Objective: To explore nutritional support under the Neuman systems model in treating dysphagia in stroke patients. Methods: In this retrospective study, we enrolled 97 patients with dysphagia after stroke admitted to ...Objective: To explore nutritional support under the Neuman systems model in treating dysphagia in stroke patients. Methods: In this retrospective study, we enrolled 97 patients with dysphagia after stroke admitted to our hospital, and randomly divided them into the Neuman group (n = 51) given nursing intervention based on Neuman systems model and a control group (n = 46) given routine nursing intervention. Both groups received nutritional support for 3 months. Nutritional indexes (serum total protein, plasma albumin, serum albumin, hemoglobin and transferrin levels) and immune indexes (immunoglobulin (Ig) A, IgG, IgM and total lymphocyte count (TLC) in both groups were recorded and compared. Pulmonary function recovery, video fluoroscopic swallowing study score, water swallowing test score, complication rate, and health knowledge mastery level were also compared between the two groups. Results: After the intervention, the Neuman group showed less decrease in the nutritional and immune index scores (serum total protein, plasma albumin, hemoglobin, serum albumin;IgA, IgG, IgM, and TLC;all P Conclusion: For patients with stroke and dysphagia, comprehensive nursing intervention (e.g., nutritional support) under theNeuman systems model can promote the recovery of immune, swallowing, and pulmonary function, reduce complication incidence and facilitate comprehensive rehabilitation, ensuring adequate nutritional intake.展开更多
Association rules mining is a major data mining field that leads to discovery of associations and correlations among items in today’s big data environment. The conventional association rule mining focuses mainly on p...Association rules mining is a major data mining field that leads to discovery of associations and correlations among items in today’s big data environment. The conventional association rule mining focuses mainly on positive itemsets generated from frequently occurring itemsets (PFIS). However, there has been a significant study focused on infrequent itemsets with utilization of negative association rules to mine interesting frequent itemsets (NFIS) from transactions. In this work, we propose an efficient backward calculating negative frequent itemset algorithm namely EBC-NFIS for computing backward supports that can extract both positive and negative frequent itemsets synchronously from dataset. EBC-NFIS algorithm is based on popular e-NFIS algorithm that computes supports of negative itemsets from the supports of positive itemsets. The proposed algorithm makes use of previously computed supports from memory to minimize the computation time. In addition, association rules, i.e. positive and negative association rules (PNARs) are generated from discovered frequent itemsets using EBC-NFIS algorithm. The efficiency of the proposed algorithm is verified by several experiments and comparing results with e-NFIS algorithm. The experimental results confirm that the proposed algorithm successfully discovers NFIS and PNARs and runs significantly faster than conventional e-NFIS algorithm.展开更多
Stroke is characterized by high incidence,high recurrence,high disability,and high morbidity and mortality in China,resulting in a heavy social and clinical burden.A clinical decision support system,as an intelli-gent...Stroke is characterized by high incidence,high recurrence,high disability,and high morbidity and mortality in China,resulting in a heavy social and clinical burden.A clinical decision support system,as an intelli-gent computer system,can assist nurses in decision-mak-ing to collect information quickly,make the most suitable personalized decisions for patients,and improve nurses’decision-making judgment and quality of care.Promoting the development and application of decision support sys-tems in stroke nursing significantly enhances the nursing staff’s work quality and patients’prognosis.Therefore,this paper reviews the research progress of domestic and international clinical decision support systems in stroke nursing care to provide other researchers with specific research directions for developing and applying decision support systems in stroke nursing care.展开更多
Objective:To describe discharge readiness and determine whether self-efficacy,social support,and the quality of discharge teaching can predict discharge readiness among patients with mild-to-moderate ischemic stroke.M...Objective:To describe discharge readiness and determine whether self-efficacy,social support,and the quality of discharge teaching can predict discharge readiness among patients with mild-to-moderate ischemic stroke.Methods:A total of 120 patients with mild-to-moderate ischemic stroke were recruited using simple random sampling.Five instruments,namely,the Demographic Data Questionnaire,the Chinese version of the Readiness for Hospital Discharge Scale(RHDS_C),the SelfEfficacy for Managing Chronic Disease 6-Item Scale(SES6),the Perceived Social Support Scale(PSSS),and the Quality of Discharge Teaching Scale(QDTS),were used for data collection.Descriptive statistics and standard multiple linear regression were used for data analysis.Results:The mean score of discharge readiness among patients with mild-to-moderate ischemic stroke was at a moderate level(M=7.6,SD=0.92),and 75.8%of the participants felt ready for discharge.Standard multiple linear regression revealed that selfefficacy(β=0.62,P<0.001)and the quality of discharge teaching(β=0.28,P<0.001)were the influencing factors.However,social support could not predict discharge readiness significantly.All the factors combined explained 64.9%of the variance in discharge readiness.Conclusions:Intervention programs aimed at improving self-efficacy and the quality of discharge teaching may be helpful in promoting discharge readiness in patients with mild-to-moderate ischemic stroke,especially in coping ability.展开更多
Stroke research and rehabilitation have traditionally focused on the physical and functional impact of a stroke. Less attention has been given to the psychosocial factors associated with this chronic condition. By the...Stroke research and rehabilitation have traditionally focused on the physical and functional impact of a stroke. Less attention has been given to the psychosocial factors associated with this chronic condition. By the few studies that have specifically focused on psychosocial factors in the context of stroke, poststroke depression is demonstrated to significantly influence stroke outcomes. Associations of stroke with psychological symptoms other than depression have rarely been evaluated. This study was aimed to investigate the changes of psychological stress, social support and medication adherence in patients with ischemic stroke in the mainland of China. In this study, 90 patients with hemiplegia one year after first-ever middle cerebral artery infarction（stroke group） in the Zhongnan Hospital of Wuhan University from June 2008 to June 2011 were recruited for interview. Ninety age- and sex-matched normal volunteers（control group） were also examined at the same period. The psychological distress was assessed by the Symptom Checklist 90（SCL-90）, the social support by the Social Support Rating Scale（SSRS）, and medication adherence by Morisky＇s self-reported inventory, respectively. Group differences were analyzed using unpaired-t test and chi-squared test. The results showed that total mean scores of the SCL-90 in the stroke group were higher than those in the control group（P〈0.01）. Except two dimensions, paranoid ideation and psychoticism, mean scores of the rest dimensions（including somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, and phobic anxiety） of SCL-90 were significantly higher in the stroke group than those in the control group（P〈0.05, or P〈0.01）. The objective support, subjective support, support availability and total social support scores in the stroke group were significantly higher than those in the control group（P〈0.05, or P〈0.01）. Those in the ＂SCL-90 total scores 〉150 group＂ were significantly higher than in the ＂SCL-90 total scores 〈100 group＂ and the ＂SCL-90 total scores between 100 to 150 group＂（P〈0.05, or P〈0.01）. Those in the ＂SCL-90 total scores between 100 to 150 group＂ were significantly higher than in the ＂SCL-90 total scores 〈100 group＂（P〈0.05）. In 90 patients with ischemic stroke, 26（28.89%） patients obtained high medication adherence, 47（52.22%） patients medium medication adherence, and 17（18.89%） patients low medication adherence, respectively. Among these stroke patients, there were 17（50.00%） patients with high medication adherence in the ＂SCL-90 total scores 〉150 group＂, 28（75.67%） patients with medium medication adherence in the ＂SCL-90 total scores between 100 to 150 group＂, and 12（61.16%） patients with low medication adherence in the ＂SCL-90 total scores 〈100 group＂, respectively. There was significant difference in the medication adherence rate among the different SCL-90 scores groups in these stroke patients（P〈0.05 or P〈0.01）. It was led to conclude that ischemic stroke patients one year after hemiplegia have psychological distress, low level of social support and poor medication adherence in the mainland of China. Therefore, it is necessary to mobilize the government, medical institutions and various social support groups to offer psychological interventions to relieve the stress of patients with ischemic stroke, and improve their medication adherence.展开更多
Using a convenience sampling method, 81 aged patients who were between 6 and 24 months post-stroke were selected from five communities of Shanghai, China. The correlations between social support and depression, as wel...Using a convenience sampling method, 81 aged patients who were between 6 and 24 months post-stroke were selected from five communities of Shanghai, China. The correlations between social support and depression, as well as other influential factors, were investigated. Results revealed that 46% （37/81） of the stroke patients suffered from depression. Depression was correlated with social support total scores and the two domains of subjective support and utilization. Older age, male gender, low income, absence of spouse and cerebral hemorrhage were risk factors for depression and identify more vulnerable groups.展开更多
目的探索脑血管病临床决策支持系统(clinical decision support system,CDSS)对卒中医疗服务质量关键绩效指标改进是否具有积极作用。方法回顾性连续纳入首都医科大学附属北京天坛医院血管神经病学2病区应用脑血管病CDSS前(2020年1—11...目的探索脑血管病临床决策支持系统(clinical decision support system,CDSS)对卒中医疗服务质量关键绩效指标改进是否具有积极作用。方法回顾性连续纳入首都医科大学附属北京天坛医院血管神经病学2病区应用脑血管病CDSS前(2020年1—11月)住院治疗的缺血性卒中患者作为对照组,应用脑血管病CDSS后(2021年1—11月)收治的缺血性卒中患者作为干预组,比较两组患者的基线特征和缺血性卒中医疗服务质量关键绩效指标,评估脑血管病CDSS对卒中医疗服务质量的影响。结果本研究共纳入1331例患者,其中对照组651例,干预组680例。对照组平均年龄为(71.7±11.8)岁,男性490例(75.3%);干预组平均年龄(72.3±10.2)岁,男性498例(73.2%)。缺血性卒中医疗服务质量关键绩效指标中,干预组入院48 h内不能行走患者进行深静脉血栓预防率(86.3%vs.65.0%,P<0.01)、出院时患者抗栓治疗率(98.1%vs.96.2%,P=0.03)、出院时合并心房颤动的患者抗凝治疗率(70.1%vs.44.2%,P<0.01)均高于对照组。结论脑血管病CDSS有助于改善缺血性卒中患者的医疗服务质量关键绩效指标。展开更多
目的对同伴支持干预在脑卒中患者中应用的研究进行范围审查,以识别同伴干预的要素及应用现状。方法以乔安娜布里格斯研究所范围综述指南为方法学框架,检索PubMed、Embase、CINAHL、Web of Science、Cochrane Library、中国知网、万方和...目的对同伴支持干预在脑卒中患者中应用的研究进行范围审查,以识别同伴干预的要素及应用现状。方法以乔安娜布里格斯研究所范围综述指南为方法学框架,检索PubMed、Embase、CINAHL、Web of Science、Cochrane Library、中国知网、万方和中国生物医学数据库中相关研究。检索时限为建库至2023年10月28日。结果纳入18篇文献,从纳入文献基本信息、干预类型、同伴支持者类型、会议主题和结局指标5个方面进行了总结与分析。结论同伴支持应用于脑卒中患者具有可行性和有效性,但亟需高质量研究与系统全面的干预方案。未来可进一步完善实验设计,进行更多纵向及质性研究,实施更加全面的效果与效益评估研究,为脑卒中患者提供更符合实际情况的个性化同伴支持干预。展开更多
文摘Objective: To explore nutritional support under the Neuman systems model in treating dysphagia in stroke patients. Methods: In this retrospective study, we enrolled 97 patients with dysphagia after stroke admitted to our hospital, and randomly divided them into the Neuman group (n = 51) given nursing intervention based on Neuman systems model and a control group (n = 46) given routine nursing intervention. Both groups received nutritional support for 3 months. Nutritional indexes (serum total protein, plasma albumin, serum albumin, hemoglobin and transferrin levels) and immune indexes (immunoglobulin (Ig) A, IgG, IgM and total lymphocyte count (TLC) in both groups were recorded and compared. Pulmonary function recovery, video fluoroscopic swallowing study score, water swallowing test score, complication rate, and health knowledge mastery level were also compared between the two groups. Results: After the intervention, the Neuman group showed less decrease in the nutritional and immune index scores (serum total protein, plasma albumin, hemoglobin, serum albumin;IgA, IgG, IgM, and TLC;all P Conclusion: For patients with stroke and dysphagia, comprehensive nursing intervention (e.g., nutritional support) under theNeuman systems model can promote the recovery of immune, swallowing, and pulmonary function, reduce complication incidence and facilitate comprehensive rehabilitation, ensuring adequate nutritional intake.
文摘Association rules mining is a major data mining field that leads to discovery of associations and correlations among items in today’s big data environment. The conventional association rule mining focuses mainly on positive itemsets generated from frequently occurring itemsets (PFIS). However, there has been a significant study focused on infrequent itemsets with utilization of negative association rules to mine interesting frequent itemsets (NFIS) from transactions. In this work, we propose an efficient backward calculating negative frequent itemset algorithm namely EBC-NFIS for computing backward supports that can extract both positive and negative frequent itemsets synchronously from dataset. EBC-NFIS algorithm is based on popular e-NFIS algorithm that computes supports of negative itemsets from the supports of positive itemsets. The proposed algorithm makes use of previously computed supports from memory to minimize the computation time. In addition, association rules, i.e. positive and negative association rules (PNARs) are generated from discovered frequent itemsets using EBC-NFIS algorithm. The efficiency of the proposed algorithm is verified by several experiments and comparing results with e-NFIS algorithm. The experimental results confirm that the proposed algorithm successfully discovers NFIS and PNARs and runs significantly faster than conventional e-NFIS algorithm.
文摘Stroke is characterized by high incidence,high recurrence,high disability,and high morbidity and mortality in China,resulting in a heavy social and clinical burden.A clinical decision support system,as an intelli-gent computer system,can assist nurses in decision-mak-ing to collect information quickly,make the most suitable personalized decisions for patients,and improve nurses’decision-making judgment and quality of care.Promoting the development and application of decision support sys-tems in stroke nursing significantly enhances the nursing staff’s work quality and patients’prognosis.Therefore,this paper reviews the research progress of domestic and international clinical decision support systems in stroke nursing care to provide other researchers with specific research directions for developing and applying decision support systems in stroke nursing care.
文摘Objective:To describe discharge readiness and determine whether self-efficacy,social support,and the quality of discharge teaching can predict discharge readiness among patients with mild-to-moderate ischemic stroke.Methods:A total of 120 patients with mild-to-moderate ischemic stroke were recruited using simple random sampling.Five instruments,namely,the Demographic Data Questionnaire,the Chinese version of the Readiness for Hospital Discharge Scale(RHDS_C),the SelfEfficacy for Managing Chronic Disease 6-Item Scale(SES6),the Perceived Social Support Scale(PSSS),and the Quality of Discharge Teaching Scale(QDTS),were used for data collection.Descriptive statistics and standard multiple linear regression were used for data analysis.Results:The mean score of discharge readiness among patients with mild-to-moderate ischemic stroke was at a moderate level(M=7.6,SD=0.92),and 75.8%of the participants felt ready for discharge.Standard multiple linear regression revealed that selfefficacy(β=0.62,P<0.001)and the quality of discharge teaching(β=0.28,P<0.001)were the influencing factors.However,social support could not predict discharge readiness significantly.All the factors combined explained 64.9%of the variance in discharge readiness.Conclusions:Intervention programs aimed at improving self-efficacy and the quality of discharge teaching may be helpful in promoting discharge readiness in patients with mild-to-moderate ischemic stroke,especially in coping ability.
文摘Stroke research and rehabilitation have traditionally focused on the physical and functional impact of a stroke. Less attention has been given to the psychosocial factors associated with this chronic condition. By the few studies that have specifically focused on psychosocial factors in the context of stroke, poststroke depression is demonstrated to significantly influence stroke outcomes. Associations of stroke with psychological symptoms other than depression have rarely been evaluated. This study was aimed to investigate the changes of psychological stress, social support and medication adherence in patients with ischemic stroke in the mainland of China. In this study, 90 patients with hemiplegia one year after first-ever middle cerebral artery infarction（stroke group） in the Zhongnan Hospital of Wuhan University from June 2008 to June 2011 were recruited for interview. Ninety age- and sex-matched normal volunteers（control group） were also examined at the same period. The psychological distress was assessed by the Symptom Checklist 90（SCL-90）, the social support by the Social Support Rating Scale（SSRS）, and medication adherence by Morisky＇s self-reported inventory, respectively. Group differences were analyzed using unpaired-t test and chi-squared test. The results showed that total mean scores of the SCL-90 in the stroke group were higher than those in the control group（P〈0.01）. Except two dimensions, paranoid ideation and psychoticism, mean scores of the rest dimensions（including somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, and phobic anxiety） of SCL-90 were significantly higher in the stroke group than those in the control group（P〈0.05, or P〈0.01）. The objective support, subjective support, support availability and total social support scores in the stroke group were significantly higher than those in the control group（P〈0.05, or P〈0.01）. Those in the ＂SCL-90 total scores 〉150 group＂ were significantly higher than in the ＂SCL-90 total scores 〈100 group＂ and the ＂SCL-90 total scores between 100 to 150 group＂（P〈0.05, or P〈0.01）. Those in the ＂SCL-90 total scores between 100 to 150 group＂ were significantly higher than in the ＂SCL-90 total scores 〈100 group＂（P〈0.05）. In 90 patients with ischemic stroke, 26（28.89%） patients obtained high medication adherence, 47（52.22%） patients medium medication adherence, and 17（18.89%） patients low medication adherence, respectively. Among these stroke patients, there were 17（50.00%） patients with high medication adherence in the ＂SCL-90 total scores 〉150 group＂, 28（75.67%） patients with medium medication adherence in the ＂SCL-90 total scores between 100 to 150 group＂, and 12（61.16%） patients with low medication adherence in the ＂SCL-90 total scores 〈100 group＂, respectively. There was significant difference in the medication adherence rate among the different SCL-90 scores groups in these stroke patients（P〈0.05 or P〈0.01）. It was led to conclude that ischemic stroke patients one year after hemiplegia have psychological distress, low level of social support and poor medication adherence in the mainland of China. Therefore, it is necessary to mobilize the government, medical institutions and various social support groups to offer psychological interventions to relieve the stress of patients with ischemic stroke, and improve their medication adherence.
基金the Science and Technology Foundation Program of Shanghai Jiao Tong University Medical School, No. YZ1048
文摘Using a convenience sampling method, 81 aged patients who were between 6 and 24 months post-stroke were selected from five communities of Shanghai, China. The correlations between social support and depression, as well as other influential factors, were investigated. Results revealed that 46% （37/81） of the stroke patients suffered from depression. Depression was correlated with social support total scores and the two domains of subjective support and utilization. Older age, male gender, low income, absence of spouse and cerebral hemorrhage were risk factors for depression and identify more vulnerable groups.
文摘目的探索脑血管病临床决策支持系统(clinical decision support system,CDSS)对卒中医疗服务质量关键绩效指标改进是否具有积极作用。方法回顾性连续纳入首都医科大学附属北京天坛医院血管神经病学2病区应用脑血管病CDSS前(2020年1—11月)住院治疗的缺血性卒中患者作为对照组,应用脑血管病CDSS后(2021年1—11月)收治的缺血性卒中患者作为干预组,比较两组患者的基线特征和缺血性卒中医疗服务质量关键绩效指标,评估脑血管病CDSS对卒中医疗服务质量的影响。结果本研究共纳入1331例患者,其中对照组651例,干预组680例。对照组平均年龄为(71.7±11.8)岁,男性490例(75.3%);干预组平均年龄(72.3±10.2)岁,男性498例(73.2%)。缺血性卒中医疗服务质量关键绩效指标中,干预组入院48 h内不能行走患者进行深静脉血栓预防率(86.3%vs.65.0%,P<0.01)、出院时患者抗栓治疗率(98.1%vs.96.2%,P=0.03)、出院时合并心房颤动的患者抗凝治疗率(70.1%vs.44.2%,P<0.01)均高于对照组。结论脑血管病CDSS有助于改善缺血性卒中患者的医疗服务质量关键绩效指标。
文摘目的对同伴支持干预在脑卒中患者中应用的研究进行范围审查,以识别同伴干预的要素及应用现状。方法以乔安娜布里格斯研究所范围综述指南为方法学框架,检索PubMed、Embase、CINAHL、Web of Science、Cochrane Library、中国知网、万方和中国生物医学数据库中相关研究。检索时限为建库至2023年10月28日。结果纳入18篇文献,从纳入文献基本信息、干预类型、同伴支持者类型、会议主题和结局指标5个方面进行了总结与分析。结论同伴支持应用于脑卒中患者具有可行性和有效性,但亟需高质量研究与系统全面的干预方案。未来可进一步完善实验设计,进行更多纵向及质性研究,实施更加全面的效果与效益评估研究,为脑卒中患者提供更符合实际情况的个性化同伴支持干预。
