Patient preference and adherence最新文献

Background: This study aimed to explore the effect of vitamin D supplementation on lymphocyte subsets in infertile women.

Methods: The study involved a total of 247 patients who suffered recurrent embryo implantation failure (RIF) or recurrent spontaneous abortion (RSA) between January and December 2019 in the Reproductive Medicine Center of Children's Hospital of Shanxi and Women Health Center of Shanxi. The differences in the vitamin D and lymphocyte subsets of the two diseases, the correlation between the 25-hydroxy vitamin D and lymphocyte subsets, the changes in the lymphocyte subsets after vitamin D supplementation and the impact on pregnancy outcome were analysed.

Results: The prevalence of vitamin D deficiency was 77.33% (191/247). After vitamin D supplementation, there were no significant differences in helper T cells (Th), cytotoxic T cells (Tc), Th/Tc and natural killer cells (NK) (p > 0.05), but there were significant differences in leukocyte differentiation antigens 3+ (CD3+), natural killer T cells (NKT), B lymphocytes and vitamin D (p < 0.05). Before vitamin D supplementation, the difference in the composition ratio of different vitamin D levels between the RIF and RSA groups was not statistically significant. At different vitamin D levels, there were no significant differences in CD3+, Th, Tc, Th/Tc, NK or B lymphocyte (p > 0.05), but there was a significant difference in NKT (p < 0.05).

Conclusion: Vitamin D supplementation can reduce the level of NKT in infertile women, which may be of benefit to the pregnancy outcome of couples who experience RIF.

Purpose: Obesity is a significant global public health issue affecting late primary school students' health and learning processes. This research aimed to predict factors influencing the prevention behaviors of obesity among overweight 9 to 12-year-old students.

Samples and methods: This cross-sectional predictive correlational study involved 216 overweight students in grades 4-6 and used a multi-stage sampling method. Comprehensive questionnaires meticulously collected data on demographics, self-perception, and obesity prevention behaviors. The data were analyzed using descriptive statistics, chi-square, and binary logistic regression.

Results: The mean scores for self-perception of food consumption and physical activity were moderate (M = 19.13, S.D. = 5.68; M = 19.53, S.D. = 5.64, respectively). Similarly, obesity prevention behaviors were moderate (M = 42.90, S.D. = 8.48). The study identified factors significantly related to obesity prevention behaviors, including gender, grade point average (GPA), self-perception of food consumption and physical activity, daily allowance from family, and nutrition education (p < 0.05). Binary logistic regression confirmed that self-perception of food consumption (OR = 4.29; 95% CI: 1.72-10.73) and physical activity (OR = 2.585; 95% CI: 1.02-6.56), grade point averages (OR = 0.38; 95% CI: 0.18-0.82), daily allowance received from family (OR = 0.402; 95% CI: 0.17-0.94), nutrition education (OR = 0.352; 95% CI: 0.15-0.84), and male (OR = 0.113; 95% CI: 0.02-0.56) were significant predictors (p < 0.05), providing valuable insights into the factors influencing obesity prevention behaviors among overweight students.

Conclusion: Male students who have good GPAs, high self-efficacy in food consumption and physical activity, nutrition education, and adequate financial support were more likely to engage in obesity prevention behaviors. Thus, educators and healthcare professionals should focus on enhancing self-perception, providing comprehensive nutrition education, and offering additional support to female students with lower GPAs. These measures will help improve behavior adjustment and support obesity prevention efforts.

Purpose: Treatment satisfaction among patients with psoriasis can vary significantly based on available treatment options and individual patient characteristics.

Patients and methods: This cross-sectional study utilized psoriasis-specific questionnaires to assess treatment satisfaction and identify the factors associated with treatment satisfaction in Korean patients. The study included 350 eligible patients aged 19 or older from a nationwide psoriasis group. Participants completed a self-reported web-based questionnaire assessing socioeconomic and clinical status, quality of life, and treatment satisfaction. Linear regression models were employed to analyze the factors associated with treatment satisfaction.

Results: The results showed that patients with mild to moderate psoriasis, as determined by the body surface area involvement, had higher satisfaction scores for treatment effectiveness. Moreover, patients receiving biologic therapies reported significantly higher total satisfaction scores and scores across all domains than those not utilizing biologics. However, patients reporting poorer quality of life or experiencing anxiety exhibited lower satisfaction scores.

Conclusion: Findings suggest that while biologic treatments may confer greater satisfaction to patients with psoriasis, diminished quality of life and anxiety can negatively impact satisfaction levels. The study underscores the importance of understanding the factors associated with patient satisfaction to optimize treatment outcomes in psoriasis management.

Background: Measurement of medication adherence and health-related quality of life is extremely important when planning different health policies. Drug therapy and adherence to medication are critical to prevent complications of hypertension, especially in countries like Nepal, where hypertension is one of the most prevalent diseases. However, this has not been studied in Nepal. This study, hence, aimed to explore medication adherence, factors affecting medication adherence, health-related quality of life, and the correlation between medication adherence and health-related quality of life in hypertensive patients visiting tertiary care health facilities in Lalitpur district of Nepal.

Methodology: This quantitative cross-sectional study was conducted among 380 hypertensive patients at KIST Medical College and Teaching Hospital, Lalitpur, Nepal. The Nepali version of the European Quality of Life tool EQ-5D-5L and the Hill-Bone Compliance to High Blood Pressure Therapy Scale (HBCTS) were used. Intergroup differences in medication adherence, the EQ-5D index and EQ-VAS scores were assessed for statistical significance using either the Mann-Whitney or Kruskal-Wallis tests for numerical data. Spearman correlation coefficient was used to identify the relationship among medication adherence, EQ-5D-5L index values, and EQ-VAS scores.

Results: The mean treatment score was 22.43 ± 4.12. Age, sex, and occupation were significant factors that affected treatment adherence. The EQ-5D score was 0.72 with age, sex, income, and educational status as significant factors and marital status as an insignificant factor. A slightly negative correlation was found between the total treatment adherence score and the EQ-5D index.

Conclusion: The treatment adherence of patients to antihypertensive therapy was suboptimal, which could affect the outcome of therapy. Better treatment adherence was correlated with a better health-related quality of life. Hence, both health-care providers and patients should make efforts to increase treatment adherence to attain better HRQOL.

Purpose: To clarify the meaning of treatment adherence and identify its attributes, antecedents, consequences, and empirical referents.

Design: A concept analysis.

Methods: Walker and Avant's method was used to analyze treatment adherence. PubMed, Web of Science, Wiley Online Library, and EBSCO databases were searched from 2013 to 2023. The PRISMA 2020 checklist was used.

Results: Seventeen studies were included in this analysis. The defining attributes were the ability to comply with the treatment, consistency in the treatment plan, communication with the healthcare provider, and willingness to treat. Antecedents included multiple medicines, lifestyle changes, illness perceptions and beliefs, and long-term treatment. The outcomes included treatment success, improved long-term treatment, and improved clinical outcomes.

Conclusion: Treatment adherence is a positive reaction of a patient to have the ability to comply with the treatment, consistency in the treatment plan, communication with the healthcare provider, and willingness to treat. This study proposes a detailed definition, attributes, antecedents, consequences, and empirical referents for treatment adherence. It is instructive to clinical nursing of treatment adherence, can be extended to various diseases, helps to improve clinical nursing practice regarding treatment adherence, and contribute to improving human health.

Purpose: Individualized anticoagulation therapy is a major challenge for patients after heart valve replacement. Mobile applications assisted by Artificial intelligence (AI) have great potential to meet the individual needs of patients. The study aimed to develop an AI technology-assisted mobile application (app) for anticoagulation management, understand patients' acceptance of such applications, and determine its feasibility.

Methods: After using the mobile application for anticoagulation management for 2 weeks, patients, doctors, and nurses rated its usability using the System Usability Scale (SUS). Additionally, semi-structured interviews were conducted with some patients, doctors, and nurses to gain insights about their thoughts and suggestions regarding the procedure.

Results: The study comprised 80 participants, including 38 patients, 18 doctors, and 24 nurses. The average SUS score for patients was 82.37±5.45; for doctors, it was 84.17±5.82; and for nurses, it was 81.88±6.44. This means the patients, physicians, and nurses rated the app highly usable. Semi-structured interviews were conducted on the app's usability with 18 participants (six nurses, three physicians, and nine patients). The interview results revealed that patients found the application of anticoagulation management simple and convenient, with high expectations for a precise dosage recommendation of anticoagulant drugs. Some patients expressed concerns regarding personal information security. Both doctors and nurses believed that elderly patients needed assistance from young family members to use the app and that it could improve patients' anticoagulant self-management ability. Some nurses also mentioned that the use of the app brought great convenience for transitional care.

Conclusion: This study confirmed the feasibility of using an AI technology-assisted mobile application for anticoagulation management in patients after heart valve replacement. To further develop this application, challenges lie in continuously improving the accuracy of recommended drug doses, obtaining family support, and ensuring information security.

Background: Dampness syndrome is a basic syndrome of many major and chronic diseases. Early screening and identification of dampness syndrome are important. The Dampness Syndrome Scale of Chinese Medicine (DSSCM) was developed to measure the occurrence and severity of dampness syndrome. The measurement characteristics of the DSSCM should be further validated. The objective of this study is to evaluate the reliability and validity of the DSSCM based on a cross-sectional survey.

Methods: The development of DSSCM was based on the traditional Chinese medicine (TCM) theory, expert consensus and clinical investigations. Participants were recruited from Guangdong Provincial Hospital of Chinese Medicine and Guangzhou Cadre Health Management Center in Guangdong Province, China. All participants completed the baseline questionnaire and DSSCM. The reliability of the DSSCM was evaluated by internal consistency reliability and test-retest reliability. The factor structure was tested with confirmatory factor analysis (CFA), while discriminant validity was evaluated by calculating the difference between the total score of the DSSCM and its four dimensions for participants with or without dampness syndrome. We used a clinician's diagnosis of dampness syndrome as a criterion to evaluate the criterion validity. Multivariate regression analysis was used to analyze the associations among gender, age, height, and weight and dampness syndrome.

Results: A total of 880 participants were enrolled for psychometric validation and 869 participants were included in the final analyses after exclusion. The mean age of the participants was 42.62±12.86 years. The Cronbach's alpha coefficients for the four dimensions of the DSSCM were 0.809, 0.891, 0.816 and 0.780. The ICCs for the four dimensions of the DSSCM were 0.806, 0.674, 0.780 and 0.760. For validity, the results showed that the DSSCM had good content validity, discriminant validity and criterion validity. For the CFA, the root mean square error of approximation (RMSEA) was 0.091; the standardized root mean square residual (SRMR) was 0.074; the comparative fit index (CFI) was 0.766; and the Tucker-Lewis index (TLI) was 0.745. Weight was found to be associated with the total scores of the DSSCM and its three dimensions.

Conclusion: The DSSCM has good reliability and validity to support its use as a tool for assessing the severity of dampness syndrome. This study provides empirical evidence for future updates to the DSSCM.