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BACKGROUND: Clinical nurses face high-pressure situations requiring rapid decision-making and skilled intervention, impacting their psychological responses and emergency capabilities. Understanding the relationships between psychological factors like gratitude and meaning in life is crucial for improving nurses' performance in emergencies. This study explores the mediating role of gratitude and meaning in life in the impact of psychological responses on clinical nurses' emergency capabilities, aiming to enhance their effectiveness in such situations. METHODS: This study is a multi-center cross-sectional survey. A questionnaire survey was conducted among 1833 clinical nurses in five tertiary hospitals in Anhui Province, China including general information questionnaire, nurses' emergency capability scale, Meaning in life scale, Gratitude scale and Psychological response questionnaire. According to the results of the questionnaire survey, a chain mediating model was constructed and tested. RESULTS: The total score of emergency capability of 1833 clinical nurses was (71.65 ± 10.77), the total score of meaning in life was (50.67 ± 9.04), the total score of gratitude was (30.96 ± 3.57), and the total score of psychological response was 13.00 (6.00, 20.00). The emergency capability of subjects was positively correlated with the meaning in life, the total score of gratitude scale and the scores of each dimension of the two scales, and negatively correlated with the total score of psychological response scale and each dimension of this scale (all P < 0.05). The total effect coefficient, direct effect coefficient and indirect effect coefficient of psychological response on nurses' emergency capability are - 0.230, -0.110 and - 0.120 respectively, that is, the indirect effect accounts for 52.17% of the total effect. Among the indirect effects, the specific mediating effects of gratitude and meaning in life account for 22.50% and 62.50% respectively, and the chain mediating effects of gratitude and meaning in life account for 15.00%. CONCLUSION: Gratitude and meaning in life have multiple mediating roles in the mechanism of psychological response that affecting clinical nurses' emergency capability. Therefore, it is very important to pay attention to dynamically evaluating the psychological response level of clinical nurses, and strive to improve their gratitude and meaning in life, so as to further enhance their emergency response ability.
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BACKGROUND: This study aims to construct a clinical prediction model and create a visual line chart depicting the risk of acute kidney injury (AKI) following resuscitation in cardiac arrest (CA) patients. Additionally, the study aims to validate the clinical predictive accuracy of the developed model. METHODS: Data were retrieved from the Dryad database, and publicly shared data were downloaded. This retrospective cohort study included 347 successfully resuscitated patients post-cardiac arrest from the Dryad database. Demographic and clinical data of patients in the database, along with their renal function during hospitalization, were included. Through data analysis, the study aimed to explore the relevant influencing factors of acute kidney injury (AKI) in patients after cardiopulmonary resuscitation. The study constructed a line chart prediction model using multivariate logistic regression analysis with post-resuscitation shock status (Post-resuscitation shock refers to the condition where, following successful cardiopulmonary resuscitation after cardiac arrest, some patients develop cardiogenic shock.), C reactive protein (CRP), Lactate dehydrogenase (LDH), and Alkaline phosphatase (ALP) identified as predictive factors. The predictive efficiency of the fitted model was evaluated by the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. RESULTS: Multivariate logistic regression analysis showed that post-resuscitation shock status, CRP, LDH, and PAL were the influencing factors of AKI after resuscitation in CA patients. The calibration curve test indicated that the prediction model was well-calibrated, and the results of the Decision Curve Analysis (DCA) demonstrated the clinical utility of the model constructed in this study. CONCLUSION: Post-resuscitation shock status, CRP, LDH, and ALPare the influencing factors for AKI after resuscitation in CA patients. The clinical prediction model constructed based on the above indicators has good clinical discriminability and practicality.
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Lesión Renal Aguda , Biomarcadores , Reanimación Cardiopulmonar , Paro Cardíaco , Valor Predictivo de las Pruebas , Humanos , Lesión Renal Aguda/terapia , Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/etiología , Estudios Retrospectivos , Reanimación Cardiopulmonar/efectos adversos , Masculino , Femenino , Paro Cardíaco/terapia , Paro Cardíaco/diagnóstico , Paro Cardíaco/fisiopatología , Medición de Riesgo , Persona de Mediana Edad , Anciano , Factores de Riesgo , Resultado del Tratamiento , Biomarcadores/sangre , Reproducibilidad de los Resultados , Bases de Datos Factuales , Técnicas de Apoyo para la DecisiónRESUMEN
Pancreatic pseudocyst (PPC) increases the risk of a poor prognosis in in patients with acute pancreatitis (AP). Currently, an efficient tool is not available for predicting the risk of PPC in patients with AP. Therefore, this research aimed to explore the risk factors associated with PPC secondary to AP and to develop a model based on clinical information for predicting PPC secondary to AP. This study included 400 patients with acute pancreatitis and pancreatic pseudocyst secondary to acute pancreatitis admitted to the emergency department and gastroenterology department of The First Affiliated Hospital of the University of Science and Technology of China from January 2019 to June 2022. Participants were divided into no PPCs (321 cases) and PPCs (79 cases). Independent factors of PPC secondary to AP were analyzed using univariate and multivariate logistic regression. The nomogram model was constructed based on multivariate logistic regression analyses, which included all risk factors, and evaluated using R. We enrolled 400 eligible patients and allocated 280 and 120 to the training and test sets, respectively. Clinical features, including severe pancreatitis history [odds ratio (OR)â =â 4.757; 95% confidence interval (CI): 1.758-12.871], diabetes mellitus (ORâ =â 6.919; 95% CI: 2.084-22.967), history of biliary surgery (ORâ =â 9.232; 95% CI: 3.022-28.203), hemoglobin (ORâ =â 0.974; 95% CI: 0.955-0.994), albumin (ORâ =â 0.888; 95% CI: 0.825-0.957), and body mass index (ORâ =â 0.851; 95% CI: 0.753-0.962), were significantly associated with the incidence of PPC after AP in the training sets. Additionally, the individualized nomogram demonstrated good discrimination in the training and validation samples with good calibration, The area under the curve and 95% CI of the nomogram were 0.883 (0.839-0.927) in the training dataset and 0.839 (0.752-0.925) in the validation set. We developed a nomogram model of PPC secondary to AP using R Studio. This model has a good predictive value for PPC in patients with AP and can help improve clinical decision-making.
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Seudoquiste Pancreático , Pancreatitis , Humanos , Pancreatitis/complicaciones , Enfermedad Aguda , Seudoquiste Pancreático/complicaciones , Factores de Riesgo , Nomogramas , Estudios RetrospectivosRESUMEN
The awake prone position plays an important role in the treatment of hypoxemia and the improvement of respiratory distress symptoms in non-intubated patients. It is widely used in clinical practice because of its simple operation, safety, and economy. To enable clinical medical staff to scientifically and normatively implement prone position for awake patients without intubation, the committees of consensus formulation, guided by evidence-based methodology and Delphi method, conducted literature search, literature quality evaluation and evidence synthesis around seven topics, including indications and contraindications, evaluation, implementation, monitoring and safety management, termination time, complication prevention and health education of awake prone position. After two rounds of expert letter consultation, Expert consensus on implementation strategy of awake prone positioning for non-intubated patients in China (2023) was formulated, and provide guidance for clinical medical staff.