Potential Benefits of Multimedia-Based Home Catheter Management Education in Patients With Peripherally Inserted Central Catheters: Systematic Review

The effectiveness of multimedia-based education on hypoglycemic events and associated factors in elderly individuals with type 2 diabetes

AIM

To investigate the effectiveness of multimedia-based hypoglycemia education compared to conventional hypoglycemia education on knowledge, self-care behavior, fear of hypoglycemia, social support, quality of life, nursing hours, education satisfaction, and the recurrence rate of hypoglycemic events among elderly individuals with type 2 diabetes who have experienced hypoglycemic events.

METHODS

A randomized controlled trial with a repeated-measures design was conducted on 82 elderly patients with type 2 diabetes who had experienced hypoglycemic events. Participants in the experimental group received multimedia-based hypoglycemia education, while those in the contrast group received lecture-based hypoglycemia education. Data were analyzed using descriptive statistics, chi-square tests, t-tests, and Generalized Estimating Equations (GEE).

RESULTS

The experimental group showed significantly higher mean scores in hypoglycemia knowledge (p < .001), hypoglycemia self-care behavior (p = .034), and education satisfaction (p < .001). The nursing hours spent by the experimental group were significantly lower than those of the contrast group (p < .001). Within 6 months after receiving hypoglycemia education, the recurrence rate of hypoglycemic events decreased by 61% in the experimental group and 53.70% in the contrast group.

CONCLUSIONS

Multimedia-based hypoglycemia education can enhance knowledge and self-care behavior and reduce the recurrence rate of hypoglycemia among elderly patients with type 2 diabetes. Healthcare professionals can utilize multimedia education for hypoglycemia in elderly individuals with diabetes to improve their ability for home hypoglycemia care, thereby reducing the recurrence rate of hypoglycemic events.

Knowledge, Attitude, and Practice Toward Spinal Cord Tumors Among Patients and Their Families in Beijing: A Cross-Sectional Study

Background

This study aimed to investigate the knowledge, attitude, and practice (KAP) regarding spinal cord tumors among both patients and their family members.

Methods

A cross-sectional survey was conducted at the Department of Neurosurgery, Beijing Jishuitan Hospital, between August 1, 2023, and January 31, 2024 using a self-designed questionnaire.

Results

A total of 489 valid questionnaires were analyzed, including 219 (44.79%) from patients. The mean knowledge, attitude, and practice scores were 11.09 ± 6.64 (possible range: 0-28), 18.61 ± 1.92 (possible range: 6-30), and 33.58 ± 4.34 (possible range: 8-40), respectively. Multivariate logistic regression analysis revealed that urban residency (OR = 1.904, 95% CI: 1.113-3.314, P = 0.020) and higher monthly per capita income (OR = 3.779, 95% CI: 1.697-8.599, P = 0.001) were independent predictors of proactive practice. Path analysis demonstrated that knowledge (β = 0.11, P < 0.001), monthly per capita income (β = 1.15, P < 0.001), and marital status (β = -0.93, P = 0.039) directly influenced practice behaviors.

Conclusion

Patients and their families demonstrated suboptimal knowledge, negative attitude and proactive practice towards spinal cord tumors. Efforts should be made to enhance education and awareness programs targeting both patients and their families for improving knowledge and fostering positive attitudes.

Risk factors analysis and the establishment of nomogram prediction model for PICC-related venous thrombosis in patients with lymphoma: a double-center cohort-based case-control study

Objective

The objective of this study is to examine the risk factors associated with the occurrence of PICC-Related Venous Thrombosis (PICC-RVTE) in individuals diagnosed with lymphoma, as well as to develop a predictive risk nomogram model.

Methods

A total of 215 patients with lymphoma treated at Yunnan Provincial Tumor Hospital from January 2017 to December 2020 were retrospectively evaluated as the training cohort; 90 patients with lymphoma treated at the Department of Oncology of the First People's Hospital of Anning, Affiliated to Kunming University of Science and Technology during the January 2021 to September 2023 were evaluated as the validation cohort. Independent influencing factors were analyzed by logistic regression, a nomogram was developed and validated, and the model was evaluated using internal and external data cohorts for validation.

Results

A total of 305 lymphoma patients were selected and 35 (11.48%) PICC-RVTE occurred, the median time was 13 days. The incidence within 1-2week was 65.71%. Multivariate analysis suggested that the activity amount, thrombosis history(within the last 12 months), ATIII, Total cholesterol and D-dimer levels were independently associated with PICC-RVTE, and a nomogram was constructed based on the multivariate analysis. ROC analysis indicated good discrimination in the training set (area under the curve [AUC] = 0.907, 95%CI:0.850-0.964) and the testing set (AUC = 0.896, 95%CI: 0.782-1.000) for the PICC-RVTE nomogram. The calibration curves showed good calibration abilities, and the decision curves indicated the clinical usefulness of the prediction nomograms.

Conclusions

Patients should be advised to undergo color Doppler ultrasound system testing within two week after the implantation of a PICC catheter to detect PICC-RVTE at an early stage. The validated nomogram can be used to predict the risk of catheter-related thrombosis (CRT) in patients with lymphoma who received at least one chemotherapy after PICC catheterization, no bleeding tendency, no recent history of anticoagulant exposure and no severe heart, lung, renal insufficiency. This model has the potential to assist clinicians in formulating individualized treatment strategies for each patient.

Complications Associated with Peripherally Inserted Central Catheters (PICC) in People Undergoing Autologous Hematopoietic Stem Cell Transplantation (HSCT) in Home Hospitalization

INTRODUCTION

The SARS-CoV-2 pandemic generated the need to keep immunosuppressed patients away from hospital institutions for as long as possible. This in turn stimulated the implementation of a home hospitalization model for autologous hematopoietic stem-cell transplantation (HSCT).

PURPOSE

To analyze whether there are significant differences in post-transplantation complications related to catheters observed in patients treated in the home-transplant care modality compared to patients treated in the hospital.

METHODOLOGY

Observational, analytical, longitudinal, and retrospective study of cases and controls. A convenience sample was chosen, in which the cases comprised 20 patients included in the home HSCT care model. For each patient, it was considered suitable to propose two controls among those who received autologous transplantation in the last five years with a baseline demographic and pathological profile similar to the case for whom they were control.

RESULTS

The home patients achieved an average of 22.4 ± 2.6 days of evolution with an average of 16.4 ± 2.08 days post-transplant, compared to the hospital process with an average of 21.21 ± 4.18 days of evolution and 15.51 ± 3.96 days post-transplant (evolution days p = 0.022; post-transplant days p = 0.002). A higher percentage of use of parenteral nutrition (p = 0.036) and transfusions (p = 0.003) was observed during the post-transplant phase in the hospital. The rest of the therapeutic measures did not show significant differences. When analyzing the frequency of adverse effects in the post-transplant phase, a significant increase in neutropenic fever (OR = 8.55) and positive blood cultures (OR = 6.65) was observed in hospital patients. Any other significant differences in other variables related to PICC were found (presence and days of neutropenic fever, catheter infection, complications, pathogens, admission to the ICU, or death). Concerning local complications (pain, DVT, Medical adhesive-related Skin Injury, and erythema), there was more erythema in the hospital (p = 0.056).

CONCLUSIONS

The results obtained indicate that regarding the appearance of complications associated with PICCs in home hospitalization HSCT patients, there are no significant differences compared to hospitalization, so that home care can be a safe context for people with these lines.

The effects of continuous care model using a smartphone application on adherence to treatment and self-efficacy among patients with multiple sclerosis

Background

Adherence to disease-modifying therapy is important in patients with Multiple Sclerosis (MS) to increase the positive outcomes and improve the quality of life. This study aimed to determine the effects of Continuous Care Model (CCM) using a smartphone application on adherence to treatment and self-efficacy among MS patients.

Methods

This quasi-experimental study with pre/posttest design was conducted on 72 MS patients in Shiraz, Iran from June 2020 to August 2021. The samples were randomly assigned to intervention (n = 36) and control (n = 36) groups. In the intervention group, the CCM using a smartphone application was implemented during two months. However, no intervention was performed for the control group. The data were collected using the self-report Multiple Sclerosis Treatment Adherence Questionnaire (MS-TAQ) and MS Self-Efficacy Scale (MSSS) at baseline and two and four months after the intervention.

Results

The results showed an improvement in adherence to treatment and self-efficacy in the intervention group compared to the control group after implementing the virtual CCM and at the two-month follow-up (p < 0.001).

Conclusions

Implementing the CCM using a smartphone application resulted in improvements in the MS patients’ adherence to treatment and self-efficacy. It can be concluded that providing care using an interactive multimedia application can improve the outcomes as well as patients’ satisfaction, especially during the COVID-19 pandemic. Therefore, this approach is recommended to be used for nurses, healthcare providers, and clinicians.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12911-022-01785-x.

Kinesiophobia and related factors in cancer patients with TIAPs during the long term: a cross-sectional survey

OBJECTIVE

This study is designed to investigate the status of kinesiophobia and related factors in cancer patients with totally implantable venous access ports (TIAPs).

METHODS

This is a cross-sectional study; all the participants were recruited from the Oncology Department and the Daytime Chemotherapy Center, Renji Hospital, Shanghai Jiao Tong University School of Medicine, from April 1 to May 31, 2021. The participants were interviewed by researchers using the self-made general information questionnaire and the Tampa Scale of Kinesiophobia-11 (TSK-11) scale, which allows the fear of movement to be quantified. Eligible patients were aged ≥ 18 years, confirmed with cancer, and implanted with a port. The logistic regression model was used to evaluate clinical factors and the risk of kinesiophobia.

RESULTS

A total of 282 patients were recruited (aged 58.0 ± 11.5 years), of which gastrointestinal cancer accounted for 54.6%, breast cancer accounted for 22.7%, lung cancer accounted for 11.3%, and other types accounted for 11.3%. The TSK-11 score of the 282 patients was 17.84 ± 6.06 points, 45.7% of the patients reported mild kinesiophobia (TSK-11 ≥ 18), 18.4% of the patients reported moderate to severe kinesiophobia (TSK-11 ≥ 25), and the highest score reached 34 points. Results of logistic regression analysis showed that exercise habits (P = 0.025), pain (P = 0.023), and foreign body sensation (P = 0.003) were the risk factors of kinesiophobia.

CONCLUSION

Kinesiophobia is common in cancer patients with TIAPs, and it is closely related to the subjective experience of daily activities, which requires more attention and early intervention to reduce the potential adverse effects.

Evaluación de la usabilidad de una aplicación móvil para pacientes con catéter central de inserción periférica

Resumen Objetivo: evaluar la usabilidad de la aplicación Meu PICC para el seguimiento extrahospitalario de pacientes que usan catéter central de inserción periférica por medio del instrumento validado System Usability Scale. Método: estudio transversal que aplicó el System Usability Scale a 30 pacientes que usan catéter central de inserción periférica, diez enfermeros y ocho profesionales en tecnología de la información para evaluar la usabilidad de la aplicación. Resultados: hubo diferencia estadística entre la edad y la usabilidad (p=0,006), así como una correlación negativa entre el tiempo de uso de la aplicación y la usabilidad (p=0,002). Según la escala de clasificación de adjetivos del System Usability Scale, el 40,0% de los pacientes consideró que la aplicación era mejor imaginable y el 33,3% excelente. En cuanto a las enfermeras, el 70,0% consideró que la aplicación era mejor imaginable y el 20,0% excelente; de los profesionales en tecnologías de la información, el 50,0% consideró que la aplicación era mejor imaginable y el 50,0% excelente. Conclusión: la evaluación de usabilidad determinó que los pacientes, enfermeros y profesionales en TIC consideraron que la aplicación era útil para el seguimiento de pacientes que utilizan PICC y la calificaron como adecuada, otorgándole la calificación de mejor imaginable o excelente. Estos resultados confirman el uso de la aplicación Meu PICC en el seguimiento de pacientes que usan PICC fuera del hospital.

Usability assessment of a mobile app for patients with peripherally inserted central catheters

OBJECTIVE

to evaluate usability of the Meu PICC (My PICC) app for follow-up of outpatients using peripherally inserted central catheters through the validated System Usability Scale instrument.

METHOD

a cross-sectional study that applied the System Usability Scale to 30 patients using peripherally inserted central catheters, ten nurses and eight Information and Communication Technology professionals to assess usability of the app.

RESULTS

a statistical difference was observed between age and usability (p=0.006), as well as a negative correlation between app use time and usability (p=0.002). As per the System Usability Scale adjectival classification, 40.0% and 33.3% of the patients considered the app as the best possible to be imagined and as excellent, respectively. In relation to the nurses, 70.0% considered the app as the best possible to be imagined and 20.0% as excellent; of the Information and Communication Technology professionals, 50.0% considered the app as the best possible to be imagined and the other 50.0%, as excellent.

CONCLUSION

the usability assessment showed that patients, nurses and ICT professionals considered the app useful for monitoring patients using PICCs and evaluated it as appropriate, evaluating it as the best possible to be imagined or as excellent. These results corroborate use of the Meu PICC app in the monitoring of outpatient use of PICCs.

Avaliação de usabilidade de aplicativo móvel para pacientes com cateter central de inserção periférica

Resumo Objetivo: avaliar a usabilidade do aplicativo Meu PICC para o acompanhamento extra-hospitalar de pacientes em uso de cateter central de inserção periférica por meio do instrumento validado System Usability Scale. Método: estudo transversal que aplicou o System Usability Scale a 30 pacientes em uso de cateter central de inserção periférica, dez enfermeiros e oito profissionais de tecnologia da informação para avaliar a usabilidade do aplicativo. Resultados: observou-se diferença estatística entre idade e usabilidade (p=0,006), bem como correlação negativa entre o tempo de utilização do aplicativo e usabilidade (p=0,002). Pela classificação adjetiva do System Usability Scale, 40,0% dos pacientes consideraram o aplicativo como o melhor imaginável e 33,3% como excelente. Com relação aos enfermeiros, 70,0% consideraram o aplicativo como o melhor imaginável e 20,0% como excelente; dos profissionais de tecnologia da informação, 50,0% consideraram o aplicativo como o melhor imaginável e 50,0% excelente. Conclusão: a avaliação de usabilidade mostrou que pacientes, enfermeiros e profissionais de TIC consideraram o aplicativo útil para o acompanhamento de pacientes em uso de PICC e o avaliaram como adequado, atribuindo-lhe a qualificação de melhor imaginável ou excelente. Estes resultados corroboram para o uso do aplicativo Meu PICC no acompanhamento de pacientes em uso extra-hospitalar de PICC.