The Mediating Effect of Self-Efficacy on Health Literacy and Social Support in Young and Middle-Aged Patients with Coronary Heart Disease After PCI.

Objective: To investigate the mediating effect of self-efficacy in the relationship between social support and health literacy among young and middle-aged patients with coronary heart disease following PCI. Methods: A cross-sectional study was conducted on convenience samples of 325 young and middle-aged patients with coronary heart disease who underwent PCI within 1 to 3 months. The data were collected from the outpatient department of a tertiary general hospital in Wenzhou, China, between July 2022 and February 2023. The questionnaire format was utilized to gather data on demographic characteristics, social support, self-efficacy, and health literacy. A structural equation model was employed to establish and validate the pathways. Results: The mean age of the patients included in the study was 45.32 years old, while their levels of health literacy, self-efficacy, and social support were 64.12±7.45, 27.71±4.23, and 65.53±6.43 respectively. Significant associations were observed between social support and health literacy in the CHD population, with self-efficacy playing a partial mediating role. Together, social support and self-efficacy accounted for 53.3% of the variance in health literacy. The Pearson correlation analysis revealed a significant positive association between health literacy and both social support (r = 0.390, P < 0.01) and self-efficacy (r = 0.471, P < 0.01). Conclusion: Social support exerted a direct impact on health literacy and an indirect effect on health literacy through self-efficacy among patients with CHD.

Clinical study of combined mirror and extracorporeal shock wave therapy on upper limb spasticity in poststroke patients.

Mirror therapy is a simple, inexpensive, and patient-oriented method that has been shown to reduce phantom sensations and pain caused by amputation and improve range of motion, speed, and accuracy of arm movement and function. Extracorporeal shock wave therapy (ESWT) is a new, reversible, and noninvasive method for the treatment of spasticity after stroke. To investigate the therapeutic effect of the combination of mirror and extracorporeal shock wave therapy on upper limb spasticity in poststroke patients. We randomly assigned 120 patients into four groups: A, B, C, and D. All groups received conventional rehabilitation training for 30 min per day, five times a week, for 4 weeks. Moreover, participants in groups A, B, and C also added mirror therapy, ESWT, and a combination of mirror and ESWT, respectively, for 20 min per day. Motor recovery and spasticity were measured using Fugl-Meyer assessment and modified Ashworth scale. The differences in the Fugl-Meyer assessment and modified Ashworth scale scores in group C were significantly greater than those of group D at all observed time points after treatment and were significantly greater than those of groups A and B (P<0.05), but no significant differences were observed between groups A and B until 12 months. Upper extremity spasticity was improved by combined mirror and ESWT.