1.Scoping review of exercise interventions for stroke survivors
Guiling XU ; Min ZHANG ; Yuting DAI ; Lianzi XIA ; Huiling SHI ; Qing WANG
Chinese Journal of Modern Nursing 2024;30(3):393-399
Objective:To summarize the content and effects of exercise interventions for stroke survivors, providing references for medical and nursing personnel in formulating exercise intervention plans for these patients.Methods:Literature on exercise interventions for stroke survivors was searched in databases such as China National Knowledge Infrastructure, Wanfang, VIP, China Biology Medicine disc, Cochrane Library, PubMed, Embase, and Web of Science up to May 1, 2023. Data extraction and summarization were conducted on the included literature.Results:Twenty-two articles were included in the review. The exercise types for stroke survivors primarily involved aerobic and resistance training; the intensity was mainly moderate to high; the frequency was mostly 3-5 times per week, with each session lasting 30-60 minutes; and the duration of interventions ranged from as short as two weeks to as long as one year. Exercise interventions improved stroke survivors' functional mobility, quality of life, cardiopulmonary function, mental state, cognitive function, fatigue, sleep, and compliance to varying degrees.Conclusions:Exercise interventions have achieved positive outcomes in stroke survivors. In the future, medical and nursing personnel can incorporate patient preferences into exercise intervention plans while ensuring patient safety to promote rehabilitation.
2.Early mobilization safety and effectiveness in stroke patients: an overview of systematic reviews
Yuting DAI ; Qing WANG ; Kangling JI ; Guiling XU ; Min ZHANG ; Huiling SHI
Chinese Journal of Modern Nursing 2024;30(9):1151-1158
Objective:To conduct an overview of systematic reviews on the safety and effectiveness of early mobilization in stroke patients.Methods:Systematic reviews of early mobilization in stroke were electronically searched on China National Knowledge Infrastructure, WanFang Data, VIP, Chinese Biology Medicine, Cochrane Library, PubMed, Web of Science, CINAHL, Embase, and the Joanna Briggs Institute Evidence-Based Health Care Center Database. The search period was from database establishment to May 2023. Two researchers independently conducted literature screening, data extraction, and methodological quality evaluation of the included literature, as well as evidence summary and grading.Results:A total of 10 systematic reviews were included. The methodological quality evaluation showed that one article was of medium quality, two articles were of low quality, and seven articles were of extremely low quality. The evidence quality evaluation indicated that there were three pieces of high-quality evidence, 17 pieces of medium-quality evidence, 21 pieces of low-quality evidence, and 17 pieces of extremely low-quality evidence.Conclusions:Early mobilization is beneficial for improving the daily living ability and limb motor function of stroke patients, reducing the incidence of complications, shortening hospital stay, and enhancing their walking ability in the short term. However, the quality of evidence in the systematic review is relatively low, and further improvement is needed in the research design of early mobilization intervention measures to provide strong support for clinical practice.
3.Exercise rehabilitation experience of stroke patients:a qualitative meta-synthesis
Huiling SHI ; Qing WANG ; Yuanyuan JIANG ; Min ZHANG ; Yuting DAI ; Kangling JI
Chinese Journal of Nursing 2024;59(11):1397-1404
Objective To systematically evaluate the qualitative research on the experience and feeling of elderly patients with hip fracture during rehabilitation.Methods We searched databases including the PubMed,Embase,Web of Science,Cochrane Library,CNAIHL,CNKI,Wanfang,VIP,SinoMed.The literature of qualitative research on the exercise rehabilitation experience of stroke patients from the establishment of the database to August 17,2023 was retrieved.Results A total of 59 clear research topics were extracted,and 14 new categories were formed after induction and integration,which were finally merged into 5 integrated results.Integration results 1:Perceived benefits of exercise rehabilitation.Integration results 2:Multiple driving forces of exercise rehabilitation.Integration results 3:Gradual loss of patience in long-term rehabilitation.Integrated results 4:Generating new rehabilitation needs and actively coping with them.Integrated results 5:There are many difficulties in carrying out self-rehabilitation.Conclusion During the process of exercise rehabilitation for stroke patients,medical personnel should pay attention to the patients'actual feelings,inner needs,and the practical challenges they face in participating in exercise rehabilitation.Personalized exercise rehabilitation facilitation strategies should be developed for stroke patients,aiming for the scientific and precise advancement of exercise rehabilitation,and ultimately improving long-term rehabilitation outcomes for patients.
4.Summary of the best evidence for early recognition of patients with post-stroke cognitive impairment
Deyue XIA ; Qing WANG ; Yuanyuan JIANG ; Huiling SHI ; Yan CHEN
Chinese Journal of Health Management 2024;18(9):693-700
Objective:To search, evaluate and integrate the best evidence for early recognition of patients with post-stroke cognitive impairment (PSCI).Methods:With"stroke""cognitive impairment"and"identif"as search terms, according to the 6S evidence resource pyramid model, a top-down systematic retrieval was conducted for literature on early identification of PSCI in UpToDate, BMJ Best Practice, the Joanna Briggs Institute (JBI), National institute for Health and Care Excellence (NICE), Medlive and other guideline websites, American Stroke Association (ASA), American Heart Association (AHA), European Stroke Organization (ESO), Heart and Stroke Foundation of Canada (HSFC), Australian Stroke Foundation (ASF), Royal College of Physicians (RCP) and other association networks, PubMed, Embase, Cochrane Library, CINAHL, Web of Science, CNKI, Wanfang Knowledge Data Service Platform, VIP database, Chinese Biomedical Database, Chinese Medical Journal Full Text Database and other databases. The search time was from the establishment of the databases to February 8, 2024. Two researchers trained in normative evidence-based methodology conducted literature screening, quality evaluation, and independent evidence extraction in accordance with the principle of evidence integration.Results:A total of 21 articles were included, including 1 clinical decision support, 8 guidelines, 3 expert consensus, and 9 systematic reviews. The best evidence summarized included 24 recommendations from 6 aspects, including screening objects, screening timing, screening practitioners, pre-screening assessment, screening tools and post-screening assessment, of which 70.8% was class 2b and above evidence, and 41.7% of the evidence was recommended with strength A.Conclusions:The literature on early identification of PSCI patients is of high quality and high level of evidence. The key to early identification of PSCI patients for medical professionals is to consider individual differences, select appropriate screening tools and conduct cognitive screening as soon as possible.
5.The value of clinical model, deep learning model based on baseline noncontrast CT and the combination of the two in predicting hematoma expansion in cerebral hemorrhage
Yeqing WANG ; Dai SHI ; Hongkun YIN ; Huiling ZHANG ; Liang XU ; Guohua FAN ; Junkang SHEN
Chinese Journal of Radiology 2024;58(5):488-495
Objective:To investigate the predictive value of clinical factor model, deep learning model based on baseline plain CT images, and combination of both for predicting hematoma expansion in cerebral hemorrhage.Methods:The study was cross-sectional. Totally 471 cerebral hemorrhage patients who were firstly diagnosed in the Second Affiliated Hospital of Soochow University from January 2017 to December 2021 were collected retrospectively. These patients were randomly divided into a training dataset ( n=330) and a validation dataset ( n=141) at a ratio of 7∶3 by using the random function. All patients underwent two noncontrast CT examinations within 24 h and an increase in hematoma volume of >33% or an absolute increase in hematoma volume of >6 ml was considered hematoma enlargement. According to the presence or absence of hematoma enlargement, all patients were divided into hematoma enlargement group and hematoma non-enlargement group.Two-sample t test, Mann-Whitney U test or χ2 test were used for univariate analysis. The factors with statistically significant differences were included in multivariate logistic regression analysis, and independent influences related to hematoma enlargement were screened out to establish a clinical factor model. ITK-SNAP software was applied to manually label and segment the cerebral hemorrhage lesions on plain CT images to train and build a deep learning model based on ResNet50 architecture. A combination model for predicting hematoma expansion in cerebral hemorrhage was established by combining independent clinical influences with deep learning scores. The value of the clinical factor model, the deep learning model, and the combination model for predicting hematoma expansion in cerebral hemorrhage was evaluated using receiver operating characteristic (ROC) curves and decision curves in the training and validation datasets. Results:Among 471 cerebral hemorrhage patients, 136 cases were in the hematoma enlargement group and 335 cases were in the hematoma non-enlargement group. Regression analyses showed that male ( OR=1.790, 95% CI 1.136-2.819, P=0.012), time of occurrence ( OR=0.812, 95% CI 0.702-0.939, P=0.005), history of oral anticoagulants ( OR=2.157, 95% CI 1.100-4.229, P=0.025), admission Glasgow Coma Scale score ( OR=0.866, 95% CI 0.807-0.929, P<0.001) and red blood cell distribution width ( OR=1.045, 95% CI 1.010-1.081, P=0.011) were the independent factors for predicting hematoma expansion in cerebral hemorrhage. ROC curve analysis showed that in the training dataset, the area under the curve (AUC) of clinical factor model, deep learning model and combination model were 0.688 (95% CI 0.635-0.738), 0.695 (95% CI 0.642-0.744) and 0.747 (95% CI 0.697-0.793) respectively. The AUC of the combination model was better than that of the clinical model ( Z=0.54, P=0.011) and the deep learning model ( Z=2.44, P=0.015). In the validation dataset, the AUC of clinical factor model, deep learning model and combination model were 0.687 (95% CI 0.604-0.763), 0.683 (95% CI 0.599-0.759) and 0.736 (95% CI 0.655-0.806) respectively, with no statistical significance. Decision curves showed that the combination model had the highest net benefit rate and strong clinical practicability. Conclusions:Both the deep learning model and the clinical factor model established in this study have some predictive value for hematoma expansion in cerebral hemorrhage; the combination model established by the two together has the highest predictive value and can be applied to predict hematoma expansion.
6.Pelvic Obliquity During Standing and Walking in Adolescent Idiopathic Scoliosis with Lumbar Curvature
Weihong SHI ; Lixia CHEN ; Wangshu YUAN ; Yuhang ZHANG ; Houqiang ZHANG ; Huiling ZHANG ; Yuying YANG ; Jiandong LU
Medical Journal of Peking Union Medical College Hospital 2024;15(1):124-129
7.Clinical Study on Huangjing Jiangya Decoction in the Treatment of Patients with Hypertension of Qi-Deficiency Type Accom-panied by Insomnia
Wen SHI ; Haijuan MA ; Jintao HE ; Lei DONG ; Yao LIU ; Huiling ZHAO ; Yuan XING
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(11):1256-1262
OBJECTIVE To observe the effect of Huangjing Jiangya Decoction on blood pressure and sleep in patients with hy-pertension of qi-deficiency type accompanied by insomnia.METHODS 73 patients with hypertension of qi-deficiency type accompa-nied by insomnia who met the inclusion criteria were selected and randomly divided into an observation group of 36 cases and a control group of 37 cases.The control group was treated with amlodipine besylate tablets,and the observation group was given Huangjing Jian-gya Decoction oral treatment on the basis of the control group.Both groups were treated continuously for 8 weeks.The changes in TCM syndrome scores,office blood pressure monitoring(OBPM),home blood pressure monitoring(HBPM),24-hour ambulatory blood pressure monitoring(ABPM),Pittsburgh Sleep Quality Index(PSQI)scores and clinical efficacy of the two groups of patients before and after treatment were observed.RESULTS After treatment,the TCM syndrome scores in the observation group were significantly decreased(P<0.05,P<0.01),which were better than the control group(P<0.01);OBPM and HBMP in both groups were signifi-cantly reduced(P<0.05,P<0.01),the observation group was better than the control group(P<0.05,P<0.01);the ABPM of the observation group was significantly reduced(P<0.01),which was better than the control group(P<0.05,P<0.01);the sleep quali-ty,sleep latency,sleep duration,daytime dysfunction score and PSQI total score of the observation group were significantly decreased(P<0.01),which were better than those in the control group(P<0.05,P<0.01);the clinical efficacy of hypertension and insomnia in the observation group was both better than the control group(P<0.01).CONCLUSION Huangjing Jiangya Decoction combined with amlodipine can improve the symptoms of patients with hypertension of qi-deficiency type accompanied by insomnia,lower blood pressure,improve sleep quality,shorten sleep latency,alleviate daytime dysfunction,and has good clinical efficacy.
8.The application of health education with the combination of hospital WeChat platform and teach-back method in improving the quality of life of patients with prostate cancer after operation
Tingting GU ; Huiling WANG ; Yuanyuan SHEN ; Han JIANG ; Ying GU ; Jihui SHI ; Wei FENG
Chinese Journal of Practical Nursing 2024;40(18):1403-1410
Objective:To explore the application of 'hospital WeChat' platform combined with feedback method in improving the quality of life of patients with prostate cancer after operation, to provide suggestions for health education of patients with prostate cancer after operation.Methods:A randomized controlled trial was conducted. A total of 80 male patients who underwent radical prostatectomy in the Third People's Hospital of Yancheng City from June 2022 to July 2023 were selected by convenient sampling method. They were divided into control group and experimental group by random number method, with 40 cases in each group. The control group used routine nursing health education, the experimental group used the 'hospital WeChat' platform combined with feedback method for health education. The severity of urinary incontinence, quality of life, and satisfaction with health education after discharge were compared between the two groups.Results:Forty patients in each group completed the study. The age of the control group was (73.40 ± 4.02) years old, and the age of the experimental group was (73.25 ± 4.02) years old. The urinary incontinence scores of the experimental group at 1 week, 1 month and 3 months after discharge were (14.00 ± 1.41), (11.90 ± 1.34) and (5.13 ± 3.45) points, respectively, which were significantly different from those of the control group (16.10 ± 2.04), (15.00 ± 1.20) and (10.90 ± 3.70) points, the differences were statistically significant ( t=-5.36, -10.93, -7.23, all P<0.05). The total scores of quality of life in the experimental group at 1 and 3 months after discharge were (77.51 ± 6.11) and (79.53 ± 5.42) points, which were significantly higher than (67.70 ± 6.62) and (69.05 ± 6.92) points in the control group, the differences were statistically significant ( t=6.89, 7.62, both P<0.05). The satisfaction scores of health education mode, attitude and evaluation items in the experimental group after discharge were (5.03 ± 0.70), (4.95 ± 0.81) and (5.33 ± 0.86) points, respectively, which were higher than those in the control group (3.93 ± 1.00), (3.65 ± 1.10) and (3.80 ± 0.72) points, the differences were statistically significant ( t=5.72, 6.01, 8.59, all P<0.05). Conclusions:The 'hospital WeChat' platform combined with feedback method can effectively improve the urinary incontinence of patients after prostate cancer surgery, and improve the quality of life and satisfaction of health education for patients. This study is hopeful to provide specific measures for health education for clinical prostate cancer patients.
9.Exercise rehabilitation preferences in stroke patients: a concept analysis
Yuting DAI ; Qing WANG ; Min ZHANG ; Huiling SHI ; Kangling JI
Journal of Clinical Medicine in Practice 2024;28(8):113-118
Objective To analyze and explicate the conceptual connotations of exercise rehabilitation preferences in stroke patients. Methods A systematic search was conducted across multiple databases including the China National Knowledge Infrastructure (CNKI), the Wanfang Data Knowledge Service Platform, the Chinese Biomedical Literature Database, PubMed, Web of Science, Embase, and CINAHL, with the search period extending from inception to October 2022. In accordance with inclusion and exclusion criteria, eligible literatures were selected, and a comprehensive analysis was performed by Rodgers' evolutionary concept analysis method. Results A total of 34 literatures were included. Exercise rehabilitation preferences for stroke patients encompassed 5 concept attributes: preferences for exercise rehabilitation programs, risk tolerance in rehabilitation, time preferences for engaging in exercises, supervision and support, and confidence and challenges; the antecedents to these preferences included demographic factors, disease-related factors, emotional and psychological factors, external environmental factors, and fatigue; outcomes associated with these preferences included the realization of individualized exercise rehabilitation, improvement in adherence to rehabilitation regimens, increased levels of physical activity, and facilitation of motor function recovery. Conclusion Through the conceptual analysis of exercise rehabilitation preferences in stroke patients, healthcare professionals can better understand its underlying dimensions, thereby enabling more in-depth research and exploration into exercise rehabilitation practices tailored for stroke patients.
10.Current status and influencing factors of physical activity among stroke survivors
Guiling XU ; Qing WANG ; Min ZHANG ; Yuting DAI ; Lianzi XIA ; Huiling SHI
Journal of Clinical Medicine in Practice 2024;28(13):115-120
Objective To investigate the current status and influencing factors of physical activity (PA) among stroke survivors. Methods A total of 203 stroke survivors were selected as the research subjects using convenient sampling method. General information questionnaire, Stroke Self-efficacy Scale, Perceived Social Support Scale, Modified Rankin Scale, International Physical Activity Questionnaire-Long Form, Fatigue Severity Scale, and European Five-Dimension Health Scale were used for questionnaire survey. Based on the health ecological model, hierarchical multiple linear regression analysis was used to explore the influencing factors of PA among stroke survivors. Results Using metabolic equivalents (MET) to quantify energy expenditure, the weekly PA energy expenditure of 203 stroke survivors was 693.0 (0, 1 386.0) MET. The results of hierarchical multiple linear regression analysis showed that personal traits (stroke staging), behavioral characteristics and psychology (Modified Rankin Scale score, fatigue severity, stroke recovery self-efficacy), and interpersonal networks (perceived social support-friend support dimension) were the main influencing factors of PA among stroke survivors (


Result Analysis
Print
Save
E-mail