Journal of Multidisciplinary Healthcare最新文献

Intensive care unit-acquired weakness (ICU-AW) is a common complication in critically ill patients, associated with multiple risk factors and significantly impacting long-term patient outcomes. Currently, early diagnosis remains a key challenge in managing ICU-AW: clinical scales are limited by subjectivity, while muscle ultrasound and emerging biomarkers (such as the creatinine/cystatin C ratio, miR-451a, and MuRF1), though showing potential for early identification, have not yet been widely adopted in clinical practice. In terms of management, prevention is paramount. The ABCDEF bundle emphasizes early mobilization (initiated within 24-72 hours), while nutritional strategies targeting molecular pathways (such as HMB and ω-3 fatty acids) help regulate protein metabolism balance. Novel targeted therapies (eg, the myostatin inhibitor Bimagrumab) have demonstrated potential to increase muscle mass in clinical trials. Currently, early diagnosis remains the critical barrier. This review aims to synthesize the latest evidence on the risk factors, diagnostic challenges, and management strategies for ICU-AW, providing insights for clinical practice. It also underscores the need for future research to focus on developing highly sensitive diagnostic tools, optimizing preventive strategies, and promoting the clinical translation of targeted therapies. Ultimately, this will help establish a comprehensive and precise multi-level intervention framework to improve patient outcomes.

Objective: The demand for mortality-related education among hospice care providers in China remains high; however, the overall level of death literacy in China is comparatively low. Given that nurses constitute the primary workforce in hospice and palliative care delivery, enhancing nursing education in death literacy is essential for the effective implementation of related services.

Methods: A Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis was conducted to examine the internal advantages and limitations, as well as external opportunities and challenges, associated with death literacy nursing education in China.

Results: The strengths lie in the strong policy support for healthcare and the advancement of palliative care pilot programs, as well as the growing demand for palliative and end-of-life care accompanied by the successful localization of international experience. The weaknesses include limited educational and faculty resources, a shortage of qualified professionals and institutions, and persistent cultural taboos and traditional moral barriers that hinder development in this field. The opportunities are from shifting public awareness toward end-of-life care, increased international collaboration, and the adoption of more diverse and innovative teaching methods. The threats involve the uneven distribution of medical resources, growing industry competition and talent loss, the complexity of legal, regulatory, and ethical issues, and the continuing challenges of achieving effective interdisciplinary collaboration.

Conclusion: This study is the first to systematically apply SWOT analysis to provide empirical evidence for the strategic planning of death literacy education in nursing in China. It suggests that to improve death literacy nursing education in China, it is recommended to enhance policy implementation, incorporate international best practices, and promote the integration of intelligent technologies and interdisciplinary collaboration. These efforts should aim to extend educational outreach and resource accessibility to community-level and primary care settings. These strategic initiatives are expected to directly enhance nurses' communication and care competence at the end of life, thereby improving patients' quality of life in their final stages and advancing the goals of the Healthy China 2030 initiative in the field of palliative care.

Hepatocellular carcinoma (HCC) remains one of the most common malignancies worldwide. Its high aggressiveness and complex pathophysiology contribute to diverse but often suboptimal treatment outcomes. The Multidisciplinary Team (MDT) integrates expertise from various specialties to provide personalized and optimal treatment strategies for individual patients. However, conventional MDT face limitations related to logistics, consensus-building, and patient communication. This review aims to discuss the current status and challenges of MDT in liver cancer management and explore emerging innovative technologies that can transcend the conventional model.

Objective: This study aims to investigate the cognition and application status of DeepSeek among surgical medical staff in Class III Grade A hospitals and analyse its influencing factors to optimise its clinical application.

Methods: From February to March 2025, a questionnaire survey was conducted among 440 surgical medical staff from Class III Grade A hospitals in 18 provinces in China by a convenience sampling method. The questionnaire covered, among others, basic information, cognition and use status, attitudes and barriers and training needs, and also evaluated the degree of understanding, user experience (operation convenience, results accuracy, system stability) and degree of trust concerning DeepSeek. The SPSS 25.0 software was used for data analysis, which included frequency, percentage, Mann-Whitney U-test, Kruskal-Wallis H-test and multivariate ordinal logistic regression analysis.

Results: A total of 424 valid questionnaires were collected (96.4%). The results indicated that 67.0% of the medical staff understood the basic functions of DeepSeek, and 70.3% used DeepSeek occasionally. It was mainly used for teaching and research support (43.2%), other life services (35.6%) and patient services (29.2%). Multivariate analysis showed that medical staff working in operating rooms and neurosurgery departments, those who were occasional users, and medical staff who primarily used DeepSeek for other life services demonstrated significantly higher levels of knowledge about DeepSeek.

Conclusion: Despite widespread awareness of DeepSeek's capabilities (67.0% understanding basic functions), significant implementation gaps persist, with limited clinical utilisation and predominant usage in low-risk applications. Key barriers include insufficient training (94.8% untrained), data privacy concerns (57.5%) and over-reliance fears (58.5%). These findings reveal a substantial untapped potential for AI integration in surgical practice, highlighting critical needs for targeted training interventions, enhanced data security frameworks and staged implementation protocols to bridge the awareness-utilisation gap and facilitate meaningful clinical adoption.

Purpose: Lower limb dysfunction is a common and debilitating consequence of stroke, significantly compromising patients' quality of life. This mini-review synthesizes clinical research on acupuncture for post-stroke lower limb dysfunction over the past five years, integrating traditional Chinese medicine (TCM) theories and modern evidence.

Methods: The review analyzed clinical studies and TCM theoretical perspectives. TCM attributes stroke pathogenesis to Yin-Yang disharmony, Qi-blood imbalance, and complex interactions of wind, phlegm, fire, stasis, and toxin.

Results: Acupuncture therapies, including body acupuncture, electroacupuncture, abdominal acupuncture, scalp-body acupuncture, specific acupoint stimulation, moxibustion, and combined techniques, demonstrate significant efficacy in improving motor coordination, reducing muscle tone, and enhancing voluntary movement. Mechanistically, acupuncture regulates cerebral blood flow, reduces ischemic-reperfusion injury, modulates neuroinflammation, and promotes neural regeneration. Clinical studies show that these approaches effectively alleviate symptoms, with total effective rates ranging from 70% to 95.5%.

Conclusion: Acupuncture shows considerable potential for post-stroke lower limb dysfunction, likely exerting effects through modulation of cerebral blood flow, neuroinflammation, oxidative stress, and neural plasticity. However, challenges remain, including the lack of standardized acupoint selection protocols, stimulation parameters, large multicenter trials, and in-depth mechanistic research.

Objective: To explore the effects of mindfulness meditation on core attention-deficit hyperactivity disorder (ADHD) symptoms, family functioning and social functioning in young children.

Methods: A convenience sample of 43 children aged 6-9 years who met the inclusion and exclusion criteria was recruited at our hospital between 3 June and 3 July 2024. Participants were randomly assigned to an intervention group (22 cases) or a control group (21 cases). The intervention group received family mindfulness meditation combined with medication, whereas the control group received medication alone. Relevant indicators were collected and compared before and after the intervention.

Results: Compared with pre-intervention, the intervention group showed significant improvements in: Life Skills and Risk-Taking Activities (Weiss-P Functional Defect Scale); Conduct Problems and Psychosomatic Problems (Conners Parent Symptom Questionnaire, PSQ); and Attention-Visual Function (Integrated Visual and Auditory Continuous Performance Test, IVA-CPT). In contrast, the control group only improved significantly in Hyperactivity-Impulsivity (SNAP-IV Scale) and Psychosomatic Problems (PSQ). Post-intervention, the intervention group improved more in PSQ's Conduct Problems and Psychosomatic Problems than the control group. However, the control group had no significant changes in most scale scores vs baseline, except Inattention (SNAP-IV) and Response Control (IVA-CPT).Medication subgroup analysis showed: vs pre-intervention, the intervention group improved significantly in PSQ's Conduct Problems and Psychosomatic Problems (with significant time×group interactions); the control group had no significant changes in these indicators.Additionally, ANCOVA (controlling gender/age) for Weiss-P's Self-Management showed: the intervention group's pre-post score difference was statistically significant, while the control group only had a marginally significant increase. Mixed ANOVA confirmed significant time×group interactions for Weiss-P's Life Skills and Risk-Taking Behavior, PSQ's Conduct Problems, and IVA-CPT's Response Control.

Conclusion: Simplified mindfulness meditation improves core ADHD symptoms and family functioning, and concurrent medication may influence its efficacy.

Purpose: Home medical care has emerged globally as an effective approach to addressing the medical and care needs of disabled older adults due to its comfort, convenience, and cost-effectiveness. Understanding the utilization and demand for home medical care services among this population is a key area. This study aims to analyze the utilization and demand for these services among disabled older adults in China.

Patients and methods: The data for this study were drawn from national-level data from the 2018 China Longitudinal Healthy Longevity Survey (CLHLS) and a household survey conducted in Beijing, the capital of China, in 2024. Descriptive analyses were employed to examine the utilization and demand for home medical care services among disabled older adults, while chi-squared tests and logistic regression models were used to identify factors associated with these outcomes.

Results: Based on data from 3278 disabled older adults in the CLHLS dataset, which consists of a total of 15874 records, the utilization rate of home medical care services was highest in the Eastern region, while the demand rate exceeded 85% in each regions. Data from the household survey of 958 patients in Beijing indicated that the top three service categories with the largest gaps between utilization and demand were medication treatment, traditional Chinese medicine treatment, and rehabilitation nursing, which the mismatch gap reached 17.7%, 17.6%, and 15.5%, respectively. Region and residential area significantly influenced the utilization for these services, while residential area and age impacted demand.

Conclusion: Currently, home medical care services in China are characterized by a limited range of offerings and a mismatch between utilization and demand. It is recommended that the home medical care service system be further optimized to ensure a more balanced distribution of medical and healthcare resources.

Varicose veins are a common vascular condition with diverse types, including great saphenous vein varices, varicocele, pelvic varices, and rectal varices, each presenting distinct clinical challenges. In this study, we present a narrative review based on a structured literature search to compare the nursing strategies for these varicose vein types, highlighting their effectiveness, limitations, and implications for clinical practice.Relevant literature was systematically reviewed to evaluate current nursing approaches for different varicose vein types. The review focused on common interventions such as compression therapy, postoperative care, psychological support, and lifestyle modifications, as well as specific challenges associated with each type.Compression therapy is highly effective for great saphenous vein varices, while postoperative care is critical for varicocele, particularly in preventing recurrence and preserving fertility. Multidisciplinary approaches are essential for managing pelvic varices and alleviating chronic pelvic pain. Rectal varices benefit from dietary adjustments and wound care to reduce bleeding risks. Differences in patient compliance, psychological burden, and cost-effectiveness were also observed, influencing the success of nursing strategies.Tailored nursing strategies based on the specific characteristics of each varicose vein type are essential for optimizing patient outcomes. Further research is needed to refine these strategies and develop innovative nursing solutions to address current gaps in care. Thus, nurses should adopt evidence-based, patient-centered approaches that enhance care quality and promote long-term recovery.

Objective: To investigate the clinical efficacy of combined auricular acupoint pressing and intradermal acupuncture in elderly patients with type 2 diabetes mellitus and insomnia.

Methods: A retrospective study selected 122 such patients, divided into a control group (60 patients with basic diabetes treatment) and an observation group (62 patients with basic treatment plus auricular acupoint pressing and intradermal acupuncture). Pittsburgh Sleep Quality Index (PSQI), quality of life assessment, blood glucose, glycated hemoglobin, and serum indicators including 5-hydroxytryptamine (5-HT), brain-derived neurotrophic factor (BDNF), and norepinephrine (NE) were measured. Statistical analysis was done using SPSS 26.0.

Results: In the control group, pre - treatment blood glucose of 7.84±1.89 mmol/L decreased to 7.78±1.76 mmol/L post - treatment (P<0.05). PSQI score dropped from 11.69±2.74 to 8.07±2.86 (P<0.05), with a 75.00% effective rate. In the observation group (n=62), blood glucose decreased from 8.43±2.17 to 6.96±1.68 mmol/L (P<0.05). PSQI score declined from 11.63±2.16 to 6.38±2.32 (P<0.05), and the effective rate was 90.32% (P<0.05 vs control group).

Conclusion: The combined treatment of auricular acupoint pressing and intradermal acupuncture has potential in treating these patients. But due to the retrospective nature of the study, well - designed RCTs and in - depth mechanistic studies are needed to confirm its efficacy and clarify the mechanisms.

Purpose: Among patients undergoing maintenance hemodialysis (MHD), constipation and frailty are not only common but also associated with adverse clinical outcomes. The objective of this study was to investigate the relationship between constipation and frailty in this population.

Patients and methods: This cross-sectional study included patients receiving MHD three times per week in China from November 2023 to November 2024. Rome IV criteria and Fried Frailty Phenotype scale were applied to evaluate constipation and frailty respectively. Multivariate logistic regression analysis was utilized to analyze the correlation between constipation and frailty.

Results: Among the 207 enrolled MHD patients (mean age 58.6 ± 14.7 years; 78 females; median hemodialysis vintage 38.4 months), 100 (48.3%) were diagnosed with constipation and 63 (30.4%) with frailty. After adjusting for clinical characteristics, constipation was associated with frailty (OR: 7.61, 95% CI: 2.74-21.13). Among the five frailty components, slow gait speed (OR: 2.90, 95% CI: 1.20-7.00) and low physical activity (OR: 3.51, 95% CI: 1.15-10.74) were independently associated with constipation.

Conclusion: Frailty is independently associated with constipation in MHD patients. It is important to highlight the significance of monitoring the frailty among MHD patients with constipation.