Patient Self Research Articles

Patient self rated pain: headache versus migraine a retrospective chart review

BackgroundThe International Classification of Headache Disorders (ICHD-3) uses moderate or severe pain intensity in the diagnostic criterion for migraine. However, few studies have analyzed pain rating on a visual analog scale to identify the numerical intensity that correlates with migraine.ObjectiveTo evaluate the impact of daily self-rated headache pain among patients with either episodic or chronic migraine. This study specifically aims to evaluate the probability of patients labeling their head pain as a headache vs. migraine based on the pain level reported.MethodsA retrospective chart review was conducted on patients with a clinical diagnosis of migraine from July 1, 2014, to July 1, 2019.ResultsData of 114 subjects (57 episodic migraine and 57 chronic migraine) were used for analysis. Patients with episodic migraine on average rated a migraine more severe than a headache (4.1 vs. 6.4; p < 0.001). Patients with chronic migraine on average also rated migraine more severe than a headache (4.3 vs. 6.8; p = 0.0054). Chronic migraine patients transitioned from calling head pain a headache to a migraine significantly later than episodic migraine patients (4.5 vs. 6.8; p < 0.05).ConclusionA migraine is perceived as having higher pain intensity than a headache in patients with both episodic and chronic migraine. On average, patients with chronic migraine had a higher pain rating at which they report head pain to be considered a migraine.

High levels of Patient Self Advocacy may confound clinical research in understudied patient populations.

To examine the levels of patient self-advocacy in a sample of participants with Chiari Malformation (CM) and to explore how they relate to clinical outcomes. As part of a larger clinical trial addressing chronic pain in patients with CM, 111 participants completed the Patient Self Advocacy Scale (PSAS), the Depression, Anxiety, and Stress Scale (DASS-21), and the Brief Pain Inventory (BPI). PSAS scores indicated a moderately high level of patient self-advocacy (Mean = 3.86 SD = 0.50). The PSAS was not related to depression, anxiety, stress, pain intensity, or pain interference. There were no differences in PSAS according to surgical status (t(61.25) = 0.44, p = 0.66) or use of pain medication (t(109) = 1.05, p = .29). Participants in a clinical trial for CM have high levels of pre-existing patient self-advocacy. Research is needed to understand how patient self-advocacy contributes to the management of CM and how it could impact research of individuals with understudied conditions. NCT05581472.

SurLym trial: study protocol for a multicentre pragmatic randomised controlled trial on the added value of reconstructive lymphatic surgery to decongestive lymphatic therapy for the treatment of lymphoedema

IntroductionLymphoedema is a chronic condition caused by lymphatic insufficiency. It leads to swelling of the limb/midline region and an increased risk of infection. Lymphoedema is often associated with mental and...

P006 A new digital front door for existing rheumatology patient queries

Abstract Background/Aims NICE guidelines recommend people with rheumatological conditions need rapid access to specialist care to manage flares and to advise on medication. With growing demand for NHS services, rheumatology advice lines are coming under pressure. We carried out an audit on our advice line queries over four clinics in summer 2021 with a view to developing a triaging system to improve response time. Over four advice line clinics, there were 44 calls averaging 13 minutes per call. The response time was two to three weeks. 34% of calls were deemed to be inappropriate. Inappropriate calls were considered ones that could be better directed elsewhere. Methods In 2022 we started working with DrDoctor, a digital health company to design a digital nurse advice line form to redirect inappropriate calls away from the nurse advice line call backs. This involved designing a digital pathway addressing common inappropriate themes from our audit including redirection of calls to secretaries, patient booking team, prescription management and a digital booking form for phlebotomy appointments. The new digital tool enabled us to expand the service and we used the opportunity to adopt patient assessment tools and educational videos as part of the service. We promoted the digital pathway through patient information leaflets, department website and sent a text with the link to all rheumatology patients. We continued to offer the traditional contact telephone number into the service as well. Results The digital nurse advice line went live at the end of July 2023 and after two months the response time has reduced to 1.5- 2 weeks. Since then there have been 529 form submissions from 417 unique patients. 47% of submissions were inappropriate and redirected. 97 patients called to book a blood test and 76 patients opted for the online self-service clinic. 151 patients had a query about their condition. 50% of patient had RA or inflammatory arthritis. 5% AS. 5% SLE. 17% PsA. 23% selected ‘other’ and a free text box captured conditions such as fibromyalgia, osteoporosis, PMR and OA. 26% of patients with rheumatoid arthritis opted to see the educational video on self-examination and 17% watched the educational video on rheumatoid arthritis. Based on 251 submissions that were inappropriate for the advice line, assuming each inappropriate call takes an average of nine minutes based from our previous audit, 39 hours of phone time was saved from avoiding booking inappropriate nurse advice line appointments in two months. Conclusion The digital rheumatology advice service is an efficient and effective method of responding to patient queries and can be a source of patient education and self assessment. Informal patient and staff feedback has been positive and we will be collecting formal feedback as the service becomes more established. Disclosure K. Nadesalingam: None. C. Short: None. K. Christian: None. P. Helliwell: None.

The effect of an educational program on wellbeing and symptom control of hospitalized chronic obstructive pulmonary disease patients in Jordan

ABSTRACT This study was conducted to determine what impact a structured nurse-led educational program has on patient self management and symptom control of hospitalized Chronic Obstructive Pulmonary Disease (COPD) patients in Jordan. An experimental design was used to guide data collection from 100 COPD patients who were randomly assigned to the intervention (n = 50) and control groups (n = 50). Participants in the intervention group underwent a two-week health education program that discussed smoking, medications and how to use them, exercise, and diet. A COPD educational pamphlet was also provided. Participants in the control group received only routine health education. A COPD Assessment Test (CAT) was used to measure the impact of the COPD educational program on wellbeing. The test consists of eight short questions covering cough, sputum production, chest tightness, breathlessness, activity limitations at home, confidence leaving home, sleep, and energy. The independent samples t-test findings revealed a significant difference between the two groups in relation to the post-test results (p = 0.039), with a 95 percent confidence interval −25.24 to −6.46, providing empirical support for the educational program’s success. Moreover, and as compared to the control group, participants in the intervention group showed significantly fewer COPD-related hospital admissions (p = .033). These programs should be integral components of a nurse-led COPD clinic to improve patients’ experience with the disease and reduce the risk of readmission, resulting in reduced cost and improved quality of life.

Abstract A021: Pilot study of daily exemestane in patients with Endometrial Intraepithelial Neoplasia (EIN) or grade 1 endometrial cancer

Abstract Introduction: The purpose of this study is to evaluate exemestane, an aromatase inhibitor, as a potential agent for the chemoprevention of endometrial cancer. Experimental procedures: This is a multi-center, phase IIA, single arm ‘window of opportunity’ pilot study of 25 mg per day of exemestane for 21-42 days in postmenopausal patients undergoing hysterectomy for endometrial intraepithelial neoplasia (EIN) or low-grade endometrial cancer. The primary objective is to determine if there is a decrease in proliferation index, measured by percent Ki-67 expression in endometrial tissue, from pre-treatment to post-exposure. Results of Ki-67 are compared with a historic control cohort of tumors from patients matched by preoperative histologic diagnosis, age, BMI category. Specimens from the historic control cohort included a preoperative endometrial biopsy as well as a surgical specimen, separated in time by less than 42 days. Secondary outcomes include comparison of Ki67 to historic controls, circulating serum estradiol and progesterone levels, pathologic response, tissue biomarkers, safety and adverse effects. Summary of Data: Forty patients accrued to the study between January of 2018 and March of 2021. The mean age was 63 (range 52-75). Thirty-nine patients (97.5%) self identifiedself-identified as white; 1 patient (2.5%) identified as Asian. The mean BMI was 40.3 (SD 9.75, range 22.8-60.5). Preoperative diagnoses included EIN, grade 1 endometrial adenocarcinoma, and grade 2 endometrial adenocarcinoma in 11 (27.5%), 26 (65%), and 3 (7.5%) patients respectively. Thirty-nine patients (97.5%) were compliant with exemestane dosing. All patients completed the study and no patients discontinued or interrupted therapy due to treatment related adverse events. Thirty-eight patients had evaluable specimens for both pre and post-treatment Ki-67 analysis. Median Ki-67 score decreased from 40.7% [IQR (33.9%, 50.3] at baseline to 18.1% [IQR (8.8%, 31.8%)]. This represents a median absolute change from baseline of -20.4% [IQR (-29.9, -6.7), p&amp;lt;0.001]. In total, percentage of Ki-67 in tumor cells declined in 31 patients and increased in 7 patients. In the historic control cohort, patients also had a decrease in Ki-67 score with a median absolute change from baseline of -6.7% [IQR (-12.7%, -1.3%), p&amp;lt;0.001]. However, the decrease in Ki-67 was greater in the study patients than the matched historic controls, with a median difference between the groups of -13.4% [IQR= (-23.3%, 6.9%), p=0.0095]. Serum estradiol levels did not change significantly between baseline and post-treatment (p=0.16). There was a small but significant increase from baseline to post-treatment in serum progesterone (0.14 ng/mL vs 0.37 ng/mL, p&amp;lt;0.001). Conclusion: In this pilot window of opportunity study, exemestane demonstrates anti-proliferative effects in endometrial intraepithelial neoplasia and low-grade endometrial cancer. This agent warrants further evaluation for the chemoprevention of endometrial cancer. Citation Format: Britt K. Erickson, Lisa Barrioullet, Rebecca C. Arend, Dina El-Rayes, Mahmoud Khalifa, Amy Skubitz, Kristin Boylan, Andrew Nelson, Bharat Thyagarajan, Thomas Havighurst, Richard Chappell, Eileen Dimond, Katina Deshong, Goli Samimi, Eva Szabo, Howard Bailey. Pilot study of daily exemestane in patients with Endometrial Intraepithelial Neoplasia (EIN) or grade 1 endometrial cancer [abstract]. In: Proceedings of the AACR Special Conference on Endometrial Cancer: Transforming Care through Science; 2023 Nov 16-18; Boston, Massachusetts. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(5_Suppl):Abstract nr A021.

The analysis of variables affecting patient satisfaction and its level in a hospital emergency department based on a selected emergency unit

Introduction. Patient satisfaction is perceived as one of the major criterium while evaluating the quality in the field of medical services.Aim of the study. Analysing and evaluating the level of satisfaction with the services provided by medical and nursing staff among patients of a selected Emergency Department (ED).Material and methods. The observational study was conducted from September to December 2022. The research was based on the data collected from 122 patients of the ED. The Patient Satisfaction Questionnaire and self- prepared questionnaire were used.Results. Using an 11-grade scale from 0 – 10 (0 – the worst of all possible hospitals, 10 – the best of all possible hospitals), only 15.83% (19) evaluated the researched hospital as ‘the best’. Most of the respondents - 23.33% (28) gave the hospital an 8 or 9 - point rate - 18.33% (22). While patients’ asked how often they were treated with respect and kindness by the nursing staff, the respondents most frequently answered ‘always’ - 70.83% (85) or ‘usually’ - 27.50% (33). While asked how often the doctors treated them with respect and kindness, most frequently answered ‘always’ - 61.67% (74) or ‘usually’ - 26.67% (32). Age and gender of patients did not significantly affect the level of satisfaction with care (p&gt;0.005). However, the higher the level of education, the lower the willingness to recommend the hospital to family or friends (p=0.027). Conclusions. General satisfaction with hospitalization was at a high level. The more educated the patients were, the lower the readiness to recommend the hospital to family or friends. The ED staff should take into consideration this fact while planning care in hospital emergency departments.

The Effect of Multidimensional Spiritual Psychotherapy on the Quality of Life of Bone Cancer Survivors with a History of Lower Extremity Amputation.

This study aimed to investigate the effect of multidimensional spiritual psychotherapy on anxiety, depression, and attitude towards self and god in bone cancer patients after amputation. Forty one cancer patients with a history of Below-The-Knee amputation were recruited in this quasi-experimental study. The design included pre-and post-tests in experimental and control groups. The experimental group received 15 sessions of multidimensional spiritual psychotherapy. Cattell Anxiety Inventory (CAI), Beck Anxiety Inventory (BAI), Beck's Depression Inventory (BDI), Religious Adherence Questionnaire (RAQ), and Self-concept-God concept questionnaire were administered for data collection. There was a significant difference between the control and experimental groups in terms of anxiety (P=0.0001), Depression (P=0.0001), God-image (P=0.035, F(1,38)=4.79), God-concept (P=0.006, F(1,38)=8.58), self-image (P=0.0001, F(1,38)=98.62), and self-concept (P=0.0001, F(1,38)=120.56), psychological evolution (P=0.0001, F(1,38)=19.36), and religious adherence (P=0.0001, F(1,38)=84.21). The results of the study indicated that the emphasis on spirituality and the implementation of spiritual care could improve the cancer amputated patients' well-being.

A MEDICAL AND NEUROPSYCHIATRIC MANAGEMENT SURVEY IN A BRAZILIAN COHORT OF PATIENTS WITH INFLAMMATORY BOWEL DISEASE (IBD).

Inflammatory bowel disease (IBD) can be accompanied by several neurological disorders. Since 2004, we started a Brazilian cohort to assess neuropsychiatric complications in IBD patients. Changes in therapeutic strategy and differences in the prevalence and relevance of neuropsychiatric disorders have been reported in the literature. We conducted a short patient-reported survey about the medical management of IBD (with a special focus on neuropsychiatric management) and its complications. During the enrollment period (9/1/2021 to 8/31/2022), 279 patients with IBD answered the survey (128 patients with ulcerative colitis and 151 with Crohn's disease). This is the first medical management survey aimed to verify the level of perception of IBD patients about their neuropsychiatric conditions. We found a high prevalence of neurologic (59%), psychiatric (32%), and neuropsychiatric co-morbidities (69%). There is a marked discrepancy between the findings of neurological disorders reported in our studies over the first 10 years of the cohort in comparison with the current perception/knowledge among the patients registered in the present management survey. Patients tend to have a better understanding of central rather than peripheral nerve conditions. • What is already known? • The prevalence and spectrum of neuropsychiatric co-morbidities varies among different epidemiologic studies. • What is new here? • Patients self report a high percentage of neuropsychiatric diseases but tend to better recognize central rather than peripheral nervous system disorders. • How can this study help patient care? • This study may guide practioners to educate IBD patients about their neuropsychiatric co-morbidities.

Deep Brain Stimulation - Efficacy and Safety for Neurological Treatments

Though Deep Brain Stimulation (DBS) has been a popular technology in medicine with constantly reported innovation for many years, there are only limited studies that summarize its efficacy and safety. To compensate, this article thoroughly analyses these topics of DBS as treatments for multiple neurological diseases. Initially, the history and mechanism of DBS are introduced. Then, studies targeting different neurological conditions review the general efficacy of DBS. For traditional DBS targets like Parkinson’s Disease (PD), substantial disability rating improvements in patients of large-scale clinical reports are evidence of efficacy. Whereas for novel DBS targets like Obsessive-compulsive Disorder (OCD) and Huntington’s Disease (HD), evidence mainly comes from improvements in small-scale patient case studies and thus require further studies. Next, studies covering various complications discuss the safety consideration of DBS. While intra-operational (including hemorrhage and infection) and post-operational complications (including device malfunction, psychiatric impact, motor disorder, and cognitive impairment) of DBS are proven, change in patient personality, identity, autonomy, authenticity, agency, and self (PIAAAS) after DBS operation requires further information. Finally, though current DBS technique carries multiple risk concerns and needs improvements, potential prospects and solutions are explored for this potent and thriving technology.

A self-directed digital exercise program for hip osteoarthritis (“My Hip Exercise”): protocol for a randomised controlled trial

BackgroundHip osteoarthritis (OA) is a leading global cause of chronic pain and disability. Given there is no cure for OA, patient self management is vital with education and exercise being core recommended treatments. However, there is under-utilisation of these treatments due to a range of clinician and patient factors. Innovative service models that increase patient accessibility to such treatments and provide support to engage are needed. This study primarily aims to determine the effects of a self-directed digital exercise intervention comprising online education and exercise supported by a mobile app to facilitate adherence on the primary outcomes of changes in hip pain during walking and patient-reported physical function at 24-weeks when compared to online education control for people with hip OA.MethodsWe will conduct a two-arm, superiority parallel-design, randomised controlled trial involving 182 community volunteers aged 45 years and over, with painful hip OA. After completing the baseline assessment, participants will be randomly assigned to either: i) digital exercise intervention; or ii) digital education (control). Participants randomised to the intervention group will have access to a website that provides information about hip OA and its management, advice about increasing their physical activity levels, a 24-week lower limb strength exercise program to be undertaken at home three times per week, and a mobile app to reinforce home exercise program adherence. Participants in the control group will have access to a website containing only information about hip OA and its management. All participants will be reassessed at 24 weeks after randomisation. Primary outcomes are severity of hip pain while walking using an 11-point numeric rating scale and physical function using the Western Ontario and McMaster Universities Osteoarthritis Index subscale. Secondary outcomes are the Hip dysfunction and Osteoarthritis Outcome Score subscales of pain, hip-related quality of life, and function, sports and recreational activities; global change in hip condition; health-related quality of life; measures of physical activity levels; fear of movement; self efficacy for pain and for exercise; and use of oral pain medications.DiscussionInnovative and scalable approaches to OA education, physical activity, and exercise are required in order to improve exercise participation/engagement and mitigate physical inactivity in the hip OA population. This will help minimise the burden of this major public health issue on individuals and society.Trial registrationAustralia New Zealand Clinical Trials Registry (ACTRN12622001533785).

S1717 "Open Table" Approach for Colonoscopy Direct Patient Self Scheduling via Patient Portal: A Pilot Program

S1717 "Open Table" Approach for Colonoscopy Direct Patient Self Scheduling via Patient Portal: A Pilot Program

Five-Fraction Accelerated Partial Breast Irradiation [APBI] may Reduce Health Care Disparity in Patients Receiving Adjuvant Radiation Therapy for Breast Cancer by Overcoming Treatment Barriers of Distance to Treatment Center, Age, and Ethnicity

Although changing, breast irradiation is still standard of care in many patients after breast conservation therapy (lumpectomy). Distance from radiation treatment center, Age, and Ethnicity have been shown to be barriers to completing needed adjuvant radiation therapy in breast and other cancers. In this retrospective review, it was hypothesized that the Meattini five-fraction partial breast treatment (APBI) would reduce these barriers to care, and more patients would complete treatment. Data from the radiation planning system was utilized to identify all patients treated with APBI at a single community cancer center from 3/6/2020 to 10/14/2022. The Electronic Medical Record (EMR) was used to identify home addresses and then online navigation software measured patient round trip driving distance to the treatment center. Records in EMR were reviewed to see if each patient completed treatment. Patients were divided into 2 groups for three variables: 1. Distance from clinic- <40 miles round trip vs. >40 miles round trip, 2. Age- 65 and older or less than 65, 3. Ethnicity- Hispanic or Non-Hispanic. Each variable consisting of 2 groups were then evaluated statistically using two proportion Z test. Eighty-one patients were identified who underwent APBI. There were 50 patients living <40 miles round trip and 31 living >40 miles from cancer treatment center. There were 48 patients age 65 and older and 33 patients under 65. Patients self- identified their ethnicity as: Hispanic (26 patients, 32.1%), non-Hispanic (55 patients, 67.9%: European Descent-52 patients, Native American- 2 patients, Asian American- 1 patient). 80/81 APBI patients completed the planned treatment. Using the two proportion Z-test, there was no statistical difference between patients with distance to treatment center less than 40 mi round trip commute vs greater than 40 miles round trip commute (Z score 1.28, p = .20), no statistical difference by age 65 or older vs under 65 (Z score = -.83, p = 0.40), and no statistical difference between ethnicity of Hispanic vs non-Hispanic patients (Z score 0.69, p = 0.49). Shorter course radiation therapy regimens for many reasons are easier to complete than longer treatment regimens. In this single-institution retrospective review, all but one short course five-fraction APBI patient (80/81) completed treatment. APBI short course five-fraction treatment (compared to traditional longer breast radiation therapy regimens) may help increase completion of adjuvant radiotherapy and reduce healthcare disparity in breast cancer patients and may overcome barriers to treatment such as Distance to treatment center, Age, and Ethnicity.

Hubungan Self Management Dengan Tingkat Kepatuhan Pasien Terhadap Keberhasilan Terapi Hipertensi Di Puskesmas Bonorowo Kebumen

Hypertension is a condition when blood pressure systolic over 140mmHg and diastolic blood pressure over 90mmHg . one _ effort for resolve hypertension is with self management or management self with obedience patient to success therapy hypertension . Study this aim for identify characteristics and connection patient and level percentage self management and level obedience patient to success therapy hypertension . Type study this is non - experimental nature correlational with approach cross sectional with use period on month December 2022. Method taking sample on study this that is purposive sampling . Data analysis was performed that is analysis bivariate and test chi square using the Statistical Package for the Social Science (SPSS) program. Study this carried out at the Health Center Bonorowo Kebumen . Population in study this that is all patient hypertension pure nor with participant who did examination at the Health Center as many as 106 respondents on period month December 2022. Based on results study self management sufferer hypertension as much as 49.0% of respondents is at on category enough . A total of 47.2 % of respondents own level obedience medium . There is connection significant Among self management with level compliance ( p-value 0.000) which is correlated (r-0.906) with direction connection positive . Conclusion there is connection significant Among self management with level obedience patient to success therapy hypertension at the health center Bonorowo Kebumen .

The Association Between the Patient Self-Report Survey for the Assessment of Fibromyalgia with Pain Sensitivity and Psychological Factors in Individuals with Musculoskeletal Pain.

The Patient Self-Report Survey for the Assessment of Fibromyalgia may potentially be a method for subgrouping patients with musculoskeletal pain who have a nociplastic pain presentation. Limited research has explored the convergent validity of this questionnaire against psychophysical measures of pain sensitivity and psychological factors in individuals with musculoskeletal pain. Therefore, the purpose of this study is to examine the strength of the association between total scores on the Patient Self-Report Survey for the Assessment of Fibromyalgia with clinical, pain sensitivity, and psychological factors. As a secondary analysis of a cross-sectional study, participants with shoulder (n = 20) or low back pain (n = 20) completed Quantitative Sensory Testing (QST), pain-related psychological questionnaires, and the Patient Self-Report Survey for the Assessment of Fibromyalgia. A Spearman correlation determined the association between total scores on the Patient Self Report Survey for the Assessment of Fibromyalgia with psychological factors and pain sensitivity behaviorally assessed with QST. Negative psychological factors demonstrate moderate to strong positive associations with the Patient Self-Report Survey for the Assessment of Fibromyalgia (rho range = 0.36-0.80), suggesting greater negative psychological factors were observed in patients with higher severity of fibromyalgia symptoms. Pain sensitivity factors demonstrated weak to moderate negative associations with The Patient Self-Report Survey for the Assessment of Fibromyalgia (PPT rho range=-0.36- -0.41), suggesting that elevated pain sensitivity was observed in individuals with higher severity of nociplastic pain symptoms. Collectively, this supports the convergent validity of the Patient Self-Report Survey for the Assessment of Fibromyalgia with psychological and pain sensitivity factors in patients with musculoskeletal pain.

Psychometrics and applications of a novel self-report measure of emicizumab adherence: VERITASNexGen.

Treatment adherence is critical to minimize bleeding episodes in persons with haemophilia. Suboptimal adherence increases risk of adverse medical outcomes and negatively impacts quality of life. Assessment of treatment adherence is therefore an integral component of intervention to mitigate the adverse impacts of haemophilia. To develop and validate a multifactorial, patient (self or caregiver) report adherence measure for emicizumab treatment and report the first patient-report data on adherence to specific components of emicizumab treatment (dosing, timing, injection, planning and bleeds). An IRB approved multi-site prospective study enrolled 83 participants with factor VIII deficiency being treated with emicizumab. Participants completed the 25-item VERITAS NexGen (self-report from 50 adults age 18+ years; caregiver-report from 33 parents of children aged 6months to 17years) as well as a global adherence rating (GAR) scale. Providers of participants also completed a GAR scale. Most VERITAS-NexGen subscales had good-to-excellent internal consistency reliability, test-retest reliability, and validity. VERITASNexGen scores revealed globally strong patient-reported adherence; however timing and bleed management were reported as greater challenges to adherence compared to dosing and injections. Adults struggled more with timing and planning of injections than caregivers. The VERITASNexGen is the first validated multifactorial patient-report measure of adherence designed specifically for emicizumab treatment. Results suggest excellent adherence, with only 4%-13% of participants reporting suboptimal adherence to different components of the treatment regimen. Used in conjunction with other adherence measures, VERITAS-NexGen meets a crucial need for monitoring and understanding patient adherence to emicizumab in clinical and research settings.

Diabetes risk prediction model based on community follow-up data using machine learning

Diabetes is a chronic metabolic disease characterized by hyperglycemia, the follow-up management of diabetes patients is mostly in the community, but the relationship between key lifestyle indicators in community follow-up and the risk of diabetes is unclear. In order to explore the association between key life characteristic indicators of community follow-up and the risk of diabetes, 252,176 follow-up records of people with diabetes patients from 2016 to 2023 were obtained from Haizhu District, Guangzhou. According to the follow-up data, the key life characteristic indicators that affect diabetes are determined, and the optimal feature subset is obtained through feature selection technology to accurately assess the risk of diabetes. A diabetes risk assessment model based on a random forest classifier was designed, which used optimal feature parameter selection and algorithm model comparison, with an accuracy of 91.24% and an AUC corresponding to the ROC curve of 97%. In order to improve the applicability of the model in clinical and real life, a diabetes risk score card was designed and tested using the original data, the accuracy was 95.15%, and the model reliability was high. The diabetes risk prediction model based on community follow-up big data mining can be used for large-scale risk screening and early warning by community doctors based on patient follow-up data, further promoting diabetes prevention and control strategies, and can also be used for wearable devices or intelligent biosensors for individual patient self examination, in order to improve lifestyle and reduce risk factor levels.

“Who am I?”, diminished sense of self in Korsakoff’s syndrome

ABSTRACT Little is known about how patients with Korsakoff’s syndrome (KS) experience sense of self. We addressed this issue by inviting patients with KS and control participants to produce statements describing their self, that is, statements to the question “Who am I?.” Statements were analyzed regarding three self-dimensions (i.e., physical, social, and psychological). Results showed fewer “Who am I?” statements related to physical, social, and psychological self in patients with KS than in control participants. Furthermore, patients with KS produced similar number of statements describing physical, social, and psychological self; the same finding was observed in control participants. In patients with KS and control participants, verbal fluency was significantly correlated with the general production of “Who am I?” statements but not with the production of statements related to any specific self-component. These findings demonstrate how KS affects self-images in general, and more specifically, those related to physical, social, and psychological self. These findings also suggest a diminished sense of self or even identity, in patients with KS.

Psychological care of patients during the pancreas transplantation process: issues and prospects.

Pancreas transplantation for patients with type 1 diabetes is a therapeutic option when other treatments are not effective and physical complications occur. Psychological burden is prominent in patients, and non-adherence to treatment is often one manifestation of such difficulties. Time projection is an important factor affected by chronic disease. The prospect of transplantation has the potential to repair this disruption. It could re-establish a continuity in the patient's self and history, by connecting the future to a life that was only about past and present. Taking care of oneself, adhering to treatment, being part of a long-term therapeutic project and going through transplantation are all processes that need a good ability to self-project in time. This is specifically a domain of psychotherapeutic interventions. In this article, the psychological implications of pancreas transplantation for patients and caregivers alike will be discussed, as well as the role of the psychiatrist in the transplantation process.

The impact of 4R oncology model on patient self management and satisfaction in lung versus breast cancer.

e18703 Background: Proposed under NCI ASCO Teams project, the 4R Oncology model (Right Info/Care/Patient/Time) facilitates patient self management (PSM) and team based care delivery with a novel 4R Care Sequence plan (JOP 2016). 4R has been shown to improve PSM in breast cancer (JCOOP 2021), but its impact in other cancers is unknown. Also, the 4R effect on patient satisfaction – a care quality aspect important at patient and institutional levels - has not been evaluated. We examined and compared 4R impact on PSM and patient satisfaction in lung (LC) and breast (BC) cancers at 3 centers of a large health system Oct 2020 - Dec 2021. Methods: Surveys of patient cohorts: 4R cohort who received 4R plans and historical control who received care pre-4R. Cohorts included BC stages 0-3 and all LC stages. See Table for metrics. Results: Survey response rates: 53% (control), 42% (4R). All PSM and satisfaction metrics significantly improved in 4R vs. control groups for the combined cohort of both cancers (Table). LC and BC patients significantly benefited from 4R vs control in 2 PSM metrics (b, c). LC patients benefited more than BC patients in 1 PSM and 3 satisfaction metrics (a, g, i, j). For other metrics (d, e, f, h) benefits in LC occurred in the same direction and same magnitude as in BC, but were not significant, likely due to smaller group size. Among 4R patients, similar ratios of LC and BC patients deemed 4R useful (76%, 78%, p = .7) (data not shown). Conclusions: 4R improved self management and satisfaction among patients with lung or breast cancer. Notably, it helped lung cancer patients who are typically older and sicker than breast cancer patients to better understand their cancer and manage their care. It also helped lung cancer patients feel more respected and taken seriously, suggesting that 4R countered the stigma and guilt often experienced by these patients. Variable impact in some metrics between lung and breast cancers suggest different self management needs relevant to these metrics. Further model refinement should address these differences. [Table: see text]