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Dohrn IM, von Berens Å, Olsson CB, Rydwik E, Jakobsson E, Palmlöf L. Between principles and pragmatism - primary healthcare and social services professionals' experiences and perceptions of self-care for older adults with home care: a qualitative study. Scand J Prim Health Care 2024:1-11. [PMID: 39126195 DOI: 10.1080/02813432.2024.2389116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 08/01/2024] [Indexed: 08/12/2024] Open
Abstract
OBJECTIVE To explore the experiences of healthcare and social services professionals and their perceptions of using Certificate for self-care with support (CSS) for preventive self-care for older adults with home care, including the CSS process and collaborations between primary healthcare and social services. DESIGN An inductive qualitative study including seven focus group interviews analyzed with reflexive thematic analysis. SETTING AND SUBJECTS The study was conducted in the Stockholm Region 2022/23. In total, 23 informants were recruited from four key partners involved in the CSS process: professionals from primary care rehabilitation and primary healthcare, social services officers, and home care staff. RESULT The analyses resulted in five interconnected themes: 'Guidelines with scope for interpretation,' 'Support for self-care is needed, but complicated in practice,' 'To trust the other professions' competence,' 'There is a transfer of responsibility,' and 'Communication is key.' The overarching theme 'Principles or pragmatism for safe person-centered care,' anchoring the other themes, revealed a common goal of achieving safe and individualized care within available resources, but from two conflicting perspectives: the importance of following the process according to the guidelines or taking a more pragmatic approach. CONCLUSION This study highlights the need to establish structures facilitating safe self-care among frail groups, such as older persons dependent on home care. Our findings emphasize that the demarcation between, and responsibilities of, organizations need to be discussed and clarified to offer person-centered support. Comprehensible guidelines and functioning communication channels must be established so that all important perspectives can be heard, not least the patient's.
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Affiliation(s)
- Ing-Mari Dohrn
- Stockholm Gerontology Research Center, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Åsa von Berens
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Christina B Olsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Academic Primary Healthcare Centre, Region Stockholm, Stockholm, Sweden
| | - Elisabeth Rydwik
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Medical Unit Occupational Therapy and Physical Therapy, Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, Solna, Sweden
| | - Elin Jakobsson
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Lina Palmlöf
- Stockholm Gerontology Research Center, Stockholm, Sweden
- Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
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Milavec Kapun M, Rajkovič V, Šušteršič O, Rajkovič U. A self-care process model for patients with chronic noncommunicable diseases. Health Serv Manage Res 2024; 37:189-197. [PMID: 37699151 DOI: 10.1177/09514848231201405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
Self-care of patients with chronic noncommunicable diseases is an essential component of contemporary healthcare. The purpose of this paper is to present a novel self-care process model and place it in the broader context of professional care. The extended Event-driven Process Chain approach to process modelling was used, focusing on a detailed overview of sequences of events, connections and activities and other elements/building blocks. A self-care process model was designed. The model is divided into two parts. The first part represents the self-care process when patients are able to manage their symptoms and be independent. The second part includes the process when patients are unable to perform self-care and/or need professional support. By identifying the essential elements of this process and incorporating them into the patients' care process, we can ensure that professional support for self-care creates a dynamic balance in the patients' ecosystems. Patients with chronic noncommunicable diseases need to make timely decisions about individual aspects of their health and seek professional help. In this way, an optimal level of health and well-being of patients can be achieved. Focusing on the patients' self-care process could also reduce treatment costs and improve the quality of life of patients. The novel designed model of the process of self-care, with all its essential elements, can be supported by digital technology, especially in the decision-making process and needs to become an important part of healthcare and long-term care systems.
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Affiliation(s)
| | - Vladislav Rajkovič
- Faculty of Organizational Sciences, University of Maribor, Kranj, Slovenia
| | - Olga Šušteršič
- Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - Uroš Rajkovič
- Faculty of Organizational Sciences, University of Maribor, Kranj, Slovenia
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Wientzek R, Brückner RM, Schönenberg A, Prell T. Instruments for measuring self-management and self-care in geriatric patients - a scoping review. Front Public Health 2023; 11:1284350. [PMID: 38192561 PMCID: PMC10773718 DOI: 10.3389/fpubh.2023.1284350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/22/2023] [Indexed: 01/10/2024] Open
Abstract
Introduction With demographic changes, prioritizing effective care for geriatric patients to maintain functionality, independence, and quality of life is crucial. Well-developed self-management or self-care abilities, which can be maintained and improved through interventions, are of the utmost importance. To implement these interventions tailored and effectively, a thorough assessment of the individual's self-management and self-care abilities is required. Objective This scoping review aimed to identify self-management and self-care instruments suitable for geriatric patients, their underlying theories and definitions of self-management and self-care, and their similarities and differences in item content. Methods A systematic search of the PubMed and CINAHL databases was conducted to identify retrievable full-text articles published in English in the medical and nursing fields since the 1970s, which were validated on a sample with an average age of at least 70 years, used generic rather than disease-specific items, and addressed the broad range of self-management and self-care abilities. Results Of the 20 included articles, six instruments were identified that were based on different theories and offered varying definitions of self-management or self-care. Despite these differences, all emphasize empowered individuals taking an active role in their care. Most address actual behavior and abilities referring to lifestyle factors and (anticipated) adjustment behavior. However, crucial aspects, such as psychological factors, (instrumental) activities of daily living, and social environment are not fully addressed in these instruments, nor are the types of execution to which the items refer, such as wants, feelings, confidence, or attitudes. Conclusion To fully understand how geriatric patients implement daily self-management or self-care, a combination of instruments covering the important factors of self-management and self-care and addressing multiple types of item execution, such as behaviors, abilities, wants, or attitudes, is recommended. This review provides the first comprehensive overview of self-management and self-care instruments suitable for geriatric patients.
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Affiliation(s)
- Rebecca Wientzek
- Department of Geriatrics, Halle University Hospital, Halle (Saale), Germany
| | | | - Aline Schönenberg
- Department of Geriatrics, Halle University Hospital, Halle (Saale), Germany
| | - Tino Prell
- Department of Geriatrics, Halle University Hospital, Halle (Saale), Germany
- Department of Neurology, Jena University Hospital, Jena, Germany
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Truscott A, Hayes D, Bardsley T, Choksi D, Edbrooke-Childs J. Defining young people's mental health self-care: a systematic review and co-development approach. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02320-7. [PMID: 37947894 DOI: 10.1007/s00787-023-02320-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 10/23/2023] [Indexed: 11/12/2023]
Abstract
Self-care is among the emerging types of mental health support which operate outside traditional services, although the meaning and practice of self-care for young people with mental health difficulties are currently unclear. This systematic review was pre-registered with PROSPERO (CRD42021282510) and investigated conceptualizations of self-care in academic publications which investigated or discussed self-care for young people's mental health or wellbeing. A Patient and Public Involvement (PPI) workshop facilitated young people with experience of mental health difficulties to respond to the identified concepts and co-develop a definition of self-care. Searches in PsycINFO, MEDLINE, Embase, CINAHL Plus, Scopus, Cochrane Library of Systematic Reviews, and gray literature sources resulted in 90 included publications. Content analysis indicated little conceptual consistency, with health and wellness promotion most commonly used to define self-care. The PPI workshop co-developed a definition of mental health self-care, which attendees felt should emphasize an individual process of self-awareness, self-compassion, and specific strategies to work toward emotional balance. This study highlights the gap between current academic understandings of young people's mental health self-care and young people's experience. The presented definition will enable future research to begin from an understanding of self-care which is relevant to young people with experience of mental health difficulties.
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Affiliation(s)
- Alex Truscott
- Evidence Based Practice Unit, University College London and Anna Freud National Centre for Children and Families, 4-8 Rodney St, London, N1 9JH, UK.
| | - Daniel Hayes
- Evidence Based Practice Unit, University College London and Anna Freud National Centre for Children and Families, 4-8 Rodney St, London, N1 9JH, UK
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Tom Bardsley
- Evidence Based Practice Unit, University College London and Anna Freud National Centre for Children and Families, 4-8 Rodney St, London, N1 9JH, UK
| | - Disha Choksi
- Anna Freud National Centre for Children and Families, 4-8 Rodney St, London, N1 9JH, UK
| | - Julian Edbrooke-Childs
- Evidence Based Practice Unit, University College London and Anna Freud National Centre for Children and Families, 4-8 Rodney St, London, N1 9JH, UK
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Jeon EJ, Sohng KY, Yeom HA. Development and validation of a self-care scale for older adults undergoing hip fracture surgery: the HFS-SC. BMC Nurs 2022; 21:197. [PMID: 35869535 PMCID: PMC9308275 DOI: 10.1186/s12912-022-00982-3] [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: 02/22/2022] [Accepted: 07/11/2022] [Indexed: 12/02/2022] Open
Abstract
Background The ability to take care of oneself after hip fracture surgery is important for older adults. Various scales have been developed for evaluation of this ability, but a scale specifically focusing on hip fracture has not been developed. The aim of this study was to develop and validate a scale (Hip Fracture Surgery Self-Care Scale, HFS-SC) to evaluate self-care for older adults undergoing hip fracture surgery. Methods The scale was developed according to the guidelines by DeVellis. Initial items were derived from a literature review and individual interviews with 11 older adults who underwent hip fracture surgery. To confirm the suitability of the questions, a preliminary survey was conducted on 25 older adults. Psychometric testing was performed on 300 older adults 65 years old or over living at home after surgery for hip fracture. Psychometric properties of the scale were examined by content validity, construct validity, concurrent validity, internal consistency reliability, and test-retest reliability. Results Exploratory factor analysis and confirmatory factor analysis demonstrated that the 18-item scale comprised five factors (functional independence, symptom recognition and management, positive mental health, participation and support in social activities, and a safe environment). The results of EFA showed that the factor loadings ranging from 0.51 to 0.87. The results of CFA were χ2=375.83, χ2/df=2.14, RMSEA 0.07, SRMR 0.05, GFI 0.88, TLI 0.91, and CFI 0.92 for the 18-item scale. The reliabilities of the scale were 0.91 for Cronbach’s alpha and 0.82 for test-retest reliability. Conclusions The HFS-SC has acceptable validity and reliability and is expected to be useful for evaluating the levels of self-care for older adults undergoing hip fracture surgery and adjusting at the post-fracture period at the community or out-patient department. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-022-00982-3.
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Alqahtani J, Alqahtani I. Self-care in the older adult population with chronic disease: concept analysis. Heliyon 2022; 8:e09991. [PMID: 35874086 PMCID: PMC9304718 DOI: 10.1016/j.heliyon.2022.e09991] [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: 09/13/2021] [Revised: 01/12/2022] [Accepted: 07/13/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose Chronic disease care is considered a challenging dilemma for health organizations' sustainability and patient health. Self-care is key to chronic disease management and is substantially important in all aspects of health and levels of care. In the past years, research regarding self-care in the context of chronic disease has evolved, yet this complex concept continues to be ambiguous as there are differences in the way self-care is clearly conceptualized in the literature. A discussion of an in-depth concept analysis of self-care in the older adult population with chronic disease and an outline of its defining common attributes, referents, antecedents, consequences, and related concepts. Design Qualitative concept analysis concerning the concept of self-care in the older adult population with chronic disease. Methods An extensive review of the literature concerning the concept of self-care in the older adult population with chronic disease was conducted using different databases. Literature from nursing and other disciplines was selected to differentiate this concept from other related concepts. Rodgers's evolutionary methodology of concept analysis was used to investigate the concept of self-care in detail to better understand its meanings in the context of chronic disease. Results Multiple definitions of self-care exist, and a consensus definition was not shown to have been achieved across disciplines. The common attributes, referents, antecedents, consequences, and related concepts were identified, and a model case was constructed by the authors to clarify the concept of self-care in the context of the older adult population living with chronic disease. This concept analysis provides a theoretical definition of self-care of the older adult population living with chronic disease to offer nurses and others insight into the concept, which will ultimately provide a foundation for further research needed in the areas of clinical practice, policy, and education. Identification of the core of the self-care concept affords professionals and researchers the ability to identify appropriate practice priorities, enhance current practices, and develop theories and guidelines regarding self-care, leading to improvements in patient care and outcomes.
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Affiliation(s)
- Jawhrah Alqahtani
- Medical-Surgical Nursing Department, King Saud University-College of Nursing, Riyadh, Saudi Arabia
| | - Ibtesam Alqahtani
- Community and Mental Health Nursing Department, King Saud University-College of Nursing, Riyadh, Saudi Arabia
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Murray LR, Ferraz D, Zucchi EM, da Silva Sorrentino I, Grangeiro A. Autonomy and Care in Context: The Paradox of Sex Workers' Acceptability of HIV Self-Tests in São Paulo, Brazil. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2699-2710. [PMID: 34820782 PMCID: PMC8612389 DOI: 10.1007/s10508-021-02129-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 08/06/2021] [Accepted: 08/07/2021] [Indexed: 06/13/2023]
Abstract
Cisgender female sex workers (CFSW) continue to face structural barriers to HIV prevention. We analyzed the acceptability of the oral HIV self-test (HIV-ST) among CFSW as part of a pragmatic trial on HIV prevention in Brazil. Data from in-depth interviews conducted with 12 women from diverse sex worker contexts and participant observation were analyzed using thematic analysis. CFSW valued autonomy in their workplaces and saw the HIV-ST as a possibility for self-care. Some feared clients' reactions, manager reprimands, and a positive result. HIV and sex work stigma largely drove self-care practices and perceived acceptability of the self-test. We argue that the autonomy offered by the self-test presents a paradox: increasing autonomy on the one hand while risking sidestepping structural dimensions of HIV vulnerability on the other. These nuances must be considered in interventions promoting the HIV-ST by considering the specificities of sex worker contexts, addressing stigma, and effectively involving CFSW and their organizations in intervention development.
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Affiliation(s)
- Laura Rebecca Murray
- Núcleo de Estudos de Políticas Públicas em Direitos Humanos, Universidade Federal do Rio de Janeiro, Anexo do CFCH, 3º Andar, Av. Pasteur 250 Urca, Rio de Janeiro, RJ, 22290-140, Brazil.
| | - Dulce Ferraz
- Escola FIOCRUZ de Governo, Diretoria Regional de Brasília, Fundação Oswaldo Cruz, Brasília, DF, Brazil
| | - Eliana Miura Zucchi
- Programa de Pós-Graduação em Saúde Coletiva, Mestrado Profissional em Psicologia, Desenvolvimento e Políticas Públicas, Universidade Católica de Santos, Santos, SP, Brazil
| | - Isa da Silva Sorrentino
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Alexandre Grangeiro
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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Tsai MD, Tsai JP, Chen ML, Chang LC. Frailty, Health Literacy, and Self-Care in Patients with Chronic Kidney Disease in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095350. [PMID: 35564744 PMCID: PMC9102108 DOI: 10.3390/ijerph19095350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/18/2022] [Accepted: 04/25/2022] [Indexed: 11/17/2022]
Abstract
Chronic kidney disease (CKD) is a chronic and often irreversible disease that requires active self-care to mitigate adverse outcomes. This study aimed to analyze the associations of demographic and disease data, frailty, health literacy (HL), and CKD self-care (CKDSC) in patients with CKD. We conducted a cross-sectional study at two hospitals in Taiwan. A total of 144 CKD patients with a mean age of 66.8 ± 9.1 years were included in the study. Among them, 79.2% were in CKD G3, and the mean time since diagnosis of CKD was 86 ± 48 months. Approximately 62.5% were identified as non-frail. The mean of HL and CKDSC were 11.76 ± 4.10 and 62.12 ± 9.31. In multivariate linear regression analysis, age ≥ 65 years (odds ratio (OR) = 5.67, 95% confidence interval (CI) 1.59–9.75), non-frailty (OR = 2.19, 95% CI 0.02–5.40), and high critical HL (OR = 1.43, 95% CI 0.13–2.90) showed significant positive correlation with CKDSC. Therefore, management of patients with CKD should focus on the young population, reinforcing health education strategies that improve critical HL and preventing frailty that may interfere with self-care. In addition, the patient’s social support resources should be expanded to achieve the goal of CKDSC.
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Affiliation(s)
- Mu-Dan Tsai
- Department of Nursing, Douliou Tzu Chi Hospital, Yunlin City 64041, Taiwan;
| | - Jen-Pi Tsai
- Department of Nephrology, Dalin Tzu Chi Hospital, Chiayi City 62247, Taiwan;
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
| | - Min-Li Chen
- School of Nursing, Chang Gung University of Science and Technology, Chiayi City 61363, Taiwan;
| | - Li-Chun Chang
- School of Nursing, Chang Gung University of Science and Technology, Taoyuan City 33303, Taiwan
- Chang Gung Memorial Hospital, Keelung 20401, Taiwan
- Department of Nursing, Chang Gung University, Taoyuan City 33302, Taiwan
- Correspondence:
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Bermejo-Martins E, Luis EO, Fernández-Berrocal P, Martínez M, Sarrionandia A. The role of emotional intelligence and self-care in the stress perception during COVID-19 outbreak: An intercultural moderated mediation analysis. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021; 177:110679. [PMID: 36540668 PMCID: PMC9756564 DOI: 10.1016/j.paid.2021.110679] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/09/2021] [Accepted: 01/12/2021] [Indexed: 01/04/2023]
Abstract
Background The relationship between emotional intelligence (EI) and stress has been widely studied, as well as the beneficial role of self-care to maintain health and wellbeing. However, the joint contribution of EI and self-care in predicting stress has not been examined during COVID-19 lockdown. This study aimed to examine the mediating role of self-care in the relationship between EI and stress and the potential moderator role of gender. Methods A sample of 1082 participants from four Hispanic countries completed measures related to socio-demographic, trait emotional intelligence (Trait Meta-Mood Scale), self-care activities (Self-care Activities Screening Scale) and stress (Perceived Stress Scale). Results Mediation analyses revealed that self-care increased the explained variance of the prediction of stress by EI dimensions after controlling gender and age. However, gender only moderated the relationship between self-care and stress in the mediation model corresponding to emotional attention. Conclusions Data supported a general model for the interaction of EI and self-care as contributing factors of stress. Further research is needed to replicate it in more culturally distant samples and to fully explore the potential role of gender differences. Future intervention programs should include a balanced combination of EI and self-care to increase their benefits on people's health.
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Affiliation(s)
- Elena Bermejo-Martins
- School of Nursing, University of Navarra, Spain
- Navarra Institute for Health Research IdiSNA, Spain
| | - Elkin O Luis
- School of Education and Psychology, University of Navarra, Spain
- Navarra Institute for Health Research IdiSNA, Spain
| | | | - Martín Martínez
- School of Education and Psychology, University of Navarra, Spain
- Navarra Institute for Health Research IdiSNA, Spain
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Özkeskin M, Özden F, Şahin S. Translation, Cross-cultural Adaptation, and Psychometric Properties of the Turkish Version of the Self-care Ability Scale for the Elderly. Ann Geriatr Med Res 2021; 25:122-128. [DOI: https:/doi.org/10.4235/agmr.21.0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/09/2021] [Indexed: 08/30/2023] Open
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Özkeskin M, Özden F, Şahin S. Translation, Cross-cultural Adaptation, and Psychometric Properties of the Turkish Version of the Self-care Ability Scale for the Elderly. Ann Geriatr Med Res 2021; 25:122-128. [PMID: 34120435 PMCID: PMC8273004 DOI: 10.4235/agmr.21.0046] [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: 04/29/2021] [Accepted: 06/09/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose The Self-care Ability Scale for the Elderly (SASE) is a frequently used scale that was created in Sweden according to Orem’s self-care deficit theory and later modified according to Pörn’s theory of environment and purpose. This study translated and cross-culturally adapted the Turkish version of the SASE (T-SASE) and demonstrated its psychometric properties, including its reliability and construct validity. Methods This study recruited a total of 122 participants and applied international guidelines for the translation and adaptation of the scale. The test-retest reliability of the SASE was calculated at 1-week intervals. Internal consistency was analyzed using Cronbach’s alpha. For construct validity, we compared the T-SASE to the Nottingham Extended Activities of Daily Living Scale (NEADLS) and the Exercise of Self-Care Agency Scale (ESCAS). Results The mean age of the participants was 68.6±5.7 years. The test-retest reliability of the T-SASE was excellent (intraclass correlation coefficient=0.914; 95% confidence interval, 0.81–0.95). The internal consistency of the total T-SASE score was also excellent (Cronbach’s α=0.912), as were the Cronbach’s alpha scores for the individual items, ranging from 0.901 to 0.915. The items were also highly consistent with each other (Cronbach’s α>0.80). The construct validity of the T-SASE was acceptable (0.35<r<0.50) in a convergent manner. The T-SASE was also strongly correlated with the NEADLS and ESCAS (r1=0.405, r2=0.437, p<0.01). Conclusions The T-SASE was a reliable and valid tool for assessing the self-care ability of community-dwelling older adults. Owing to its multidimensional structure, the T-SASE is an essential tool for evaluating self-care in older adults.
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Affiliation(s)
- Mehmet Özkeskin
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ege University, Izmir, Turkey
| | - Fatih Özden
- Department of Elderly Care, Koycegiz Vocational School of Health Services, Mugla Sitki Kocman University, Mugla, Turkey
| | - Sevnaz Şahin
- Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Ege University, Izmir, Turkey
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Information or Habit: What Health Policy Makers Should Know about the Drivers of Self-Medication among Romanians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020689. [PMID: 33466957 PMCID: PMC7830883 DOI: 10.3390/ijerph18020689] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/28/2020] [Accepted: 01/09/2021] [Indexed: 02/06/2023]
Abstract
We use the Knowledge, Perceptions and Practices framework to analyze determinants of three types of self-medication practices in Romania: (1) self-medication in the case of cold/flu/viral infections; (2) taking non-prescribed medicine in general; and (3) self-medication based on recommendations by others. We analyzed 706 responses to an online survey and used a factor-based Partial Least Squares algorithm (PLSF) to estimate the relationships between each type of self-medication and possible predictors. Our results show that self–medication is strongly predicted by non-cognitive behavioral factors such as habits and similarity of symptoms, while cognitive determinants such as knowledge and understanding of potential risks are not significantly associated with self-medication behaviors. This paper identifies nonlinear relationships among self-medication practices and its predictors and discusses how our results can help policymakers calibrate interventions with better accuracy.
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Life satisfaction among older adults in urban China: does gender interact with pensions, social support and self-care ability? AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x20001877] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Abstract
In urban China, the social welfare system and the family structure have changed dramatically, while gender norms are still deep-rooted, particularly among older adults. Under this social, demographic and cultural context, this study aims to take a gender-specific perspective to investigate whether and how gender moderates the roles of pensions, social support and self-care ability on older adults’ life satisfaction. Based on the survey data collected from 2,047 older adults aged 65 years and over in urban China in 2018, multiple linear regressions were applied to explore the moderation effects. The results show that the pension is important to older adults’ life satisfaction regardless of gender. For social support, the association between family support and life satisfaction is stronger for older men than for older women; interdependent social support, especially being a confidant, matters more to women than to men. The interaction between self-care ability and gender reveals some interesting patterns: self-care ability is found to have a positive association with women's life satisfaction but a negative association with men's. This study contributes to the existing literature by demonstrating how gender intertwines with the most important factors of older adult's life satisfaction in China – a society with strong gender norms and a patriarchal culture. These findings could be relevant to other Asian societies.
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The Effect of Traumatic Experiences of North Korean Adolescent Refugees upon Their Negative Health Perception: Focusing on Multiple Moderating Effect of Problem-Focused versus Social Support-Focused Coping Strategies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249484. [PMID: 33352861 PMCID: PMC7766628 DOI: 10.3390/ijerph17249484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/10/2020] [Accepted: 12/14/2020] [Indexed: 11/21/2022]
Abstract
The health problems of North Korean (NK) refugees living a new life after surviving the dangers of life and death traumas is an issue that must be taken very seriously. Adolescent refugees may be particularly vulnerable to adverse physical and mental health issues because of major physical, cognitive, and psychosocial developmental changes during adolescence. This study examines the positive roles two active coping strategies—problem-focused coping and social support-focused coping—can play in NK refugee adolescents’ health self-awareness. The analysis found that “social support-focused coping” alleviates the negative relationship between traumatic experience and health perception, acting as a protective factor. Contrary to our prediction, the protective effect of adopting “problem-focused coping” in this study was not verified. The findings suggest that providing interventions for developing appropriate coping strategies help them live healthier, both physically and mentally, in South Korean society.
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Amir-Behghadami M, Tabrizi JS, Saadati M, Gholizadeh M. Psychometric properties of the Iranian version of self-care ability scale for the elderly. BMC Geriatr 2020; 20:364. [PMID: 32962635 PMCID: PMC7510275 DOI: 10.1186/s12877-020-01775-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 09/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Measuring self-care ability in elderly people needs specific instruments. The Self-care Ability Scale for Elderly (SASE) is one of the common instruments used for assessing self-care ability. The aim of this study was to assess the psychometric properties of the SASE among Iranian elderly population. METHODS This cross-cultural adaptation study was carried out at Shahid Chamran and Shadpour Health Complex in Tabriz, Iran. The forward-backward procedure was applied to translate the SASE from English into Persian. Then, it was completed to 220 elderly people. A systematic random sampling method was used for sampling. Content validity was calculated through modified Kappa coefficient (modified CVI) based on clarity and relevance criteria. Reliability was measured by internal consistency and test-retest analysis. The construct validity also was assessed using Exploratory Factor Analysis (EFA). All the statistical analyses were performed using SPSS 21 statistical software package. RESULTS The mean of self-care ability was 61.14 ± 21.08. The CVI and modified kappa were 0.91 and 0.92 for relevance and clarity, respectively. The Cronbach's alpha coefficient was 0.73 and Intra-class correlation coefficient was 0.97. The results of EFA revealed a three-factor solution ('ability to take care of personal responsibility', 'ability to take care for the goals', and 'ability to take care of the health') that jointly explained for 64.61% of the total variance. CONCLUSION Results of the study showed that the Iranian version of the SASE has good psychometric properties and can be used in assessing the self-care ability of elderly people.
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Affiliation(s)
- Mehrdad Amir-Behghadami
- Student Research Committee (SRC), Tabriz University of Medical Sciences, Tabriz, Iran. .,Iranian Center of Excellence in Health Management (IceHM), Department of Health Service Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, University Rd, Golbad, EAZN, Tabriz, 5165665811, Iran.
| | - Jafar Sadegh Tabrizi
- Iranian Center of Excellence in Health Management (IceHM), Department of Health Service Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, University Rd, Golbad, EAZN, Tabriz, 5165665811, Iran.,Tabriz Health Service Management Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Saadati
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoumeh Gholizadeh
- Iranian Center of Excellence in Health Management (IceHM), Department of Health Service Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, University Rd, Golbad, EAZN, Tabriz, 5165665811, Iran
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16
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Contini C, Boncinelli F, Marone E, Scozzafava G, Casini L. Drivers of plant-based convenience foods consumption: Results of a multicomponent extension of the theory of planned behaviour. Food Qual Prefer 2020. [DOI: 10.1016/j.foodqual.2020.103931] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Richmond RS, Connolly M. A delineation of self-management and associated concepts. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2020. [DOI: 10.1080/20479700.2020.1810963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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18
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Høy B, Hall EOC. "Take good care of yourself" An integrative review of older widows' self-care for health and well-being. J Women Aging 2020; 34:1-30. [PMID: 32339070 DOI: 10.1080/08952841.2020.1753484] [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] [Indexed: 10/24/2022]
Abstract
Take good care of yourself is a regard often said to older bereaved women. However, what does it mean? Though self-care is a well-known phenomenon within health, it is not well understood in the context of late life spousal bereavement and widowhood. We undertook an integrative review to synthesize knowledge of older women's self-care challenges, resources and activities when bereaved and in a healthy transition to widowhood. Good care refers to health-promoting self-care and can be explained as the older widows' ability to access and mobilize resources and activities that are significant for a healthy transition to widowhood.
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Affiliation(s)
- Bente Høy
- Research Unit, Randers Regional Hospital, Randers, Denmark
| | - Elisabeth O C Hall
- Health, Aarhus University, Aarhus, Denmark.,Faculty of Natural and Health Sciences, University of Faroe Islands, Thorshavn, Faroe Islands
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Akbarbegloo M, Zamanzadeh V, Ghahramanian A, Valizadeh L, Matin H. Health and Psychosocial Self-Care Needs in Off-Therapy Childhood Cancer: Hybrid Model Concept Analysis. Patient Prefer Adherence 2020; 14:803-815. [PMID: 32494126 PMCID: PMC7225174 DOI: 10.2147/ppa.s246558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 04/19/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The self-care concept is a complicated and multi-dimensional phenomenon. There are different opinions about self-care needs; therefore, this study was conducted to clarify the self-care needs of the off-therapy childhood cancer survivors based on the hybrid model. PATIENTS AND METHODS There are three phases in the hybrid model including literature review, fieldwork, and final analysis. At the theoretical phase, 119 articles in databases were evaluated without time limits up to August 2019. At the fieldwork phase, 19 participants were selected with purposive sampling and interviewed through unstructured interviews. Then, the data were analyzed by qualitative content analysis approach. In the final phase, the overall analysis of the two previous phases was carried out and the ultimate definition of self-care needs was presented with the integration of the results of two previous phases. RESULTS Theoretical results showed that self-care needs are those that need to be performed by off therapy childhood cancer in everyday life in order to maintain health and well-being through the practice of healthy behaviors and activities. Also, fieldwork results indicated that self-care needs are increased due to the physical, mental, and social vulnerability of the disease. Following that, the need for protective self-care behaviors to prevent against physical and psychosocial side effects arises. If the patients are unable to implement protective behaviors, the need for support from others is created. Therefore, by synthesizing the findings of literature review and fieldwork, self-care needs are two-dimensional concept: (1) need for changing in behavior to protect themselves against physical and psychosocial distress and (2) need for supporting to implement care. CONCLUSION Taking into account the self-care needs, healthcare providers can support childhood cancer survivors in gaining and maintaining independency in self-care. On the other hand, the results of this study by creating a basic knowledge in the field of self-care needs can be used in the development of policy and standards of care to meet the needs of this group.
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Affiliation(s)
- M Akbarbegloo
- Department of Pediatric Nursing, Faculty of Nursing, Khoy University of Medical Sciences, Khoy, Iran
| | - V Zamanzadeh
- Department of Medical- Surgical Nursing, Faculty of Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
| | - A Ghahramanian
- Department of Medical- Surgical Nursing, Faculty of Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
| | - L Valizadeh
- Department of Pediatric Nursing, Faculty of Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
- Correspondence: L Valizadeh Tabriz, East Azerbaijan Province, IranTel +98 41 3479 6770Fax +98 4133340634 Email
| | - H Matin
- Department of Health Education and Promotion, Faculty of Health, Khoy University of Medical Sciences, Khoy, Iran
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20
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Göransson C, Wengström Y, Ziegert K, Langius-Eklöf A, Blomberg K. Self-care ability and sense of security among older persons when using an app as a tool for support. Scand J Caring Sci 2019; 34:772-781. [PMID: 31769888 DOI: 10.1111/scs.12782] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 10/02/2019] [Indexed: 01/01/2023]
Abstract
THE STUDY'S RATIONALE The need for home care among older persons is increasing, and mHealth is evolving to help meet the challenge. When developing an app to help maintain their health, it is essential to incorporate older persons' preferences. AIMS AND OBJECTIVES To describe and evaluate the experiences of self-care support and sense of security among older persons using an interactive app to report health concerns. METHODOLOGICAL DESIGN AND JUSTIFICATION The study had a descriptive and evaluative design. Qualitative and quantitative methods were applied to achieve a broader understanding. ETHICAL ISSUES AND APPROVAL Ethical approval was obtained from the Regional Ethical Review Board. The older persons received verbal and oral information about the study and gave written informed consent. RESEARCH METHODS Questionnaires (n = 17 older persons) answered at baseline, end of the intervention and at a 6-month follow-up were analysed with statistical analysis. Interviews (n = 17 older persons) conducted at the end of the intervention were analysed using a qualitative directed approach. MEASUREMENTS AND INTERVENTION The questionnaire included the Appraisal of Self-care Agency Scale and a question concerning sense of security. For 3 months, the older persons used an app for regular reporting of health concerns. The app included self-care advice, graphs and a risk assessment model that generated alerts directly to the nurses. RESULTS The older persons described how self-care and sense of security increased at the end of intervention, but statistically, it was shown to decrease afterwards. STUDY LIMITATIONS The small sample size for statistical analysis. CONCLUSIONS This study shows that an app can be a complementary tool to conventional home care that can increase older persons' sense of security and self-care ability. The results mirror the older persons' awareness that the support they received with the app was only temporary. Larger studies are needed for generalisation.
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Affiliation(s)
- Carina Göransson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.,School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Yvonne Wengström
- Cancer Theme, Karolinska University Hospital, Stockholm, Sweden.,Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Kristina Ziegert
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Ann Langius-Eklöf
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Karin Blomberg
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
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Haanes GG, Hall EO, Eilertsen G. Acceptance and adjustment: A qualitative study of experiences of hearing and vision impairments and daily life among oldest old recipients of home care. Int J Older People Nurs 2019; 14:e12236. [PMID: 31099486 PMCID: PMC6767382 DOI: 10.1111/opn.12236] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 02/01/2019] [Accepted: 04/05/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The severity of age-related hearing and vision impairments increases with age. Such sensory impairments are risk factors for functional decline, reduced social participation, withdrawal, depression and accidents, and hence they make people vulnerable and adversely affect their quality of life. AIM The aim of this study was to explore how the oldest old recipients of home care experience sensory impairments in daily life. DESIGN An inductive, descriptive research design was used. METHOD Ten recipients of home care with a mean age of 89 years were interviewed in their homes. The study was implemented in accordance with the suggestions from Elo and Kyngäs for inductive content analysis. FINDINGS The main theme concerned acceptance and adjustment in daily life. Subcategories concerning the category of reduced hearing were identified as "acceptable though annoying" and "hesitant about using hearing aids." Subcategories concerning the category of reduced vision were "reading is increasingly challenging" and "living with vision diseases." The third category of feeling weak was elucidated in the subcategories "troublesome bodily changes" and "strenuous days with limited energy." CONCLUSIONS It is imperative to recognise that the oldest old are in a distinct phase of the lifespan. Despite this population being aware of their hearing and vision impairments, they do not always have the strength to alter the situation. Instead they accept it; they often struggle with more serious health challenges. Therefore, they are not prioritising using their limited energy reserves to try to improve or optimise their hearing and vision impairments themselves. IMPLICATIONS FOR PRACTICE The oldest old with sensory impairments cannot be expected to perform all the necessary activities of daily living or address their functional sensory impairments. Close monitoring and assistance need to be applied to the oldest old.
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Affiliation(s)
- Gro Gade Haanes
- Faculty of Natural and Health Sciences, Department of NursingUniversity of the Faroe IslandsTórshavnFaroe Islands
| | - Elisabeth O.C. Hall
- Faculty of Natural and Health Sciences, Department of NursingUniversity of the Faroe IslandsTórshavnFaroe Islands
- Section of Nursing, Department of Public HealthAarhus UniversityAarhusDenmark
| | - Grethe Eilertsen
- Faculty of Health and Social Sciences, Department of Nursing and Health SciencesUniversity of South‐Eastern NorwayDrammenNorway
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Voraroon S, Hellzen O, Enmarker I, Meebunmak Y, Devik SA. The impact of shareholding networks for facilitating care in rural Thailand. Geriatr Nurs 2019; 40:392-398. [PMID: 30765176 DOI: 10.1016/j.gerinurse.2019.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 01/06/2019] [Accepted: 01/09/2019] [Indexed: 11/19/2022]
Abstract
This study explored the existential meaning of being a participant in shareholding networks for the care of older people in Thailand. Ten older persons were interviewed about their experiences of participating in the networks. A reflective lifeworld perspective based on phenomenological philosophy was used. The findings show that participating in shareholding network activities entails an always-present existence of aging intertwined with life. Its constituents further describe the essential meaning of the phenomenon: "experience of improved self-management", "feeling of increased self-esteem", and "bridging a gap in the care of older people". Participation in shareholding network activities means keeping contact with oneself and being able to have a life that corresponds to how one perceives oneself to be and must therefore be understood from a holistic perspective. The present study recommends that older persons' need for support include places where safe and profound reflection on existential issues.
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Affiliation(s)
- Supaporn Voraroon
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden; Boromarajonani College of Nursing, Suphanburi, Thailand.
| | - Ove Hellzen
- Department of Nursing Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Ingela Enmarker
- Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
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Kristensen MAT, Guassora AD, Arreskov AB, Waldorff FB, Hølge-Hazelton B. 'I've put diabetes completely on the shelf till the mental stuff is in place'. How patients with doctor-assessed impaired self-care perceive disease, self-care, and support from general practitioners. A qualitative study. Scand J Prim Health Care 2018; 36:342-351. [PMID: 29929420 PMCID: PMC6161682 DOI: 10.1080/02813432.2018.1487436] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE This paper investigated patients' experiences of disease and self-care as well as perceptions of the general practitioner's role in supporting patients with impaired self-care ability. DESIGN Qualitative interviews with 13 patients with type 2 diabetes, concurrent chronic diseases, and impaired self-care ability assessed by a general practitioner. We analyzed our data using systematic text condensation. The shifting perspectives model of chronic illness formed the theoretical background for the study. RESULTS Although most patients experienced challenges in adhering to recommended self-care activities, many had developed additional, personal self-care routines that increased wellbeing. Some patients were conscious of self-care trade-offs, including patients with concurrent mental disorders who were much more attentive to their mental disorder than their somatic diseases. Patients' perspectives on diseases could shift over time and were dominated by emotional considerations such as insisting on leading a normal life or struggling with limitations caused by disease. Most patients found support in the ongoing relationship with the same general practitioner, who was valued as a companion or appreciated as a trustworthy health informant. CONCLUSION Patient experiences of self-care may collide with what general practitioners find appropriate in a medical regimen. Health professionals should be aware of patients' prominent and shifting considerations about the emotional aspects of disease. Patients valued the general practitioner's role in self-care support, primarily through the long-term doctor-patient relationship. Therefore, relational continuity should be prioritized in chronic care, especially for patients with impaired self-care ability who often have a highly complex disease burden and situational context. Key points Little is known about the perspectives of disease and self-care in patients with a doctor-assessed impaired ability of self-care. • Although patients knew the prescribed regimen they often prioritized self-care routines that increased well-being at the cost of medical recommendations. • Shifting emotional aspects were prominent in patients' considerations of disease and sustained GPs' use of a patient-centred clinical method when discussing self-care. • Relational continuity with general practitioners was a highly valued support and should be prioritized for patients with impaired self-care.
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Affiliation(s)
- Mads Aage Toft Kristensen
- Department of Public Health, The Research Unit for General Practice and Section of General Practice, University of Copenhagen, Copenhagen, Denmark;
- Southern Køge Medical Centre, Køge, Denmark;
- CONTACT Mads Aage Toft KristensenDepartment of Public Health, The Research Unit for General Practice and Section of General Practice, University of Copenhagen, Øster Farimagsgade 5, P.O. box 2099, Copenhagen K, DK, 1014, Denmark
| | - Ann Dorrit Guassora
- Department of Public Health, The Research Unit for General Practice and Section of General Practice, University of Copenhagen, Copenhagen, Denmark;
| | - Anne Beiter Arreskov
- Department of Public Health, The Research Unit for General Practice and Section of General Practice, University of Copenhagen, Copenhagen, Denmark;
| | - Frans Boch Waldorff
- Department of Public Health, The Research Unit for General Practice and Section of General Practice, University of Copenhagen, Copenhagen, Denmark;
- Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark;
| | - Bibi Hølge-Hazelton
- Zealand University Hospital, Roskilde, Denmark;
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Assis MRD, Maraglia PH, Brandão MAG, Peixoto MAP. Metacognition as an educational technology in self-care learning: the case of prevention of post-surgical lymphedema of breast cancer. ESCOLA ANNA NERY 2018. [DOI: 10.1590/2177-9465-ean-2017-0440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Aim: To introduce metacognition as an educational technology for learning self-care. In order to achieve this goal, it discusses the prevention of lymphedema after breast cancer surgery. Method: Reflexion paper based on philosophical and theoretical reasoning in adition of empirical evidence to support the use of metacognition for self care learnig. It states that using metacognitive resources as educational technology may promote more effective both teaching-learning process, stimulates critical and reflexive thinking, increasing conscious and autonomous decision-making. Results: The characteristics of metacognition and self-care interpenetrate. In addition metacognition has been beneficial in other disorders and diseases. Final considerations and implications for practice: It was concluded that the metacognitive approach, used as technology, opens wide possibilities for nursing in its teaching-learning actions for self-care, making them more effective, resulting in the empowerment of women, specifically enabling clients to make decisions, making the process more conscious, deliberate and autonomous.
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Raffaele B, Biagioli V, Cirillo L, De Marinis MG, Matarese M. Cross-validation of the Self-care Ability Scale for Elderly (SASE) in a sample of Italian older adults. Scand J Caring Sci 2018; 32:1398-1408. [PMID: 29855058 DOI: 10.1111/scs.12585] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 04/17/2018] [Indexed: 01/23/2023]
Abstract
The assessment of self-care among older adults is important as it permits the tailoring of educational interventions directed to prevent health deterioration and contrast the effects of ageing. The Self-care Ability Scale for the Elderly (SASE) was developed to assess the perceived self-care ability in older adults. Its psychometric properties were tested only in Scandinavian countries and China. This research was a cross-validation of the SASE on 402 Italian adults aged 65 and older recruited in hospitals, clinics and homes, from September 2016 to February 2017. We performed exploratory and confirmatory factor analyses on two subsamples and identified three factors, self-care ability to perform ADLs, self-care ability to achieve well-being and self-care ability to set personal goals, with a good model fit (CFI > 0.93; RMSEA = 0.07; SRMR = 0.06). We eliminated four items, however, to improve the structural validity. Internal consistency for the three factors of the Italian version of the SASE (SASE-I) ranged from 0.72 to 0.92. The test-retest reliability indicated good stability of the scale (ICC coefficient = 0.92). We assessed convergent validity by comparing the SASE-I with the Katz Index of Independence in Activities of Daily Living and the Lawton Instrumental Activities of Daily Living Scale, showing moderate-to-strong correlations. In addition, the SASE-I discriminated the self-care ability in groups with different ages, levels of education and settings. Our study produced a 13-item version of the SASE with good psychometric properties that could be recommended for use in clinical practice and research after further validation on different populations and settings.
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Affiliation(s)
- Barbara Raffaele
- Department of Biomedicine and Public Health, Nursing Science University of Rome Tor Vergata, Rome, Italy
| | - Valentina Biagioli
- Department of Biomedicine and Public Health, Nursing Science University of Rome Tor Vergata, Rome, Italy
| | | | | | - Maria Matarese
- Research Unit of Nursing Science, Campus Bio-Medico University of Rome, Rome, Italy
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Matarese M, Lommi M, De Marinis MG, Riegel B. A Systematic Review and Integration of Concept Analyses of Self-Care and Related Concepts. J Nurs Scholarsh 2018; 50:296-305. [DOI: 10.1111/jnu.12385] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Maria Matarese
- Associate Professor, Research Unit of Nursing Science; Campus Bio-medico University of Rome; Rome Italy
| | - Marzia Lommi
- Adjunct Professor, University of Rome Tor Vergata; Rome Italy
| | - Maria Grazia De Marinis
- Professor, Research Unit of Nursing Science; Campus Bio-medico University of Rome; Rome Italy
| | - Barbara Riegel
- Professor and Edith Clemmer Steinbright Chair of Gerontology; School of Nursing, University of Pennsylvania; Philadelphia PA USA
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LeBlanc RG, Jacelon CS. Self-care among older people living with chronic conditions. Int J Older People Nurs 2018; 13:e12191. [PMID: 29573333 DOI: 10.1111/opn.12191] [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: 07/26/2017] [Accepted: 02/01/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to clarify the concept of self-care among older people living with chronic health conditions. This concept clarification will assist nurses in addressing self-care among older people through research, policy and practice in offering an expanded conceptual model. BACKGROUND Several policy influences over the past decade directly relate to the increased importance and economic necessity to require self-directed care for older people living with chronic health conditions to maintain their care at home in the community. METHOD A selective review of literature on the concept of self-care included 31 sources. The Norris Concept Clarification method (1982) was used for clarification. The phenomenon is described historically according to its antecedents, attributes and consequences. RESULTS A proposed definition is provided based on the clarification of this concept. A conceptual model is presented through an ecological framework. Self-care among older people living with chronic conditions is multidimensional and has multilevel influences (individual, community, system levels) and is mediated by the contexts and processes of ageing. Self-care originates along one's life course and is learned. Self-care responses are based on care needs when living with chronic health conditions. CONCLUSION Self-care is an individual capacity, disposition and activity older people manifest in living with multiple chronic conditions. These features (capacity, disposition, action) influence one another and are hierarchical and continuous. Research, practice and policies that promote self-care among older people can focus on these features to improve health outcomes and promote new models of care consistent with personal development and chronic care needs in older age. IMPLICATIONS FOR PRACTICE This concept clarification can offer a model to support self-care among older people living with chronic conditions.
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Affiliation(s)
- Raeann G LeBlanc
- University of Massachusetts Amherst College of Nursing, Amherst, MA, USA
| | - Cynthia S Jacelon
- University of Massachusetts Amherst College of Nursing, Amherst, MA, USA
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Kristensen MAT, Hølge-Hazelton B, Waldorff FB, Guassora AD. How general practitioners perceive and assess self-care in patients with multiple chronic conditions: a qualitative study. BMC FAMILY PRACTICE 2017; 18:109. [PMID: 29273001 PMCID: PMC5741911 DOI: 10.1186/s12875-017-0679-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 12/08/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND It is not known how general practitioners (GPs) perceive the concept of self-care and how they assess self-care ability in patients with multiple chronic conditions. As a part of the strategy to improve the care of people living with chronic conditions, disease management programs in Denmark require GPs and other health care workers to assess and support patients' self-care ability. The aim of the present study was to explore GPs' perceptions and assessment of self-care ability in patients with multiple chronic conditions who have difficulty following a given treatment. METHODS A qualitative study conducted through in-depth, semi-structured interviews with a purposive sample of 12 GPs in rural areas of Denmark with economically disadvantaged populations. The interviews involved 36 complex patient cases selected by the GPs themselves. Our analysis followed the principles of systematic text condensation. RESULTS Most GPs in our study had a health-related perception of self-care, but some had a broader perception encompassing the situational context of the patient's life. The GPs' assessments of patients' self-care ability were based on information from the ongoing and often long-term relationships with the patients. GPs identified four major factors that influenced patients' self-care ability, which accumulated and fluctuated over time: multimorbidity, cognitive resources, material resources, and the patients' social contexts. CONCLUSIONS The GPs in this study had dual perceptions of self-care, related to both the chronic health conditions and to the broader situational contexts of their patients' lives. GPs' assessments of self-care ability depended largely on their experiences from the doctor-patient relationship, and they emphasized that the factors affecting self-care ability were highly dynamic over the patient's lifetime. However, these findings might be resisted by the Danish disease management programs, which tend to have a static and more narrow, health-related view of patient self-care. The Danish programs require GPs to assess self-care ability upfront at the beginning of treatment and do not consider whether a relationship with the patient is established. If GPs' perceptions and assessments of self-care ability are not included in chronic disease management models, there is a risk that they vill be insufficiently implemented in general practice.
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Affiliation(s)
- Mads Aage Toft Kristensen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, P.O. box 2099, DK-1014, Copenhagen K, Denmark.
| | - Bibi Hølge-Hazelton
- Zealand University Hospital, Munkesøvej 20, DK-4000, Roskilde, Denmark.,Department of Regional Health Research, University of Southern Denmark, Winsløwparken 19, 3, DK-5000, Odense C, Denmark
| | - Frans Boch Waldorff
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, P.O. box 2099, DK-1014, Copenhagen K, Denmark.,Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9, DK-5000, Odense C, Denmark
| | - Ann Dorrit Guassora
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, P.O. box 2099, DK-1014, Copenhagen K, Denmark
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Göransson C, Wengström Y, Ziegert K, Langius-Eklöf A, Eriksson I, Kihlgren A, Blomberg K. Perspectives of health and self-care among older persons-To be implemented in an interactive information and communication technology-platform. J Clin Nurs 2017; 26:4745-4755. [PMID: 28334519 DOI: 10.1111/jocn.13827] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2017] [Indexed: 11/29/2022]
Abstract
AIM AND OBJECTIVES To acquire knowledge regarding the contents to be implemented in an interactive information and communication technology-platform perceived to be relevant to health and self-care among older persons based on the literature, healthcare professionals and the older persons themselves. BACKGROUND The growing ageing population places demands on the healthcare system to promote healthy ageing and to strengthen the older person's self-care ability. This requires innovative approaches to facilitate communication between the older person and healthcare professionals, and to increase the older person's participation in their care. An information and communication technology-platform could be used for this purpose, but the content needs to be relevant to both the older persons and the healthcare professionals. DESIGN Descriptive qualitative design. METHODS This study was based on three samplings: a scoping review of the literature (n = 20 articles), interviews with healthcare professionals (n = 5) and a secondary analysis of interviews with older persons (n = 8) and nursing assistants (n = 7). The data were analysed using qualitative content analysis. RESULTS Four areas were identified to be of relevance to older persons' perceived health: frame of mind, having relationships and social activities, physical ability and concerns, and maintaining self-care. Self-care was described in the literature and by the healthcare professionals more than by the older persons. CONCLUSIONS The results show a concordance in the data samplings that give a clear indication of the areas relevant to older persons' health and self-care that can be integrated in an interactive information and communication technology-platform for use in regular daily care assessments. Descriptions of self-care were limited indicating a possible gap in knowledge that requires further research. RELEVANCE TO CLINICAL PRACTICE Areas relevant to older persons' health and self-care could be used for regular assessment to support and promote healthy ageing.
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Affiliation(s)
- Carina Göransson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden.,Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Yvonne Wengström
- Division of Nursing, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden
| | - Kristina Ziegert
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Ann Langius-Eklöf
- Division of Nursing, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden
| | - Irene Eriksson
- School of Life Sciences, University of Skövde, Skövde, Sweden
| | - Annica Kihlgren
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Karin Blomberg
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
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Gao H, Söderhamn U, Cliffordson C, Guo L, Guo Q, Liu K. Reliability and validity of the Chinese version of the Self-care Ability Scale for the Elderly. J Clin Nurs 2017; 26:4489-4497. [PMID: 28231632 DOI: 10.1111/jocn.13779] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2017] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To translate the Self-care Ability Scale for the Elderly into Simplified Chinese and to test the Chinese version of the scale regarding its reliability and validity among older people. BACKGROUND Self-care is an important topic in nursing. When assessing older people's self-care ability, it is essential that a reliable and valid instrument is used. DESIGN This study employed across-sectional design. METHODS We translated the English version of the Self-care Ability Scale for the Elderly into Simplified Chinese according to Brislin's translation guidelines and carried out a questionnaire survey among 610 older people, including both community-dwelling people and hospital patients, in Jinzhou City, People's Republic of China. Eighty participants completed the instrument twice for test-retest reliability. Data analyses were performed using spss 17.0 and Mplus, version 5, to assess reliability and validity. RESULTS A Cronbach's alpha coefficient of .89 and statistically significant item-to-total correlations showed evidence of homogeneity. An intraclass correlation coefficient of .99 for the test-retest between total scores and intraclass correlation coefficients between .87-.99 for the test-retest scores of each item explained the almost perfect test-retest reliability noted in this study. Content validity was found to be good, and a three-factor model was obtained in an exploratory factor analysis (explaining a variance of 57%) and modified in a confirmatory factor analysis (χ2 = 261.559, df = 98, root mean square error of approximation = 0.074; standardised root mean square residual = 0.059), which reflected an acceptable construct validity. CONCLUSIONS This study shows that the Chinese version of the Self-care Ability Scale for the Elderly has sufficient psychometric properties for assessing self-care ability among older people in China. RELEVANCE TO CLINICAL PRACTICE A reliable and valid instrument is available to assess the self-care ability of older Chinese people.
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Affiliation(s)
- Han Gao
- College of Nursing, Jinzhou Medical University, Jinzhou City, Liaoning Province, China
| | - Ulrika Söderhamn
- Center for Caring Research-Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | | | - Lina Guo
- College of Nursing, Jinzhou Medical University, Jinzhou City, Liaoning Province, China
| | - Qiyun Guo
- College of Nursing, Jinzhou Medical University, Jinzhou City, Liaoning Province, China
| | - Kun Liu
- College of Nursing, Jinzhou Medical University, Jinzhou City, Liaoning Province, China
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Huang FH. Self-Care Needs of Seniors With Chronic Medical Conditions for Living in Their Own Homes. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2016. [DOI: 10.1177/1084822315607848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Health care expenditure and the maintenance of seniors’ well-being and health are important issues in Taiwan because of increased longevity and the fact that 89% of seniors have at least one chronic disease. In this study, a face-to-face questionnaire survey was conducted with 400 senior patients, to elicit their self-care needs for living in their own homes. Results showed that seniors required care from relatives and friends and social resource and medical information. Moreover, each need was affected by their family relationships, economic stress, education, religion, and living conditions. Therefore, government policy should be directed at addressing the needs of society, providing information and medication to reduce unnecessary health care expenditure, and enhancing seniors’ autonomy and quality of life.
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Affiliation(s)
- Fei-Hui Huang
- Oriental Institute of Technology, New Taipei, Taiwan
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32
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Irwan AM, Kato M, Kitaoka K, Kido T, Taniguchi Y, Shogenji M. Self-care practices and health-seeking behavior among older persons in a developing country: Theories-based research. Int J Nurs Sci 2016. [DOI: 10.1016/j.ijnss.2016.02.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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The experiences of self-care in community-dwelling older people: A meta-synthesis. Int J Nurs Stud 2015; 52:1854-67. [DOI: 10.1016/j.ijnurstu.2015.06.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 06/22/2015] [Accepted: 06/26/2015] [Indexed: 11/24/2022]
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Moore L, Frost J, Britten N. Context and complexity: the meaning of self-management for older adults with heart disease. SOCIOLOGY OF HEALTH & ILLNESS 2015; 37:1254-1269. [PMID: 26235674 DOI: 10.1111/1467-9566.12316] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Self-management policies have presented opportunities for patients with long-term conditions to take control and actively improve their health. However, the work of self-management appears to be packaged in the form of essential and desirable skills and attributes required for success. This article presents the findings of a qualitative study, employing longitudinal diary interviews with 21 patients aged between 60 and 85 years diagnosed with coronary heart disease from three contrasting general practice areas. Drawing on concepts of the care of the self and the reflexive self, this article presents the diversity of self-management practices by older patients in the context of their lifeworld. Illustrated through individual case studies, it clearly identifies where patients are engaged self-managers with the agency, knowledge and self-discipline to modify their behaviour for an improved health outcome. This study highlights their life and illness perspectives as well as those of patients who are burdened with emotional insecurity, comorbidities and caring responsibilities. It shows the spectrum of relationships with health professionals that influence engaged self-management. We suggest that policy initiatives that favour behavioural change neglect social context and the individualised practices that are a necessary response to structural and psychosocial constraints.
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Affiliation(s)
- Lucy Moore
- Institute of Health Research, University of Exeter Medical School, UK
| | - Julia Frost
- Institute of Health Research, University of Exeter Medical School, UK
| | - Nicky Britten
- Institute of Health Research, University of Exeter Medical School, UK
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Laxy M, Mielck A, Hunger M, Schunk M, Meisinger C, Rückert IM, Rathmann W, Holle R. The association between patient-reported self-management behavior, intermediate clinical outcomes, and mortality in patients with type 2 diabetes: results from the KORA-A study. Diabetes Care 2014; 37:1604-12. [PMID: 24667462 DOI: 10.2337/dc13-2533] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Little is known about the impact of diabetes self-management behavior (SMB) on long-term outcomes. We aimed to examine the association among patient-reported SMB, intermediate clinical outcomes, and mortality in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS Data were collected from 340 patients with type 2 diabetes of the KORA-A study (1997/1998) who were recruited from two previous population-based surveys (n = 161) and a myocardial infarction registry (n = 179) in southern Germany. Based on previous methodological work, a high level of SMB was defined as being compliant with at least four of six different self-care dimensions, comprising physical exercise, foot care, blood glucose self-monitoring, weight monitoring, having a diet plan, and keeping a diabetes diary. The vital status of the participants was observed until 2009. Multivariable linear, logistic, and Cox regression models were applied to assess the association with intermediate clinical outcomes at baseline and to predict mortality over the follow-up period, adjusted for sociodemographic, behavioral, and disease-related factors. RESULTS In the cross-sectional perspective, a high level of SMB was weakly associated with a lower glycated hemoglobin A1c level (-0.44% [-4.8 mmol/mol] [95% CI -0.88 to 0.00]), but not with low-density lipoprotein cholesterol, systolic blood pressure, or the presence of microalbuminuria, peripheral arterial disease, or polyneuropathy. During a mean follow-up time of 11.6 years, 189 patients died. SMB was a preventive factor for all-cause (hazard ratio 0.61 [95% CI 0.40-0.91]) and cardiovascular mortality (0.65 [95% CI 0.41-1.03]). CONCLUSIONS Although measuring SMB is difficult and the used operationalization might be limited, our results give some indication that a high level of SMB is associated with prolonged life expectancy in patients with type 2 diabetes and highlight the potential impact of the patients' active contribution on the long-term trajectory of the disease. We assume that the used proxy for SMB is associated with unmeasured, but important, dimensions of health behavior.
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Affiliation(s)
- Michael Laxy
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Neuherberg, GermanyGerman Center for Diabetes Research (DZD), Germany
| | - Andreas Mielck
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Neuherberg, Germany
| | - Matthias Hunger
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Neuherberg, Germany
| | - Michaela Schunk
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Neuherberg, Germany
| | - Christa Meisinger
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany
| | - Ina-Maria Rückert
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany
| | - Wolfgang Rathmann
- German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Institute of Biometrics and Epidemiology, Düsseldorf, Germany
| | - Rolf Holle
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Neuherberg, GermanyGerman Center for Diabetes Research (DZD), Germany
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Anuruang S, Hickman LD, Jackson D, Dharmendra T, Van Balen J, Davidson PM. Community-based interventions to promote management for older people: an integrative review. J Clin Nurs 2013; 23:2110-20. [PMID: 24354884 DOI: 10.1111/jocn.12445] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2013] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To review community programmes promoting self-care or self-management for older people with chronic disease in Thailand. BACKGROUND Identifying successful elements of culturally appropriate and effective community-based interventions to promote self-care with chronic illness is increasingly important. DESIGN Integrative review. DATA SOURCES CINAHL, Medline, Health Source Nursing Academic databases. METHODS Integrative review of peer-reviewed articles written between 1946-2012. Articles were included if they described self-care, self-management, chronic disease and community care interventions targeting older people in Thailand. RESULTS Of the 58 articles retrieved, only 13 articles met the eligibility criteria. Elements of effective interventions included: (1) providing culturally sensitive information, (2) including approaches of shared decision-making and mutual goal setting and (3) flexibility within the intervention to adapt to participant needs. CONCLUSIONS Shared decision-making and mutual goal setting between interventionists and patients improved health behaviours and outcomes. Moreover, the flexibility to adopt the intervention to local characteristics demonstrated positive results. RELEVANCE TO CLINICAL PRACTICE Promoting effective self-care and self-management behaviours is critical to improving outcomes for chronic conditions. The tailoring and targeting of interventions appropriate to individuals and communities are likely to be most effective in leveraging behaviour change. This review has identified that mutual goal setting improved health behaviours. The flexibility to adopt self-care interventions to community-based settings showed improved patient outcomes.
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Tareque MI, Begum S, Saito Y. Gender differences in disability-free life expectancy at old ages in Bangladesh. J Aging Health 2013; 25:1299-312. [PMID: 24013854 DOI: 10.1177/0898264313501388] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We examined gender differences in the prevalence of disability and Disability-free Life Expectancy (DFLE) for Bangladeshi older adults. METHOD We used data representing 4,189 elderly subjects aged 60 years and over from a nationally representative survey (Bangladesh's Household Income and Expenditure Survey-2010). The Sullivan method was used to compute DFLE. RESULTS Eyesight disability is prevalent among 28.94 and 36.47 men and women, respectively, and is the most prevalent type of disability in Bangladesh. Women have each disability and at least one disability in significantly higher percentages than men. At all ages, and in both numbers and proportion, women have longer life expectancy but shorter DFLE than men. DISCUSSION Attention should be given to the elderly, with special care devoted to elderly women. The findings of the current study have important implications for risk of disability and the need for, and use of, long-term care services.
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Nurses' Experiences of Caring for Older Persons in Transition to Receive Homecare: Being Somewhere in between Competing Values. Nurs Res Pract 2013; 2013:181670. [PMID: 23766895 PMCID: PMC3671552 DOI: 10.1155/2013/181670] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 02/25/2013] [Accepted: 04/25/2013] [Indexed: 11/18/2022] Open
Abstract
Older persons in transition to need professional care in their homes will constitute a large group in municipalities in the future. The aim of this study was to obtain insight into nurses' experiences and perceptions of caring for patients in transition to receive homecare. Eleven home nurses divided into two focus groups were interviewed, and a phenomenological hermeneutical design was used. Four interpretations closely related to each other were revealed: it is essential to have an understanding of the patients' transition history; the nurse' repertoire is challenged in the transition process; care must be adapted to the patients' life world; the excellence of care is threatened by the context. The nurses strived to provide care based upon respect for the independent individual as a living whole. Their ambitions were, however, challenged and threatened by the caring context. The cooperation across organizational levels was pointed out as a critical factor with potential for improvement. This must be taken seriously to support the nurses in their endeavors to provide excellent care.
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Dale B, Saevareid HI, Söderhamn O. Testing reliability and validity of Lorensen's Self-care Capability Scale (LSCS) among older home-living, care-dependent individuals in Norway. Int J Older People Nurs 2012; 8:166-73. [PMID: 22883140 DOI: 10.1111/j.1748-3743.2012.00339.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM AND OBJECTIVE The aim of this study was to test reliability and validity of the Lorensen's Self-Care Capability Scale (LSCS). BACKGROUND The assessment of self-care capability among older people living at home is essential for maintaining independence for as long as possible. METHOD The study sample consisted of 242 home nursing patients who were 75 + years old and living at home. The responsible home nurses documented their answers. In addition to the LSCS, help dependency, subjective health and demographic characteristics were recorded. Various statistical analyses were used to assess reliability and validity of the LSCS. RESULTS Reliability of the LSCS was supported by a Cronbach's alpha coefficient of 0.97. Regarding validity, six factors extracted in the factor analysis explained 69.8% of the variance in the group. The extracted factors supported the underlying theoretical assumptions of the instrument. Construct validity was supported by significant differences between groups with expected low and expected high LSCS scores, respectively. Concurrent validity was established by a significant correlation between LSCS and Barthel's ADL Index. CONCLUSION AND IMPLICATIONS FOR PRACTICE This study has shown that LSCS is a reliable and valid instrument for assessing self-care capability in older people living at home.
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Affiliation(s)
- Bjørg Dale
- Centre for Caring Research - Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
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Goetz K, Szecsenyi J, Campbell S, Rosemann T, Rueter G, Raum E, Brenner H, Miksch A. The importance of social support for people with type 2 diabetes - a qualitative study with general practitioners, practice nurses and patients. PSYCHO-SOCIAL MEDICINE 2012; 9:Doc02. [PMID: 22879856 PMCID: PMC3413874 DOI: 10.3205/psm000080] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Social support is an important element of family medicine within a primary care setting, delivered by general practitioners and practice nurses in addition to usual clinical care. The aim of the study was to explore general practitioner's, practice nurse's and people with type 2 diabetes' views, experiences and perspectives of the importance of social support in caring for people with type 2 diabetes and their role in providing social support. METHODS Interviews with general practitioners (n=10) and focus groups with practice nurses (n=10) and people with diabetes (n=9). All data were audio-recorded, fully transcribed and thematically analysed using qualitative content analysis by Mayring. RESULTS All participants emphasized the importance of the concept of social support and its impacts on well-being of people with type 2 diabetes. Social support is perceived helpful for people with diabetes in order to improve diabetes control and give support for changes in lifestyle habits (physical activity and dietary changes). General practitioners identified a lack of information about facilities in the community like sports or self-help groups. Practice nurses emphasized that they need more training, such as in dietary counselling. CONCLUSIONS Social support given by general practitioners and practice nurses plays a crucial role for people with type 2 diabetes and is an additional component of social care. However there is a need for an increased awareness by general practitioners and practice nurses about the influence social support could have on the individual's diabetes management.
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Affiliation(s)
- Katja Goetz
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Germany
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Money AG, Barnett J, Kuljis J, Lucas J. Patient perceptions of epinephrine auto-injectors: exploring barriers to use. Scand J Caring Sci 2012; 27:335-44. [DOI: 10.1111/j.1471-6712.2012.01045.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Dale B, Söderhamn U, Söderhamn O. Life situation and identity among single older home-living people: a phenomenological-hermeneutic study. Int J Qual Stud Health Well-being 2012; 7:QHW-7-18456. [PMID: 22848230 PMCID: PMC3406221 DOI: 10.3402/qhw.v7i0.18456] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/13/2012] [Indexed: 11/26/2022] Open
Abstract
Being able to continue living in their own home as long as possible is the general preference for many older people, and this is also in line with the public policy in the Nordic countries. The aim of this study was to elucidate the meaning of self-care and health for perception of life situation and identity among single-living older individuals in rural areas in southern Norway. Eleven older persons with a mean age of 78 years were interviewed and encouraged to narrate their self-care and health experiences. The interviews were audio taped, transcribed verbatim and analysed using a phenomenological–hermeneutic method inspired by the philosophy of Ricoeur. The findings are presented as a naïve reading, an inductive structural analysis characterized by two main themes; i.e., “being able to do” and “being able to be”, and a comprehensive interpretation. The life situation of the interviewed single-living older individuals in rural areas in southern Norway was interpreted as inevitable, appropriate and meaningful. Their identity was constituted by their freedom and self-chosen actions in their personal contexts. The overall impression was that independence and the ability to control and govern their own life in accordance with needs and preferences were ultimate goals for the study participants.
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Affiliation(s)
- Bjørg Dale
- Centre for Caring Research, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway.
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Sundsli K, Söderhamn U, Espnes GA, Söderhamn O. Ability for self-care in urban living older people in southern Norway. J Multidiscip Healthc 2012; 5:85-95. [PMID: 22536079 PMCID: PMC3333801 DOI: 10.2147/jmdh.s29388] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The number of older people living in urban environments throughout the world will increase in the coming years. There is a trend in most European countries towards improved health among older people, and increased life expectancy for both women and men. Norway has experienced less increase in life expectancy than some other European countries, and it is therefore important to investigate older urban Norwegian people’s health and ways of living in a self-care environment, with special regard to health promotion. Aim The aim of this study was to describe self-care ability among home-dwelling older (65+ years) individuals living in urban areas in southern Norway in relation to general living conditions, sense of coherence (SOC), screened nutritional state, physical activity, perceived self-reported health, mental health, and perceived life situation. Methods In 2010, a randomized sample of 1044 men and women aged 65+ years who were living in urban areas in southern Norway answered a postal questionnaire consisting of five instruments, some background variables, and 17 health-related questions. Univariate and multivariate statistical methods were used in the analyses of the data. Results The mean age of the participants was 74.8 years (SD = 7.1). Eighty-three percent of the participants had higher abilities to care for themselves. Self-care agency, perceived good health, being active, being frequently active, good mental health, not being at risk of undernutrition, and satisfaction with life were all positively related to self-care ability. Negative factors were perceived helplessness, receiving home nursing, being anxious, and being at a more advanced age. People aged 85+ years had worse mental health, were less physically active, and more at risk of undernutrition. Conclusion Health professionals should focus on the health-promoting factors that reinforce older people’s ability to care for themselves, and be aware of important symptoms and signs associated with a reduction in a person’s self-care ability. Politicians should assume responsibility for health care with a special regard to senior citizens.
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Affiliation(s)
- Kari Sundsli
- Department of Social Work and Health Science, Faculty of Social Sciences and Technology Management, NTNU, Trondheim, Norway
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Tomstad ST, Söderhamn U, Espnes GA, Söderhamn O. Testing two self-care-related instruments among older home-dwelling people in Norway. Int J Older People Nurs 2012; 8:189-98. [PMID: 22276973 DOI: 10.1111/j.1748-3743.2011.00307.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Older persons' ability and agency for self-care is an important issue. Therefore, the development of reliable and valid instruments to measure self-care with regard to both clinical nursing practice and personal health is important for nursing research and practice. Aim and objective. To test reliability and validity of the Norwegian versions of the two self-care-related instruments, the Self-care Ability Scale for the Elderly (SASE) and the Nutritional Form For the Elderly (NUFFE) among older home-dwelling individuals. METHODS A postal questionnaire that contained these instruments, background variables, health-related questions and two other self-care-related instruments was completed by a randomised sample of 158 older persons in southern Norway. Reliability was assessed as internal consistency and validity as concurrent and construct validity. RESULTS SASE reached a Cronbach's alpha coefficient of 0.85 and significant Spearman's rank correlations for 16 of 17 items. For NUFFE, a Cronbach's alpha coefficient of 0.64 was obtained and significant correlations for 13 of 15 items. Validity was supported for both instruments. An appropriate cut-off was found for SASE. For NUFFE, a low cut-off point was obtained. CONCLUSIONS SASE was shown to have sufficient psychometric properties and can be used in research and clinical practice among older persons. Implications for practice. The psychometric properties of NUFFE can be assessed as sufficient, but further studies are needed regarding the cut-off point.
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Affiliation(s)
- Solveig T Tomstad
- Department of Social Work and Health Science, Faculty of Social Sciences and Technology Management, NTNU, Trondheim, Norway.
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Dale B, Söderhamn U, Söderhamn O. Self-care ability among home-dwelling older people in rural areas in southern Norway. Scand J Caring Sci 2011; 26:113-22. [DOI: 10.1111/j.1471-6712.2011.00917.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Godfrey CM, Harrison MB, Lysaght R, Lamb M, Graham ID, Oakley P. Care of self - care by other - care of other: the meaning of self-care from research, practice, policy and industry perspectives. INT J EVID-BASED HEA 2011; 9:3-24. [PMID: 21332659 DOI: 10.1111/j.1744-1609.2010.00196.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Currently, no single definition of self-care is broadly accepted in the literature. Definitions vary as to (i) who engages in self-care behaviour; (ii) what motivates self-care behaviours; and (iii) the extent to which healthcare professionals are involved. Perspectives of self-care differ between healthcare professionals and the general public, and between healthcare professionals in different disciplines and different roles. As different professions view self-care within their own domain of practice, we are left with a multitude of explanations and descriptions. This variety of conceptualisations does impact and complicate research on self-care. As part of a larger enquiry focused on the clarification of this complex concept, this study provides a content analysis of documented definitions of self-care, and a summary of the evolution of the definition of self-care over time. OBJECTIVES To examine the diversity of definitions of self-care from the perspectives of research, practice, policy and industry, and to identify themes or trends in the evolution of the definition of self-care over time. SEARCH STRATEGY The search strategy was designed in consultation with a library scientist to find both published and unpublished papers. A three-step search strategy was used to locate the literature. The databases searched included CINAHL, Medline, EMBASE, PsycINFO, AMED, Cochrane Library, Scirus and Mednar. DATA COLLECTION AND ANALYSIS The definition of self-care was extracted from each paper included in the study. Using an inductive process, a content analysis was performed identifying common terms and phrases from the definitions. The definitions were then divided into four decades, 1970s, 1980s, 1990s and 2000s, and the evolution of the definition of self-care was examined. RESULTS AND CONCLUSIONS In this study we sought to clarify the concept of self-care by examining in detail the definition of self-care. Content analysis of 139 definitions identified seven components of the definition and a range of terms that were applicable to each component. Evolution of the definition over time showed a more expansive definition by the end of the 2000s. Current and evolving definitions of self-care would benefit by being comprehensive and encompassing as many facets of the concept as possible. IMPLICATIONS FOR PRACTICE Healthcare professionals assess, guide, instruct and support individuals as they initiate or engage in self-care. Using a comprehensive definition of self-care would provide an anchor linking each discipline as they interact not only with the individual but also among themselves. IMPLICATIONS FOR RESEARCH The concept of self-care is a many-layered one. Identifying the components in the definition of the term delineates the different areas for potential research in this area. When planning a research project, the definition of the key concept guides the research and shapes the approach to the investigation. For researchers in this area, this study illustrates the wealth and diversity of the definitions of self-care.
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Affiliation(s)
- Christina M Godfrey
- Queen's Joanna Briggs Collaboration: A Collaborating Centre of the Joanna Briggs Institute, Queen's University, Kingston, Ontario, Canada.
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Ovayolu OU, Ovayolu N, Karadag G. The relationship between self-care agency, disability levels and factors regarding these situations among patients with rheumatoid arthritis. J Clin Nurs 2011; 21:101-10. [PMID: 21371146 DOI: 10.1111/j.1365-2702.2011.03710.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To assess the relationship between self-care agency scores, disability levels and factors regarding these situations among Turkish patients with rheumatoid arthritis. BACKGROUND Rheumatoid arthritis is characterised by severe to slight synovial joint inflammation that can lead to pain, stiffness and joint destruction with subsequent physical deformities, disabilities and reduced self-care. Self-care is an important component of comprehensive chronic disease management such as rheumatoid arthritis. If patients have high levels of self-care and adhere to rheumatoid arthritis treatment, it can be expected that they will have fewer symptoms and better functional capabilities. DESIGN A cross-sectional, design was used. METHOD This study was conducted with 467 rheumatoid arthritis patients who applied at the Rheumatology Outpatient Department of Gaziantep University between September 2008-February 2009. The data collection instruments used in this study were the Demographic Data Form, Health Assessment Questionnaire (including disability index and pain scale) and Self-as-Carer Inventory. The frequency, mean, Student's t-test, one-way anova, Kruskal-Wallis, chi-square, correlation and regression analysis were used; p < 0·05 was accepted as statistically significant. RESULTS For patients the self-care agency classification of 13·7% and 86·3% were 'moderate' and 'poor', respectively; while the disability levels of 12·2 51·2 and 36·6% were 'mild', 'moderate' and 'severe', respectively; and their pain average was 'moderate'. It was also determined that, as the patients' self-agency scores declined, their disability levels deteriorated even further and their pain levels increased even more. CONCLUSIONS In conclusion we found that in Turkish patients with Rheumatoid Arthritis, the higher disability and pain rate were, the lower self-care agency score was. RELEVANCE TO CLINICAL PRACTICE Nurses should strive to provide individuals with RA the knowledge, skills and resources necessary for active participation in self-care, as this might promote the capacity for self-care.
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Affiliation(s)
- Ozlem Ucan Ovayolu
- Department of Nursing, School of Health, Gaziantep University, Gaziantep, Turkey.
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Nurse Perceptions and Experiences of Patient Health Assets in Oncology Care: A Qualitative Study. Res Theory Nurs Pract 2011; 25:284-301. [DOI: 10.1891/1541-6577.25.4.284] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Health assets, a term that refers to patients’ strengths and potentials, has emerged as an important aspect of health care. A conceptual analysis of health assets revealed five core dimensions: mobilization, motivational, relational, volitional, and protective strengths. How nurses experience and use patients’ health assets, however, is unknown. In this qualitative study, 26 expert nurses in cancer care participated in focus group interviews. The nurses had a large repertoire of experiences with cancer patients’ health assets. When the data were subjected to thematic analysis, three new core dimensions were revealed: cognitive, emotional, and physical strengths. Balancing processes within and among health assets—identified as an overriding theme—appeared to be affected by individual and contextual variations. The nurses realized that patients’ health assets could be better used and voiced a need for the clinical and organizational support to do so. New issues about health assets raised in this study may be caused by its novel context (e.g., expert nurses in oncology care). More research is needed on health assets in other contexts, such as patients with different health problems, and of possible strategies to support nurses’ use of health assets.
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Deng G, Weber W, Sood A, Kemper KJ. Research on integrative healthcare: context and priorities. Explore (NY) 2010; 6:143-58. [PMID: 20451148 DOI: 10.1016/j.explore.2010.03.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
It is important that integrative healthcare research be conducted to optimize the effectiveness, safety, costs, and social and economic impact of prospective, personalized, patient-centered, comprehensive, and holistic healthcare that focuses on well-being as well as disease management, and that the research itself be well understood. The scope of this research extends beyond evaluation of specific therapies, to include evaluations of multimodality whole system intervention, practitioner-patient relationships, patient goals and priorities, promoting self-care and resilience, personalized diagnostic and therapeutic measures, practitioner well-being, the comparative effectiveness of different educational and outreach strategies in improving health and healthcare, and the environmental/social causes and consequence of health and healthcare. In this paper, we describe the state of the science of research on integrative healthcare, research needs, and opportunities offered by cutting-edge research tools. We propose a framework for setting priorities in integrative health research, list areas for discussion, and pose a few questions on a future research agenda.
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Affiliation(s)
- Gary Deng
- Memorial Sloan-Kettering Cancer Center, 1429 First Avenue, New York, NY 10021, USA.
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Moyle W, Clarke C, Gracia N, Reed J, Cook G, Klein B, Marais S, Richardson E. Older people maintaining mental health well-being through resilience: an appreciative inquiry study in four countries. ACTA ACUST UNITED AC 2010. [DOI: 10.1111/j.1752-9824.2010.01050.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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