Determinants influencing health-promoting behaviors in individuals at high risks of stroke: a cross-sectional study.

Background: Quit smoking, moderate drinking, exercise, and healthy eating habits are all known to decrease the risk of stroke. As a result, understanding the health behaviors of high risk groups for stroke is crucial. Health behavior is influenced by knowledge, social environment, and health beliefs. However, little research has been done on these relationships. For a better grasp of the relationships mentioned above, consider using the COM-B model (capability, opportunity, motivation, and behavior). The purpose of this study was to investigate the variables related to health behavior and to test the mediating effect of health beliefs. Methods: The cross-sectional study was carried out at a physical examination center of a tertiary hospital in Shanghai, China. 986 high-risk populations of stroke have been tested using the Health Behavior Scale (HBS-SP), Stroke Knowledge Questionnaire (SKQ), Health Beliefs Questionnaire (HBS), and Multidimensional Scale of Perceived Social Support (MSPSS). The structural equation modeling was used in this study. Results: The scores for MSPSS, SKQ, HBS, and HBS-SP were 60.64 ± 13.72, 26.60 ± 9.77, 157.71 ± 34.34, and 2.46 ± 0.41, respectively. The revised model fits well (approximate root mean square error = 0.042; comparative fit index = 0.946). The health behavior was obviously and positively correlated to social Support, stroke knowledge, and health beliefs. Moreover, health belief has a mediating effect on the relation of social support, stroke knowledge, and health behavior. Conclusion: Chinese high risk groups for stroke have a mediate level of health behaviors. Factors associated with health behaviors are knowledge of stroke, health beliefs, and social support. The COM-B-based model can be used to explain the health behavior of individuals at risk of stroke and to guide the formulation of effective health management programs.

Feasibility of an oral health promotion program among older people in geriatric care facilities, Shanghai, China: a pre/post-implementation study.

BACKGROUND: The oral health of older people is closely related to their overall health. Timely and effective intervention in oral issues is necessary to maintain their overall health. This study aimed to evaluate the feasibility and effectiveness of an Oral Health Promotion Program (OHPP) in Geriatric Care Facilities (GCFs). METHODS: The OHPP was implemented in two GCFs and evaluated using a pre/post-design. Questionnaires on self-efficacy and attitude for providing oral care were sent to 42 nurse participants before and three months after the implementation of the OHPP. Outcomes of 295 patient participants were assessed at four time points (T1-baseline, T2-one month, T3-two months, and T4-three months post-implementation) including Activities of Daily Living (ADL), Mini-Mental State Examination (MMSE), and Oral Health Assessment Tool (OHAT). RESULTS: The oral health and daily activity ability of patient participants showed an improving trend at four time points pre/post-implementation of the OHPP. The proportion of patients with healthy mouths (OHAT: 0-3 points) increased from 29.8 to 67.8% and their scores of OHAT and ADL were significantly better at T4 compared to T1, T2, and T3 (p < 0.001). Self-efficacy (SE-PMC: T1 = 18.93 ± 3.18, T4 = 28.83 ± 6.56, p < 0.001) and attitude (A-PMC: T1 = 18.78 ± 3.09, T4 = 28.20 ± 6.03, p < 0.001) for oral care among nurse participants improved after the implementation of the OHPP. CONCLUSIONS: This study highlights the feasibility of implementing OHPP within GCFs, potentially enhancing the oral health and daily living activities of older individuals. Integrating the OHPP into routine care in geriatric settings is not only practical but also widely acceptable, offering a proactive approach to address oral health disparities among older residents. Stakeholders can maximize the impact of the OHPP by fostering collaboration among healthcare professionals, administrators, and residents, ultimately improving oral health outcomes and overall quality of life of older residents. TRIAL REGISTRATION: ChiCTR2000035236 (registration date: 04/08/2020).

Development and psychometric testing of burn inpatient nursing dependency assessment scale.

AIMS: The aim was to develop and psychometrically test the burn inpatient nursing dependency assessment scale (BINDAS). DESIGN: This was a scale development study. METHODS: This study was conducted in four phases from November 2019 to November 2021. Items were generated and the initial scale was constructed in phase 1. The preliminary evaluation of items was conducted through expert reviews and a pilot study in phase 2. The scale, including item quality, reliability and validity, was validated with 420 individuals in phase 3. The translation of the scale from Chinese to English was performed in phase 4. RESULTS: Content validity was satisfactory. Thirteen items were retained after item analysis, and three factors accounting for 73% of the total item variance were extracted through exploratory and confirmatory factor analyses. Predictive validity with nursing time spent with patients during 24 h was also estimated, with r = .66 (p < .01). Receiver operating characteristic analysis was conducted, and an area under the curve of the scale of 0.94 was obtained. Concurrent validity with Barthel index was estimated, with r = -.71 (p < .01). Cronbach's alpha coefficient for scale was .93, and the correlation between raters for total scores was .95. CONCLUSION: Burn inpatient nursing dependency assessment scale is a psychometrically valid and reliable measurement instrument as well as objective other-rating scale with 12 items for scoring on a four-point scale (0, 1, 2 or 3) and 1 item for scoring on a two-point scale (0 or 2). BINDAS with 13 items was developed in this study. Nurses can give each patient a total score of 0-38. A high score indicates high nursing dependency. The 13-item scale consists of three factors: basic care need, physiological index, and psychology and adaptation. IMPACT: This scale demonstrated satisfactory psychometric properties and can be used to evaluate patient dependency on nurses in burn units and optimize an individual's care plan to achieve efficient staff allocation.

Impact of safety monitoring on error probabilities of binary efficacy outcome analyses in large phase III group sequential trials.

In phase III clinical trials, some adverse events may not be rare or unexpected and can be considered as a primary measure for safety, particularly in trials of life-threatening conditions, such as stroke or traumatic brain injury. In some clinical areas, efficacy endpoints may be highly correlated with safety endpoints, yet the interim efficacy analyses under group sequential designs usually do not consider safety measures formally in the analyses. Furthermore, safety is often statistically monitored more frequently than efficacy measures. Because early termination of a trial in this situation can be triggered by either efficacy or safety, the impact of safety monitoring on the error probabilities of efficacy analyses may be nontrivial if the original design does not take the multiplicity effect into account. We estimate the actual error probabilities for a bivariate binary efficacy-safety response in large confirmatory group sequential trials. The estimated probabilities are verified by Monte Carlo simulation. Our findings suggest that type I error for efficacy analyses decreases as efficacy-safety correlation or between-group difference in the safety event rate increases. In addition, although power for efficacy is robust to misspecification of the efficacy-safety correlation, it decreases dramatically as between-group difference in the safety event rate increases.