Unmet Need for Social and Emotional Support and Lack of Recalled Screening Is Associated with Depression in the Long-Term Course After Stroke

A reliability and validity study of the electronic health literacy scale among stroke patients in China

BACKGROUND

Patients with stroke usually use smartphones to obtain online information to maintain their health. But their ability to identify, evaluate and apply this information is still unknown.

AIM

This study was designed to examine the reliability and validity of the electronic Health Literacy Scale among patients with stroke in China.

DESIGN

This is a cross-sectional survey.

METHODS

A demographic questionnaire, the electronic Health Literacy Scale (e-HLS) and the eHealth Literacy Scale (eHEALS) were administered to a sample of 648 patients with ischemic stroke recruited from December 2020 to March 2021 in a tertiary hospital.

RESULTS

The Cronbach'α coefficient on the e-HLS-CHI was 0.907. Kappa consistency coefficient of test-retest reliability was 0.691 (p < .05). Three factors were extracted by Exploratory Factor Analysis (EFA), accounting for 90.84% of the total variance. Confirmatory Factory Analysis (CFA) revealed that three factors of e-HLS-CHI fit well (NFI = 0.979, RFI = 0.955, IFI = 0.987, TLI = 0.972, CFI = 0.987, RMSEA = 0.070, CMIN/DF = 2.586). Good simultaneous validity was suggested by the positive correlation of 0.94 (p < .001) between the e-HLS-CHI and eHEALS. When using eHEALS as the standard, the area under the ROC curve of e-HLS-CHI was 0.896 (95% CI: 0.831-0.960, p < .001). The sensitivity and specificity were 97.8% and 70.4% respectively.

CONCLUSIONS

The e-HLS can be used to evaluate electronic health literacy of patients with stroke in China after translation and cultural adaption.

[Position paper on stroke aftercare of the German Stroke Society-Part 1: long-term care after stroke: status quo of the reality and deficits of care in Germany]

Die Akutversorgung des Schlaganfalls in Deutschland hat ein sehr hohes Niveau, dargestellt durch die Stroke-Units. Die Erkrankung Schlaganfall hat eine Akutphase, gefolgt von einer chronischen Phase mit einem hohen und qualifizierten multi- und interprofessionellen Versorgungsbedarf. Die Deutsche Schlaganfall-Gesellschaft (DSG) hat 2020 eine Nachsorgekommission gegründet, mit dem Ziel der Darstellung der aktuellen Versorgungssituation und zur Erarbeitung von Vorschlägen für eine Verbesserung der Versorgung nach der Akutphase. In dieser Arbeit wird der Status quo ermittelt und Defizite benannt. Analysiert wurden Beiträge unterschiedlicher Beteiligter im deutschen Gesundheitswesen, dargestellt werden unterschiedliche Projekte einer Nachsorge. In Deutschland existiert kein anerkanntes strukturiertes Nachsorgekonzept für Patienten nach einem Schlaganfall. Die bestehende hausarztbasierte Versorgung ohne eine zukünftig stärkere und abgestimmte Integration der Neurologen erschwert eine leitlinien- und qualitätsgesteuerte Nachsorge. Aufgabenverteilungen sowie notwendige Ausbildungsstandards für ihre leitliniengerechte Erfüllung durch die Fachgruppen liegen nicht vor. Zu selten werden neben den medizinischen Domänen die physischen, sozialen und emotionalen Domänen durch ein multiprofessionelles Versorgungsteam beachtet. Zu diskutieren ist eine Weiterentwicklung eines regionalen Care-Management-Konzeptes. Evaluiert werden müssen die Ergebnisse und die Kosten eines Nachsorgekonzeptes vor einer breiten Anwendung.

Internet Access and Usage Among Stroke Survivors and Their Informal Caregivers: Cross-sectional Study

Background

Web-based interventions have shown promise for chronic disease management but have not been widely applied to populations with stroke. Existing barriers may inhibit the adoption of web-based interventions among stroke survivors and necessitate the involvement of informal caregivers. However, limited information is available on internet accessibility and usability among stroke survivors and their caregivers.

Objective

This study aims to investigate internet access and usage in a cohort of stroke survivors and their caregivers.

Methods

A cross-sectional survey was conducted with 375 participants (248 stroke survivors and 127 caregivers). Descriptive statistics were generated using cross-tabulation. Comparisons with categorical data were conducted using the chi-square test, whereas the Mann-Whitney U test was used for comparisons involving ordinal variables.

Results

Overall, 86.1% (323/375) of the participants reported having internet access. Caregivers were more likely than stroke survivors to access the internet (N=375, χ²₁=18.5, P<.001) and used text messaging (n=321, χ²₁=14.7, P<.001). Stroke survivors and caregivers with internet access were younger than stroke survivors and caregivers without internet access. The highest number of participants who reported internet access were non-Hispanic White. Smartphones were the most common devices used to access the internet. Email was the most common type of internet usage reported. Patients who survived for >12 months after a stroke reported higher internet access than those who survived <3 months (P<.001). The number of hours per week spent using the internet was higher for caregivers than for stroke survivors (P<.001).

Conclusions

Future feasibility and acceptability studies should consider the role of the informal caregiver, participant age, race and ethnicity, the use of smartphone apps, email and text correspondence, and the amount of time elapsed since the stroke event in the design and implementation of web-based interventions for populations with stroke.

The Influence of Nonpharmacological Complex Therapy Conducted at a Community Day-Care Center on Cognitive function and Mood in Older Adults

Introduction

Nonpharmacological interventions in the elderly may lead to the reduction of cognitive and depressive symptoms. The aim of the study was to evaluate changes in cognitive functions and mood in older adults participating in therapy, conducted in the community day-care center (CD-CC).

Patients and Methods

The study group (SG) included 46 elderly adults (21 M, 25 W), the control group (CG) included 45 adults (12 M, 33 W), who participated in the activities of the University of the Third Age. The following measuring tools were used: Mini-Mental State Examination, Clock-Drawing Test, Verbal Fluency Test, Digit Span Test, Stroop Color and Word Test, Beck’s Depression Inventory, and Hospital Anxiety and Depression Scale. The intervention consisted of CD-CC 6-month nonpharmacological therapy.

Results

In the SG, compared to the CG, the scores on all the cognitive tests were significantly lower, Beck’s Depression Inventory was significantly higher. After intervention, the SG and the CG did not show substantial differences in their scores on the Mini-Mental State Examination, Clock-Drawing Test, and Beck’s Depression Inventory. In the SG, a significant improvement was reported on the Verbal Fluency Test, Beck’s Depression Inventory and Hospital Anxiety and Depression Scale scores.

Conclusion

The CD-CC complex therapy can be helpful for cognitive and emotional elderly functioning.