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Zhang R, Wang MY, Zhang XQ, Gong YW, Guo YF, Shen JH. Self-care activities mediate self-perceived burden and depression in Chinese patients with type 2 diabetes. World J Psychiatry 2025; 15:104766. [DOI: 10.5498/wjp.v15.i5.104766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2024] [Revised: 02/27/2025] [Accepted: 03/14/2025] [Indexed: 04/30/2025] Open
Abstract
BACKGROUND Diabetes is becoming increasingly common and has become an important global health issue. In addition to physical damage, diabetes often leads to psychological complications, such as depressive symptoms. Self-care is considered to be the cornerstone of type 2 diabetes mellitus (T2DM) management. This research evaluated depression and explored the associations between self-care activities, self-perceived burden, and depression among T2DM patients in China.
AIM To investigate the self-care activities and the association between depression and self-perceived burden among Chinese inpatients with T2DM.
METHODS A cross-sectional study was conducted in participants with T2DM. The data collected encompassed basic characteristics, diabetes self-care activities, depression levels, and self-perceived burdens. Bootstrapping was utilized to assess the mediating role of diabetes self-care activities.
RESULTS There were 599 T2DM patients in the survey, and 71.8% had been diagnosed with the disease for 1–10 years. There were significant correlations between self-care activities, depression, and self-perceived burden. The significant coefficients for paths a (B = -0.281, P < 0.001) and b (B = -0.041, P < 0.05) suggested negative associations between self-perceived burden and self-care behavior and between self-care activities and depression. The indirect effect (path a × b) of self-perceived burden on depression through self-care behaviors was significant (B = 0.020, P < 0.05), with a 95% bias-corrected bootstrap confidence interval of 0.007–0.036.
CONCLUSION The mediating model presented here highlights the role of self-care activities in exerting both direct and indirect effects on depression in participants with T2DM.
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Affiliation(s)
- Rong Zhang
- Department of Endocrinology, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde 415000, Hunan Province, China
| | - Mei-Yan Wang
- Department of Neurosurgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde 415000, Hunan Province, China
| | - Xue-Qing Zhang
- Department of Nursing, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde 415000, Hunan Province, China
| | - You-Wen Gong
- Department of Nursing, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde 415000, Hunan Province, China
| | - Ya-Fen Guo
- Department of Nursing, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde 415000, Hunan Province, China
| | - Jin-Hua Shen
- Department of Nursing, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde 415000, Hunan Province, China
- Department of General Surgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde 415000, Hunan Province, China
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Liu JQ, He MJ, Zhang XQ, Zeng FH, Mo H, Shen JH. The association between nutrition risk status assessment and hospital mortality in Chinese older inpatients: a retrospective study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:229. [PMID: 39731201 DOI: 10.1186/s41043-024-00726-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 12/20/2024] [Indexed: 12/29/2024]
Abstract
PURPOSE The association between nutritional risk status assessment and hospital mortality in older patients remains controversial. The aim of this study was to assess the relationship between nutritional risk on admission and in-hospital mortality, and explore the best Nutritional Risk Status Screening 2002 (NRS2002) threshold for predicting in-hospital mortality of older inpatients in China. METHOD The elderly inpatients were recruited from a hospital in Hunan Province, China. Nutritional risk was screened and assessed using the NRS2002. Logistic regression was used to analyze whether NRS2002 scores were independently associated with hospital mortality, and the results were expressed as odds ratios (OR) and 95% confidence intervals (CIs). Receiver operating characteristic curve (ROC) was used to determine the best NRS2002 threshold for predicting in-hospital mortality in elderly inpatients. And 500 bootstrap re-samplings were performed for ROC analysis. RESULT In total, 464 elderly inpatients completed the survey (15 of whom died, 205 males and 259 females, mean age = 72.284 ± 5.626 years). Multifactorial analysis revealed that age, the NRS2002 score, and length of hospital stay significantly influenced in-hospital mortality among older inpatients (P < 0.05). The results also showed that higher NRS2002 scores were associated with an increased risk of in-hospital mortality in both the unadjusted (OR = 1.731,95%CI = 1.362-2.20, P < 0.0001), adjusted model I (OR = 1.736, 95% CI = 1.354-2.206, P < 0.0001) and model II (OR = 1.602, 95% CI = 1.734-2.488, P = 0.0005). The optimal NRS2002 threshold for predicting in-hospital mortality in older inpatients was 3.5, with the largest ROC area of 0.84. CONCLUSION Our findings indicated that nutritional risk was an independent predictor of in-hospital mortality, with a cut-off value of 3.50 for the NRS2002 nutritional risk assessment being more appropriate than a cut-off value of 3.0.
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Affiliation(s)
- Jie-Qiong Liu
- Department of Orthopedics, Changde Hospital, Xiangya School of Medicine, Central South University(The first people's hospital of Changde city), Changde, Hunan Province, China
| | - Meng-Jun He
- Department of Nursing, Changde Hospital, Xiangya School of Medicine, Central South University(The first people's hospital of Changde city), Changde, Hunan Province, China
| | - Xue-Qing Zhang
- Department of Nursing, Changde Hospital, Xiangya School of Medicine, Central South University(The first people's hospital of Changde city), Changde, Hunan Province, China
| | - Feng-Hua Zeng
- Department of Surgery, Changde Hospital, Xiangya School of Medicine, Central South University(The first people's hospital of Changde city), Changde, Hunan Province, China.
- Department of Surgery, Changde Hospital, Xiangya School of Medicine, Central South University(The first people's hospital of Changde city), 818 Ren min Road, Changde, Hunan Province, China.
| | - Hui Mo
- Department of Nutrition, Changde Hospital, Xiangya School of Medicine, Central South University(The first people's hospital of Changde city), Changde, Hunan Province, China.
- Department of Nutrition, Changde Hospital, Xiangya School of Medicine, Central South University(The first people's hospital of Changde city), 818 Ren min Road, Changde, Hunan Province, China.
| | - Jin-Hua Shen
- Department of Nursing, Changde Hospital, Xiangya School of Medicine, Central South University(The first people's hospital of Changde city), Changde, Hunan Province, China.
- Department of Surgery, Changde Hospital, Xiangya School of Medicine, Central South University(The first people's hospital of Changde city), Changde, Hunan Province, China.
- Department of Nursing, Changde Hospital, Xiangya School of Medicine, Central South University(The first people's hospital of Changde city), 818 Ren min Road, Changde, Hunan Province, China.
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Zou D, Liu Y, Gong Y, Zhang X, Liu J, Shen J. Self-Efficacy's Mediating Role in the Relationship Between Self-Perceived Burden and Health-Related Quality of Life Among Older-Adult Inpatients in China: A Cross-Sectional Study. J Multidiscip Healthc 2024; 17:2157-2163. [PMID: 38736537 PMCID: PMC11088387 DOI: 10.2147/jmdh.s460151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 05/01/2024] [Indexed: 05/14/2024] Open
Abstract
Purpose This study investigated the current state of self-efficacy and the association between self-perceived burden (SPB) and health-related quality of life (HRQoL) among Chinese older-adult inpatients. Methods A cross-sectional study was conducted using convenience sampling to survey Chinese older-adult inpatients. Data regarding demographic characteristics, self-efficacy, SPB, and HRQoL were collected. Pearson's correlation analysis was used to examine the correlations among the research variables. SPSS® Statistics V26.0, and SPSS® PROCESS Macro Model 4 were used to analyze the available data. The bootstrap method was used to analyze the mediating role of self-efficacy. Results Survey participants included 514 older-adult inpatients, with a mean age of 72.28±5.58 years. Self-efficacy (r=0.471, p<0.01) was positively correlated with HRQoL, whereas self-efficacy (r=-0.891, p<0.01) and HRQoL (r=-0.516, p<0.01) were negatively correlated with SPB. The mediating effect analysis revealed that self-efficacy either completely or partially mediated the effect of SPB on HRQoL, with the indirect effect accounting for 30.2% of the total. Conclusion This study provides a mediating model suggesting that SPB exerts both direct and indirect effects on the HRQoL of older-adult inpatients through self-efficacy.
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Affiliation(s)
- Dongmei Zou
- Department of Cardiovascular Surgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde city), Changde, People’s Republic of China
| | - Yanqiong Liu
- Department of Cardiology, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde, People’s Republic of China
| | - Youwen Gong
- Department of Neurosurgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde, People’s Republic of China
| | - Xueqing Zhang
- Department of Nursing, Changde Hospital, Xiangya School of Medicine, Central South University (The first People’s hospital of Changde city), Changde, People’s Republic of China
| | - Jieqiong Liu
- Department of Nursing, Changde Hospital, Xiangya School of Medicine, Central South University (The first People’s hospital of Changde city), Changde, People’s Republic of China
| | - Jinhua Shen
- Department of Nursing, Changde Hospital, Xiangya School of Medicine, Central South University (The first People’s hospital of Changde city), Changde, People’s Republic of China
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Gao N, Li Y, Sang C, He J, Chen C. Effect of high-quality nursing on neurological function psychological moods quality of life of elderly patients with stroke. Front Neurol 2023; 14:1259737. [PMID: 37909031 PMCID: PMC10613641 DOI: 10.3389/fneur.2023.1259737] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/22/2023] [Indexed: 11/02/2023] Open
Abstract
Objectives The primary objective of the present investigation was to meticulously examine the efficacy of high-quality nursing care (HQN) on neurological restoration, amelioration of adverse psychological states, and augmentation of quality of life in geriatric patients diagnosed with acute cerebral infarction (ACI). Methods A cohort of 240 patients, afflicted by ACI and admitted to our healthcare institution between February 2020 and March 2023, were incorporated into this longitudinal prospective analysis. Employing a random number table methodology, the patient cohort was bifurcated into a control group (n = 120) receiving conventional care and an observation group (n = 120) receiving HQN. Comparisons were conducted between the two cohorts concerning neurological functionality [as quantified by the National Institutes of Health Stroke Scales (NIHSS) and Barthel Index (BI) scores], psychological wellbeing [utilizing the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores], overall quality of life [assessed via the Generic Quality of Life Inventory-74 (GQOLI-74) scores], and self-perceived burden [evaluated through the Self-Perceived Burden Scale (SPBS)]. Further assessments included patient satisfaction and incidence of complications, both in the pre- and post-interventional phases. Results Post-intervention, the observation group demonstrated superior outcomes compared to the control group, as evidenced by diminished NIHSS and SPBS scores and elevated BI metrics. Moreover, SAS and SDS scores in both groups manifested a decline post-intervention; however, the decrement was statistically more pronounced in the observation group (P < 0.05). Similarly, all dimensions of GQOLI-74 showed an upward trend in both cohorts, yet the increase was significantly more substantial in the observation group (P < 0.05). Furthermore, the observation group exhibited a reduced frequency of complications coupled with heightened levels of nursing satisfaction. Conclusion The implementation of HQN in the geriatric population afflicted by ACI markedly enhances neurological recuperation, attenuates adverse psychological states, and ameliorates overall quality of life. The intervention is also associated with a diminution in complication rates and an increase in nursing satisfaction, thereby substantiating its clinical utility.
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Affiliation(s)
- Na Gao
- Department of Neurology, First Affiliated Hospital of Anhui University of Science and Technology (First People's Hospital of Huainan), Huainan, China
| | - Yaqiang Li
- Department of Neurology, First Affiliated Hospital of Anhui University of Science and Technology (First People's Hospital of Huainan), Huainan, China
- Department of Neurology, People's Hospital of Lixin County, Bozhou, China
| | - Changru Sang
- Department of Neurology, First Affiliated Hospital of Anhui University of Science and Technology (First People's Hospital of Huainan), Huainan, China
| | - Jiale He
- Department of Neurology, First Affiliated Hospital of Anhui University of Science and Technology (First People's Hospital of Huainan), Huainan, China
| | - Congxia Chen
- Department of Neurology, First Affiliated Hospital of Anhui University of Science and Technology (First People's Hospital of Huainan), Huainan, China
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Fan W, Ma KK, Yang CX, Guo YL. The mediating effect of stigma between self-perceived burden and loneliness in stroke patients. Front Psychiatry 2023; 14:1219805. [PMID: 37575575 PMCID: PMC10412817 DOI: 10.3389/fpsyt.2023.1219805] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/12/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction Stroke patients may experience reduced socialization and feelings of isolation due to post-stroke sequelae such as impaired motor function and cognitive deficits. Factors associated with loneliness need to be explored to develop targeted interventions. However, little is known about the impact of self-perceived burden and illness stigma on loneliness in this population.The aim of this study was to explore the mediating effect of stigma on self-perceived burden and loneliness in stroke patients. Methods The cluster random sampling method was adopted to select 1028 stroke patients from the neurology department of third-grade A hospitals and second-grade A hospitals in 5 cities of Henan Province from May 2022 to August 2022. A general data questionnaire, self-perceived burden scale, stroke stigma scale, and loneliness scale were used to investigate. The structural equation model was used to analyze the mediating effect of stigma between self-perceived burden and stigma. Results The loneliness of stroke patients was positively correlated with self-perceived burden and stigma. The results of the mediation analysis showed that stigma played a complete mediating role between self-perceived burden and loneliness. Discussion The results of the study revealed the relationship between self-perceived burden, stigma, and loneliness in stroke patients. Stigma mediated the relationship between self-perceived burden and loneliness in this population.Stigma should be emphasized as an important modifiable psychological factor that affects loneliness of stroke patients.
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Affiliation(s)
- Wenfeng Fan
- Nursing and Health School, Zhengzhou University, Zhengzhou, China
| | - Ke ke Ma
- Neurology of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Cai xia Yang
- Neurology of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuan li Guo
- Neurology of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Saragih ID, Saragih IS, Tarihoran DETAU, Sharma S, Chou FH. A meta-analysis of studies of the effects of case management intervention for stroke survivors across three countries. J Nurs Scholarsh 2023; 55:345-355. [PMID: 36310396 DOI: 10.1111/jnu.12822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 08/05/2022] [Accepted: 09/09/2022] [Indexed: 12/31/2022]
Abstract
PURPOSE A stroke survivor who is discharged to home care faces many challenges during the transition from the hospital to home, including managing their care at home and engaging in rehabilitation and recovery. Case management was developed to ease the transition from hospital to home and help people with stroke cope with their care management challenges. However, the effects of case management intervention remain inconclusive. Case management was designed to direct care and may represent a novel method for reducing the burden of care. This study was designed to evaluate the effects of case management interventions on mental health outcomes, activities of daily living capacity, physical function, and social function among stroke survivors. DESIGN Systematic review and meta-analysis. METHODS This study included studies examining the impacts of case management interventions for stroke survivors that were published in English and identified by searching eight databases, from database inception to February 20, 2022. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were used to pool effect sizes using a random-effects model (in Stata 16.0). The revised Cochrane risk-of-bias tool for randomized trials (RoB-2) was used to assess the methodological quality of each study. FINDINGS The inclusion criteria were satisfied by eight studies (including a total of 1119 stroke survivors). Case management had positive effects on mental health (SMD: 0.26; 95% CI: 0.07 to 0.45, p = 0.001) and activities of daily living (SMD: 0.68; 95% CI: 00.37 to 0.99, p < 0.001). However, no significant effects were observed for either physical function or social function. CONCLUSION Case management appears to enhance the mental health and activities of daily living among stroke survivors. CLINICAL RELEVANCE Case management interventions hold promise as efficient, cost-effective, and accessible strategies to positively influence care for stroke survivors. This intervention strategy could be applied to the hospital-to-home transition to guide care among this population.
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Affiliation(s)
| | | | - Dame Elysabeth Tuty Arna Uly Tarihoran
- School of Nursing, Universitas Kristen Krida Wacana Jakarta, Indonesia.,School of Nursing Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Sapna Sharma
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Fan-Hao Chou
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
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