Annals of medicine最新文献

{"title":"Access to healthcare: waiting time until the surgical procedure.","authors":"Cassiane de Santana Lemos, Ana Maria Muller Magalhães, Danielle Saraiva Tuma Dos Reis, Alessandra Yuri Takehana de Andrade, Karla Cristina de Almeida, Fabiana Zerbieri Martins, Nancy Reynolds, Vanessa de Brito Poveda","doi":"10.1080/07853890.2025.2452358","DOIUrl":"10.1080/07853890.2025.2452358","url":null,"abstract":"<p><strong>Background: </strong>Understanding the determinants that limit the population's access to surgical care in health services is highly relevant in order to provide data to support political interventions.</p><p><strong>Objective: </strong>This study aimed to evaluate the time between diagnosis and elective surgery in adult patients with the longest waiting lists in Brazil; identify the determinants that interfere with access to the health service to perform surgery; and analyze the quality of life after the indicative diagnosis of surgical intervention.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with adult patients treated at three hospitals in the Southeast, North and South regions of Brazil, from October 2020 to October 2022. Data collection included socio-demographic data and assessment of quality of life using the WHOQOL-Bref instrument in the immediate postoperative period and one month after surgery.</p><p><strong>Results: </strong>A total of 250 patients participated in the study, 55.6% patients from the Southeast, 20.4% patients from the North and 24% patients from the South, with a mean age of 51.86 (SD = 14.27) years and clinical history such as arterial hypertension (<i>p</i> < 0.001). The longest mean waiting time for surgery identified was 26.23 (SD = 17.62) months in the South region, with a significant difference between the evaluated institutions (<i>p</i> = 0.02). Differences were observed between the first place of care of the evaluated patients (<i>p</i> < 0.001). There was a difference in the perception of quality of life between the immediate and late postoperative periods (<i>p</i> = 0.007) and in the physical domain, with an increase in scores among older patients (<i>p</i> = 0.004) and previous clinical history (<i>p</i> = 0.03).</p><p><strong>Conclusion: </strong>Access to the health system varies by region and does not meet the standards proposed by the Brazilian health system. In addition, it seems that longer waiting times for surgery more perceptibly affect the quality of life of older adults and those with other associated diseases.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2452358"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning for differential diagnosis of parotid tumors based on 2.5D magnetic resonance imaging.","authors":"Wenfeng Mai, Xiaole Fan, Lingtao Zhang, Jian Li, Liting Chen, Xiaoyu Hua, Dong Zhang, Hengguo Li, Minxiang Cai, Changzheng Shi, Xiangning Liu","doi":"10.1080/07853890.2025.2520401","DOIUrl":"10.1080/07853890.2025.2520401","url":null,"abstract":"<p><strong>Purpose: </strong>Accurate preoperative diagnosis of parotid gland tumors (PGTs) is crucial for surgical planning since malignant tumors require more extensive excision. Though fine-needle aspiration biopsy is the diagnostic gold standard, its sensitivity in detecting malignancies is limited. While Deep learning (DL) models based on magnetic resonance imaging (MRI) are common in medicine, they are less studied for parotid gland tumors. This study used a 2.5D imaging approach (Incorporating Inter-Slice Information) to train a DL model to differentiate between benign and malignant PGTs.</p><p><strong>Methods: </strong>This retrospective study included 122 parotid tumor patients, using MRI and clinical features to build predictive models. In the traditional model, univariate analysis identified statistically significant features, which were then used in multivariate logistic regression to determine independent predictors. The model was built using four-fold cross-validation. The deep learning model was trained using 2D and 2.5D imaging approaches, with a transformer-based architecture employed for transfer learning. The model's performance was evaluated using the area under the receiver operating characteristic curve (AUC) and confusion matrix metrics.</p><p><strong>Results: </strong>In the traditional model, boundary and peritumoral invasion were identified as independent predictors for PGTs, and the model was constructed based on these features. The model achieved an AUC of 0.79 but demonstrated low sensitivity (0.54). In contrast, the DL model based on 2.5D T2 fat-suppressed images showed superior performance, with an AUC of 0.86 and a sensitivity of 0.78.</p><p><strong>Conclusion: </strong>The 2.5D imaging technique, when integrated with a transformer-based transfer learning model, demonstrates significant efficacy in differentiating between PGTs.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2520401"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The spectrum of overlapping anti-NMDAR encephalitis and demyelinating syndromes: a systematic review of presentation, diagnosis, management, and outcomes.","authors":"Saboor Saeed, Huaizhi Wang, Mengjie Jia, Ting Ting Liu, Le Xu, Xuhong Zhang, Shao-Hua Hu","doi":"10.1080/07853890.2025.2517813","DOIUrl":"10.1080/07853890.2025.2517813","url":null,"abstract":"<p><strong>Background: </strong>Anti-NMDAR encephalitis frequently overlaps with demyelinating diseases (MOGAD, NMOSD, MS), creating complex syndromes with diverse presentations and challenging management.</p><p><strong>Methods: </strong>Systematic search of databases including MEDLINE, Google Scholar, Embase, Scopus, Cochrane Library, and Web of Science up to March 2024 for studies on co-existing anti-NMDAR encephalitis and demyelinating syndromes. Data extracted on clinical characteristics, diagnostics, treatments, and outcomes.</p><p><strong>Results: </strong>Twenty-five studies identified 256 patients (16.2%) with co-existing Anti-NMDAR encephalitis and demyelinating syndromes, primarily MOGAD (94.5%), with fewer cases involving NMOSD or MS. The Anti-NMDAR + MOGAD subgroup exhibited seizures (51-72.7%), psychiatric symptoms (45.5-71.4%), cognitive dysfunction (30.6%), and movement disorders (30.6%). All patients had CSF anti-NMDAR antibodies, with MOG (60%) or AQP4 (25%) antibodies. Use of standardized, cell-based assays and adherence to established criteria are essential to avoid false positives, particularly for MOG. MRI abnormalities were seen in 75% of patients. First-line immunotherapies were effective in 70% of cases; 80% of refractory cases responded to second-line therapies.</p><p><strong>Conclusions: </strong>Anti-NMDAR encephalitis overlapping with demyelinating diseases is challenging. Tailored treatments based on detailed immune profiles are key to better outcomes.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2517813"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of serum hsa_tsr014055 as a potential biomarker for diagnosis and prognosis of hepatocellular carcinoma.","authors":"Jing Xu, Bairong Chen, Jing Qi, Jinran Wu, Wei Feng, Kangfeng Jin, Hongyi Bao, Lin Chen, Feng Wang","doi":"10.1080/07853890.2025.2528978","DOIUrl":"10.1080/07853890.2025.2528978","url":null,"abstract":"<p><strong>Background: </strong>Mounting evidence has shown that tRNA-derived small RNAs (tsRNAs) play critical roles in the progression of tumors, including hepatocellular carcinoma (HCC). Nevertheless, the clinical values of serum tsRNAs for HCC are still largely unknown.</p><p><strong>Methods: </strong>Serum samples were procured from 153 HCC patients, 93 hepatitis cases, and 89 healthy donors from the Affiliated Hospital of Nantong University. A series of analyses, including qRT-PCR, receiver operating characteristic (ROC) curve, and Kaplan-Meier analysis, were performed to investigate the potential performance of serum tsRNA-Val-5-0035, also known as hsa_tsr014055, for HCC clinical practice.</p><p><strong>Results: </strong>Methodological evaluation showed that qRT-PCR detection of serum hsa_tsr014055 had better stability, repeatability, and primer specificity. Moreover, serum hsa_tsr014055 was significantly higher in HCC patients than in hepatitis cases and healthy donors. Dynamic monitoring disclosed that it was dropped in HCC patients who had undergone surgery. Besides, it was positively correlated with TNM stage, differentiation grade, and microvascular invasion, as well as the prognosis of HCC patients. Additionally, serum hsa_tsr014055 had potential diagnostic value for HCC. Importantly, when it was combined with alpha-fetoprotein (AFP) and des-γ-carboxyprothrombin (DCP), the diagnostic efficacy was obviously improved. Also, bioinformatic prediction demonstrated that hsa_tsr014055 had 717 downstream targets, which were enriched in Hedgehog and cAMP signaling pathways.</p><p><strong>Conclusion: </strong>Serum hsa_tsr014055 may be a promising biomarker in the diagnosis, evaluation of therapeutic effects, and assessment of HCC prognosis. Especially when serum hsa_tsr014055 was combined with AFP and DCP, the diagnostic efficacy for HCC would be enhanced.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2528978"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psoas muscle CT radiomics-based machine learning models to predict response to infliximab in patients with Crohn's disease.","authors":"Zhuoyan Chen, Weimin Cai, Yuanhang He, Tianhao Mei, Yuxuan Zhang, Shiyu Li, Yiwen Hong, Yuhao Chen, Huiya Ying, Yuan Zeng, Fujun Yu","doi":"10.1080/07853890.2025.2527954","DOIUrl":"10.1080/07853890.2025.2527954","url":null,"abstract":"<p><strong>Background: </strong>Crohn's disease (CD) is a chronic inflammatory bowel disease, with infliximab (IFX) commonly used for treatment. However, no clinically applicable model currently exists to predict the response of patients with CD to IFX therapy. Given the strong association between sarcopenia and IFX treatment outcomes, this study developed computerized tomography radiomics-based machine learning (ML) models, utilizing psoas muscle volume as a proxy for skeletal muscle mass, to predict the response of patients with CD to IFX therapy.</p><p><strong>Methods: </strong>In this retrospective study, patients with CD from two institutions were recruited between January 2010 and January 2023, following stringent inclusion and exclusion criteria. Regions of interest were delineated using 3D Slicer software, and radiomics features were extracted with the Pyradiomics package in Python. <i>Z</i> score standardization and independent sample <i>t</i> test were applied to identify optimal predictive features, which were then utilized in seven ML algorithms for training and validation. Model performance was assessed through receiver-operating characteristic curves, precision-recall curves, and calibration curve analyses, evaluating accuracy and clinical applicability. Binary logistic regression was employed to identify predictors of IFX treatment response.</p><p><strong>Results: </strong>A total of 134 patients were included, divided into a training cohort (<i>n</i> = 84) and a validation cohort (<i>n</i> = 50). Twenty differential radiomics features were selected for integration into the ML models. All models demonstrated strong predictive performance in the validation cohort, with a mean area under the curve of 0.849. The eXtreme Gradient Boosting algorithm outperformed others, achieving an area under the curve of 0.910.</p><p><strong>Conclusion: </strong>Psoas computerized tomography radiomics-based ML models effectively predict the response of patients with CD to IFX therapy, with the eXtreme Gradient Boosting model exhibiting superior performance.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2527954"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regarding effect of different doses of intravenous dexmedetomidine as an adjunct to the serratus anterior plane block in patients undergoing modified radical mastectomy: a randomized controlled trial.","authors":"Fu-Shan Xue, Dan-Feng Wang, Zhi-Bin Huang, Yong-Bao Lin","doi":"10.1080/07853890.2025.2551279","DOIUrl":"https://doi.org/10.1080/07853890.2025.2551279","url":null,"abstract":"","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2551279"},"PeriodicalIF":4.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of the association between ultrasound-detected features and laboratory inflammatory biomarkers in hand osteoarthritis.","authors":"Omar Alshalawi, Jonathan Fulford, Hussein Al-Shaari, Merlisa C Kemp, Abasiama Dick Obotiba","doi":"10.1080/07853890.2025.2549523","DOIUrl":"https://doi.org/10.1080/07853890.2025.2549523","url":null,"abstract":"<p><strong>Objectives: </strong>To systematically review observational studies for the relationship between ultrasound (US)-detected features and laboratory inflammatory biomarkers in hand osteoarthritis (OA).</p><p><strong>Methods: </strong>A systematic literature search was performed in MEDLINE, EMBASE, CINAHL, and Web of Science from their inception to June 2025 to identify relevant observational studies. Study quality was evaluated using the Newcastle-Ottawa Scale (NOS), with two independent reviewers validating the papers. Correlation coefficients and corresponding confidence intervals and P values between US-detected features and biomarkers were extracted and analysed.</p><p><strong>Results: </strong>Out of 5,128 citations, four studies (546 participants, 91.75% female, mean age 56.1-66.3 years) scored >5 on the NOS. Significant correlations (<i>r</i> = 0.3-0.57) were found between serum inflammatory markers (e.g. TNF, MIP-β, PDGF-bb, IP-10) and grey-scale synovitis (GSS) specifically in erosive hand OA. No significant correlations were observed between other US-detected features (e.g. power Doppler (PD) signals, osteophytes (OST), effusion, cartilage thickness) and inflammatory biomarkers, with coefficients generally <0.2.</p><p><strong>Conclusion: </strong>These findings highlight a critical gap in research linking US-detected features and serum inflammatory markers in hand OA. While some evidence suggests that US-detected GSS may reflect subclinical inflammation, particularly in erosive hand OA, inconsistent results across studies underscore the need for larger, standardised research to support phenotyping and inform targeted diagnostic and therapeutic strategies.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2549523"},"PeriodicalIF":4.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144982162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycemic variability in type 2 diabetic patients with metabolic dysfunction-associated steatotic liver disease: a case-control study.","authors":"Yueqiu Wang, Jing Liu, Yaoqin Yang, Qiong Wang, Yiqiong Sun, Ruiting Shen, Mingchen Zhang","doi":"10.1080/07853890.2025.2548976","DOIUrl":"https://doi.org/10.1080/07853890.2025.2548976","url":null,"abstract":"<p><strong>Aims: </strong>A case-control study was conducted to assess glycemic variability (GV) in individuals diagnosed with metabolic dysfunction-associated steatotic liver disease (MASLD) and type 2 diabetes mellitus (T2DM), as well as in those with either condition independently.</p><p><strong>Methods: </strong>This study encompassed 2897 consecutive inpatients diagnosed with diabetes at the Department of Endocrinology, Ningbo No.2 Hospital. Patients with MASLD were matched to patients without MASLD based on age and sex. GV was evaluated utilizing glucose standard deviation (SD), coefficient of variation (CV), and mean amplitude of glycemic excursions (MAGE). HOMA-IR and HOMA-β indices were used to assess insulin resistance and islet β-cell function. The degree of hepatic fibrosis was graded using the FIB-4 score. SPSS software (version 26.0) was used for the statistical analysis.</p><p><strong>Results: </strong>1. MASLD was diagnosed in 41.66% of T2DM inpatients. Among individuals with normal body weight, 32.45% suffered from MASLD, whereas the prevalence significantly escalated to 77.55% among those classified as obese. Based on the FIB-4 index, 47.11% of DM + MASLD patients were at risk for the development of hepatic fibrosis, with 7.85% classified as at high risk for advanced liver fibrosis. 2. In contrast to the DM+Non-MASLD cohort, the DM+MASLD group displayed markedly reduced GV, lower incidence of hypoglycemia, and elevated HOMA-IR and HOMA-β values (all <i>p</i> < 0.001). 3. The CV showed a direct positive correlation with HbA1c (<i>β =</i> 0.367, <i>p</i> < 0.001) in patients with coexisting T2DM and MASLD.</p><p><strong>Conclusions: </strong>Patients with T2DM and MASLD exhibit reduced GV and a lower incidence of hypoglycemia but more serious insulin resistance. Effective control of HbA1c is essential to mitigate GV in these patients.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2548976"},"PeriodicalIF":4.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144982245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, mortality, and DALYs of global pharyngeal cancer: systematic analysis and projections Based on global burden of disease study 2021.","authors":"Tianjiao Zhou, Ying Shen, Enhui Zhou, Jingyu Zhang, Xiaoting Wang, Fan Song, Lili Xiao, Chen Xu, Wen Lu, Haibo Ye, Kaiming Su, Hongliang Yi, Weijun Huang","doi":"10.1080/07853890.2025.2547092","DOIUrl":"10.1080/07853890.2025.2547092","url":null,"abstract":"<p><strong>Introduction: </strong>Compared to other head and neck cancers, pharyngeal cancer (PC) has poorer survival, representing a significant health burden. This study aimed to assess the burden and trends of PC at global, regional, and national levels and analyze mortality-related factors.</p><p><strong>Methods: </strong>Data on PC, including incidence, mortality, disability-adjusted life-years (DALYs), and death-related risk factors from 1990 to 2021, were obtained from the Global Burden of Disease Study 2021. Estimated annual percentage changes (EAPCs) were calculated to assess trends.</p><p><strong>Results: </strong>In 2021, PC incidence was 169,820, with 98,435 deaths and 2,843,781 DALYs. Age-standardized rates for incidence, death, and DALYs were 1.93, 1.13, and 32.30 per 100,000, respectively. South Asia had the highest death and DALYs rates (3.23 and 93.00). Low-middle socio-demographic index (SDI) regions showed the highest death rate (2.19) and the greatest EAPC for death rates (0.684%). A positive correlation between SDI and death rates was observed globally (<i>R</i> = 0.26, <i>p</i> < 0.05), particularly in males (<i>R</i> = 0.3, <i>p</i> < 0.05), but not in females. Males exhibited a trend toward younger ages at death by aclohol, peaking in the 35-39-year group.</p><p><strong>Conclusion: </strong>In 2021, global PC incidence, deaths, and DALYs increased significantly, with notable regional disparities, especially in low-middle SDI regions. Alcohol-related mortality disproportionately affected younger males. Strengthening oral health resources, controlling alcohol and tobacco use are essential to reducing the global PC burden.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2547092"},"PeriodicalIF":4.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of a nurse-led HAPA-based discharge planning on post-operative outcomes in urolithiasis patients with double-J stents: protocol for a randomized controlled trial.","authors":"Jiangtao OuYang, Jia Li, Bin Wang, Jiali Wu, Jing Chen, Xujuan Zheng","doi":"10.1080/07853890.2025.2519676","DOIUrl":"10.1080/07853890.2025.2519676","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with urolithiasis undergoing double-J stent placement often face challenges during the post-operative period, including insufficient discharge preparedness and difficulties in self-management. Discharge planning can assist patients during this critical period. However, the effects of delivering a nurse-led discharge planning program remain under-studied. This study aims to apply the Health Action Process Approach (HAPA) model to develop and evaluate a nurse-led discharge planning intervention.</p><p><strong>Aim: </strong>This randomized controlled trial evaluates the effectiveness of a nurse-led, HAPA-based discharge planning intervention in improving discharge preparedness, self-management behaviors, and quality of life in patients undergoing double-J stent placement for urolithiasis.</p><p><strong>Methods: </strong>A total of 86 patients with urolithiasis undergoing double-J stent placement will be randomly assigned to either the intervention group (HAPA-based discharge planning + usual care planning) or the control group (usual care planning). The intervention consists of four phases: assessment, planning, implementation, and evaluation, delivered during hospitalization, with a 30-day follow-up post-discharge. Primary outcomes include discharge readiness, self-management ability, and quality of life, which will be assessed at baseline, discharge, and 7 and 30 days post-discharge. Secondary outcomes include complications following double-J stent placement and unplanned healthcare service utilization rate.</p><p><strong>Discussion: </strong>The results of this study will provide empirical evidence supporting the application of the HAPA model in post-operative discharge planning for urolithiasis patients. If successful, this intervention could lead to significant improvements in self-management behaviors, reduce complications and unplanned healthcare service utilization rates, and ultimately enhance the quality of life for these patients.</p><p><strong>Trial registration number: </strong>Registered in the Chinese Clinical Trial Registry (ChiCTR2400093503).</p><p><strong>Version identifier: </strong>Version 1.0, 2024-11-07.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2519676"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}