Testing a healthcare provider-patient communicative relationship quality model of pharmaceutical care in hospitals

Factor structure and reliability of the symptom measurement of post-stroke depression in the rehabilitation stage

BACKGROUND

The incidence of Post Stroke Depression (PSD) in the Rehabilitation Stage is high, which can bring serious physical and psychological disorders to patients. However, there is still a lack of targeted tools for screening PSD in the rehabilitation stage. Therefore, the aim of this study was to evaluate the factor structure and reliability of a measurement instrument to screen for PSD in the rehabilitation stage.

METHODS

A cross-sectional study was conducted on 780 hospitalized stroke patients who were within the rehabilitation stage from May to August 2020. Exploratory factor analysis (EFA) as well as first- and second-order confirmatory factor analysis (CFA) were performed to evaluate the factor structure of the newly developed Symptom Measurement of Post-Stroke Depression in the Rehabilitation Stage (SMPSD-RS). The reliability and validity of the SMPSD-RS were also verified using several statistical methods.

RESULTS

EFA extracted a 24-item, five-factor (cognition, sleep, behavior, emotion, and obsession) model that can clinically explain the symptoms of PSD during the rehabilitation stage. A first-order CFA confirmed the EFA model with good model fit indices, and the second-order CFA further confirmed the five-factor structure model and showed acceptable model fit indices. Acceptable reliability and validity were also achieved by the corresponding indicators.

CONCLUSION

The SMPSD-RS was proven to have a stable factor structure and was confirmed to be reliable and valid for assessing PSD symptoms in stroke patients during the rehabilitation stage.

The impact of children's temperament on recurrent unintentional injuries: the role of paternal parenting styles as a mediator

Background

Unintentional injuries (UIs) pose a threat to the health of children all over the world and are a major global health problem. The recurrence of UIs are influenced by the host itself or environmental factors. Children's temperament and paternal parenting styles (PPS) are important potential factors for poor health outcomes, including recurrent unintentional injuries (recurrent UIs). Therefore, exploring the relationship among these variables may help reduce the likelihood of recurrent UIs in children.

Purpose

To elucidate the mediating effect of PPS in the relationship of children's temperament characteristics and recurrent UIs among children.

Methods

By multistage random cluster sampling method, a total of 2,850 pupils in grades four and five from 10 different schools were included. The survey included the characteristics of UIs in the past year, parenting styles, and children's temperament. Structural equation modeling (SEM) was used to examine the possible mediating effect of PPS between children's temperament and recurrent UIs.

Results

In this study, the incidence rate of recurrent UIs was 3.8%. In temperament, children with recurrent UIs had higher mean scores than the non-recurrent UIs group (t = -3.40, -3.52, -3.45, respectively; p < 0.001) in the activity, predictability, persistence. Meanwhile, the scores of negative PPS (punishing, over-interference, rejection, and overprotection) were higher in the recurrent UIs group than in the non-recurrent UIs group (t = -5.78, -5.05, -5.56, and -3.29; p < 0.001, < 0.001, < 0.001, < 0.001, respectively). Using a stepwise binary logistic regression model, grade (OR = 0.23, 95% CI [0.12-0.41], p < 0.001), activity (OR = 1.61, 95% CI [1.14-2.26], p = 0.007) and over-interference (OR = 2.28, 95% CI [1.37-3.80], p = 0.002) had a significant independent relationship with recurrent UIs. The SEM results indicated that children's temperament was significantly related to negative PPS (β = 0.26, p < 0.001) and recurrent UIs (β = 0.11, p = 0.029). The results of the bootstrap test confirmed the significance of the mediating effect of PPS (β = 0.06, p < 0.001) between children's temperament and recurrent UIs.

Conclusions

These results suggest that negative PPS plays an important role in mediating children's temperament and recurrent UIs. It is essential to consider PPS when creating tailored intervention programs to reduce children's recurrent UIs.

Improving pharmacist-patient communications based on King's theory of goal attainment: Study protocol for a cluster randomized controlled trial

INTRODUCTION

Previous studies revealed widespread poor communications between pharmacists and patients in various settings. But little is known about how pharmacists communicate with patients and its impact on patient outcomes. King's theory of goal attainment (TGA) describes the dynamic interpersonal interactions in which a patient develops and attains certain goals. This study aims to: (i) test the TGA model in the interface between pharmacists and patients; and (ii) evaluate the effects of TGA-guided interventions.

METHODS

The study will be conducted in 30 community pharmacies recruited from three cities in China's Hubei province. It will start with a baseline cross-sectional survey on 640 patients to test the hypothesized TGA model in community pharmacies. An intervention program will then be developed based on the TGA model and will be evaluated in a matched-pair cluster randomized trial. The participating pharmacies will be pair-matched and randomly allocated to an intervention group and a control group. Pharmacists in the intervention group will receive three sessions of training in line with the TGA model over one year, compared with a pharmaceutical training program in the control group without a communication component. A double-blind procedure will apply. Changes in patient experience in communications and pharmaceutical care will be analyzed. Ethics and dissemination: The study was approved by the Research Ethics Committee of Tongji Medical College, Huazhong University of Science and Technology (IORG: IORG 0003571).

TRIAL REGISTRATION

ChiCTR1800014679.