training for clearer role definition, more balanced clinical case designs to ensure equitable participation, incorporation of visual/high-fidelity simulation elements and stronger integration into core curricula.

Conclusion: Both students and facilitators perceive IPE positively, reinforcing its role in fostering collaborative practice readiness. The significant improvement in community-centered attitudes and overall satisfaction support IPE implementation across healthcare programs. However, optimizing its impact requires addressing critical gaps particularly in facilitators preparation, session design, and curricular alignment. This research provides a conceptual framework and methodological outline to initiate IPE sessions within the university and elsewhere in the country and the region.