A predictive model of well-being and self-care for rural elderly women in Taiwan

Nursing observations of stage-based care in patients diagnosed with hepatitis B virus infection based on TBIL and ALT levels

This study explored techniques and effects of stage-based care on patients with chronic hepatitis B virus (HBV) infection. The clinical data of 156 patients with chronic HBV infection treated in our hospital from September 2018 to December 2019 were retrospectively analyzed and classified as the experimental group (EG). Patients were categorized into early, intermediate, and late hepatitis stages and received targeted clinical care during the various phases of chronic HBV infection. In addition, 144 cases of patients with chronic HBV admitted to the hospital from January 2018 to August 2018 and treated without stage-based care were classified as the control group (COG). General care was implemented for all patients before the initiation of stage-based care. Patient satisfaction, mortality rates of patients at different stages, liver pain scores, depression scores, blood biochemical indices, and alanine transaminase and total bilirubin levels before and after nursing care were compared. The total satisfaction rate of the EG group (90.38%) was significantly higher than that of the COG group (83.33%) (P < .05). We found no significant differences in the mortality rates of early-, middle-, and late-stage patients in the EG group when compared with those of the COG group at corresponding stages (P < .05). The self-care agency scores (for all dimensions) and psychosocial adaptation scores in the EG group were significantly higher than those in the COG group (P < .05) after care. Moreover, the pain scores in the EG group were significantly lower than those in the COG group after care (P < .05). Furthermore, the observed psychological status of patients in the EG group significantly improved when compared with that in the COG group (P < .05). Stage-based care for patients with severe chronic type B hepatitis increased clinical satisfaction, relieved pain, reduced depression, and improved blood biochemical indices. Therefore, stage-based care for chronic HBV infection should be included in the clinical environment.

Women's Participation in Self-Care and the Importance of Paying Attention to Cultural Capital: A Cross-Sectional Study among Women in Yazd (Iran)

The present study aimed to investigate the relationship between women's cultural capital and self-care. A survey was employed with a sample size of 737 women living in the marginal, middle, and upper areas of Yazd in terms of socioeconomic characteristics. Data were analyzed using structural equation modelling by SPSS and Amos version 24. The results revealed that the effect of cultural capital on self-care was positive and significant (β = 0.46, p < 0.001). The effectiveness rates of cultural capital on women's self-care in the marginal, middle, and upper areas were 0.44, 0.32 and 0.45, respectively (p < 0.001). Besides, there was no significant difference between the intensity of the relationship between cultural capital and self-care in the three areas (CR < 1.96). The fit indices also indicated that the model had a good fit (CMIN/DF = 2.560, NFI = 0.916, RMSEA = 0.033, CFI = 0.946, TLI = 0.922, GFI = 0.963, IFI = 0.947).

The Relationship of Physiopsychosocial Factors and Spiritual Well-Being in Elderly Residents: Implications for Evidence-Based Practice

BACKGROUND

Older adults in residential settings frequently suffer from functional decline, mental illness, and social isolation, which make them more vulnerable to spiritual distress. However, empirical evidence of the interrelationships between physiopsychosocial variables and spiritual well-being are still lacking, limiting the application of the biopsychosocial-spiritual model in institutional healthcare practice.

AIMS

To explain the mechanisms by which these variables are linked, this cross-sectional study tested a causal model of predictors of spiritual well-being among 377 institutionalized older adults with disability using a structural equation modeling approach.

METHODS

The primary variables in the hypothesized model were measured using the Barthel Index for functional ability, the Geriatric Depression Scale-short form for depression, the Personal Resources Questionnaire 85-Part 2 for perceived social support, and the Spiritual Well-Being Scale for spiritual well-being.

RESULTS

The model fit indices suggest that the hypothesized model had a reasonably adequate model fit (χ² = 12.18, df = 6, p = .07, goodness-of-fitness index [GFI] = 0.99, adjusted GIF index [AGFI] = 0.93, nonnormed fit index [NFI] = 0.99, comparative fit index [CFI] = 0.99). In this study, perceived social support and depression directly affected spiritual well-being, and functional ability indirectly affected spiritual well-being via perceived social support or depression. In addition, functional ability influenced perceived social support directly, which in turn influenced depression and ultimately influenced spiritual well-being.

DISCUSSION

This study results confirm the effect of physiopsychosocial factors on institutionalized older adults' spiritual well-being. However, the presence and level of functional disability do not necessarily influence spiritual well-being in late life unless it is disruptive to social relationships and is thus bound to lead to low perceived social support and the onset of depression.

LINKING EVIDENCE TO ACTION

The findings address the fact that the practice of spirituality is multidimensional and multileveled. Psychosocial interventions for institutionalized elders with disabilities should focus on increasing nurse-patient interaction and providing access to meaningful social activities to improve mental health and spiritual well-being.

Prevalence and risk factors of depression among community dwelling elderly

Depression in the elderly is associated with increased morbidity and mortality. The purpose of this study was to determine the prevalence and risk factors of depression among community-dwelling older population in an urban setting in Turkey. This cross-sectional study was conducted among 482 elderly individuals 65 years and over in an urban area. Cluster sampling method was used for sample size. Depression in the elderly had been diagnosed by a clinical interview and Geriatric Depression Scale. Data were collected by door-to-door survey. Chi square test was used for statistical analysis. P value, which was calculated by the results of chi square test and coefficient of phi (φ), below 0.05 was included in the analysis of logistic regression. Depression was significantly associated with female gender, being single or divorced, lower educational status, low income, unemployment, and lack of health insurance. However, logistic regression analysis revealed higher depression rates in the elderly with chronic obstructive pulmonary disease, psychiatric disease, cerebrovascular disease, low income and being dependent. Depression is common among community-dwelling older people in an urban area of Izmir, Turkey. Older adults living in community should be cautiously screened to prevent or manage depression.

Correlates of self-care behaviors among low-income elderly women with hypertension in South Korea

OBJECTIVE

To identify correlates of self-care behaviors among elderly, low-income Korean women with hypertension.

RESEARCH DESIGN

A secondary analysis of data from a community-based intervention trial for hypertension control.

SETTING

Three community health posts in the Gangwon province, South Korea.

PARTICIPANTS

Two hundred thirty-four (234) low-income elderly women (age 60-93) who had previously participated in a community-based intervention trial for hypertension control.

METHODS

The researchers collected data that included patient background characteristics, hypertension self-care behavior, self-efficacy of hypertension control, general knowledge of hypertension, and social support. The data were analyzed using descriptive and inferential statistics, including hierarchical regression analysis.

RESULTS

The model explained 41.1% of the total variance in hypertension self-care behavior scores. Among elderly, low-income Korean women, the significant factors of their hypertension self-care behavior included: (a) self-efficacy of hypertension control (β = .62), (b) social support (β = .16), and (c) age (β = -.14). Hierarchical regression analysis showed that elderly Korean women that had higher self-efficacy of hypertension control, higher social support, and were younger were more likely to have higher hypertension self-care behavior scores.

CONCLUSIONS

The results highlight the need for interventions that focus on improving an individual's self-efficacy and social support to enhance hypertension self-care. The findings of this study can help nurses better understand hypertension self-care behavior in elderly, low-income Korean women.

The impact of foreign caregiving on depression among older people in Taiwan: model testing

AIM

  This article is a report of a study of predicting the factors that influence depression in the older people in Taiwan. Background.  In 1991, Taiwan opened the labour market to foreign caregivers for the older people who needed long-term care. With the differences in language, culture and lifestyle between foreign caregivers and older people in Taiwan, it was hypothesized that the older people would not be able to relate to them, and therefore become depressed.

METHODS

  The data were collected from 116 Taiwanese older people from July to September, 2005. Path analysis using multiple regression analyses was conducted to estimate the direct and indirect effects of caregiving communication, activities of daily living, income and social support on depression among older people in Taiwan. To evaluate the hypotheses for this research, bi-variate linear regression and multiple regression analyses were used.

RESULTS/FINDINGS

  The results indicated that the level of activities of daily living (β = -0·201, P = 0·010), care-giving communication (β = -0·272, P = 0·002) income (β = -0·305, P = 0·000) and social support (β = -0·276, P = 0·002) were the predictors of depression in older people in Taiwan. Social support was a mediating factor for caregiving communication and depression. Furthermore, foreign caregiver care was not correlated with depression among older people in Taiwan.

CONCLUSIONS

  The findings influence the public awareness of depression in older people, and provide the foundational information to influence the policy makers of Taiwan to evaluate the foreign caregiver policy.

Reliability, validity and factor structure of the Appraisal of Self-Care Agency Scale-Revised (ASAS-R)

RATIONALE, AIMS AND OBJECTIVES

Self-care agency is a fundamental concept in nursing and health care research. Having self-care agency enhances an individual's health-promoting behaviours and/or specific capabilities for chronic disease self-management. The purpose of this study was to continue the development and psychometric testing of the Appraisal of Self-Care Agency - Revised (ASAS-R).

METHODS

A cross-sectional methodological design was used to examine the reliability, validity and factor structure of the ASAS-R among individuals from the general population. The sample consisted of 629 adults who were randomly selected to conduct an exploratory factor analysis (EFA; n=240) and a confirmatory factor analysis (CFA; n=389) of the scale. A demographic questionnaire, the ASAS-R and the Health-Promoting Lifestyle Profile (HPLP-II) were the measures used to collect the data.

RESULTS

The final 15-item three-factor ASAS-R had an overall Cronbach's alpha (α) of 0.89. The three factors extracted, rotated and scored in this study were labelled: having power for self-care, developing power for self-care and lacking power for self-care. All inter-items and item-to-total correlations met recommended criteria of r=0.30 to r=0.70, except for one of the items that had an item-to-total correlation of 0.71, slightly exceeding the maximum recommended item-to-total correlation. The three factors had Cronbach's alphas of 0.86, 0.83 and 0.79, respectively. The three factors together explained 61.7% of the scale items variance. Each item of the scale had a strong factor loading ranging from 0.52 to 0.81. All measures of model fit exceeded the recommended criteria, indicating that the 15-item ASAS-R had a very good fit (χ(2) /d.f.=1.97, GFI=0.94, AGFI=0.92, CFI=0.96, TLI=0.95, RMSEA=0.05, RMR=0.05 and the PCLOSE=0.48).

CONCLUSIONS

The 15-item three-factor ASAS-R is a short, reliable and valid instrument to measure self-care agency among individuals from the general population, but further psychometric evaluation is needed among individuals with chronic diseases, especially those with diabetes mellitus.

The Relation of Power and Well-Being in Korean Adults

The researchers examined the relation of power and well-being in a sample of 881 men and women living in South Korea. Rogers' science of unitary human beings, Barrett's theory of power, and Gueldner's theoretical perspective of well-being served as the theoretical rationale. The hypothesis was supported by a significant positive correlation between power and well-being (r = .52, p < .001). Reliabilities by Cronbach's alpha were .96 for the Power as Knowing Participation in Change Tool and .84 for the Well-Being Picture Scale. Well-being can be facilitated by enhancing person's power as knowing participation in change.

Prevalence and predictors of depressive symptoms among rural older Australians and Americans

OBJECTIVE

To examine the predictors of depressive symptoms among older married rural Australian and American men and women, using comparable measures from two separate studies.

DESIGN

Postal survey for Australians; telephone interviews for Americans.

SETTING

Rural Australia (six states and two territories) and America (Virginia).

PARTICIPANTS

Older married rural men and women, aged 65 years and over, in Australia (n = 216) and America (n = 156).

MAIN OUTCOME MEASURES

Whether predictors of depressive symptoms, specifically demographic factors, health, pain, functional limitations and social networks, differed according to nationality or sex.

RESULTS

Approximately one-third of older rural Australian (37%) and Americans (28%) reported recently experiencing depressive symptoms. For Australian men and women, pain was the strongest predictor of depressive symptoms. For American women, dissatisfaction with social support predicted depressive symptoms, whereas no variable predicted depressive symptoms in American men.

CONCLUSIONS

In the context of a globally ageing population, the fact that nearly one in three older rural people on two continents described themselves as recently feeling depressed is a troubling finding of considerable importance to both practitioners and policy-makers. The findings raise questions about the cultural acceptance, definition and manifestations of symptoms of depression in rural communities, as well as the role of different public health and support systems in the two countries.

Self-care agency and factors related to this agency among patients with hypertension

AIMS AND OBJECTIVES

The aim of this study is to assess the self-care agency and factors regarding this agency among patients with hypertensions.

DESIGN

This study, descriptive, analytical and cross-sectional in nature, was conducted to evaluate the self-care agency of 120 hypertensive patients at the Cardiology and Internal Diseases Polyclinic of University of Ege, Faculty of Medicine; izmir Atatürk State Hospital; University of Selçuk, Faculty of Medicine; and Karaman State Hospital between July and August 2003.

METHODS

The data were collected by using the self-care agency scale and a questionnaire designed to determine the socio demographic features, and evaluated by means of percentage calculation and chi-square tests.

RESULTS

The mean self-care agency rate of the patients in general was moderate. It was determined that educational situation and social insurance affected self-care.

CONCLUSION

Self-care agency and health are related to economic, social and educational factors.

RELEVANCE TO CLINICAL PRACTICE

Data obtained could be used for policy formulation, health planning, outcome evaluation of instruments, better health education strategies and, ultimately, to demonstrate the worth of nursing in the marketplace.

Self-Care and Well-Being Model for Elderly Women: A Comparison of Rural and Urban Areas

The purposes of this study were to examine the relationships among age, social class, perceived health, self-care, and well-being in urban and rural elderly women and to validate and compare two models using these two groups. A causal model of self-care and well-being was proposed for this study based on Orem's self-care model and empirical data. Data were collected using a survey-interview method. Of the 351 elderly women recruited, 159 were in the urban group and 192 in the rural group. Two models of self-care and well-being were tested using path analysis with the LISREL 8 program. The resultant models yielded a Chi-squared of 1.98 with two degrees of freedom (p = 0.37) in the urban group and a Chi-squared of 4.20 with three degrees of freedom (p = 0.24) in the rural group, indicating good fit between the data and the two models. These two models provide guidelines for community nurses to design appropriate self-care programs for elderly women.