Home-based exercise in dialysis patients with end-stage renal disease: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Lack of exercise may reduce the quality of life, physical capability, and functional capability of dialysis patients. Home-based exercise seems to be a desirable form of low-cost intervention. But the effectiveness of this intervention in the dialysis population is still unclear. The purpose of this meta-analysis is to provide effective evidence to determine the impact of home-based exercise on functional capacity, physical capacity, muscular strength, biochemical parameters, and health-related quality of life among dialysis patients with end-stage renal disease (ESRD). METHODS: PubMed, Embase, Cochrane Library, and Web of Science were searched from inception to May 2023, to identify potential randomized controlled trials (RCTs) assessing the effectiveness of home-based exercise in dialysis patients with ESRD. Two independent reviewers selected studies, extracted data, and assessed the risk of bias using the Cochrane tool. Evidence summary using fixed or random effects for meta-analysis. RESULTS: Twelve RCTs including 1008 dialysis patients met the inclusion criteria. The meta-analysis showed significant effects of home-based exercise on physical capacity. Seven studies reported the results of the 6-min walking test, compared with short-term (0-3 months) home-based exercise (P = 0.76), long-term (3-6 months) interventions (P < 0.001) can significantly improve the results of the 6-min walking test. The results showed that home-based exercise did significantly improve patients' VO2 peak (P = 0.007). Compared with center-based exercise or usual care, home exercise did not significantly improve handgrip strength, quality of life or CRP and other biochemical parameters (P > 0.05). CONCLUSION: The results showed that long-term home-based exercise can improve walking ability. In addition, home-based exercise had the benefit on the VO2 peak of ESRD patients receiving dialysis patients. However, there was no statistically significant difference in handgrip strength, health-related quality of life, CRP, and other biochemical parameters.

Adolescents' attitudes toward non-suicidal self-injury (NSSI) and their perspectives of barriers to seeking professional treatment for NSSI.

PURPOSE: This study aimed to investigate the attitudes of adolescents toward NSSI, and to explore their perspectives on barriers to seeking professional treatment for NSSI. METHODS: A qualitative phenomenological design was used to conduct in-depth interviews with 17 adolescents with NSSI in a psychiatric hospital in Beijing, China. Data from the 17 adolescents were analyzed using Colaizzi's 7-step analysis. RESULTS: Two themes were extracted: (1) attitudes toward NSSI (normal, effective, ignorant, disgraceful); (2) subjective/objective barriers to seeking professional treatment (negative attitudes toward NSSI, fear of being regarded as an attention getter, fear of interfering with personal relationships, fear of aggravating the family burden, fear of being criticized by parents, fear of ongoing hospitalization, fear of the side effects of medication, etc.). CONCLUSIONS: It is suggested to strengthen the knowledge of NSSI among adolescents, families and society, formulate interventions suitable for Chinese sociocultural backgrounds, and cultivate the specialty literacy of mental health nurses and their abilities to identify the barriers, which are required for eliminating barriers to seeking professional treatment and establishing a system for seeking full coverage of professional treatment.

Global prevalence of self-harm during the COVID-19 pandemic: a systematic review and meta-analysis.

BACKGROUND: COVID-19 and its transmission mitigation measures have caused widespread mental health problems. Previous studies have suggested that psychological, economic, behavioral, and psychosocial problems associated with the COVID-19 pandemic may lead to a rise in self-harm. However, little is known about the prevalence of self-harm worldwide during COVID-19. Therefore, a quantitative synthesis is needed to reach an overall conclusion regarding the prevalence of self-harm during the pandemic. METHODS: By using permutations of COVID-19, self-harm or relevant search terms, we searched the following electronic databases from November 2019 to January 2022: Web of Science, PubMed, MEDLINE, Embase, PsycINFO, Cochrane Database of Systematic Reviews, China National Knowledge Infrastructure (CNKI), Wanfang Database and systematically reviewed the evidence according to MOOSE guidelines. We employed Cochran's chi-squared test (Cochran's Q), I2test and subgroup analysis to assess and address the heterogeneity. Sensitivity analysis was conducted by eliminating each included study individually and then combining the effects. RESULTS: Sixteen studies that met the inclusion and exclusion criteria were identified, with sample sizes ranging from 228 to 49,227. The methodological quality of the included studies was mostly at the medium level. By using a random effect model, the pooled prevalence of self-harm was 15.8% (95% CI 13.3-18.3). Based on subgroup analysis, the following characteristics of the included studies were more likely to have a higher prevalence of self-harm: studies conducted in Asia or prior to July 2020, cross-sectional studies, samples recruited in hospitals or schools, adolescents, females, the purpose of self-harm (NSSI), mental symptoms and restriction experiences. CONCLUSIONS: We provided the first meta-analytic estimated prevalence of self-harm based on a large sample from different countries and populations. The prevalence of self-harm during COVID-19 was not encouraging and requires attention and intervention. Further high-quality and prospective research are needed in order to determine the prevalence of self-harm with greater accuracy because to the clear heterogeneity across the included studies. In addition, this study also provides new directions for future research, including the identification of high-risk groups for self-harm, the formulation and implementation of prevention and intervention programs, and the long-term impact of COVID-19 on self-harm.

Mediating effects of ageism and knowledge on the relationship between contact with older adults and attitudes toward older adults' sexuality among nursing students.

BACKGROUND: Healthcare professionals often ignore sexuality in aging and avoid discussing related topics, especially in China. Nursing students, as future professionals, can address the sexuality of older adults encountered in clinical practice by establishing positive attitudes toward aging sexuality. Previous studies have demonstrated that contact has positive impacts on nursing students' attitudes toward aging sexuality. However, little is known about the mechanism underlying this relationship between contact and attitudes. OBJECTIVES: To explore the mediating effects of ageism and knowledge on the relationship between contact and nursing students' attitudes toward aging sexuality. DESIGN: This was a cross-sectional study. SETTINGS: The study was conducted at a nursing school in Hefei city, China. PARTICIPANTS AND METHODS: 614 nursing students completed online-administered questionnaires measuring the level of contact with older adults, ageism, knowledge, and attitudes toward aging sexuality. Data were analyzed using SPSS and AMOS. RESULTS: The mean scores for knowledge and attitudes toward aging sexuality were 85.70 (SD = 16.39) and 104.91 (SD = 14.88), respectively. Overall, our findings confirmed that these hypotheses were accepted. Ageism (ß = -0.079, P = 0.007) and knowledge (ß = -0.070, P < 0.001) mediated the relationship between contact and attitude. CONCLUSION: Given the mediating role of ageism and knowledge in the relationship between contact and attitude, reducing ageism and enhancing knowledge are vital to changing students' attitudes, including integrating ageism and aging sexuality knowledge learning into the nursing curriculum and creating opportunities for contact with older adults. The frequency and quality of contact between nursing students and older adults can be improved by rationalizing the internship duration, tasks, and assessment objectives of placements on geriatric wards and by the role of clinical faculty role models in cultivating positive attitudes toward aging sexuality.

Prevalence of Adverse Childhood Experiences and Their Associations with Non-Suicidal Self-Injury Among Chinese Adolescents with Depression.

The presence of adverse childhood experiences (ACEs) in adolescents diagnosed with depression has been associated with an extensive range of mental health issues, including non-suicidal self-injury (NSSI). However, there has been a dearth of research into the prevalence of ACEs and their associations with NSSI among depressed adolescent populations in China. This study aimed to investigate the prevalence of different types of ACEs and their associations with NSSI in depressed Chinese adolescents. Utilizing Chi-squared tests, latent class analysis (LCA), and multinomial logistic regression, the prevalence of different types of ACEs and their associations with NSSI were determined in a sample of 562 adolescents with depression. Among depressed adolescents. 92.9% of depressed adolescents reported ACEs, and the prevalence of emotional neglect, physical abuse, caregiver treated violently, and bullying was relatively high. ACEs, including sexual abuse (OR = 5.645), physical abuse (OR = 3.603), emotional neglect (OR = 3.096), emotional abuse (OR = 2.701), caregiver divorce/family separation (OR = 2.5), caregiver treated violently (OR = 2.221), and caregiver substance abuser (OR = 2.117), were associated with increased odds of exposure among depressed adolescents with NSSI. The high ACEs class (19%), the moderate ACEs class (40%), and the low ACEs class (41%) were identified as latent classes. NSSI was more prevalent in the high/moderate ACEs class compared to the low ACEs class, particularly in the high ACEs class. The situation of the prevalence of ACEs among adolescents with depression was unsatisfactory, and certain types of ACEs were associated with NSSI. Eliminating potential risk factors for NSSI requires the early prevention and targeted intervention of ACEs. Moreover, additional large-scale longitudinal studies are necessary to assess the different development trajectories associated with ACEs, such as the relationships between the different development periods of ACEs and NSSI, and to ensure the adoption of evidence-based prevention and intervention strategies.

[Obstacles in the Practice of Palliative Care Consultation Services in Grade A Tertiary Hospitals].

Objective To explore the obstacles in palliative care consultation services and put forward the suggestions for improving the services in grade A tertiary hospitals. Methods A semi-structured interview was conducted with 17 medical workers who had requested palliative care consultation services in Peking Union Medical College Hospital. Results The palliative care consultation services were hindered by five obstacle factors including insufficient knowledge of patients and their families about palliative care,unsound understanding of medical workers about palliative care,poor implementation of consultation opinions,limited labor of palliative care team,and poor economic benefits from palliative care.In view of such obstacles,the following suggestions were put forward,which included increasing the acceptance of palliative care by patients and their families,enriching the knowledge of medical staff on palliative care,establishing a new cooperation model between consultation team and medical staff,strengthening the institutional guarantee for the development of palliative care,and establishing and perfecting the laws and policies related to palliative care. Conclusion Although there are many difficulties in the in-hospital palliative care consultation services in grade A tertiary hospitals,the demand and expectation of medical staff for palliative care are still increasing.

Impact of the nurse-related information through social media use on undergraduate nursing students' professional identity in nursing: A mixed-methods study.

AIM: To understand the impact of nurse-related information, through social media usage on undergraduate nursing students' professional identity. BACKGROUND: Previous research has addressed professional knowledge and practice that affect the development of undergraduate nursing students' professional identities. As an increasingly crucial factor in the internet age, social media needs to be explored in-depth for its influence on the professional identity in nursing. DESIGN: Sequential explanatory mixed method was used in this study. METHODS: In this quantitative study, participants (N = 698) completed an e-questionnaire survey between June and July of 2020. The relationship between main variables was analyzed by linear regression using SPSS 20.0. Then, face-to-face semi-structured and audio-recorded interviews were carried out among participants (N = 16) between January and March of 2021. RESULTS: The quantitative findings indicated that the mean score of professional identity was 93.07 ± 11.96 in participants. The results of the linear regression showed that the year in school, whether nursing was the first choice, online time per day, frequency of reading official accounts related nursing on WeChat and appraisal of the online nurse-related information and so on explained 49.0 % of the variance in professional identity. Four major themes emerged from the qualitative study: 1) increased concern; 2) few and non-professional information; 3) encouraged by positive information; 4) limited impact of negative information. CONCLUSIONS: Nurse-related information on social media has the potential to have an impact on undergraduate nursing students' professional identity. Nursing educators should guide undergraduate nursing students to use social media appropriately and assist them in developing their professional identity with it.

Circ_0110940 Exerts an Antiapoptotic and Pro-Proliferative Effect in Gastric Cancer Cells via the miR-1178-3p/SLC38A6 Axis.

Circular RNAs (circRNAs) are essential regulators in human cancers, including gastric cancer, by the miRNA/mRNA axis. A previous study identified the upregulation of circ_0110940 in human gastric cancer tissues. The present study performed in vitro assays to reveal the functions of circ_0110940 and its downstream miRNA/mRNA axis in gastric cancer cells. Traditional proliferation and apoptosis assays including colony formation, EdU staining, and Annexin V-PI staining assays were conducted. A luciferase reporter assay was performed to assess the binding between miR-1178-3p and circ_0110940 or SLC38A. We found the significant upregulation of circ_0110940 in human gastric cancer cells AGS and MKN45. Circ_0110940 was a stable circRNA and exerted an antiproliferative and proapoptotic effect in AGS and MKN45. Circ_0110940 binded with miR-1178-3p, which further targeted SLC38A6 3'UTR. Circ_0110940 degraded miR-1178-3p, and miR-1178-3p degraded SLC38A6. Thus, circ_0110940 has a positive effect on SLC38A6 expression. Furthermore, SLC38A6 rescued the effects of circ_0110940 knockdown on gastric cancer cell proliferation and apoptosis. In conclusion, circ_0110940 exerted an antiapoptotic and pro-proliferative effect in gastric cancer cells via the miR-1178-3p/SLC38A6 axis, which may provide basis for the targeted therapy of gastric cancer.

[International Research Status and Trend of Community Palliative Care:A Study Based on Cite Space].

Objective To systematically analyze the international progress of community palliative care and to provide reference for promoting the development of community palliative care in China.Methods We searched the Web of Science core collection of the English-language papers associated with community palliative care published from January 1,2014 to November 1,2021 and then used CiteSpace 5.8.R1 to establish the cooperation and co-occurrence networks.Results A total of 1509 papers were included in this study.The annual number of published papers and the citations associated with community palliative care showed an increasing trend.The country,institution,and author publishing the most papers in this field were the United States,the King's College London,and Irene J Higginson at the King's College London,respectively.The research hotspot was identified as hospice of end-of-life patients like cancer patients,which aimed at improving the quality of life.The care will be expanded to dementia patients and old people.Research subjects involve family caregiver and palliative care worker.The predicted focuses of future studies include intervention methods and efficacy,patients' preference,and advance care planning.Conclusions Community palliative care has been rapidly developing in recent years and expanding from patients to the whole population for a full-life care.The Chinese researchers need to strengthen international exchange and cooperation and to learn the diverse development approaches for the whole population,thereby promoting the practice and development of community palliative care in China.

Identification of four patterns for self-management behaviors in clients with schizophrenia: A cross-sectional study.

This study aimed to describe different patterns of self-management behaviors among clients with schizophrenia in China. Two hundred twenty-eight clients with schizophrenia living in eight communities of Beijing were investigated using the Self-Management Instrument for Persons with Schizophrenia and a Demographic and Clinical Characteristics Questionnaire. Cluster analysis was performed to categorize the data. Four distinct self-management behavior patterns and variables of clients associated with non-adherent self-management were identified. The self-management behaviors and demographic characteristics were similar in each pattern but different among patterns. These findings could guide the development of more personalized and cost-effective self-management interventions for different patterns of clients in the future.

Emotion Reactivity and Suicide Risk in Patients With Depression: The Mediating Role of Non-Suicidal Self-Injury and Moderating Role of Childhood Neglect.

Background: The association between emotion reactivity (ER) and suicide risk has been confirmed in recent studies, especially in patients with depression. However, there is a lack of understanding of the underlying mechanism of the relation from ER to suicide risk among patients with depression. This study planned to examine a model of how ER, non-suicidal self-injury (NSSI), and childhood neglect (CN) interact to affect suicide risk in depressed patients. Methods: Four hundred and ninety-six patients (64.5% female, mean age = 30.40 years, SD = 12.56) who have accomplished self-rating instruments of ER, NSSI, CN, and suicide risk were included. Results: Findings showed that ER was positively connected with suicide risk, and NSSI partially mediated the above connection. Besides, CN moderated the mediation model, that is, the mediation effect was more pronounced in depressed patients with CN compared to depressed patients without CN. Conclusions: It was concluded that there is a relationship among ER, NSSI, CN, and suicide risk in patients with depression, and it strengthens our knowledge of the mechanism behind suicide risk. Our findings emphasize that the identification of NSSI and CN should be considered when assessing the suicide risk of patients with depression, as well as the intervention focus on emotion regulation and support for patients.

Prevalence and risk factors for non-suicidal self-injury among patients with depression or bipolar disorder in China.

BACKGROUNDS: Non-suicidal self-injury is a serious health problem among patients with depression or bipolar disorder. However, few studies within the Chinese context have investigated the prevalence of NSSI and its risk factors in above populations. The purpose of this study was to investigate the prevalence of non-suicidal self-injury and its risk factors in patients with depression or bipolar disorder in China. METHODS: The final sample comprised of 394 inpatients(Mage = 29.71; SDage = 11.95) with depression or bipolar disorder from two psychiatric hospitals in Beijing, China. A General Demographic Data Form, the Non-suicidal Self-injury Questionnaire(NSSI-Q), Impulsivity Item and the Adverse Childhood Experiences-International Questionnaire(ACE-IQ) were completed by all patients. RESULTS: Of the 394 patients examined, 245(62.2%) of this sample reported NSSI in past year. Of the 245 patients with NSSI, 135(55.1%) were diagnosed with depression and 110(44.9%) were diagnosed with bipolar disorder. The most common methods of NSSI for female was "pinching"(23.1%) and "scratching"(22.8%), while for male it was "hiting hard objects"(12.7%). By multivariate regression analysis, young age, unemployment, a higher monthly family income, single, impulsivity, long duration of illness and ACEs were risk factors for NSSI in patients with depression and bipolar disorder(P<0.05). CONCLUSIONS: Our study points to the fact that there was an unfortunate message about the prevalence of NSSI among patients with depression or bipolar disorder in China. It is necessary not only to raise the awareness of NSSI in families and society, but also to formulate targeted assessment and intervention. Moreover, future research should not only focus on individuals being hospitalized, but should be representative of individuals treated at home or in the community because there are no national statistics on NSSI among such patients in China.

[Effects of Palliative Care Consultation on Medicals in Peking Union Medical College Hospital].

Objective To explore the effects of palliative care consultation on medical professionals who have requested it in Peking Union Medical College Hospital. Methods Semi-structured interviews were conducted with 17 medical professionals who had requested palliative care consultation.Results Palliative care consultation had the following positive effects:building a bridge for doctor-patient communication,providing psychological support to reduce the sense of occupational exhaustion for medical professionals,providing technical support for medical professionals to help patients relieve symptoms,helping medical professionals in the multidisciplinary learning of palliative care,adding humanistic care and neglected ethical concerns.Conclusion Palliative care consultation improves the quality of care for dying patients,and the capacity of consultation needs to be enhanced urgently.

The prevalence of child maltreatment among Chinese primary and middle school students: a systematic review and meta-analysis.

PURPOSE: The purpose of this study was to provide an estimate of the prevalence of child maltreatment among Chinese primary and middle school students. An attempt was also made to explore the causes of heterogeneity by analyzing stratified variables and other potentially related factors included in the study. METHODS: Literature retrieval has been carried out in the databases, including Pubmed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang database and China Biology Medicine disc (CBMdisc), for relevant published studies up to October 2019. The Cochran's chi-squared test (Cochran's Q), I2 test and subgroup analysis were performed to evaluate the heterogeneity. Funnel plots were used to detect publication bias. Trim-and-fill method was performed to identify possible asymmetry and assess the robustness of the conclusions. RESULTS: A total of 1433 studies were obtained after retrieval. Finally, 19 eligible studies were included in meta-analysis after detailed exclusion. The pooled prevalence of child physical abuse (CPA), child emotional abuse (CEA), child sexual abuse (CSA), child physical neglect (CPN) and child emotional neglect (CEN) were 0.20 (95% CI 0.13, 0.27), 0.30 (95% CI 0.20, 0.39), 0.12 (95% CI 0.09, 0.15), 0.47 (95% CI 0.35, 0.58) and 0.44 (95% CI 0.28, 0.59), respectively. In subgroup analyses, a higher prevalence of CEN was reported in rural areas. Meanwhile, the prevalence of CPN and CEN in non-only child group was higher than that observed in only child group. Compared with children without mental symptoms, children with mental symptoms have a higher incidence of all categories of child maltreatment. In terms of assessment tools, studies using Childhood Trauma Questionnaire as an assessment tool reported lower prevalence of CPA, CEA. Childhood Trauma Questionnaire In addition, the prevalence of CPN, CEN in studies conducted in northern China was significantly higher than that estimated in southern and central China. For CSA, eight additional studies required trimming according to the trim-and-fill analysis, and the pooled estimate was 0.042 after filling. For CPA, CEA, CPN and CEN, there were no indications of publication with the trim and fill method (data unchanged). CONCLUSION: Our findings indicated that primary and middle school students had a relatively high prevalence of maltreatment. Because of the visible heterogeneity of the studies included, more large samples, high-quality and prospective studies are needed in the future to acquire the accurate prevalence of child maltreatment in China. Certainly, future research needs to focus not only on the estimate of prevalence of child maltreatment, but also on risk factors and intervention strategies for child maltreatment.

[Qualitative Study on Survival Stressors of 15 Community-dwelling People with Mental Illness].

Objective To understand the survival stress of community-dwelling people with mental disorder. Methods Fifteen cases were selected by purposive sampling and received semi-structured individualized interviews.The data were analyzed by Colaizzi framework and themes were extracted. Results Four themes were extracted:physiological stress due to psychiatric symptoms and side effects of drugs;psychological stress due to the outcome of mental illness and to conflict of roles in daily life;social and environmental stress such as social discrimination,lack of job opportunities,and difficulty in obtaining social welfare resources;and interpersonal stress caused by discrimination and deteriorating family relations. Conclusions Community-dwelling people with mental illness have a higher level survival stress after returning to their families and society,with the stressors including symptoms of illness,social discrimination,and interpersonal relationship.Eliminating self-discrimination of the patients,improving social support and social welfare system,and increasing individualized community mental rehabilitation activities may reduce the survival stress of these patients and promote their rehabilitation.

Violence against primary caregivers of people with severe mental illness and their knowledge and attitudes towards violence: A cross-sectional study in China.

PURPOSE: The purpose of this study is to investigate the current situation of violence on primary caregivers of people with severe mental illness outside the hospital and the cognition of primary caregivers about violence among mental patients. METHODS: A self-designed questionnaire was used to investigate the primary caregivers (N = 208) of people with severe mental illness in a psychiatric hospital in Beijing. RESULTS: The incidence rate of violence suffered by primary caregivers was 74.03%, of which 61.54% had experienced verbal attacks, 54.33% had experienced threats, and 45.19% experienced physical attacks. Physical violence, mainly by unarmed attacks, has resulted in soft tissue injury and pain in the majority of caregivers. Multiple admission times, a lower educational level, single in marital status and involuntary hospitalizations were risk factors; growing older was protective factor. The causes of violence were dominated by mental symptoms in 120 cases (57.69%). Tolerance and avoidance were the coping styles of most caregivers adopted after violence, accounting for 51.44%. Furthermore, most of primary caregivers have limited knowledge of violence and adopted an attitude of pessimism towards patients' violence. CONCLUSIONS: It was reported that violence was suffered by primary caregivers of persons with severe mental illness outside the hospital. The study indicated that formulating reasonable nursing intervention, providing health education as well as organizing training towards violence of patients are required to play an important role in effectively preventing and reducing the violence among the people with severe mental illness in China. More information and support needs to be obtained to help caregivers fulfill their duty of care outside the hospital.

Puerarin alleviates liver fibrosis via inhibition of the ERK1/2 signaling pathway in thioacetamide-induced hepatic fibrosis in rats.

Liver fibrosis is a complex pathological process and an early step in the progression of liver cirrhosis, which can eventually develop into hepatocellular carcinoma. Currently, there is no effective treatment for liver fibrosis. Puerarin is a traditional Chinese herb, which is commonly used in the treatment of various diseases. In addition, it is also believed to have a therapeutic effect in liver fibrosis. However, whether puerarin reduces liver fibrosis via the ERK1/2 signaling pathway to inhibit the activation of hepatic stellate cell (HSC) and excessive collagen deposition in liver fibrosis remains unknown. The aim of the current study was to establish a liver fibrosis in vivo model by intraperitoneal injection of thioacetamide (TAA) and investigate the effect of puerarin in the treatment of liver fibrosis. Hematoxylin and eosin and Van Gieson's staining were used to examine histopathological changes associated with liver fibrosis. Liver hydroxyproline content was examined to determine the total amount of collagen in the liver. The relative protein expression levels of transforming growth factor ß1 (TGFß1), α-smooth muscle actin (α-SMA), collagen type I, fibronectin, ERK1/2 and p-ERK1/2 were determined by western blot analysis. In the TAA group, histopathological changes and collagen fiber content in rat liver tissue samples were significantly increased compared with the control group (P<0.05). In addition, treatment with puerarin significantly decreased histopathological changes and collagen fiber content in rat liver tissue samples (P<0.05). The relative protein expression levels of TGFß1, α-SMA, collagen type I, fibronectin and p-ERK1/2 were significantly upregulated in the TAA group compared with the control group (P<0.05), whereas puerarin treatment reversed these changes. These findings suggest that treatment with puerarin may reduce HSC activation and alleviate extracellular matrix protein expression levels by inhibiting the TGF-ß/ERK1/2 pathway in liver fibrosis.

Self-management in Chinese people with schizophrenia and their caregivers: a qualitative study on facilitators and barriers.

The purpose of this study was to explore facilitators and barriers of self-management from the viewpoint of Chinese people with schizophrenia and their caregivers. A qualitative study using the individual interview method was used. Twenty-one people with schizophrenia and 14 caregivers were interviewed. Three facilitators were identified: family and peer support, positive relationships with health professionals, and positive attitudes towards self-management. Four barriers were identified: lack of knowledge and skills, financial constraint, social stigma, and uncoordinated mental health services. The findings from this study should help nurses to recognize the factors that influence self-management and provide direction for nurses and other health professionals involved in initiating and implementing family-based self-management programmes for people with schizophrenia. The findings also call for the development of antistigma programmes, which are needed to help reduce prejudice and discrimination towards individuals with schizophrenia in China. The study also provides information for health policy makers in China to help them make potential changes in mental health services, which can better meet the needs of Chinese people with schizophrenia.

Self-management among Chinese people with schizophrenia and their caregivers: a qualitative study.

This study explores the practice of self-management in Chinese people with schizophrenia and their caregivers. Twenty-one patients and 14 caregivers were interviewed. Four themes were identified, reflecting the practice of self-management from both the patients' and caregivers' perspective: managing medication, monitoring and dealing with symptoms, maintaining social relations, and seeking health information and maintaining medical appointments. In general, self-management practices among Chinese people with schizophrenia were not optimal. This study highlights the importance of developing and implementing family-based self-management programs for Chinese people with schizophrenia and their family in order to enhance their self-management abilities and improve care outcomes.

Self-management education interventions for persons with schizophrenia: a meta-analysis.

Although self-management education programs for persons with schizophrenia are being developed and advocated, uncertainty about their overall effectiveness remains. The purpose of this meta-analysis was to examine outcomes of self-management education interventions in persons with schizophrenia. Six electronic databases were searched. Manual searches were conducted of the reference lists of the identified studies and major psychiatric journals. Randomized controlled trials of self-management education interventions aimed at reducing relapse and hospital readmissions, as well as improving symptoms, psychosocial functioning, and adherence to medication treatment were identified. Data were extracted and the quality of included studies were rated by two authors independently. Finally, 13 studies with 1404 patients were included. Self-management education interventions were associated with a significant reduction of relapse events and re-hospitalizations. Patients who received self-management education were more likely to improve adherence to medication and symptoms compared to patients receiving other care. However, a benefit on psychosocial functioning was not confirmed in the current meta-analysis. The study concludes that self-management education intervention is a feasible and effective method for persons with schizophrenia and should be routinely offered to all persons with schizophrenia.