{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T17:36:14Z","timestamp":1791999374716,"version":"4.4.0"},"reference-count":50,"publisher":"Wiley","issue":"5-6","license":[{"start":{"date-parts":[[2018,2,21]],"date-time":"2018-02-21T00:00:00Z","timestamp":1519171200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Clinical Nursing"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec><jats:title>Aims and objectives<\/jats:title><jats:p>To examine the roles of two modifiable factors\u2014health\u2010promoting behaviours and perceived stress\u2014in predicting aneurysmal rupture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Unruptured intracranial aneurysm detection produces significant stress and anxiety in patients because of the risk of rupture. Compared to nonmodifiable risk factors for rupture such as age, gender and aneurysm size\/location, less attention has been given to modifiable risk factors. Two modifiable factors, health\u2010promoting behaviours and perceived stress, have hardly been examined as potential predictors of rupture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>This study used a cross\u2010sectional design.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We assessed 155 patients with intracranial aneurysms\u2014that is, subarachnoid haemorrhage (<jats:italic>n<\/jats:italic>\u00a0=\u00a077) or unruptured intracranial aneurysm (<jats:italic>n<\/jats:italic>\u00a0=\u00a078)\u2014to examine (i) baseline characteristics (patient and aneurysmal factors), (ii) health\u2010related factors (lifestyle habits and health\u2010promoting behaviour) and (iii) perceived stress levels (psychological stress and physical stress). Patient records provided medical histories and aneurysmal factors; other data were collected using a structured questionnaire addressing lifestyle habits, the Health\u2010Promoting Lifestyle Profile\u2010<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> to measure health\u2010promoting behaviour and the Perceived Stress Questionnaire to measure perceived\u2010psychological stress and perceived\u2010physical stress levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Bivariate analysis indicated that aneurysm rupture risk was associated with female gender, aneurysm size\/location, defecation frequency, hyperlipidaemia, sedentary time, low Health\u2010Promoting Lifestyle Profile\u2010<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> mean scores and high perceived\u2010psychological stress scores. After adjusting for known risk factors, the mean Health\u2010Promoting Lifestyle Profile\u2010<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> and perceived\u2010psychological stress scores remained robust predictors of rupture. Furthermore, known risk factors combined with these scores had greater predictive power than known risk factors alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Health\u2010promoting behaviour and psychological stress are promising modifiable factors for reducing risk of aneurysmal rupture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Relevance to clinical practice<\/jats:title><jats:p>Our findings may stimulate greater understanding of mechanisms underlying aneurysmal rupture and suggest practical strategies for nurses to employ in optimising conservative management of rupture risk by teaching patients how to modify their risk. Both health\u2010promoting behaviour and perceived stress should be addressed when designing preventive nursing interventions for patients with unruptured intracranial aneurysm.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocn.14149","type":"journal-article","created":{"date-parts":[[2017,10,27]],"date-time":"2017-10-27T09:21:03Z","timestamp":1509096063000},"source":"Crossref","is-referenced-by-count":13,"title":["The predictive role of health\u2010promoting behaviours and perceived stress in aneurysmal rupture"],"prefix":"10.1111","volume":"27","author":[{"given":"Mi\u2010Sun","family":"Lee","sequence":"first","affiliation":[{"name":"Kyungpook National University Hospital Daegu Korea"},{"name":"College of Nursing Keimyung University Daegu Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang G","family":"Park","sequence":"additional","affiliation":[{"name":"College of Nursing University of Illinois at Chicago Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tonda L","family":"Hughes","sequence":"additional","affiliation":[{"name":"School of Nursing and Department of Psychiatry Columbia University New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang\u2010Eun","family":"Jun","sequence":"additional","affiliation":[{"name":"College of Nursing Keimyung University Daegu Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kum","family":"Whang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Wonju College of Medicine Yonsei University Wonju Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3005-2720","authenticated-orcid":false,"given":"Nahyun","family":"Kim","sequence":"additional","affiliation":[{"name":"College of Nursing Keimyung University Daegu Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,2,21]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jagp.2012.06.001"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/954954"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.001575"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(14)70015-8"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.3340\/jkns.2016.59.1.11"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/271582"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2009.106"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2007.117655"},{"key":"e_1_2_12_10_1","first-page":"S191","article-title":"Health promoting behaviors in a population\u2010based sample of middle\u2010aged women and its relevant factors in Yazd, Iran","volume":"3","author":"Enjezab B.","year":"2012","journal-title":"International Journal of Preventive Medicine"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.004815"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70025-0"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000190838.02954.e8"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006199-200503000-00003"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.112.679159"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/1010539513500338"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surneu.2009.03.007"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.011351"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/nur.21644"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2011-302068"},{"key":"e_1_2_12_21_1","first-page":"523","article-title":"Analysis of rupture during follow\u2010up of unruptured aneurysm","volume":"43","author":"Koyama S.","year":"2015","journal-title":"No Shinkei Geka. 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