Conectar
by Zihang Zhao, Xiang Zhang, Xi Hou, Zihan Liu, Zhiyong Hou, Lianxin Song, Ruipeng Zhang
Percutaneous Bunnell repair and open modified Kessler repair remain debated options for acute Achilles tendon rupture (AATR). We retrospectively compared a minimally invasive percutaneous Bunnell technique (Group A) with an open modified Kessler repair (Group B) within a standardized early functional rehabilitation (EFR) protocol at a single center. Fifty-five adults with closed AATR treated between January 2021 and December 2022 were analyzed (Group A, n = 25; Group B, n = 30). Between-group comparisons used Welch t tests for continuous variables and χ² or Fisher exact tests for categorical variables; American Orthopaedic Foot & Ankle Society (AOFAS) and Achilles Tendon Total Rupture Score (ATRS) were assessed at 12 and 24 weeks, with Holm adjustment applied within each scale. Compared with Group B, Group A had shorter operative time (56.6 ± 15.1 vs 68.2 ± 23.2 minutes; mean difference −11.6; 95% CI −22.05 to −1.15; P = 0.030), less intraoperative blood loss (28.4 ± 8.4 vs 74.7 ± 19.4 mL; −46.3; 95% CI −54.22 to −38.38; PTo explore the latent categories and influencing factors of dyadic decision self-efficacy among stroke patients and their caregivers.
A cross-sectional survey involving 305 patient-caregiver pairs was conducted using standardised questionnaires. Latent profile analysis was used to identify dyadic self-efficacy categories and multinomial logistic regression was employed to analyse influencing factors.
The dyadic decision self-efficacy of stroke patients and their caregivers was classified into three categories: low common decision self-efficacy group (35.6%), patients' high decision self-efficacy and caregivers' moderate decision self-efficacy group (38.6%), and high common decision self-efficacy group (25.8%). Influencing factors included patients' education level, income and health literacy, as well as caregivers' education, caregiving duration and social support.
The levels of dyadic decision self-efficacy among stroke patients and their caregivers are heterogeneous. Clinicians can develop targeted interventions involving both patients and caregivers, based on the population's characteristics and influencing factors, to improve their dyadic decision self-efficacy.
This study was conducted and reported in accordance with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines.
To explore the association between psychological capital and psychological distress in stroke patient–spouse dyads and examine the mediating effect of relationship satisfaction in this association.
A population of 207 stroke patient-spouse dyads completed the Positive Psychological Capital Questionnaire, Quality of Relationship Index, and Kessler Psychological Distress Scale. A dyadic analysis was conducted using the actor-partner interdependence mediation model.
In stroke-affected couples, a noteworthy interaction exists between moderately elevated levels of psychological capital (p < 0.01). Patients exhibit significantly diminished psychological capital and heightened psychological distress compared to their spouses (t = −5.429, p < 0.001; t = 2.536, p < 0.05). Conversely, there is no significant variance in relationship satisfaction between patients and the partners (t = −0.920, p > 0.05). Patient relationship satisfaction acts as a mediator in the correlation between dyadic psychological capital and patient psychological distress (β = −0.020, p < 0.05; β = −0.011, p < 0.05). Similarly, spousal relationship satisfaction serves as a mediator in the connection between dyadic psychological capital and spousal psychological distress (β = −0.011, p < 0.05; β = −0.020, p < 0.05).
Psychological distress was reduced when psychological capital or relationship satisfaction in stroke dyads was promoted, and relationship satisfaction is an important mediator of the impact of psychological capital on psychological distress in the dyads. Healthcare providers should pay equal attention to spouses and implement dyadic psychological capital interventions centered on stroke couples to enhance relationship satisfaction and reduce psychological distress.
To examine the effects of depression on dyadic self-care in stroke patients and their caregivers, as well as the potential mediating role of self-efficacy in this relationship.
A multi-centre cross-sectional study design was employed.
From May to September 2022, stroke patients and their caregivers were recruited from China using a multi-centre stratified sampling method. Data analysis was conducted using a structural equation model based on the Actor-Partner Interdependence Model extended to include mediation. Depression in patients and caregivers was assessed using the Patient Health Questionnaire-9. The self-care self-efficacy scale was utilised to measure patient self-efficacy, while the caregiver self-efficacy in contributing to patient self-care scale was used for caregivers. Patient self-care was evaluated with the Self-Care of Stroke Inventory and caregiver contributions to self-care were assessed using the Caregiver Contributions to Self-Care of Stroke Inventory.
This study followed the STROBE checklist.
306 patient-caregiver dyads were enrolled. The direct effect between depression and dyadic self-care was not confirmed in stroke patients and their caregivers (p > 0.05). Patient self-efficacy had significant indirect actor effects on self-care maintenance (β = −0.173, p < 0.001), monitoring (β = −0.146, p < 0.001) and management (β = −0.186, p < 0.001). Caregiver self-efficacy had an indirect actor effect on caregiver contributions to self-care maintenance (β = −0.096, p < 0.001), monitoring (β = −0.073, p < 0.001) and management (β = −0.106, p < 0.001). The partner effect analysis showed caregiver self-efficacy plays a potential mediating role in the relationship between patient depression and caregiver contributions to self-care maintenance (β = −0.037, p = 0.036), monitoring (β = −0.028, p = 0.032) and management (β = −0.040, p = 0.036). Caregiver depression reduced caregiver self-efficacy, lowering patient self-care monitoring (β = −0.040, p = 0.004) and management (β = −0.047, p = 0.002) levels.
The findings indicate interactive effects between depression, self-efficacy and dyadic self-care among stroke patients and their caregivers. Therefore, the development of targeted dyadic interventions to address depression and enhance self-efficacy in both patients and caregivers should be considered.
To investigate the relationship among dyadic coping, mental health and the individual and mutual influences on stroke survivors and their spouse caregivers.
A cross-sectional descriptive study was conducted in China from November 2019 to August 2020. The STROBE checklist was used to report the present study.
The analysis included 224 dyads of stroke survivors and their spouse caregivers in China. Data on stroke survivors and their spouse caregivers were collected using the Dyadic Coping Inventory (DCI), the Patient Health Questionnaire nine-item scale (PHQ-9) and the Generalised Anxiety Disorder seven-item scale (GAD-7). The dyadic analysis was conducted based on the Actor-Partner Interdependence Model (APIM).
Regarding actor effects, spouse caregivers' dyadic coping and perceived dyadic coping had a negative predictive effect on their own anxiety and depression. Stroke survivors' perceived dyadic coping had a negative effect on their own depression. Regarding partner effects, spouse caregivers' perceived dyadic coping also had a negative predictive effect on the depression of the patients. In contrast, stroke survivors' perceived dyadic coping was positively associated with spouse caregivers' anxiety and depression. These findings suggested that mental health of stroke survivors and their spouse caregivers was affected by various dyadic coping dimensions.
Our research has the potential to contribute to the understanding dyadic coping and mental health of stroke survivor-spouse caregiver dyads. The findings reveal that the coping strategies employed by stroke couples are closely related to the mental health of both partners.
This study provides evidence for the significant impact of dyadic coping on the psychological well-being of stroke survivors and their spouse caregivers. Therefore, dyadic interventions aiming at strengthening dyadic coping may have positive effects on their mental health.
This study directly involved the patients and family caregivers in hospital settings.
FreshRSS 