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AnteayerJournal of Clinical Nursing

Effectiveness of E‐Health Interventions on Improving Physical Activity in Pregnant Women: A Systematic Review and Meta‐Analysis

ABSTRACT

Aims

This study aimed to (1) evaluate the effectiveness of e-health interventions in improving physical activity and associated health outcomes during pregnancy, (2) compare the e-health functions employed across interventions and (3) systematically identify the behaviour change techniques (BCTs) used and examine their interrelationships.

Design

A systematic review and meta-analysis following the PRISMA 2020 guidelines.

Methods

Randomised controlled trials were included. Meta-analyses and subgroup analyses were performed using RevMan 5.3. Social network analysis was conducted to determine the most central BCTs within the intervention landscape.

Data Sources

Ten databases were searched, including PubMed, Embase, Web of Science, Cochrane Library, ProQuest, Scopus, SinoMed, China National Knowledge Infrastructure, WanFang and the China Science and Technology Journal Database, from inception to April 22, 2024.

Results

Thirty-five studies were included. Pooled analyses indicated that e-health interventions significantly improved both total (SMD: 0.19; 95% CI: 0.10 to 0.27; I 2 = 55%) and moderate-to-vigorous physical activity (SMD: 0.16, 95% CI: 0.06 to 0.26; I 2 = 53%) in pregnant women. Subgroup analyses revealed that interventions based on theoretical frameworks and those not specifically targeting overweight or obese women demonstrated greater effectiveness. Additionally, e-health interventions were associated with significant reductions in both total and weekly gestational weight gain. Six of the twelve e-health functions were utilised, with ‘client education and behaviour change communication’ being the most prevalent. Thirty unique BCTs were identified; among them, ‘instruction on how to perform the behaviour’, ‘self-monitoring’, ‘problem solving’, and ‘goal setting’ showed the highest degree of interconnectedness.

Conclusion

E-health interventions are effective in enhancing physical activity and reducing gestational weight gain during pregnancy. Incorporating theoretical frameworks and well-integrated BCTs is recommended to optimise intervention outcomes.

Relevant to the Clinical Practice

Integrating e-health interventions into existing perinatal care models holds promise for enhancing physical activity among pregnant women and improving maternal health outcomes.

Reporting Method

This study adhered to the PRISMA checklist.

Patient or Public Contribution

No patient or public involvement.

Trial Registration

The study protocol was preregistered in the International Prospective Register of Systematic Reviews (CRD42024518740)

Trajectories and Co‐Occurrence of Perceived Control in Patients With Heart Failure and Self‐Efficacy in Their Caregivers: A Three‐Month Longitudinal Study of Dual Trajectories

ABSTRACT

Aim

This study aims to explore the trajectories and co-occurrence of perceived control and caregiver self-efficacy among patients with heart failure (HF) and their caregivers within 3 months post-discharge and identify associated risk factors.

Design

A prospective cohort design.

Methods

A prospective cohort study was conducted from March to June 2024 in Tianjin, China. Information on perceived control and caregiver self-efficacy was collected 24 h before discharge, 2 weeks, 1 month, and 3 months after discharge. Group-Based Dual Trajectory Modelling (GBDTM) and logistic regression were used for analysis.

Results

The study included 203 dyads of patients with HF and their caregivers (HF dyads). Perceived control identified three trajectories: low curve (15.3%), middle curve (57.1%) and high curve (27.6%). Caregiver self-efficacy demonstrated three trajectories: low curve (17.2%), middle curve (56.7%) and high stable (26.1%). GBDTM revealed nine co-occurrence patterns, with the highest proportion (36.7%) being ‘middle-curve group for perceived control and middle-curve group for caregiver self-efficacy’, and 16.7% being ‘high-curve group for perceived control and high-stable group for caregiver self-efficacy’. Age, gender, household income, NYHA class, symptom burden and psychological resilience were identified as risk factors for perceived control trajectories; marital status, regular exercise and psychological resilience were identified as risk factors for caregiver self-efficacy trajectories.

Conclusion

We identified distinct trajectories, co-occurrence patterns and risk factors of perceived control and caregiver self-efficacy among HF dyads. These findings help clinical nurses to better design and implement interventions, strengthening the comprehensive management and care outcomes for HF dyads.

Impact

These findings highlighted the interactive relationship between perceived control and caregiver self-efficacy trajectories, suggesting that interventions should boost both to improve personalised treatment plans and outcomes for HF dyads.

Reporting Method

This study adhered to the STROBE checklist.

Patient or Public Contribution

Patients and their caregivers contributed by participating in the study and completing the questionnaire.

Quantifying Patient‐Level Factors Associated With Mobilisation in Intensive Care: A Prospective Study

ABSTRACT

Aim

To quantify how specific patient-level characteristics influence the actual amount of mobilisation received during ICU care, thereby identifying key predictors to support individualised mobilisation strategies.

Study Design

A prospective observational study was conducted in four tertiary hospitals among a convenience sample of 141 critically ill patients from July to November 2023. Data on mobilisation and patient characteristics were collected using standardised data collection tools, including a mobilisation log and a demographic information sheet. Data were analysed using non-parametric tests, Spearman correlation analysis, and multivariate regression to examine associations between early mobilisation and patient-related factors.

Results

Males and surgical patients engaged in more activity (p < 0.001). Muscle strength (r = 0.568, p < 0.001) and haemoglobin levels (r = 0.207, p = 0.014) were positively associated with mobilisation, while higher disease severity (r = −0.321, p < 0.001) and greater pain (r = −0.284, p < 0.001) were linked to reduced activity. Muscle strength, disease severity, surgical status, and sex were independent predictors, explaining 32.5% of the variance.

Conclusion

Early mobilisation in the ICU is influenced by various patient-related factors. Protocols should be tailored to individual patient profiles to enhance outcomes.

Implications for Clinical Practice

This study provides guidance for ICU clinicians to develop targeted mobilisation strategies that consider patients' specific clinical profiles. Tailored approaches may help optimise early mobilisation practices and patient outcomes.

Clusters of Sleep Disturbance and Associated Factors in People With Systemic Lupus Erythematosus: A Latent Profile Analysis

ABSTRACT

Background

Individuals with systemic lupus erythematosus (SLE) often suffer from sleep disturbance, which exhibits heterogeneity. Whether it could be grouped into different clusters remains unknown, posing challenges to the development of personalised interventions to address sleep disturbance.

Aim

To examine clusters of sleep disturbance and associated factors in people with SLE.

Design

Cross-sectional design.

Methods

From November 2023 to January 2024, people diagnosed with SLE were recruited by a convenience sampling approach. Data were collected via an online platform Wenjuanxing. Sleep disturbance was evaluated by the Pittsburgh Sleep Quality Index (PSQI). Other information, such as disease activity, pain, fatigue, depression and anxiety was also collected using validated instruments. Latent profile analysis was performed to reveal the distinct clusters of sleep disturbance. Multiple logistic regression analysis was performed to investigate factors associated with the clusters.

Results

A total of 538 participants were included, with a response rate of 85.1% (538/632). Only those with sleep disturbance (PSQI > 5) were included in the final analyses. Participant mean age was 32.9 (SD = 8.4) years and 402 (92.6%) were females. All had sleep disturbance (PSQI > 5) and their mean PSQI was 8.8 (SD = 2.9). Three distinct clusters were identified: mild sleep disturbance with poor sleep quality, adequate sleep duration and good daytime functioning (50.7%), mild sleep disturbance with poor sleep quality, adequate sleep duration and poor daytime functioning (30.9%) and moderate sleep disturbance with poor sleep quality, inadequate sleep duration and impaired daytime functioning (18.4%). There are both overlaps and unique aspects in terms of factors associated with each cluster of sleep disturbance, including age, body mass index, cardiovascular system damage, musculoskeletal system damage, depression and anxiety.

Conclusions

Sleep disturbance in patients with SLE showed three distinct clusters, with each cluster having slightly different predisposing factors.

Implications for the Profession

In clinical practice, nurses are recommended to prioritise assessment and interventions for those at-risk subgroups. They could also use the above information to develop and provide personalised interventions to address the unique needs of each cluster of sleep disturbance.

Reporting Method

Checklist for reporting of survey studies.

Patient or Public Contribution

No patient or public contribution.

Interpretable Machine Learning Prediction Model for Predicting Mortality Risk of ICU Patients With Pressure Ulcers Based on the Braden Scale: A Clinical Study Based on MIMIC‐IV

ABSTRACT

Aims

This study was to create an interpretable machine learning model to predict the risk of mortality within 90 days for ICU patients suffering from pressure ulcers.

Design

We retrospectively analysed 1774 ICU pressure ulcer patients from the Medical Information Mart for Intensive Care (MIMIC)-IV database.

Methods

We used the LASSO regression and the Boruta algorithm for feature selection. The dataset was split into training and test sets at a 7:3 ratio for constructing machine learning models. We employed logistic regression and nine other machine learning algorithms to build the prediction model. Restricted cubic spline (RCS) was used to analyse the linear relationship between the Braden score and the outcome, whereas the SHAP (Shapley additive explanations) method was applied to visualise the model's characteristics.

Results

This study compared the predictive ability of the Braden Scale with other scoring systems (SOFA, APSIII, Charlson, SAPSII). The results showed that the Braden Scale model had the highest performance, and SHAP analysis indicated that the Braden Scale is an important influencing factor for the risk of 90-day mortality in the ICU. The restricted cubic spline curve demonstrated a significant negative correlation between the Braden Scale and mortality. Subgroup analysis showed no significant interaction effects among subgroups except for age.

Conclusions

The machine learning-enhanced Braden Scale has been developed to forecast the 90-day mortality risk for ICU patients suffering from pressure ulcers, and its efficacy as a clinically reliable tool has been substantiated.

Patient or Public Contribution

Patients or public members were not directly involved in this study.

The Parallel Chain‐Mediating Role of Sense of Coherence and Coping Styles in Caregivers of Patients With Stroke: A Cross‐Sectional Study

ABSTRACT

Objectives

This study explored the multiple mediating roles of sense of coherence (SOC) and coping styles in the relationship between caregiver burden and family adaptation among family caregivers of patients with stroke.

Method

A cross-sectional study of 347 family caregivers of patients with stroke was conducted in China. Data were collected using a general information questionnaire, Zarit Caregiver Burden Interview and other questionnaires, and were analysed using descriptive, Pearson's correlation and path analyses.

Results

SOC–positive and SOC–negative coping styles played a fully parallel chain-mediating role in the relationship between caregiver burden and family adaptation among family caregivers of patients with stroke.

Conclusions

Improving caregivers' SOC and encouraging them to adopt positive coping styles are crucial for reducing the negative impact of caregiver burden on family adaptation.

Implications for Patient Care

This study provides a new perspective for medical staff to improve the family adaptation of family caregivers of patients with stroke. Targeted interventions aimed at improving the SOC level and enhancing positive coping styles of the family caregivers of patients with stroke are necessary to improve their family adaptation.

Impact

Our study provides insights into the potential influencing mechanism of caregiver burden on family adaptation in family caregivers of patients with stroke, providing a new perspective for developing effective and precise intervention strategies to maintain better family adaptation.

Reporting Method

This study adhered to the STROBE checklist.

What Does This Paper Contribute to the Wider Global Clinical Community?

Promoting SOC and focusing on the transformation of negative coping styles into positive ones may be crucial in developing nursing programmes for family adaptation.

Patient or Public Contribution

No patient or public contribution.

The Effect of ICU Diaries on Psychological Outcomes and Quality of Life of Patients and Relatives: Overview of Systematic Reviews

ABSTRACT

Aims and Objective

Many systematic reviews (SRs) and meta-analyses (MAs) have reported the potential advantages and risks of ICU diary psychotherapy in patients and relatives, but the results remain uncertain and their quality has not yet been adequately assessed. We summarise existing SRs/MAs and assess their quality and level of evidence.

Design

This overview of SRs was conducted in accordance with the preferred reporting items for overviews of reviews statement.

Methods

We conducted a detailed and comprehensive search of eight Chinese and English electronic databases from inception until March 2025. The Assessment of Multiple Systematic Reviews 2 (AMSTAR 2), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA 2020), and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) were used to assess methodological quality, reporting quality and evidence quality for inclusion in SRs/MAs, respectively.

Results

Fifteen published SRs/MAs met the inclusion criteria and were included in the study. The results of the AMSTAR 2 assessment showed that the methodological quality of the included studies was critically low. In the PRISMA 2020 assessment, the response rate of “Yes” for items 7, 14, 15, 16, 21, 22, 24, 25 and 27 was less than 50%. The GRADE assessment showed that no results were high-quality evidence, 2 results were moderate-quality evidence, 26 results were low-quality evidence and 45 results were very low-quality evidence.

Conclusion

ICU diaries can improve patients' psychological outcomes and quality of life, and whether there are advantages for their relatives needs to be further explored. However, the methodological quality of the studies was low and the risk of migration was high, reducing its reliability. Therefore, these conclusions should be treated with caution. High-quality studies with large sample sizes are needed to provide stronger and more scientific evidence.

Patient or Public Contribution

Our paper presents an overview of systematic reviews, and therefore, such specific details may not be relevant to our study.

Trial Registration

PROSPERO: CRD42023448359

Development and Validation of a Dynamic Online Nomogram for Predicting Central Venous Catheter‐Related Thrombosis in Children With Congenital Heart Disease

ABSTRACT

Aims

To develop and validate a tool to estimate the risk of central venous catheter-related thrombosis (CRT) in children with congenital heart disease.

Background

Children with congenital heart disease face an elevated risk of CRT, which is closely linked to adverse clinical outcomes. Early detection of CRT may improve prognosis and reduce mortality. However, no specific tools currently exist to effectively assess it.

Design

A cross-sectional study.

Methods

From January 2020 to April 2023, we enrolled 503 children with congenital heart disease. Four hundred and three were assigned to the modelling cohort and 100 to the validation cohort. Using binary logistic regression, a predictive model was constructed, followed by the development of a dynamic online nomogram. The model's internal and external verification were performed using ROC analysis, the Hosmer–Lemeshow test, and decision curve analysis, respectively. The study adhered to the TRIPOD guidelines.

Results

The prevalence of CRT in the modelling cohort and validation cohort was 23.57% and 21.00%, respectively. Logistic regression analysis identified duration of catheterization, length of ICU stay, duration of sedation, fibrinogen ≥ 4 g/L and platelet count ≥ 400 × 109/L as independent predictive factors for CRT, all of which were incorporated into the nomogram. The nomogram achieved an AUC of 0.866 in the modelling cohort and 0.761 in the validation cohort, demonstrating strong discriminatory power. In both cohorts, the calibration curve indicated good agreement and decision curve analysis confirmed its significant clinical utility.

Conclusions

We developed a dynamic online nomogram that demonstrated strong predictive accuracy and was practical for identifying CRT in children with congenital heart disease.

Relevance to Clinical Practice

This nomogram enables healthcare providers to estimate the risk of CRT in children with congenital heart disease, offering an effective tool for risk stratification and a basis for implementing targeted interventions.

Patient or Public Contribution

No patient or public contribution.

Patient Engagement in Mobile Technology‐Based Rehabilitation for Arthroplasty: A Scoping Review

ABSTRACT

Aims

To map the evidence on patient engagement in mobile technology-based rehabilitation for arthroplasty, including outcome indicators, data collection methods, assessment results, facilitators and barriers, and promoting strategies.

Design

A scoping review.

Methods

This study was conducted using a five-stage methodological framework, which included identifying the research questions, identifying relevant studies, selecting the studies, charting the data, and collating, summarising, and reporting the results.

Data Sources

Ten computerised databases were searched to identify eligible studies published between January 2015 and March 2024.

Results

Forty-seven studies were included in this review. Most studies used data on patient adherence to interventions and programme usage to indicate patient engagement in mobile arthroplasty rehabilitation. Data were primarily collected through mobile device records and online or paper-based surveys. Over half of the studies reported a high level of patient engagement in mobile arthroplasty rehabilitation. Patient engagement was influenced by individual and environmental factors, such as the design of programmes, patients' ability to engage with technology, and the accessibility and functionality of equipment. Strategies to promote patient engagement include applying user-centred design principles, offering support from healthcare professionals, caregivers, and peer patients, and employing behaviour-changing strategies.

Conclusions

Existing studies have shown promising results in patient adherence to and use of mobile arthroplasty rehabilitation programmes. Further research can explore engaging patients in programme development, optimising outcome evaluation and data collection, identifying the mechanisms of patient engagement, and testing the effectiveness of promoting strategies.

Impact

The study findings provide practical implications for nurses and other healthcare professionals to deepen their understanding of patient engagement in mobile arthroplasty rehabilitation. They may consider employing strategies, such as user-centred design, to enhance patient engagement in mobile rehabilitation programmes, thereby improving patient care.

Reporting Method

This review adhered to the PRISMA-ScR checklist.

Patient or Public Contribution

No patient or public contribution.

Mediating Role of Nurses' Perceived Professional Benefits Between ICU Nurses' Emotional Intelligence and Spiritual Care Competency: A Multicentre Cross‐Sectional Study

ABSTRACT

Aim

This study aims to investigate the levels of emotional intelligence, nurses' perceived professional benefits, and spiritual care competency among ICU nurses, explore the correlations among these three variables, and further analyse the mediating role of perceived professional benefits between emotional intelligence and spiritual care competency.

Study Design

A multicenter cross-sectional study was conducted following the STROBE guidelines.

Methods

From January to March 2024, 568 ICU nurses from seven tertiary hospitals in China completed an online questionnaire including demographic items, the Wong and Law Emotional Intelligence Scale, the Nurses' Perceived Professional Benefits Questionnaire, and the Spiritual Care Competency Scale. Data were analysed using SPSS 27.0 and Amos 27.0. Pearson correlation, structural equation modelling (SEM), and bootstrap analysis (5000 samples) were used to test associations and mediation effects.

Results

ICU nurses reported above-average scores in EI, NPPB, and SCC. EI was positively associated with both NPPB and SCC, and NPPB partially mediated the relationship between EI and SCC.

Conclusion

EI significantly contributes to ICU nurses' SCC both directly and indirectly through NPPB. These findings highlight the psychological mechanisms that support competency in spiritual care.

Impact

Nursing managers are encouraged to implement structured training programmes focusing on emotional regulation and professional value reinforcement, which may effectively enhance SCC and improve holistic care quality in ICU settings.

Patient or Public Contribution

Not applicable.

Effectiveness of Telehealth‐Based Exercise Interventions for Patients With Stroke: A Meta‐Analysis of Randomised Controlled Trials

ABSTRACT

Aim

To explore the effects of telehealth-based exercise interventions on balance, motor function, walking ability and activities of daily living (ADLs) in patients with stroke.

Design

Meta-analysis of randomised controlled trials.

Methods

This meta-analysis of randomised controlled trials was reported to follow the PRISMA statement and the Cochrane Handbook guidelines. The study employed either a fixed-effects model or a random-effects model according to the statistical heterogeneity observed.

Data Sources

The literature search was performed in six databases including PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, PsycINFO and CINAHL from inception to December 2023.

Results

A total of 15 randomised controlled trials were included in this meta-analysis. Most of the studies were evaluated for some concerns. The quality of the evidence in this analysis ranged from low to moderate in terms of the outcome. Meta-analysis revealed that telehealth-based exercise interventions presented significant effects on walking ability, motor function and ADLs in patients with stroke. Nonetheless, the balance remained unaffected by statistical significance.

Conclusion

Telehealth-based exercise interventions could effectively improve walking ability, motor function and ADLs in patients with stroke; however, the impact on balance was not significant. Telehealth-based exercise interventions are recommended for stroke survivors residing in remote areas or facing economic constraints.

Implications for the Profession and Patient Care

This meta-analysis showed that telehealth-based exercise interventions could bring benefits to the rehabilitation of patients with stroke. Telehealth-based exercise interventions should be considered effective to better promote the rehabilitation of patients.

Reporting Method

The study was reported in compliance with the PRISMA statement.

Patient or Public Contribution

None.

Trial Registration

PROSPERO (https://www.crd.york.ac.uk/PROSPERO): CRD42024501015

The Effectiveness of Picture Books on Reducing Preoperative Anxiety in Children: A Systematic Review and Meta‐Analysis of Randomised Controlled Trials

ABSTRACT

Background

Children experience significant psychological and physical stress during medical procedures. Picture books can help reduce anxiety by familiarising children with their upcoming procedures.

Aim

To synthesise and evaluate the effectiveness of picture books on reducing preoperative anxiety in children and their parents.

Design

A systematic review and meta-analysis of randomised controlled trials reported following the PRISMA guidelines.

Methods

PubMed, CINAHL, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Wanfang databases were searched from inception to January 1, 2024. This review includes randomised controlled trials published in Chinese or English that evaluate the efficacy of picture book interventions in reducing preoperative anxiety among children undergoing elective surgery. Studies were excluded if: (1) they were conference abstracts, protocols or repetitive publications; (2) they were not available in full text; (3) the data reported in the study could not be obtained from the authors; and (4) they were not published in Chinese or English. The Cochrane Risk of Bias Tool version 2.0 was used to assess the risk of bias of the included studies. Meta-analysis was conducted using Review Manager 5.4.

Results

Five studies with a total of 418 patients were included in the analysis. Picture books can significantly reduce children's preoperative anxiety (SMD = −0.57, 95% CI = −0.76 to −0.37; p < 0.001). The certainty of the evidence for the effectiveness of picture books on preoperative anxiety was considered moderate.

Conclusions

Picture books can effectively reduce preoperative anxiety in children by familiarising them with the unknown. It has shown the potential to serve as preoperative educational material for paediatric patients.

Patient or Public Contribution

Not applicable.

Relevance to Clinical Practice

This meta-analysis highlights the effectiveness of picture books in reducing preoperative anxiety in children undergoing medical procedures. Healthcare professionals should consider integrating these interventions into preoperative health education.

Trial Registration

CRD42023435105 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023435105)

Development of Paediatric‐Friendly Care Assessment Scale in Emergency Department: A Cross‐Sectional Study

ABSTRACT

Aim

To validate the psychometric properties of the Paediatric-Friendly Care Assessment Scale in the Emergency Department (PFCAS-ED) among clinical nurses.

Design

A cross-sectional study.

Methods

A total of 463 emergency nurses participated in the study between May and September 2023. The participants were randomly divided into two groups to assess the psychometric properties of the PFCAS-ED, including its reliability, construct validity, convergent validity, discriminant validity, and criterion-related validity.

Results

Exploratory factor analysis on data from the first group revealed six components of the PFCAS-ED: paediatric/adolescent timely care and resources, child protection mechanisms and safety, paediatric emergency care competency training and practice, paediatric emergency consultation information and space, paediatric crisis management and response, and a harmless environment and actions for toddlers. These factors explained 69.408% of the total variance and exhibited strong internal consistency. This six-factor structure and its 28 items were further validated using confirmatory factor analysis on data from the second group, yielding satisfactory fit indices and convergent and discriminant validity. Additionally, the scale exhibited excellent 2-week test–retest reliability and criterion-related validity.

Conclusion

The PFCAS-ED had excellent psychometric properties when used with clinical nurses and was proven to be a reliable instrument for evaluating emergency nurses' perceptions of the importance of providing paediatric-friendly care to children and their families.

Implications for the Profession and Patient Care

This standardised scale enables nurses to assess their perceptions of the importance of paediatric-friendly care and design targeted interventions on the basis of available resources. Additionally, hospital administrators can use the PFCAS-ED to identify priorities, strengths, and areas requiring improvement in paediatric emergency care, thereby informing the development of effective strategies and comprehensive policies.

Reporting Method

This study adhered to the STROBE guidelines.

Patient or Public Contribution

No patient or public involvement.

Current Status and Factors Influencing Nutrition Literacy in Stroke Patients: A Cross‐Sectional Study

ABSTRACT

Aims

This study investigated the current status of nutrition literacy and related influencing factors in stroke patients, with a view to providing a reference for the development of targeted interventions.

Design

Cross-sectional study.

Methods

A convenience sampling method was used to select 342 stroke patients from June to November 2024 as the study population, and a cross-sectional survey was conducted using the General Information Questionnaire, Nutrition Literacy Scale, Herth Hope Scale, Chronic Disease Self-Efficacy Scale and Social Support Rating Scale. Descriptive analysis, independent samples t-test, one-way ANOVA, Pearson's correlation analysis and multiple linear regression analysis were used for data analysis.

Results

The results showed that the nutrition literacy score of stroke patients was 122.24 ± 16.66, and gender, age, education level, monthly per capita family income, nutrition education, hope level, self-efficacy and social support were the factors affecting the nutrition literacy of stroke patients (all p < 0.05).

Conclusion

According to the study, stroke patients' nutrition literacy has to be raised, and medical practitioners should create focused intervention plans to raise patients' nutrition literacy levels.

Relevance to Clinical Practice

Healthcare professionals should assess the level of nutritional literacy in order to provide targeted interventions. The establishment of a multidisciplinary care team and implementation of long-term nutritional management after stroke are essential to reduce stroke recurrence and mortality.

Reporting Method

The study adhered to the STROBE checklist.

Patient or Public Contribution

No patient or public contribution.

Clinically Significant Functional Impairments and Symptoms in COVID‐19 Survivors: Empirical Research Quantitative

ABSTRACT

Background

COVID-19 survivors may experience complex, distressing and persistent symptoms, referred to as long COVID, lasting months or years after diagnosis. More evidence is needed for effective long COVID screening and management.

Aim

To explore the clinical profile of long COVID and factors associated with its development.

Design

A multicentre correlational study using a cross-sectional design.

Methods

Adults diagnosed with COVID-19 6–9 months earlier were recruited via social media and referrals from three facilities. Participants provided demographic data and assessed their symptoms and functional status using validated questionnaires. Data were analysed using descriptive statistics and binomial logistic regression.

Results

Among 102 participants, 13%–30% reported significant impairments in cognitive, emotional and physical functioning. Over 10% experienced symptoms such as diarrhoea, sleep problems, dyspnoea, nausea, fatigue and pain. These impairments and symptoms were associated with acute symptom severity, chronic disease, overweight status, regular exercise and living without partners.

Conclusion

This study adds to the literature by examining long-term functional status and symptoms in omicron survivors using comprehensive, validated tools. The findings highlight the prevalence and clinical significance of long COVID symptoms, aiding in the identification of functional impairments requiring medical and nursing interventions.

Implications for the Profession and Patient Care

Nurses should recognise these symptoms and educate survivors about potential challenges. Policies addressing long-term issues, including research, health services and education, are essential.

Reporting Method

This study follows the STROBE guideline (Table S1).

Patient or Public Contribution

Patients self-reported symptoms for this study.

Trial Registration

ClinicalTrials.gov (NCT05303103)

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