Objective This study aimed to evaluate whether cardiac rehabilitation with a technology-assisted personalized exercise prescription is superior to traditional remote home-based rehabilitation in improving cardiorespir...Objective This study aimed to evaluate whether cardiac rehabilitation with a technology-assisted personalized exercise prescription is superior to traditional remote home-based rehabilitation in improving cardiorespiratory endurance and quality of life in postoperative patients.Methods From October 2022 to April 2024,62 patients who underwent percutaneous coronary intervention for coronary heart disease were recruited from a tertiary hospital in Beijing and randomly assigned to either an intervention group or a control group.After baseline assessments of cardiorespiratory endurance and exercise function,the intervention group received a digitalized personalized exercise prescription combined with remote monitoring rehabilitation.This included an exercise prescription delivered via a mobile application,weekly remote monitoring sessions with an exercise therapist to supervise prescription adherence,provide feedback based on real-time electrocardiographic data,and make personalized adjustments to the exercise prescription based on this information.The control group received an application-delivered exercise movement library and a wearable electrocardiogram device for self-monitoring of exercise intensity.Both groups underwent the 12-week intervention.Changes in maximal oxygen uptake and quality of life were evaluated at enrollment,as well as at 4 weeks,12 weeks,and 24 weeks after the intervention commenced.Results A total of 58 participants completed the study(the intervention group[n=30],the control group[n=28]).Twelve weeks after the interventions,the intervention group showed statistically improvements in VO2AT(Z=2.247,P=0.025),general health(Z=2.126,P=0.033)and social functioning(Z=3.349,P=0.001)compared to the control group.At 24 weeks of follow-up,the intervention group continued to exhibit statistically significant improvements in VO2AT(Z=2.017,P=0.044)and social functioning(Z=3.126,P=0.002).The exercise duration of patients in the intervention group during the exercise test was significantly prolonged at both 4 weeks(Z=−2.420,P=0.021),12 weeks(Z=−2.240,P=0.029)and 24weeks(Z=−2.300,P=0.025)showing statistically significant differences compared to the control group.Conclusions This study provides new evidence-based support for the practical effectiveness of nurses acting as supervisors of rehabilitation implementation and coordinators of multidisciplinary teams within a remote digital cardiac rehabilitation model,underscoring their significant value in the secondary prevention management system for cardiovascular diseases in the information era.展开更多
目的构建老年糖尿病患者认知衰弱风险预测模型,为认知衰弱风险筛查提供工具。方法便利抽样法选取北京市9所医院收治的501例老年糖尿病患者为研究对象。2022年12月至2023年6月收集的390例为模型开发样本,2023年6-8月收集的111例为模型外...目的构建老年糖尿病患者认知衰弱风险预测模型,为认知衰弱风险筛查提供工具。方法便利抽样法选取北京市9所医院收治的501例老年糖尿病患者为研究对象。2022年12月至2023年6月收集的390例为模型开发样本,2023年6-8月收集的111例为模型外部验证样本,采用Logistic回归法确定影响因素,基于影响因素构建逻辑回归、随机森林、支持向量机、XGBoost模型,用5折交叉验证法进行内部验证,确定最佳模型,以外部验证样本对最佳模型进行外部验证。结果筛选出年龄、文化程度、规律运动、跌倒史、使用胰岛素、抑郁6个影响因素用于构建模型,5折交叉验证结果显示,模型的受试者工作特征曲线下面积(area under curve,AUC)值为0.852,准确率为80.77%,灵敏度为77.62%,特异度为81.13%,布里尔(Brier)评分为0.103,综合表现优于其他模型;外部验证结果显示,模型AUC值为0.833,准确率为72.07%,灵敏度为80.00%,特异度为70.83%,Brier评分为0.098,校准曲线与理想曲线一致性较好。结论逻辑回归模型预测性能最佳,有较好的区分度和校准度,同时具有较好的临床适用性。展开更多
目的:检索并总结超重或肥胖2型糖尿病病人非药物体重管理的最佳证据。方法:检索BMJ Best Practice、UpToDate、JBI循证卫生保健研究中心网站、英国国家临床优化研究所(NICE)官网、国际指南协作网(GIN)、美国医疗保健研究与质量局网站(AH...目的:检索并总结超重或肥胖2型糖尿病病人非药物体重管理的最佳证据。方法:检索BMJ Best Practice、UpToDate、JBI循证卫生保健研究中心网站、英国国家临床优化研究所(NICE)官网、国际指南协作网(GIN)、美国医疗保健研究与质量局网站(AHRQ)、世界卫生组织(WHO)指南网、加拿大安大略注册护士协会(RANO)、国际糖尿病联合会网站(IDF)、美国糖尿病协会(ADA)官网、医脉通、Cochrane Library、EMbase、CINAHL、Scopus、PubMed、中华医学会期刊全文数据库、万方数据知识服务平台、中国知网、中国生物医学文献数据库、维普数据库等网站,检索时间为建库至2025年2月5日。2名研究者通过文献质量评价,提炼并总结形成超重或肥胖2型糖尿病病人非药物体重管理的最佳证据。结果:共纳入20篇文献,包括1篇临床实践、1篇临床决策、5篇指南、5篇专家共识、8篇系统评价;最终从体重管理获益、体重管理目标、评估与监测及生活方式干预4个方面汇总了23条最佳证据。结论:总结形成的超重或肥胖2型糖尿病病人非药物体重管理的最佳证据具有科学性和实用性,可为医务人员管理超重或肥胖2型糖尿病病人体重提供参考。展开更多
目的总结老年CHF患者多重用药管理的最佳证据,为临床医护人员评估用药、优化管理提供循证依据。方法依据6S模型,检索UpToDate、BMJ Best Practice、JBI循证实践数据库、英国国家卫生与临床优化研究所(NICE)指南网站、医脉通、Cochrane L...目的总结老年CHF患者多重用药管理的最佳证据,为临床医护人员评估用药、优化管理提供循证依据。方法依据6S模型,检索UpToDate、BMJ Best Practice、JBI循证实践数据库、英国国家卫生与临床优化研究所(NICE)指南网站、医脉通、Cochrane Library、Embase、PubMed、Web of Science、中国知网、万方数据知识服务平台、中国生物医学文献数据库,检索时限为建库至2025年3月。采用PIPOST模式明确循证问题,纳入的文献类型包括指南、证据总结、系统评价、专家共识及临床决策。由两名研究者独立进行文献筛选、质量评价与证据提取,冲突由第三人协商解决。最终对提取的证据进行主题归类与整合,并采用JBI证据预分级系统(2014版)进行证据等级分级。结果共纳入11篇文献,整合形成29条最佳证据。本总结首次构建了涵盖评估、处方、干预、随访与教育的全方位管理框架;核心是提出了适用于我国医疗资源现状的“分层协同”实施路径,证据特别凸显了跨团队协作、本土化工具开发及护士在延续性照护中的核心协调作用。结论本研究汇总的证据可结合不同医疗机构特点、临床场景及患者个体差异选择应用,为老年CHF患者多重用药管理提供了全面、循证的实践依据。展开更多
摘要Objective This study aimed to evaluate whether cardiac rehabilitation with a technology-assisted personalized exercise prescription is superior to traditional remote home-based rehabilitation in improving cardiorespiratory endurance and quality of life in postoperative patients.Methods From October 2022 to April 2024,62 patients who underwent percutaneous coronary intervention for coronary heart disease were recruited from a tertiary hospital in Beijing and randomly assigned to either an intervention group or a control group.After baseline assessments of cardiorespiratory endurance and exercise function,the intervention group received a digitalized personalized exercise prescription combined with remote monitoring rehabilitation.This included an exercise prescription delivered via a mobile application,weekly remote monitoring sessions with an exercise therapist to supervise prescription adherence,provide feedback based on real-time electrocardiographic data,and make personalized adjustments to the exercise prescription based on this information.The control group received an application-delivered exercise movement library and a wearable electrocardiogram device for self-monitoring of exercise intensity.Both groups underwent the 12-week intervention.Changes in maximal oxygen uptake and quality of life were evaluated at enrollment,as well as at 4 weeks,12 weeks,and 24 weeks after the intervention commenced.Results A total of 58 participants completed the study(the intervention group[n=30],the control group[n=28]).Twelve weeks after the interventions,the intervention group showed statistically improvements in VO2AT(Z=2.247,P=0.025),general health(Z=2.126,P=0.033)and social functioning(Z=3.349,P=0.001)compared to the control group.At 24 weeks of follow-up,the intervention group continued to exhibit statistically significant improvements in VO2AT(Z=2.017,P=0.044)and social functioning(Z=3.126,P=0.002).The exercise duration of patients in the intervention group during the exercise test was significantly prolonged at both 4 weeks(Z=−2.420,P=0.021),12 weeks(Z=−2.240,P=0.029)and 24weeks(Z=−2.300,P=0.025)showing statistically significant differences compared to the control group.Conclusions This study provides new evidence-based support for the practical effectiveness of nurses acting as supervisors of rehabilitation implementation and coordinators of multidisciplinary teams within a remote digital cardiac rehabilitation model,underscoring their significant value in the secondary prevention management system for cardiovascular diseases in the information era.
摘要目的构建老年糖尿病患者认知衰弱风险预测模型,为认知衰弱风险筛查提供工具。方法便利抽样法选取北京市9所医院收治的501例老年糖尿病患者为研究对象。2022年12月至2023年6月收集的390例为模型开发样本,2023年6-8月收集的111例为模型外部验证样本,采用Logistic回归法确定影响因素,基于影响因素构建逻辑回归、随机森林、支持向量机、XGBoost模型,用5折交叉验证法进行内部验证,确定最佳模型,以外部验证样本对最佳模型进行外部验证。结果筛选出年龄、文化程度、规律运动、跌倒史、使用胰岛素、抑郁6个影响因素用于构建模型,5折交叉验证结果显示,模型的受试者工作特征曲线下面积(area under curve,AUC)值为0.852,准确率为80.77%,灵敏度为77.62%,特异度为81.13%,布里尔(Brier)评分为0.103,综合表现优于其他模型;外部验证结果显示,模型AUC值为0.833,准确率为72.07%,灵敏度为80.00%,特异度为70.83%,Brier评分为0.098,校准曲线与理想曲线一致性较好。结论逻辑回归模型预测性能最佳,有较好的区分度和校准度,同时具有较好的临床适用性。
摘要目的:检索并总结超重或肥胖2型糖尿病病人非药物体重管理的最佳证据。方法:检索BMJ Best Practice、UpToDate、JBI循证卫生保健研究中心网站、英国国家临床优化研究所(NICE)官网、国际指南协作网(GIN)、美国医疗保健研究与质量局网站(AHRQ)、世界卫生组织(WHO)指南网、加拿大安大略注册护士协会(RANO)、国际糖尿病联合会网站(IDF)、美国糖尿病协会(ADA)官网、医脉通、Cochrane Library、EMbase、CINAHL、Scopus、PubMed、中华医学会期刊全文数据库、万方数据知识服务平台、中国知网、中国生物医学文献数据库、维普数据库等网站,检索时间为建库至2025年2月5日。2名研究者通过文献质量评价,提炼并总结形成超重或肥胖2型糖尿病病人非药物体重管理的最佳证据。结果:共纳入20篇文献,包括1篇临床实践、1篇临床决策、5篇指南、5篇专家共识、8篇系统评价;最终从体重管理获益、体重管理目标、评估与监测及生活方式干预4个方面汇总了23条最佳证据。结论:总结形成的超重或肥胖2型糖尿病病人非药物体重管理的最佳证据具有科学性和实用性,可为医务人员管理超重或肥胖2型糖尿病病人体重提供参考。
摘要目的总结老年CHF患者多重用药管理的最佳证据,为临床医护人员评估用药、优化管理提供循证依据。方法依据6S模型,检索UpToDate、BMJ Best Practice、JBI循证实践数据库、英国国家卫生与临床优化研究所(NICE)指南网站、医脉通、Cochrane Library、Embase、PubMed、Web of Science、中国知网、万方数据知识服务平台、中国生物医学文献数据库,检索时限为建库至2025年3月。采用PIPOST模式明确循证问题,纳入的文献类型包括指南、证据总结、系统评价、专家共识及临床决策。由两名研究者独立进行文献筛选、质量评价与证据提取,冲突由第三人协商解决。最终对提取的证据进行主题归类与整合,并采用JBI证据预分级系统(2014版)进行证据等级分级。结果共纳入11篇文献,整合形成29条最佳证据。本总结首次构建了涵盖评估、处方、干预、随访与教育的全方位管理框架;核心是提出了适用于我国医疗资源现状的“分层协同”实施路径,证据特别凸显了跨团队协作、本土化工具开发及护士在延续性照护中的核心协调作用。结论本研究汇总的证据可结合不同医疗机构特点、临床场景及患者个体差异选择应用,为老年CHF患者多重用药管理提供了全面、循证的实践依据。