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Clinical Decision Support System for Clinical Nurses' Decision Making on Nurse-to-Patient Assignment: A Scoping Review

Tue, 31 Dec 2024 15:00:00 GMT

Title: Clinical Decision Support System for Clinical Nurses' Decision Making on Nurse-to-Patient Assignment: A Scoping Review Author(s): Hyunjeong Kwon; Dayoen Lee Abstract: The nurse-to-patient assignment (NPA) process is essential for delivering patient-centered care, yet it remains largely dependent on manual decisions by charge nurses due to its complexity. This scoping review, guided by the Arksey and O’Malley framework, examined Clinical Decision Support Systems (CDSSs) and optimization models applied to NPA. From 6,918 records, 16 studies were included. Identified optimization techniques included heuristic algorithms, mixed-integer programming, simulation models, Benders decomposition, and clustering methods. Key CDSS considerations involved patient acuity, continuity of care, workload equity, and spatial proximity. CDSS implementation showed positive outcomes, including improved workload distribution, enhanced nursing efficiency, and fairer assignments, contributing to greater nurse satisfaction and reduced overtime.

Impact of comorbidities on health-related quality of life in diabetic patients: Evidence from a South Korean population-based panel study

Tue, 31 Dec 2024 15:00:00 GMT

Title: Impact of comorbidities on health-related quality of life in diabetic patients: Evidence from a South Korean population-based panel study Author(s): Djoko Priyono; Sanghee Kim Abstract: Objective: This study employed data derived from a nationally representative panel survey to investigate the impact of comorbidities on the health-related quality of life (HRQoL) of individuals living with diabetes mellitus. Methods: A retrospective, cross-sectional, population-based analysis was conducted using data from 10,049 participants in the Korea Health Panel Survey (KHPS) in 2020. The participants were divided into three groups: individuals without diabetes, individuals with diabetes only, and individuals with diabetes and comorbidities. HRQoL was assessed using the European Quality of Life—5 Dimensions (EQ-5D) tool. Multiple regression analyses were performed to examine the contribution of comorbidities to HRQoL scores. Results: Comorbidities were associated with lower scores in physiological, psychological, and overall HRQoL. A significant reduction in HRQoL was observed with comorbidities, and a negative association was established between the number of comorbidities and physiological and overall HRQoL (P < .001). Demographic factors such as age, education, and disability significantly influenced HRQoL. In addition, psychological factors such as high stress had a substantial impact on HRQoL, particularly in individuals with diabetes and comorbidities (P < .01). Conclusion: Comorbidities considerably impair HRQoL among patients with diabetes. Health providers should consider the presence of comorbidities and diseases in diabetes when developing intervention methods to effectively manage diabetes and patients’ well-being.

Preoperative Tyrosine Levels as Predictive Biomarkers for Excessive Fat-Free Mass Loss Following Laparoscopic Sleeve Gastrectomy in Patients with Morbid Obesity

Tue, 31 Dec 2024 15:00:00 GMT

Title: Preoperative Tyrosine Levels as Predictive Biomarkers for Excessive Fat-Free Mass Loss Following Laparoscopic Sleeve Gastrectomy in Patients with Morbid Obesity Author(s): Inyoung Lee; Eunhye Seo; Yeongkeun Kwon; Chang Min Lee; Nam Hoon Kim; Jong-Han Kim; Sung Il Choi; Sungsoo Park Abstract: Background/Objectives: Fat-free mass (FFM) loss after metabolic and bariatric surgery (MBS) is associated with adverse long-term outcomes, including osteoporosis. Identifying biomarkers that predict excessive FFM loss can improve perioperative patient management and postoperative risk stratification. This study investigated whether preoperative amino acid metabolite (AAM) levels could predict excessive FFM loss after laparoscopic sleeve gastrectomy (LSG). Methods: Forty patients with morbid obesity who underwent LSG between 2019 and 2020 were retrospectively analyzed. Based on the FFM loss to body weight loss ratio (%FFML/BWL) at 3 months postoperatively, patients were categorized into excessive (>25%) and non-excessive (≤25%) FFM loss groups. Anthropometric measurements and serum sampling were performed preoperatively and at 3, 6, and 12 months postoperatively. AAM profiles were collected before surgery. Statistical analyses, including logistic regression and receiver operating characteristic curves, were performed. Results: Twenty-five patients showed excessive FFM loss 3 months after surgery. They had significantly lower preoperative tyrosine (Tyr) levels (p = 0.025). Logistic regression revealed that higher Tyr levels were significantly associated with lower odds of being male, suggesting a potential protective effect (odds ratio (OR) =0.019, p = 0.010). Tyr profiling demonstrated acceptable predictive performance (area under the curve =0.715, p = 0.025). Despite nonsignificant p-values, trends showed lower FFM and muscle mass and higher fat mass in the excessive FFM loss group throughout follow-up. Conclusions: Preoperative Tyr profiling may help identify patients at risk for excessive FFM loss. These findings support prioritizing metabolic health alongside total weight loss in the evaluation of MBS outcomes.

Identifying Health Care Services Offered in the HIV Care Continuum via a Machine Learning-Based Topic Modeling Approach: Exploratory Literature Review

Tue, 31 Dec 2024 15:00:00 GMT

Title: Identifying Health Care Services Offered in the HIV Care Continuum via a Machine Learning-Based Topic Modeling Approach: Exploratory Literature Review Author(s): SangA Lee; Layoung Kim; Mi-So Shim; Gwang Suk Kim Abstract: Background: It remains unclear whether the existing health care services reflect the HIV care continuum, which underscores the need for integrated care beyond viral suppression. Objective: This study aimed to analyze the literature on health care services for people living with HIV to enhance the understanding of trends and knowledge structures. Methods: A literature review was conducted using BERTopic, an advanced machine learning-based topic modeling technique. We searched PubMed, CINAHL, EMBASE, and Cochrane databases for English-language studies published between 2013 and 2023. Analyses were performed twice: first, to gain a broad understanding of the literature, and second, to examine the specific details of health care services described. Results: Among the 11,269 articles screened, 204 studies met the inclusion criteria. Within the HIV care continuum, most studies focused on the treatment retention stage, while studies focusing on the long-term stage were limited. A broad literature analysis identified five key topics, with “ART adherence” emerging as the most prominent topic. A more comprehensive analysis of health care services within the literature revealed 7 topics, reflecting diverse delivery methods and content in providing health care services for people living with HIV. The predominant topic, “ART adherence and counseling,” encompassed the largest number of studies, indicating the strongest emphasis in the field. Notably, the distribution of topics exhibited a distinct pattern: while health care service diversity was the highest in the earlier stages of the HIV care continuum, it became increasingly limited in the later stages. Conclusions: This study provides valuable insights into current HIV care services and highlights areas for future research and intervention. Despite the shift toward lifelong HIV management, existing literature remains heavily focused on medication treatment, overlooking the multifaceted health care needs of people living with HIV. Research disparities, particularly concerning vulnerable populations, underscore the need for more inclusive studies and tailored health care services. Efforts should be intensified to bridge these gaps, ensuring inclusive and equitable health care services across diverse populations and fostering interdisciplinary collaboration to meet the evolving needs of people living with HIV, thereby enhancing the HIV care continuum for all.