Short-term effectiveness of a culturally tailored educational intervention on foot self-care among type 2 diabetes patients in Morocco

The Efficacy of Self-care Behaviors, Educational Interventions, and Follow-up Strategies on Hospital Readmission and Mortality Rates in Patients with Heart Failure

Heart failure (HF), a worldwide epidemic with significant morbidity and mortality risks, is frequently secondary to cardiovascular disorders and probably is the common final way to survive patients. Almost 25% of hospitalized patients with acute HF are expected to be readmitted within 30 days post-discharge, and the rates of rehospitalization increase to almost one-third at 60 days and 60 percent within one year of discharge. Although care planning for patients with heart failure is complex, multidisciplinary, and resource-dependent, optimal self-care management along with appropriate educational intervention and follow-up strategy could be able to reduce readmissions, decline the duration of hospitalization, increase life expectancy, decrease the rates of mortality, and reduce costs of healthcare services for patients with HF. However, there are contradictions in previous reports about the efficacy of self-care, mainly due to patients' non-adherence to self-care behaviors. Therefore, the current study aimed to review the investigations on the effectiveness of self-care of HF patients in reducing hospital readmissions and increasing quality of life, and discuss novel approaches for predischarge educational interventions and postdischarge follow-up strategies.

Video-Based Educational Interventions for Patients With Chronic Illnesses: Systematic Review

BACKGROUND

With rising time constraints, health care professionals increasingly depend on technology to provide health advice and teach patients how to manage chronic disease. The effectiveness of video-based tools in improving knowledge, health behaviors, disease severity, and health care use for patients with major chronic illnesses is not well understood.

OBJECTIVE

The aim of this study was to assess the current literature regarding the efficacy of video-based educational tools for patients in improving process and outcome measures across several chronic illnesses.

METHODS

A systematic review was conducted using CINAHL and PubMed with predefined search terms. The search included studies published through October 2021. The eligible studies were intervention studies of video-based self-management patient education for an adult patient population with the following chronic health conditions: asthma, chronic kidney disease, chronic obstructive pulmonary disease, chronic pain syndromes, diabetes, heart failure, HIV infection, hypertension, inflammatory bowel disease, and rheumatologic disorders. The eligible papers underwent full extraction of study characteristics, study design, sample demographics, and results. Bias was assessed with the Cochrane risk-of-bias tools. Summary statistics were synthesized in Stata SE (StataCorp LLC). Data reporting was conducted per the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist.

RESULTS

Of the 112 studies fully extracted, 59 (52.7%) were deemed eligible for inclusion in this review. The majority of the included papers were superiority randomized controlled trials (RCTs; 39/59, 66%), with fewer pre-post studies (13/59, 22%) and noninferiority RCTs (7/59, 12%). The most represented conditions of interest were obstructive lung disease (18/59, 31%), diabetes (11/59, 19%), and heart failure (9/59, 15%). The plurality (28/59, 47%) of video-based interventions only occurred once and occurred alongside adjunct interventions that included printed materials, in-person counseling, and interactive modules. The most frequently studied outcomes were disease severity, health behavior, and patient knowledge. Video-based tools were the most effective in improving patient knowledge (30/40, 75%). Approximately half reported health behavior (21/38, 56%) and patient self-efficacy (12/23, 52%) outcomes were improved by video-based tools, and a minority of health care use (11/28, 39%) and disease severity (23/69, 33%) outcomes were improved by video-based tools. In total, 48% (22/46) of the superiority and noninferiority RCTs and 54% (7/13) of the pre-post trials had moderate or high risk of bias.

CONCLUSIONS

There is robust evidence that video-based tools can improve patient knowledge across several chronic illnesses. These tools less consistently improve disease severity and health care use outcomes. Additional study is needed to identify features that maximize the efficacy of video-based interventions for patients across the spectrum of digital competencies to ensure optimized and equitable patient education and outcomes.

The Effect of Culturally Appropriate Self-Care Intervention on Health Literacy, Health-Related Quality of Life and Glycemic Control in Iranian Patients with Type 2 Diabetes: A Controlled Randomized Clinical Trial

Background

Cultural and language differences are necessary factors for diabetes management and self-care education programs in patients suffering from diabetes. This study aims to investigate the effectiveness of culture-based self-care intervention on health literacy, quality of life, and glycemic parameters in patients with type 2 diabetes.

Materials and Methods

This randomized clinical trial has been carried out in selected centers in Darreh Shahr, Iran; 80 participants were randomly assigned into intervention and control groups. The intervention group received an educational program for 6 sessions twice a week, but the control group only received routine services. Data were collected using health literacy and life quality scales for diabetic patients, which were completed by both groups before, immediately after, and 3 months after the intervention; hemoglobin A1C (HbA1c) was checked before and 3 months after the intervention. SPSS software was also analyzed data using χ2, Fisher's exact, independent t, and repeated measures analysis of variance tests.

Results

There were no significant differences between the 2 groups before the study (p >0.05) goes forward. But, mean scores of health literacy (F2,40 = 5.61, p =0.007), quality of life (F2, 40 = 4.09, p =0.01), and HbA1c levels (t, 39 = 6. 91, p <0.001) have shown significant differences between the 2 groups immediately and 3 months after the intervention have been applied.

Conclusions

Culturally appropriate intervention should be offered as a part of the nurse' care program for diabetic to control HbA1c, and improve their life quality and health literacy.

Development and testing of a new electronic foot health promotion programme on nurses' foot self-care

Background

Nurses form the largest professional group in health care, and they spend most of their working day on their feet. From the perspective of work well-being, healthy feet are important to tolerate the physical demands of nursing work. However, little is known about how nurses’ foot self-care practices can be promoted with computerised interventions. The aim of this study was two-fold: to explore the preliminary effects of the electronic Foot Health Promotion Programme (FHPP) on foot self-care in nurses and to examine the usability of the programme.

Methods

A single group pretest-posttest design was used. The FHPP was targeted at nurses working in the operating theatre. The FHPP lasted for 4 weeks and focused on improving nurses’ knowledge and awareness of foot self-care through self-directed learning tasks. The primary outcome was knowledge of foot self-care. The secondary outcomes were foot health and work ability. Thirty-seven participants completed the study. The outcomes were assessed at baseline (April–June 2017) and 4 weeks (August–September 2017) after the intervention ended. The data were analysed statistically.

Results

Participants’ knowledge of foot self-care and foot health improved; however, the changes were not statistically significant. The FHPP was considered to be usable and has potential as a tool to increase knowledge of foot self-care among nurses.

Conclusions

The FHPP developed in this study is a newly developed potential tool to increase nurses’ knowledge of foot self-care. Application of the FHPP as part of occupational health care may enhance nursing personnel’s foot self-care and lower extremity health.

Trial registration

ClinicalTrials.gov NCT03116451, 17.4.2017.

Beliefs and practices in diabetes care

Diabetes mellitus is considered a chronic non-communicable disease with high morbidity, presents to its high prevalence, social, family, and economic costs. Interventions aimed at life-style changes are fundamental in managing; due to this, patients must receive education. The aim of the study was to identify the beliefs and practices of the persons with diabetes mellitus, to propose nurse care according to these precepts. This was a descriptive study of systematic literature review, searching for articles in databases, Springer Science, Elsevier, ProQuest, Science Direct, Index, Pubmed, SciELO, Medigraphic, and Medline during 2016 to 2018, published between 2001 and 2018, in Spanish, English, and Portuguese. A total of 49 studies were contributing to fulfilling the objective. Within the beliefs for the management of disease, is the use of herbs, some consider as cause "fright"; Others take into account risk factors such as heredity, obesity, poor eating habits. Various beliefs are presented in relation to insulin treatment. Spirituality is emphasized; seeking refuge in God and prayer. Is important to understand the person, from their values, beliefs, customs and feelings. Education is a fundamental tool to control the disease, but health beliefs must be taken into account in order to achieve favorable results.

Support Factors of Self Foot Care for Diabetes Mellitus Patients

Introduction: Diabetes mellitus is a chronic disease of the endocrine system that has numerous complications such as diabetic foot ulcers. Amputation is the last frontier for the treatment of diabetic foot ulcers but they can be prevented through proper self-foot-care behavior. The aim of this study was to explain the support factors of self foot care for diabetes mellitus patients.Methods: The methods used were self-foot-care identification in the literature, with the relevant literature identification based on the topics and titles obtained from Scopus, ScienceDirect and ProQuest. This was as well as analysis of the results from examining the various behaviors that support self-foot-care behavior in the literature. The references included was the research conducted from 2013 - 2019 as follows: 2 descriptive correlation studies, 3 descriptive studies, 2 prospective studies, 1 prospective cohort study, 1 pre-experimental study, 3 quasi-experimental studies, 1 case study and 3 cross-sectional studies.Results: All of the journals included discussed foot care behavior. Education programs regarding foot care are a major factor that supports foot care behavior.Conclusion: All of the journals that were obtained stated that there was a positive influence on the diabetic foot condition where routine foot care behavior was implemented. Self-foot-care behavior also requires other supporting factors to obtain the maximum results.

Diabetes Self-Management Education (DSME) - Effect on Knowledge, Self-Care Behavior, and Self-Efficacy Among Type 2 Diabetes Patients in Ethiopia: A Controlled Clinical Trial

PURPOSE

Diabetes patients must be equipped with the necessary knowledge to confidently undertake appropriate self-care activities. We prepared a diabetes self-management education (DSME) intervention and assessed how it affected patients' self-reported levels of diabetes knowledge, self-care behaviors, and self-efficacy.

PATIENTS AND METHODS

A before-and-after, two-group intervention study was conducted at Jimma University Medical Centre among adult patients with type 2 diabetes. At baseline, we randomly assigned 116 participants to the DSME intervention and 104 to a comparison group. Six interactive DSME sessions supported by an illustrative handbook and fliers, experience-sharing, and take-home activities were administered to the intervention group by two nurses during a six-month period. Diabetes knowledge, self-care behaviors, and self-efficacy were measured at baseline and at nine months following the commencement of DSME intervention (endpoint) in both groups.

RESULTS

At the endpoint, data from 78 intervention group participants and 64 comparison group participants were included in final analysis. The difference in the mean Diabetes Knowledge Scale scores before and after the DSME intervention was significantly greater in the intervention group (p = 0.044). The measured self-care behaviors included diet, exercise, glucose self-monitoring, footcare, smoking, alcohol consumption, and khat chewing. The mean number of days per week on which the intervention group participants followed general dietary recommendations increased significantly at the endpoint (p = 0.027). The intervention group followed specific dietary recommendations (p = 0.019) and performed footcare (p = 0.009) for a significantly greater number of days. There were no significant differences within or between the groups in other self-reported diabetes self-care behavior regimens or in diabetes self-efficacy.

CONCLUSION

Our study found significant improvements in the intervention participants' diabetes knowledge scores and in their adherence to dietary and footcare recommendations. This demonstrates that our DSME intervention may be of clinical importance in developing countries such as Ethiopia.

TRIAL REGISTRATION

ClinicalTrials.gov, Identifier NCT03185689, retrospectively registered on June 14, 2017: https://clinicaltrials.gov/ct2/show/NCT03185689.

Effects of an Outpatient Diabetes Self-Management Education on Patients with Type 2 Diabetes in China: A Randomized Controlled Trial

OBJECTIVE

This study is aimed at assessing the effectiveness of a simple outpatient diabetes self-management education programme.

METHODS

In the study, 60 patients with type 2 diabetes mellitus were randomly allocated into the control group (n = 30) and intervention group (n = 30). Regular and 2-session health education programmes were provided. The summary of diabetes self-care activity measure, problem areas in the diabetes scale, fasting blood glucose, postprandial 2 h blood glucose, and HbA1c were measured before and after the intervention to assess the effects of this 2-session diabetes education programme.

RESULTS

The total mean score of the summary of diabetes self-care activities measure was 17.60 ± 6.63 points. The problem areas in the diabetes scale revealed that the total mean score was 29.82 ± 15.22 points; 27% of the patients had diabetes-related distress, while 9% suffered from severe emotional distress. Compared with the control group, scores of the summary of diabetes self-care activities measure and problem areas in the diabetes scale, fasting blood glucose, postprandial 2 h blood glucose, and HbA1c were significantly improved in the intervention group after the intervention (P < 0.01).

CONCLUSION

This study showed that the 2-session diabetes education programme could effectively improve the level of self-reported self-management, psychological distress, and glycemic control in patients with type 2 diabetes mellitus.