Background and Purpose—: Evidence shows self-management programs are associated with improved recovery outcomes. This article reports on the effectiveness of a new nurse-led self-efficacy–based stroke self-management program. Methods—: A randomized controlled trial of participants recruited from 3 acute stroke units was conducted. The intervention group received the 4-week stroke self-management program. The control group received usual care. All participants were assessed at baseline and 8 weeks after randomization. Data were analyzed using generalized estimating equations. Outcomes included self-efficacy, outcome expectation, and satisfaction with performance of self-management behaviors. Results—: One hundred twenty-eight participants were randomized with mean age, 67.46 years (SD, 11.95); 59% men; and mean duration poststroke, 45 days (SD, 26.16). At 8 weeks of follow-up in the intention-to-treat population, the intervention group improved significantly in self-efficacy (95% confidence interval, 2.55–12.45; P <0.01), outcome expectation (95% confidence interval, 5.47–14.01; P <0.01), and satisfaction with performance of self-management behaviors (95% confidence interval, 3.38–13.87; P <0.01) compared with the control. Similar results were obtained at 8 weeks of follow-up in the per-protocol population. Conclusions—: The stroke self-management program improved survivors’ self-efficacy, outcome expectation, and satisfaction with performance of self-management behaviors. Clinical Trial Registration—: URL: http://www.clinicaltrials.gov . Unique identifier: NCT02112955.

Background/Objectives: Effective prevention of cardiovascular events in people with hypertension requires optimal control of blood pressure. Despite advances in management, poor adherence to antihypertensive medications is often reported as the major reason attenuating treatment efficacy. Research has provided limited evidence of associations between illness perceptions, satisfaction with consultations, and medication adherence. The aim of this study is to identify factors significantly associated with medication adherence in a group of Chinese older adults with essential hypertension. Design/Setting/Participants: A cross-sectional correlational study was conducted. Data were collected from 195 older adults (mean [SD] age, 76 [6.6] years) recruited from 12 community centers. Measurements: The Illness Perception Questionnaire–Revised was used to measure illness perceptions, and the Medical Interview Satisfaction Scale was used to measure satisfaction with individual consultations. The Morisky Medication Adherence Scale was used to measure the extent of adherence to antihypertensive medications. Multivariate logistic regression analysis was performed to examine factors, including illness perceptions, consultation satisfaction, and demographic and clinical characteristics, that were significantly associated with medication adherence. Results: More than half of the respondents (55.9%) acknowledged some degree of medication nonadherence. Older age, living alone, and perception related to treatment control were independently associated with increased odds of medication adherence, with odds ratios ranging from 1.14 to 1.92 (P < .05). Conclusion: The results highlight the importance of cultivating positive beliefs that hypertension is amenable to control by treatment. Furthermore, the adherence behavior of those of younger individuals and living with family should be closely monitored.

Background: Virtual reality (VR) in different immersive conditions has been increasingly used as a nonpharmacological method for managing chronic musculoskeletal pain. Objective: We aimed to assess the effectiveness of VR-assisted active training versus conventional exercise or physiotherapy in chronic musculoskeletal pain and to analyze the effects of immersive versus nonimmersive VR on pain outcomes. Methods: This systematic review of randomized control trials (RCTs) searched PubMed, Scopus, and Web of Science databases from inception to June 9, 2024. RCTs comparing adults with chronic musculoskeletal pain receiving VR-assisted training were included. The primary outcome was pain intensity; secondary outcomes included functional disability and kinesiophobia. Available data were pooled in a meta-analysis. Studies were graded using the Cochrane Risk-of-Bias Tool version 2. Results: In total, 28 RCTs including 1114 participants with some concerns for a high risk of bias were identified, and 25 RCTs were included in the meta-analysis. In low back pain, short-term outcomes measured post intervention showed that nonimmersive VR is effective in reducing pain (standardized mean difference [SMD] –1.79, 95% CI –2.72 to –0.87; P<.001), improving disability (SMD –0.44, 95% CI –0.72 to –0.16; P=.002), and kinesiophobia (SMD –2.94, 95% CI –5.20 to –0.68; P=.01). Intermediate-term outcomes measured at 6 months also showed that nonimmersive VR is effective in reducing pain (SMD –8.15, 95% CI –15.29 to –1.01; P=.03), and kinesiophobia (SMD –4.28, 95% CI –8.12 to –0.44; P=.03) compared to conventional active training. For neck pain, immersive VR reduced pain intensity (SMD –0.55, 95% CI –1.02 to –0.08; P=.02) but not disability and kinesiophobia in the short term. No statistical significances were detected for knee pain or other pain regions at all time points. In addition, 2 (8%) studies had a high risk of bias. Conclusions: Both nonimmersive and immersive VR–assisted active training is effective in reducing back and neck pain symptoms. Our study findings suggest that VR is effective in alleviating chronic musculoskeletal pain. Trial Registration: PROSPERO CRD42022302912; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=302912

Background: Self-efficacy is a significant factor influencing stroke survivors’ participation in self-care and outcomes. The Stroke Self-Efficacy Questionnaire (SSEQ) is a stroke-specific measure of stroke survivors’ self-efficacy in performing daily functional activities and self-management. However, there has been no Chinese version of the questionnaire. Objective: The current study aims to examine the reliability and validity of a translated Chinese version of SSEQ (SSEQ-C). Methods: The English version of SSEQ has been translated into Chinese. A descriptive study was conducted. A convenience sample of 135 Chinese stroke survivors (mean age 58.9, SD 9.75) was recruited from three community centers and a stroke support group. Eligible participants completed the SSEQ-C, and the Chinese versions of General Self-Efficacy Scale (GSES), Frenchay Activities Index (FAI), and Stroke-Specific Quality of Life Scale (SSQOL). Thirty of the participants completed the questionnaires at baseline and 4 weeks afterwards. Results: SSEQ-C had a high internal consistency (Cronbach’s α 0.92). Test–retest reliability was satisfactory with the intraclass correlation coefficient of the total scale 0.52. Positive correlations were found between the total scores of SSEQ-C, GSES, FAI, and SSQOL (Spearman’s ρ: 0.48–0.68, p < 0.01), suggesting acceptable convergent validity. Principal component analysis suggested a two-factor model, namely “Live with new challenges” and “Activity and exercise engagement” in contrast to the single-factor model for the original questionnaire. Conclusion: The results suggest SSEQ-C is a reliable and valid tool for measuring Chinese community-dwelling stroke survivors’ self-efficacy in managing post-stroke condition. More studies are warranted to confirm the two-factor model of the questionnaire.

BACKGROUND: Stroke survivors constantly feel helpless and unprepared after discharge from hospitals. More flexible and pragmatic support are needed for their optimized recovery. We examined the effects of a virtual multidisciplinary stroke care clinic on survivors’ health and self-management outcomes. METHODS: A randomized controlled trial was conducted. Survivors were recruited from 10 hospitals and randomized at 1:1 ratio into the intervention or the control groups. Intervention group participants received the Virtual Multidisciplinary Stroke Care Clinic service (monthly online consultations with a nurse, follow-up phone calls, and access to an online platform). Control group participants received the usual care. Outcomes of self-efficacy (stroke self-efficacy questionnaire; primary), self-management behaviors (Stroke Self-Management Behaviors Performance Scale), social participation (reintegration to normal living index), and depression (Geriatric Depression Scale; secondary) were measured at baseline, and 3 and 6 months after commencing the intervention (post-randomization). A generalized estimating equations model was used to compare the differential changes in outcomes at 3 and 6 months with respect to baseline between 2 groups. RESULTS: Between July 2019 and June 2022, 335 eligible participants were enrolled in the study. Participants (intervention group; n=166) showed significantly greater improvements in outcomes of self-efficacy (group-by-time interaction regression coefficient, B=4.60 [95% CI, 0.16 to 9.05]), social participation (B=5.07 [95% CI, 0.61 to 9.53]), and depression (B=−2.33 [95% CI, −4.06 to −0.61]), and no significant improvement in performance of self-management behaviors (B=3.45, [95% CI, −0.87 to 7.77]), compared with the control group (n=169) right after the intervention (6 months after its commencement). Hedges’ g effect sizes of the intervention on outcomes: 0.19 to 0.36. CONCLUSIONS: The results provide some positive evidence on the usefulness of the Virtual Multidisciplinary Stroke Care Clinic service. The effect sizes are regarded as small to medium, which may not be of clinical relevance. The baseline levels in outcomes were in favor of the control group, the intervention effects might be overestimated. The service must be tested further to determine its effectiveness. REGISTRATION: URL: https://www.chictr.org.cn ; Unique identifier: ChiCTR1800016101.