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      Research on the factors that influence patients with colorectal cancer participating in the prevention and control of surgical site infection: Based on the extended theory of planned behaviour

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          Abstract

          Background

          The most common and severe type of nosocomial infection in patients with colorectal cancer is surgical site infection (SSI). Patient‐related factors are an important components of SSI. So it is necessary to participate in SSI prevention and control. It is important to identify the factors that influence patients' participation behaviour and to explore the mechanism of these effects.

          Methods

          A total of 580 patients with colorectal cancer completed relevant measures. Based on the extended theory of planned behaviour, a structural equation model was used to analyse the relationship among the influencing factors.

          Results

          The factors influencing participation of patients with colorectal cancer in SSI prevention and control were participation intention, participation ability, self‐efficacy, participation attitude, perceived medical staff support, trust in physicians and social support. The direct effect coefficients of participation intention, participation ability and physician trust on SSI prevention and control behaviour were 0.67, 0.21 and 0.11, respectively. Self‐efficacy, participation attitude, perceived medical staff support and social support indirectly affect participation behaviour through participation intention, and their effect values are 0.21, 0.11, 0.11 and 0.08, respectively.

          Conclusions

          Based on the structural equation model developed in this study, targeted intervention measures should be implemented to mobilize the intention and enthusiasm of patients with colorectal cancer to participate in the prevention and control of SSI.

          Patient or Public Contribution

          Patients or public contribute to spreading research findings, and promote broad participation in the implementation of policies or strategies.

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          Most cited references31

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          Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis.

          Health-care-associated infection is the most frequent result of unsafe patient care worldwide, but few data are available from the developing world. We aimed to assess the epidemiology of endemic health-care-associated infection in developing countries. We searched electronic databases and reference lists of relevant papers for articles published 1995-2008. Studies containing full or partial data from developing countries related to infection prevalence or incidence-including overall health-care-associated infection and major infection sites, and their microbiological cause-were selected. We classified studies as low-quality or high-quality according to predefined criteria. Data were pooled for analysis. Of 271 selected articles, 220 were included in the final analysis. Limited data were retrieved from some regions and many countries were not represented. 118 (54%) studies were low quality. In general, infection frequencies reported in high-quality studies were greater than those from low-quality studies. Prevalence of health-care-associated infection (pooled prevalence in high-quality studies, 15·5 per 100 patients [95% CI 12·6-18·9]) was much higher than proportions reported from Europe and the USA. Pooled overall health-care-associated infection density in adult intensive-care units was 47·9 per 1000 patient-days (95% CI 36·7-59·1), at least three times as high as densities reported from the USA. Surgical-site infection was the leading infection in hospitals (pooled cumulative incidence 5·6 per 100 surgical procedures), strikingly higher than proportions recorded in developed countries. Gram-negative bacilli represented the most common nosocomial isolates. Apart from meticillin resistance, noted in 158 of 290 (54%) Staphylococcus aureus isolates (in eight studies), very few articles reported antimicrobial resistance. The burden of health-care-associated infection in developing countries is high. Our findings indicate a need to improve surveillance and infection-control practices. World Health Organization. Copyright © 2011 Elsevier Ltd. All rights reserved.
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            Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

            Summary Background Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p<0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p<0·001). Interpretation Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication. Funding DFID-MRC-Wellcome Trust Joint Global Health Trial Development Grant, National Institute of Health Research Global Health Research Unit Grant.
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              Self-management approaches for people with chronic conditions: a review.

              The purpose of this paper is to provide an overview of self-management approaches for people with chronic conditions. The literature reviewed was assessed in terms of the nature of the self-management approach and the effectiveness. Findings are discussed under the headings of: chronic conditions targeted, country where intervention was based, type of approach (e.g. format, content, tutor, setting), outcomes and effectiveness. The last of these focused on reports of randomised controlled studies.
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                Author and article information

                Contributors
                Role: RN
                Role: Professor
                Role: RN
                Role: Professor, RN
                Role: Associate Professorliyuerong12@sohu.com
                Journal
                Health Expect
                Health Expect
                10.1111/(ISSN)1369-7625
                HEX
                Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
                John Wiley and Sons Inc. (Hoboken )
                1369-6513
                1369-7625
                12 September 2021
                December 2021
                : 24
                : 6 ( doiID: 10.1111/hex.v24.6 )
                : 2087-2097
                Affiliations
                [ 1 ] Department of Anesthesiology The First Affiliated Hospital of Chongqing Medical University Chongqing China
                [ 2 ] Department of Urology The First Affiliated Hospital of Chongqing Medical University Chongqing China
                [ 3 ] Department of Nosocomial Infection Control The Second affiliated Hospital of Army Medical University Chongqing China
                [ 4 ] Department of Nursing The First Affiliated Hospital of Chongqing Medical University Chongqing China
                Author notes
                [*] [* ] Correspondence Yuerong Li, MSN, RN, Associate Professor, Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, #1 youyi Rd, Yuzhong District, 400016 Chongqing, China.

                Email: liyuerong12@ 123456sohu.com

                Author information
                http://orcid.org/0000-0003-0161-6520
                https://orcid.org/0000-0003-0694-1234
                https://orcid.org/0000-0003-2941-5261
                https://orcid.org/0000-0002-1648-9352
                https://orcid.org/0000-0002-3115-3128
                https://orcid.org/0000-0003-0763-0171
                Article
                HEX13355
                10.1111/hex.13355
                8628591
                34510675
                8e01a8a8-edfb-4c38-8a31-212bf7011e1f
                © 2021 The Authors. Health Expectations published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 20 July 2021
                : 22 May 2021
                : 19 August 2021
                Page count
                Figures: 2, Tables: 5, Pages: 11, Words: 5828
                Funding
                Funded by: Construction of Chengdu‐Chongqing Economic Circle
                Funded by: Science and Technology Innovation Project
                Award ID: KJCX2020018
                Funded by: First Affiliated Hospital of Chongqing Medical University
                Funded by: Hospital‐level Nursing Project
                Award ID: HLJJ202024
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                December 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.9 mode:remove_FC converted:29.11.2021

                Health & Social care
                colorectal cancer,health and safety,infection control,patient participation

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