Mediating effects of social participation quality on the relationship between perceived social constraints and mental health status in first stroke patients / 中国实用护理杂志

Objective:To explore the relationships among perceived social constraints, social participation, as well as anxiety and depression in first stroke patients, and to further analyze the mediating effect of social participation on these variables.Methods:A total of 216 first stroke patients in the Department of Neurology of Affiliated Hospital of Qingdao University from April to December 2020 were recruited by convenience sampling and investigated by general information questionnaire, Social Constraints Scale (SCS), Chinese version of Impact on Participation and Autonomy Questionaire (IPA-C) and Hospital Anxiety and Depression Scale (HADS).Results:The total score of SCS, IPA-C, depression and anxiety were 33.49 ± 6.81, 43.42 ± 9.62, 8.05 ± 4.15 and 8.61 ± 2.59. Social constraints were positively correlated with social participation as well as anxiety ( r=0.644, 0.383, both P<0.05). Social constraints were positively correlated with social participation as well as depression ( r=0.482, 0.371, both P<0.05). The quality of social participation partially mediated the relationship between social constraints and anxiety (intermediary effect was 0.119), and also partially mediated the relationship between social constraints and depression (intermediary effect was 0.270). Conclusions:First stroke patients experience high level of social constraints, low quality of social participation and severe anxiety and depression. Social constraints can affect anxiety and depression through social participation. Medical staff should build a good environment to meet the needs of stroke patients of social participation, help patients to establish a correct psychological coping style, reduce patients' avoidance of social participation due to perceived constraints and exclusion, and thus promote the mental health of patients.

Comparison of sequential feeding and continuous feeding on the blood glucose of critically ill patients: a non-inferiority randomized controlled trial / 中华医学杂志(英文版)

BACKGROUND@#Glucose control is an important aspect in managing critically ill patients. The goal of this study was to compare the effects of sequential feeding (SF) and continuous feeding (CF) on the blood glucose of critically ill patients.@*METHODS@#A non-inferiority randomized controlled trial was adopted in this study. A total of 62 patients who were fed enteral nutritional suspension through gastric tubes were enrolled. After achieving 80% of the nutrition target calories (25 kcal·kg-1·day-1) through CF, the patients were then randomly assigned into SF and CF groups. In the SF group, the feeding/fasting time was reasonably determined according to the circadian rhythm of the human body as laid out in traditional Chinese medicine theory. The total daily dosage of the enteral nutritional suspension was equally distributed among three time periods of 7 to 9 o'clock, 11 to 13 o'clock, and 17 to 19 o'clock. The enteral nutritional suspension in each time period was pumped at a uniform rate within 2 h by an enteral feeding pump. In the CF group, patients received CF at a constant velocity by an enteral feeding pump throughout the study. Blood glucose values at five points (6:00/11:00/15:00/21:00/1:00) were monitored and recorded for seven consecutive days after randomization. Enteral feeding intolerance was also recorded. Non-inferiority testing was adopted in this study, the chi-square test or Fisher test was used for qualitative data, and the Mann-Whitney U test was used for quantitative data to determine differences between groups. In particular, a repeated measure one-way analysis of variance was used to identify whether changes in glucose value variables across the time points were different between the two groups.@*RESULTS@#There were no significant demographic or physiological differences between the SF and CF groups (P > 0.050). The average glucose level in SF was not higher than that in CF (8.8 [7.3-10.3] vs. 10.7 [9.1-12.1] mmol/L, Z = -2.079, P for non-inferiority = 0.019). Hyperglycemia incidence of each patient was more common in the CF group than that in the SF group (38.4 [19.1-63.7]% vs. 11.8 [3.0-36.7]%, Z = -2.213, P = 0.027). Hypoglycemia was not found in either group. Moreover, there was no significant difference during the 7 days in the incidence of feeding intolerance (P > 0.050).@*CONCLUSIONS@#In this non-inferiority study, the average blood glucose in SF was not inferior to that in CF. The feeding intolerance in SF was similar to that in CF. SF may be as safe as CF for critically ill patients.@*TRIAL REGISTRATION@#ClinicalTrials.gov, NCT03439618; https://clinicaltrials.gov/ct2/show/record/NCT03439618.

Model test to improve self-management behavior of middle-aged stroke patients: based on the integration of health belief model and planned behavior theory / 中国实用护理杂志

Objective@#To examine the integrated model of self-management behavior in middle-aged stroke patients based on health belief model and planned behavior theory.@*Methods@#A self-designed general information questionnaire, self-management behavior cognition and attitude questionnaire and self-management behavior scale, were used to investigate 654 cases of first middle-aged stroke patients in the neurology department of 3 grade a hospitals in Qingdao.@*Results@#The standardization factor load of each theoretical dimension in the theoretical integration model was 0.51-0.91 (0.72±0.11). Behavioral intention had a direct positive predictive effect on self-management behavior, with an effect value of 0.49 (t = 7.41, P < 0.01). Perceived behavior control not only had a direct positive prediction effect on self-management behavior, but also indirectly influenced self-management behavior through behavioral intention. The effect values are 0.12 (t = 2.75, P < 0.05) and 0.04 (t = 2.18, P < 0.05), respectively. Behavioral attitude exerts influence on self-management behavior through behavioral intention, and the effect value is 0.40 (t = 14.71, P < 0.01). Subjective norms not only influenced self-management behavior through behavioral intention, but also indirectly influenced behavioral intention and self-management behavior through behavioral attitude, with the effect value of 0.25. The effects of perceived benefits and perceived severity on self-management behaviors were 0.21 and 0.04, respectively. The theoretical integration model can explain 62% variance variation of self-management behavior.@*Conclusion@#The theoretical integration model of self-management behavior of middle-aged stroke patients based on the health belief model and planned behavior theory can better explain the behavior. This model can be applied to stroke patients in an attempt to provide theoretical basis for the formulation of personalized nursing measures for stroke patients.

Model test to improve self-management behavior of middle-aged stroke patients: based on the integration of health belief model and planned behavior theory / 中国实用护理杂志

Objective To examine the integrated model of self-management behavior in middle-aged stroke patients based on health belief model and planned behavior theory. Methods A self- designed general information questionnaire, self- management behavior cognition and attitude questionnaire and self-management behavior scale, were used to investigate 654 cases of first middle-aged stroke patients in the neurology department of 3 grade a hospitals in Qingdao. Results The standardization factor load of each theoretical dimension in the theoretical integration model was 0.51-0.91 (0.72±0.11). Behavioral intention had a direct positive predictive effect on self-management behavior, with an effect value of 0.49 (t=7.41, P<0.01). Perceived behavior control not only had a direct positive prediction effect on self-management behavior, but also indirectly influenced self-management behavior through behavioral intention. The effect values are 0.12 (t=2.75, P<0.05) and 0.04 (t=2.18, P<0.05), respectively. Behavioral attitude exerts influence on self- management behavior through behavioral intention, and the effect value is 0.40 (t = 14.71, P < 0.01). Subjective norms not only influenced self-management behavior through behavioral intention, but also indirectly influenced behavioral intention and self-management behavior through behavioral attitude, with the effect value of 0.25. The effects of perceived benefits and perceived severity on self-management behaviors were 0.21 and 0.04, respectively. The theoretical integration model can explain 62% variance variation of self-management behavior. Conclusion The theoretical integration model of self-management behavior of middle-aged stroke patients based on the health belief model and planned behavior theory can better explain the behavior. This model can be applied to stroke patients in an attempt to provide theoretical basis for the formulation of personalized nursing measures for stroke patients.

New progress in prevention of pressure ulcers for patients undergoing prone ventilation patients / 中国实用护理杂志

As an important means of lung protective strategy, prone position ventilation (PPV) which can effectively shorten the time of mechanical ventilation, significantly reduce the mortality of patients with acute respiratory distress syndrome (ARDS), and is suitable for popularization and application in the ICU. However, some studies show that prolonged prone position can significantly increase the incidence of Stress injury, making it difficult to implement PPV in the practical level. In order to achieve the goal of safe and effective prevention of skin Stress injury, and to promote the correct implementation of PPV, this paper review the methods of preventing Stress injury in patients with PPV.

Circle of Willis variants and white matter lesions / 国际脑血管病杂志

Circle of Willis is the most important intracranial collateral circulation system,it has many types of variation.Circle of Willis variants reduce intracranial blood perfusion and increase the risks of ischemic cerebrovascular diseases and white matter lesions.White matter lesions are white matter damage caused by a variety of causes.With the wide application of neuroimaging technology,the detection rate of white matter lesions is significantly higher,and it is closely associated with the ischemic cerebrovascular disease.This article reviews the correlation between circle of Willis variants and white matter lesions.

Correlation between C3435T polymorphism of ABCB1 gene and response to antiplatelet drugs in Chinese Han patients with ischemic stroke / 国际脑血管病杂志

Objective To investigate the correlation between multidrug resistance gene ABCB1 C3435T polymorphism and antiplatelet drug reactivity in Chinese Han patients with ischemic stroke.Methods Consecutive inpatients with non-cardiogenic embolic ischemic stroke were enrolled.They were divided into a good response to antiplatelet drug group and poor response to antiplatelet drug group according to the results of thrombelastogram.Polymerase chain reaction-restriction fragment length polymorphism technique was use to detect the C3435T polymorphism of ABCB1 gene.Multivariate logistic regression analysis was used to determine the independent risk factors for poor response to antiplatelet drugs in patients with ischemic stroke.Results A total of 260 patients with ischemic stroke were enrolled,including 87 females (33.5％) and 173 males (66.5％).There were 193 patients (74.2％) in the good response group and 67 (25.8％)in the poor response group.The age was younger and male was more common in the good response group,and the proportions of smoking and triacylglycerol level were significantly higher (all P ＜0.05).The frequencies of TT genotype and T allele of the poor response group were significantly higher than those of the good response group (all P ＜ 0.05).Multivariable logistic regression analysis showed that triacylglycerol (odds ratio 1.045,95％ confidence interval 1.011-2.010;P =0.014) and C3435T TT genotype (odds ratio 1.512,95％ confidence interval 1.013-2.256;P=0.043) were the independent risk factors for poor response to antiplatelet drugs after adjusting confounding factors.Conclusion The C3435T TT genotype is an independent risk factor for poor response to antiplatelet drugs in Chinese Han patients with ischemic stroke.