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Ruksakulpiwat S, Phianhasin L, Benjasirisan C, Ding K, Ajibade A, Kumar A, Stewart C. Assessing the Efficacy of ChatGPT Versus Human Researchers in Identifying Relevant Studies on mHealth Interventions for Improving Medication Adherence in Patients With Ischemic Stroke When Conducting Systematic Reviews: Comparative Analysis. JMIR Mhealth Uhealth 2024; 12:e51526. [PMID: 38710069 PMCID: PMC11106699 DOI: 10.2196/51526] [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: 08/17/2023] [Revised: 02/11/2024] [Accepted: 03/27/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND ChatGPT by OpenAI emerged as a potential tool for researchers, aiding in various aspects of research. One such application was the identification of relevant studies in systematic reviews. However, a comprehensive comparison of the efficacy of relevant study identification between human researchers and ChatGPT has not been conducted. OBJECTIVE This study aims to compare the efficacy of ChatGPT and human researchers in identifying relevant studies on medication adherence improvement using mobile health interventions in patients with ischemic stroke during systematic reviews. METHODS This study used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Four electronic databases, including CINAHL Plus with Full Text, Web of Science, PubMed, and MEDLINE, were searched to identify articles published from inception until 2023 using search terms based on MeSH (Medical Subject Headings) terms generated by human researchers versus ChatGPT. The authors independently screened the titles, abstracts, and full text of the studies identified through separate searches conducted by human researchers and ChatGPT. The comparison encompassed several aspects, including the ability to retrieve relevant studies, accuracy, efficiency, limitations, and challenges associated with each method. RESULTS A total of 6 articles identified through search terms generated by human researchers were included in the final analysis, of which 4 (67%) reported improvements in medication adherence after the intervention. However, 33% (2/6) of the included studies did not clearly state whether medication adherence improved after the intervention. A total of 10 studies were included based on search terms generated by ChatGPT, of which 6 (60%) overlapped with studies identified by human researchers. Regarding the impact of mobile health interventions on medication adherence, most included studies (8/10, 80%) based on search terms generated by ChatGPT reported improvements in medication adherence after the intervention. However, 20% (2/10) of the studies did not clearly state whether medication adherence improved after the intervention. The precision in accurately identifying relevant studies was higher in human researchers (0.86) than in ChatGPT (0.77). This is consistent with the percentage of relevance, where human researchers (9.8%) demonstrated a higher percentage of relevance than ChatGPT (3%). However, when considering the time required for both humans and ChatGPT to identify relevant studies, ChatGPT substantially outperformed human researchers as it took less time to identify relevant studies. CONCLUSIONS Our comparative analysis highlighted the strengths and limitations of both approaches. Ultimately, the choice between human researchers and ChatGPT depends on the specific requirements and objectives of each review, but the collaborative synergy of both approaches holds the potential to advance evidence-based research and decision-making in the health care field.
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Affiliation(s)
- Suebsarn Ruksakulpiwat
- Department of Medical Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Lalipat Phianhasin
- Department of Medical Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | | | - Kedong Ding
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - Anuoluwapo Ajibade
- College of Art and Science, Department of Anthropology, Case Western Reserve University, Cleveland, OH, United States
| | - Ayanesh Kumar
- School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Cassie Stewart
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, United States
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Boima V, Doku A, Agyekum F, Tuglo LS, Agyemang C. Effectiveness of digital health interventions on blood pressure control, lifestyle behaviours and adherence to medication in patients with hypertension in low-income and middle-income countries: a systematic review and meta-analysis of randomised controlled trials. EClinicalMedicine 2024; 69:102432. [PMID: 38333367 PMCID: PMC10850120 DOI: 10.1016/j.eclinm.2024.102432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 02/10/2024] Open
Abstract
Background Digital health interventions can be effective for blood pressure (BP) control, but a comparison of the effectiveness and application of these types of interventions has not yet been systematically evaluated in low- and middle-income countries (LMICs). This study aimed to compare the effectiveness of digital health interventions according to the World Health Organisation (WHO) classifications of patients in terms of BP control, lifestyle behaviour changes, and adherence to medication in patients with hypertension in LMICs. Methods In this systematic review and meta-analysis, we searched the PubMed, Scopus, Web of Science, Embase, CINAHL, and Cochrane Library databases for randomised controlled trials (RCTs) published in English, comprised of adults (≥18 years old) with hypertension and the intervention consisted of digital health interventions according to WHO's classifications for patients in LMICs between January 1, 2009, and July 17, 2023. We excluded RCTs that considered patients with hypertension comorbidities such as diabetes and hypertension-mediated target organ damage (HMTOD). The references were downloaded into Mendeley Desktop and imported into the Rayyan web tool for deduplication and screening. The risk of bias was assessed using Cochrane Risk of Bias 2. Data extraction was done according to Cochrane's guidelines. The main outcome measures were mean systolic blood pressure (SBP) and BP control which were assessed using the random-effect DerSimonian-Laird and Mantel-Haenszel models. We presented the BP outcomes, lifestyle behaviour changes and medication adherence in forest plots as well as summarized them in tables. This study is registered with PROSPERO, CRD42023424227. Findings We identified 9322 articles, of which 22 RCTs from 12 countries (n = 12,892 respondents) were included in the systematic review. The quality of the 22 studies was graded as high risk (n = 7), had some concerns (n = 3) and low risk of bias (n = 12). A total of 19 RCTs (n = 12,418 respondents) were included in the meta-analysis. Overall, digital health intervention had significant reductions in SBP [mean difference (MD) = -4.43 mmHg (95% CI -6.19 to -2.67), I2 = 92%] and BP control [odds ratio (OR) = 2.20 (95% CI 1.64-2.94), I2 = 78%], respectively, compared with usual care. A subgroup analysis revealed that short message service (SMS) interventions had the greatest statistically significant reduction of SBP [MD = -5.75 mm Hg (95% Cl -7.77 to -3.73), I2 = 86%] compared to mobile phone calls [MD = 3.08 mm Hg (-6.16 to 12.32), I2 = 87%] or smartphone apps interventions [MD = -4.06 mm Hg (-6.56 to -1.55), I2 = 79%], but the difference between groups was not statistically significant (p = 0.14). The meta-analysis showed that the interventions had a significant effect in supporting changes in lifestyle behaviours related to a low salt diet [standardised mean difference (SMD) = 1.25; (95% CI 0.64-1.87), I2 = 89%], physical activity [SMD = 1.30; (95% CI 0.23-2.37), I2 = 94%] and smoking reduction [risk difference (RR) = 0.03; (95% CI 0.01-0.05), I2 = 0%] compared to the control group. In addition, improvement in medication adherence was statistically significant and higher in the intervention group than in the control group [SMD = 1.59; (95% CI 0.51-2.67), I2 = 97%]. Interpretation Our findings suggest that digital health interventions may be effective for BP control, changes in lifestyle behaviours, and improvements in medication adherence in LMICs. However, we observed high heterogeneity between included studies, and only two studies from Africa were included. The combination of digital health interventions with clinical management is crucial to achieving optimal clinical effectiveness in BP control, changes in lifestyle behaviours and improvements in medication adherence. Funding None.
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Affiliation(s)
- Vincent Boima
- Department of Medicine and Therapeutics, University of Ghana Medical School, Accra, Ghana
- Department of Public & Occupational Health, University of Amsterdam Medical Centre, University of Amsterdam, Netherlands
| | - Alfred Doku
- Department of Medicine and Therapeutics, University of Ghana Medical School, Accra, Ghana
- Department of Public & Occupational Health, University of Amsterdam Medical Centre, University of Amsterdam, Netherlands
| | - Francis Agyekum
- Department of Medicine and Therapeutics, University of Ghana Medical School, Accra, Ghana
| | - Lawrence Sena Tuglo
- Department of Nutrition and Dietetics, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
- Department of Epidemiology, School of Public Health, Nantong University, 9 Seyuan Road, Nantong, Jiangsu, China
| | - Charles Agyemang
- Department of Public & Occupational Health, University of Amsterdam Medical Centre, University of Amsterdam, Netherlands
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Folkvord F, Würth AR, van Houten K, Liefveld AR, Carlson JI, Bol N, Krahmer E, Beets G, Ollerton RD, Turk E, Hrubos‐Strøm H, Nahoui H, Einvik G, Schirmer H, Moen A, Barrio‐Cortes J, Merino‐Barbancho B, Arroyo P, Fico G, Midão L, Sampaio R, Fonseca JA, Geipel K, Scheckenbach K, de Ruiter LE, Lupiáñez‐Villanueva F. A systematic review on experimental studies about patient adherence to treatment. Pharmacol Res Perspect 2024; 12:e1166. [PMID: 38204399 PMCID: PMC10782217 DOI: 10.1002/prp2.1166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/23/2023] [Accepted: 12/03/2023] [Indexed: 01/12/2024] Open
Abstract
A better understanding of patients' adherence to treatment is a prerequisite to maximize the benefit of healthcare provision for patients, reduce treatment costs, and is a key factor in a variety of subsequent health outcomes. We aim to understand the state of the art of scientific evidence about which factors influence patients' adherence to treatment. A systematic literature review was conducted using PRISMA guidelines in five separate electronic databases of scientific publications: PubMed, PsycINFO (ProQuest), Cochrane library (Ovid), Google Scholar, and Web of Science. The search focused on literature reporting the significance of factors in adherence to treatment between 2011 and 2021, including only experimental studies (e.g., randomized controlled trials [RCT], clinical trials, etc.). We included 47 experimental studies. The results of the systematic review (SR) are grouped according to predetermined categories of the World Health Organization (WHO): socioeconomic, treatment, condition, personal, and healthcare-related factors. This review gives an actual overview of evidence-based studies on adherence and analyzed the significance of factors defined by the WHO classification. By showing the strength of certain factors in several independent studies and concomitantly uncovering gaps in research, these insights could serve as a basis for the design of future adherence studies and models.
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Affiliation(s)
- Frans Folkvord
- PredictByBarcelonaSpain
- Tilburg Center for Cognition and Communication (TiCC), Department of Communication and CognitionTilburg UniversityTilburgThe Netherlands
| | | | | | | | | | - Nadine Bol
- Tilburg Center for Cognition and Communication (TiCC), Department of Communication and CognitionTilburg UniversityTilburgThe Netherlands
| | - Emiel Krahmer
- Tilburg Center for Cognition and Communication (TiCC), Department of Communication and CognitionTilburg UniversityTilburgThe Netherlands
| | - Gwenn Beets
- Tilburg Center for Cognition and Communication (TiCC), Department of Communication and CognitionTilburg UniversityTilburgThe Netherlands
| | - Rachel Drbohlav Ollerton
- Tilburg Center for Cognition and Communication (TiCC), Department of Communication and CognitionTilburg UniversityTilburgThe Netherlands
| | - Eva Turk
- Institute for Health and SocietyUniversity of OsloOsloNorway
| | - Harald Hrubos‐Strøm
- Akershus University HospitalLørenskogNorway
- Institute of Clinical MedicineUniversity of OsloOsloNorway
| | | | | | | | - Anne Moen
- Institute for Health and SocietyUniversity of OsloOsloNorway
| | - Jaime Barrio‐Cortes
- Foundation for Biosanitary Research and Innovation in Primary CareMadridSpain
- Research Unit, Primary Healthcare Management, Madrid Health ServiceMadridSpain
- University Camilo José CelaMadridSpain
| | | | - Peña Arroyo
- Universidad Politécnica de Madrid, Life Supporting Technologies Research GroupMadridSpain
| | - Giuseppe Fico
- Universidad Politécnica de Madrid, Life Supporting Technologies Research GroupMadridSpain
| | - Luís Midão
- Associate Laboratory i4HB – Institute for Health and Bioeconomy, UCIBIO – Applied Molecular Biosciences Unit, Porto4Ageing – Competence Centre on Active and Healthy Ageing, Faculty of Pharmacy of the University of PortoPortoPortugal
| | - Rute Sampaio
- CINTESIS@RISE, Department of BiomedicineFaculty of Medicine of the University of PortoPortoPortugal
| | - João A. Fonseca
- MEDIDA, Medicina, EDucação, I&D e Avaliação LdaPortugal
- MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of MedicineUniversity of PortoPortoPortugal
| | - Katja Geipel
- Department of OtorhinolaryngologyHeinrich‐Heine‐UniversityDüsseldorfGermany
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Thompson AN, Dawson DR, Legasto-Mulvale JM, Chandran N, Tanchip C, Niemczyk V, Rashkovan J, Jeyakumar S, Wang RH, Cameron JI, Nalder E. Mobile Technology-Based Interventions for Stroke Self-Management Support: Scoping Review. JMIR Mhealth Uhealth 2023; 11:e46558. [PMID: 38055318 PMCID: PMC10733834 DOI: 10.2196/46558] [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: 02/16/2023] [Revised: 10/03/2023] [Accepted: 10/18/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND There is growing interest in enhancing stroke self-management support using mobile health (mHealth) technology (eg, smartphones and apps). Despite this growing interest, "self-management support" is inconsistently defined and applied in the poststroke mHealth intervention literature, which limits efforts to synthesize and compare evidence. To address this gap in conceptual clarity, a scoping review was conducted. OBJECTIVE The objectives were to (1) identify and describe the types of poststroke mHealth interventions evaluated using a randomized controlled trial design, (2) determine whether (and how) such interventions align with well-accepted conceptualizations of self-management support (the theory by Lorig and Holman and the Practical Reviews in Self-Management Support [PRISMS] taxonomy by Pearce and colleagues), and (3) identify the mHealth functions that facilitate self-management. METHODS A scoping review was conducted according to the methodology by Arksey and O'Malley and Levac et al. In total, 7 databases were searched. Article screening and data extraction were performed by 2 reviewers. The data were analyzed using descriptive statistics and content analysis. RESULTS A total of 29 studies (26 interventions) were included. The interventions addressed 7 focal areas (physical exercise, risk factor management, linguistic exercise, activities of daily living training, medication adherence, stroke education, and weight management), 5 types of mobile devices (mobile phones or smartphones, tablets, wearable sensors, wireless monitoring devices, and laptops), and 7 mHealth functions (educating, communicating, goal setting, monitoring, providing feedback, reminding, and motivating). Collectively, the interventions aligned well with the concept of self-management support. However, on an individual basis (per intervention), the alignment was less strong. CONCLUSIONS On the basis of the results, it is recommended that future research on poststroke mHealth interventions be more theoretically driven, more multidisciplinary, and larger in scale.
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Affiliation(s)
- Alexandra N Thompson
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Deirdre R Dawson
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jean Michelle Legasto-Mulvale
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Nivetha Chandran
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Chelsea Tanchip
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Veronika Niemczyk
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Jillian Rashkovan
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Saisa Jeyakumar
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Rosalie H Wang
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Jill I Cameron
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Emily Nalder
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
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Guo L, Zhang M, Namassevayam G, Wei M, Zhang G, He Y, Guo Y, Liu Y. Effectiveness of health management among individuals at high risk of stroke: An intervention study based on the health ecology model and self-determination theory (HEM-SDT). Heliyon 2023; 9:e21301. [PMID: 37964830 PMCID: PMC10641168 DOI: 10.1016/j.heliyon.2023.e21301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/11/2023] [Accepted: 10/19/2023] [Indexed: 11/16/2023] Open
Abstract
Background Stroke is the second leading cause of death in adults worldwide. However, up to 80% of strokes can be prevented by modifying risk factors. Objective The study aims to assess the effectiveness of the Health Ecology Model and Self-Determination Theory (HEM-SDT) based health management intervention among individuals at high risk of stroke. Methods A randomized controlled trial was conducted in Zhengzhou from May 1st, 2020, to December 31st, 2020. A total of 229 participants were recruited for the study, with 116 individuals at high risk of stroke being randomly assigned to the HEM-SDT health management group, while 113 participants were enrolled in the control group, following their current routine practices. The Generalized Estimating Equation model (GEE) was used to analyze the differences in health knowledge, belief and, behavior between the two groups at the beginning of the intervention, and at 6-month intervals after the intervention. The chi-square test was utilized to assess the control rate of risk factors. Results After 6 months of intervention, there were significant improvements in health knowledge, behavior, and belief among the participants. The study found significant differences in the interaction effects between time and group for health knowledge (Mean, SD = 25.62 ± 3.88, 95%CI: 7.944-9.604, P<0.001), health belief (Mean, SD = 87.18 ± 14.21, 95%CI: 23.999-29.887, P<0.001), and health behavior (Mean, SD = 173.28 ± 24.22, 95%CI: 22.332-36.904, P<0.001). Additionally, the rates of hypertension, hyperglycemia, dyslipidemia, high or medium risk condition of stroke, obesity, hyperhomocysteinemia, smoking, alcohol consumption, and lack of exercise also showed statistical significance (P<0.05) after the intervention. Conclusion The HEM-SDT health management model improves the health knowledge, behavior, and beliefs in people at high risk of stroke and remarkably it shows improvement in modifiable risk factors. It can be recommended for systematic health management in people at high-risk of stroke.
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Affiliation(s)
- Lina Guo
- Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Mengyv Zhang
- Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Genoosha Namassevayam
- Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Department of Supplementary Health Sciences, Faculty of Health-Care Sciences, Eastern University, Sri Lanka
| | - Miao Wei
- Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Gege Zhang
- Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yv He
- Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Reproductive Medicine Center, Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
| | - Yuanli Guo
- Department of Neurology, National Advanced Stroke Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yanjin Liu
- Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China
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Li Z, Li J, Yang L, Tan J, Zhu F, Wan LH. Effects of a digital learning platform on health behaviours in stroke patients from baseline to 6 months after discharge: a randomized controlled trial. Eur J Cardiovasc Nurs 2023; 22:575-585. [PMID: 36790874 DOI: 10.1093/eurjcn/zvad025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 01/17/2023] [Accepted: 02/13/2023] [Indexed: 02/16/2023]
Abstract
AIMS Improving the health behaviour can help prevent stroke recurrence. The existing health education interventions require more human resource. There is a lack of constructing a low-cost, highly universal, and easy-to-use stroke secondary prevention platform based on the existing medical resources. METHODS AND RESULTS This was a randomized controlled trial to test the effects of a digital learning platform on the health knowledge, beliefs, and behaviours of stroke patients from baseline to 6 months after discharge. The control group received routine health education while the intervention group received health belief education during hospitalization and used a digital learning platform for 6 months after discharge. The health knowledge was assessed by The Stroke Health Knowledge Questionnaire, health beliefs by The Short Form Health Belief Model Scale for Stroke Patients, and health behaviours by the Stroke Health Behavior Scale. A total of 90 patients were included: 45 each in the intervention group and the control group, of whom 38 and 37 completed the study, respectively. At 6 months after discharge, (1) the health knowledge score of the intervention group was insignificantly higher than that of the control group, (2) the health belief score of the intervention group was significantly higher than that of the control group, and (3) the intervention group had higher health behaviour scores especially in physical activity than that of the control group. Other health behaviour dimensions have time effect, but not significant. CONCLUSIONS The digital learning platform can improve health behaviours of stroke patients 6 months after discharge, especially in physical activity. REGISTRATION ChiCTR1800019936.
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Affiliation(s)
- Zhuoran Li
- School of Nursing, Sun Yat-sen University, 74 Zhongshan Rd. 2, Guangzhou 510089, China
| | - Jingjing Li
- School of Nursing, Sun Yat-sen University, 74 Zhongshan Rd. 2, Guangzhou 510089, China
| | - Lijun Yang
- Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, 111 Dade Rd., Guangzhou 510120, China
| | - Juxiang Tan
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, 2693 Kaichuang Road, Guangzhou 510013, China
| | - Fenyan Zhu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, 2693 Kaichuang Road, Guangzhou 510013, China
| | - Li-Hong Wan
- School of Nursing, Sun Yat-sen University, 74 Zhongshan Rd. 2, Guangzhou 510089, China
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Cadel L, Cimino SR, Bradley-Ridout G, Hitzig SL, Patel T, Ho CH, Packer TL, Lofters AK, Hahn-Goldberg S, McCarthy LM, Guilcher SJT. Medication self-management interventions for persons with stroke: A scoping review. PLoS One 2023; 18:e0285483. [PMID: 37200316 DOI: 10.1371/journal.pone.0285483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 04/25/2023] [Indexed: 05/20/2023] Open
Abstract
The use of multiple medications is common following a stroke for secondary prevention and management of co-occurring chronic conditions. Given the use of multiple medications post-stroke, optimizing medication self-management for this population is important. The objective of this scoping review was to identify and summarize what has been reported in the literature on interventions related to medication self-management for adults (aged 18+) with stroke. Electronic databases (Ovid Medline, Ovid Embase, EBSCO CINAHL, Ovid PsycINFO, Web of Science) and grey literature were searched to identify relevant articles. For inclusion, articles were required to include an adult population with stroke undergoing an intervention aimed at modifying or improving medication management that incorporated a component of self-management. Two independent reviewers screened the articles for inclusion. Data were extracted and summarized using descriptive content analysis. Of the 56 articles that met the inclusion criteria, the focus of most interventions was on improvement of secondary stroke prevention through risk factor management and lifestyle modifications. The majority of studies included medication self-management as a component of a broader intervention. Most interventions used both face-to-face interactions and technology for delivery. Behavioural outcomes, specifically medication adherence, were the most commonly targeted outcomes across the interventions. However, the majority of interventions did not specifically or holistically target medication self-management. There is an opportunity to better support medication self-management post-stroke by ensuring interventions are delivered across sectors or in the community, developing an understanding of the optimal frequency and duration of delivery, and qualitatively exploring experiences with the interventions to ensure ongoing improvement.
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Affiliation(s)
- Lauren Cadel
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Stephanie R Cimino
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | | | - Sander L Hitzig
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Tejal Patel
- University of Waterloo School of Pharmacy, Kitchener, ON, Canada
- Schlegel-University of Waterloo Research Institute of Aging, Waterloo, ON, Canada
| | - Chester H Ho
- Division of Physical Medicine & Rehabilitation, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Tanya L Packer
- Schools of Occupational Therapy and Health Administration, Dalhousie University, Halifax, NS, Canada
- Department of Rehabilitation, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Aisha K Lofters
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Women's College Research Institute, Toronto, ON, Canada
| | - Shoshana Hahn-Goldberg
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- OpenLab, University Health Network, Toronto, ON, Canada
| | - Lisa M McCarthy
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Sara J T Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
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Yang J, Yang J, Guo D, Zhao Q, Chen Y. Outcome of Nursing Based on Health Belief United with Knowledge, Belief, and Practice Mode on Gastroscopy of Patients with Gastric Cancer. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:9491454. [PMID: 36226241 PMCID: PMC9550492 DOI: 10.1155/2022/9491454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 08/29/2022] [Accepted: 09/21/2022] [Indexed: 11/30/2022]
Abstract
Aim If gastric cancer can be detected through early screening, and scientific and reasonable intervention methods can be selected in time, the condition can be effectively controlled. Routine nursing has been unable to obtain satisfactory results, and the effect on improving the compliance of the examiner is not outstanding. The research aims to estimate the outcome of nursing based on health belief combined with knowledge, belief, and practice on gastroscopy in patients with gastric cancer. Methods 126 patients with clinically diagnosed gastric cancer in the Number Two Hospital of Baoding from May 2020 to May 2022 were randomly divided into belief guidance group and mode group, with 63 instances each. The mode group was intervened via the mode of knowledge, belief, and practice, and the belief guidance group was intervened via the nursing based on health belief on the basis of the mode group. Before and after the nursing, the health belief, examination compliance, inappropriateness, and negative emotion in different time periods were contrasted between the two groups. Results After the nursing, the scores of health belief scale in the belief guidance group were enhanced than those in the mode group; the compliance rate of the belief guidance group was markedly enhanced than that of the mode group, and the inappropriateness during the insertion and examination was lower than that of the mode group; the scores of self-rating anxiety scale (SAS) and self-rating depression scale (SDS) in the two groups preinsertion and postnursing were markedly lower than those in the mode group. Conclusion Nursing based on health belief guidance united with knowledge, belief, and practice mode nursing can advance the health belief and compliance of gastroscopy in patients with gastric cancer, reduce discomfort, and effectively advance the negative emotions of patients. It is worthy of clinical application.
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Affiliation(s)
- Junna Yang
- Department of Endoscopy, The Number Two Hospital of Baoding, Baoding, Hebei 071000, China
| | - Jing Yang
- Digestive Endoscopy Department, Hebei Province Chinese Medicine Hospital, No. 389 Zhongshan East Road, Shijiazhuang, Hebei 050011, China
| | - Dongmei Guo
- Department of Nursing, The Number Two Hospital of Baoding, Baoding, Hebei 071000, China
| | - Qingchao Zhao
- Department of Endoscopy, The Number Two Hospital of Baoding, Baoding, Hebei 071000, China
| | - Yang Chen
- Nuclear Magnetic Resonance Room, The Number Two Hospital of Baoding, Baoding, Hebei 071000, China
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9
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Singh H, Tang T, Steele Gray C, Kokorelias K, Thombs R, Plett D, Heffernan M, Jarach CM, Armas A, Law S, Cunningham HV, Nie JX, Ellen ME, Thavorn K, Nelson MLA. Recommendations for the Design and Delivery of Transitions-Focused Digital Health Interventions: Rapid Review. JMIR Aging 2022; 5:e35929. [PMID: 35587874 PMCID: PMC9164100 DOI: 10.2196/35929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/06/2022] [Indexed: 12/02/2022] Open
Abstract
Background Older adults experience a high risk of adverse events during hospital-to-home transitions. Implementation barriers have prevented widespread clinical uptake of the various digital health technologies that aim to support hospital-to-home transitions. Objective To guide the development of a digital health intervention to support transitions from hospital to home (the Digital Bridge intervention), the specific objectives of this review were to describe the various roles and functions of health care providers supporting hospital-to-home transitions for older adults, allowing future technologies to be more targeted to support their work; describe the types of digital health interventions used to facilitate the transition from hospital to home for older adults and elucidate how these interventions support the roles and functions of providers; describe the lessons learned from the design and implementation of these interventions; and identify opportunities to improve the fit between technology and provider functions within the Digital Bridge intervention and other transition-focused digital health interventions. Methods This 2-phase rapid review involved a selective review of providers’ roles and their functions during hospital-to-home transitions (phase 1) and a structured literature review on digital health interventions used to support older adults’ hospital-to-home transitions (phase 2). During the analysis, the technology functions identified in phase 2 were linked to the provider roles and functions identified in phase 1. Results In phase 1, various provider roles were identified that facilitated hospital-to-home transitions, including navigation-specific roles and the roles of nurses and physicians. The key transition functions performed by providers were related to the 3 categories of continuity of care (ie, informational, management, and relational continuity). Phase 2, included articles (n=142) that reported digital health interventions targeting various medical conditions or groups. Most digital health interventions supported management continuity (eg, follow-up, assessment, and monitoring of patients’ status after hospital discharge), whereas informational and relational continuity were the least supported. The lessons learned from the interventions were categorized into technology- and research-related challenges and opportunities and informed several recommendations to guide the design of transition-focused digital health interventions. Conclusions This review highlights the need for Digital Bridge and other digital health interventions to align the design and delivery of digital health interventions with provider functions, design and test interventions with older adults, and examine multilevel outcomes. International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2020-045596
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Affiliation(s)
- Hardeep Singh
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,March of Dimes Canada, Toronto, ON, Canada.,Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Terence Tang
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Carolyn Steele Gray
- Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Kristina Kokorelias
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Rachel Thombs
- Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | - Donna Plett
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Matthew Heffernan
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Carlotta M Jarach
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Alana Armas
- March of Dimes Canada, Toronto, ON, Canada.,Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | - Susan Law
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | - Jason Xin Nie
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Moriah E Ellen
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Kednapa Thavorn
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Michelle LA Nelson
- March of Dimes Canada, Toronto, ON, Canada.,Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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10
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Factors influencing the delivery of telerehabilitation for stroke: A systematic review. PLoS One 2022; 17:e0265828. [PMID: 35544471 PMCID: PMC9094559 DOI: 10.1371/journal.pone.0265828] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 03/08/2022] [Indexed: 11/24/2022] Open
Abstract
Objective Despite the available evidence regarding effectiveness of stroke telerehabilitation, there has been little focus on factors influencing its delivery or translation from the research setting into practice. There are complex challenges to embedding telerehabilitation into stroke services and generating transferable knowledge about scaling up and routinising this service model. This review aimed to explore factors influencing the delivery of stroke telerehabilitation interventions, including platforms, technical requirements, training, support, access, cost, usability and acceptability. Methods MEDLINE, EMBASE, CINAHL, Web of Science and Cochrane Library and Central Registry of Clinical Trials were searched to identify full-text articles of randomised controlled trials (RCTs) and protocols for RCTs published since a Cochrane review on stroke telerehabilitation services. A narrative synthesis was conducted, providing a comprehensive description of the factors influencing stroke telerehabilitation intervention delivery. Results Thirty-one studies and ten protocols of ongoing studies were included. Interventions were categorised as synchronous telerehabilitation (n = 9), asynchronous telerehabilitation (n = 11) and tele-support (n = 11). Telephone and videoconference were the most frequently used modes of delivery. Usability and acceptability with telerehabilitation were high across all platforms, although access issues and technical challenges may be potential barriers to the use of telerehabilitation in service delivery. Costs of intervention delivery and training requirements were poorly reported. Conclusions This review synthesises the evidence relating to factors that may influence stroke telerehabilitation intervention delivery at a crucial timepoint given the rapid deployment of telerehabilitation in response to the COVID-19 pandemic. It recommends strategies, such as ensuring adequate training and technical infrastructure, shared learning and consistent reporting of cost and usability and acceptability outcomes, to overcome challenges in embedding and routinising this service model and priorities for research in this area.
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11
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Dickens RR, Gyang T, Sanders S, Ellis C, Simpkins AN. The Importance of Incorporating Stroke Survivors' Health Perceptions in Addressing Health Care Disparities. Ethn Dis 2022; 32:145-148. [PMID: 35497402 DOI: 10.18865/ed.32.2.145] [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: 11/18/2022] Open
Abstract
Patient-centered research in determining health care disparities among stroke patients is limited. Several studies have examined patient perceptions in stroke survivors and have utilized the Illness Perceptions Questionnaire-Revised (IPQ-R) and Brief Illness Perceptions Questionnaire (BIPQ), which are validated measures of illness beliefs. Yet, there are several domains these surveys could assess that warrant more investigation, including: perception of medication side effects; acceptance of the stroke diagnosis; consequence and long-term impact of symptoms; the importance of medications in long-term health maintenance; and perception of ease of access to equitable health care. Though these surveys are available, representation of diverse and under-represented groups within stroke surveys utilizing them is low. Also, only a limited number of studies of stroke patients' perceptions have focused on health disparities or specifically beliefs and attitudes of under-represented stroke survivors. Due to insufficient current research, future studies should focus on using these patient perception questionnaires with underrepresented populations. Improvements in this field may allow providers to offer patient-centered care among a diverse population, bridging gaps in health care equity.
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Affiliation(s)
| | - Tirisham Gyang
- Department of Neurology, Ohio State University, Columbus, OH
| | - Sadie Sanders
- Department of Health Education & Behavior, University of Florida, Gainesville, FL
| | - Charles Ellis
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, FL
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12
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Salt Consumption and Blood Pressure in Rural Hypertensive Participants: A Community Filed Trial. ScientificWorldJournal 2022; 2022:2908811. [PMID: 35401060 PMCID: PMC8986400 DOI: 10.1155/2022/2908811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 03/04/2022] [Accepted: 03/08/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose. Hypertension is a major cause of morbidity and mortality in the world. This study aimed to evaluate an intervention based on the Health Belief Model regarding the whole family’s salt consumption and blood pressure among hypertensive patients in rural areas in Iran. Methods. This clinical multicenter trial (clinical and community) with a control and an intervention group was conducted on the residents of 14 villages covered by 14 health houses. Totally, 200 hypertensive patients (n = 100 in each group) were selected via multistage random sampling. The intervention included a two-day workshop on blood pressure and reducing salt consumption based on HBM structures for health personnel and an eight-session workshop on how to reduce salt intake and blood pressure for mothers who were responsible for the families’ diets. Participants completed the questionnaires before and immediately after the intervention. Results. Compared to the control group, in the intervention group, a significant reduction was observed in salt consumption by the families (urine sodium and creatinine reduced by 35 mEq/l and 7.5 mg/dL, respectively). The results also revealed a significant decrease in blood pressure in the intervention group. Conclusion. The results showed that the mothers’ model-based education could effectively improve the diet of the whole family members and, as a result, reduce the associated diseases. The main advantage of this study was the involvement of the rural health personnel, which helped run longer and larger-scale health-promotion programs in the communities.
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13
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Tam HL, Leung LYL, Wong EML, Cheung K, Chan ASW. Integration of text messaging intervention into hypertension management among older adults: A systematic review and meta-analysis. Worldviews Evid Based Nurs 2022; 19:16-27. [PMID: 35014147 DOI: 10.1111/wvn.12549] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/17/2021] [Accepted: 08/02/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND An aging population and required hypertension control are global concerns that burden the healthcare system. Text messaging interventions have been developed to support hypertension management, but their effects on the older population are unknown. OBJECTIVES This review aimed to identify the effects of a text messaging intervention on hypertension management among older adults. METHODS Four English and two Chinese databases with randomized controlled trials published between January 2010 and December 2020 were searched. The mean age of the participants was 60 years or above. Participants were also diagnosed with hypertension. The Cochrane risk-of-bias tool was used for the critical appraisal. Data in each study were extracted, and a meta-analysis was presented in terms of mean difference (MD) and standardized mean difference (SMD). RESULTS A total of 1670 records were screened, of which six were included in the final review. The intervention of the included studies lasted up to 6 months, and one-way text messaging was commonly used. Meta-analysis showed that a text messaging intervention significantly reduced systolic blood pressure (MD = -6.11, p < .01) but not diastolic blood pressure. Regarding medication adherence, a moderate effect was noted with the use of text messaging among older adults with hypertension (SMD = 0.65, p = .01). LINKING EVIDENCE TO ACTION A text messaging intervention can improve hypertension management among older adults. The standardized content of one-way text messaging is suggested to be delivered weekly.
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Affiliation(s)
- Hon Lon Tam
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong S.A.R., China.,Kiang Wu Nursing College of Macau, Macau S.A.R., China
| | - Leona Yuen Ling Leung
- Ronin Institute Independent Scholars, Canadian Academy of Independent Scholars, Vancouver, Canada
| | | | - Kin Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong S.A.R., China
| | - Alex Siu Wing Chan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong S.A.R., China
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14
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Luo Y, Chen Hsu C, Jui Lin K, Kai Fu S, Ru Chen J, Lai CC. Effectiveness of a Water Intake Program at the Workplace in Physical and Mental Health Outcomes. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221085778. [PMID: 35403464 PMCID: PMC8998380 DOI: 10.1177/00469580221085778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Introduction Adequate water intake is a low-cost and effectively non-invasive strategy for individual health outcomes. We aimed to demonstrate the efficacy of water intake intervention in intensive-labor and static-type workplaces. Method Smart drinking cups were provided to the participants, and a built-in application (App) associated with the cup was downloaded on their phones. The App collected and recorded the amount of drinking water consumed by the participants set reminders for drinking water and drinking water health education information. We assessed the data, including the amount of and time interval between water intake, sedentary time, the degree of physical and psychological importance of oneself, self-satisfaction, and physical fitness. Results After the intervention, water intake in the two companies significantly increased during the reminder period compared with the non-reminder period. A significant increase was noted in week 3 in the amount of water intake by the participants after using the App, and the total sedentary time considerably decreased. Furthermore, the interval between water consumption decreased compared with the preintervention interval. The systolic and diastolic blood pressure decreased in the participants working at the static-type and intensive-labor workplaces after the intervention, respectively. The participants ' lower limb muscle performance also improved significantly, and the emphasis on self-care was significantly improved. Conclusions The health-promoting effects of the water intake wellness intervention were akin to the butterfly effect. Besides significantly increasing water intake, the intervention improved other health behaviors, thereby benefiting physical and mental health. Hence, promoting water consumption in workplaces till it becomes a habit may benefit the employees.
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Affiliation(s)
- Yin Luo
- Graduate Institute of Sports Training, University of Taipei, Taipei City, Taiwan
| | - Chia Chen Hsu
- Graduate Institute of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan City, Taiwan
- Department of Otorhinolaryngology, Taipei City Hospital, Taipei City, Taiwan
- Department of Exercise and Health Sciences, University of Taipei, Taipei City, Taiwan
| | - Kuo Jui Lin
- Department of Physical Education, University of Taipei, Taipei City, Taiwan
| | - Szu Kai Fu
- Graduate Institute of Sports Training, University of Taipei, Taipei City, Taiwan
| | - Jyun Ru Chen
- Department of Exercise and Health Sciences, University of Taipei, Taipei City, Taiwan
| | - Chang-Chi Lai
- Department of Exercise and Health Sciences, University of Taipei, Taipei City, Taiwan
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15
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Effects of Self-Management Intervention Programs Based on the Health Belief Model and Planned Behavior Theory on Self-Management Behavior and Quality of Life in Middle-Aged Stroke Patients. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:8911143. [PMID: 34707678 PMCID: PMC8545554 DOI: 10.1155/2021/8911143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 09/29/2021] [Indexed: 12/12/2022]
Abstract
Objectives To study the effect of self-management intervention programs based on the health belief model and planned behavior theory on self-management behavior and quality of life in middle-aged stroke patients. Most of the intervention studies on the self-management of middle-aged stroke patients focus on traditional Chinese medicine nursing and continuous nursing, lacking theoretical support. In particular, there is a lack of interventions based on the integration of two or more theories. Method The middle-aged stroke patients were divided into the control group and the intervention group according to the disease area. A total of 70 patients were included, and 35 patients were included in the control group and the intervention group, respectively. The control group received routine neurological treatment and health education during hospitalization and continued to receive routine health education for 3 months after discharge. On this basis, the intervention group received an intervention program based on an integrated model of health beliefs and planned behavior theory, including 3 health education sessions during hospitalization and 3 months of postdischarge health education. A self-administered stroke general information questionnaire was used to collect basic information on patients' age, gender, and comorbidities. The Stroke Self-Management Behavior Rating Scale and Stroke-Specific Quality-of-Life Scale (SS-QOL) were used to evaluate the management behavior and quality of life of the patients in both groups before and after the intervention. Results Before the intervention, there was no statistically significant difference between the two groups in terms of self-management score, quality of life total score, and scores of each dimension (P > 0.05). At different periods after the intervention, the total score of self-management, total score of quality of life, and scores of each dimension were significantly higher in both groups than before the intervention (P < 0.05). In particular, the self-management and quality of life scores of the intervention group were higher than those of the control group at 1 and 3 months after the intervention (P < 0.05). Conclusion The self-management intervention scheme based on the integrated model of health belief and planned behavior theory is beneficial to improve the self-management ability and quality of life of stroke patients. It provides basis for clinical nurses to further improve the self-management ability and quality of life of stroke patients. Our findings may also serve as a reference for caregivers in other countries to improve the self-management and quality of life of stroke patients.
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16
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Li ZR, Ruan HF, Shen LP, Zhang XP, Wan LH. Gender Difference in the Association Between Stroke Knowledge and Health Behavior Before the Onset of Stroke Among Chinese Hypertensive Patients. J Neurosci Nurs 2021; 53:160-165. [PMID: 34116556 DOI: 10.1097/jnn.0000000000000599] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
ABSTRACT BACKGROUND: Previous research has shown that men and women have different levels of stroke knowledge and differing health behaviors, which are important factors affecting blood pressure, as hypertension is a key risk factor for stroke occurrence. There has been little research on the effects of sex on the association between these 2 variables before the onset of stroke among Chinese hypertensive patients. METHODS: A cross-sectional study and a convenience sampling method were used. 272 male and 118 female hypertensive stroke patients were recruited. Each patient completed the Stroke Knowledge Questionnaire and the Health Behavior Scale for stroke patients. RESULTS: Compared with female patients, male patients had greater stroke knowledge and worse prestroke health behavior. The Pearson correlation coefficient between stroke knowledge and prestroke health behavior was 0.149 and 0.223 in male and female participants, respectively, P < .05. The results of a multiple regression analysis showed that Chinese hypertensive stroke patients' prestroke health behavior was significantly influenced by sex and stroke knowledge. CONCLUSION: Chinese male and female hypertensive stroke patients had disparities in stroke knowledge and prestroke health behavior; moreover, the correlation between these 2 variables before experiencing a hypertensive stroke was different between men and women. Men with hypertension should be considered at a higher risk for an initial or recurrent stroke. Developing sex-specific intervention for primary or secondary stroke prevention in China is essential.
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17
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Lv M, Wu T, Jiang S, Chen W, Zhang J. Effects of Telemedicine and mHealth on Systolic Blood Pressure Management in Stroke Patients: Systematic Review and Meta-Analysis of Randomized Controlled Trials. JMIR Mhealth Uhealth 2021; 9:e24116. [PMID: 34114961 PMCID: PMC8235282 DOI: 10.2196/24116] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 01/27/2021] [Accepted: 03/11/2021] [Indexed: 11/28/2022] Open
Abstract
Background Stroke is a common, harmful disease with high recurrence and mortality rates. Uncontrolled blood pressure is an important and changeable risk factor for stroke recurrence. Telemedicine and mobile health (mHealth) interventions may have the potential to facilitate the control of blood pressure among stroke survivors, but their effect has not been established. Objective This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to estimate the effects of telemedicine and mHealth interventions on the control of systolic blood pressure among stroke survivors. Methods The research literature published up to June 28, 2020, and consisting of RCTs related to telemedicine and mHealth interventions was searched in PubMed, EMBASE, Web of Science, and the Cochrane Library. The Cochrane risk of bias tool (RoB 2.0) was used to evaluate the quality of the studies. The Cochran Q test and I2 statistic were used to assess heterogeneity. Data were meta-analyzed using a random-effects model. Mean difference (MD) with 95% CI and 95% prediction interval (PI) were calculated. Results In total, 9 RCTs with a total sample size of 1583 stroke survivors met the inclusion criteria. Compared with the usual care, telemedicine and mHealth had a significantly greater impact on the control of systolic blood pressure (MD –5.49; 95% CI –7.87 to –3.10; P<.001; 95% PI –10.46 to –0.51). A subgroup analysis showed that the intervention mode of telephone plus SMS text messaging (MD –9.09; 95% CI –12.71 to –5.46; P<.001) or only telephone (MD –4.34; 95% CI –6.55 to –2.13; P<.001; 95% PI –7.24 to –1.45) had a greater impact on the control of systolic blood pressure than usual care. Among the stroke survivors with an intervention interval ≤1 week (MD –6.51; 95% CI –9.36 to –3.66; P<.001; 95% PI –12.91 to –0.10) or a baseline systolic blood pressure ≥140 mm Hg (MD –6.15; 95% CI –9.44 to –2.86; P<.001; 95% PI –13.55 to 1.26), the control of systolic blood pressure using telemedicine and mHealth was better than that of usual care. Conclusions In general, telemedicine and mHealth reduced the systolic blood pressure of stroke survivors by an average of 5.49 mm Hg compared with usual care. Telemedicine and mHealth are a relatively new intervention mode with potential applications for the control of systolic blood pressure among stroke survivors, especially those with hypertensive stroke.
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Affiliation(s)
- Meina Lv
- Department of Pharmacy, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, China
| | - Tingting Wu
- Department of Pharmacy, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, China
| | - Shaojun Jiang
- Department of Pharmacy, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, China
| | - Wenjun Chen
- Department of Pharmacy, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, China
| | - Jinhua Zhang
- Department of Pharmacy, Fujian Medical University Union Hospital, Fujian Medical University, Fuzhou, China
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18
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Lee S, Pantik C, Duggirala S, Lindquist R. A Comparison Between Self-Reported and Investigator-Measured Cardiovascular Risk-Related Biometric Numbers. West J Nurs Res 2021; 44:724-733. [PMID: 33955791 DOI: 10.1177/01939459211013580] [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: 11/16/2022]
Abstract
The purpose of this study was to examine individuals' knowledge of cardiovascular risk-related biometric numbers and to compare self-reported and investigator-measured numbers in a convenience sample of adults in the Midwest region. Sociodemographic data and personal knowledge of cardiovascular risk-related biometric numbers were assessed using self-reported questionnaires. Investigators conducted health assessments to obtain biometric numbers. Among the 224 participants, participants' reported knowledge about their cardiovascular risk-related biometric numbers was low, especially for high-density lipoprotein and fasting blood glucose levels. Participants' knowledge was associated with education level and the recency of their last healthcare visit for health assessment. We found statistically significant mean differences between self-reported and investigator-measured blood pressure, and weight. This study found that there were discrepancies between self-reported and investigator-measured cardiovascular risk-related numbers. Future research is needed to develop educational interventions to improve personal knowledge of cardiovascular risks.
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Affiliation(s)
- Sohye Lee
- Loewenberg College of Nursing, University of Memphis, Memphis, TN, USA
| | - Catherine Pantik
- Loewenberg College of Nursing, University of Memphis, Memphis, TN, USA
| | - Sree Duggirala
- School of Public Health, University of Memphis, Memphis, TN, USA
| | - Ruth Lindquist
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
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19
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Pinho S, Cruz M, Ferreira F, Ramalho A, Sampaio R. Improving medication adherence in hypertensive patients: A scoping review. Prev Med 2021; 146:106467. [PMID: 33636195 DOI: 10.1016/j.ypmed.2021.106467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/23/2021] [Accepted: 02/20/2021] [Indexed: 11/17/2022]
Abstract
In recent years, interest in medication adherence has greatly increased. Adherence has been particularly well studied in the context of arterial hypertension treatment. Numerous interventions have addressed this issue, however, the effort to improve adherence has been often frustrating and frequently disorganized. The aim of present study was to perform a scoping review of medication adherence interventions in hypertensive patients, so that a clear overview was achieved. Moreover, an evidence-based categorization of interventions was developed. The review was performed according to the PRISMA-ScR statement. MEDLINE and Web of Science were searched, and studies published from database inception until August 17, 2020 were included. A total of 2994 non-duplicate studies were retrieved. After screening and eligibility phases, a total of 45 articles were included. Studies were analyzed regarding their design, participant characteristics and management of adherence strategies employed. Furthermore, medication adherence and blood pressure outcomes, as well as adherence measuring tools were evaluated. Each study's intervention was then categorized using a novel evidence-based system of categorization, derived from the conceptual clustering framework used in machine learning. This work is an important step in pushing for better informed and more efficient future research efforts, both by providing an overview of the research field and by creating a new, evidence-based intervention categorization tool. It also provides valuable information to clinicians about medication adherence to antihypertensive therapy.
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Affiliation(s)
- Simão Pinho
- Department of Biomedicine, Faculty of Medicine, University of Porto, Alameda Hernâni Monteiro, 4200-319 Porto, Portugal.
| | - Mariana Cruz
- Department of Biomedicine, Faculty of Medicine, University of Porto, Alameda Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Filipa Ferreira
- Department of Anatomy, Instituto de Ciências Biomédicas Abel Salazar - ICBAS, University of Porto, R. Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal
| | - André Ramalho
- CINTESIS - Centre for Health Technology and Services Research, R. Dr. Plácido da Costa, 4200-450 Porto, Portugal; MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal.
| | - Rute Sampaio
- Department of Biomedicine, Faculty of Medicine, University of Porto, Alameda Hernâni Monteiro, 4200-319 Porto, Portugal; CINTESIS - Centre for Health Technology and Services Research, R. Dr. Plácido da Costa, 4200-450 Porto, Portugal.
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