Search

Objective To dectect six-minute walking distance (6MWD) of patients with multimorbidity by an intelligent six-minute walking test (6MWT) device, and to investigate the correlation of 6MWD with lung function, quality of life, and clinical indicators. Methods A total of 138 patients with multimorbidity who were hospitalized in the General Practice Department of Peking University Third Hospital from January to December 2022 were selected. 6MWT was conducted in patients, and pulmonary function before and after the test was measured, and the general data, height, weight, blood routine ［white blood cell (WBC) count, hemoglobin (Hb), platelet (PLT) count］, liver function ［albumin (ALB), aspartate aminotransferase (AST), alanine aminotransferase (ALT)］, renal function ［creatine (Cr), blood urea nitrogen (BUN), uric acid (UA)］, carbohydrate metabolism indicators ［fasting blood glucose (FPG), glycated hemoglobin (HbA1c)］, blood lipids ［total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)］, echocardiographic indicators ［left ventricular end diastolic diameter (LAD), E peak, A peak, left ventricular ejection fraction］ and SF-36 scores were collected. The correlations between 6MWD and the above indicators were analyzed. Results Among the 138 patients, 58, 47, 23, and 10 patients coexisted with 2, 3, 4, 5 diseases respectively. 6MWD was positively correlated with height, pre- and post-test pulmonary function ［forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC］, physical function, role-physical, Hb, ALT, LDL-C (P＜0.05), and negatively correlated with age, FPG, HbA1c, and A-peak (P＜0.05). Conclusion 6MWD is correlated with cardiovascular function and quality of life in patients with multimorbidity, and can play an important role in evaluating and monitoring the overall function of patients with multimorbidity.

General practice research focuses on a range of topics, such as patients' physical health and mental health, physicians' competencies and career motivation, quality of healthcare and physician-patient relationships and cooperation. However, these are not resolved well only using quantitative research which is still dominated in the field of general practice. In this case, qualitative method is often required, although it is considered to be subjective, and is mainly used to describe a phenomenon that is little known in a small sample. Mixed methods research, which incorporates qualitative and quantitative research and combines the advantages of both, can analyze specific problems more extensively and intensively, is suitable for studying complex problems, and for general practice research as an approach integrating clinical medicine and sociology. However, mixed methods research in general practice is still in its early phase in China, and the standardization of its design and implementation needs to be improved. For better elaborating the key points in the design and implementation of mixed methods research, we detailed a study using mixed methods, providing a reference for general practitioners to carry out mixed methods research.

Background: The overall satisfaction of patients after total knee arthroplasty (TKA) is approximately 80%, and current studies have demonstrated that patients with depression may have lower patient satisfaction. The purpose of this study was to determine whether perioperative psychological intervention in patients with depression improves the clinical outcomes and patient satisfaction in patients undergoing TKA.Methods: Six hundred patients who underwent primary TKA from May 2016 to January 2018 were prospectively screened for eligibility. A preoperative psychological evaluation was conducted by a psychiatrist to evaluate each patient's psychological status. Patients who were diagnosed with depression were randomly divided into 2 groups: the intervention group (patients received psychological interventions that were administered by a psychiatrist at the first visit before surgery and from then on) and the control group (patients received routine TKA care without psychological interventions). The primary outcome was patient satisfaction at 6 months postoperatively. The secondary outcomes were patient satisfaction at 2 years postoperatively as well as the Hospital for Special Surgery (HSS) scores, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, and range of motion at 6 months and 2 years postoperatively.Results: Fifty-three patients with depression were identified. Fifty-one patients were enrolled in the randomized controlled trial. Two patients were lost to follow-up at 6 months after surgery. Therefore, 49 patients (25 in the intervention group and 24 in the control group) remained in the final analysis. At 6 months postoperatively, statistical differences in patient satisfaction were identified between the 2 groups (88.0% in the intervention group compared with 62.5% in the control group; odds ratio = 4.40; 95% confidence interval, 1.02 to 18.99). There was a significant improvement in the Self-Rating Depression Scale (SDS) score (the reduction rate was 51.97% in the intervention group compared with 17.35% in the control group) and the Symptom Checklist 90 Revised (SCL-90-R) subscore for depression (the reduction rate was 44.66% in the intervention group compared with 15.73% in the control group). The clinical outcomes, including the WOMAC scores, the HSS scores, and maximal range of motion, in the intervention group had improved significantly more compared with those in the control group.Conclusions: Psychological interventions during the perioperative period can improve patient satisfaction in patients with depression who undergo TKA. Therefore, psychological intervention and management may be beneficial for patients with depression who are planning to undergo TKA.Level Of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

Introduction: Assembly‐line migrant workers (AMWs), as a major workforce in China, may be at particularly high risk of depression due to their relative low social economic status and particular job characteristics. However, little is known about the frequency and characteristics of depression among Chinese AMWs. This study investigated the prevalence and correlates of depressive symptoms in Chinese AMWs. Methods: In this cross‐sectional survey, 915 Chinese AMWs from two shoe‐making factories completed a standardized questionnaire to report their socio‐demographics, physical health, migration, and work. They also reported their depressive symptoms by completing the Beck Depression Inventory—Short Form (BDI—SF). We conducted multiple logistic regression analysis to identify factors related to depression. Results: We found that 31.7% of AMWs were clinically depressed (BDI‐SF ≥ 8). The multiple regression model included age, self‐rated physical health, pain, family relationships, having no good friends at the same factory, and working under high pressure. Discussion: Our findings suggest that depression is common among Chinese AMWs. We argue that there is an urgent need for health care providers and factory managers to work on the early identification of AMWs, who are at high risk for depression. Psychological and psychiatric treatments are necessary in the Chinese labor‐intensive industries. [ABSTRACT FROM AUTHOR]

Objective: To investigate the current status of the application of diagnostic and assessment tools for chronic obstructive pulmonary disease(COPD) by respiratory physicians in China. Method: An on-line questionnaire was designed to address the common questions in COPD diagnosis and evaluation, and this survey was conducted through Wechat. Result: A total of 3 204 valid questionnaires were collected. 71.7% of the physicians were from tertiary hospitals. 75.4% of the physicians diagnosed COPD strictly on the basis of lung function results after inhaled bronchodilators, and this percentage was higher in tertiary hospitals than in secondary hospitals(78.71% vs. 66.92%, P <0.01). 99.3% of the physicians evaluated symptoms of dyspnea, but 26.8% of physicians did not use a scoring system(CAT or mMRC) for quantitative assessment. Although 83.8% of physicians would use the guideline-recommended comprehensive assessment(ABCD classification), only 45.1% of them chose initial therapy exactly according to the classification. In addition, 28.3% of physicians did not routinely order blood eosinophil counts and 20.1% did not inquire the history of tuberculosis. Conclusions: Although most respiratory physicians followed the guidelines in the diagnosis and evaluation of COPD, the use of assessment tools was inadequate, which should be addressed in educational programs for COPD management.

Background: The overall satisfaction of patients after total knee arthroplasty (TKA) is approximately 80%, and current studies have demonstrated that patients with depression may have lower patient satisfaction. The purpose of this study was to determine whether perioperative psychological intervention in patients with depression improves the clinical outcomes and patient satisfaction in patients undergoing TKA., Methods: Six hundred patients who underwent primary TKA from May 2016 to January 2018 were prospectively screened for eligibility. A preoperative psychological evaluation was conducted by a psychiatrist to evaluate each patient's psychological status. Patients who were diagnosed with depression were randomly divided into 2 groups: the intervention group (patients received psychological interventions that were administered by a psychiatrist at the first visit before surgery and from then on) and the control group (patients received routine TKA care without psychological interventions). The primary outcome was patient satisfaction at 6 months postoperatively. The secondary outcomes were patient satisfaction at 2 years postoperatively as well as the Hospital for Special Surgery (HSS) scores, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, and range of motion at 6 months and 2 years postoperatively., Results: Fifty-three patients with depression were identified. Fifty-one patients were enrolled in the randomized controlled trial. Two patients were lost to follow-up at 6 months after surgery. Therefore, 49 patients (25 in the intervention group and 24 in the control group) remained in the final analysis. At 6 months postoperatively, statistical differences in patient satisfaction were identified between the 2 groups (88.0% in the intervention group compared with 62.5% in the control group; odds ratio = 4.40; 95% confidence interval, 1.02 to 18.99). There was a significant improvement in the Self-Rating Depression Scale (SDS) score (the reduction rate was 51.97% in the intervention group compared with 17.35% in the control group) and the Symptom Checklist 90 Revised (SCL-90-R) subscore for depression (the reduction rate was 44.66% in the intervention group compared with 15.73% in the control group). The clinical outcomes, including the WOMAC scores, the HSS scores, and maximal range of motion, in the intervention group had improved significantly more compared with those in the control group., Conclusions: Psychological interventions during the perioperative period can improve patient satisfaction in patients with depression who undergo TKA. Therefore, psychological intervention and management may be beneficial for patients with depression who are planning to undergo TKA., Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence., Competing Interests: Disclosure: This study was fully funded by the Beijing Municipal Science & Technology Commission (project number Z151100003915107). The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJS/G236)., (Copyright © 2020 by The Journal of Bone and Joint Surgery, Incorporated.)