{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T12:44:06Z","timestamp":1777466646969,"version":"3.51.4"},"reference-count":27,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T00:00:00Z","timestamp":1706140800000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Medical Science and Technology Research Foundation of Guangdong Province","award":["A2023453"],"award-info":[{"award-number":["A2023453"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,1,11]]},"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>China is one of the countries with the highest burden of hypertensive intracerebral haemorrhage (HICH), and its morbidity and mortality rates are almost twice the world average. Most survivors experience negative emotions such as anxiety and depression due to symptoms such as speech disorders, dysphagia, cognitive impairment, hemiplegia and ataxia. While evidence has emerged, supporting the acceptance of disability is a major factor in psychosocial adjustment of patients with disabilities. However, most relevant studies mainly focus on cross-sectional design, and the impact of disability on physical and mental health is a complex and comprehensive process, and its mechanism is still unclear. Therefore, we aimed to use the latent growth mixture model (LGMM) and the decision tree model to analyse the trajectory and predictors of disability acceptance in patients with HICH from stable hospitalisation to 2 years after discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>The objective of this prospective study will be to examine the 2-year trajectory of disability acceptance in a cohort of persons with HICH. 180 participants will be recruited, and baseline general data collection, disability acceptance, family caring index and self-efficacy of chronic disease will be conducted. All of them will be followed up at the stable hospitalisation period, 6\u2009month, 1\u2009year and 2\u2009year after discharge using the same protocol. As a major result, disability acceptance trajectories and potential categories will be analysed using LGMM. Additionally, the independent variables with statistical significance will be included in the decision tree model, and the Classification And Regression Trees\uff08CART\uff09 algorithm programme will be used to construct the prediction model of influencing factors of disability acceptance trajectory. The exploratory outcome will provide scientific basis for the optimal intervention time point and the formulation of rehabilitation measures for this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval was obtained from the medical research ethics committee of Heyuan People\u2019s Hospital (YXYJLL-2022S58). The results will be disseminated nationally and internationally through the publication of research papers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ChiCTR2300071778.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-076314","type":"journal-article","created":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T12:30:44Z","timestamp":1706185844000},"page":"e076314","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["The trajectory and influencing factors of disability acceptance in patients with hypertensive intracerebral haemorrhage: a protocol for prospective longitudinal cohort study in Heyuan City, China"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3121-2167","authenticated-orcid":false,"given":"Jia","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Heyuan People's Hospital, Heyuan, Guangdong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Heyuan People's Hospital, Heyuan, Guangdong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zuolian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Heyuan People's Hospital, Heyuan, Guangdong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,1,25]]},"reference":[{"key":"2025121601380922000_14.1.e076314.1","unstructured":"Vlf A , Cmlf B , Dab C . Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review, 2009."},{"key":"2025121601380922000_14.1.e076314.2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(20)30925-9"},{"key":"2025121601380922000_14.1.e076314.3","first-page":"29","article-title":"Influence of psychological nursing on mental state of patients with hypertensive cerebral hemorrhage","volume":"27","author":"Yin","year":"2011","journal-title":"Chinese J Pract Nurs"},{"key":"2025121601380922000_14.1.e076314.4","first-page":"899","article-title":"Impacts of well-being PERMA mode on acceptance of disability and mental health of patients with hypertensive cerebral hemorrhage","volume":"29","author":"Guo","year":"2021","journal-title":"China J Health Psychol"},{"key":"2025121601380922000_14.1.e076314.5","first-page":"105","article-title":"The relationship between stigma and negative emotions in cerebral hemorrhage patients after Hematoma removal","volume":"49","author":"Zhou","year":"2022","journal-title":"J Int Psychiatry"},{"key":"2025121601380922000_14.1.e076314.6","first-page":"5","article-title":"Assessments and analysis of adult disabled mental health conditions","volume":"04","author":"Yan","year":"2013","journal-title":"Dis Res"},{"key":"2025121601380922000_14.1.e076314.7","doi-asserted-by":"crossref","DOI":"10.1161\/STROKEAHA.115.010997","article-title":"Guidelines for the management of spontaneous intracerebral hemorrhage A guideline for Healthcare professionals from the American heart Association\/American stroke Association","volume":"46","author":"Dixit","year":"2015","journal-title":"Stroke"},{"key":"2025121601380922000_14.1.e076314.8","doi-asserted-by":"crossref","first-page":"537","DOI":"10.4040\/jkan.2012.42.4.537","article-title":"A meta-analysis of the variables related to depression in Korean patients with a stroke","volume":"42","author":"Park","year":"2012","journal-title":"J Korean Acad Nurs"},{"key":"2025121601380922000_14.1.e076314.9","first-page":"1213","article-title":"Analysis of mental state of stroke patients","volume":"4","author":"Cao","year":"2000","journal-title":"Modern Rehabilit"},{"key":"2025121601380922000_14.1.e076314.10","first-page":"459","article-title":"Correlation between stigma and disability acceptance in patients with Hemiplegia due to cerebral hemorrhage","volume":"20","author":"Zha","year":"2020","journal-title":"Chinese Nurs Manag"},{"key":"2025121601380922000_14.1.e076314.11","unstructured":"Jiao D-U , Chen Y-Q , Li W-U . The Reliability and validity of the Chinese version of the stigma scale for chronic illness 8-items in patients with neurological disorders. J North Sichuan Medical College 2018."},{"key":"2025121601380922000_14.1.e076314.12","doi-asserted-by":"crossref","unstructured":"Wright BA . Physical disability, a psychosocial approach. New York: Harper & Row, 1983.","DOI":"10.1037\/10589-000"},{"key":"2025121601380922000_14.1.e076314.13","first-page":"1324","article-title":"Effects of family caring and self-efficacy on disability acceptance in patients with post-stroke disability","volume":"40","author":"Lu","year":"2020","journal-title":"Chinese J Gerontol"},{"key":"2025121601380922000_14.1.e076314.14","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1080\/23279095.2019.1569523","article-title":"Self-efficacy and acceptance of disability following mild traumatic brain injury: A pilot study","volume":"27","author":"Yehene","year":"2020","journal-title":"Appl Neuropsychol Adult"},{"key":"2025121601380922000_14.1.e076314.15","first-page":"3908","article-title":"Disability acceptance and life meaning perception of patients after modified radical mastectomy","volume":"30","author":"Chai","year":"2021","journal-title":"Henan Medical 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