Objective:To explore the dual mediating effects of health belief and depression among health knowledge, social support, and health behaviors based on the capacity, opportunity, motivation-behavior (COM-B) model, and analyze the influencing factors of health behaviors in patients with ischemic stroke.Methods:This multi-center cluster sampling research recruited ischemic stroke patients ( n=1 696) who were hospitalized in neurology departments of five tertiary hospitals in Henan Province from October 2023 to October 2024. A cross-sectional investigation was conducted using the general information questionnaire, social support rating scale (SSRS), stroke prevention knowledge questionnaire(SPKQ), short form health belief model scale(SF-HBMS), health promoting lifestyle profile-Ⅱ (HPLP-Ⅱ), and patient health questionnaire-9(PHQ-9) to ultimately reveal the pathways and effect sizes among variables. Partial correlation analysis and multiple linear stepwise regression analysis were conducted to examine the relationships among social support, health knowledge, health belief, health behaviors, and depression in stroke patients by SPSS 26.0 software. Structural equation modeling was constructed using AMOS 28.0 software, and the mediating effect was tested using the Bootstrap method. Results:The scores of social support, health knowledge, health belief, and health behaviors among ischemic stroke patients were (37.46±9.94), (26.56±6.84), (75.62±12.62) and (130.79±26.27), respectively. The score of depression was 5.00 (2.00, 8.00). Health behaviors were positively correlated with health knowledge, social support, and health belief( r=0.333, 0.246, 0.267, all P<0.05), while negatively correlated with depression ( r=-0.146, P<0.05). Multiple linear stepwise regression analysis showed that health knowledge, social support, health belief, and depression were all influencing factors of health behaviors in ischemic stroke patients (all P<0.05). Health belief (effect value=0.068, 95% CI=0.048-0.093) and depression (effect value=0.009, 95% CI=0.003-0.018) both played partial mediating roles between health knowledge and health behaviors, accounting for 17.3%(0.077/0.446) of the total effect. Meanwhile, health belief (effect value=0.045, 95% CI=0.029-0.063) and depression (effect value=0.016, 95% CI=0.008-0.027) both played partial mediating roles between social support and health behaviors, accounting for 26.5%(0.061/0.230) of the total effect. Conclusion:Health knowledge and social support can not only directly influence health behaviors but also indirectly affect them through health belief and depression in patients with ischemic stroke.

Objective:To explore the dual mediating effects of health belief and depression among health knowledge, social support, and health behaviors based on the capacity, opportunity, motivation-behavior (COM-B) model, and analyze the influencing factors of health behaviors in patients with ischemic stroke.Methods:This multi-center cluster sampling research recruited ischemic stroke patients ( n=1 696) who were hospitalized in neurology departments of five tertiary hospitals in Henan Province from October 2023 to October 2024. A cross-sectional investigation was conducted using the general information questionnaire, social support rating scale (SSRS), stroke prevention knowledge questionnaire(SPKQ), short form health belief model scale(SF-HBMS), health promoting lifestyle profile-Ⅱ (HPLP-Ⅱ), and patient health questionnaire-9(PHQ-9) to ultimately reveal the pathways and effect sizes among variables. Partial correlation analysis and multiple linear stepwise regression analysis were conducted to examine the relationships among social support, health knowledge, health belief, health behaviors, and depression in stroke patients by SPSS 26.0 software. Structural equation modeling was constructed using AMOS 28.0 software, and the mediating effect was tested using the Bootstrap method. Results:The scores of social support, health knowledge, health belief, and health behaviors among ischemic stroke patients were (37.46±9.94), (26.56±6.84), (75.62±12.62) and (130.79±26.27), respectively. The score of depression was 5.00 (2.00, 8.00). Health behaviors were positively correlated with health knowledge, social support, and health belief( r=0.333, 0.246, 0.267, all P<0.05), while negatively correlated with depression ( r=-0.146, P<0.05). Multiple linear stepwise regression analysis showed that health knowledge, social support, health belief, and depression were all influencing factors of health behaviors in ischemic stroke patients (all P<0.05). Health belief (effect value=0.068, 95% CI=0.048-0.093) and depression (effect value=0.009, 95% CI=0.003-0.018) both played partial mediating roles between health knowledge and health behaviors, accounting for 17.3%(0.077/0.446) of the total effect. Meanwhile, health belief (effect value=0.045, 95% CI=0.029-0.063) and depression (effect value=0.016, 95% CI=0.008-0.027) both played partial mediating roles between social support and health behaviors, accounting for 26.5%(0.061/0.230) of the total effect. Conclusion:Health knowledge and social support can not only directly influence health behaviors but also indirectly affect them through health belief and depression in patients with ischemic stroke.

Objective:To explore the latent profile types of capability-opportunity-motivation-behavior in stroke patients and analyze the influencing factors of different latent profiles.Methods:From January to October 2023, totally 596 stroke patients from the Neurology Department of five ClassⅢ Grade A hospitals in Henan Province were selected by stratified random sampling. The patients were surveyed using a general information questionnaire, the Stroke Prevention Knowledge Questionnaire (SPKQ), the Social Support Rating Scale (SSRS), the WHO's Quality of Life Questionnaire- Brief Version (WHOQOL-BREF), the Short Form Health Belief Model Scale (SF-HBMS), and the Health Promoting Lifestyle ProfileⅡ (HPLPⅡ). Latent profile analysis was used to classify the capability-opportunity-motivation-behavior characteristics of stroke patients, and multiple logistic regression was conducted to explore the influencing factors of different latent profiles.Results:Three latent profiles of capability-opportunity-motivation-behavior in stroke patients were identified, including low capability-opportunity-motivation-behavior with high health beliefs (32.4%, 193/596), moderate capability-opportunity-motivation-behavior with insufficient health beliefs (47.5%, 283/596), and high capability-opportunity-motivation-behavior with lack of social support (20.1%, 120/596). Multiple logistic regression analysis showed that educational level, smoking history, family history, body mass index, and Charlson Comorbidity Index score were influencing factors of different latent profiles ( P<0.05) . Conclusions:Stroke patients exhibit distinct classifications of capability-opportunity-motivation-behavior. Targeted interventions should be conducted based on the characteristics of each category to improve health behavior management outcomes in patients.

Objective:To explore the mediating effect of rumination between self-perceived burden (SPB) and stigma in stroke patients, so as to provide theoretical basis for the development of targeted nursing interventions in clinical practice.Methods:In September 2022, cluster sampling was used to select 1 126 stroke patients admitted to Department of Neurology of five ClassⅢ Grade A hospitals in Henan Province as subjects. General Information Questionnaire, Self-Perceived Burden Scale (SPBS), Stroke Stigma Scale (SSS), and Chinese Version of Event Related Rumination Inventory (C-ERRI) were used to investigate stroke patients. Pearson correlation analysis was used to explore the correlation between SPB, rumination, and stigma. AMOS 28.0 software was used to establish the structural equation model, and Bootstrap method was used to test the mediating effect.Results:A total of 1 126 questionnaires were distributed, and 1 026 valid questionnaires were collected, with a valid response rate of 91.12% (1 026/1 126). SPBS score of 1 026 stroke patients was (28.68±8.32), the SSS score was (40.53±9.48) and the C-ERRI score was (25.43±12.62). Pearson correlation analysis showed that SPB in stroke patients was positively correlated with stigma and rumination ( P<0.01), and rumination was positively correlated with stigma ( P<0.01). Bootstrap mediating effect test showed that rumination partially mediated the relationship between SPB and stigma in stroke patients, accounting for 55.15% of the total effect. Conclusions:SPB of stroke patients both directly affect stigma and indirectly affect stigma through rumination. Clinical nursing workers should promptly evaluate patients' SPB, pay attention to the mediating role of rumination, develop effective psychological intervention programs, implement personalized and targeted nursing measures, relieve patients' stigma, and improve treatment and rehabilitation compliance.

Objective:To understand the research status and hotspots in the field of stroke health management at home and abroad, and to provide insights for stroke health management research in China.Methods:Relevant literature on stroke health management published between 2013 and 2023 was retrieved from the Web of Science Core Collection and China National Knowledge Infrastructure databases. CiteSpace 6.1.R6 was used for the visual analysis of the number of publications, authors, institutions, countries, and keywords.Results:A total of 382 relevant articles were included, with 169 in English and 213 in Chinese. The number of publications on stroke health management showed a fluctuating upward trend. Research hotspots and frontiers in stroke health management mainly focused on telemedicine, big data and "Internet+", primary and secondary prevention, risk prediction models, quality of life, and swallowing disorders. Future research trends may focus on management models for post-stroke swallowing disorders, risk identification, and the role of caregivers in remote rehabilitation interventions.Conclusions:Researchers can refer to the research hotspots and trends shown by the visual analysis, with particular attention to health management models for patients with post-stroke swallowing disorders and issues related to remote intervention rehabilitation.

Objective:To clarify the applicability of the Chinese version of Cornell Assessment of Pediatric Delirium Scale (CAPD) for neonatal delirium screening in Neonatal Intensive Care Units (NICU) .Methods:From March 2021 to May 2022, convenience sampling was used to select 210 newborns admitted to NICU at Zhuji Maternal and Child Health Care Hospital in Zhejiang Province as the study subject. This study used the American Diagnostic and Statistical Manual of Mental Disorders-V (DSM-V) as the gold standard to test the diagnostic validity of the Chinese version of CAPD in the assessment of neonatal delirium in NICU.Results:This study ultimately included 189 newborns. A total of 43 newborns with delirium were diagnosed by DSM-V, with an incidence rate of 22.75% (43/189). There was no statistically significant difference in the incidence of neonatal delirium among newborns with different gestational age, day age, gender, and disease diagnosis ( P>0.05). Compared with DSM-V, the consistency Kappa value between two results of scales was 0.72 ( P<0.01). When the CAPD diagnostic threshold was set at 15, the sensitivity of the Chinese version of CAPD was 86.01%, the specificity was 86.30%, and the maximum Youden index obtained was 0.723. Conclusions:The diagnostic validity of the Chinese version of CAPD for neonatal delirium assessment in NICU is good, and it can provide reliable tool support for neonatal delirium assessment.

Objective To investigate the changing trend of platelet count (PLT) and related influencing factors in patients with hepatitis B virus-related chronic-on-acute liver failure (HBV-ACLF) after artificial liver support system (ALSS) therapy. Methods A total of 152 patients with HBV-ACLF who were hospitalized and treated in The Third Affiliated Hospital of Sun Yat-Sen University from January 2018 to November 2021 were included in the study, among whom 102 patients received plasma exchange (PE) and 50 patients received double plasma molecular absorption system combined with low-dose PE, and their clinical data and laboratory marker were measured. The independent samples t -test or the Mann-Whitney U test was used for the comparison of continuous data between two groups, and the chi-square test was used for the comparison of categorical data between two groups; a multivariate logistic regression analysis was used to investigate the risk factors for PLT > 50×10 9 /L after ALSS therapy; the receiver operating characteristic (ROC) curve was used to investigate the value of baseline PLT in predicting PLT > 50×10 9 /L after ALSS therapy. Results The patients were mostly middle-aged male adults; among the 152 patients, 70 (46.1%) had liver cirrhosis on admission, 114 (75.0%) received three sessions of ALSS therapy, and 88% had a baseline PLT count of > 50×10 9 /L. There was a significant reduction in PLT from baseline to after ALSS therapy (79.5±47.7 vs 112.5±64.1, t =4.965, P < 0.001), and at 1 week after treatment, PLT increased to the baseline level (97.2±50.7 vs 112.5±64.1, t =1.787, P =0.075). As for the change in PLT from baseline to 1 week after ALSS therapy, the liver cirrhosis group had a significantly greater reduction in PLT than the non-liver cirrhosis group ( U =1986.5, P =0.026), while there was no significant difference between different procedures of ALSS therapy and different sessions of treatment (3-5 sessions) (all P > 0.05). The multivariate logistic regression analysis showed that cirrhosis (odds ratio [ OR ]=3.097, 95% confidence interval [ CI ]: 1.255-7.645, P =0.014) and PLT > 50×10 9 /L at baseline ( OR =0.019, 95% CI : 0.002-0.154, P < 0.001) were independent risk factors for PLT > 50×10 9 /L after ALSS therapy. The ROC curve analysis of baseline PLT showed that PLT > 80.5×10 9 /L at baseline was the optimal cut-off value affecting PLT > 50×10 9 /L after treatment, with an area under the ROC curve of 0.818. Conclusion The influence of ALSS therapy on PLT is temporary, but cirrhotic patients have a weaker PLT generation ability than non-cirrhotic patients. PLT > 80.5×10 9 /L at baseline is the optimal cut-off value to reduce the risk of bleeding after ALSS therapy.

Objective:To explore the diagnostic efficiency of CT enterography (CTE) comprehensive score combined with spectral imaging for Crohn's disease (CD) in active phase.Methods:A retrospective analysis was performed on the case data of 87 CD patients who were admitted to the First People's Hospital of Chenzhou from October 2018 to October 2020. According to CD activity index (CDAI), they were divided into active phase group ( n=58) and remission phase group ( n=29). The results of CTE and spectral imaging in both groups were collected. The diagnostic value of CTE comprehensive score combined with spectral imaging for CD in active phase was analyzed. Multiple linear stepwise regression analysis was used to analyze the independent related factors affecting the active phase of CD. Receiver operating characteristic (ROC) curve was used to predict the area under curve (AUC), sensitivity, specificity and cutoff value of CTE comprehensive score combined with energy spectrum imaging (intestinal wall thickness, intestinal wall uniform enhancement and iodine concentration in portal phase) in active phase of CD. Results:The probability of comb sign, intestinal stenosis or expansion and target sign in CTE of patients with active CD was significantly higher than that in patients with remission CD, the probability of fat sign was significantly lower than that in patients with remission CD, and the CTE comprehensive score was significantly higher than that in patients with remission CD ( P<0.05). Multiple linear stepwise regression analysis showed that the thickness of intestinal wall, uniform enhancement of intestinal wall and iodine concentration in portal phase were independent related factors affecting the active phase of CD ( P<0.05). ROC curve analysis showed that AUC of CTE comprehensive score combined with intestinal wall thickness, intestinal wall uniform enhancement and iodine concentration in portal phase for predicting CD in active phase was 0.953, higher than 0.869, 0.907, 0.914 and 0.913 of single index. The cut-off values of CTE comprehensive score, intestinal wall thickness and iodine concentration in portal phase were 6.0 points, 0.89 cm and 2.68 mg/ml, respectively. There was no homogeneous enhancement of intestinal wall in spectral imaging. Conclusions:CTE comprehensive score combined with intestinal wall thickness, intestinal wall enhancement and iodine concentration in portal phase can more accurately determine CD in active phase, which provide a new quantitative diagnostic reference.

Objective:To understand the discharge preparation and health education needs of parents of children in Neonatal Intensive Care Unit (NICU) , and to provide the basis for taking scientific and effective health guidance programs.Methods:Using the purposive sampling method, a total of 13 parents of newborns who were hospitalized in NICU of a municipal maternal and child health hospital in Zhejiang Province from May to July 2020 were selected as the research objects. A descriptive research method was used to conduct semi-structured interviews with parents of newborns, and the data was analyzed using the Colaizzi 7-step method.Results:Three themes and five sub-themes were extracted, namely psychological state, knowledge needs (including two sub-themes of knowledge identification needs and disease-related knowledge needs) and seeking multi-party support (including three sub-themes of medical support, social support and peer support) .Conclusions:Parents have more needs during the transition period after NICU children are discharged. As medical professionals, they need to provide psychological support, professional health guidance and establish multiple ways of care and support, in order to promote the smooth transition of NICU children to home care.

Objective To explore the effects of transtheoretical model-based intervention plan on the quality of life in patients with laryngeal cancer.Methods Totally 67 patients with laryngeal cancer who received surgery between January and June 2016 in Harbin Medical University Cancer Hospital were selected as the control group,and 71 patients who received surgery between July and December 2016 as the experimental group by purposive sampling.Patients in the control group received conventional interventions,while patients in the experimental group received transtheoretical model-based interventions.The phonic function and quality of life were compared between the two groups.Results The patients in the experimental group showed improved fundamental frequency and fundamental frequency perturbation compared to the patients in the control group post intervention (P ＜ 0.05).And the patients in the experimental group scored higher in physical,psychological,social function,feature modules and total score of quality of life than the patients in the control group (P ＜ 0.05).Conclusions The transtheoretical model-based intervention plan helps to improve the patients' phonic function and quality of life,thus worthy of application.