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Research progress of mobile health in drug inhalation technology management of patients with respiratory diseases
DUAN Jilong, ZHANG Xiaona, CHANG Yan, ZHANG Xue, ZHANG Wenyue, LIU Zhiping, LU Hongyan
Chinese Journal of Nursing    2023, 58 (20): 2538-2542.   DOI: 10.3761/j.issn.0254-1769.2023.20.015
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Mastery of correct inhalation technique is crucial for the effective completion of inhalation therapy. Mobile healthcare can promote the management of drug inhalation techniques among patients with respiratory diseases. This article introduces the forms of mobile healthcare applications in the management of inhalation techniques in patients with respiratory diseases,summarizes the effects of mobile healthcare applications in the management of inhalation techniques in patients with respiratory diseases,and analyzes the shortcomings and challenges of mobile healthcare applications in the management of inhalation techniques among patients with respiratory diseases. The aim is to provide references for the development of mobile healthcare equipment or applications in China.

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Analysis on the status and influencing factors of dysphagia in elderly patients with chronic obstructive pulmonary disease
ZHANG Rui, CHANG Yan, ZHANG Xiaona, ZHAO Jie, LI Xindan, LU Lu, LU Hongyan
Chinese Journal of Nursing    2022, 57 (23): 2898-2903.   DOI: 10.3761/j.issn.0254-1769.2022.23.012
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Objective To investigate the status and influencing factors of dysphagia in elderly patients with chronic obstructive pulmonary disease(COPD). Methods A total of 1 268 elderly patients with COPD hospitalized in the respiratory department of 13 general hospitals in Ningxia were selected by convenience sampling method from April 2019 to August 2020. Patients were investigated by the general information questionnaire,the Water Swallowing Test,Modified Medical Research Council Dyspnea Scale,Activities of Daily Living,the Geriatric Depression Scale,the Mini Nutritional Assessment-Short Form,COPD Assessment Test Scale,the FRAIL debilitation assessment scale. Logistic regression analysis was performed to analyze the influencing factors of dysphagia in COPD patients with statistically significant variables. Results The incidence of dysphagia in elderly COPD patients was 20.39%. Logistic regression analysis showed that smoking status,tooth loss,feeding attention,feeding position,PaCO2,dyspnea,nutritional status and COPD severity were the influential factors of dysphagia(P<0.05). Conclusion The incidence of dysphagia in elderly COPD patients is higher. COPD patients with severe disease,high degree of dyspnea,high PaCO2,long-term smoking,number of missing teeth≥6,malnutrition,not paying attention to eating,and semi-recumbent position have a higher risk of dysphagia. Clinical medical staff can formulate relevant intervention measures according to the influencing factors to prevent the occurrence of dysphagia.

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Intervention effects of discharge preparation service on patients with chronic obstructive pulmonary diseases:a meta-analysis
ZHANG Xiaona, LI Xindan, LU Hongyan, ZHAO Jie, FENG Xiangkan
Chinese Journal of Nursing    2022, 57 (1): 42-48.   DOI: 10.3761/j.issn.0254-1769.2022.01.006
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Objective To evaluate the effect of discharge preparation service in patients with chronic obstructive pulmonary disease (COPD) through meta-analysis. Methods A systematic search of PubMed,Cochrane Library,Web of Science,CINAHL,Embase,OVID,CNKI,CBM and Wanfang database was carried out to collect randomized controlled trials(RCTs) on discharge preparation service for COPD patients from inception to March 2021. Literature screening,information extraction and quality evaluation were conducted by 2 reviewers,and RevMan 5.2 software was adopted for meta-analysis. Results A total of 14 RCTs with 2 023 patients were finally included. The results showed that discharge preparation services reduced readmission rates [OR=0.62,95%CI(0.48,0.80),Z=3.69,P<0.001],the number of readmissions [MD=-0.57,95%CI(-0.96,-0.19),Z=2.94,P=0.003] and length of stay [MD=-1.77,95%CI (-2.78,-0.76),Z=3.42,P<0.001],and improved MMRC [MD=-0.39,95%CI(-0.70,-0.09),Z=2.56,P=0.010]. There was no significant difference in quality of life by the SGRQ [MD=-3.27,95%CI(-7.57,1.03),Z=1.49,P=0.140]. The quality of life was improved by the SOLDQ [MD=49.38,95%CI(43.11,55.65),Z=15.43,P<0.001]. There was no significant difference in reducing mortality [OR=0.90,95%CI(0.61,1.34),Z=0.50,P=0.620]. Conclusion Discharge pre-paration service can effectively reduce the readmission rate,the number of readmissions and length of stay,and improve MMRC in patients with COPD,but the impact on mortality and quality of life is still uncertain,and high-quality research is still needed for further demonstration.

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Application comparison of Frailty Phenotype and FRAIL Scale in frailty risk screening of elderly inpatients
WU Zhenzhen,ZHANG Rui,CHANG Yan,LU Hongyan
Chinese Journal of Nursing    2021, 56 (5): 673-679.   DOI: 10.3761/j.issn.0254-1769.2021.05.005
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Objective To compare the screening ability of Frailty Phenotype and FRAIL scale for frailty risk in elderly inpatients,and to provide references for clinical selection of appropriate screening tools for frailty.Methods A total of 462 elderly inpatients in a tertiary hospital in Ningxia were selected by convenience sampling method,and the Frailty Index,Frailty Phenotype and FRAIL scale were used to score them. Taking Frailty Index as the diagnostic standard,the predictive value of the 2 scales for frailty risk was compared by the Receiver Operating Characteristic(ROC) and Bayes discriminant analysis.Results The incidences of frailty in elderly hospitalized patients by Frailty Phenotype,FRAIL and Frailty Index were 34.2%,25.1% and 30.5%,respectively. The consistency of the screening results of Frailty Phenotype,FRAIL scale and Frailty Index showed that the Kappa values are 0.511,0.479(P<0.01).The Frailty Phenotype and FRAIL area under ROC curve are 0.823(95%CI:0.784~0.858) and 0.853(95%CI:0.815~0.885).The differences are not statistically significant(Z=1.366,P>0.05).The accuracy of cross-validation in the determination of frailty are 78.6% and 79.0%. The best predictive values are 3 and 2;the sensitivity is 0.709 and 0.837;the specificity is 0.817 and 0.790;the Youden indexes are 0.529 and 0.625;the positive predictive values are 0.697 and 0.702;the negative predictive values are 0.825 and 0.891.Conclusion The ability of Frailty Phenotype and FRAIL scale to screen the frailty risk of elderly inpatients is moderate. FRAIL scale is more effective in predicting the risk of frailty and more convenient to use,and it is more suitable for screening the frailty risk of the elderly inpatients.

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