The effectiveness of a comprehensive reminder system in the secondary prevention of hypertensive ischaemic stroke: randomized controlled trial protocol

Wan, Li-Hong; You, Liming; Chen, Shaoxian; Zhang, Xiao-Pei; Mo, Miao-Miao; Zhang, Yingmei; Ou, Cui-Ling; Ao, You-Ai; Xiong, Xiao-Ni; Zhang, Min; Lu, Yu‐Wei

doi:10.1111/jan.13095

Cited by 12 publications

(35 citation statements)

References 36 publications

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“…One study [ 35 ] had three arms (two intervention arms and an attention matched control arm that performed an upper limb training programme). The remaining eight studies [ 31 – 34 , 36 – 39 ] had two arms (intervention versus usual care/attention matched control).…”

Section: Resultsmentioning

confidence: 99%

“…Six studies included short- (3-months [ 32 – 34 , 36 , 38 , 39 ]) and medium-term follow-up periods (6-months [ 31 – 34 , 36 , 37 ]), with only two studies conducting long-term (12 months [ 31 , 35 ]) follow-up assessments.…”

Section: Resultsmentioning

confidence: 99%

“…One intervention was rated as very promising [ 31 ], five as quite promising [ 32 – 36 ] and three as non-promising [ 37 – 39 ]. Inter-rater reliability for assessment of promise was 89% indicating excellent agreement between coders.…”

Section: Resultsmentioning

confidence: 99%

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How should long-term free-living physical activity be targeted after stroke? A systematic review and narrative synthesis

Moore

Hrisos

Flynn

et al. 2018

Int J Behav Nutr Phys Act

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BackgroundIncreasing physical activity (PA) levels (regular movement such as walking and activities of daily living) and reducing time spent sedentary improves cardiovascular health and reduces morbidity and mortality. Fewer than 30% of independently mobile stroke survivors undertake recommended levels of PA. Sedentary behaviour is also high in this population. We aimed to systematically review the study characteristics and the promise of interventions targeting free-living PA and/or sedentary behaviour in adult stroke survivors.MethodsSeven electronic databases were searched to identify randomised controlled trials (≥3-months follow-up) targeting PA and/or sedentary behaviour in adults with first or recurrent stroke or transient ischaemic attack. The quality assessment framework for RCTs was used to assess risk of bias within and across studies. Interventions were rated as “very”, “quite” or “non-promising” based on within- or between-group outcome differences. Intervention descriptions were captured using the TIDieR (Template for Intervention Description and Replication) Checklist. Behaviour change techniques (BCTs) within interventions were coded using the BCT Taxonomy v1, and compared between studies by calculating a promise ratio.ResultsNine studies fulfilled the review criteria (N = 717 randomised stroke patients) with a high or unclear risk of bias. None of the studies targeted sedentary behaviour. Six studies were very/quite promising (reported increases in PA post-intervention). Studies were heterogeneous in their reporting of participant age, time since stroke, stroke type, and stroke location. Sub-optimal intervention descriptions, treatment fidelity and a lack of standardisation of outcome measures were identified. Face to face and telephone-based self-management programmes were identified as having promise to engage stroke survivors in PA behaviour change. Optimal intensity of contact, interventionist type and time after stroke to deliver interventions was unclear. Nine promising BCTs (ratios ≥2) were identified: information about health consequences; information about social and environmental consequences; goal setting-behaviour; problem-solving; action planning; feedback on behaviour; biofeedback; social support unspecified; and credible source.ConclusionsFuture research would benefit from establishing stroke survivor preferences for mode of delivery, setting and intensity, including measurement of physical activity. Interventions need to justify and utilise a theory/model of behaviour change and explore the optimal combination of promising BCTs within interventions.Electronic supplementary materialThe online version of this article (10.1186/s12966-018-0730-0) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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How should long-term free-living physical activity be targeted after stroke? A systematic review and narrative synthesis

Moore

Hrisos

Flynn

et al. 2018

Int J Behav Nutr Phys Act

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“…This study showed that the changes in mRS score of both control group (change = −0.31, p = .004) and intervention group (change = −0.59, p < .001) were statistically significant at 6‐month after discharge. This may be because the patients with physical disability would seek functional rehabilitation actively (Wan, 2017). The main factors influencing functional rehabilitation of stroke patients should be further explored in the future.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, a Comprehensive Reminder System based on Health Belief Model (CRS‐HBM) was established (Wan, You, et al, 2016) and the 3‐month results showed that the CRS‐HBM improved health behaviour and BP control and decreased the severity of disability in hypertensive ischemic stroke patients (Wan, Zhang, You, Ruan, & Chen, 2018). Health behaviours and effective BP control were very important for secondary prevention of stroke.…”

Section: Introductionmentioning

confidence: 99%

Factors influencing health behaviour, blood pressure control, and disability in hypertensive ischaemic stroke patients after a comprehensive reminder intervention

Zhang

Pan

Wan

et al. 2020

Journal of Advanced Nursing

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Aims:To test prospective pathways of a Comprehensive Reminder System based on the Health Belief Model (CRS-HBM), stroke knowledge, health belief in health behaviour, blood pressure (BP) control, and disability in hypertensive ischaemic stroke patients at 6-month postdischarge.Design: A nested cohort study design. Methods: Data were derived from a randomized controlled trial evaluating the effects of the intervention (N = 174, performed during February 2015 -March 2016). Data were collected by questionnaires and analysed in structural equation modelling in Mplus software. Results: The proposed model provided a good fit to the data. This model accounted for 51.5% of the variance in health behaviour, 34.1% in BP control, and 5.7% in modified Rankin Scale score at 6-month postdischarge. The CRS-HBM had: (a) direct positive effect (β = .391, p < .001) and indirect positive effects (β = .186, p = .002) on health behaviour; (b) direct positive effect (β = .356, p < .001) and indirect positive effects (β = .183, p = .009) on BP control; and (c) indirect negative effect (β = −.146, p = .008) on disability. Being female was linked to better health behaviour. Higher education predicted higher level of stroke knowledge and health belief. Conclusions:The CRS-HBM can not only directly but also indirectly improve patients' health behaviours by improving their health knowledge or health belief. Better health behaviour can improve patients' BP control and reduce disability. Therefore, nurses need to pay more attention to not only patients' health knowledge but also their health belief when providing education. Impact:The CRS-HBM intervention accounted for 51.5% of variance in health behaviour, 34.1% in BP control, and 5.7% in modified Rankin Scale score at 6-month postdischarge. This research can help nurses improve health education strategies in postdischarge and community contexts to achieve better health results. | 1385ZHANG et Al.

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Application of a nurse‐led transitional care programme for patients discharged with T‐tubes after biliary surgery

Wang

Hua

et al. 2023

Nursing Open

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In recent decades, the use of Kehr's tube, more commonly known as the T-tube, has decreased significantly due to advances in biliary surgery (Padmore et al., 2021). It has been suggested that routine placement of a T-tube is unnecessary in common bile duct explorations for simple bile duct stones (Zhu et al., 2021) or in liver transplantation (Zhao et al., 2021). However, for select complex hepatobiliary stones, biliary tumours and biliary tract repair surgeries, intraoperative placement of a T-tube remains a common procedure (Jabłonska, 2014;Padmore et al., 2021). In such cases, T-tube placement can reduce the incidence of bile leakage due to high bile duct pressures (Strücker et al., 2013), provide structural support to the bile duct thereby preventing biliary stenosis (Nagino et al., 2007) and facilitate post-operative retrieval of residual stones through the sinus of the drainage tube (Mori et al., 2006;Wen et al., 2018).T-tubes are typically left in place for 4-8 weeks. In some patients with residual stones or biliary pathological abnormalities, the removal of the T-tube must be deferred for up to 3 months or more (Zhang et al., 2015). According to reports, the average length of stay (LOS) for biliary surgery is approximately 6-11 days (Noba

show abstract

The effectiveness of a comprehensive reminder system in the secondary prevention of hypertensive ischaemic stroke: randomized controlled trial protocol

Cited by 12 publications

References 36 publications

How should long-term free-living physical activity be targeted after stroke? A systematic review and narrative synthesis

How should long-term free-living physical activity be targeted after stroke? A systematic review and narrative synthesis

Factors influencing health behaviour, blood pressure control, and disability in hypertensive ischaemic stroke patients after a comprehensive reminder intervention

Application of a nurse‐led transitional care programme for patients discharged with T‐tubes after biliary surgery

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