Effects of proprioceptive training for people with stroke: A meta-analysis of randomized controlled trials.

OBJECTIVE: To evaluate the effectiveness of proprioceptive training on balance performance, trunk control, and gait speed in people with stroke. METHODS: We searched PubMed, Science Direct, Cochrane, Embase, and Medline for randomized controlled trials that evaluated the effects of proprioceptive training for patients with stroke from the date of each database's inception to July 26, 2021. Two reviewers independently screened the titles and abstracts of potentially eligible articles that were identified on the basis of the search criteria. Methodological quality was determined using version 2 of the Cochrane risk of bias tool for randomized trials. Data were analyzed using Comprehensive Meta-Analysis software. The treatment effect was estimated by calculating Hedges' g and 95% confidence intervals (CIs) using a random-effects model. Statistical heterogeneity was assessed according to the I2 value. The primary outcome was balance performance and secondary outcomes were trunk control, gait speed, and basic functional mobility. RESULTS: In total, 17 trials involving 447 people with stroke were included. Proprioceptive training had a significant effect on balance performance (Hedges' g = 0.69, 95% CI = 0.36-1.01), gait speed (Hedges' g = 0.57, 95% CI = 0.19-0.94), trunk control (Hedges' g = 0.75, 95% CI = 0.33-1.17), and basic functional mobility (Hedges' g = 0.63, 95% CI = 0.31-0.94) among people with stroke. CONCLUSION: Proprioceptive training may be effective in improving balance performance, gait speed, trunk control, and basic functional mobility among people with stroke.

Psychometric Properties and Factorial Structure of Vietnamese Version of the Hypertension Self-care Profile Behavior Scale.

BACKGROUND: The Hypertension Self-care Profile Behavior (HTN-SCPB) scale is a self-report instrument with which a patient's self-care behavior can be assessed. However, its psychometric properties for adult patients with hypertension in Vietnam require clarification. OBJECTIVE: The aim of this study was to translate the HTN-SCPB scale into Vietnamese and to assess its psychometric properties. METHODS: The study included 220 adult patients with hypertension. To evaluate test-retest reliability, 133 participants were tested twice with a 3-week interval between tests. For construct validity, exploratory factor analysis was used to assess factor structure, and confirmatory factor analysis was used to evaluate the structural model fit of the scale. RESULTS: Reliability was confirmed by internal consistency (Cronbach α = 0.79) and test-retest reliability (intraclass correlation coefficient, 0.88). The Kaiser-Meyer-Olkin value was 0.75, and Bartlett's test of sphericity was significant (P < .001) and adequate for exploratory factor analysis. A 5-factor structure was obtained, and the factors were named as follows: "advanced self-management skills," "adverse health behaviors," "medication adherence," "diet-related knowledge regarding hypertension," and "information skills." Confirmatory factor analysis revealed that the model fit indices were acceptable (root-mean-square error of approximation, 0.07) or slightly less than the good fit values (comparative fit index, 0.85; incremental fit index, 0.85; goodness-of-fit index, 0.88; adjusted goodness-of-fit index, 0.84; and Tucker-Lewis index, 0.82). CONCLUSIONS: The Vietnamese HTN-SCPB scale had satisfactory validity and reliability for assessing self-care behaviors in patients with hypertension in Vietnam.

Effects of self-management programs on blood pressure, self-efficacy, medication adherence and body mass index in older adults with hypertension: Meta-analysis of randomized controlled trials.

AIM: To assess the effects of self-management interventions on systolic blood pressure, diastolic blood pressure, self-efficacy, medication adherence and body mass index in older adults with hypertension. BACKGROUND: Effective treatment of hypertension may require the practice of self-management behaviours. However, evidence on effects of self-management interventions on blood pressure, self-efficacy, medication adherence and body mass index in older adults with hypertension is lacking. DESIGN: A systematic review and meta-analysis. DATA SOURCES: CINAHL, Cochrane Library, Embase, Ovid-Medline, PubMed, Scopus, Web of Science and other sources were searched to October 2020. REVIEW METHODS: Data were analysed using Comprehensive Meta-Analysis 2.0 and quality assessment was done using ROB 2.0. The pooled effect sizes were reported as Hedges' g values with corresponding 95% confidence intervals using a random-effects model. RESULTS: Twelve randomized controlled trials met our inclusion criteria. The results revealed that self-management interventions significantly decreased blood pressure and increased self-efficacy and medication adherence in older adult patients with hypertension, with no significant effect on body mass index. CONCLUSIONS: Self-management interventions have considerable beneficial effects in older adults with hypertension. Health care providers should implement self-management interventions to strengthen the patient's role in managing their health.

Sexual awareness and cognitive social capital among high school students: a cross-sectional study in rural Vietnam.

Objective: Since the late 1980s, Vietnam has seen numerous social changes, likely leading to changes in adolescent sexual awareness. Adolescents are currently exposed to a plethora of sexual information without adequate sex education and knowledge. Globally, researchers have identified sexual knowledge and self-esteem as determinants of adolescent sexual awareness and behavior, but little is known about the role of social capital, especially in rural areas. This study aimed to clarify the relationship between sexual awareness and cognitive social capital among high school students in rural Vietnam. Materials and Methods: We conducted a questionnaire-based survey assessing sexual knowledge, sexual awareness, perceptions of peers' sexual experience, structural and cognitive social capital, and self-esteem (Rosenberg Self-Esteem Scale) in March 2017 among 1,583 11th graders at four public high schools in Hai Duong Province, Vietnam. Results: The final sample comprised 1,517 students (95.8% of total responses): 609 boys (40.1%) and 908 girls (59.9%). Multiple logistic regression analysis was performed with intolerance toward premarital sex as the dependent variable. In the first model, the independent variables were self-esteem, knowledge of proper timing for condom use, and perception that many peers are sexually experienced. The second model added an indicator of cognitive social capital. In the first model, self-esteem, knowledge of proper timing for condom use, and perception that many peers are sexually experienced were all significantly associated with intolerance toward premarital sex for both boys and girls. In the second model, for both boys and girls, only cognitive social capital was significantly associated with intolerance toward premarital sex. Conclusion: The results of this study regarding the effect of social capital in rural Vietnam are consistent with previous findings in urban areas. Social capital should be emphasized in efforts to improve sexual awareness and, in turn, sexual and reproductive health among adolescents in rural areas.

Effects of Patient Activation Intervention on Chronic Diseases: A Meta-Analysis.

BACKGROUND: Patient activation has been described as a potential strategy to improve chronic disease self-management. However, the effects of patient activation interventions on psychological and behavioral outcomes have not been systematically evaluated. PURPOSE: This study was designed to evaluate the effects of patient activation interventions on physiological, psychological, behavioral, and health-related quality of life outcomes in patients with chronic diseases. METHODS: We systematically searched four databases (PubMed, Cochrane, CINAHL, and Embase) from inception to September 1, 2017. We identified English- and Chinese-language published reports of randomized controlled trials that evaluated the effects of patient activation interventions for adults with chronic diseases. Study selection, data extraction, and quality assessment were performed by two reviewers independently. We summarized the intervention effects with Hedges's g values and 95% confidence intervals using a random-effects model. We used the Cochrane Handbook to assess the methodological quality of the randomized controlled trials. RESULTS: Twenty-six randomized controlled trials were included in the qualitative synthesis and meta-analysis. In terms of overall study quality, most of the included studies were affected by performance and detection bias. Patient activation interventions produced significant effects on outcomes related to physiological, psychological, behavioral, and health-related quality of life in the context of chronic diseases. The following effect sizes were obtained: (a) physiological, namely, glycated hemoglobin = -0.31 (p < .01), systolic blood pressure = -0.20 (p < .01), diastolic blood pressure = -0.80 (p = .02), body weight = -0.12 (p = .03), and low-density lipoprotein = -0.21 (p = .01); (b) psychological, namely, depression = -0.16 (p < .01) and anxiety = -0.25 (p = .01); (c) behavioral, namely, patient activation = 0.33 (p < .01) and self-efficacy = 0.57 (p < .01); and (d) health-related quality of life = 0.25 (p = .01). CONCLUSIONS: Patient activation interventions significantly improve patients' physiological, psychosocial, and behavioral health statuses. Healthcare providers should implement patient activation interventions that tailor support to the individual patients' level of patient activation and strengthen the patients' role in managing their healthcare to improve chronic-disease-related health outcomes.