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1.
J Clin Nurs ; 2021 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-34664325

RESUMO

AIMS AND OBJECTIVES: To investigate the status of physical activity and exercise (PAE) adherence and identify its influential factors among community-dwelling stroke survivors. BACKGROUND: Regular PAE after stroke is essential for recovery and secondary prevention, while adherence to PAE and its influential factors are rarely studied. DESIGN: A cross-sectional descriptive study. METHODS: In total, 208 stroke survivors (70.25 ± 9.08 years) were randomly selected from three communities. The influential factors of PAE adherence and associations between these variables were explored using multiple linear regression and path analyses. This study adhered to the EQUATOR checklist, STROBE. RESULTS: The mean adherence rate was moderate (62.00%), and stroke survivors tended to be more adherent to PAE than monitoring and seeking advice (70.30%>53.50%>48.30%). The regression results revealed that seven factors were significantly associated with PAE adherence, including knowledge, attitude, self-efficacy, social support, self-care ability, community rehabilitation experience and times since stroke. Furthermore, the path analysis showed that knowledge had a significant indirect positive influence on adherence with self-efficacy as a mediator, while attitude and social support impacted both directly and indirectly with self-efficacy as the mediator. Moreover, self-efficacy had the most substantial direct effect on community-dwelling stroke survivors' PAE adherence. These four variables accounted for a total of 67.00% of the variance in PAE adherence among community-dwelling stroke survivors. CONCLUSIONS: The PAE adherence of community stroke survivors needs to be improved. Healthcare professionals should develop more effective interventions to promote PAE adherence through enhancing self-efficacy among this population. RELEVANCE TO CLINICAL PRACTICE: Adherence to the recommended regimen is the most challenging dimension of stroke physical activity and exercise. This study contributes to exploring status and influential factors of PAE adherence, and self-efficacy was found to be a significant determinant. The results could be used to inspire future community-based intervention programs for stroke survivors.

2.
J Adv Nurs ; 2021 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-34636437

RESUMO

AIMS: To understand how survivors of stroke perceive secondary prevention and explore their perceived barriers and facilitators using the Theoretical Domains Framework. DESIGN: A qualitative descriptive study. METHODS: Nineteen survivors of stroke from three hospitals were recruited and interviewed from April 2019 to April 2020. The data were analysed deductively and inductively by content analysis strategies. RESULTS: Three main themes of perception of secondary prevention were identified, these being active treatment-seeking, attention to taking medications and negative attitude towards lifestyle changes. Using deductive analysis, eight domains of the Theoretical Domains Framework were reported to be relevant in the secondary prevention behaviour of survivors of stroke that mapped to five 'barrier' domains (i.e. knowledge, physical skills, beliefs about capability, beliefs about consequences and optimism) as well as six 'facilitator' domains (i.e. knowledge, interpersonal skills, beliefs about capability, intention, emotion and social influences). Using inductive analysis we identified two additional important factors not falling in the domains of the Theoretical Domains Framework. These comprised female spouses' support and patients' economic autonomy, both of which could be classified as a facilitator or barrier. CONCLUSION: Survivors of stroke perceive seeking treatment and using preventive medication as more important than modifying lifestyle behaviours. Knowledge and insight into the barriers and facilitators of secondary prevention in this specific context provides a theoretical and practical basis for the design of future secondary prevention interventions. IMPACT: Stroke survivors' perceptions of secondary prevention, barriers and facilitators were explored in the context of a developing country. These findings highlight the need to better communicate the importance of improving lifestyle modification and medication adherence, and provide evidence for designing relevant interventions for stroke management in the community.

3.
BMC Public Health ; 21(1): 1911, 2021 10 21.
Artigo em Inglês | MEDLINE | ID: mdl-34674681

RESUMO

BACKGROUND: There were few studies exploring the associations between depressive symptoms, anxiety symptoms and health-related quality of life (HRQoL) in the general population, especially in resource limited area. The aims of this study were to assess the associations between depressive symptoms, anxiety symptoms, their comorbidity and HRQoL in rural area. METHODS: A total of 23,496 eligible participants from Henan rural cohort were included. The Patient Health Questionnaire-2 (PHQ-2) and Generalized Anxiety Disorder-2 (GAD-2) were employed to assess depressive and anxiety symptoms, respectively. HRQoL was measured via European Quality of Life Five Dimension Five Level Scale (EQ-5D-5L). Tobit regression and generalized linear model were utilized to explore the associations between depressive symptoms, anxiety symptoms, their comorbidity and HRQoL. RESULTS: A total of 1320 individuals were identified as depressive symptoms with a prevalence rate of 5.62%, while 1198 participants were classified as anxiety symptoms with a prevalence rate of 5.10%. After multiple adjustment, the regression coefficients (ß) and 95% confidence interval (CI) of utility index for depressive and anxiety symptoms were - 0.166 (- 0.182, - 0.149) and - 0.132 (- 0.149, - 0.114), respectively. The ß and 95% CI of VAS score for depressive and anxiety symptoms were - 7.65 (- 8.60, - 6.70) and - 5.79 (- 6.78, - 4.80), respectively. Additionally, the comorbidity was strongly associated with low utility index and VAS score. These findings were observed robustly in men and women. CONCLUSION: Depressive symptoms, anxiety symptoms and their comorbidity were associated with low HRQoL in rural population, which needed further efforts on preventive and treatment interventions. CLINICAL TRIAL REGISTRATION: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699 ). Date of registration: 06 July, 2015.


Assuntos
Depressão , Qualidade de Vida , Ansiedade/epidemiologia , Estudos de Coortes , Comorbidade , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Masculino , Inquéritos e Questionários
4.
Health Expect ; 24(6): 1962-1970, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34363288

RESUMO

BACKGROUND: Among stroke survivors, the risk of stroke recurrence is high, and stroke survivors' perception of the risk of recurrence is crucial to promote healthy behaviours. OBJECTIVES: This study aimed to explore the perceptions of stroke survivors about their risk of recurrence and healthy behavioural modifications. DESIGN: A qualitative interview study was carried out. RESULTS: We interviewed 19 stroke survivors from 3 hospitals. Thematic analysis showed that the perceptions of recurrence risk and healthy behavioural changes differed between first-ever and recurrent stroke survivors. Three themes were generated from the data of first-ever stroke survivors: indifference to and unawareness of the risk of stroke recurrence, the need for professional information support and different awareness of the importance of different healthy behaviours. For first-relapse stroke patients: worry but feel powerlessness towards recurrent event, accurate information is still warranted, regret of unhealthy behaviour patterns. For the survivors suffered two or more times recurrences: perceived severity of recurrences, increased psychological care need, incorrect perceptions of healthy behaviour. DISCUSSION AND CONCLUSION: Stroke survivors with or without recurrence hold different perceptions towards the risk of recurrence and behavioural changes. The need for information related to warning signs, recurrence risk and risk factors remained consistently unmet. The benefits of healthy behaviours could be a double-edged sword for the prevention of stroke recurrence if the survivors fail to understand these accurately. It is strongly recommended that a specific recurrence risk communication tool and related health education plan be explored on the basis of the number of times patients have experienced stroke recurrence to inform secondary prevention of stroke in the future. PATIENT/PUBLIC CONTRIBUTION: The patients were involved in the formulation of interview questions and conduct of this study. No public was involved in this study.

5.
BMJ Open ; 11(4): e045560, 2021 04 20.
Artigo em Inglês | MEDLINE | ID: mdl-33879490

RESUMO

OBJECTIVES: Understanding the unmet needs of community-dwelling stroke survivors is essential for further intervention. This systematic review was performed to summarise their unmet needs from a quantitative viewpoint. DESIGN: Systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES: A comprehensive search of six databases was conducted from inception to February 2020: PubMed, EMBASE, CINAHL, PsycINFO, SCOPUS and CBM. The methodological quality of the studies was assessed. Unmet needs were categorised, and a pooled analysis of the main outcomes was conducted. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We included quantitative studies focused on the unmet needs of stroke survivors who live at homes rather than in any other institutionalised organisation. RESULTS: In total, 32 of 2660 studies were included, and 1980 unmet needs were identified. The prevalence of patients with unmet needs ranged from 15.08% to 97.59%, with a median of 67.20%; the median number of unmet needs per patient ranged from 2 to 8 (0-31). The prevalence of unmet needs was high at 6 months post-stroke (62.14%) and 2 years post-stroke (81.37%). After categorisation, the main concerns among these patients were revealed to be information support, physical function and mental health; a few studies reported unmet needs related to leisure exercise, return to work and so on. Additionally, differences in the measurement tools used across studies affect what unmet needs participants report. CONCLUSIONS: Sufficient, accurate, individualised and dynamic information support is a priority among community-dwelling stroke survivors. Physical function and mental health are also the most significant concerns for re-achieving social participation. It is essential to design and disseminate standard, effective and time-saving tools to assess unmet needs. TRIAL REGISTRATION NUMBER: CRD42018112181.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Vida Independente , Saúde Mental , Acidente Vascular Cerebral/terapia , Sobreviventes
6.
Artigo em Inglês | MEDLINE | ID: mdl-33671734

RESUMO

The unmet needs perceived by community-dwelling stroke survivors may truly reflect the needs of patients, which is crucial for pleasant emotional experiences and a better quality of life for community-dwelling survivors not living in institutionalized organizations. The purpose of the study is to identify the scope of unmet needs from the perspectives of stroke patients in the community. A qualitative meta-synthesis was performed according to the Joanna Briggs Institute method. Six electronic databases were searched from inception to February 2020. A total of 24 articles were involved, providing data on 378 stroke survivors. Eight categories were derived from 63 findings, and then summarized into four synthesized findings based on the framework of ICF: (1) unmet needs regarding with the disease-related information; (2) unmet physical recovery and activity/participation needs; (3) unmet needs for social environmental resources; (4) unmet psycho-emotional support needs. We found the framework of ICF mostly complete, but unmet information needs still remain. The needs that are mainly unsatisfied include physical, psychosocial and informational, as well as the practical support from professional or environment resources. The ever-present unmet needs perceived by community-dwelling stroke survivors who do not live in institutions are discoverable and mitigable. Future studies should focus on quantifying unmet needs comprehensively derived from experiential domains, assessing the rationality of the unmet needs expressed by patients' perspectives and developing flexible strategies for long-term and changing needs.


Assuntos
Vida Independente , Acidente Vascular Cerebral , Humanos , Pesquisa Qualitativa , Qualidade de Vida , Acidente Vascular Cerebral/terapia , Sobreviventes
7.
Sci Rep ; 11(1): 5011, 2021 03 03.
Artigo em Inglês | MEDLINE | ID: mdl-33658589

RESUMO

The aims were to identify the possible influencing factors of health-related quality of life (HRQoL) and its domain-specific scores in patients with coronary heart disease (CHD). A total of 1247 patients with CHD from the Henan Rural Cohort Study (n = 39,259) were included in this study. The Chinese version of the European Quality of Life Five Dimension Five level scale (EQ-5D-5L) and Visual Analogue Scale (VAS) were used to evaluate HRQoL in patients with CHD. Tobit regression, generalized linear models and binary logistic regression were applied to determine the potential factors influencing the EQ-5D utility, as well as each domain, and the VAS. CHD patients had lower per capita monthly actual income, and higher rates of diabetes mellitus, stroke, anxiety and poor sleep quality, which significantly decreased EQ-5D index and VAS scores. In addition, sex, older age, education, not having a spouse, ever drinking alcohol, a high-fat diet, physical activity, hypertension and depression affected the various domain-specific EQ-5D scores in CHD patients. CHD patients in rural areas have a lower HRQoL. Factors associated with the EQ-5D index, including each domain, and the VAS need attention. CHD patients in rural areas need to be managed systematically.

8.
Neurol Sci ; 42(1): 61-71, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33040195

RESUMO

BACKGROUND: Stroke is still the main cause of death and disability worldwide, numerous studies of recurrence risk have been reported, while systematic estimates of stroke recurrence risk in the last 10 years are variable. This review aims to estimate the cumulative stroke recurrence risk in the last 10 years for secondary prevention management in future. METHODS: A systematic search from January 2009 to March 2019 was conducted through PubMed, EMBASE, Web of Science, Wan-fang, and CNKI. Search terms were in English and Chinese. RESULTS: A total of 37 studies involving 1,075,014 stroke patients were included. The pooled stroke recurrence rate was 7.7% at 3 months, 9.5% at 6 months, 10.4% at 1 year, 16.1% at 2 years, 16.7% at 3 years, 14.8% at 5 years, 12.9% at 10 years, and 39.7% at 12 years after the initial stroke. In addition, the pooled recurrence rate of 32 studies including stroke patients over 50 years only at seven time points except for subgroup of 10 years was 7.7%, 9.5%, 11.2%, 16.1%, 19.3%, 18.1%, and 39.7%, respectively. Meta-regression showed that the time points explained 23.02% of the variance among studies, while regions, age, and stroke types showed no significant contribution to heterogeneity. CONCLUSIONS: The risk of stroke recurrence varies greatly from 3 months to over 10 years and increases significantly over time in both young and old subgroup. The heterogeneity may be explained by follow-up time, regions, age, methodology differences, and stroke types, which was needed further exploration in future.


Assuntos
Neoplasias , Acidente Vascular Cerebral , Humanos , Recidiva , Prevenção Secundária , Acidente Vascular Cerebral/epidemiologia
9.
Patient Prefer Adherence ; 14: 2477-2487, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33363363

RESUMO

Background: The Living with Medicines Questionnaire (LMQ-3) is a reliable, valid instrument used to assess the medication-related burden of patients with chronic disease using long-term medication, but it has not been used in China. Purpose: To translate and cross-culturally adapt the LMQ-3 into Chinese and assess its reliability and validity among elderly patients with chronic disease. Methods: After translation and back-translation, views from an expert group and cognitive interviews with elderly persons using multiple medicines were used to ensure the cultural relevance of the LMQ-3. Then, 412 participants aged 60-92 years were recruited from three communities in Zhengzhou to complete the instrument. Item analysis, internal consistency, content validity, exploratory factor analysis (EFA) and reliability testing were performed. Results: Item analysis identified nine items for possible removal, which were discussed with the originating team. Internal consistency testing confirmed the suitability of removing two of these items, which concurred with the views of the expert group and cognitive interviews. All other items were retained, but four were modified for clarification without changing their meaning, resulting in a 39-item instrument. EFA of this 39-item measure yielded an eight-factor model, similar to the English version. Cronbach's alpha of the Chinese version of LMQ-3 (C-LMQ-3) for elderly patients with chronic diseases was 0.855, and alpha values for the eight domains ranged from 0.822 to 0.932. Test-retest reliability was satisfactory, with ICC values for the eight domain scores ranging from 0.751 to 0.881. Conclusion: With only minor modifications compared to the English version, the 39-item C-LMQ-3 is a valid tool, with adequate reliability, which can be used to assess the medication-related burden of long-term use of multiple medicines in elderly patients in China.

10.
Disabil Rehabil ; : 1-10, 2020 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-33202159

RESUMO

PURPOSE: To translate the MOSE from English to Chinese and investigate the psychometric properties of the Chinese-translated version of the Measure of Stroke Environment (MOSE). MATERIALS AND METHODS: The MOSE was translated into Chinese using a cultural adaptation process. To validate this Chinese version, 311 stroke survivors were recruited to complete the questionnaire. The psychometric properties of the MOSE were evaluated by determining item analysis, test-retest reliability, internal consistency, content validity, construct validity, and floor/ceiling effects, respectively. RESULTS: The MOSE was translated without any major difficulties. Regarding psychometric performances, a moderate level of correlation between the items and the domains (r > 0.4), and the significant differences in items between the high group and the low group were tested by independent sample t-tests (p < 0.05). The test-retest reliability was excellent (Intraclass Coefficient Correlation = 0.938). Very high internal consistency was also observed (Cronbach's α = 0.945, split-half reliability = 0.778). An acceptable I-CVI ranged from 0.714 to 1.000 and a high S-CVI of 0.973. Correlations with the subscales of the WHODAS 2.0 were significant in similar domains reflecting good convergent validity. No floor or ceiling effects were observed. CONCLUSION: This study provides psychometric evidence supporting the use of the Chinese version of the MOSE among stroke survivors.IMPLICATIONS FOR REHABILITATIONThe Measure of Stroke Environment was translated into Chinese through a rigorous cultural adaptation process.MOSE-C is now a reliable and valid tool for Chinese-speaking survivors who have suffered from a stroke.It is necessary to assess the perceived environmental barriers of stroke survivors and develop targeted intervention programs in China.

11.
BMJ Open ; 10(10): e038344, 2020 10 19.
Artigo em Inglês | MEDLINE | ID: mdl-33077565

RESUMO

OBJECTIVES: The caregiving experience includes both caregiver burdens and benefits finding. However, the benefits obtained by family caregivers of stroke survivors in Chinese community dwellings are unknown. The objective of this study was to explore the benefits experienced by family caregivers of stroke survivors in Chinese community dwellings. DESIGN: A qualitative descriptive design was used, fulfilling the consolidated criteria for the Standards for Reporting Qualitative Research reporting guidelines. Semi-structured interviews were conducted with 20 family caregivers of stroke survivors. The interviews were audiotaped, transcribed and analysed. Thematic analysis was performed to analyse the interview transcripts. SETTING AND PARTICIPANTS: Home interviews were conducted with family caregivers of stroke survivors in two communities in Zhengzhou, China. RESULTS: The family caregivers of stroke survivors experienced various benefits from caregiving. There were both internal benefits (increases in knowledge and skills, the development of positive attitudes, and the development of a sense of worthiness and achievement) and external benefits (family growth and gains in social support), which interact to create a healthy lifestyle. CONCLUSION: Our findings provide a comprehensive perspective in understanding the benefits perceived by family caregivers of stroke survivors. This study provides insights into interventions focused on identifying benefits finding in six domains that may help reduce negative emotions and promote the mental health of caregivers.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Cuidadores , China , Família , Humanos , Pesquisa Qualitativa , Sobreviventes
12.
Front Psychiatry ; 11: 734, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32848914

RESUMO

In recent years, increased attention has been paid to the benefit finding of family caregivers due to the important role they play. Although some instruments measure benefit finding of caregivers, they do not comprehensively address it in terms specific to the family caregivers of stroke survivors, who require long-term, consistent care. This study is the first effort to develop a comprehensive Caregiver Benefit Finding Scale for the family caregivers of stroke survivors in a Chinese cultural setting. First, 50 items were extracted from a systematic literature review, and a semi-structured interview was conducted with 20 stroke family caregivers to develop the preliminary version of the scale (Version 1). Second, Delphi procedures with 20 experts were used to revise the first version and create Version 2 (37 items). Another six experts were recruited for content validation. Item content validity index (I-CVI) values ranged from 0.83 to 1.00, and the value of the scale CVI was 0.97. Third, 309 family caregivers completed the Version 2 questionnaire and the Chinese version of the Positive Aspects of Caregiving. Two weeks later, 35 family caregivers once again completed the questionnaires. An exploratory factor analysis produced four components (personal growth, health promotion, family growth, and self-sublimation) and 26 items for Version 3 (the cumulative proportion variance was 74.14%). Subsequently, 311 family caregivers completed Version 3. A confirmatory factor analysis confirmed the structure. The goodness of fit index (GFI) = 0.921, adjusted GFI = 0.901, normal fit index = 0.951, incremental fit index = 0.990, comparative FI = 0.990, and the root mean square error of approximation = 0.02 were within the acceptable range. Criterion-related validity was equal to 0.803. The model-based internal consistency index was 0.845 and the values of the Cronbach'α coefficient of the four dimensions were 0.885-0.953. The split-half reliability was 0.92, and the test-retest reliability was 0.994. These findings provide preliminary evidence of the validity and reliability of the Caregiver Benefit Finding Scale. The scale can help researchers and clinicians to achieve a more comprehensive understanding of stroke family caregivers' positive experience. This understanding is necessary for future efforts to address issues in benefit finding by targeting the underlying mechanism and intervention.

13.
J Adv Nurs ; 76(11): 3164-3170, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32857428

RESUMO

AIM: The aim of this study is to describe a longitudinal research protocol for exploring the relationship of dyadic appraisal, dyadic coping (DC), and dyadic mental health among stroke survivors and their spouses and its action path. BACKGROUND: Stroke can be considered as a dyad phenomenon which affects the mental health of both the survivors and their spouse caregivers. Studies based on dyadic theories are needed to examine the roles of dyadic appraisal and DC on the mental health of stroke dyads. DESIGN: Longitudinal study. METHODS: Stroke survivors and their spouse caregivers will be recruited from hospital, when the survivors are stable and about to discharge. Follow-up assessments will take place in 3, 6, 9, and 12 months after participants discharge. The structural equation modelling will be used for statistic analysing. DISCUSSION: Our study seeks to expand the theory of Developmental-Contextual Model to examine the association among variables including dyadic appraisal, DC, and mental health for the couples coping with stroke.


Assuntos
Saúde Mental , Acidente Vascular Cerebral , Adaptação Psicológica , Cuidadores , Humanos , Estudos Longitudinais , Cônjuges
14.
Medicine (Baltimore) ; 99(27): e20656, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629637

RESUMO

INTRODUCTION: Stroke-related smartphone applications (apps) present enormous potential for stroke management as apps become increasingly prevalent in China. However, there is no comprehensive study reported about the currents status of stroke-related apps available to adopt in Chinese app market. The aim of this study is to assess the current status of stroke-related apps available to adopt in China. MATERIALS AND METHODS: Using Stroke-related keywords written in either Chinese or English, the top 6 most prevalent apps online stores in China were searched from June to August 2018, including android market, 360 app market, wan dou jia, baidu mobile app, ying yong bao, apple app store. The basic features of selected apps were analyzed based on operating system, cost, target people, engagement, online interaction, release date, size, popularity, and usefulness. The information accountability of selected apps was evaluated with the Silberg scale. The functionality of selected apps targeting stroke patients at home were reviewed by researchers. RESULTS: Our study showed that the downloads of stroke-related apps from android platform and the engagement of health professionals in apps development were critically insufficient. And most apps didn't offer a platform to facilitate online interaction with health professional. The information accountability of apps also presented a huge room for improvement. The average Silberg score of 127 apps was 3.5 (out of 9) with most apps not disclosing sponsorship, authors' affiliations, credentials, and sources or references of information. Few apps were modified in the past months. What's more, although the apps targeting stroke patients at home have covered 9 functionalities, most apps had only a simple functionality. CONCLUSION: This study identified areas for improvement concerning information accountability of stroke-related apps available for adoption in China and reviewed functionality of apps targeting stroke patients at home. The findings might guide the development for stroke-related apps in China in the future.


Assuntos
Aplicativos Móveis/estatística & dados numéricos , Reabilitação do Acidente Vascular Cerebral , Humanos
15.
Artigo em Inglês | MEDLINE | ID: mdl-32485790

RESUMO

Health literacy is the ability of individuals to access, process, and understand health information to make decisions regarding treatment and their health on the whole; it is critical to maintain and improve public health. However, the health literacy of urban and rural populations in China has been little known. Thus, this study aims to assess the status of health literacy and explore the differences of its possible determinants (e.g., socio-economic factors) among urban and rural populations in Henan, China. A cross-sectional study, 78,646 participants were recruited from a populous province in central China with a multi-stage random sampling design. The Chinese Resident Health Literacy Scale was adopted to measure the health literacy of the respondents. In the participants, the level of health literacy (10.21%) in central China was significantly lower than the national average, and a big gap was identified between urban and rural populations (16.92% vs. 8.09%). A noticeable difference was reported in different aspects and health issues of health literacy between urban and rural populations. The health literacy level was lower in those with lower levels of education, and a significant difference was identified in the level of health literacy among people of different ages and occupations in both urban and rural areas. Note that in rural areas, as long as residents educated, they all had higher odds to exhibit basic health literacy than those uneducated; in rural areas, compared with those aged 15 to 24 years, residents aged 45 to 54 years (OR = 0.846,95% CI (0.730, 0.981)), 55 to 64 years (OR = 0.716,95% CI (0.614, 0.836)) and above 65 years (OR = 0.679, 95% CI (0.567, 0.812)) were 84.6%, 71.6%, and 67.9%, respectively, less likely to exhibit basic health literacy. Considering the lower health literacy among rural residents compared with their urban counterparts, a reorientation of the health policy-making for Chinese rural areas is recommended. This study suggests that urban-rural disparity about health literacy risk factors should be considered when implementing health literacy promotion intervention.


Assuntos
Letramento em Saúde , População Rural , Adolescente , Adulto , China , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários , População Urbana , Adulto Jovem
16.
Clin Gerontol ; : 1-13, 2020 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-32496892

RESUMO

OBJECTIVES: To verify the effectiveness and feasibility of a nine-week benefit-finding intervention on the burden, quality of life, and benefit finding of caregivers, as well as on the quality of life of stroke survivors. METHODS: Benefit finding refers to the individual, social, psychological and spiritual benefits perceived by an individual experiencing stress or post-traumatic events. A randomized controlled trial was performed in which 68 stroke survivors and their caregivers were recruited from the Zhengzhou community, China, and randomly split into two groups. The intervention group included those having undergone a nine-week benefit-finding intervention, while the control group included those individuals having undergone a nine-week routine health education. At baseline and one-week post-intervention (after a 9-week intervention), the quality of life of stroke survivors and caregivers and the burden and benefit finding of caregivers were determined. RESULTS: In comparison to the control group, caregiver benefit finding, quality of life, burden, and stroke survivor quality of life were significantly improved (P <.005). CONCLUSIONS: The intervention appears to be feasible for stroke patients and caregivers. The intervention is capable of improving the quality of life of caregivers and survivors, increasing the benefit finding of caregivers and reducing the burden of caregivers. CLINICAL IMPLICATIONS: The benefit-finding intervention is capable of improving the health condition of stroke patients and caregivers.

17.
Med Sci Monit ; 26: e920325, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-32006420

RESUMO

BACKGROUND Cerebral ischemia-reperfusion injury (CIRI) remains a serious health problem. Centella asiatica formulations are used to treat central nervous system disorders. In the present study, asiaticoside, an extract of the plant Centella asiatica, was investigated in CIRI in vivo and vitro. MATERIAL AND METHODS We made a CIRI model in vivo in SD rats treated by middle cerebral artery occlusion, and a cell model of ischemia-reperfusion injury was made in PC12 cells treated by deprivation of oxygen and glucose/restoration. CIRI in vivo was assessed by scores of neurological functions, encephaledema, and cerebral infarction area. Inflammation level and oxidative stress level were detected by the appropriate kits. TUNEL assay was performed for assessment of cell apoptosis and Western blot analysis was performed to assess protein expression levels. CCK8 assay was performed for evaluation of cell survival and flow cytometer was used to detect cell apoptosis in vitro. RESULTS Nervous function injury, brain edema, cell apoptosis, infarct size, apoptosis-related protein expressions, and protein expressions of the NOD2/MAPK/NF-kappaB signaling pathway in the CIRI model were all reversed by asiaticoside in rats. The cell apoptosis, inflammation level, and oxidative stress level in the model of cerebral ischemia-reperfusion injury were reduced by asiaticoside. The effects of asiaticoside on CIRI were reversed by NOD 2 agonists. CONCLUSIONS Asiaticoside showed a protective effect against cerebral ischemia-reperfusion injury via the NOD2/MAPK/NF-kappaB signaling pathway. These findings are vital for future research on use of asiaticoside in CIRI, providing a new avenue for alleviating CIRI.


Assuntos
Proteínas Quinases Ativadas por Mitógeno/metabolismo , NF-kappa B/metabolismo , Traumatismo por Reperfusão/tratamento farmacológico , Traumatismo por Reperfusão/metabolismo , Transdução de Sinais , Triterpenos/uso terapêutico , Animais , Apoptose/efeitos dos fármacos , Edema Encefálico/tratamento farmacológico , Edema Encefálico/patologia , Edema Encefálico/fisiopatologia , Infarto Encefálico/tratamento farmacológico , Infarto Encefálico/patologia , Infarto Encefálico/fisiopatologia , Sobrevivência Celular/efeitos dos fármacos , Inflamação/patologia , Proteína Adaptadora de Sinalização NOD2/agonistas , Proteína Adaptadora de Sinalização NOD2/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Células PC12 , Fosforilação/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley , Traumatismo por Reperfusão/fisiopatologia , Triterpenos/farmacologia
18.
Curr Neurovasc Res ; 16(5): 441-454, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31660818

RESUMO

OBJECTIVE: This study was to investigate the potential protective effects of curcumin in cerebral ischemia-reperfusion (CIR) and its regulation of miR-7. METHODS: Rats were occluded by middle cerebral artery occlusion (MCAO) for 1.5 h and reperfused for 2 h to establish a local CIR model. After 24 hours of model establishment, MCAO rats were given curcumin for 3 days by intragastric administration. PC12 cells were cultured for 6 h in oxygen-glucose deprivation medium and then reoxygenated for 24 h to establish an oxygenglucose deprivation/reoxygenation (OGD/R) model. The OGD/R model cells were treated with curcumin for 48 h. RESULTS: Curcumin inhibited the decrease of miR-7-5p expression and an increase of RelA p65 expression induced by CIR and ODG/R. RelA p65 was a target of miR-7-5p. MiR-7-5p antagonists were able to counteract the effect of curcumin on the expression of RelA p65 in ischemic brain tissue of MCAO rats and OGD/R model cells. Curcumin improved OGD/R-induced inhibition of cell activity, necrosis and apoptosis. Curcumin significantly reduced the levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-1ß, reactive oxygen species (ROS) and malondialdehyde (MDA) and increased the activity of superoxide dismutases (SOD) and catalase (CAT) in OGD/R-induced cells. Curcumin may inhibit OGD/R-induced cell damage by regulating miR-7-5p. Curcumin improved cerebral infarction, nerve damage and cognitive dysfunction in rats with CIR, which may be related to the regulation of miR-7-5p/RelA p65 axis. CONCLUSION: Curcumin exerts cerebral protection by attenuating cell necrosis and apoptosis, inflammatory response and oxidative stress following CIR, which may be related to its regulation of the miR-7/RELA p65 axis.


Assuntos
Transtornos Cognitivos/prevenção & controle , Curcumina/uso terapêutico , Infarto da Artéria Cerebral Média/metabolismo , MicroRNAs/metabolismo , Fármacos Neuroprotetores/uso terapêutico , Traumatismo por Reperfusão/prevenção & controle , Animais , Apoptose/efeitos dos fármacos , Transtornos Cognitivos/metabolismo , Curcumina/farmacologia , Regulação da Expressão Gênica/efeitos dos fármacos , Masculino , MicroRNAs/genética , Fármacos Neuroprotetores/farmacologia , Estresse Oxidativo/efeitos dos fármacos , Ratos , Espécies Reativas de Oxigênio/metabolismo , Traumatismo por Reperfusão/metabolismo
19.
BMJ Open ; 9(6): e029160, 2019 06 21.
Artigo em Inglês | MEDLINE | ID: mdl-31230030

RESUMO

INTRODUCTION: Stroke is a leading cause of disability worldwide. The average hospital length of stay ranges from 3 to 28 days, and after discharge home the stroke survivors will live with physical, cognitive, even psychological disorders for the rest of their lives. It is essential to review the unmet needs of stroke survivors. METHODS AND ANALYSIS: A systematic review of previous quantitative and qualitative studies reporting the unmet needs of stroke survivors in their homes will be conducted. The following six databases will be searched from inception to December 2018 for relevant articles: PubMed, EMBASE, CINAHL, PsycINFO, SCOPUS and China Biology Medicine. We will include studies limited to human and published in English or Chinese, and the patients with stroke should discharge home rather than any other professional organisations including nursing homes or community rehabilitation units and so on. Data of quantitative research will be standardised for comparison, thematic analysis will be used for qualitative data and a narrative synthesis and pooled analysis of the main outcomes will be reported. ETHICS AND DISSEMINATION: This review will be submitted to an international professional journal, and the detailed search strategies and analysis flowchart will be openly included as supplements. This study does not require ethical approval as no patient's identifiable data will be used. Our findings will give a new look at the aspect of stroke survivors' unmet needs in their long-term recovery stage, especially the trajectories of unmet needs at different timepoints. What is more, this review will demonstrate the long-term unmet needs of stroke survivors from different countries, will compare any variations between high-income and low-income regions, and the geographical differences of needs will be mapped if necessary. We will endeavour to provide as much information as possible to healthcare professionals and public health policy makers in order to promote further medical reform. TRIAL REGISTRATION NUMBER: CRD42018112181.


Assuntos
Vida Independente , Determinação de Necessidades de Cuidados de Saúde , Reabilitação do Acidente Vascular Cerebral , Sobreviventes/psicologia , Atividades Cotidianas , Adaptação Psicológica , Cognição , Humanos , Vida Independente/psicologia , Vida Independente/normas , Projetos de Pesquisa , Reabilitação do Acidente Vascular Cerebral/métodos , Reabilitação do Acidente Vascular Cerebral/psicologia , Revisões Sistemáticas como Assunto
20.
Int J Nurs Pract ; 24(2): e12625, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29457315

RESUMO

AIMS: To develop a culturally appropriate and functional standard Mandarin Chinese translation of the Self-Administration of Medication tool and to examine its validity and reliability. METHODS: We used Brislin's guidelines for the translation and back-translation procedures. We recruited 130 patients from June 2015 to September 2016. Correlation analysis, Cronbach's alpha coefficient, split-half reliability, item analysis and the content validity index, and exploratory factor analysis were performed. RESULTS: Strong and moderate correlations were seen between the total Self-Administration of Medication score and nurses' and patients' perceptions. Item analysis indicated that the correlation coefficient ranged from 0.744 to 0.975. Cronbach's alpha ranged from 0.933 to 0.976. The split-half reliability ranged from 0.911 to 0.936 for the instrument's subscales, and 0.953 for the total scale. The content validity index value ranged from 0.823 to 0.972 for individual items and was 0.968 for the total scale. The factor loading matrix of the SAM ranged from 0.514 to 0.837. A moderate correlation existed between the scores of the Self-Administration of Medication tool and the Barthel Index. CONCLUSION: The Chinese version of the Self-Administration of Medication tool is statistically acceptable and can be used in the evaluation of self-medication ability based on self-report and nurses' assessment.


Assuntos
Doença Crônica/tratamento farmacológico , Autoadministração , Inquéritos e Questionários , Idoso , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Traduções
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