Effect of Exercise Rehabilitation in Patients With Acute Heart Failure: A Systematic Review and Meta-analysis.

BACKGROUND: Exercise rehabilitation is conducive to increasing functional ability and improving health outcomes, but its effectiveness in patients with acute heart failure (AHF) is still controversial. PURPOSE: In this study, our aim was to systematically examine the efficacy of exercise rehabilitation in people with AHF. METHODS: A search was conducted for randomized controlled trial studies on exercise rehabilitation in patients with AHF up to November 2021. Two investigators conducted literature selection, quality assessments, and data extractions independently. The primary outcome was 6-minute walk distance, and the secondary outcomes were left ventricular ejection fraction, quality of life, Short Physical Performance Battery, readmission, and mortality. RevMan (version 5.3) software was used for the meta-analysis. RESULTS: Twelve studies with 1215 participants were included. Exercise rehabilitation significantly improved the 6-minute walk distance (mean difference [MD], 33.04; 95% confidence interval [CI], 31.37-34.70; P < .001; I2 = 0%), quality of life (MD, -11.57; 95% CI, -19.25 to -3.89; P = .003; I2 = 98%), Short Physical Performance Battery (MD, 1.40; 95% CI, 1.36-1.44; P < .001; I2 = 0%), and rate of readmission for any cause (risk ratio, 0.48; 95% CI, 0.26-0.88; P = .02; I2 = 7%), compared with routine care. However, no statistically significant effects on left ventricular ejection fraction (MD, 0.94; 95% CI, -1.62 to 3.51; P = .47; I2 = 0%) and mortality (risk ratio, 1.07; 95% CI, 0.64-1.80; P = .79; I2 = 0%) were observed. CONCLUSIONS: Compared with routine care, exercise rehabilitation improved functional ability and quality of life, reducing readmission in patients with AHF.

Chinese translation and psychometric testing of the cardiac self-efficacy scale in patients with coronary heart disease in mainland China.

BACKGROUND: A person's self-efficacy plays a critical role during the chronic management process of a health condition. Assessment of self-efficacy for patients with heart diseases is essential for healthcare professionals to provide tailored interventions to help patient to manage the disease. OBJECTIVE: To translate and test the psychometric properties of the Chinese version of Cardiac Self-efficacy Scale (C-CSES) as a disease-specific instrument for patients with coronary heart disease (CHD) in mainland China. METHODS: The original English version of the CSES was translated into Chinese using a forward-backward translation approach. A convenience sample consisting of 224 Chinese patients with CHD were recruited from a university-affiliated hospital in Shiyan, China. The C-CSES and the General Self-efficacy Scale (GSES) were used in this study. The factor structure, convergent and discriminative validities, and internal consistency of the C-CSES were evaluated. RESULTS: The confirmatory factor analysis (CFA) supported a three-factor high-order structure of the C-CSES with model fit indexes (RMSEA = 0.084, CFI = 0.954, NNFI = 0.927, IFI = 0.954 and χ 2 /df = 2.572). The C-CSES has good internal consistency with a Cronbach's alpha of 0.926. The convergent validity of the C-CSES was established with significantly moderate correlations between the C-CSES and the Chinese version of the GSES (p < 0.001). The C-CSES has also shown good discriminative validity with significant differences of cardiac self-efficacy being found between patients with and without comorbidities of hypertension, diabetes, or heart failure. CONCLUSION: The empirical data supported that the C-CSES is a valid and reliable disease-specific instrument for assessing the self-efficacy of Chinese patients with CHD.

Readmission Risk Prediction Model for Patients with Chronic Heart Failure: A Systematic Review and Meta-Analysis.

Background: The present systematic review and meta-analysis aimed to systematically evaluate a risk prediction model for the readmission of patients with CHF. Methods: The search was carried out in databases including PubMed, Embase, EBSCO, Web of Science, Cochrane Library and also domestic databases including Chinese Biomedical Literature Database, Chinese Academic Journal Full Text Database, Wanfang Database, and Vipu Chinese Journal Service Platform. All the original studies published by July 2021. Two researchers identified previous studies involving readmission risk prediction models that met our selection criteria. The quality of the included studies was evaluated based on the CHARMS checklist, and the prediction models were systematically evaluated. Results: Of the overall 4787 studies retrieved, nine studies-two prospective, seven retrospective-met our selection criteria. The area under the receiver operating characteristic curve exceeded 0.63 (0.63-0.80) for all the studies. The most common predictors in the model were B-type natriuretic peptide (BNP) or N-terminal pro-brain BNP (Odds Ratio 4.35; 95% confidence interval (CI) 2.53-7.49; P<0.001), renal insufficiency (Odds Ratio 1.60; 95%CI 1.24-2.08; P<0.001), comorbidities, and a history of hospitalization. Conclusion: The use of non-parametric statistical methods and assessment of large samples of electronic data improve the predictive abilities of the risk assessment models. It is necessary to calibrate and verify such models and promote the combined use of parametric and non-parametric methods to establish precise predictive models for clinical use.

Effects of using WeChat-assisted perioperative care instructions for parents of pediatric patients undergoing day surgery for herniorrhaphy.

OBJECTIVE: This study examined the effects of WeChat-assisted perioperative instructions for parents whose children were to undergo herniorrhaphy. METHOD: A randomized controlled trial was conducted in a day surgery center in China. Participants were randomly assigned to the intervention (WeChat) group (n = 209) and the control (Leaflet) group (n = 209). The primary outcomes of this study were parents' knowledge regarding hernia and rate of cancellation of children's surgery. The secondary outcomes were the rate of lost-to-follow-up and the rate of complications and adverse events during the seventh postoperative follow-up day. RESULTS: There was a significant difference in the rate of cancelling the surgery and the mean knowledge score between the WeChat group and leaflet groups. The lost-to-follow-up rate was significantly lower in the WeChat group (0.54%) than in the leaflet group (3.66%). The incidence of postoperative complications were higher in the control group. CONCLUSIONS: WeChat-assisted perioperative care instructions enhanced parents' knowledge on perioperative instructions and promoted the preparation of their children for day surgery resulting in lower rate of cancelling the surgery. PRACTICE IMPLICATIONS: WeChat has the ability to expand health services outside the hospital confines and could be used as an important low-cost health educational medium in China.

Socioeconomic Status and the Prevalence of Type 2 Diabetes Among Adults in Northwest China.

PURPOSE: The purpose of the study was to investigate (1) the associations of socioeconomic status, lifestyle risk factors, and the prevalence of newly diagnosed type 2 diabetes and (2) the mediating effects of lifestyle risk factors on the association of socioeconomic status and the prevalence of newly diagnosed type 2 diabetes among Chinese adults in northwest China. METHODS: Based on a correlational design and random multistage sampling in communities (N = 3243), data were collected through face-to-face interviews and anthropometric measurements. Education, occupation, and income were considered indicators of socioeconomic status. RESULTS: Approximately 7.5% persons interviewed had newly diagnosed type 2 diabetes. Chi-square analyses showed that higher socioeconomic indicators (higher income, nonmanual occupation) were associated with increased risk. Lifestyle risk factors, including alcohol use, unhealthy diet, and higher body mass index, were significantly positively associated with type 2 diabetes. Adjusting for demographic characteristics, hierarchical logistic regression analyses showed that unhealthy diet and high body mass index were significantly associated with type 2 diabetes. CONCLUSIONS: Higher incomes and nonmanual occupations were related to a greater prevalence of type 2 diabetes, and high body mass index mediated these associations. These findings suggest that interventions for type 2 diabetes in China should be targeted at populations with high socioeconomic status and nonmanual occupations to reduce lifestyle risk factors and prevent diabetes.