Health Scale Research Articles

Traditional Value Identity and Mental Health Correlation Among Chinese Adolescents

This study explores the identity of traditional values among Chinese adolescents and its correlation with their mental health. A questionnaire survey, utilizing the Confucian Traditional Values Scale and the Secondary School Students’ Mental Health Scale, was conducted with 500 students from Grade 7 through the final year of college. Our results showed the following: (1) adolescents generally agree with traditional values; (2) there were no significant differences in overall agreement with traditional values among adolescents based on their gender, place of birth, class cadre status, only-child status, or academic major, though differences were observed in specific dimensions based on these variables; (3) traditional values identity varied across grade levels, with senior high school students showing notably higher identification than junior high school and college students, peaking in the second year of senior high school; and (4) there is a significant negative correlation between adolescents’ traditional values identity scores and their mental health scores, indicating that higher traditional values identity scores are associated with better mental health levels. These findings highlight the positive influence of traditional values on the development and well-being of Chinese adolescents, underscoring the importance of integrating these values into educational and developmental frameworks in China and other East Asian regions with similar cultural backgrounds.

The impact of health literacy on health-promoting lifestyle among community residents: the chain-mediating role of family health and physical activity

BackgroundAdopting health-promoting lifestyle (HPL) is crucial for improving overall well-being and reducing the risk of chronic diseases. The relationship between health literacy (HL) and HPL among Chinese community residents is complex, with potential mediating factors yet to be fully understood. Family health and physical activity (PA) may play significant roles in this relationship. This study aims to construct a chain mediation model to explore whether family health and PA mediate the effects of HL on HPL in Chinese community residents.MethodsUsing the convenient sampling method, 1,072 Chinese community residents were selected for a cross-sectional study. All participants completed a self-report questionnaire that collected demographic information, as well as data from the Health Literacy Scale Short-Form (HLS-SF12), Family Health Scale Short-Form (FHS-SF), Physical Activity Rating Scale (PARS-3), and Health Promoting Lifestyle Profile-II Revise (HPLP-II R). Data were analyzed using SPSS 26.0, with mediation analysis performed using the SPSS PROCESS macro.ResultsThere were significant pairwise correlations between HL, family health, PA, and HPL (p < 0.01). HL was directly linked to HPL (effect = 0.442; SE = 0.025; 95% CI: 0.392, 0.491). Additionally, three indirect pathways were identified: family health independently mediated 6.02% of the effect (effect = 0.032; SE = 0.010; 95% CI: 0.013, 0.051), PA also independently mediated 9.02% of the effect (effect = 0.048; SE = 0.010; 95% CI: 0.030, 0.068), and a combined chain mediation through both family health and PA accounted for 1.88% of the effect (effect = 0.010; SE = 0.003; 95% CI: 0.005, 0.017).ConclusionHL not only has a direct impact on promoting HPL but also influences it indirectly through the mediating roles of family health and PA. These insights elucidate the mechanisms by which HL affects HPL, providing valuable theoretical guidance for the development and implementation of effective strategies to encourage healthy lifestyle practices.

Assessing Disease Self-Management in Multi-Ethnic Patients with Chronic Conditions and Evaluating Psychometric Properties of the Partners in Health Scale

Assessing Disease Self-Management in Multi-Ethnic Patients with Chronic Conditions and Evaluating Psychometric Properties of the Partners in Health Scale

Is Frailty Discouraging Surgeons from Performing Thoracolumbar Fusion? A Retrospective Study.

Retrospective cohort study. To evaluate whether frailty scoring is associated with adverse outcomes and management of thoracolumbar fractures (TLF) patients. Trauma patients with TLF often face longer recovery. The Canadian Study of Health and Aging clinical frailty scale (CSHA-CFS) predicts outcomes in older trauma patients. Adult trauma patients admitted from 2017 to 2021 who presented with TLF were included. Frailty was scored using CSHA-CFS. Endpoints were in-hospital mortality, hospital length of stay, surgery, complications, and discharge disposition. Multivariate analyses adjusting for baseline characteristics were performed. P<0.05 was considered significant. Overall, 1456 patients were included; 1013 fit, 240 pre-frail, and 203 frail. Frail patients underwent fewer surgeries (OR=0.5 [0.32-0.77], P=0.002). TL fusion was associated with lower mortality (OR=0.31 [0.11-0.85], P=0.024). Pre-frailty and frailty were associated with increased risk of pneumonia (OR=2.522 [1.428-4.456], P=0.001; OR=2.93 [1.32-6.54], P=0.008, respectively) and death (OR=3.581 [1.853-6.921], P<0.001; OR=2.46 [1.07-5.67], P=0.035). Pre-frail and frail patients were more likely to discharge to skilled nursing facilities (OR=1.687 [1.024-2.780], P=0.04; OR=4.89 [2.66-9.0]), P<0.001). Pre-frailty and frailty were associated with poor outcomes and higher level of care at discharge. Frail patients were less likely to undergo TL fusion, despite its association with improved survival. This suggests frailty should not discourage surgeons from performing thoracolumbar fusion. Frailty scoring upon admission may help guide management and set realistic expectations for patients and their families.

The Relationship of Emergency Contraception Knowledge of Young Individuals with Family Planning, Sexual and Reproductive Health Attitudes: A Cross-Sectional Study

Aim: To investigate the relationship between emergency contraception (EC) knowledge and attitudes towards family planning and sexual and reproductive health (SRH) among men and women aged 18-25 years living in Turkey and studying at university. Methods: The cross-sectional study was conducted between August-October 2023 with 492 participants Turkey. The data of the study were obtained through "Data Collection Form" and "Reproductive Health and Family Planning Attitude Scale (RHFPAS)". Results: In women, there was a significant difference between those who had heard of EC, knew the time of use, access, and side effects and RHFPAS. In men, there was a statistically significant difference between those who had heard of EC, time of use, access and side effects and infertility and assisted reproductive treatments. There was a weak moderate positive correlation between SRH knowledge level and RHFPAS total mean score in women and men(p

Characterization of baseline symptoms and functional impairments in a large cohort of outpatients attending a long covid rehabilitation clinic in the United Kingdom

Objective: In response to the high prevalence and morbidity associated with long COVID (LC), outpatient rehabilitation programmes were created across jurisdictions. We aimed to characterize baseline symptoms and impairments of patients attending outpatient LC rehabilitation. Design: This study was a retrospective quality-improvement analysis. Subjects/Patients: Patients attending outpatient LC rehabilitation at the Oxfordshire Post-Covid Service. Methods: Data included age/sex and 6 questionnaires performed at baseline: Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Dyspnoea-12 (D12), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Assessment-7 (GAD-7), Visual Analogue Scale (VAS) of self-rated health, and the Work And Social Adjustment Scale (WSAS). All scores were dichotomized (indicating presence/absence of clinically significant pathology). Potential differences between age (&lt;/≥ 50 years) and sex were assessed using χ2 tests. Results: A total of 422 patients were included (mean/standard deviation [SD] age = 47.1/13.2;132/31.3% male). A total of 76% had significant fatigue (FACIT-F), 69% had breathlessness (D12), 55% had depression (PHQ-9), 34% had anxiety (GAD-7), 41% self-reported poor health (VAS), and 57% had work/social life dysfunction (WSAS). D12 scores differed between age groups (older &gt; younger, χ2 = 3.19/p = 0.048), with no differences observed on other scales. Conclusion: In this preliminary study, a high proportion of LC outpatients had significant impairments across domains. The findings of this study reaffirm the need for high-quality, multidisciplinary LC rehabilitation, and may be used to help build a standardized set of outcome measures moving forward.

Shared care in heart failure management is linked with physical and mental health by perceived control in patient-caregiver dyads

Abstract Background Patients with heart failure (HF) and their family caregivers have interdependent relationships in managing HF. Shared care within dyads refers to interpersonal interactions characterized by exchanging care and support in chronic illness management. High levels of shared care improve patients’ health outcomes, but it is unclear if shared care is equally beneficial for caregivers. Also unknown is how shared care contributes to the outcomes of both dyad members. We propose that perceived control may be critical in the link between shared care and health status for dyads. Thus, the purpose of this study was to determine whether perceived control over one’s health mediates the association between shared care and physical and mental health in patients with HF and their caregivers. Method Patients with HF and their primary caregivers (N=151 dyads) completed questionnaires in this cross-sectional study. Shared care, perceived control over one’s own health, and health status were assessed using the three subscales of the Shared Care Instrument (i.e., communication, decision-making, and reciprocity), the Cardiac Attitudes Scale-Revised, and the Medical Outcomes Study Health Survey-36, physical and mental health scales, respectively. A series of actor-partner interdependence models with mediation dyadic analyses were conducted. Results Patients with HF (mean age 60.3 Years, 64% male) and their caregivers (mean age 56.6 years, 75% female) reported similar levels of communication and reciprocity in shared care, but patients reported higher scores of decision-making in shared care than their caregivers (P &amp;lt; .001). Perceived control over one’s own health significantly mediated the association between communication and physical health (indirect actor effect = .1487; 95% CI: 0.0478 to 0.2759) and between communication and mental health (indirect actor effect = .1650; 95% CI: 0.0454 to 0.3260) for patients, not caregivers (Figures A1 &amp; A2). Similarly, perceived control significantly mediated the association between reciprocity and physical and mental health for patients, not caregivers (Figures B1 &amp; B2). Perceived control mediated the association of decision-making with physical health and mental health for caregivers, not patients (Figures C1 &amp; C2). Conclusion Higher levels of communication and reciprocity increased patients’ perceived control, ultimately improving their physical and mental health, whereas caregivers’ decision-making improved their health by enhancing their perceived control over their health. The different patterns of shared care are linked to the health of patients and caregivers by enhancing perceived control over one’s health.Figure A &amp; BFigure C

How to measure the general Environmental Health Literacy

Abstract Background Many environmental factors, both natural or man-made, are associated with health risks. To make informed decisions about these potential risks, certain skills and competencies are necessary. The concept of Environmental Health Literacy (EHL) which integrates aspects of Science Literacy, Health Literacy and Environmental Literacy encompasse these competencies. To assess to what extent individuals or groups are environmental health literate, a general Environmental Health Literacy Scale is necessary. To the best of our knowledge, there is no validated instrument to measure general EHL. Methods Two phases of scale construction were conducted: 1) Item development with deductive methods which includes a literature review and assessment of existing scales resulting in two suitable studies for scale construction. Included items were translated to German language. 2) Scale development with pre-testing of items followed by applying potential items (n = 38) to a sample of of 454 students. Internal consistency (Cronbach’s alpha), Kaiser-Meyer-Olkin Criterion (KMO), Bartlett’s test, Velicer’s minimum average partial (MAP) test for number of underlying factors and Exploratory Factor Analysis using Principal Component Analysis with oblimin rotation and stepwise item reduction were assessed. Results Velicer’s MAP identified 3 factors, Cronbach’s alpha = .92, KMO = .92, Bartlett’s Test revealed significant correlation. Seven items were removed from the scale due to low factor loadings (&amp;lt; .3). Factor 1 (access) explains 18% of variance, factor 2 (knowledge) 12% and factor 3 (reflection) 10%, respectively. Overall, the model explains 40% of variance. Model fit represented by RMSEA index = .05. Conclusions A new general EHL scale has been developed and proven to be suitable for a students sample. This marks the first step towards a validated tool for multiple purposes. Cultural adaptation as well as multiple language validations are in process. Key messages • The process towards a general Environmental Health Scale has started. • The development of a validated EHL scale will improve understanding on whether the general population or subgroups are able to gain, understand and act upon information regarding environmental health.

An anthropological critique of psychiatric rating scales

SUMMARY This article discusses sceptical arguments about measurement scales. Measurement scales are part of a promising agenda of openness, transparency and patient and public involvement (PPI) in medical research, but have received critical, sometimes hostile attention from anthropologists. This is because scales repackage localised cultural assumptions about distress as something universal and pan-human and have the capacity to reshape people's interior lives in unhelpful, possibly harmful ways. We take as an example the Patient Health Questionnaire-9 (PHQ-9). Use of the PHQ-9 is currently mandated by major funders. But its history suggests flawed PPI and a lack of openness. The article suggests a constructive role for anthropology in mental health research, using ethnographic evidence and theory to show how, although they have their uses, mental health scales should not be regarded as inert or harmless.

Improved health-related quality of life in patients with recurrent Clostridioides difficile infection after treatment with faecal microbiota transplantation

Background Clostridioides difficile is a major burden for both healthcare systems and the patients. Faecal microbiota transplantation (FMT) is becoming more common as a treatment since it reduces the risk of recurrent Clostridioides difficile infection (rCDI). Objectives To evaluate how treatment with FMT is affecting the health-related quality of life (HRQoL) in patients with rCDI. Methods A prospective observational cohort study was conducted where patients who were offered FMT as a treatment for rCDI were asked to fill in a questionnaire based on the Short Health Scale (SHS) and EuroQol 5-Dimensions 5-Levels (EQ-5D-5L) about their HRQoL before and after treatment. Results Patients with rCDI had poor HRQoL, which improved following FMT. Conclusions Since FMT cures, reduces the risk of new recurrences of CDI and improves the HRQoL of the patients, it should be offered as a treatment for patients with rCDI. Also, SHS is a useful and reliable instrument for measuring HRQoL in patients with rCDI.

The mediating impact of exercise frequency and duration on the relationship between digital health literacy and health among older adults: A cross-sectional study.

Although several studies have discussed the relationships among digital health literacy, health, and exercise behavior, few have integrated these 3 factors into a single model. This study aims to address this research gap. This article aims to analyze the impact of digital health literacy on the health of older adults, as well as the mediating mechanisms related to exercise frequency and duration. A cross-sectional survey was conducted in Luoyang and Zhengzhou urban areas from December 2023 to January 2024. Utilizing random sampling methods, data were collected from 661 older adults through the "digital health literacy scale," "health scale," and "count of exercise duration and frequency" questionnaires. The data were processed by employing SPSS 20 and Process, v3.0, and analyzed through independent samples t test, 1-way ANOVA (F-test), and mediation testing methods. The results indicate that no statistical significance (P > .05) is observed in terms of the 3 dimensions of digital health literacy, exercise behavior, and health status among older adults with different genders, living conditions, educational backgrounds, and economic status. In contrast, statistical significance (P < .05) is observed in terms of exercise frequency and health status among older adults with varying levels of smoking and drinking. The 3 dimensions of digital health literacy among older adults statistically impact (P < .05) their exercise duration, frequency, and health. The dimension of access and assessment exerts the most significant influence on exercise duration (β = 0.415) and a considerable impact on health (β = 0.214). Furthermore, the impact of exercise duration and frequency on health status is statistically significant (P < .05). In terms of the interactive capability dimension, exercise frequency exerts the most significant influence (β = 0.199). Digital health literacy has a significant impact on the health of older adults. The duration and frequency of exercise play a partial mediating role between older adults' digital health literacy and their physical health status. Digital health literacy can encourage older adults to increase the duration and frequency of exercise, which, in turn, promotes their physical health.

A Review of Survey Instruments and Pharmacy Student Outcomes for Stress, Burnout, Depression and Anxiety.

While the need to measure burnout, stress and mental health among pharmacy students has been emphasized in the literature, there is limited information on which validated scales should be used. The objective of this scoping review was to identify published studies that used validated scales for burnout, stress and mental health among pharmacy students to provide recommendations for implementation at schools/colleges of pharmacy. Thirty-two out of 153 articles published in the United States from 1 January 2000 to 30 September 2022 were included and categorized into studies measuring stress (20), burnout (4) and depression/anxiety (8). The most common validated scales used to assess stress and burnout among pharmacy students were the Perceived Stress Scale (PSS) and the Maslach Burnout Inventory and the Oldenburg Burnout Inventory, respectively. For mental health, anxiety was most commonly investigated using a variety of scales such as the Generalized Anxiety Disorder-7; the Patient Health Questionnaire, 9-item was used to measure depression in two studies. Validity, ease of use, cost and generalizability are important considerations for selecting a scale. The PSS has been studied extensively in pharmacy students and has been correlated with other well-being domains. Studies that measured burnout and mental health (specifically, depression and anxiety) have less published evidence among pharmacy students.

Describing the Framework for AI Tool Assessment in Mental Health and Applying It to a Generative AI Obsessive-Compulsive Disorder Platform: Tutorial.

As artificial intelligence (AI) technologies occupy a bigger role in psychiatric and psychological care and become the object of increased research attention, industry investment, and public scrutiny, tools for evaluating their clinical, ethical, and user-centricity standards have become essential. In this paper, we first review the history of rating systems used to evaluate AI mental health interventions. We then describe the recently introduced Framework for AI Tool Assessment in Mental Health (FAITA-Mental Health), whose scoring system allows users to grade AI mental health platforms on key domains, including credibility, user experience, crisis management, user agency, health equity, and transparency. Finally, we demonstrate the use of FAITA-Mental Health scale by systematically applying it to OCD Coach, a generative AI tool readily available on the ChatGPT store and designed to help manage the symptoms of obsessive-compulsive disorder. The results offer insights into the utility and limitations of FAITA-Mental Health when applied to "real-world" generative AI platforms in the mental health space, suggesting that the framework effectively identifies key strengths and gaps in AI-driven mental health tools, particularly in areas such as credibility, user experience, and acute crisis management. The results also highlight the need for stringent standards to guide AI integration into mental health care in a manner that is not only effective but also safe and protective of the users' rights and welfare.

Early Changes in Health-Related Quality of Life as a Biomarker of Survival in African Patients with HIV-Associated Kaposi Sarcoma.

Sub-Saharan Africa bears the largest public health burden of Kaposi sarcoma (KS), a leading cause of cancer mortality. Quality of life (QOL) assessments in cancer patients can provide information on prognosis beyond traditional biomarkers or biological measures. The prognostic value of QOL measures in patients with HIV-KS was evaluated. Prognostic associations of baseline QOL scores (by quartiles or thresholds for clinical importance) and changes in QOL scores (using minimum important difference) over the first 3 months of therapy were evaluated in 112 participants with HIV-KS randomised to receive ART, with or without chemotherapy. Cox's regression analysis assessed the prognostic contribution of QOL scores from the EORTC QLQ-C30 questionnaire. Survival curves were generated using the Kaplan-Meier method. Baseline QOL scores did not predict overall survival. The change in the 3-month QOL scores for the global health scale, fatigue, and pain domains was prognostic; the hazard ratios were 3.88 (95% CI 1.32-11.38, p = 0.01), 3.72 (95% CI 1.61-8.62, p = 0.00) and 5.96 (95% CI 2.46-14.43, p = 0.00), respectively. QOL assessments can provide useful prognostic information in patients with HIV-KS. Patients lacking meaningful improvement early into treatment represent a population at high risk of death.

Oxygen Extraction Fraction Mapping on Admission Magnetic Resonance Imaging May Predict Recovery of Hyperacute Ischemic Brain Lesions After Successful Thrombectomy: A Retrospective Observational Study.

In acute stroke, diffusion-weighted imaging (DWI) is used to assess the ischemic core. Dynamic-susceptibility contrast perfusion magnetic resonance imaging allows an estimation of the oxygen extraction fraction (OEF), but the outcome of DWI lesions with increased OEF postrecanalization is unclear. This study investigated the impact of OEF on the fate of DWI lesions in patients achieving recanalization after thrombectomy. This was a retrospective analysis of the HIBISCUS-STROKE cohort (Cohort of Patients to Identify Biological and Imaging Markers of Cardiovascular Outcomes in Stroke; NCT: 03149705), a single-center observational study that prospectively enrolled patients who underwent magnetic resonance imaging triage for thrombectomy and a day-6 T2-fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging. Automated postprocessing of admission dynamic-susceptibility contrast perfusion magnetic resonance imaging generated OEF maps. At visual analysis, the OEF status within DWI lesions was assessed in comparison to the contralateral side and correlated with volume changes (difference of ischemic lesion between admission DWI and registered day-6 T2-FLAIR). At voxel-based analysis, recovered DWI regions (lesions present on the admission DWI but absent on the registered day-6 T2-FLAIR) and nonrecovered regions were segmented to extract semiquantitative OEF values. Of the participants enrolled from 2016 to 2022, 134 of 321 (41.7%) were included (median age, 71.0 years; 58.2% male; median baseline National Institutes of Health Scale score, 15.0). At visual analysis, 46 of 134 (34.3%) patients had increased OEF within DWI lesions. These patients were more likely to show a reduction in ischemic lesion volumes compared with those without increased OEF (median change, -4.0 versus 4.8 mL; P<0.0001). Multivariable analysis indicated that increased OEF within DWI lesions was associated with a reduction in ischemic lesion volumes from admission DWI to day-6 T2-FLAIR (odds ratio, 0.68 [95% CI, 0.49-0.87]; P=0.008). At voxel-based analysis, recovered DWI regions had increased OEF, while nonrecovered regions had decreased OEF (median, 126.9% versus -27.0%; P<0.0001). Increased OEF within hyperacute DWI lesions was associated with ischemic lesion recovery between admission DWI and day-6 T2-FLAIR in patients achieving recanalization after thrombectomy. URL: https://www.clinicaltrials.gov; Unique identifier: NCT03149705.

Quality of life under treatment with the immune checkpoint inhibitors ipilimumab and nivolumab in melanoma patients. Real-world data from a prospective observational study at the Skin Cancer Center Kiel

PurposeCombined immunotherapy (ipilimumab + nivolumab) has improved survival in stage IV melanoma patients, making Health-related Quality of Life (HrQoL) crucial due to potential immune-related adverse events (irAEs). Previous studies treated HrQoL as secondary/explorative endpoint, and no specific HrQoL questionnaire for melanoma patients on immune checkpoint inhibitor (ICI) therapy exists. This study aimed to gather specific HrQoL data during combined ICI therapy, tracking changes during and after treatment, and examining associations with gender, irAEs, and treatment response.Methods35 melanoma patients (22 males, 13 females) undergoing combined ICI were surveyed using the Short-form 36 questionnaire (SF-36), the Inflammatory Bowel Disease Questionnaire – Deutsch (IBDQ-D), and the distress thermometer (DT). HrQoL was evaluated during treatment, after six months, and at the onset of autoimmune colitis.ResultsirAEs occurred in 51.4% of patients, with colitis being the most common (26.1%). 45.7% had progressive disease. SF-36 showed stable HrQoL during treatment and follow-up. Women had worse HrQoL on the physical component scale than men (p = 0.019). Patients with progression showed worse HrQoL over time in physical (p = 0.015) and mental health scales (p = 0.04). IBDQ-D showed constant HrQoL throughout treatment and follow-up. Distress on DT remained constant, with women reporting higher levels of distress.ConclusionHrQoL remained stable during and after therapy. Female gender and disease progression negatively impacted HrQoL. The development of irAEs was not associated with HrQoL, though this may not apply to severe irAEs like colitis, which were not assessed.

Estimating Change in Health-Related Quality of Life before and after Stroke: Challenges and Possible Solutions.

Estimating change in health-related quality of life (HRQOL) from pre- to poststroke is challenging because HRQOL is rarely collected prior to stroke. Leveraging HRQOL data collected both before and after stroke, we sought to estimate the change in HRQOL from prestroke to early poststroke. Stroke survivors completed the Patient-Reported Outcomes Measurement Information System Global Health (PROMIS-GH) scale at both pre- and early poststroke. Patient characteristics were compared for those who did and did not complete the PROMIS-GH. The mean change in PROMIS-GH T-score was estimated using complete case analysis, multiple imputation, and multiple imputation with delta adjustment. A total of 4,473 stroke survivors were included (mean age 63.1 ± 14.1 y, 47.5% female, 82.6% ischemic stroke). A total of 993 (22.2%) patients completed the PROMIS-GH at prestroke while 2,298 (51.4%) completed it early poststroke. Compared with those without PROMIS-GH, patients with PROMIS-GH prestroke had worse comorbidity burden. Patients who completed PROMIS-GH early poststroke had better early poststroke clinician-rated function and shorter hospital length of stay. Complete case analysis and multiple imputation revealed patients' PROMIS-GH T-scores worsened by 2 to 3 points. Multiple imputation with delta adjustment revealed patients' PROMIS-GH T-scores worsened by 4 to 10 points, depending on delta values chosen. Systematic differences in patients who completed the PROMIS-GH at both pre- and early poststroke suggest that missing PROMIS-GH scores may be missing not at random (MNAR). Multiple imputation with delta adjustment, which is better suited for MNAR data, may be a preferable method for analysis of change in HRQOL from pre- to poststroke. Given our study's large proportion of missing HRQOL data, future studies with less missing HRQOL data are necessary to verify our results. Estimating the change in health-related quality of life from pre- to poststroke is challenging because health-related quality-of-life data are rarely collected prior to stroke. Previously used methods to assess the burden of stroke on health-related quality of life suffer from recall bias and selection bias.Using health-related quality-of-life data collected both before and after stroke, we sought to estimate the change in health-related quality of life after stroke using statistical methods that account for missing data.Comparisons of patients who did and did not complete health-related quality-of-life scales at both pre- and poststroke suggested that missing data may be missing not at random.Statistical methods that account for data that are missing not at random revealed more worsening in health-related quality of life after stroke than traditional methods such as complete case analysis or multiple imputation.

Loneliness and Social Health: A Study in Individuals Participating in Recreational Activities

In this study, it was aimed to examine the relationship between loneliness level and social health in individuals participating in recreational activities. The research group consisted of 300 people who participated in the study by random sampling method on the basis of volunteerism. Personal Information Form, Loneliness Scale and Recreational Social Health Scale were used as data collection tools. All analyses were performed using the SPSS 22 package program, taking into account the significance level of "p

Social Determinants of Health and Risk-Adjusted Sepsis Mortality in the Nationwide Veterans Affairs Healthcare System.

Traditional risk prediction and risk adjustment models have focused on clinical characteristics, but accounting for social determinants of health (SDOH) and complex health conditions could improve understanding of sepsis outcomes and our ability to predict outcomes, treat patients, and assess quality of care. To evaluate the impact of SDOH and health scales in sepsis mortality risk prediction and hospital performance assessment. Observational cohort study. One hundred twenty-nine hospitals in the nationwide Veterans Affairs (VA) Healthcare System between 2017 and 2021. Veterans admitted through emergency departments with community-acquired sepsis. Individual- and community-level SDOH (race, housing instability, marital status, Area Deprivation Index [ADI], and rural residence) and two health scales (the Care Assessment Need [CAN] score and Claims-Based Frailty Index [CFI]). The primary outcome was 90-day mortality from emergency department arrival; secondary outcomes included 30-day mortality and in-hospital mortality. Among 144,889 patients admitted to the hospital with community-acquired sepsis, 139,080 were men (96.0%), median (IQR) age was 71 (64-77) years, and median (IQR) ADI was 60 (38-81). Multivariable regression models had good calibration and discrimination across models that adjusted for different sets of variables (e.g., AUROC, 0.782; Brier score, 1.33; and standardized mortality rate, 1.00). Risk-adjusted hospital performance was similar across all models. Among 129 VA hospitals, three hospitals shifted from the lowest or highest quintile of performance when comparing models that excluded SDOH to models that adjusted for all variables. Models that adjusted for ADI reported odds ratios (CI) of 1.00 (1.00-1.00), indicating that ADI does not significantly predict sepsis mortality in this cohort of patients. In patients with community-acquired sepsis, adjusting for community SDOH variables such as ADI did not improve 90-day sepsis mortality predictions in mortality models and did not substantively alter hospital performance within the VA Healthcare System. Understanding the role of SDOH in risk prediction and risk adjustment models is vital because it could prevent hospitals from being negatively evaluated for treating less advantaged patients. However, we found that in VA hospitals, the potential impact of SDOH on 90-day sepsis mortality was minimal.

Do social media epistemological beliefs and health perception impact parents' vaccine hesitancy? A mediation analysis.

In recent years, there has been a notable increase in vaccine hesitancy among individuals. It is crucial to identify the factors contributing to vaccine hesitancy to effectively address this issue. This study aims to investigate the impact of social media-specific epistemological beliefs on vaccine hesitancy and the mediating role of health perception in this impact. This study is a cross-sectional study conducted with 444 parents. Data were collected using the Personal Information Form, the Social Media-Specific Epistemological Beliefs Scale, the Perception of Health Scale, and the Vaccine Hesitancy Scale. When there is no mediator variable, the total effect of social media-specific epistemological beliefs on vaccine hesitancy is statistically significant (β = -0.219, p < 0.001). However, it was found that health perception did not mediate the relationship between social media-specific epistemological beliefs and vaccine hesitancy (β = 0.0038, 95% confidence interval (-0.0090, 0.0205)). Furthermore, it was determined that social media-specific epistemological beliefs positively predicted health perception (β = 0.136, p < 0.01). Health perception was found to have no significant effect on vaccine hesitancy (β = 0.028, p > 0.05). It can be concluded that social media-specific epistemological beliefs negatively predict vaccine hesitancy, and this effect is independent of health perception. Primary healthcare professionals should consider incorporating interventions aimed at enhancing individuals' social media-specific epistemological beliefs into their health education programs related to vaccines.