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Zhou Z, Fang X, Huang Y, Hu J, Zhang K, Jia S. A scoping review of factors associated with self-management in young adults with stroke. PATIENT EDUCATION AND COUNSELING 2024; 125:108308. [PMID: 38705023 DOI: 10.1016/j.pec.2024.108308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 03/30/2024] [Accepted: 04/25/2024] [Indexed: 05/07/2024]
Abstract
PURPOSE To synthesize the available evidence on factors associated with self-management behavior in young stroke patients. METHODS The methodological guidelines for scoping reviews developed by the Joanna Briggs Institute and the PRISMA-scR-checklist for scoping reviews were used. A total of 5586 studies were identified through bibliographic searches of the scientific databases Medline (OVID), Embase (OVID), CINAHL (EBSCO), and PsycINFO, limited to the period 2000-2023. Studies were independently assessed for inclusion and exclusion criteria by two reviewers. Quantitative observational data and qualitative studies were extracted, mapped, and summarized to provide a descriptive summary of trends and considerations for future research. RESULTS Nine papers were finally selected to answer the research question. Young patients' self-management was mainly influenced by demographic factors (age, gender, income, education, and stroke knowledge), disease-related factors (functionality and independence, duration of stroke diagnosis, cognitive function, and poststroke fatigue), and psychosocial factors (hardiness, spiritual self-care, self-efficacy, and social support). CONCLUSION Further research is needed to determine the trajectory of poststroke self-management over time and its potential predictors, which should lead to the development of specific stroke rehabilitation and stroke self-management support programs for young people (considering factors that influence return to work in young stroke patients' self-management). PRACTICE IMPLICATIONS Healthcare providers can design more efficient interventions to improve the quality of life of young stroke patients after discharge. Gaining an in-depth understanding of the factors that influence self-management can help achieve this.
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Affiliation(s)
- Zifang Zhou
- School of Nursing, Jiangxi Medical College, Nanchang University, Jiangxi, China
| | - Xiaoqun Fang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Youhong Huang
- School of Nursing, Jiangxi Medical College, Nanchang University, Jiangxi, China
| | - Jiangyu Hu
- School of Nursing, Jiangxi Medical College, Nanchang University, Jiangxi, China
| | - Kaibing Zhang
- School of Nursing, Jiangxi Medical College, Nanchang University, Jiangxi, China
| | - Shulei Jia
- School of Nursing, Jiangxi Medical College, Nanchang University, Jiangxi, China.
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Douglas ME, Driver S, Ochoa C, McShan E, Callender L, Froehlich-Grobe K. Baseline health-related self-efficacy for individuals following stroke, traumatic brain injury, and spinal cord injury prior to enrollment in a weight-loss intervention. Disabil Rehabil 2024; 46:3314-3322. [PMID: 37753959 DOI: 10.1080/09638288.2023.2261845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 09/15/2023] [Indexed: 09/28/2023]
Abstract
PURPOSE To examine health-related self-efficacy for individuals following acquired brain or spinal cord injury prior to enrollment in a weight-loss intervention and associations with demographics, injury characteristics, and additional physiologic variables. MATERIALS AND METHODS Cross-sectional analysis of baseline data for community-dwelling adults following stroke (CVA), traumatic brain injury (TBI), or spinal cord injury (SCI) across three disability-adapted weight-loss interventions. RESULTS Overall results suggest a significant difference between injury type and self-efficacy as measured by the Self Rated Abilities for Health Practices (SRAHP) scale. On average, individuals with SCI had the lowest overall perceived self-efficacy of the three groups (11.2-unit difference; (CI: -17.4, -5.0), followed by those with TBI (9.5-unit difference; (CI: -16.7, -2.4). There were also differences between groups in age, number of household members, time since injury, sex, race, marital status, physiological measures, and employment status. CONCLUSIONS Results suggest that individuals with different disabilities following neurological injuries have different baseline perceptions in their ability to eat a healthy diet and exercise regularly. Health interventions should be tailored for these groups based on disability-specific barriers and should include components to enhance health-related self-efficacy to address weight management among these populations.IMPLICATIONS FOR REHABILITATIONEvidence suggests that health-related self-efficacy may differ following different injury types and level of disability may impact one's ability to maintain health-related behaviorsResults suggest that individuals with a spinal cord injury may have different baseline perceptions of self-efficacy related to their ability to eat a healthy diet and exercise regularly compared to those with a traumatic brain injury or stroke.Health interventions should be tailored to encompass disability-specific barriers which may impact an individual's health-related self-efficacy.
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Affiliation(s)
- Megan E Douglas
- Baylor Scott & White Research Institute, Dallas, TX, USA
- Baylor Scott & White Institute for Rehabilitation, Dallas, TX, USA
| | - Simon Driver
- Baylor Scott & White Research Institute, Dallas, TX, USA
- Baylor Scott & White Institute for Rehabilitation, Dallas, TX, USA
| | - Christa Ochoa
- Baylor Scott & White Research Institute, Dallas, TX, USA
- Baylor Scott & White Institute for Rehabilitation, Dallas, TX, USA
| | - Evan McShan
- Baylor Scott & White Research Institute, Dallas, TX, USA
- Baylor Scott & White Institute for Rehabilitation, Dallas, TX, USA
| | - Librada Callender
- Baylor Scott & White Research Institute, Dallas, TX, USA
- Baylor Scott & White Institute for Rehabilitation, Dallas, TX, USA
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Steca P, Adorni R, Serino S, D'Addario M. Self-efficacy beliefs as key ingredients to healthy and sustainable lifestyles. A five-year longitudinal study on diet and physical activity habits of newly diagnosed patients with acute coronary syndrome. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2024. [PMID: 38840556 DOI: 10.1002/ijop.13151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 05/08/2024] [Indexed: 06/07/2024]
Abstract
Cardiovascular diseases represent a significant cause of morbidity and mortality worldwide, and an unhealthy lifestyle notoriously accounts for a large percentage of their risk. Identifying resources to stimulate lifestyle changes is an essential goal of primary and secondary cardiovascular prevention. Self-efficacy beliefs are among the major psychological factors proven to impact health status and lifestyle. This study aimed to confirm the role of self-efficacy beliefs by investigating their associations over 5 years of adherence to healthy lifestyles in terms of diet and physical activity in a sample of 275 newly diagnosed patients with acute coronary syndrome. Longitudinal profiles of lifestyles and self-efficacy beliefs in their improvement were identified through latent class growth analysis. Correlations were then performed to explore the associations between lifestyles and self-efficacy trajectories. Results showed a positive association between virtuous lifestyle profiles and high self-efficacy in implementing behavioural change. Finally, two logistic regressions were performed to test the hypothesis that a high self-efficacy profile would predict better lifestyles 5 years after the coronary event. This hypothesis was confirmed for diet. Overall, current findings confirm the importance of implementing repeated psychological interventions that promote patients' efficacy beliefs in self-regulating their behaviour changes over time.
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Affiliation(s)
- Patrizia Steca
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Roberta Adorni
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Silvia Serino
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Marco D'Addario
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
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Supriya, Singh R, Ahsan A. Relevance of Emotion of Anxiety and Fear of Dentistry as Motivational Conflict in Oral Health Behaviors. J Contemp Dent Pract 2024; 25:280-288. [PMID: 38690703 DOI: 10.5005/jp-journals-10024-3643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
AIM This study was undertaken with an aim to explore the influence of factors associated with anxiety and fear of dentistry on oral health behavior. MATERIALS AND METHODS A total of 84 patients aged 20-40 years visiting the dental institute for the management of gum diseases (gingivitis and periodontitis) and tooth decay (dental caries) were enrolled. Fear of dentistry and oral health behaviors were recorded employing a dental fear survey (DFS) and oral health behaviors checklist. Each of the 20-item scale of DFS was rated on a 5-point Likert scale. The oral health behavior checklist was based on oral hygiene habits, patterns of utilization of dental services, food habits, and use of tobacco products. Each of the 13-item checklist comprised a closed-ended statement with a high score corresponding to more positive oral health behavior. RESULTS Domains of dental fear (avoidance of dentistry, physiological arousal, and fear of specific stimuli) and total dental fear did not predict oral hygiene habits and nutritional preferences (p > 0.05). Physiological arousal was a positive predictor of utilization of dental services (p = 0.009) and oral health behavior (p = 0.042). Oral health behaviors were found to be positively correlated with three factors of DFS. CONCLUSION Anxiety and fear of dentistry are not found to influence personal preventive oral care with reference to oral hygiene habits. Avoidance of dentistry factor of DFS is positively correlated with oral health behavior. Dental fear and anxiety do not impact oral health behaviors adversely. CLINICAL SIGNIFICANCE In this era of youth and beauty, the utilization of professional dental care services is not affected by fear of invasive nature of dental procedures. Establishing the groundwork for knowledge regarding the scope of fear appeals in anxiety for dentistry may help to augment positive oral health behaviors for effective primary prevention of oral diseases. Interactions among personality characteristics, attitudes, emotions, and health behavior need further exploration. How to cite this article: Supriya, Singh R, Ahsan A. Relevance of Emotion of Anxiety and Fear of Dentistry as Motivational Conflict in Oral Health Behaviors. J Contemp Dent Pract 2024;25(3):280-288.
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Affiliation(s)
- Supriya
- Department of Psychology, Faculty of Behavioral Sciences, SGT University Gurugram, Haryana, India, Phone: +91 9821848374, e-mail: , Orcid: https://orcid.org/0009-0000-8224-9309
| | - Rajbir Singh
- Department of Psychology, Faculty of Behavioral Sciences, SGT University Gurugram, Haryana, India
| | - Amra Ahsan
- Department of Psychology, Faculty of Behavioral Sciences, SGT University Gurugram, Haryana, India
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Wang X, Zhang ZX, Lin BL, Jiang H, Wang W, Mei YX, Zhang C, Zhang Q, Chen SY. Mediation role of perceived social support between recurrence risk perception and health behaviour among patients with stroke in China: a cross-sectional study. BMJ Open 2024; 14:e079812. [PMID: 38355172 PMCID: PMC10868314 DOI: 10.1136/bmjopen-2023-079812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/26/2024] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVES To examine whether patients who had a stroke with high recurrence risk perception would have healthier behaviour and to explore whether perceived social support would function as a mediator. DESIGN A cross-sectional study. SETTING The study was conducted in a public tertiary hospital in China. PARTICIPANTS A total of 254 patients with stroke were invited to participate, and 250 patients with stroke completed questionnaires validly. PRIMARY AND SECONDARY OUTCOME MEASURES Questionnaires were administered offline to collect data, consisting of four parts: general demographics and scales related to recurrence risk perception, perceived social support, and health behaviour. A path analysis and correlation analysis were used to analyse the data. RESULTS Out of 250 patients with stroke, 78.4% had moderately low health behaviour. The majority (70.8%) of these patients were elderly. High recurrence risk perception and high perceived social support were significantly associated with better health behaviour (all p<0.001). Perceived social support mediated the relationship between recurrence risk perception and health behaviour after controlling for age, gender, education and monthly income in the regression model (95% CI 0.263 to 0.460) and the effect value was 0.360. It was also confirmed that perceived social support had the highest mediation effect with a proportion of mediation up to 59.31%. CONCLUSIONS Recurrence risk perception and perceived social support were influential factors in promoting health behaviour. Moreover, the impact of recurrence risk perception on health behaviour was partially mediated by perceived social support. Therefore, to enhance the sustainability of health behaviour, it is crucial to inform patients with stroke about the risk of recurrence. Patients with more perception of recurrence risk can improve their recovery confidence and thus perceive more social support.
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Affiliation(s)
- Xiaoxuan Wang
- Nursing and Health school, Zhengzhou University, Zhengzhou, China
| | - Zhen-Xiang Zhang
- Nursing and Health school, Zhengzhou University, Zhengzhou, China
| | - Bei-Lei Lin
- Nursing and Health school, Zhengzhou University, Zhengzhou, China
| | - Hu Jiang
- Nursing and Health school, Zhengzhou University, Zhengzhou, China
| | - Wenna Wang
- Nursing and Health school, Zhengzhou University, Zhengzhou, China
| | - Yong-Xia Mei
- Nursing and Health school, Zhengzhou University, Zhengzhou, China
| | - Chunhui Zhang
- Nursing and Health school, Zhengzhou University, Zhengzhou, China
| | - Qiushi Zhang
- Nursing and Health school, Zhengzhou University, Zhengzhou, China
| | - Su-Yan Chen
- Nursing and Health school, Zhengzhou University, Zhengzhou, China
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Ouyang RG, Long Y, Zhang JQ, Cao Z. Interventions for improving self-efficacy in patients after stroke based on self-efficacy-related principles of Bandura's cognition theory: a systematic review and meta-analysis. Top Stroke Rehabil 2023; 30:820-832. [PMID: 36755444 DOI: 10.1080/10749357.2023.2172832] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/22/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND Interventional approaches based on Bandura's cognition theory are effective in improving self-efficacy poststroke. However, a systematical investigation for identifying effectives therapeutic components of the intervention has not yet been conducted. OBJECTIVE This meta-analysis was conducted to systematically investigated the effects of interventions with different principles on improving self-efficacy after stroke. METHODS Searches were conducted in PubMed, EMBASE, CINAHL, PsycINFO, MEDLINE, Cochrane Library, and two randomized controlled trials registration websites for randomized controlled trials from inception to 18th January 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. The meta-analysis was performed using Review Manager and Stata software. RESULTS In total, 36 RCTs were included. Interventions using any one of the self-efficacy principles - principle 1 (Mastery), principle 2 (Modeling), principle 3 (Social persuasion), and principle 4 (Understanding), were more effective in improving self-efficacy in patients with stroke at post-training and follow-up, compared with the control group. Psycho-educational interventions might significantly improve self-efficacy in both post-intervention and follow-up stages, compared with control group. Meta-regression revealed time since stroke onset was significantly associated with effect sizes. CONCLUSION Interventions developed based on Bandura's cognition theory are beneficial to the improvement of self-efficacy. This review highlights principles of Bandura's cognition theory are worth considering to be integrated to interventions targeted at improving self-efficacy. The application of self-efficacy principles with Bandura's cognitive theory could be encouraged in clinical practice in the future. PROTOCOL REGISTRATION NUMBER PROSPERO CRD42020154984.
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Affiliation(s)
- Rang-Ge Ouyang
- Department of Rehabilitation, Xiangya Hospital Central South University, Changsha, Hunan, China
| | - Yi Long
- Department of Rehabilitation, Xiangya Hospital Central South University, Changsha, Hunan, China
| | - Jia-Qi Zhang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Zeng Cao
- Department of Rehabilitation, Xiangya Hospital Central South University, Changsha, Hunan, China
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Fang WJ, Zheng F, Zhang LZ, Wang WH, Yu CC, Shao J, Wu YJ. Research progress of clinical intervention and nursing for patients with post-stroke dysphagia. Neurol Sci 2022; 43:5875-5884. [PMID: 35661279 PMCID: PMC9166186 DOI: 10.1007/s10072-022-06191-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/31/2022] [Indexed: 11/29/2022]
Abstract
Post-stroke dysphagia (PSD) is a common and costly complication of stroke and is associated with increased mortality, morbidity, and hospitalization. Although most patients can spontaneously resume swallowing, there are still many patients who do not recover and even die. Despite multiple advances in the acute treatment and secondary prevention of stroke, the effective treatment of PSD remains a neglected area. Studies have shown that repair mechanisms of neurostimulation techniques and increased cortical activity play an important role in the treatment of PSD. In addition, nutritional interventions are also crucial for the treatment of malnutrition in PSD patients. Therefore, this article reviews the effects of the current main clinical treatment methods and nutritional interventions on the treatment and rehabilitation of PSD patients. It also emphasized the necessity of developing an individualized care plan for PSD patients, which is of great significance to promote the clinical treatment, nutritional status, prognosis, and quality of life of PSD patients.
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Affiliation(s)
- Wen-Juan Fang
- Department of Neurology, The Second People's Hospital of Hefei, Heifei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230011, China
| | - Fei Zheng
- Department of Neurology, The Second People's Hospital of Hefei, Heifei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230011, China
| | - Lin-Zhi Zhang
- Department of Neurology, The Second People's Hospital of Hefei, Heifei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230011, China
| | - Wen-Hui Wang
- Department of Neurology, The Second People's Hospital of Hefei, Heifei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230011, China
| | - Cheng-Chen Yu
- Department of Neurology, The Second People's Hospital of Hefei, Heifei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230011, China
| | - Juan Shao
- Department of Neurology, The Second People's Hospital of Hefei, Heifei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230011, China
| | - Yi-Jin Wu
- The Second Affiliated Hospital of Wannan Medical College, Wuhu, 241000, Anhui, China.
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Fikriana R, Afik A, Marinda MM. The Behavior of Using Masks during the Coronavirus Disease 19 Pandemic in Malang Regency, Indonesia: Application of Theory of Planned Behavior and Social Support. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The use of masks during the coronavirus disease 2019 (COVID-19) pandemic is one of the efforts to prevent its transmission. However, it was found that the behavior of the use of masks in the community is still low.
AIM: This study aims to analyze people’s behavior in the use of masks with the theory of planned behavior and social support approach.
METHODS: Research using a cross-sectional design. The study was conducted on 90 people in Malang, Indonesia, taken with simple random sampling techniques. Variables measured are behavioral beliefs, evaluation of behavioral outcomes, normative beliefs, motivation to comply, control beliefs, perceived power, attitude, subjective norm, perceived control, intention, family support, peer support, and mask usage behavior. Research instrument is questionnaire. The data were analyzed using a linear regression test.
RESULTS: Results showed that the behavior of mask use according to the theory of planned behavior was significantly influenced by perceived power (p < 0.001), normative beliefs (p = 0.019), and intention to perform the behavior (p = 0.041). While in the social support component, peer support obtained a significant effect (p = 0.002).
CONCLUSION: As an effort to improve the behavior of the use of masks in the community during the COVID-19 pandemic, it is necessary to strengthen perceived power, normative beliefs, and intentions accompanied by good peer support so that the community complies with the use of masks for the prevention of transmission.
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Patterns of Adherence to Secondary Prevention Measures Among Chinese Patients With Coronary Artery Disease: A Longitudinal Study. J Cardiovasc Nurs 2021; 37:E61-E72. [PMID: 34238840 DOI: 10.1097/jcn.0000000000000830] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Adherence to secondary prevention measures among patients with coronary artery disease (CAD) affects patient prognosis, whereas patients' adherence behaviors change over time. OBJECTIVES The aims of this study were to identify adherence trajectories to secondary prevention measures including medication-taking and a heart-healthy lifestyle and to estimate predictors of adherence trajectories among patients with CAD. METHODS This longitudinal study enrolled 698 patients with CAD who received a percutaneous coronary intervention in China. Demographics, clinical characteristics, adherence to secondary prevention measures, and patient-related factors including disease knowledge, self-efficacy, and health literacy were measured during hospitalization. Adherence behaviors were followed at 1, 3, and 6 months, and 1 year after discharge. Group-based trajectory models estimated adherence trajectories, and multinomial logistic regression identified trajectory group predictors. RESULTS Four trajectory groups were identified for medication-taking adherence: sustained adherence (39.9%), increasing and then decreasing adherence (23.1%), increasing adherence (23.4%), and nonadherence (13.6%). The 3 adherence trajectory groups for a heart-healthy lifestyle were sustained adherence (59.7%), increasing adherence (28.3%), and nonadherence (12.0%). Married patients were more likely (odds ratio [OR], 3.42; 95% confidence interval [CI], 1.56-7.52) to have sustained adherence to medication-taking. However, patients with higher disease knowledge were less likely (OR, 0.93; 95% CI, 0.87-0.99) to be adherent. Patients who were not working (OR, 2.25; 95% CI, 1.03-4.92) had higher self-efficacy (OR, 1.21; 95% CI, 1.08-1.37). Those with higher health literacy (OR, 1.18; 95% CI, 1.01-1.38) were more likely to have sustained adherence to a heart-healthy lifestyle. However, patients having no coronary stents (OR, 0.36; 95% CI, 0.19-0.70) were less likely to have done so. CONCLUSIONS Trajectories of adherence to secondary prevention measures among mainland Chinese patients with CAD are multipatterned. Healthcare providers should formulate targeted adherence support, which considers the influence of disease knowledge, self-efficacy, and health literacy.
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Brouwer-Goossensen D, Scheele M, van Genugten L, Lingsma HF, Dippel DWJ, Koudstaal PJ, den Hertog HM. Motivational interviewing in a nurse-led outpatient clinic to support lifestyle behaviour change after admission to a stroke unit: a randomized controlled trial. Eur J Cardiovasc Nurs 2021; 21:36-45. [PMID: 33824973 DOI: 10.1093/eurjcn/zvab001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/23/2020] [Accepted: 01/12/2021] [Indexed: 11/13/2022]
Abstract
AIMS Modification of health behaviour is an important part of stroke risk management. However, the majority of people with cardiovascular disease fail to sustain lifestyle modification in the long term. We aimed to evaluate the effectiveness of motivational interviewing to encourage lifestyle behaviour changes after transient ischaemic attack (TIA) or minor ischaemic stroke. METHODS AND RESULTS We performed a randomized controlled open-label phase II trial with blinded endpoint assessment. The intervention consisted of three 15-minute visits in 3 months by a motivational interviewing trained nurse practitioner. Patients in the control group received standard consultation after 1 and 3 months by a nurse practitioner. Primary outcome was lifestyle behaviour change, defined as smoking cessation and/or increased physical activity (30 min/day) and/or healthy diet improvement (5 points at the Food Frequency Questionnaire) at 6 months. We adjusted for age and sex with multivariable logistic regression. Between January 2014 and February 2016, we included 136 patients (of whom 68 were assigned to the intervention group). Twenty-five of 55 patients in the intervention group (45%) and 27 of 61 patients in the control group (44%) had changed their lifestyle at 6 months. We found no effect of motivational interviewing on lifestyle behaviour change after 6 months (aOR 0.99; 95% confidence interval: 0.44-2.26). CONCLUSION Our results do not support the effectiveness of motivational interviewing in supporting lifestyle behaviour change after TIA or ischaemic stroke. However, the overall lifestyle behaviour change was high and might be explained by the role of specialized nurses in both groups.
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Affiliation(s)
- Dorien Brouwer-Goossensen
- Department of Neurology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Maaike Scheele
- Department of Neurology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Lenneke van Genugten
- Department of Neurology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Hester F Lingsma
- Department of Neurology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Diederik W J Dippel
- Department of Neurology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Peter J Koudstaal
- Department of Neurology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
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Brouwer-Goossensen D, den Hertog HM, Mastenbroek-de Jong MA, van Gemert-Pijnen LJEWC, Taal E. Patient perspectives on health-related behavior change after transient ischemic attack or ischemic stroke. Brain Behav 2021; 11:e01993. [PMID: 33662179 PMCID: PMC8035466 DOI: 10.1002/brb3.1993] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 11/18/2020] [Accepted: 11/20/2020] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Unhealthy lifestyle is common among patients with ischemic stroke or TIA. Hence, health-related behavior change may be an effective way to reduce stroke recurrence. However, this is often difficult to carry out successfully. We aimed to explore patients' perspectives on health-related behavior change, support in this change, and sustain healthy behavior. METHODS We conducted a descriptive qualitative study with in-depth, semistructured interviews in eighteen patients with recent TIA or ischemic stroke. Interviews addressed barriers, facilitators, knowledge, and support of health-related behavior change framed by the protection motivation theory. All interviews were transcribed and thematically analyzed. RESULTS Patients seem unable to adequately appraise their own health-related behavior. More than half of the patients were satisfied with their lifestyle and felt no urgency to change. Self-efficacy as coping factor was the most important determinant (both barrier and facilitator). Fear as threat factor was named as facilitator for health-related behavior change by half of the patients. Most of the patients did not need support or already received support in changing health behavior. Patients indicated knowledge, guidelines, and social support as most needed to support and preserve a healthy lifestyle. CONCLUSION This study suggests that patients with recent TIA or ischemic stroke often do not have a high intention to change health-related behavior. The results fit well within the framework of the protection motivation theory. As many patients seem unable to adequately appraise their health behaviors, interventions should focus on increasing knowledge of healthy behavior and improving self-efficacy and social support.
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Affiliation(s)
| | | | | | | | - Erik Taal
- University of Twente, Twente, The Netherlands
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Brouwer-Goossensen D, Lingsma HF, Koudstaal PJ, den Hertog HM. The optimal timing of supporting patients in health-related behavior change after TIA or ischemic stroke: a prospective cohort study to determinants of health-related intention to change over time. Int J Rehabil Res 2021; 44:32-37. [PMID: 33208689 PMCID: PMC7884245 DOI: 10.1097/mrr.0000000000000443] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/10/2020] [Indexed: 11/25/2022]
Abstract
The optimal timing of an intervention to support health-related behavior after transient ischemic attack (TIA) or ischemic stroke is unknown. We aimed to assess determinants of patients' health-related intention to change over time. We prospectively studied 100 patients with TIA or minor ischemic stroke. Patients completed questionnaires on fear, response-efficacy (belief that lifestyle change reduces risk of recurrent stroke), and self-efficacy (patients' confidence to carry out lifestyle behavior) for behavior change, at baseline, 6 weeks and at 3 months after their TIA or ischemic stroke. We studied differences between these determinants at each visit by means of Wilcoxon signed-rank tests. Median self-efficacy score at baseline was 4.3 [interquartile range (IQ) 3.9-4.7], median fear 16 (IQ 7-21), and response-efficacy 10 (9-12). Fear was significantly higher at baseline than at 3 months (mean difference 2.0; 95% confidence interval: 0.78-3.9) and started to decrease after 6 weeks. No change in self-efficacy or response-efficacy was found. Since fear significantly decreased over time after TIA or ischemic stroke and self-efficacy and response-efficacy scores remained high, the optimal moment to start an intervention to support patients in health-related behavior change after TIA or ischemic stroke seems directly after the stroke or TIA.
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Boland P, Connell L, Thetford C, Janssen J. Exploring the factors influencing the use of electrically assisted bikes (e-bikes) by stroke survivors: a mixed methods multiple case study. Disabil Rehabil 2020; 44:1389-1398. [PMID: 32945706 DOI: 10.1080/09638288.2020.1817986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE E-bikes have the potential to overcome some of the barriers that stroke survivors face with regards to physical activity. This study aims to explore the factors that affect e-bike usage by stroke survivors. METHODS A mixed methods multiple case studies design, using semi-structured interviews and GPS data. Subject to GP approval, participants loaned an e-bike or e-trike for up to three months. Interviews were undertaken pre and post intervention. The COM-B behaviour change model acted as a framework for analysis. GPS data relating to journey duration and distance travelled was collected fortnightly. RESULTS Six participants were recruited; only three loaned an e-bike/e-trike (with adaptations as required). Storage, being unable to get GP approval, and safety were withdrawal reasons. Level of impairment was a factor influencing the type of e-bike used, level of support required and the motivation of the participants. CONCLUSION Stroke survivors can use e-bikes although barriers exist. Electrical assistance was a positive factor in enabling some of the participants to cycle outdoors. Due to the small sample size and the number of participants who were able to loan an e-bike, further research is required to determine whether e-bikes are a feasible and effective intervention to increase physical activity for stroke survivors.IMPLICATIONS FOR REHABILITATIONThe assistance provided by the e-bike/e-trike could provide stroke survivors the opportunity to cycle outdoors.E-bikes/e-trikes could facilitate participation of activities of everyday living such as shopping, hobbies and increase levels of physical activity.Rehabilitation could focus on physical impairment, its effects on self-confidence, and knowledge surrounding the e-bike to overcome barriers to cycling.Social support, the belief that e-bike was an enjoyable mode of physical activity that was good for their health were reported by the participants as important factors for using the e-bike/e-trike.
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Affiliation(s)
- Paul Boland
- Faculty of Health and Wellbeing, School of Nursing, University of Central Lancashire, Preston, UK
| | - Louise Connell
- Allied Health Research Unit, Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK
| | - Clare Thetford
- Faculty of Health and Wellbeing, School of Nursing, University of Central Lancashire, Preston, UK
| | - Jessie Janssen
- Department of Health Sciences, Institute of Therapeutic Sciences, IMC University of Applied Sciences, Krems, Austria
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Matsuda Y, Karino M, Kanno T. Relationship between the Functional Oral Intake Scale (FOIS) and the Self-Efficacy Scale among Cancer Patients: A Cross-Sectional Study. Healthcare (Basel) 2020; 8:E269. [PMID: 32823778 PMCID: PMC7551334 DOI: 10.3390/healthcare8030269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/06/2020] [Accepted: 08/10/2020] [Indexed: 11/29/2022] Open
Abstract
A few studies have provided detailed reports suggesting that subjective swallowing disorders may be related to dysphagia. Therefore, we verified the relationship between oral health-related self-efficacy and dysphagia severity in cancer treatment using a cross-sectional study. Participants included patients undergoing treatment for cancer at Shimane University Hospital in Shimane, Japan, and those receiving outpatient treatment at the hospital's Oral Care Center between August 2018 and April 2019. In all, 203 participants enrolled in the study and completed the Functional Oral Intake Scale (FOIS), the Self-efficacy Scale for Advanced Cancer (SEAC), and the Oral Health-related Self-Efficacy Scale for Patients with Cancer (OSEC). Multivariate analysis showed a statistically significant correlation between the low FOIS score and the SEAC subscales of Activities of Daily Living Self-efficacy (ADE) (odds ratio 1.04, 95% [CI] 1.00-1.07) and Symptom Coping Self-efficacy (SCE) (odds ratio 0.61, 95% [CI] 0.42-0.88). Based on the Jonckheere-Terpstra test, the SEAC and the OSEC tended to increase as the category of the FOIS progressed. To conclude, self-efficacy played an important role in dysphagia and may affect the severity of dysphagia in cancer patients.
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Affiliation(s)
- Yuhei Matsuda
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Shimane 693-8501, Japan; (M.K.); (T.K.)
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15
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Sammut M, Fini N, Haracz K, Nilsson M, English C, Janssen H. Increasing time spent engaging in moderate-to-vigorous physical activity by community-dwelling adults following a transient ischemic attack or non-disabling stroke: a systematic review. Disabil Rehabil 2020; 44:337-352. [PMID: 32478574 DOI: 10.1080/09638288.2020.1768599] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Purpose: The risk of recurrent stroke following a transient ischaemic attack (TIA) or non-disabling stroke is high. Clinical guidelines recommend this patient population accumulate at least 150 minutes of moderate-to-vigorous physical activity each week to reduce the risk of recurrent stroke. We aimed to identify interventions that increase time adults spend in moderate-to-vigorous physical activity following TIA or non-disabling stroke.Method: We searched thirteen databases for articles of secondary prevention interventions reporting outcomes for duration in moderate-to-vigorous physical activity or exercise capacity.Results: Eight trials were identified (n = 2653). Of these, three (n = 198) reported changes in time spent in moderate-to-vigorous physical activity. Only one trial (n = 70), reported significant change in time spent engaging in moderate-to-vigorous physical activity (between-group difference: 11.7 min/day [95% CI 4.07-19.33]) when comparing participation in a six-month exercise education intervention to usual care. No trial measured moderate-to-vigorous physical activity after intervention end.Conclusion: Despite recommendations to participate in regular physical activity at moderate-to-vigorous intensity for secondary stroke prevention, there is very little evidence for effective interventions for this patient population. There is need for clinically feasible interventions that result in long-term participation in physical activity in line with clinical guidelines. Trial registration: Protocol registration: PROSPERO CRD42018092840Implications for rehabilitationThere is limited evidence of the effectiveness of interventions that aim to increase time spent engaging in moderate-to-vigorous physical activity (MVPA) for people following a TIA or non-disabling stroke.A program comprising aerobic and resistance exercises ≥2 per week, supervised by a health professional (supplemented with a home program) over at least 24 weeks appears to be effective in assisting people adhere to recommended levels of moderate to vigorous physical activity after TIA or non-disabling stroke.Secondary prevention programs which include health professional supervised exercise sessions contribute to better adherence to physical activity guidelines; didactic sessions alone outlining frequency and intensity are unlikely to be sufficient.
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Affiliation(s)
- Maria Sammut
- School of Health Sciences, University of Newcastle, Newcastle, Australia
| | - Natalie Fini
- Melbourne School of Health Sciences, University of Melbourne, Melbourne, Australia
| | - Kirsti Haracz
- School of Health Sciences, University of Newcastle, Newcastle, Australia
| | - Michael Nilsson
- Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, Australia.,Centre for Research Excellence in Stroke Rehabilitation and Recovery, Hunter Medical Research Institute, New Lambton Heights, Australia.,School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - Coralie English
- School of Health Sciences, University of Newcastle, Newcastle, Australia.,Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, Australia.,Centre for Research Excellence in Stroke Rehabilitation and Recovery, Hunter Medical Research Institute, New Lambton Heights, Australia.,Florey Institute of Neuroscience, University of Melbourne, Melbourne, Australia
| | - Heidi Janssen
- School of Health Sciences, University of Newcastle, Newcastle, Australia.,Centre for Research Excellence in Stroke Rehabilitation and Recovery, Hunter Medical Research Institute, New Lambton Heights, Australia.,Stroke Service, Hunter New England Local Health District, Newcastle, Australia
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16
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Stretton CM, Mudge S, Kayes NM, McPherson KM. What does real-world walking mean to people with stroke? An interpretive descriptive study. Disabil Rehabil 2020; 44:315-322. [PMID: 32466665 DOI: 10.1080/09638288.2020.1767704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: Understanding personal experiences of real-world walking for stroke survivors could assist clinicians to tailor interventions to their clients' specific needs. We explored the research questions: "What does real-world walking mean to people after stroke and how do they think it can be better?"Method: Using an Interpretive Descriptive methodology, we purposively sampled eight stroke survivors who reported difficulty walking in the real-world. We sought diversity on key participant characteristics. Participants were interviewed using a semi-structured guide. Data were analysed with thematic analysis.Results: Many found real-world walking, particularly in the outdoors, created opportunities for freedom from dependence and a visible step by step progress, which generated hope for future recovery. Conversely, when participants did not experience sufficient progress, they expressed negative emotions. Participants strove to overcome challenges to their walking goals using everyday routines, planning skills, and confidence building experiences to motivate themselves. They also drew on, and extended, social resources highlighting the relational aspects of real-world walking.Conclusions: Walking in their real-world provided a meaningful, desirable, but challenging goal for participants that required significant emotional effort. Successful progress in real-world walking builds confidence and hope and can contribute to psychological wellbeing by providing opportunities for successful mastery and social connectedness.IMPLICATIONS FOR REHABILITATIONReal-world settings can be unpredictable which makes walking in the real-world after stroke demanding.Positive experiences of walking in the real-world can provide significant psychological benefits to stroke survivors.Many survivors need to carefully concentrate on the act of walking in outdoor settings.Pre-planning routes, confidence-building experiences and developing daily routines may help patients overcome these challenges.
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Affiliation(s)
- Caroline M Stretton
- Centre for Person Centred Research (PCR), School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology (AUT), Auckland, New Zealand.,School of Interprofessional Health Studies, Faculty of Health and Environmental Sciences, Auckland University of Technology (AUT), Auckland, New Zealand
| | - Suzie Mudge
- Centre for Person Centred Research (PCR), School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology (AUT), Auckland, New Zealand
| | - Nicola M Kayes
- Centre for Person Centred Research (PCR), School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology (AUT), Auckland, New Zealand
| | - Kathryn M McPherson
- Centre for Person Centred Research (PCR), School of Clinical Sciences, Faculty of Health and Environmental Sciences, Auckland University of Technology (AUT), Auckland, New Zealand
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Jansson ASB, Carlsson G. Physical activity on prescription at the time of stroke or transient ischemic attack diagnosis - from a patient perspective. Disabil Rehabil 2019; 43:1121-1128. [PMID: 31522573 DOI: 10.1080/09638288.2019.1650296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Physical activity is known to reduce the risk of recurrent stroke. Despite this many individuals diagnosed with stroke have an insufficient level of physical activity. Physical activity on prescription is provided within healthcare to encourage increased physical activity. PURPOSE To examine individuals' experiences of physical activity on prescription at the time of stroke or transient ischemic attack diagnosis and explore various factors affecting the ability to follow the prescription. MATERIAL AND METHOD A qualitative approach was undertaken; using interviews, analyzed with content analysis to elicit information from individuals who had been admitted to a stroke unit due to stroke or transient ischemic attack. RESULTS Five women and five men (median age 60.5 years), eight with stroke and two with TIA (median NIHSS at onset 2.5), participated and the analysis resulted in an overall theme Change of life-style through physical activity on prescription - a multifaceted process containing the categories Experience of support, Barriers and opportunities and Personal motivators. CONCLUSION Individuals need to participate in the prescription process when prescription on physical activity is initiated in acute stroke care and clinicians need to reflect on how the prescription is implemented and followed-up; creating good conditions for long-term effects.IMPLICATIONS FOR REHABILITATIONWhen prescribing physical activity on prescription healthcare providers in acute stroke care need to consider:• The right timing: when and how physical activity on prescription should be given.• How to create opportunities for individuals to participate in the prescription process.• How to create individual adaptation of the prescription.• How to ensure that follow-up is conducted by registered healthcare professionals with knowledge of physical activity as disease prevention.
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Affiliation(s)
- Ann-Sofie B Jansson
- Department of Occupational Therapy and Physiotherapy, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Gunnel Carlsson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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18
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Xi HY, Si ZH, Li JC, Zhu JG, Yan HY. Assessment of cerebral infarction after transient cerebral ischemic attack by ABCD2 score combined with the position of intracranial vascular stenosis. Medicine (Baltimore) 2019; 98:e15081. [PMID: 30985660 PMCID: PMC6485873 DOI: 10.1097/md.0000000000015081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This study aims to investigate the value of the ABCD score combined with the position of the offending vessel stenosis in predicting the risk of transient ischemic attack (TIA) to develop into cerebral infarction.The ABCD score and head magnetic resonance imaging + magnetic resonance angiography (MRA) results of 192 patients with TIA were retrospectively analyzed. With the 7th day as the endpoint time, these patients were divided into 3 groups, according to ABCD scores: low-risk group (n = 105), moderate-risk group (n = 60), and high-risk group (n = 27). Blood vessels were screened using head MRA results, and patients were accordingly divided into 2 groups: proximal vascular stenosis group (n = 71) and nonproximal vascular stenosis group (n = 171). Then, the association of the position of the intracranial vascular stenosis and ABCD score with short-term prognosis was analyzed.Based on the ABCD score, the incidence of cerebral infarction after 1 week was significantly higher in the high-risk group (85.7%) than in the moderate-risk group (16.7%) and low-risk group (1.9%), and the differences were statistically significant (P < .05). When the ABCD score was ≥4 points, the incidence of cerebral infarction after 1 week was significantly higher in the proximal vascular stenosis group (59.1%) than in the nonproximal vascular stenosis group (30.8%), and the difference was statistically significant (P < .05). When the ABCD score was <4 points, the incidence of cerebral infarction after 1 week in the proximal stenosis group (2%) was not significantly different from that in the nonproximal stenosis group (1.9%, P > .05).The ABCD score combined with proximal offending vessel stenosis can improve the short-term prediction of cerebral infarction in patients with TIA.
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19
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Brouwer-Goossensen D, van Genugten L, Lingsma HF, Dippel DWJ, Koudstaal PJ, den Hertog HM. Self-efficacy for health-related behaviour change in patients with TIA or minor ischemic stroke. Psychol Health 2018; 33:1490-1501. [DOI: 10.1080/08870446.2018.1508686] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Dorien Brouwer-Goossensen
- Department Neurology and Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Lenneke van Genugten
- Department Neurology and Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Hester F. Lingsma
- Department Neurology and Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Diederik W. J. Dippel
- Department Neurology and Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Peter J. Koudstaal
- Department Neurology and Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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20
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Lieber AC, Hong E, Putrino D, Nistal DA, Pan JS, Kellner CP. Nutrition, Energy Expenditure, Dysphagia, and Self-Efficacy in Stroke Rehabilitation: A Review of the Literature. Brain Sci 2018; 8:E218. [PMID: 30544517 PMCID: PMC6316714 DOI: 10.3390/brainsci8120218] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 12/03/2018] [Accepted: 12/05/2018] [Indexed: 12/20/2022] Open
Abstract
While significant research has been performed regarding the use of thrombolytic agents and thrombectomy in the setting of acute stroke, other factors, such as nutritional status of stroke patients, is a less explored topic. The topic of nutrition is critical to the discussion of stroke, as up to half of stroke survivors may be considered malnourished at discharge. Dysphagia, old age, restricted upper limb movement, visuospatial impairment, and depression are all important risk factors for malnutrition in this cohort. The purpose of this review is to analyze current literature discussing neuroprotective diets, nutritional, vitamin, and mineral supplementation, dysphagia, and post-stroke coaching in stroke patients.
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Affiliation(s)
- Adam C Lieber
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Estee Hong
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - David Putrino
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Dominic A Nistal
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Jonathan S Pan
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
| | - Christopher P Kellner
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
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21
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Prior PL, Suskin N. Exercise for stroke prevention. Stroke Vasc Neurol 2018; 3:59-68. [PMID: 30191075 PMCID: PMC6122300 DOI: 10.1136/svn-2018-000155] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/02/2018] [Accepted: 06/04/2018] [Indexed: 01/24/2023] Open
Abstract
We review evidence concerning exercise for stroke prevention. Plausible biological reasons suggest that exercise would be important in preventing stroke. While definitive randomised controlled trials evaluating the impact of physical activity (PA) and exercise on preventing stroke and mortality are lacking, observational studies, small randomised controlled trials and meta-analyses have provided evidence that PA and exercise favourably modify stroke risk factors, including hypertension, dyslipidaemia, diabetes, sedentary lifestyle, obesity, excessive alcohol consumption and tobacco use. It is, therefore, important to understand the factors associated with poststroke PA/exercise and cardiorespiratory fitness. Positively associated factors include self-efficacy, social support and quality of patients' relationships with health professionals. Negatively associated factors include logistical barriers, medical comorbidities, stroke-related deficits, negative exercise beliefs, fear of falling, poststroke fatigue, arthropathy/pain and depression. Definitive research is needed to specify efficacious behavioural approaches to increase poststroke exercise. Effective techniques probably include physician endorsement of exercise programmesto patients, enhancement of patient-professional relationships, providing patients an exercise rationale, motivational interviewing, collaborative goal-setting with patients, addressing logistical concerns, social support in programsmes, structured exercise programming, individualised behavioural instruction, behavioural diary recording, reviewing behavioural consequences of exercise efforts, reinforcing successful exercise performance. Exercise programming without counselling may increase short-term activity; simple advice or information-giving is probably ineffective. Older patients or those with cognitive impairment may need increased structure, with emphasis on behaviour per se, versus self-regulation skills. We support the latest American Heart Association/American Stroke Association guidelines (2014) recommending PA and exercise for stroke prevention, and referral to behaviourally oriented programmes to improve PA and exercise.
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Affiliation(s)
- Peter L Prior
- Lawson Health Research Institution, London, Ontario, Canada.,St. Josephs Health Care Cardiac Rehabilitation and Secondary Prevention Program, London, Ontario, Canada
| | - Neville Suskin
- Lawson Health Research Institution, London, Ontario, Canada.,St. Josephs Health Care Cardiac Rehabilitation and Secondary Prevention Program, London, Ontario, Canada.,Department of Medicine (Cardiology), Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
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22
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Lecky DM, Dhillon H, Verlander NQ, McNulty CAM. Animations designed to raise patient awareness of prudent antibiotic use: patient recall of key messages and their immediate effect on patient attitude. BMC Res Notes 2017; 10:701. [PMID: 29208027 PMCID: PMC5718068 DOI: 10.1186/s13104-017-3048-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 11/30/2017] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES This study aimed to determine if patients recalled key messages from antibiotic animations shown on digital displays in General Practice waiting rooms, and if watching them changed patients' immediate intentions to consult their GP for upper respiratory tract infections, seek antibiotics and self-care. RESULTS The pre intervention focus group found the animations intergenerational, informative and educational. 3119 patients were observed in 3 GP practices during project team visits; 145 (4.6%) were observed watching the animations; 132 (91%) remembered seeing them; the key messages were retained by 47-55% of patients. Significant positive differences were observed for questions related to intended antibiotic related behaviours.
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Affiliation(s)
- Donna M. Lecky
- Public Health England, Primary Care Unit, Microbiology Department, Gloucester Royal Hospital, Great Western Road, Gloucester, GL1 3NN England, UK
| | - Harpal Dhillon
- Public Health England, Primary Care Unit, Microbiology Department, Gloucester Royal Hospital, Great Western Road, Gloucester, GL1 3NN England, UK
- Present Address: Shire, 1 Kingdon Street, London, W2 6BD England, UK
| | - Neville Q. Verlander
- Public Health England, Statistics and Modelling Economics Unit, 61 Colindale Avenue, London, NW9 5EQ England, UK
| | - Cliodna A. M. McNulty
- Public Health England, Primary Care Unit, Microbiology Department, Gloucester Royal Hospital, Great Western Road, Gloucester, GL1 3NN England, UK
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Hsieh HL, Kuo YM, Wang SR, Chuang BK, Tsai CH. A Study of Personal Health Record User's Behavioral Model Based on the PMT and UTAUT Integrative Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 14:E8. [PMID: 28025557 PMCID: PMC5295259 DOI: 10.3390/ijerph14010008] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 12/19/2016] [Accepted: 12/19/2016] [Indexed: 11/17/2022]
Abstract
The personal health record (PHR) is a system that enables borderless medical care services by combining technological innovation and human consideration. This study explored factors affecting the adoption of PHR from technical, medical, and social perspectives according to the Protection Motivation Theory (PMT) and Unified Theory of Acceptance and Use of Technology (UTAUT) model. A survey using a structured questionnaire was subsequently conducted, which produced the following results: (1) The PMT and UTAUT were effective at predicting PHR usage behaviors; (2) Perceived ease-of-use was the most decisive factor influencing the use of PHR, followed by self-efficacy and perceived usefulness; and (3) Behavioral intention for PHR was significantly and positively correlated with usage behavior. From the obtained results, this study recommends that health authorities and medical institutions promote self-efficacy in the use of PHR to improve the levels of behavioral intention and usage behavior among the people. Additionally, medical care institutions are recommended to promote health management and preventive healthcare concepts to help improve public acceptance of the PHR system as a means to self-manage their health. Finally, community centers, medical institutions, and health authorities are urged to work together to enhance public medical knowledge and pool resources for the PHR system, both of which are essential for improving the popularity of the PHR, public quality of life, and the effectiveness of health management.
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Affiliation(s)
| | - Yu-Ming Kuo
- Department of Marketing and Distribution, Tzu Chi University of Science and Technology, Hualien 970, Taiwan.
| | - Shiang-Ru Wang
- Department of Business Administraiton, National Dong Hwa University, Hualien 974, Taiwan.
| | | | - Chung-Hung Tsai
- Department of Health Administration, Tzu Chi University of Science and Technology, Hualien 974, Taiwan.
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