TY - JOUR
T1 - Self-Efficacy and Self-Care as Risk Factors for Ischemic Stroke
T2 - Development and Validation of a Nomogram
AU - Rasyid, Al
AU - Pemila, Uke
AU - Aisah, Siti
AU - Harris, Salim
AU - Wiyarta, Elvan
AU - Fisher, Marc
N1 - Funding Information:
We gratefully acknowledge the Directorate of Research and Development Universitas Indonesia and the Ministry of Research/National Agency for Research and Innovation for funding granted via the Publikasi Terindeks Internasional (PUTI) Q1 grant number NKB-404/UN2.RST/HKP.05.00/2022. We also want to thank all Cipto Mangunkusumo National Hospital nurses (Sulasmi, Ryan Arrida, Dian Aryanti, Dian Kartikasari, Kumalasari, Eva Rista, Duma Elga, Misella, Dimas, and Nur Ikhwan) who have helped this study.
Publisher Copyright:
© 2023 by the authors.
PY - 2023/9
Y1 - 2023/9
N2 - Background: This study addresses the knowledge gap on how self-efficacy and self-care affect stroke risk as factors and develops a valuable tool for clinicians to assess stroke risk. Methods: From January 2022 to January 2023, this nested-case control study was conducted. Medical data including gender, age, ethnicity, locality, education, marital status, employment, caregiver, social environment, blood viscosity, Barthel Index, modified Rankin Scale (mRS), stroke risk score, self-care score, and self-efficacy score were collected. Logistic regression was used to predict stroke risk, and a nomogram was developed and validated. Results: 240 patients were included in the analysis. Stroke risk score (OR: 3.513; p = 0.005), self-efficacy score (OR: 0.753; p = 0.048), and self-care score (OR: 0.817; p = 0.018) were predictors of ischemic stroke. Internal validation was carried out, with a C-index of 0.774, and the Hosmer–Lemeshow test indicated a good fit (p = 0.92). The calibration plot also shows that this nomogram model has good calibration abilities. The decision curve analysis (DCA) results show a threshold probability range of 10–95%. Conclusion: A nomogram has been developed with good validity, calibration, and clinical utility, including self-care and self-efficacy as risk factors for predicting ischemic stroke.
AB - Background: This study addresses the knowledge gap on how self-efficacy and self-care affect stroke risk as factors and develops a valuable tool for clinicians to assess stroke risk. Methods: From January 2022 to January 2023, this nested-case control study was conducted. Medical data including gender, age, ethnicity, locality, education, marital status, employment, caregiver, social environment, blood viscosity, Barthel Index, modified Rankin Scale (mRS), stroke risk score, self-care score, and self-efficacy score were collected. Logistic regression was used to predict stroke risk, and a nomogram was developed and validated. Results: 240 patients were included in the analysis. Stroke risk score (OR: 3.513; p = 0.005), self-efficacy score (OR: 0.753; p = 0.048), and self-care score (OR: 0.817; p = 0.018) were predictors of ischemic stroke. Internal validation was carried out, with a C-index of 0.774, and the Hosmer–Lemeshow test indicated a good fit (p = 0.92). The calibration plot also shows that this nomogram model has good calibration abilities. The decision curve analysis (DCA) results show a threshold probability range of 10–95%. Conclusion: A nomogram has been developed with good validity, calibration, and clinical utility, including self-care and self-efficacy as risk factors for predicting ischemic stroke.
KW - Indonesia
KW - ischemic stroke
KW - patient education
KW - prevention
KW - self-confidence
UR - http://www.scopus.com/inward/record.url?scp=85170230280&partnerID=8YFLogxK
U2 - 10.3390/jcm12175665
DO - 10.3390/jcm12175665
M3 - Article
AN - SCOPUS:85170230280
SN - 2077-0383
VL - 12
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 17
M1 - 5665
ER -