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In recent years, the critical role of health literacy in diabetes management has become increasingly prominent. The aim of this study was to investigate the impact of social support on health literacy among patients with diabetes, to test the mediating role of self-efficacy and empowerment between social support and health literacy, and the moderating role of eHealth literacy.
A cross-sectional study conducted between August 2023 and June 2024.
This study adopted the cluster sampling method and conducted a questionnaire survey among 251 patients with diabetes in a tertiary hospital in Wuhu City, Anhui Province. The questionnaires included the Social Support Rating Scale, the Self-Efficacy for Diabetes scale, the Health Empowerment Scale, the eHealth Literacy Scale and the Diabetes Health Literacy Scale.
Social support was positively associated with health literacy in patients with diabetes. Self-efficacy and empowerment mediated the relationship and formed chained mediation pathways respectively. eHealth literacy has a moderating role between self-efficacy and empowerment.
The results revealed that social support influences health literacy among patients with diabetes through the mediating pathways of self-efficacy and empowerment, and that this process is moderated by eHealth literacy. These findings provide a theoretical basis and practical insights for improving health literacy among patients with diabetes.
Enhancing health literacy among people with diabetes by strengthening social support, self-efficacy and empowerment levels, while focusing on the technology-enabling role of eHealth literacy in this context.
This study adheres to the relevant EQUATOR guidelines based on the STROBE cross-sectional reporting method.
We thank all patients who participated in the study for their understanding and support.
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.
We retrospectively analysed 1774 ICU pressure ulcer patients from the Medical Information Mart for Intensive Care (MIMIC)-IV database.
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.
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.
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.
Patients or public members were not directly involved in this study.
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.
Meta-analysis of randomised controlled trials.
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.
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.
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.
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.
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.
The study was reported in compliance with the PRISMA statement.
None.
PROSPERO (https://www.crd.york.ac.uk/PROSPERO): CRD42024501015
This review aims to explore factors influencing family resilience in families providing care for patients with cancer and to provide suggestions for future research directions.
Six electronic databases were searched including Web of Science, CINAHL, EMBASE, PsycINFO, PubMed and CNKI from their inception to December 2023. The article reference lists were also manually searched. The Mixed Method Appraisal Tool was used to assess the included studies in this review. The 27-item checklist Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed to report this review.
Twenty-one studies from six online databases reported that either individual or family factors have effects on family resilience and were described into five clusters on the basis of the Walsh model of family resilience, including demographic and clinical factors, personal strengths and resources, family stressors, family resilient coping processes and family resilient adaptation outcomes.
Family resilience in cancer families plays a pivotal role in coping with family stressors and facilitating positive outcomes through domains of coping. Future researches need to explore factors related to family resilience from dyadic perspectives and to establish multidisciplinary intervention strategies for developing levels of family resilience in cancer families.
PROSPERO: CRD42024535349
To evaluate the duration of subsyndromal delirium (SSD) in intensive care unit (ICU) patients and the factors associated with SSD duration.
This retrospective study included adult patients admitted to the ICU of Affiliated Hospital of Nantong University between December 2019 and June 2020. All patients with Richmond Agitation Sedation Scale scores of ≥−2 were evaluated every 8 h using the confusion assessment method of the intensive care unit (CAM-ICU) until the patients with SSD were negative, progressed to delirium, fell into a coma, died, or were discharged from the ICU. Multivariable Cox regression analyses were performed to determine the factors associated with SSD duration.
Of the 388 patients, 53.6% had SSD, and 20.7% progressed from SSD to delirium. The duration of SSD ranged from 8 to 248 h, and the median duration was 48 h (interquartile range, 24–72). Age (hazard ratio [HR] = 0.985, 95% confidence interval [CI], 0.971–0.999, p = 0.035), surgery or not (HR = 0.514; 95% CI, 0.310–0.850; p = 0.010), duration of ventilation (HR = 1.003; 95% CI, 1.000–1.006; p = 0.044), duration of hypoxia (HR = 0.212; 95% CI, 0.103–0.438; p < 0.001), and adapted cognitive exam scores (HR = 1.057; 95% CI, 1.030–1.085; p < 0.001) were independently associated with the duration of SSD.
The duration of SSD was associated with age, surgery, duration of ventilation, duration of hypoxia, and cognitive function. SSD has a high incidence among ICU patients, and many patients progress to delirium.
The study team met with public members of the evaluation teams throughout the project in a series of workshops. Workshops informed study design, data collection tools and data interpretation.
ICU staff should pay attention to SSD patients with older age, history of surgery, longer duration of ventilation, prolonged duration of hypoxia, and lower ACE scores.
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