ICU探视方式的改进与效果

目的有效控制医院感染的发生。方法对神经内科ICU的入室探视方式进行了改进:神志清醒的患者随时通过电话与其家属和亲友进行交流,并于每天15:00~16:00透过玻璃窗相互看望。改进前、后分别对ICU进行医院感染监测和患者心理状态调查。结果探视方式改进后,ICU空气细菌培养合格率显著提高,与改进前比较差异具有统计学意义;改进前医院感染发生率为10.99%,改进后医院感染发生率为3.95%,经2检验P(0.01;探视方式改进前、后患者心理状态比较差异无统计学意义。结论电话交流配合室外探望,取消入室探视制度,既可有效控制医院感染,又不会对患者心理产生不良影响。     

Renal function and outcome after heart transplantation

Objectives

To investigate whether measured glomerular filtration rate (mGFR) is a risk factor for death and/or end-stage renal disease (ESRD) after heart transplantation (HTx).

Development of the Impact of Nighttime Urination (INTU) questionnaire to assess the impact of nocturia on health and functioning

Aims

This study describes development of the Impact of Nighttime Urination (INTU) questionnaire to assess nocturia impacts on health and functioning.

Methods

Development of the questionnaire followed an iterative patient‐directed process as recommended by current guidance for patient‐reported outcome (PRO) measures. An initial 15‐item questionnaire was devised based on reviewing the published literature, and then modified through four rounds of semi‐structured interviews of 28 individuals with nocturia. In each round, open‐ended concept elicitation, followed by cognitive debriefing, was used to assess the questionnaire. Items were modified based on participants’ responses and incorporated into the next round of interviews.

Results

In all rounds, participants reported that their experiences were easy to recall and report on a daily basis and that the burden of completing the questionnaire was low. The final questionnaire has a same‐day recall period. It includes six daytime impact items—having limited concentration, a sense of feeling tired, difficulty getting things done, irritability, not feeling rested, and drowsiness—and four items that measure the nighttime impact of nocturia—patient concern, waking up too early, difficulty getting enough sleep, and feeling bothered by having to get up at night to void. Responses follow a 5‐ or 4‐point scale. The final INTU captures the key concepts associated with nocturia as confirmed by cognitive debriefing.

Conclusions

Development of the 10‐item INTU, a nocturia‐specific PRO measure, was based on direct input and feedback from patients and has demonstrated that it captures the patient‐reported impacts of nocturia.