BackgroundLow self-efficacy in chronic disease patients is one of the main disturbances which require physical and mental rehabilitation, calling for the development of a home accessible way to improve self-management.ObjectivesThe purpose of this study was to explore the effectiveness of a community based Baduanjin exercise on self-efficacy in adults with cardiovascular disease.DesignA randomized controlled trial, longitudinal research design was employed.ParticipantsAfter screening by health documents in Community Health Service Station, a total of 134 patients with records of cardiovascular diseases were had been enrolled according to the following inclusion criteria: (1) Community dwelling adults in Xili Community; (2) Patients diagnosed with cardiovascular diseases by community doctors, or other clinicians in health records in the past 3 years (2013–2015); (3) independent walking.Participants were excluded if they: (1) had impaired mobility and limited extremities functionality; (2) had not been in stable health condition and could not adhere to the exercise regime; (3) had communication difficulties and limited ability to follow instructions.MethodsParticipants were randomly assigned to the Baduanjin group or the control group. Those in the Baduanjin group received 16 weeks of Baduanjin exercise training, while those in the control group kept the original exercise mode unchanged. The Self-Efficacy for Managing Chronic Disease 6-item Scale (SEMCD6) was administered to subjects before and after intervention.ResultsDemographic data showed that 65.12% of the enrolled 129 participants were aged 65 or older, 92.25% received less than 12 years of education, and 68.21% participants’ monthly income was less than 1999 RMB. Before intervention, SEMCD6 scores of 86.36% participants in Baduanjin group were below 7 points, while 85.71% in control group; after 16 weeks of Baduanjin exercise, SEMCD6 scores lower than 7 points in Baduanjin group (21.21%) were significantly lower than that of the control group (84.13%). The increase of SEMCD6 scores in Baduanjin group was statistically significant in the confidence to keep the fatigue, to keep the physical discomfort or pain, to keep the emotional distress and do the different tasks and activities (P<0.01).ConclusionsAdults with cardiovascular diseases in community have lower level of education, most of whom have a low monthly income; thus, community dwelling cardiovascular disease patients are more suitable for an economic program to persist their long term management of the disease. Baduanjin is a traditional Chinese medicine regimen with less physical and cognitive demand; community based exercise of Baduanjin could help to increase self-efficacy in patients with cardiovascular diseases, thus better self-management of rehabilitation process.
Background The efficacy of stellate ganglion block (SGB) in alleviating postoperative pain remains uncertain. This meta-analysis aimed to determine the efficacy of ultrasound-guided SGB in relieving acute postoperative pain in patients undergoing surgery with general anesthesia. Methods A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted comparing SGB with control or placebo. The primary outcome was pain score at 24h after surgery. Secondly outcomes included postoperative pain scores at other times (0, 2, 4, 6, 8, 12h) and postoperative nausea and vomiting. A random effects model was used to calculate mean difference (MD) or risk ratio (RR) with 95% confidence intervals. Results Eight studies, with a total of 470 patients, were included in this meta-analysis. Ultrasound-guided SGB was associated with lower pain score at 24h after surgery (MD − 0.71; 95% CI: −1.26, − 0.16, p = 0.01, I2 = 86%), with low level of evidence. Ultrasound-guided SGB was also linked to a lower pain score at postoperative 8h (MD − 0.65; 95% CI: −1.03, − 0.28, p = 0.01, I2 = 29%), with moderate level of evidence. There was no difference in pain scores at 0, 2, 4, 6,12 hours after surgery. Conclusion Ultrasound-guided SGB is effective in alleviating acute postoperative pain. However, given the low level of evidence and a limited number of trials, more large-scale and high-quality RCTs are required in the future researches.
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