Patient preference and adherence最新文献

Purpose: This paper compiles the scope of research on exercise rehabilitation intention among patients with cardiovascular diseases and identifies the current landscape, influencing factors, assessment instruments, and intervention strategies related to exercise rehabilitation intention, aiming to inform clinical efforts aimed at encouraging active patient engagement in rehabilitation.

Methods: Eleven Chinese and English databases were systematically searched between the database's creation and August 28, 2024, under the scoping review methodology. Two researchers independently performed literature screening and data extraction.

Results: A total of 25 studies were included (21 in English, 4 in Chinese), 16 specifically assessed exercise rehabilitation intentions in cardiovascular disease patients, approximately half (8/16) of the cardiovascular disease patients exhibited suboptimal exercise rehabilitation intention. The assessment tools for exercise rehabilitation intentions are diverse, with dimensions primarily focused on willingness and planning. Determinants included psychosocial, disease-related, and sociodemographic factors. Identified intervention strategies included group health education, individual psychological support, and motivational interviewing.

Conclusion: Among cardiovascular disease patients exercise rehabilitation intentions remain inconsistent, as approximately half of the studies indicating medium-to-low average levels, which are influenced by several factors. Therefore, to accurately assess patients' levels of exercise rehabilitation intention, further research may focus on enhancing the dimensions, reliability, and validity of assessment tools. Exploring multifaceted and varied intervention strategies could potentially improve patients' exercise rehabilitation intention and compliance.

Objective: Previous research on breast cancer patients has primarily examined singular behavioral indicators, often overlooking the coexistence and interaction between physical activity and sedentary behavior-particularly screen-based sedentary time. This study aims to identify the latent activity pattern categories among breast cancer patients during chemotherapy intervals and explore their associated factors to inform targeted behavioral interventions.

Methods: A cross-sectional survey was conducted with 292 breast cancer patients undergoing chemotherapy intervals at four general hospitals in Foshan, Guangdong Province. Latent Profile Analysis (LPA) was applied as a person-centered analytic approach to identify distinct activity pattern profiles. Data were collected using a general information questionnaire, the Adult Sedentary Behavior Questionnaire (ASBQ), the Chinese version of the International Physical Activity Questionnaire (IPAQ-SC), the Exercise Self-Efficacy Scale (ESES), the Perceived Social Support Scale (PSSS), and the Hospital Anxiety and Depression Scale (HADS).

Results: The activity patterns of breast cancer patients were categorized into three groups: Moderate Activity-Dominant Group (37.33%), Screen-Sedentary High-Risk Group (8.22%), and Activity-Sedentary Coexistence Group (54.45%). Logistic regression analysis showed that, compared to the Moderate Activity-Dominant Group, patients with low exercise self-efficacy and higher anxiety and depression levels were more likely to be classified into the Screen-Sedentary High-Risk Group and Activity-Sedentary Coexistence Group. Higher education levels and being on medical leave were associated with a higher probability of belonging to the Activity-Sedentary Coexistence Group (all P < 0.05).

Conclusion: Activity patterns in breast cancer patients show significant heterogeneity. Healthcare providers should pay attention to the individual physical activity characteristics of patients and offer personalized physical activity guidance. Tailored interventions that meet the needs of breast cancer patients should be developed to improve health outcomes.

Background: Effective self-care is essential for managing type 2 diabetes and preventing complications. However, adherence remains suboptimal. This study assessed self-care behaviors and associated factors among patients with type 2 diabetes in southwestern Iran.

Methods: A cross-sectional study was conducted on 153 patients (selected from 160 invited individuals; response rate: 95.6%) in Behbahan and Susangerd between October 2023 and March 2024. Questionnaires were checked for completeness, and complete-case analysis was performed. Self-care was assessed using the Persian version of the Summary of Diabetes Self-Care Activities (SDSCA). Differences among components were tested using Cochran's Q, and multivariate logistic regression identified factors associated with adherence, with significance set at p < 0.05. An operational cutoff of ≥3.5 days per week was used to define "adequate" self-care.

Results: Adherence differed significantly among components (p < 0.001). It was highest for Diabetes Diet (OR 7.57, 4.63-12.39) and Non-Smoking (OR 5.23, 3.25-8.41) compared with General Diet (39.2%), whereas Glucose Monitoring (OR 0.41, 0.25-0.67), Foot Care (OR 0.07, 0.03-0.17), and Physical Activity (OR 0.03, 0.01-0.10) were substantially lower. Only 8.5% adhered to five or more components. Higher income, older age, longer disease duration, and being single were associated with better adherence to specific behaviors.

Conclusion: Overall self-care was suboptimal, particularly for physical activity and foot care. Targeted interventions focusing on patient education and follow-up, especially for individuals with lower income or education, are urgently needed to improve adherence and reduce diabetes-related complications.

Background: Obesity is a rising public health concern in Palestine and is increasingly recognized as a chronic disease requiring long-term management. Understanding knowledge, attitudes, and practices (KAP) related to obesity and anti-obesity medications is essential for improving prevention and treatment efforts. This study assessed KAP levels and awareness of anti-obesity medications among overweight and obese Palestinian adults.

Methods: A cross-sectional survey was conducted between September and December 2024 using a validated electronic questionnaire distributed through social media platforms. Overweight and obese adults aged 18-80 years were invited to participate.

Results: Among 380 respondents, 85% demonstrated good knowledge of obesity, 65.5% showed positive attitudes, and 50.5% reported good practices. Awareness of anti-obesity medications was high (75.8%), although only 8% had used them.

Conclusion: Despite strong knowledge and generally positive attitudes toward obesity management, practical engagement in healthy behaviors remains suboptimal. Public-health programs and educational interventions are needed to bridge the gap between awareness and effective practice, including better integration of evidence-based pharmacologic options.

Purpose: Patients receiving long-term maintenance hemodialysis (MHD) are prone to psychological distress, which adversely affects their self-management capabilities and overall quality of life. This study explores the experiences and strategies related to positive psychological adjustment in this population, with the aim of informing interventions to improve disease adjustment and quality of life.

Patients and methods: This study, guided by the Roy adaptation model, utilized an interpretative phenomenological methodology. Adopting the patient perspective, semi-structured interviews were used to investigate the experiences of patients undergoing maintenance hemodialysis. From May to July 2025, a purposive sampling approach was employed to recruit 15 patients receiving maintenance hemodialysis from Henan Province, China, who demonstrated positive psychological adjustment. The data was organized via NVivo 12.0 and analyzed via Colaizzi's method.

Results: Four primary themes were identified: (1) Balancing acceptance of physiological limitations with proactive adjustment to life on maintenance hemodialysis; (2) Accurate Self-Repositioning; (3) Pursuing a renewed life by exploring and embracing novel social roles; (4) Drawing upon the strength of kinship and friendship to restore confidence in life.

Conclusion: The psychological adjustment of patients undergoing maintenance hemodialysis is a dynamic process characterized by accepting their health status, reconstructing personal values, and reshaping social roles, with robust social support systems playing a pivotal role in this process. This experiential framework offers critical insights for informing clinical patient management and designing targeted psychological interventions.

Background: The atrial fibrillation better care (ABC) pathway is an effective strategy for the integrated management of atrial fibrillation (AF). However, the adherence rate of ABC pathway in rural Chinese patients with AF is extremely low.

Aim: To explore the factors and mechanisms of adherence to the ABC pathway based on the integrated theory of health behavior change (ITHBC) among rural patients with AF.

Methods: In this cross-sectional study, we recruited 940 patients with AF from rural areas in China from July 2022 to September 2023. Patients completed a questionnaire covering AF-related demographic and clinical characteristics, AF knowledge, AF health beliefs, AF self-management ability, and social support. Adherence to ABC pathway was assessed based on AF-demographic and clinical characteristics. Path analysis was used to explore the relationship between variables.

Results: Adherence to ABC pathway among rural patients with AF was extremely low (5.7%). AF self-management ability (β = 0.449; P<0.001) and social support (β = 0.429; P<0.001) directly and positively affected adherence to ABC pathway. Additionally, AF knowledge (β = 0.211; P<0.001), AF health beliefs (β = 0.350; P<0.001) and social support (β = 0.085; P<0.001) can also indirectly and positively affect adherence to ABC pathway through AF self-management ability. AF knowledge (β = 0.121; P<0.001) can indirectly affect adherence to the ABC pathway through a series of mediations via AF health beliefs and AF self-management ability.

Conclusion: AF knowledge, AF health beliefs, and social support are important intervention components that should be closely integrated with AF self-management ability.

Objective: To explore how patients with PAH experience self-management challenges.

Methods: A descriptive phenomenological research was applied to conduct face-to-face, semi-structured, in-depth interviews with 12 patients diagnosed with PAH recruited from Fuwai Central China Cardiovascular Hospital in Henan Province, from January to June 2025. The collected data were analyzed using Colaizzi's phenomenological analysis method.

Results: Analysis revealed two overarching themes: (1) Individual-level barrier, comprising lack of awareness,insufficient knowledge about medications and disease management, and heavy financial burden; and (2) Contextual challenges, comprising uncertainty about the disease progression, lack of family and social support, poor accessibility to medications, and disruptions due to public health emergencies.

Conclusion: Patients with PAH face significant multi-faceted barriers to effective self-management. Interventions should be multifaceted, involving structured patient education, psychological support, family involvement, and policy-level changes to improve drug accessibility and financial support.

Objective: Oral cancer patients frequently experience high rates of dysphagia, multiple complications, and poor rehabilitation compliance post-surgery. This study aims to evaluate the effectiveness of specialized nurse-led dysphagia rehabilitation program in improving patients' swallowing function, quality of life, adherence, and nutritional status.

Methods: A single center randomized controlled trial design was employed. 89 patients admitted to the Department of Oral and Maxillofacial Surgery at Zhejiang Cancer Hospital between July 17, 2025, and October 20, 2025, were randomly assigned to an intervention group (n=45) or a usual care group (n=44). The intervention group received a comprehensive rehabilitation program (diagnostic phase, perioperative phase, pre-discharge preparation phase, adjustment and adaptation phase) implemented by a multidisciplinary team led by specialized nurses, supported by a WeChat mini-program. The usual care group received a standard rehabilitation program. Outcome measures included functional oral intake scale, swallowing-related quality of life scale, swallowing function exercise compliance scale, and body mass index. Assessments were conducted at baseline (T0), 1 week post-surgery (T1), 2 weeks (T2), and 4 weeks (T3). Generalized estimating equations were used to analyze changes in outcomes over time.

Results: Post-intervention, the intervention group demonstrated significantly superior scores compared to the usual care group in swallowing function (at T2 and T3), quality of life (at T1, T2, and T3), and adherence (at T1, T2, and T3). Nutritional status was also significantly better in the intervention group at T1 and T2. Generalized estimating equations analysis revealed statistically significant group-by-time interaction effects for swallowing function, quality of life, adherence, and nutritional status.

Conclusion: Compared with conventional rehabilitation protocols, a swallowing rehabilitation program led by specialized nurses effectively improves swallowing function, quality of life, adherence, and early nutritional status in patients after oral cancer surgery.

Introduction: Perinatal depression affects 17.7% of women globally, with prevalence reaching 20-30% in China and higher in low-income regions. It poses severe risks, including adverse pregnancy outcomes, maternal suicide, and infanticide. Despite its high prevalence, many cases go undiagnosed due to low screening participation. Screening is cost-effective and reduces depression risk by 2.1-9.1%, yet current strategies often fail to align with patient preferences. In this study, a discrete choice experiment was utilized to assess women's preferences for postpartum depression screening characteristics, and to quantify trade-offs and preference heterogeneity, providing information for a more patient-centered approach.

Methods: We identified six key screening attributes through literature review, interviews, and focus groups. A D-efficiency design approach was implemented to create 36 choice sets and randomly divide them into 3 blocks. A mixed logit model was applied to analyze participants' preferences, assess the relative importance of attributes, and predict the choice probabilities of participants for screening situations.

Results: There are 291 respondents were included in analysis. Healthcare provider type emerged as the most important screening characteristic (27% relative importance), with strongest preference for doctor-led screenings. Women consistently preferred shorter screening duration (15 minutes). Younger women (18-34 years) preferred online screening, while Postpartum women showed stronger preferences for telephone screenings. The most preferred scenario-online by a physician, lasted 15 minutes, occurred every three months, and provided as a rouhad a 0.270 predicted choice probability. These findings highlight the need for tailored screening approaches based on age and pregnancy status.

Conclusion: This study identified a preference for brief, physician-led screening with follow-up. To enhance implementation in primary care, particularly in resource-limited settings, we recommend integrating short screenings into routine visits and utilizing trained non-specialists with digital support. These strategies can improve screening accessibility and long-term management.