Psychosocial adjustment in young and middle-aged adults after coronary stent implantation: A mixed-method study.

BACKGROUND: Currently, the status and principal factors of psychosocial adjustment of young and middle-aged patients after coronary stent implantation (CSI) are understudied. OBJECTIVE: To investigate the psychosocial adjustment and the life experiences of young and middle-aged patients after CSI and the corresponding support necessary to maintain psychosocial health for this patient population. METHODS: This is a mixed-method study. Self-reported questionnaires were used to survey 236 patients after CSI from November 2019 to November 2020 in Guangdong, China. Eight of these patients were purposefully invited to participate in semi-structured interviews. RESULTS: The mean score of psychosocial adjustment were 55.25 (SD=19.96), 55.91 (SD=17.99) for the young and middle-aged patients after CSI respectively. The results of regression analysis showed that resilience, social support, and having diabetes were predictors of psychosocial adjustment of young patients after CSI (R2=0.703, P<0.001). Resilience, social support, current cardiac function, and need to care for parents with chronic diseases were identified as predictors of psychosocial adjustment among middle-aged patients after CSI (R2=0.640, P<0.001). Two themes and six sub-themes related to adjustment challenges and adjustment efforts were identified from the in-depth interviews. CONCLUSIONS: Psychosocial adjustment of young and middle-aged patients after CSI still needs to be improved. Higher level of social support and resilience would promote patient's psychosocial adjustment after CSI. Diabetes was a negative factor of psychosocial adjustment in young patients, whereas limited cardiac function, need to take care of parents with chronic diseases were negative factors in middle-aged patients. After CSI, both young and middle-aged patients faced various challenges of adjustment.

A Meta-Analysis of the Effect of Abdominal Acupuncture on Post-Stroke Depression.

Objective: China has the highest stroke incidence in the world, with a large percentage of post-stroke depression (PSD). Abdominal acupuncture is used frequently to treat PSD. This research systematically evaluated the clinical efficacy of this treatment for PSD. Methods: A literature search retrieved randomized controlled trials in English and Chinese on abdominal acupuncture in conjunction with other therapies (experimental groups), compared to conventional therapies (control groups) for treating PSD from January 2000 to November 2020. Literature quality was evaluated with the Cochrane Library bias-risk assessment tool. RevMan5.3 software was used for the meta-analysis. Results: A total of 10 RCTs involving 708 patients were evaluated. Hamilton Depression Scale scores of the experimental groups were significantly lower than in the control groups (mean difference [MD] = -2.34; 95% confidence interval [CI]: -2.89, -1.78; P < 0.00001). Total effective rates of the experimental groups were significantly higher than in the control groups (odds ratio = 3.90; 95% CI: 2.29, 6.62, P < 0.00001). Barthel index scores in the experimental groups were significantly higher than in the control groups (MD = -11.39; 95% CI: 9.07, 13.72; P < 0.00001). There were no significant differences in National Institutes of Health Stroke Scale (NIHSS) scores between the 2 groups (MD = -0.03; 95% CI: -0.68, 0.62; P = 0.93). Conclusions: Abdominal acupuncture for treating PSD is generally effective. However, the degree of neurologic improvement needs further investigation.