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Torun T, Çavuşoğlu H, Doğru D. The application of the self-care deficit nursing theory in adolescents with cystic fibrosis: A randomized controlled study. J Pediatr Nurs 2024; 77:96-105. [PMID: 38490107 DOI: 10.1016/j.pedn.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 02/29/2024] [Accepted: 03/06/2024] [Indexed: 03/17/2024]
Abstract
PURPOSE The present study evaluates the effects of the application of Self-Care Deficit Nursing Theory (SCDNT) on the self-care knowledge and skills in adolescents with Cystic Fibrosis. DESIGN AND METHODS This randomized controlled study included 30 adolescents who were equally divided into the intervention and control groups. The data were collected by using the Sociodemographic Data Form and the Self-Care Knowledge and Skills Evaluation Forms for Adolescents with Cystic Fibrosis. A total of seven home visits were conducted with the adolescents in the intervention group, during which individualized care plans were applied based on the Self-Care Deficit Nursing Theory. The self-care needs of the adolescents in the control group were identified based on data collected during two home visits conducted at the onset of the study and after 4.5 months. RESULTS As a result of the application of nursing interventions based on the SCDNT, a statistically significant increase was noted in the self-care knowledge and skills of the adolescents in the intervention group (p < 0.05). Additionally, after the interventions based on SCDNT, the need of adolescents for nursing interventions decreased significantly over time in all adolescents in the intervention group (p < 0.05). CONCLUSIONS The application of nursing interventions based on the SCDNT was effective in enhancing the self-care knowledge and skills of adolescents with Cystic Fibrosis. PRACTICE IMPLICATIONS Nurses can benefit from Orem's Self-Care Deficit Nursing Theory in the design and application of the individualized care of adolescents with Cystic Fibrosis to improve their self-care practices.
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Affiliation(s)
- Tuğçe Torun
- Pediatric Nursing Department, Faculty of Nursing, Hacettepe University, Turkey.
| | - Hicran Çavuşoğlu
- Head of Pediatric Nursing Department, Faculty of Nursing, Hacettepe University, Turkey
| | - Deniz Doğru
- Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Turkey
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Saxby N, Beggs S, Kariyawasam N, Battersby M, Lawn S. Do guidelines provide evidence-based guidance to health professionals on promoting developmentally appropriate chronic condition self-management in children? A systematic review. Chronic Illn 2020; 16:239-252. [PMID: 30244592 DOI: 10.1177/1742395318799844] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To determine whether evidence-based practice guidelines promote developmentally appropriate chronic condition self-management for children with asthma, type 1 diabetes mellitus, and cystic fibrosis. METHODS Systematic review of clinical guidelines current as at 22 September 2017, including assessment of quality of each guideline using the iCAHE 'Guideline Quality Checklist', and mapping of the supporting evidence. RESULTS Fifteen guidelines were identified: asthma (n=7) and type 1 diabetes mellitus (n=7), CF (n=1). Guideline quality was variable, and 11 different grading systems were used. In total, there were 28 recommendations promoting age/developmental considerations. Recommendations focused on: collaboration (n=15), chronic condition self-management education (n= 17), clinicians' skills (n= 4); personalized action plans (n=3), problem-solving (n=2); and the assessment of children's chronic condition self-management needs (n=3). Developmental transitions are highlighted as important time points in some guidelines: preschool (n=2), and adolescence (n=3). All guidelines encouraged triadic partnerships between children, adult caregivers and clinicians. Evidence supporting the developmental aspects of the guidelines' recommendations was poor; only 14 out of 57 journals listed as evidence were concordant. DISCUSSION Current guidelines articulate that developmentally appropriate chronic condition self-management is important; however, more work needs to be done to translate the concept into practical clinical tools.
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Affiliation(s)
- Nicole Saxby
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia.,Tasmanian Cystic Fibrosis Service, Tasmanian Health Service, Hobart, Tasmania
| | - Sean Beggs
- Tasmanian Cystic Fibrosis Service, Tasmanian Health Service, Hobart, Tasmania
| | - Nadish Kariyawasam
- eHealth Services Research Group, University of Tasmania, Hobart, Tasmania
| | - Malcolm Battersby
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia
| | - Sharon Lawn
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia
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Reisinho MDCMSRO, Gomes BP. Nursing interventions in monitoring the adolescent with Cystic Fibrosis: a literature review. Rev Lat Am Enfermagem 2016; 24:e2845. [PMID: 27982311 PMCID: PMC5171783 DOI: 10.1590/1518-8345.1396.2845] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 09/22/2016] [Indexed: 11/25/2022] Open
Abstract
Objectives: to search for nursing interventions focused on the improvement of quality of life
and promotion of self-care of adolescents suffering from the Cystic Fibrosis. Method: literature review. The inclusion criteria were: primary studies and studies with
interventions developed by nurses in the adolescent population with Cystic
Fibrosis, using Portuguese, Spanish, French and English with no time limit, and
supported by the databases Scopus, Web of Science and CINAHL. The search
expressions were: nursing AND care AND adolescent AND "Cystic Fibrosis" AND
("quality of life" OR "self-care"). Results: a total of 59 articles was retrieved; 8 matched the criteria chosen. Nursing
interventions targeted at adolescents with Cystic Fibrosis and their family
members were identified. These interventions were organized according to the
nurses' role, namely caregiver, coordinator, counsellor, researcher, trainer and
care partner. Conclusions: nursing interventions targeted at following up the adolescent during the entire
therapeutic process, involving the presence of parents/significant others, since
both the adolescent and family have to be responsible for self-care. Healthcare
professionals should be capable of identifying the specific needs of patients with
chronic disease and their family, permitting a better understanding and adaptation
to the health-disease transition process.
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Conway S, Balfour-Lynn IM, De Rijcke K, Drevinek P, Foweraker J, Havermans T, Heijerman H, Lannefors L, Lindblad A, Macek M, Madge S, Moran M, Morrison L, Morton A, Noordhoek J, Sands D, Vertommen A, Peckham D. European Cystic Fibrosis Society Standards of Care: Framework for the Cystic Fibrosis Centre. J Cyst Fibros 2015; 13 Suppl 1:S3-22. [PMID: 24856776 PMCID: PMC7105239 DOI: 10.1016/j.jcf.2014.03.009] [Citation(s) in RCA: 124] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A significant increase in life expectancy in successive birth cohorts of people with cystic fibrosis (CF) is a result of more effective treatment for the disease. It is also now widely recognized that outcomes for patients cared for in specialist CF Centres are better than for those who are not. Key to the effectiveness of the specialist CF Centre is the multidisciplinary team (MDT), which should include consultants, clinical nurse specialist, microbiologist, physiotherapist, dietitian, pharmacist, clinical psychologist, social worker, clinical geneticist and allied healthcare professionals, all of whom should be experienced in CF care. Members of the MDT are also expected to keep up to date with developments in CF through continued professional development, attendance at conferences, auditing and involvement in research. Specialists CF Centres should also network with other Centres both nationally and internationally, and feed Centre data to registries in order to further the understanding of the disease. This paper provides a framework for the specialist CF Centre, including the organisation of the Centre and the individual roles of MDT members, as well as highlighting the value of CF organisations and disease registries.
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Affiliation(s)
- Steven Conway
- Paediatric and Adult CF Units, Leeds Teaching Hospitals Trust, UK.
| | | | | | - Pavel Drevinek
- Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic; Department of Paediatrics, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic; University Hospital Motol, Prague, Czech Republic
| | - Juliet Foweraker
- Department of Microbiology, Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, UK
| | | | - Harry Heijerman
- HagaZiekenhuis, Department of Pulmonology & Cystic Fibrosis, The Hague, The Netherlands
| | - Louise Lannefors
- Copenhagen CF Centre, Rigshospitalet, University Hospital, Copenhagen, Denmark
| | - Anders Lindblad
- Gothenburg CF Centre, Queen Silvia Children's Hospital, Göteborg, Sweden
| | - Milan Macek
- Department of Biology and Medical Genetics, University Hospital Motol, Prague, Czech Republic; Second School of Medicine, Charles University Prague, Prague, Czech Republic
| | - Sue Madge
- Department of Respiratory Medicine, Royal Brompton Hospital, Sydney Street, London, UK
| | - Maeve Moran
- National Referral Centre for Adult Cystic Fibrosis, Pharmacy Department, St. Vincent's University Hospital, Ireland
| | - Lisa Morrison
- Gartnavel General Hospital, West of Scotland Adult CF Unit, Glasgow, UK
| | - Alison Morton
- Adult Cystic Fibrosis Unit, St James's Hospital, Leeds, UK
| | | | - Dorota Sands
- Department of Pediatrics, Institute of Mother and Child, Warsaw, Poland
| | | | - Daniel Peckham
- Adult Cystic Fibrosis Unit, St James's Hospital, Leeds, UK
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van Groningen J, Ziniel S, Arnold J, Fishman LN. When independent healthcare behaviors develop in adolescents with inflammatory bowel disease. Inflamm Bowel Dis 2012; 18:2310-4. [PMID: 22374585 DOI: 10.1002/ibd.22937] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Accepted: 02/11/2012] [Indexed: 12/09/2022]
Abstract
BACKGROUND Patients with chronic health needs are expected to gradually assume responsibility for health maintenance behavior as they move toward adulthood. We sought to evaluate the influence of factors such as age, duration of disease, and gender by examining the self-reported health behaviors of adolescents with inflammatory bowel disease (IBD). METHODS Confidential voluntary surveys were administered to all IBD outpatients over age 10 during a 4-month period. Questions addressed responsibility for health behaviors such as medication, provider visits, and communication. Likert scales measured the degree of independence: 1 (my parents only) through 3 (parents share equally with me) to 5 (I do it myself). Patient participation during doctor visits was also assessed. RESULTS Of 358 patients approached, 294 (82%) returned completed surveys. Respondents were 51% male and 69% had Crohn's disease. Patients took increasingly active roles, but by ages 19-21 only 45% ordered medication refills, and 50% picked up medication from pharmacy. Only 35% of 19-21-year-olds scheduled appointments and 30% contacted providers between visits if problems arose. Most patients could answer provider questions (55% at age 16-18) but fewer asked questions of the provider (15% at the same age). Males were less likely to order their own prescription refills (P = 0.017) or prepare questions (P = 0.009). Duration of disease did not change skill acquisition. CONCLUSIONS Adolescents develop independence in managing their IBD slowly and many patients ≥ 18 years are still assisted by parents. Focus on specific skill acquisition may help patients with self-management skills expected in adult healthcare.
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Medication knowledge: an initial step in self-management for youth with inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2011; 53:641-5. [PMID: 21681113 DOI: 10.1097/mpg.0b013e3182285316] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVE Adolescents with chronic illness need to develop skills to independently manage their own health. Knowledge of medication is an early step in this process. We explored which factors affect acquisition of medication knowledge in adolescents with inflammatory bowel disease (IBD). PATIENTS AND METHODS Consecutive patients with IBD older than 10 years received a confidential survey at an outpatient visit including questions regarding medication name, dose, and adverse effects. Results were compared with the medical record. Demographic characteristics obtained included age, sex, disease duration, and type of IBD. RESULTS Completed surveys were returned by 294 patients (65% of those approached). Overall, 95% of patients could name their medication and 54% could identify their correct dose. Of 95 patients receiving biologics, 88% could identify the medicine and 50% could report either dose or timing. Of 139 patients on immunomodulator therapy, 94% could name medicine and 68% reported correct dose. Sex, type, or duration of disease did not affect name or dose knowledge. Generally, older patients did not demonstrate better medication or dosage knowledge than younger patients, although there was a significant trend toward improved knowledge of side effects for older patients. However, <32% of all of the patients could report a single major medication side effect. CONCLUSION Medication knowledge is an early stage of self-management, yet many adolescents cannot report the dose of IBD medications, nor know the side effects of immunosuppression. This finding persists into late adolescence, which has ramifications for patients as they separate from parents for college or work.
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Malbrunot-Wagner AC, Bonnemains C, Troussier F, Darviot E, Chiffoleau M, Person C, Urban T, Giniès JL. Passage de l’enfant à l’adulte : l’exemple d’un centre de ressources et de compétences pour la mucoviscidose. Arch Pediatr 2009; 16:235-42. [DOI: 10.1016/j.arcped.2008.12.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2008] [Revised: 10/30/2008] [Accepted: 12/14/2008] [Indexed: 10/21/2022]
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Baker LK, Denyes MJ. Predictors of self-care in adolescents with cystic fibrosis: a test of Orem's theories of self-care and self-care deficit. J Pediatr Nurs 2008; 23:37-48. [PMID: 18207046 DOI: 10.1016/j.pedn.2007.07.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2007] [Revised: 07/24/2007] [Accepted: 07/26/2007] [Indexed: 10/22/2022]
Abstract
Pediatric nurses often struggle to find ways to encourage adolescents with cystic fibrosis (CF) to engage in self-care that is essential to their health and life. A study of predictors of self-care was conducted to provide a stronger evidence base for nursing practice with these youth. Orem's theories of self-care and self-care deficit were tested to explain and predict the universal and health deviation self-care of 123 adolescents with CF. Four dimensions of self-care agency emerged as predictors of universal self-care, two of which were also predictive of health deviation self-care. Seventy percent of the variance or change in universal self-care scores and 40% of health deviation self-care variance were explained. Clarification and extension of Orem's theories were also an important outcome. Development of nursing interventions designed to strengthen predictors of universal and health deviation-specific self-care identified in this research holds the potential to improve length and quality of life for adolescents with CF.
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Affiliation(s)
- Lois K Baker
- Cedarville University, Cedarville, OH 45314, USA.
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