Patient Participation in Urine Specific Gravity Screening for Arginine Vasopressin Deficiency in an Inpatient Neurosurgical Clinic.

IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Jeanne-Marie Nollen, Anja H Brunsveld-Reinders, Nienke R Biermasz, Marco J T Verstegen, Eline Leijtens, Wilco C Peul, Ewout W Steyerberg, Wouter R van Furth
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引用次数: 0

Abstract

Objective: Detecting hypotonic urine (specific gravity < 1005 g/L) is crucial for the early identification of arginine vasopressin deficiency (AVP-deficiency), a common complication after pituitary surgery. This study aimed to evaluate the agreement between urine specific gravity measurements taken by patients using urine test strips and those taken by nurses using a refractometer, to assess the reliability of patient-conducted measurements for diagnosing this condition.

Design: A prospective cohort study was conducted in a neurosurgical ward.

Patients: The study included 110 participants who collectively provided 609 specific gravity measurements.

Measurements: Specific gravity measurements were taken using Combur-10 urine test strips by patients and using an ATAGO MASTER-SUR/Nα refractometer by nurses. Agreement was analysed using Weighted Kappa and intraclass correlation coefficient (ICC).

Results: Moderate agreement was found between patient-conducted measurements and those from the refractometer (Kappa = 0.47, ICC = 0.69). Substantial to good agreement was observed between patient and nurse measurements using urine test strips (Kappa = 0.82, ICC = 0.89). A threshold of 1.015 g/L in test strip measurements ensured no cases of hypotonic urine were missed, reducing the need for nurse-led testing by 50%. Patient satisfaction was high (mean 7.8), while nurse satisfaction was lower (mean 6.4).

Conclusions: Although patients are less accurate than nurses in measuring specific gravity, they can reliably screen for hypotonic urine in AVP-deficiency diagnostics using urine test strips. A higher cut-off point improves diagnostic accuracy, enhances patient participation and reduces the screening workload for nurses.

住院神经外科门诊患者参与精氨酸抗利尿激素缺乏症尿比重筛查。
目的:检测低渗尿比重设计:在神经外科病房进行前瞻性队列研究。患者:该研究包括110名参与者,他们总共提供了609个比重测量值。测量方法:患者使用Combur-10尿液试纸进行比重测量,护士使用ATAGO MASTER-SUR/ n - α折射仪进行比重测量。采用加权Kappa和类内相关系数(ICC)分析一致性。结果:患者自行测量结果与屈光计测量结果有一定程度的一致性(Kappa = 0.47, ICC = 0.69)。患者和护士使用尿液测试条测量结果基本一致(Kappa = 0.82, ICC = 0.89)。测试条测量的阈值为1.015 g/L,确保没有漏检低渗尿病例,减少了50%的护士主导测试的需要。患者满意度较高(平均7.8),护士满意度较低(平均6.4)。结论:尽管患者测量比重的准确性低于护士,但在avp缺乏症诊断中,他们可以通过尿液试纸可靠地筛查低渗尿。较高的分界点提高了诊断的准确性,提高了患者的参与度,减少了护士的筛查工作量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Clinical Endocrinology
Clinical Endocrinology 医学-内分泌学与代谢
CiteScore
6.40
自引率
3.10%
发文量
192
审稿时长
1 months
期刊介绍: Clinical Endocrinology publishes papers and reviews which focus on the clinical aspects of endocrinology, including the clinical application of molecular endocrinology. It does not publish papers relating directly to diabetes care and clinical management. It features reviews, original papers, commentaries, correspondence and Clinical Questions. Clinical Endocrinology is essential reading not only for those engaged in endocrinological research but also for those involved primarily in clinical practice.
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