Network analysis of perception of exercise benefits/barriers and kinesiophobia among patients with cardiovascular diseases.

BACKGROUND: Perception of exercise benefits/barriers and kinesiophobia are important predictors of low exercise behaviors in patients with cardiovascular diseases (CVDs). Little is known about the complex intercorrelations between different components of perception of exercise benefits/barriers and kinesiophobia. OBJECTIVES: To identify the central components of kinesiophobia and to explore the interconnectedness between perception of exercise benefits/barriers and kinesiophobia. METHODS: A total of 258 patients with CVDs were recruited in this study. The Tampa Scale for Kinesiophobia Heart and the Exercise Benefits/Barriers Scale were used to assess kinesiophobia and perception of exercise benefits/barriers. R software was used to visualize the networks and analyze the centrality of the networks. The index "expected influence" and "bridge expected influence" were employed to identify the central components and the bridge components of the networks. RESULTS: In the item network of kinesiophobia, three items ("It is really not safe for a person in my condition to be physically active/exercise", "I cannot do the same things as others because there is a too big risk that I will get heart problems", and "If I tried to be physically active/exercise my heart problem would increase") had the highest expected influence. In the exercise benefits/barriers-kinesiophobia network, the dimension of physical exertion had the highest positive bridge expected influence, while psychological outlook had highest negative value. CONCLUSIONS: The three central components of kinesiophobia and the two bridge components (perception exercise barriers of physical exertion and perception exercise benefits of psychological outlook) should be targeted in specific intervention for relieving kinesiophobia and further promoting exercise behaviors.

The role of self-efficacy and self-care agency as mediating factors in the link between health literacy and health-promoting lifestyle among older adults post covid 19 era: A multiple mediator model.

Health-promoting lifestyle is poor in older adults during COVID-19 pandemic. Elucidate the underlying mechanisms between health literacy and health-promoting lifestyle is important. Therefore, we investigated the mediating effect of self-efficacy and self-care agency in relation between health literacy and health-promoting lifestyle among older adults post covid 19 era. A cross-sectional descriptive survey on 200 older adults with the mean age of 68.3 were recruited from Lecai urban community in China, through convenience sampling. Information was assessed using Health literacy Assessment Scale for Infectious Diseases of Chinese Residents, the General Self Efficacy Scale, Chinese version of the Elderly Self-care Ability Scale, and the Health-Promoting Lifestyle Profile-Chinese Elderly. A serial multiple mediation modeling was tested using the PROCESS macro for SPSS to validate the pathways. Results indicated that positive correlations were found between health literacy, self-efficacy, self-care agency and health-promoting lifestyle in older adults. Meanwhile, health literacy was linked to enhanced health-promoting lifestyle through two pathways: (1) self-efficacy; (2) chain combination of self-efficacy and self-care agency. Self-efficacy and self-care agency mediated the relationship between health literacy and health-promoting lifestyle in older adults. Therefore, attention to improving self-efficacy, self-care agency and health literacy should be considered crucial for improving health-promoting lifestyle.

Exercise Intention and its Associated Factors Among Persons Post-Stroke: A Cross-Sectional Study.

Purpose: To investigate the level of exercise intention and its associated factors among persons post-stroke using the Theory of Planned Behavior. Patients and Methods: In this cross-sectional study, a total of 333 participants admitted to the neurology units of a tertiary care hospital in China with a confirmed diagnosis of stroke were recruited. A self-administered instrument based on the Theory of Planned Behavior was used to determine the exercise intention and its associated factors among persons post-stroke. Results: The results revealed that only 128 participants had exercise intention after discharge with a prevalence of 38.4%. Multivariable linear regression analysis revealed that monthly income, living situation, subjective norms, attitude, and perceived behavioral control were significant predictors of exercise intention of persons post-stroke. Perceived behavioral control and living situation were the most relevant factors of exercise intention. Conclusion: The level of exercise intention among persons post-stroke was found to be low. Perceived behavioral control and living situation were particularly important and contributed to exercise intention. Healthcare professionals' adequate guidance on exercise should be provided, with a focus on educating both patients and their family members, especially spouses, to promote exercise intention in persons post-stroke.

A structural equation model linking health literacy, self efficacy and quality of life in adults with coronary heart disease.

BACKGROUND: Cardiovascular disease is the world major cause of death. There is sufficient evidence that patients with coronary heart disease (CHD) experience poor quality of life. Health literacy and self efficacy are modifiable psychosocial factors that could affect quality of life, and these factors should be considered as targets for intervention. As the relationships among health literacy, self efficacy, and quality of life in the CHD population have not been well understood. Thus, we constructed the structure equation model in these valuables. METHODS: A cross-sectional study of a convenience sample among 200 patients with CHD were participated from outpatient clinics in three tertiary general hospitals in Baoding City in mainland China, from December 2018 to June 2019. Data regarding demographic features, health literacy, self efficacy and quality of life were assessed. A structure equation model was used to construct and validate the pathways. RESULTS: The mean age of the study sampled patients was 65.37 years old. The average level of health literacy, self efficacy and quality of life were 9.6 ± 3.5, 28.8 ± 13.9 and 381.8 ± 130.1 respectively. Significant associations were observed from health literacy to quality of life, and self efficacy played a partial mediating role between health literacy and quality of life in the CHD population. Health literacy and self efficacy explained for 59.6% of the variance in quality of life. CONCLUSIONS: Health literacy had a direct influence on quality of life, and an indirect influence on quality of life via self efficacy in the patients with CHD.

Social Support and Self-Efficacy as Mediating Factors Affecting the Association Between Depression and Medication Adherence in Older Patients with Coronary Heart Disease: A Multiple Mediator Model with a Cross-Sectional Study.

PURPOSE: Medication non-adherence is a major public health issue. Recent evidence suggests that depression, inadequate social support, and lower levels of self-efficacy are associated with poor medication adherence. However, the mechanism underlying the association among depression, social support, self-efficacy and medication adherence is unclear. This study aims to examine the mediating role of social support and self-efficacy between depression and medication adherence in older patients with coronary heart disease. PATIENTS AND METHODS: Data were collected from 238 hospitalized older patients with coronary heart disease. Depression, social support, self-efficacy, and medication adherence were assessed using structured questionnaires. A serial multiple mediation model was tested using the PROCESS macro for SPSS. RESULTS: A total of 238 older patients with CHD with a mean age of 70.5 years were involved in this cross-sectional study. Depression was negatively correlated with medication adherence in older patients with coronary heart disease. Social support and self-efficacy were positively associated with medication adherence, and fully mediated the relationship between depression and medication adherence. Three mediation paths were included in the model: (a) social support, (b) chain combination of social support and self-efficacy, and (c) self-efficacy. CONCLUSION: Social support and self-efficacy explain the association of depression and medication adherence in older CHD patients and may be the keys target for enhanced intervention to improve medication adherence in older CHD patients with depression.

Nucleus-targeting imaging and enhanced cytotoxicity based on naphthalimide derivatives.

Organelles possess critical biological effects in cellular processes. However, the relationship between organelle targeting and antitumour activity is a challenging issue. In this paper, a number of amide/acylhydrazine modified naphthalimide derivatives were designed and synthesized. Interestingly, amide modified naphthalimide derivatives NI-A-NH and NI-C-NH with (R)-piperdine and (S)-pyrrolidine functionalization exhibited enhanced cytotoxicity compared with acylhydrazine modified derivatives NI-A-2NH and NI-C-2NH. However, acylhydrazine modified derivatives NI-B-2NH and NI-D-2NH with (S)-piperdine and achiral piperdine conjugates possessed better cytotoxicity than NI-B-NH and NI-D-NH with amide modifications. Fluorescence imaging, DNA binding interactions and cell cycle analyses were further completed to clarify that the nucleus-targeting effects showed enhanced cytotoxic activity, strong DNA binding and the blocking of cells in S phase. These results provide a preliminary theoretical basis for the further design of organelle-targeting antitumour drugs.

Health literacy and health outcomes in hypertension: An integrative review.

OBJECTIVE: The aim of this study was to summarize the evidence of health literacy and health outcomes in hypertensive patients. METHODS: Articles published in English were searched from six databases: MEDLINE, CINAHL, Embase, ERIC, psycINFO, and SCOPUS. The articles published up to September 2017 were included. RESULTS: Nineteen publications were included in the review. There was quality and consistent evidence that hypertensive patients with lower literacy had poorer knowledge. There was inconsistent evidence to show the relationship between health literacy and clinical outcomes, of systolic and diastolic blood pressure, and blood pressure control; behavioral outcomes, of self-care, self-efficacy, adherence; patient-physician interactions outcomes, of patient-physician communication, patient trust, involvement in decision making and other outcomes. CONCLUSION: The person with low health literacy is likely to have poor knowledge of hypertension. However, there is insufficient evidence to suggest that health literacy is associated with outcomes of hypertension independently.

Cardiac rehabilitation knowledge in patients with coronary heart disease in Baoding city of China: A cross-sectional study.

OBJECTIVE: The purpose of this study is to assess the awareness on cardiac rehabilitation (CR) in patients with coronary heart disease (CHD). METHODS: Inpatients diagnosed with coronary heart disease were recruited from 3 hospitals in this study. The study employed a cardiac structured questionnaire to assess respondents' level of awareness, and bivariate to analyze the sociodemographic factors that influence the awareness on CR. RESULTS: Of all 500 participants, 66.40% were male and the mean age was 62.51  ±  9.96 years. The mean score of knowledge was 44.00  ±  17.00 (score range: 0-93), and the mean level of awareness was 47.31% (awareness range: 0-100%). The highest mean level of awareness was in the reexamination subscale (98%) and the lower were in the basic information about CR program, SP optimized medication and heart rate subscale. Bivariate analysis showed that higher age was associated with less knowledge. Patients with higher education level and better income status had better knowledge. And patients who lived in rural and had no jobs had less knowledge. CONCLUSIONS: This study showed low levels of awareness on CR program in CHD patients in Baoding. Therefore, the need for health education is indicated in this study to improve the awareness on CR among CHD patients.