ABSTRACT
BACKGROUND: This study addresses the knowledge gap on how self-efficacy and self-care affect stroke risk as factors and develops a valuable tool for clinicians to assess stroke risk. METHODS: From January 2022 to January 2023, this nested-case control study was conducted. Medical data including gender, age, ethnicity, locality, education, marital status, employment, caregiver, social environment, blood viscosity, Barthel Index, modified Rankin Scale (mRS), stroke risk score, self-care score, and self-efficacy score were collected. Logistic regression was used to predict stroke risk, and a nomogram was developed and validated. RESULTS: 240 patients were included in the analysis. Stroke risk score (OR: 3.513; p = 0.005), self-efficacy score (OR: 0.753; p = 0.048), and self-care score (OR: 0.817; p = 0.018) were predictors of ischemic stroke. Internal validation was carried out, with a C-index of 0.774, and the Hosmer-Lemeshow test indicated a good fit (p = 0.92). The calibration plot also shows that this nomogram model has good calibration abilities. The decision curve analysis (DCA) results show a threshold probability range of 10-95%. CONCLUSION: A nomogram has been developed with good validity, calibration, and clinical utility, including self-care and self-efficacy as risk factors for predicting ischemic stroke.
ABSTRACT
Context: The worldwide burden of stroke is projected to grow unless proper stroke education is implemented. Information alone cannot promote patient self-efficacy and self-care and reduce risk factors. Aim: This trial aimed to test self-efficacy and self-care-based stroke education (SSE) on changes in self-efficacy, self-care, and risk factor modification. Design setting and participants: This study is a single-center, double-blinded, interventional, two-arm randomized controlled trial with a 1- and 3-month follow-up in Indonesia. Between January 2022 and October 2022, 120 patients were prospectively enrolled from Cipto Mangunkusumo National Hospital, Indonesia. Participants were assigned using a computer-generated random number list. Intervention: SSE was given before discharge from the hospital. Primary outcome measure: Self-care, self-efficacy, and stroke risk score was measured 1 month and 3 months after discharge. Secondary outcome measure: Modified Rankin Scale, Barthel Index, and blood viscosity was measured at 1 month and 3 months after discharge. Results: A total of 120 patients (intervention n = 60; standard care n = 60) were randomized. In the 1st month, the intervention group showed a more significant change in self-care (4.56 [95% CI: 0.57, 8.56]), self-efficacy (4.95 [95% CI: 0.84, 9.06]), and stroke risk (-2.33 [95% CI:-3.19, -1.47]) compared to the controlled group. In the 3rd month, the intervention group also showed a more significant change in self-care (19.28 [95% CI: 16.01, 22.56]), self-efficacy (19.95 [95% CI: 16.61, 23.28]), and stroke risk (-3.83 [95% CI: -4.65, -3.01]) compared to the controlled group. Conclusion: SSE may boost self-care and self-efficacy, adjust risk factors, enhance functional outcomes, and decrease blood viscosity. Clinical trial registration: ISRCTN11495822.
ABSTRACT
Introduction: As the younger female generation, female adolescents should understand anaemia prevention. This study examined the effects of animated educational videos on the knowledge of anaemia prevention among female adolescents using the Health Belief Model (HBM). Method: A quasi-experimental method with a randomised pre-test and post-test control group design was applied. Animated educational videos about anaemia prevention were used as the intervention. One hundred sixty-one female adolescents were recruited through multistage random sampling and divided into intervention (n=78) and control (n=83) groups. The intervention group received education via animated educational videos. The HBM questionnaire was used to measure the nine HBM indicators (r=0.8); the item categories were valid and reliable. Descriptive analyses, independent t-tests and repeated-measures ANOVA were used to analyse the data. Results: The animated educational videos played thrice significantly increased the knowledge of the intervention group (mean score: pre-test, 94; post-test one, 99; post-test two, 102). The scores for anaemia examination barriers (P=0.001), anaemia susceptibility (P=0.001), anaemia severity (P=0.001), anaemia prevention benefits (P=0.001), anaemia examination benefits (P=0.001), self-efficacy for obtaining iron tablets (P=0.001), self-recognition of anaemia signs and symptoms (P=0.001), signs of anaemia prevention (P=0.001) and health motivation (P=0.001) significantly changed. Meanwhile, the knowledge of the control group did not significantly increase (pre-test, 93; post-test one, 94; post-test two, 97). The intervention group had significantly higher mean scores in both the first and second measurements than the control group (P=0.05). Conclusion: Animated educational videos significantly increased the knowledge of anaemia prevention, including the nine HBM indicators.
ABSTRACT
BACKGROUND: A foreign body reaction (FBR) is a typical tissue response to a biomaterial that has been injected or implanted in human body tissue. There has been a lack of data on the classification of foreign body reaction to silicone injection, which can describe the pattern of body tissue responses to silicone. OBJECTIVE: Determine the foreign body reaction to silicone injection. METHOD: We modified the classification proposed by Duranti and colleagues, which has categorized a FBR to hyaluronic acid injection into a new classification of an FBR to silicone injection. A cohort study of 31 women suffering from silicone-induced granulomas on their chin was conducted. Granulomatous tissue and submental skin were stained with hematoxylin-eosin and evaluated. RESULTS: Our data revealed that there were at least 7 categories of FBRs to silicone injection that could be developed. Categories 1 to 4 showed inflammatory activity, and categories 5 to 8 showed tissue repair by fibrosis. CONCLUSION: Using histopathological staining, we are able to sequence the steps of body reactions to silicone injection. Initial inflammatory reaction is then replaced by fibrosis process repairing the damaged tissues. The process depends on the host immune tolerance.
