Nurses can learn and use the sources of self-efficacy to enhance patients' self-efficacy on their glycaemic control in clinical care. The health education is most important in nursing care and should be considered while organising the hospital-based clinic intervention.

Background Older patients with end-stage renal disease (ESRD) have experienced diminished quality of life and debilitating symptoms. Conservative management may be a potential treatment option. Currently, limited studies have been conducted about the main outcome of conservative management, including quality of life, symptoms and sleep quality. The aim of this systematic review was to examine the quality of life, symptoms and sleep quality of elderly patients with ESRD undergoing conservative management. Methods Evidence-based medicine database (JBI and Cochrane) and original literature database (PubMed, Medline, EMbase, Web of Science) were searched up to March 12, 2018. The quality of included papers was evaluated with the Newcastle-Ottawa Scale. Results Eight studies met the inclusion criteria. The total of 1229 patients were involved with an average age of 60.6 ~ 82 years. Patients choosing conservative management were older and more functionally impaired compared to those opting for dialysis. 55% patients undergoing conservative management had stable or improved quality of life and symptoms in prospective cohort study. However, the results revealed that there were no significant differences in quality of life and symptom between conservative management and renal replacement therapy. Only one study assessed quality of life of older patients using SF-36, with a lower score in physical health subscale of conservative management patients than those of renal replacement therapy. Although more than 40% of the patients had poor sleep quality, no significant difference was found between conservative management and renal replacement therapy. Sleep disorders were associated with fatigue and other symptoms. Conclusions Although there is a limited literature, conservative management is likely to improve quality of life and alleviate symptoms of end-stage renal disease patients with considerable clinical implications mainly in elderly patients. Future study should pay more attention to the various treatment outcomes of conservative management, providing abundant evidence. Electronic supplementary material The online version of this article (10.1186/s12955-019-1146-5) contains supplementary material, which is available to authorized users.

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Introduction The DECAF score is a simple and effective tool for predicting mortality in patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease (AECOPD); however, the DECAF score has not been validated in AECOPD patients requiring invasive mechanical ventilation (IMV). We devised the ventilator (v)‐DECAF score, in which “anemia” replaces “acidaemia,” for use in AECOPD patients requiring IMV. The objective of this study was to compare the predictive efficacy of the v‐DECAF score and the DECAF score. Methods This study prospectively recruited 112 consecutive AECOPD patients requiring IMV from a single center. The clinical endpoint was 90‐day all‐cause mortality. Demographic and clinical data were recorded, as well as APACHE II, GCS, CURB‐65, BAP‐65 and DECAF scores, and the newly devised v‐DECAF score. The discriminatory value of the scoring systems in predicting 90‐day all‐cause mortality was determined using the area under the receiver operating characteristic (AUROC) curve. Results In multivariate logistic regression analysis, the v‐DECAF score was an independent predictor of 90‐day all‐cause mortality (odds ratio 3.004, 95% CI 1.658‐5.445, P < 0.001). The AUROC of the v‐DECAF and DECAF scores were 0.852 (95% CI 0.766‐0.938) and 0.777 (95%CI: 0.676‐0.878), respectively. The v‐DECAF score had a better predictive value for 90‐day all‐cause mortality compared to the DECAF score (Z = 2.338, P = 0.019). Conclusion The v‐DECAF score had good discriminatory power in predicting 90‐day all‐cause mortality in AECOPD patients requiring IMV.