Search

To investigate the preventive effect of different dressings on pressure injuries related to non‐invasive ventilation equipment and to screen the efficacy of dressings. Systematic review and network meta‐analysis. PubMed, the Cochrane Library, Web of Science, EMBASE, Cumulative Index to Nursing & Allied Health Literature (CINAHL), China Knowledge Resource Integrated Database (CNKI), Wanfang Database, Chinese Biomedical Database (CBM) and Weipu Database (VIP) were used for the search from the date of inception of each database to 15 October 2023. The quality of the data was assessed using the Cochrane Risk of Bias tool. Stata 16.0 Software was used to analysis and ranking of different types of dressings. A total of 23 randomized controlled trials on 7 interventions were included in the final analysis. The effectiveness of these in preventing the overall incidence of pressure injuries is ranked from best to worst as follows: hydrogel dressing > foam dressing > petroleum jelly gauze dressing > hydrocolloid dressing > film dressing > clean gauze dressing > sterile gauze. Sixteen studies reported the incidence of Stage I pressure injuries, the effectiveness in preventing the incidence of Stage I pressure injuries was ranked from best to least effective: foam dressing > hydrogel dressing > petroleum jelly gauze dressing > hydrocolloid dressing > film dressing > clean gauze dressing > sterile gauze dressing. Fourteen studies reported the incidence of Stages I/II pressure injuries, the effective in preventing the incidence of Stages I and II pressure injuries was ranked from best to least effective: foam dressing > hydrogel dressing > petroleum jelly gauze dressing > hydrocolloid dressing > clean gauze dressing > sterile gauze dressing. Considering the advantages and disadvantages of different dressings, both hydrogel and foam dressings are effective in preventing pressure injuries related to non‐invasive ventilation equipment. [ABSTRACT FROM AUTHOR]

To compare the predictive properties of the Jackson/Cubbin scale and Waterlow scales in intensive care unit patients. A multi‐centre study. This study was conducted between April 2021 and February 2023 in 72 intensive care units of 38 tertiary hospitals in Gansu Province, China. All adults admitted to the intensive care unit for 24 hours or more without pressure injury on admission were screened using the Waterlow scale and Jackson/Cubbin scales in intensive care. Additionally, the negative predictive value, positive predictive value, sensitivity, specificity and receiver operating characteristic curve with area under the curve of the Waterlow scale and Cubbin/Jackson scales were determined. The participant population for this study included 6203 patients. Predictive properties for the Jackson/Cubbin scales and Waterlow scales, respectively, were as follows: Cut‐off scores, 28 versus 22; AUC, 0.859 versus 0.64; sensitivity, 92.4% versus 51.9%; specificity, 67.26% versus 71.46%; positive predictive value, 35% versus 23%; negative predictive value, 99.9% versus 99.1%. Both Waterlow scales and Jackson/Cubbin scales could predict pressure injury risk for patients in the intensive care unit. However, the Jackson/Cubbin scale demonstrated superior predictive properties than the Waterlow scale. [ABSTRACT FROM AUTHOR]

Deep tissue injuries (DTIs) are a serious type of pressure injuries that mainly occur at the bony prominences and can develop rapidly, making prevention and treatment more difficult. Although consistent research efforts have been made over the years, the cellular and molecular mechanisms contributing to the development of DTIs remain unclear. More recently, ferroptosis, a novel regulatory cell death (RCD) type, has been identified that is morphological, biochemical and genetic criteria distinct from apoptosis, autophagy and other known cell death pathways. Ferroptosis is characterized by iron overload, iron‐dependent lipid peroxidation and shrunken mitochondria. We also note that some of the pathological features of DTI are known to be key features of the ferroptosis pathway. Numerous studies have confirmed that ferroptosis may be involved in chronic wounds, including DTIs. Here, we elaborate on the basic pathological features of ferroptosis. We also present the evidence that ferroptosis is involved in the pathology of DTIs and highlight a future perspective on this emerging field, desiring to provide more possibilities for the prevention and treatment of DTIs. [ABSTRACT FROM AUTHOR]

Despite the fact that machine learning (ML) algorithms to construct predictive models for pressure injury development are widely reported, the performance of the model remains unknown. The goal of the review was to systematically appraise the performance of ML models in predicting pressure injury. PubMed, Embase, Cochrane Library, Web of Science, CINAHL, Grey literature and other databases were systematically searched. Original journal papers were included which met the inclusion criteria. The methodological quality was assessed independently by two reviewers using the Prediction Model Risk of Bias Assessment Tool (PROBAST). Meta‐analysis was performed with Metadisc software, with the area under the receiver operating characteristic curve, sensitivity and specificity as effect measures. Chi‐squared and I2 tests were used to assess the heterogeneity. A total of 18 studies were included for the narrative review, and 14 of them were eligible for meta‐analysis. The models achieved excellent pooled AUC of 0.94, sensitivity of 0.79 (95% CI [0.78–0.80]) and specificity of 0.87 (95% CI [0.88–0.87]). Meta‐regressions did not provide evidence that model performance varied by data or model types. The present findings indicate that ML models show an outstanding performance in predicting pressure injury. However, good‐quality studies should be conducted to verify our results and confirm the clinical value of ML in pressure injury development. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to investigate the incidence of alexithymia in intensive care unit nurses and determine the associated factors. Design: A multi‐center, cross‐sectional study. Methods: In total, 485 nurses in intensive care unit were recruited from 53 hospitals in China. Data collection tools used in the study included demographic characteristics, the Social Support Rating Scale (SSRS), Emotional Intelligence Scale (EIS), and the 20‐item Toronto Alexithymia Scale (TAS‐20). SPSS 25.0 software (Corp., Armonk, NY, USA) was used to preform data analysis. Results: About 43.7% of intensive care unit nurses were classified as alexithymia in the whole sample (males: 50%, females: 43%). The median TAS‐20 score was 60 (interquartile range = 9). The study found that alexithymia was significantly associated with marital status, whether living alone, working years, and social support (Adjusted R Squared = 0.194, F = 6.466, p < 0.01), while emotional intelligence was not statistically significant with alexithymia. Conclusions: Alexithymia is a psychological problem with high incidence in intensive care unit nurses. In this study, being unmarried or divorced, living alone, and having fewer years of work (≤5 years) were associated with a higher risk of alexithymia. Interventions that strengthen social support may also help improve the mental health of ICU nurses. [ABSTRACT FROM AUTHOR]

To systematically assess the prevalence of facial pressure injuries related to adult non‐invasive ventilation equipment, and risk factors of facial pressure injuries. PubMed, Cochrane Library, Web of Science, Embase, China Knowledge Resource Integrated Database, Wanfang Database, Chinese Biomedical Database and Weipu Database were comprehensively searched for observational studies investigating the prevalence and risk factors of facial pressure injuries related to adult non‐invasive ventilation equipment from inception to May 16th, 2022. Filter articles based on inclusion and exclusion criteria. The quality of the included studies was evaluated independently by two investigators. Meta‐analysis was conducted using Stata 16.0 software package. In total, 2835 articles were screened and data from 12 studies were used in meta‐analysis. The prevalence of facial pressure injuries related to adult non‐invasive ventilation equipment was 25% (95% confidence interval, CI:15% to 37%, I2 = 97.34%, P < 0.0001). After controlling for confounding variables, the following risk factors of facial pressure injuries: use equipment form, with diabetes, fever, cumulative time of using equipment, facial skin oedema and Glasgow score. Understanding the risk factors of facial pressure injuries can provide the healthcare personnel with the theoretical basis for the management and treatment of the patients. [ABSTRACT FROM AUTHOR]

Deep tissue injuries (DTIs) are a serious type of pressure injuries that mainly occur at the bony prominences and can develop rapidly, making prevention and treatment more difficult. Although consistent research efforts have been made over the years, the cellular and molecular mechanisms contributing to the development of DTIs remain unclear. More recently, ferroptosis, a novel regulatory cell death (RCD) type, has been identified that is morphological, biochemical and genetic criteria distinct from apoptosis, autophagy and other known cell death pathways. Ferroptosis is characterized by iron overload, iron-dependent lipid peroxidation and shrunken mitochondria. We also note that some of the pathological features of DTI are known to be key features of the ferroptosis pathway. Numerous studies have confirmed that ferroptosis may be involved in chronic wounds, including DTIs. Here, we elaborate on the basic pathological features of ferroptosis. We also present the evidence that ferroptosis is involved in the pathology of DTIs and highlight a future perspective on this emerging field, desiring to provide more possibilities for the prevention and treatment of DTIs., (© 2023 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.)

Objective: Even though 32%-83% for fear of falling (FoF) in patients with stroke, very little is known about the predictors of the problems. Therefore, we systematically reviewed the literature on risk factors for FoF in patients with stroke., Design: A systematic review and meta-analysis DATA SOURCES: PubMed, Embase, Cochrane Library database, Web of Science, CINAHL, PsycINFO, Grey literature and other relevant databases for related publications were searched (from inception to 17 July 2021)., Results: Eight studies involving 1597 participants were selected to analyse risk factors for patients with stroke with FoF. The quality of all included studies was assessed and categorised as medium or high quality. Review Manager V.5.3 merged the OR value and 95% CI of the potential risk factors. Meta-regression and Egger's test were performed by Stata V.15.1. The risk factors for FoF in patients with stroke were women (OR=2.13, 95% CI 1.47 to 3.09), impaired balance ability (OR=5.54; 95% CI 3.48 to 8.81), lower mobility (OR=1.12; 95% CI 1.05 to 1.19), history of falls (OR=2.33; 95% CI 1.54 to 3.53) and walking aid (OR=1.98; 95% CI 1.37 to 2.88), anxiety (OR = 2.29; 95% CI 1.43 to 3.67), depression (OR=1.80; 95% CI 1.22 to 2.67), poor lower limb motor function ( OR =1.14; 95% CI 1.00 to 1.29) and physically inactiveness (OR=2.04; 95% CI 1.01 to 4.12). Measurement of heterogeneity between studies was high for all outcomes ( I 2 =0%-93%), indicating that the substantial interstudy heterogeneity in estimated proportions was not attributed to the sampling error. Sensitivity analysis (leave-one-out method) showed that the pooled estimate was stable., Conclusion: This meta-analysis indicated that female population, impaired balance ability, lower mobility, history of falls and walking aid in patients with stroke might be at greater risk for FoF. Future studies are recommended to determine other risk factors specific to patients with stroke., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)