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Wu L, Liu M, Huang C, Yin J, Zhou H, Hu H. The development of a self-management evaluation scale for elderly adults with hypertension based on the capability, opportunity, and motivation-behaviour (COM-B) model. BMC Geriatr 2023; 23:245. [PMID: 37087433 PMCID: PMC10122353 DOI: 10.1186/s12877-023-03879-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 03/08/2023] [Indexed: 04/24/2023] Open
Abstract
BACKGROUND Using accurate assessment tools to assess patients in clinical practice is important to mining influencing factors and implementing interventions. However, most evaluation tools for the self-management of elderly patients with hypertension lack a theoretical basis and wide applicability, which makes the intervention effect insignificant. METHODS Based on the Capability, Opportunity, and Motivation-Behaviour (COM-B) model, combined with literature review and qualitative research, a questionnaire item pool was initially formulated; then the initial items were screened and adjusted through expert consultation and pre-testing to form an initial scale. A field survey of 450 elderly hypertensive patients was then performed using the initial scale to test the reliability and validity of the scale. Cronbach's alpha, test-retest reliability and composite reliability were used to test the reliability of the scale, and the validity of the scale was evaluated from two aspects: content validity and construct validity. The evaluation results of the content validity of the scale by experts were used as the content validity index; the results of exploratory factor analysis and confirmatory factor analysis were used as the structural validity index to further verify the model structure of the scale and develop a formal scale. RESULTS The final self-management scale included 4 dimensions and 33 items. The Scale-Content Validity Index was 0.920. Exploratory factor analysis extracted four factors that explained 71.3% of the total variance. Cronbach's alpha of the formal scale was 0.867, test-retest reliability was 0.894, and composite reliability of the 4 dimensions were within 0.943 ~ 0.973. Confirmatory factor analysis showed the scale had good construct validity. CONCLUSIONS The Self-management Capability, Support and Motivation-Behaviour scale for elderly hypertensive patients has good reliability and validity, providing a tool for medical staff to evaluate the self-management level of elderly hypertensive patients.
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Affiliation(s)
- Lirong Wu
- School of Nursing, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
- The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Hunan, 410013, Changsha, China
| | - Minhui Liu
- Nursing School of Central South University, Changsha, 410013, China
| | - Chongmei Huang
- Nursing School of Central South University, Changsha, 410013, China
| | - Jinzhi Yin
- School of Nursing, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
- The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Hunan, 410013, Changsha, China
| | - Hui Zhou
- School of Nursing, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
- The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Hunan, 410013, Changsha, China
| | - Hongjuan Hu
- The First Affiliated Hospital, Department of Public Service/Nursing department, Hengyang Medical School, University of South China, Hunan, 421001, Hengyang, China.
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Kouchaki L, Darvishpoor Kakhki A, Safavi Bayat Z, Khan HTA. Association between fear of falling and self-care behaviours of older people with hypertension. Nurs Open 2023; 10:3954-3961. [PMID: 36824048 PMCID: PMC10170935 DOI: 10.1002/nop2.1654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 12/01/2022] [Accepted: 02/04/2023] [Indexed: 02/25/2023] Open
Abstract
AIM This study investigated the association between fear of falling and self-care behaviours of older people with hypertension. DESIGN A cross-sectional study. METHODS This study was conducted in 2019 on 301 older people with hypertension above the age of 60 years in Tehran, Iran. Data were collected using a demographic questionnaire, the Persian Falls Efficacy Scale-International, and a hypertension-related self-care behaviour questionnaire. RESULTS Analyses revealed that gender, educational level and history of falling were significant factors associated with fear of falling; and marital status, educational level and income source were significant factors associated with self-care behaviours (p < 0.05). Partial correlations controlling for education revealed a significant positive correlation showing that high fear of falling is associated with worse health promotion self-care behaviours and significant inverse correlations with psycho-emotional, social and daily self-care behaviours (p < 0.05), meaning that high fear of falling is associated with better self-care for these dimensions. PATIENT OR PUBLIC CONTRIBUTION This study involved patients in order to evaluate the validity and reliability of the questionnaires. The study was conducted on older people with hypertension referred to hypertension clinics in hospitals.
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Affiliation(s)
- Leila Kouchaki
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Darvishpoor Kakhki
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Safavi Bayat
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hafiz T A Khan
- College of Nursing, Midwifery and Healthcare, University of West London, London, UK
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Wu Y, Wen J, Wang X, Wang Q, Wang W, Wang X, Xie J, Cong L. Associations between e-health literacy and chronic disease self-management in older Chinese patients with chronic non-communicable diseases: a mediation analysis. BMC Public Health 2022; 22:2226. [PMID: 36447176 PMCID: PMC9710041 DOI: 10.1186/s12889-022-14695-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Chronic non-communicable diseases (CNCDs) are an urgent public health issue in China, especially among older adults. Hence, self-management is crucial for disease progression and treatment. Electronic health (e-health) literacy and self-efficacy positively correlate with self-management. However, we know little about their underlying mechanisms in older adults with CNCDs. OBJECTIVE To explore the factors that influence chronic disease self-management (CDSM) and verify self-efficacy as the mediator between e-health literacy and self-management behavior in older patients with CNCDs. METHODS This cross-sectional study included 289 older patients with CNCDs from Hunan province, China, between July and November 2021. E-health literacy, self-efficacy, social support, and CDSM data were collected through questionnaires. The influence of each factor on CDSM was explored with multiple linear regression analysis. Intermediary effects were computed via a structural equation model. RESULTS The total CDSM score in the patients was 29.39 ± 9.60 and only 46 (15.92%) patients used smart healthcare devices. The regression analysis showed e-health literacy, self-efficacy, and social support were the factors that affected CDSM. Furthermore, the structural equation model revealed that self-efficacy directly affected CDSM (β = 0.45, P < 0.01), whereas e-health literacy affected it directly (β = 0.42, P < 0.01) and indirectly (β = 0.429, P < 0.01) through self-efficacy. CONCLUSIONS This study revealed that self-management among older patients with CNCDs is at a low level, and few of them use smart healthcare devices. Self-efficacy plays a partial intermediary role between e-health literacy and self-management in older patients with CNCDs. Thus, efforts to improve their CDSM by targeting e-health literacy may be more effective when considering self-efficacy.
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Affiliation(s)
- Ying Wu
- grid.411427.50000 0001 0089 3695School of Medicine, Hunan Normal University, Changsha, 410013 People’s Republic of China
| | - Jing Wen
- grid.411427.50000 0001 0089 3695School of Medicine, Hunan Normal University, Changsha, 410013 People’s Republic of China
| | - Xiaohui Wang
- grid.411427.50000 0001 0089 3695School of Medicine, Hunan Normal University, Changsha, 410013 People’s Republic of China
| | - Qingyao Wang
- grid.411427.50000 0001 0089 3695School of Medicine, Hunan Normal University, Changsha, 410013 People’s Republic of China
| | - Wen Wang
- grid.216417.70000 0001 0379 7164Xiangya Hospital, Central South University, Changsha, 41008 People’s Republic of China
| | - Xiangjia Wang
- grid.411427.50000 0001 0089 3695School of Medicine, Hunan Normal University, Changsha, 410013 People’s Republic of China
| | - Jiang Xie
- grid.411427.50000 0001 0089 3695School of Medicine, Hunan Normal University, Changsha, 410013 People’s Republic of China
| | - Li Cong
- grid.411427.50000 0001 0089 3695School of Medicine, Hunan Normal University, Changsha, 410013 People’s Republic of China
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Zhang L, Wang M, Deng C, Lin M, Chen J, Wan L. Ecological model of health behaviour of hypertensive stroke patients at the end of recovery period. J Clin Nurs 2022. [DOI: 10.1111/jocn.16566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/26/2022] [Accepted: 10/04/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Li‐Yuan Zhang
- School of Nursing Sun Yat‐Sen University Guangzhou China
| | - Meng‐Yao Wang
- School of Public Health The University of Hong Kong Li Ka Shing Faculty of Medicine Pokfulam Hong Kong SAR, China
| | - Cheng‐Song Deng
- Department of Neurology and Stroke Center The Third Affiliated Hospital, Sun Yat‐sen University Guangzhou China
| | - Man‐Qiu Lin
- Department of Neurology Guangdong Provincial Hospital of Traditional Chinese Medicine Guangzhou China
| | - Jie‐Han Chen
- Department of Neurology Guangdong Provincial Hospital of Traditional Chinese Medicine Guangzhou China
| | - Li‐Hong Wan
- School of Nursing Sun Yat‐Sen University Guangzhou China
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Adherence to Self-Care among Patients with Hypertension in Ethiopia: A Systematic Review and Meta-Analysis. Int J Hypertens 2022; 2022:5962571. [PMID: 35879985 PMCID: PMC9308551 DOI: 10.1155/2022/5962571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 03/01/2022] [Accepted: 06/27/2022] [Indexed: 11/17/2022] Open
Abstract
Background Self-care adherence for hypertensive patients is a cornerstone for the control of it and prevention of its complications. However, there are inconsistent findings for self-care adherence of hypertensive patients in Ethiopia. Thus, this systematic review and meta-analysis was done to determine the pooled estimate self-care adherence. Methods This systematic review and meta-analysis was reported based on the Preferred Reporting Items for Systematic Review and Meta-Analysis guideline. An intensive search of online databases such as PubMed (MEDLINE), CINHAL, Google Scholar, and advanced Google search was made to access both published and unpublished articles that report self-care adherence among hypertensive patients in Ethiopia. The pooled estimate was done with STATA version 11 metan commands in a 95% confidence interval. The presence of heterogeneity and publication bias were detected by I2 and Egger's test, respectively. A random-effect model was obtained, and subgroup analysis was done for the management of heterogeneity. Result A total of 24 articles with a total of 7224 participants were included in the final systematic review and meta-analysis. The pooled estimate of overall self-care adherence among hypertensive patients was 36.98% (95% CI: 27.13–46.83). In subgroup analysis, the highest overall self-care adherence was observed in the Amhara region at 53% (95% CI: 46.54, 59.47). The pooled estimate of self-care dimensions such as medication adherence, low-salt diet, physical activity, smoking abstinence, alcohol abstinence, and weight management was 62.71%, 65.96%, 47.28%, 92.53%, 67.59%, and 52.54%, respectively. Conclusion The pooled estimate of good self-care adherence among hypertensive patients was low. From the dimensions of self-care, the lowest level was in physical activity and the highest level was in smoking abstinence. Comparing all regions, the lowest level of overall self-care adherence was observed in Addis Ababa, Tigray region, and South Nations and Nationalities of Ethiopia. Screening of adherence to self-care and health education should be provided to every patient during every visit.
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Hong D, Shan W. Improvement in Hypertension Management with Pharmacological and Non- Pharmacological Approaches: Current Perspectives. Curr Pharm Des 2021; 27:548-555. [PMID: 32962608 DOI: 10.2174/1381612826666200922153045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 08/18/2020] [Indexed: 11/22/2022]
Abstract
PURPOSE Improving hypertension management is still one of the biggest challenges in public health worldwide. Existing guidelines do not reach a consensus on the optimal Blood Pressure (BP) target. Therefore, how to effectively manage hypertension based on individual characteristics of patients, combined with the pharmacological and non-pharmacological approach, has become a problem to be urgently considered. METHODS Reports published in PubMed that covered Pharmacological and Non-Pharmacological Approaches in subjects taking hypertension management were reviewed by the group independently and collectively. Practical recommendations for hypertension management were established by the panel. RESULTS Pharmacological mechanism, action characteristics, and main adverse reactions varied across different pharmacological agents, and patients with hypertension often require a combination of antihypertensive medications to achieve the target BP range. Non-pharmacological treatment provides an additional effective method for improving therapy adherence and long-term BP control, thus reducing the risk of cardiovascular diseases, and slowing down the progression of the disease. CONCLUSION This review summarizes the available literature on the most convincing guideline principles, pharmacological treatment, biotechnology interference, interventional surgical treatment, managing hypertension with technical means of big data, Artificial Intelligence and Behavioral Intervention, as well as providing future directions, for facilitating Current and Developing knowledge into clinical implementation.
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Affiliation(s)
- Dongsheng Hong
- Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Wenya Shan
- Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
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Jaarsma T, Strömberg A, Dunbar SB, Fitzsimons D, Lee C, Middleton S, Vellone E, Freedland KE, Riegel B. Self-care research: How to grow the evidence base? (reprint). Int J Nurs Stud 2021; 116:103903. [PMID: 33637295 DOI: 10.1016/j.ijnurstu.2021.103903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 02/18/2020] [Accepted: 02/26/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND OBJECTIVE The number of studies in the area of self-care is growing and international researchers are increasingly developing self-care interventions to improve outcomes of individual patients and communities. However, growth of the evidence is still slow due to challenges with designing and testing self-care interventions. In this article we address major methodological challenges with regard to the definition of self-care, use of theory, and research design, intended to provide guidance to researchers in this field. METHOD During the inaugural conference of the International Center for Self-Care Research held in Rome, Italy in June 2019 we identified important issues in existing self-care research. Discussion and literature review lead to eight recommendation for future self-care research. RESULTS In preparation, begin with a theoretically sound definition of self-care. In planning the intervention, build on and extend previous studies. Use theory to develop self-care interventions and consider translational models to guide development, evaluation and implementation of complex self-care interventions. Employ a study design that fits the current phase and objectives of the research and measure self-care and related factors carefully. In reporting, describe the sample and setting sufficiently so that others can draw conclusions about generalizability and applicability to their practice and patient population. In interpretation, describe how the intervention is assumed to work (causal assumptions) and its key components. CONCLUSION Our review of existing self-care research clearly illustrates that the recommendations we provide are needed if we are to substantially grow the evidence base supporting self-care. Embracing a core set of principles will allow us to build on each other's work. Tweetable abstract: A core set of methodological principles is needed to substantially grow the evidence base supporting self-care.
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Affiliation(s)
- T Jaarsma
- Department of Health, Medicine and Caring Sciences, Linkoping University, 58381 Linköping, Sweden; Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia; Julius Center, University Medical Center Utrecht, the Netherlands.
| | - A Strömberg
- Department of Health, Medicine and Caring Sciences, Linkoping University, 58381 Linköping, Sweden; Department of Cardiology, Linkoping University, Sweden
| | - S B Dunbar
- Nell Hodgson Woodruff School of Nursing, Emory University, USA
| | - D Fitzsimons
- School of Nursing & Midwifery, Queen's University Belfast, UK
| | - C Lee
- William F. Connell, School of Nursing, Boston College, USA
| | - S Middleton
- Nursing Research Institute, St Vincent's Health Australia & Australian Catholic University, Australia
| | - E Vellone
- University of Rome "Tor Vergata", Italy
| | - K E Freedland
- Department of Psychiatry, Washington University School of Medicine, USA
| | - B Riegel
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia; School of Nursing, University of Pennsylvania, USA
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Self-care research: How to grow the evidence base? Int J Nurs Stud 2020; 105:103555. [DOI: 10.1016/j.ijnurstu.2020.103555] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 02/18/2020] [Accepted: 02/26/2020] [Indexed: 02/06/2023]
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