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Stamoulis T, Dragioti E, Gouva M, Mantzoukas S, Κourakos M. Unveiling the Nexus: Depressive Symptoms and Medication Adherence in Hypertensive Patients' Self-care: A Systematic Review. Mater Sociomed 2024; 36:65-72. [PMID: 38590593 PMCID: PMC10999142 DOI: 10.5455/msm.2024.36.65-72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/25/2024] [Indexed: 04/10/2024] Open
Abstract
Background Hypertension, a significant public health concern, is frequently linked to emotional disorders like depression. Research shows a reciprocal link between depression and hypertension, potentially influencing patients' adherence to self-care routines. Objective This systematic review aimed to examine the association between depressive symptoms and aspects of self-care, with a focus on medication adherence in individuals diagnosed with hypertension. Methods Following PRISMA guidelines, a systematic review was conducted by searching PubMed, PsycINFO and Scopus until March 17, 2023. The included studies involved quantitative primary research conducted in English, focusing on adults (≥18 years) diagnosed with hypertension and experiencing depressive symptoms. Observational studies were assessed using the Newcastle-Ottawa Scale, and randomized controlled trials were evaluated using the revised Cochrane Risk of Bias Tool (RoB 2.0). Due to the great diversity of these studies, a narrative synthesis of the results was undertaken. Results: A total of 18 studies involving 6,131 people with hypertension, that met our eligibility criteria were ultimately included. The reported rates of depressive symptoms ranged from 4% to 43%. Of these studies, nine reported a statistically significant association, showcasing an adverse impact of depressive symptoms on medication adherence. The remaining nine did not confirm the above. Conclusion This systematic review highlights the diverse body of research exploring depressive symptoms and medication adherence among individuals with hypertension. The review suggests a need for increased attention to self-care practices, particularly in relation to adherence to antihypertensive medication. However, it recommends the conduction of more robust longitudinal studies to comprehensively explore this relationship.
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Affiliation(s)
- Theofilos Stamoulis
- Research Laboratory Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina
| | - Elena Dragioti
- Research Laboratory Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina
| | - Mary Gouva
- Research Laboratory Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina
| | - Stefanos Mantzoukas
- Research Laboratory of Integrated Health, Care and Well-being, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina
| | - Michael Κourakos
- Research Laboratory Psychology of Patients, Families & Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina
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Du M, Kong H, Ran L, Ran Y, Bai L, Du Y, Guan H, Dong Y, Zhao Y. Associations among health-promoting lifestyle, self-care agency and health-related quality of life in Bai older adults with hypertension in Yunnan China. BMC Geriatr 2022; 22:942. [PMID: 36476421 PMCID: PMC9730677 DOI: 10.1186/s12877-022-03608-0] [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: 05/22/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Previous Chinese studies focused on the prevalence and influential factors of hypertension; however, little is known about their self-care literacy and quality of life among the Bai older adults with hypertension. The purpose of this research was to explore the associations among health-promoting lifestyle, self-care agency, and health-related quality of life in Bai ethnic older patients with hypertension, as well as the related factors of hypertension self-care abilities. METHODS A total of 472 Bai ethnic hypertension older adults aged 60 and above were enrolled in this study voluntarily from 5 rural communities of the Bai ethnic group. The Exercise of Self-Care Agency Scale (ESCAS) was employed to assess the Self-care ability of hypertension for the subjects, the Health-promoting lifestyle profile II(HPLP-II) was utilized to evaluate the health behavior, and MOS 36-Item Short Form Health Survey (SF-36) was chosen to assess the HRQOL for the studying population. All descriptive analyses, including demographic characteristics, socio-economic status, and clinical characteristics were stratified by Bai hypertensive elderly. Pearson correlation analysis model was used to examine the associations among health-promoting lifestyle, self-care agency, and health-related quality of life in Bai ethnic elderly with hypertension. RESULTS The HPLP-II, ESCA, and of HRQOL levels of the subjects were low, and the mean HPLP and ESCA scores had no significant statistical variance among different age groups. Significant statistical differences were found in Bai elderly subjects in the domain of PF and PH as well as the overall score in SF-36(all P< 0.01), 60-64 year group had the highest score of the above three domains in SF-36 than other age groups. The SF-36 scores were positively associated with HPLP and ESCA levels. CONCLUSION The HPLP-II, ESCA, and of HRQOL levels of the Bai subjects were poor in the Bai ethnic hypertensive elderly. The HRQOL scores of subjects were positively connected with HPLP-II and ESCA abilities. More attention should be paid to lifestyle, healthy behaviors, and self-care abilities improvements to enhance the better HRQOL of Bai minority older adults with hypertension.
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Affiliation(s)
- Mengqi Du
- grid.21729.3f0000000419368729Teacher’s College of Columbia University, New York, NY USA
| | - Hongqian Kong
- Disease Control and Prevention Center, Yunnan Qujing, China
| | - Lingyun Ran
- grid.285847.40000 0000 9588 0960Nursing School of Kunming Medical University, Kunming, Yunnan China
| | - Yuanyuan Ran
- grid.506978.5Hunan University of Finance and Economics, Changsha, China
| | - Leixao Bai
- grid.285847.40000 0000 9588 0960Nursing School of Kunming Medical University, Kunming, Yunnan China
| | - Yongxue Du
- grid.285847.40000 0000 9588 0960Nursing School of Kunming Medical University, Kunming, Yunnan China
| | - Hongxue Guan
- grid.285847.40000 0000 9588 0960Nursing School of Kunming Medical University, Kunming, Yunnan China
| | - Yong Dong
- grid.285847.40000 0000 9588 0960Nursing School of Kunming Medical University, Kunming, Yunnan China
| | - Ying Zhao
- Disease Control and Prevention Center, Yunnan Lijiang, China
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Pahria T, Nugroho C, Yani DI. Factors Influencing Self-Care Behaviors in Hypertension Patients With Complications. Vasc Health Risk Manag 2022; 18:463-471. [PMID: 35818584 PMCID: PMC9270883 DOI: 10.2147/vhrm.s366811] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/24/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Tuti Pahria
- Faculty of Nursing, Universitas Padjadjaran, Jatinangor, 45363, Indonesia
| | - Cahyo Nugroho
- Faculty of Nursing, Universitas Padjadjaran, Jatinangor, 45363, Indonesia
- Nursing Management Team, Majenang Hospital, Majenang, 53257, Indonesia
| | - Desy Indra Yani
- Faculty of Nursing, Universitas Padjadjaran, Jatinangor, 45363, Indonesia
- Correspondence: Desy Indra Yani, Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Bandung-Sumedang KM 21, Jatinangor, 45363, Indonesia, Tel/Fax +62 22-7796647, Email
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Loizeau V, Morvillers JM, Bertrand DP, Kilpatrick K, Rothan-Tondeur M. Defining an enabling environment for those with chronic disease: an integrative review. BMC Nurs 2021; 20:252. [PMID: 34930230 PMCID: PMC8686648 DOI: 10.1186/s12912-021-00741-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 10/08/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Health policies are currently being implemented to cope with the 37% of those affected by chronic disease and 63% of deaths worldwide. Among the proposals, there is accelerating support for greater autonomy for patients, which incorporates several concepts, including empowerment. To achieve this, develop an environment to increase an individual's capacity for action seems to be a fundamental step. The aim of this study is to characterize an enabling environment for patients in the context of chronic disease management. METHODS An integrative review design was applied. Medline, CINAHL, and Web of Science databases were searched to identify relevant literature published between 2009 and 2019. Overall, the review process was guided by the PRISMA 2020 checklist. The Mixed Methods Appraisal Tool for quality evaluation was used. RESULTS A total of 40 articles were analyzed, divided into 18 quantitative studies, 11 qualitative studies, two mixed studies, seven expert opinions, one theory and one conference report. The following characteristics defining an enabling environment were taken from the literature relating to those with a chronic condition: Needs assessment-adaptation of responses, supporting "take care", involvement in support, knowledge improvement, engagement with professionals, use of information and communication technologies, and organization of care. Beyond that, the interactions highlighted between these seven categories characterize an enabling environment. CONCLUSION This review specifies the essential elements of an enabling environment for patients with chronic conditions. It encompasses the partnership between the healthcare professional, such as the advanced practice nurse, and the individual for whom interventions and care strategies must be devised.
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Affiliation(s)
- Valérie Loizeau
- Centre Hospitalier Intercommunal Poissy Saint Germain, Université Sorbonne Paris Nord, Nursing Sciences Research Chair, Laboratory Educations and Health Practices (LEPS), (EA 3412), UFR SMBH, F-93017, Bobigny, France.
| | - Jean-Manuel Morvillers
- Research in Nursing Sciences, Health Education and Practice Laboratory (LEPS), (EA 3412), UFR SMBH, F-93017, Bobigny, France
| | | | - Kelley Kilpatrick
- Susan E. French Chair in Nursing Research and Innovative Practice, Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, 680 Sherbrooke Street West, Office 1811, Montreal, Quebec, H3A 2M7, Canada
| | - Monique Rothan-Tondeur
- Research in Nursing Sciences Tondeur, Paris, France
- Laboratoire d'Enseignements et de Pratiques de Santé (LEPS), (EA 3412), UFR SMBH, F-93017, Bobigny, France
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Isik K, Cengiz Z, Doğan Z. The Relationship Between Self-Care Agency and Depression in Older Adults and Influencing Factors. J Psychosoc Nurs Ment Health Serv 2020; 58:39-47. [PMID: 32845340 DOI: 10.3928/02793695-20200817-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 06/02/2020] [Indexed: 12/20/2022]
Abstract
Depression is a significant mental health problem in older adults. There is a decrease in self-care agency and an increase in the prevalence of depression with aging. The current study was conducted to determine the relationship between self-care agency and depression in Turkish older adults aged ≥65 years (N = 473) and the influencing factors. Data were collected using a demographics questionnaire, the Self-Care Agency Scale, and the Geriatric Depression Scale. Self-care agency was related to age, marital status, level of education, economic status, and persons lived with, and depression was related to gender, marital status, level of education, economic status, chronic disease, and persons lived with. A negative correlation was found between the scales. As the score of self-care agency increased, depression decreased. [Journal of Psychosocial Nursing and Mental Health Services, 58(10), 39-47.].
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Zhang B, Zhang W, Sun X, Ge J, Liu D. Physical Comorbidity and Health Literacy Mediate the Relationship Between Social Support and Depression Among Patients With Hypertension. Front Public Health 2020; 8:304. [PMID: 32850572 PMCID: PMC7419472 DOI: 10.3389/fpubh.2020.00304] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 06/04/2020] [Indexed: 02/05/2023] Open
Abstract
Depression is a common comorbidity among patients with hypertension. Patients with hypertension and depression have worse health outcomes compared to those without depression. The combined effects of social support, physical comorbidity, and health literacy on depression among individuals with hypertension remain unclear. A survey was conducted between December 2017 and May 2018 to investigate the relationships among social support, physical comorbidity, health literacy, and depression in a population of patients with hypertension in rural areas of Sichuan province, China. Multiple linear regression was used to examine factors that influenced depression, and structural equation modeling (SEM) was used to examine the relationships among the four study variables. The mean scores of 549 patients with hypertension were 37.17 ± 6.84 for social support, 14.62 ± 6.26 for health literacy, and 3.56 ± 3.05 for depression; furthermore, 34.2% of participants had physical comorbidity. Gender and per capita annual family income were significantly associated with depression. Physical comorbidity was directly positively related to depression while health literacy was directly negatively related to depression. Social support had an indirect negative association with depression by the mediating effects of health literacy and physical comorbidity. Adequate social support and health literacy, and less physical comorbidity could potentially contribute to reducing depression. The study highlights the importance of social support in maintaining mental health among patients with hypertension. Strategies that target the enhancement of social support and health literacy should be prioritized to relieve depression among patients with hypertension. More attention should be paid to women, low-income individuals, and patients with physical comorbidities.
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Affiliation(s)
- Baiyang Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Wenjie Zhang
- The Department of Academic Affairs, West China School of Medicine/ West China Hospital, Sichuan University, Chengdu, China
| | - Xiaxia Sun
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jingjing Ge
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Danping Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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Gholamnejad H, Kakhki AD, Ahmadi F, Rohani C. Development and Psychometric Evaluation of the Elderly Hypertension Self-Care Index. J Nurs Meas 2019; 27:418-432. [PMID: 31871283 DOI: 10.1891/1061-3749.27.3.418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This study was done to develop and evaluate the psychometric properties of the Elderly Hypertension Self-Care Index. METHODS This was an exploratory mixed method study. Items were developed through conducting a qualitative study with conventional content analysis approach and comprehensively reviewing the existing literature. Then, the developed index was assessed for face, content, and construct validity as well as reliability. RESULTS Analyses identified four themes of self-care: intelligent acceptance, self-actualization in the pass of the disease, effective supporters, and destructive constraints. Exploratory factor analysis revealed that only 28 items were appropriate which were loaded on six factors, accounting for 45.035% of the total variance of hypertension self-care. Cronbach's alpha and test-retest intraclass correlation coefficients of the index were 0.80 and 0.96, respectively. CONCLUSION The Elderly Hypertension Self-Care Index showed that it is a valid and reliable index in the elderly health context; and can be used for self-care assessment among elderly people with hypertension.
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Affiliation(s)
- Hanieh Gholamnejad
- Students Research Office, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Darvishpoor Kakhki
- Department of Medical-Surgical Nursing School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fazlollah Ahmadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Camelia Rohani
- School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ademe S, Aga F, Gela D. Hypertension self-care practice and associated factors among patients in public health facilities of Dessie town, Ethiopia. BMC Health Serv Res 2019; 19:51. [PMID: 30665405 PMCID: PMC6341627 DOI: 10.1186/s12913-019-3880-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 01/04/2019] [Indexed: 02/07/2023] Open
Abstract
Background Hypertension self-care practice is essential for blood pressure control and reduction of hypertension complications. Nevertheless, we know little concerning hypertension self-care practice in Ethiopia. The purpose of this study was to assess hypertension self-care practice and associated factors among patients in public health facilities in Dessie town, Ethiopia. Methods In this cross-sectional study, 309 hypertensive patients (mean age 58.8 years, 53.4% women) completed the interviewer-administered questionnaire in Amharic language. Descriptive and logistic regression analyses were conducted using SPSS version 22. Result The mean score for hypertension self-care was 37.7 ± 8.2 and 51% scored below the mean. Divorced participants (AOR = 0.115, 95% CI = 0.026, 0.508, p-value < 0.01) and those who lack source of information (AOR = 0.084, 95% CI = 0.022, 0.322, p-value < 0.01) were less likely to have good self-care practice. But, participants who had convenient place for exercise (AOR = 2.968, 95% CI = 1.826, 4.825, p-value < 0.01), who had good social support (AOR = 2.204, 95% CI = 1.272, 3.821, p-value < 0.01), who had traditional clergy-based teaching (AOR = 2.209, 95% CI = 1.064, 4.584, p-value < 0.05), and who had good self-care agency (AOR = 1.222, 2.956, p-value < 0.05) were more likely to have good self-care practice. Conclusion Most of the study participants reported poor self-care practices. Factors associated with hypertension self-care practice are marital status, education, source of self-care information, place for exercise, social support, and self-care agency. Targeted interventions are needed to improve hypertension self-care practice.
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Affiliation(s)
- Sewunet Ademe
- Department of Adult Health Nursing, School of Nursing & Midwifery, Wollo University, P.O. Box: 1145, Dessie, Ethiopia
| | - Fekadu Aga
- Department of Nursing, School of Nursing & Midwifery, College of Health Science, Addis Ababa University, P.O. Box: 9083, Addis Ababa, Ethiopia.
| | - Debela Gela
- Department of Nursing, School of Nursing & Midwifery, College of Health Science, Addis Ababa University, P.O. Box: 4412, Addis Ababa, Ethiopia
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Ma C. An investigation of factors influencing self-care behaviors in young and middle-aged adults with hypertension based on a health belief model. Heart Lung 2018; 47:136-141. [PMID: 29395265 DOI: 10.1016/j.hrtlng.2017.12.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 12/18/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To explore whether five variables of the health belief model were factors influencing self-care behaviors in young and middle-aged adults with hypertension. BACKGROUND The self-care behaviors of young and middle-aged adults with hypertension are suboptimal in China, and the factors associated with self-care behaviors have rarely been studied in the population. METHODS A questionnaire survey was adopted in the study. 382 eligible participants were recruited from two tertiary teaching hospitals using the convenience sampling. RESULTS The predictors of self-care behaviors in young and middle-aged adults with hypertension included age, complications related to hypertension, perceived susceptibility, severity, benefits, barriers and self-efficacy. Five aspects of health beliefs model accounted for 47.0% of total variance. CONCLUSIONS The perceived susceptibility, severity, benefits, barriers, and self-efficacy were key factors affecting self-care behaviors in young and middle-aged adults with hypertension. A health education program targeting improving health beliefs for the population should be developed.
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Affiliation(s)
- Chunhua Ma
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, China.
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Alavi M, Molavi R, Eslami P. A Structural Equation Model of Self-care Activities in Diabetic Elderly Patients. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2018; 23:61-65. [PMID: 29344049 PMCID: PMC5769188 DOI: 10.4103/ijnmr.ijnmr_38_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background: Self-care is a valuable strategy to improve health and reduce events of hospitalization and the duration of hospital stay in elderly diabetic patients. This study aimed to examine the model of self-care behaviors in elderly diabetic patients. Materials and Methods: A survey was conducted among 209 diabetic elderly patients who were admitted in three hospitals affiliated with the Isfahan University of Medical Sciences, Iran. Convenience sampling method was used to recruit the participants. Depression, anxiety, stress, and perceived social support were considered as predicting exogenous variables and elderly patients' self-care activities were treated as endogenous variables. The data were collected by a four-part questionnaire consisting of demographic and health-related characteristics; 21-item depression anxiety stress scale, multidimensional scale of perceived social support, and Diabetes Self-care Activities scale. Structural equation modelling by Statistical Package for the Social Sciences (SPSS) version 16 and Analysis of Moment Structures-7 (AMOS) software was applied for data analysis. Results: Mean (standard deviation) of depression, anxiety, stress, perceived social support, and self-care activities of participants were 14.29 (4.3), 13.62 (3.74), 16.83 (4.23), 57.33 (14.19), and 44.56 (13.77), respectively. The results showed that the overall model fitted the data (χ2/df = 3.8, goodness-of-fit index (GFI) = 0.52, incremental fit index (IFI) = 0.48, and root mean square error of approximation (RMSEA) = 0.14). Three out of four variables (i.e., perceived social support, anxiety, and depression) significantly predicted adherence to self-care behaviors among diabetic elderly patients (p < 0.05). Conclusions: The perceived social support, anxiety, and depression were identified as key constructs which need to be taken into account and well managed by health care professionals to enhance adherence to self-care activities in diabetic elderly patients.
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Affiliation(s)
- Mousa Alavi
- Nursing and Midwifery Care Research Center, Faculty of nursing and midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Razieh Molavi
- Nursing and Midwifery Care Research Center, Faculty of nursing and midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvin Eslami
- Nursing and Midwifery Care Research Center, Faculty of nursing and midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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Irwan AM, Kato M, Kitaoka K, Ueno E, Tsujiguchi H, Shogenji M. Development of the salt-reduction and efficacy-maintenance program in Indonesia. Nurs Health Sci 2016; 18:519-532. [DOI: 10.1111/nhs.12305] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 06/08/2016] [Accepted: 07/07/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Andi Masyitha Irwan
- School of Nursing; Hasanuddin University; Makassar Indonesia
- Graduate School of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Ishikawa Japan
| | - Mayumi Kato
- Graduate School of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Ishikawa Japan
| | - Kazuyo Kitaoka
- Graduate School of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Ishikawa Japan
| | - Eiichi Ueno
- School of Nursing; Fukui University; Fukui Japan
| | - Hiromasa Tsujiguchi
- Graduate School of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Ishikawa Japan
| | - Miho Shogenji
- Graduate School of Medical, Pharmaceutical and Health Sciences; Kanazawa University; Ishikawa Japan
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