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. 2026 Jan 6;12:1679180. doi: 10.3389/fmed.2025.1679180

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Copyright © 2026 Hou, Liu, Hou, Ping, He, Chen, Tian, Qin, Zhou, Xu and Ruan.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Bar charts comparing ESCA scores for control and study groups before and after intervention in four categories: Health knowledge level, Self-concept, Self-responsibility, and Self-care skills. Study group scores (purple) show significant improvement after intervention compared to the control group (black). Error bars indicate variability, and asterisks denote statistical significance. — Self-care ability in both groups. ^**p < 0.01; ns indicates that the difference was not significant.