Background:Treatment adherence is crucial in managing schizophrenia, as nonadherence leads to relapse and increased societal burden. However, validated tools for assessing treatment adherence in Chinese patients with schizophrenia are lacking.
Objective:This study aimed to adapt the Treatment Adherence Questionnaire (TAQ) for the Chinese population and evaluate its psychometric properties.
Methods:A cross-sectional study was conducted with 252 Chinese patients diagnosed with schizophrenia. The TAQ was culturally adapted, and its structural validity was assessed through item analysis, structural equation modeling, and multigroup confirmatory factor analysis. Reliability, convergent validity, and content validity were also examined.
Results:We enrolled 252 patients (mean age 46.69 years; 46.8 % female; 19.8 % married). The Treatment Adherence Questionnaire demonstrated a three-factor structure. Content validity was excellent (0.960), and scale scores were positively correlated with the Medication Adherence Rating Scale, supporting construct validity. The questionnaire demonstrated high internal consistency, with Cronbach’s alpha of 0.931 and split-half reliability of 0.842. Group confirmatory factor analysis confirmed measurement invariance across gender, age, and disease course at the scalar level.
Conclusion:The Chinese version of the TAQ is a reliable and valid tool for assessing treatment adherence in Chinese patients with schizophrenia. Its use could improve clinical assessment and support better management outcomes for this population.
Background:Recently, the prevalence of type 2 diabetes has substantially increased, largely due to improvements in economic conditions and lifestyle changes. Type 2 diabetes disrupts carbohydrate and lipid metabolism, leading to damage to multiple organs, including the kidneys. Diabetic kidney disease (DKD) is a chronic microvascular complication of diabetes that can result in end-stage renal disease.
Objective:This study aimed to elucidate the biochemical factors involved in the diagnosis of DKD and their interrelationships for delaying the progression of DKD. The plasma levels of vitamin D, inflammatory factors, blood lipids, and complement were analyzed in patients with DKD. Furthermore, the risk factors and their relationship in patients with DKD were examined to provide clinical evidence for delaying the progression of DKD.Study design:Patients were divided into three groups according to urinary albumin-creatinine ratio (UACR). Group 1 comprised individuals with type 2 diabetes and normal microalbuminuria (stage A1), group 2 included those with type 2 diabetes and microalbuminuria (stage A2), and group 3 consisted of individuals with type 2 diabetes and macroalbuminuria (stage A3).
Methods:A total of 112 patients with type 2 diabetes who were hospitalized in the endocrinology department between July 2020 and December 2023 were selected in the study. The patients were divided into three groups based on their albuminuria status: the normal albuminuria group (A1, n=53; control group), the microalbuminuria group (A2, n=28), and the macroalbuminuria group (A3, n=31) groups. The fasting levels of vitamin D3, blood lipids, UACR, inflammatory factors, complement, and glucose metabolism indices were measured and subjected to statistical analysis.
Results:Compared with the A1 group (with normal microalbuminuria), increased serum low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), erythrocyte sedimentation rate (ESR), visual analog scale (VAS) scores (P < 0.001, P=0.016, P < 0.001, and P < 0.001, respectively), and decreased high-density lipoprotein cholesterol (HDL-C) and vitamin D3 levels (P=0.046 and P < 0.001, respectively) were found in the A2 and A3 groups. The UACR values in groups A2 and A3 were inversely proportional to serum vitamin D3 levels (P < 0.001) and positively proportional to serum TG, LDL-C, and VAS scores (P=0.003, P=0.015, and P=0.005, respectively). A negative correlation was observed between vitamin D3 and LDL-C levels (P=0.003). Further logistic regression analysis demonstrated that a decline in vitamin D3 and elevations in LDL-C and TG levels were independent risk factors for DKD. The areas under the curve of serum vitamin D3, LDL-C, and TG for predicting DKD with macroproteinuria were 0.79, 0.695, and 0.632, respectively.
Conclusion:The severity, pain, and lipid metabolism of patients with DKD are associated with vitamin D3 levels. Serum vitamin D3 levels were identified as a highly predictive factor for the development of DKD with macroproteinuria.
Background:Global incidence and prevalence of diabetes have been rising steadily, leading to increased disability, mortality, and a significant economic burden. Despite advances in medical care, challenges such as shortage of diabetes specialists, unequal distribution of healthcare resources, suboptimal medication adherence, and poor self-management have contributed to inadequate glycemic control in patients.
Objective:This review examines the latest advances in artificial intelligence (AI) applications for diabetes management, evaluating its potential to improve patient outcomes and reduce the economic burden on healthcare systems.
Methods:We comprehensively reviewed recent studies and clinical trials that explore the use of AI in diabetes prevention, diagnosis, and management. Key technologies such as machine learning, predictive analytics, and digital health tools were assessed for their clinical applicability and impact on patient care.
Results:AI-driven approaches, including predictive models for glycemic control, personalized treatment plans, and digital monitoring systems, have shown promising results in enhancing diabetes management. However, challenges remain in integrating these technologies into clinical practice, particularly regarding data privacy, algorithmic transparency, and training of healthcare providers.
Conclusion:While AI presents substantial opportunities for improving diabetes care and reducing healthcare costs, its successful implementation requires overcoming several barriers, including regulatory hurdles and ensuring equitable access to technology. Future research should focus on developing interoperable AI systems that seamlessly integrate into existing healthcare infrastructures and address the diverse needs of diabetic populations.
Background:Hemophilia is a generic bleeding disorder that significantly affects patient quality of life (QoL). Patient-reported outcome measures (PROMs) can capture health outcomes from a patient’s perspective. The identification of PROMs used in adult patients with hemophilia (PwHs) can improve our understanding of patient care needs.
Objective:To examine the current use of PROMs in adult PwHs, evaluate the frequency of PROMs, and summarize the main evaluation dimensions and descriptive data of the included publications.
Methods:In this scoping review, PubMed, EMBASE, The Cochrane Library, Web of Science, Scopus, and EBSCO were searched from January 2000 to June 2023. This review focused on descriptions of the use of PROMs in adult PwHs. The search strategy followed the PRISMA-ScR guidelines.
Results:Of 32 934 sources identified, 394 articles including 56028 patients were included. A wide range of measures was available, and many were used only once. One hundred and fifty-four different PROMs were identified. The most commonly used generic PROMs were the EuroQoL Five-Dimensional Questionnaire (EQ-5D) (n=105, 26.6 %) and the 36-item Short Form General Health Survey (SF-36) (n=95, 24.1 %). The most commonly used hemophilia-specific PROM was the Hemophilia-specific health-related QoL questionnaire (A36 Hemofilia-QoL) (n=15, 3.8 %). However, psychological health has rarely been separately assessed.
Conclusion:This study provides a valuable summary of PROMs to facilitate research on hemophilia. Disease-specific instruments should be used more frequently to capture changes in patients, and psychological health should be considered in future studies.
Background:Diabetes management after mild cognitive impairment (MCI) onset remains controversial, with no consensus on optimal treatment goals and appropriate medication use.
Objective:We aimed to comprehensively summarize the existing literature on diabetes management after MCI onset, focusing on changes in HbA1c targets, medication choices, and the risk of Alzheimer’s disease and related dementia (ADRD).
Study design and methods:A systematic literature search was conducted in PubMed, Embase, and Cochrane Library (January 1, 2000, and October 31, 2024) to identify studies related to MCI, glycemic targets, and medication use after MCI onset. The review included guidelines, clinical trials, and observational studies. Two reviewers independently performed the literature search, including title/abstract screening, duplication removal, eligibility assessment, data extraction, and quality assessment.
Results:A total of 32 studies were identified, focusing on two primary areas: glycemic control (moderate vs. intensive) and the role of medications in delaying the onset of ADRD. Most guidelines recommended a more relaxed glycemic target to avoid hypoglycemia after MCI onset. However, existing evidence links improved glycemic control with a lower risk of ADRD onset. Observational studies and small clinical trials suggest that the use of metformin, thiazolidine, dipeptidyl peptidase-4 inhibitors, and glucagon-like peptide-1 receptor agonists may slow the decline in cognitive function. However, whether such effects are attributable to improved glycemic control or other mechanisms, such as neural protective effects, remains inconclusive.
Conclusion:The risk-benefit tradeoff in glycemic control is vital for individuals with diabetes and MCI. A significant gap exists in our understanding of the underlying mechanism of the potential protective effect of glucose-lowering medications on cognitive function.
Background:Nonpharmacological interventions, including music therapy, are widely used for pain management and improving cognitive function and emotional well-being. Music therapy has particularly shown significant benefits in chronic pain management.
Objective:This study aimed to evaluate the effectiveness of music therapy in lowering the pressure pain threshold (PPT) and enhancing cognitive function and emotional well-being. The interrelationships among these factors were also investigated.Study design:A randomized controlled trial was employed in this study.
Methods:A total of 54 participants were recruited, with 40 healthy college students randomly assigned to one of two groups. The music therapy group listened to Mozart’s K. 448 for 20 min, whereas the control group listened to it for 2 min. Each participant’s 50-minute session comprised a pre-session, intervention, and post-session, with 15 min for emotional and cognitive assessments of the pre-and post-sessions and 20 min for the intervention. The outcome measures included the PPT, Color-Word Stroop test (CWST), and self-assessment manikin (SAM) score.
Results:The average PPT of most muscles significantly increased in the music therapy group (P < 0.05) than in the control group. In the CWST, the music therapy group performed more accurately than the control group did. The increase in the mean of the SAM score of arousal was also statistically significantly higher in the music therapy group than in the control group. Correlation analysis showed a moderate positive correlation between PPT and SAM.
Conclusion:This study shows that music therapy helps regulate pain sensitivity. It also improves participants’ memory, executive function, and pleasurable and arousal emotions.
Background:Patients with amyotrophic lateral sclerosis (ALS) also exhibit non-motor symptoms; however, the relationship between the disease and post-traumatic stress disorder (PTSD) is unclear.
Objective:This study aimed to determine the frequency of PTSD and its correlation with motor disability and cognitive impairment in patients with ALS.
Methods:PTSD was diagnosed according to the Diagnostic and Statistical Manual V (DSM-V), and its severity was quantified using the PTSD Checklist for DSM-5 (PCL-5) in 106 patients with ALS and 55 healthy controls (HCs). Patients were assessed for clinical symptom severity by the revised ALS Functional Rating Scale (ALSFRS-R). Cognitive and behavioral functioning were assessed by the Edinburgh Cognitive and Behavioral ALS Screen (ECAS), the Frontal Behavioral Inventory (FBI), the Hamilton Anxiety Rating Scale (HARS), and the Hamilton Depression Rating Scale (HDRS) scales.
Results:PTSD was diagnosed in 32 (30.2 %) patients with ALS. Compared to patients with ALS and without PTSD (ALS-NP), patients with ALS and PTSD (ALS-P) had significantly lower ALSFRS-R and higher FBI scores (P < 0.05). Moreover, in the ALS-P patients, the PCL-5 scores significantly correlated with the ALSFRS-R scores (r = − 0.302; P = 0.03) and FBI scores (r = 0.421; P = 0.02).
Conclusion:Our findings suggest that PTSD is a common condition in patients with ALS.
Background:As the population ages, the importance of improving the well-being of older adults grows.
Objective:To understand the current impact of intergenerational support on the life satisfaction of older adults in China, we aimed to further improve the quality of elder care and promote the physical and mental health of older adults.
Methods:We used a probit regression analysis to examine 7825 individuals from the 2018 China Longitudinal Aging Social Survey (CLASS).
Results:Various types of intergenerational support was differentially associated with older adults’ satisfaction, with significant disparities between living in a rural or urban area. Emotional support played a significant role in enhancing the life satisfaction of rural older adults, whereas the life satisfaction of urban older adults was only related to instrumental support. In general, providing support had a more positive impact than receiving support, except for emotional support.
Conclusion:The positive impact of intergenerational support on older adults may no longer be simple reciprocity or feedback but rather involve more altruistic characteristics and the pursuit of higher-level needs, such as love, respect, and self-actualization.