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M H Jagodage H, McGuire A, Seib C, Bonner A. Effectiveness of teach-back for chronic kidney disease patient education: A systematic review. J Ren Care 2024; 50:92-103. [PMID: 37010245 DOI: 10.1111/jorc.12462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/25/2023] [Accepted: 02/25/2023] [Indexed: 04/04/2023]
Abstract
BACKGROUND Education is an essential component in optimising chronic disease self-management. Teach-back is a robust approach in patient education, which is suitable for varying health literacy although its effectiveness in chronic kidney disease patient education is unknown. OBJECTIVE To evaluate the impact of teach-back method in health education for improving self-management and adherence to treatment regimens in chronic kidney disease. DESIGN Systematic review. PARTICIPANTS Adults with any chronic kidney disease grade or treatment modality. MEASUREMENTS A comprehensive search was undertaken in MEDLINE, CINHAL, EMBASE, Cochrane library, PsychINFO, Web of Science, ERIC, JBI library and WHO International Clinical Trial Registry to identify published studies from September 2013 to December 2022. The methodological quality of studies was assessed using Joanna Briggs Institute guidelines. RESULTS Six studies involving 520 participants were retrieved for this review. A meta-analysis could not be conducted due to substantial heterogeneity between studies. Nevertheless, there was some evidence that teach-back could improve self-management, self-efficacy and knowledge. There was limited evidence on improvement in psychological outcomes or health-related quality of life. CONCLUSION Teach-back seems to improve both objective and patient-reported outcomes, although further studies are needed. Using teach-back can improve both understanding of health information and the development of skills. Kidney care teams could use teach-back for all patients as it takes account of varying patient health literacy abilities. Teach-back assists with communicating important health information to improve patients' knowledge, confidence and skills in self-managing this disease and its treatment.
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Affiliation(s)
- Hemamali M H Jagodage
- School of Nursing and Midwifery and Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Department of Nursing, Faculty of Allied Health Sciences, University of Ruhuna, Sri Lanka
| | - Amanda McGuire
- School of Nursing and Midwifery and Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Charrlotte Seib
- School of Nursing and Midwifery and Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Ann Bonner
- School of Nursing and Midwifery and Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
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Yang J, Pu Y, Jiang X, Yao Q, Luo J, Wang T, Zhang X, Yang Z. Association between quality of discharge teaching and self-management in patients after percutaneous coronary intervention: A chain mediation model. J Clin Nurs 2024. [PMID: 38764246 DOI: 10.1111/jocn.17204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 04/23/2024] [Accepted: 04/28/2024] [Indexed: 05/21/2024]
Abstract
AIMS To examine chain mediating effect of discharge readiness and self-efficacy between quality of discharge teaching and self-management in patients after percutaneous coronary intervention (PCI). BACKGROUND Although self-management after PCI has significant benefits in controlling risk factors and delaying disease progression, the status of self-management remains unoptimistic. A large number of studies have explored the close relationship between the quality of discharge teaching and patients self-management, but little is known about the underlying mechanisms. METHODS The cross-sectional samples was collected from a tertiary hospital in China. Self-reported questionnaires were used to assess quality of discharge teaching, discharge readiness, self-efficacy and self-management. Pearson correlation analysis and mediation effect analysis were used for statistical analysis. REPORTING METHOD The study used the STROBE checklist for reporting. RESULTS A total of 198 patients with a mean age of 64.99 ± 11.32 (34-85) were included. The mean score of self-management was 88.41 ± 11.82. Quality of discharge teaching, discharge readiness, self-efficacy and self-management were all positively correlated. Mediation effect analysis showed that the mediating effects of discharge readiness, self-efficacy, discharge readiness and self-efficacy between quality of discharge teaching and self-management were 0.157, 0.177 and 0.049, respectively, accounting for 21.96%, 24.76% and 6.85% of the total effect. CONCLUSION The quality of discharge teaching for patients after PCI not only directly affects self-management, but also can indirectly affect self-management through discharge readiness and self-efficacy. RELEVANCE TO CLINICAL PRACTICE To improve the life quality of patients after PCI, medical staff should pay attention to the influence of self-management of quality of discharge teaching, and develop intervention strategies based on the path of discharge readiness and self-efficacy. PATIENT OR PUBLIC CONTRIBUTION Questionnaires filled out by patients were used to understand the association between quality of discharge teaching, discharge readiness, self-efficacy and self-management.
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Affiliation(s)
- Jin Yang
- Chengdu Medical College, Chengdu, China
- Department of Cardiology, Sichuan Mianyang 404 Hospital, Mianyang, China
| | - You Pu
- Department of Oncology, Sichuan Mianyang 404 Hospital, Mianyang, China
| | - Xia Jiang
- Department of Cardiology, Sichuan Mianyang 404 Hospital, Mianyang, China
| | - Qian Yao
- Chengdu Medical College, Chengdu, China
| | - Jian Luo
- Chengdu Medical College, Chengdu, China
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Zhang M, Zhang X, Yang Y, Weng Y, Chen X, Chen Y, Shi Y. Diabetes Distress Among Patients Undergoing Surgery for Diabetic Retinopathy and Associated Factors: A Cross- Sectional Survey [Response to Letter]. Psychol Res Behav Manag 2024; 17:2039-2040. [PMID: 38766315 PMCID: PMC11102753 DOI: 10.2147/prbm.s474995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 04/28/2024] [Indexed: 05/22/2024] Open
Affiliation(s)
- Mengyue Zhang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People’s Republic of China
| | - Xiaoxian Zhang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People’s Republic of China
| | - Yingrui Yang
- Henan Provincial People’s Hospital, Zhengzhou City, Henan Province, 450003, People’s Republic of China
| | - Yun Weng
- The Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People’s Republic of China
| | - Xiaojun Chen
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People’s Republic of China
| | - Yanyan Chen
- The Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People’s Republic of China
| | - Yinghui Shi
- The Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People’s Republic of China
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Liu Y, Jiang F, Zhang M, Niu H, Cao J, Du S, Chen H, Wang H, Gong L, Rao F, Wu H. Health literacy and self-management among middle-aged and young hypertensive patients: a parallel mediation effect of illness perception and self-efficacy. Front Psychol 2024; 15:1349451. [PMID: 38765827 PMCID: PMC11099212 DOI: 10.3389/fpsyg.2024.1349451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 04/19/2024] [Indexed: 05/22/2024] Open
Abstract
Background Hypertension is increasingly prevalent among young and middle-aged populations in rural China, accompanied by suboptimal self-management. Given that this population forms the backbone of the labor force, enhancing their self-management capabilities is crucial for improving overall population health. Studies indicate that individuals with good health literacy are more likely to effectively manage their health. Methods Grounded in the health literacy skills framework, a model was constructed in this study to examine the impact of health literacy on self-management among young and middle-aged hypertensive patients in rural China. Meanwhile, the mediating roles of illness perception and self-efficacy were also verified. Using a multi-stage stratified random sampling method, 338 patients were recruited to participate in the study. Structural equation modeling was utilized to establish the relationship model, and bootstrap tests were carried out to examine the mediating effects. Results The average self-management score was 70.45 ± 11.36. Health literacy exhibited a positive correlation with self-management (standardized β = 0.372, p < 0.001). The mediating effects through illness perception and self-efficacy were 0.040 and 0.236, constituting 6.68 and 39.31% of the total effect, respectively. Conclusion Illness perception and self-efficacy serve as parallel mediators amid the association between health literacy and self-management. Implementing psychological counseling and health education is imperative for augmenting self-management competence and cultivating an adaptive coping mentality.
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Affiliation(s)
| | - Feng Jiang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Parviniannasab AM, Dehghani F, Hosseini SA. The mediating role of hope in the relation between uncertainty and social support with self-management among patients with ESKD undergoing hemodialysis. BMC Nephrol 2024; 25:129. [PMID: 38609885 PMCID: PMC11010407 DOI: 10.1186/s12882-024-03558-2] [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: 12/23/2023] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Self-management behaviours are critical for patients requiring regular hemodialysis (HD) therapy. This study aimed to test the relationship between social support, uncertainty and self-management among HD patients and to explore whether hope plays a mediating role. METHODS In a cross-sectional study, a convenience sample of 212 HD patients from two hospitals completed the Perceived Social Support Scale (PSSS), Herth Hope Index (HHI), Short form Mishel Uncertainty in Illness Scale (SF-MUIS), and hemodialysis Self-Management Instrument (HD-SMI). Data were analysed using structural equation modelling. RESULTS The main finding indicated that social support positively affected self-management (β = 0.50, t = 4.97, p < 0.001), and uncertainty negatively affected self-management (β =-0.37, t=-4.12, p = < 0.001). In mediational model analysis, the effect of social support on self-management was fully mediated [(β = 0.12; 95% BC CI (0.047, 0.228)] by hope. Also, the effect of uncertainty on self-management was fully mediated [(β=- 0.014; 95% BC CI (-0.114, -0.003)] by hope. CONCLUSIONS "Considering factors influencing self-management in HD patients is crucial for improving quality of life. Receiving support and informational resources can not only foster hope but also reduce their uncertainty, thus aiding in enhancing clinical outcomes, quality of life, and reducing complications. "Health care providers, especially nurses were advised to accept the existence of uncertainty, help patients make optimal use of support resources, and give more importance to disambiguation to reassure them. Therefore, well-designed interventions that enhance social support and hope and reduce uncertainty may help improve self-management behaviour in HD patients.
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Affiliation(s)
| | - Fatemeh Dehghani
- Bachelor of Science in Nursing, Larestan University of Medical Sciences, Larestan, Iran
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Suarilah I, Widyawati IY, Umam K, Lin CC, Purwanti R, Supriyono S, Mundt K. The Javanese Cultural Beliefs and Practices Among Patients With End-Stage Renal Disease Undergoing Hemodialysis. J Transcult Nurs 2024:10436596241239304. [PMID: 38526031 DOI: 10.1177/10436596241239304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
Introduction: Poor prognosis and higher mortality of chronic kidney disease are linked with cultural beliefs and practices. This study explored cultural beliefs and practices of Javanese people with end-stage renal disease undergoing hemodialysis for ≥5 years. Methods: A qualitative narrative inquiry was applied in this study. Data were collected through in-depth narrative interviews, followed by text messages, calls, and audio-visual calls for 6 weeks. Results: There were 14 participants; their mean age was 51.15 years and hemodialysis duration was 5 years and 2 months up to 10 years and 9 months. Four themes emerged: life-and-death acceptance, expectation of end-of-life care, contemplation of withdrawal from hemodialysis, and wishing for a good death. Discussion: Life values guided the ability to survive for the individual. Adherence to renal disease management regimen clashed with cultural values on occasions, such as social gatherings. Therefore, the unmet needs of patients should be addressed with a transcultural approach to modify personal health behaviors.
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Zou H, Liu J, Jiang D, Hou L, Wang W, Zhang L. The Effect of Health Literacy on Disease Management Self-Efficacy in Chronic Disease Patients: The Mediating Effects of Social Support and the Moderating Effects of Illness Perception. Patient Prefer Adherence 2024; 18:657-666. [PMID: 38500561 PMCID: PMC10944975 DOI: 10.2147/ppa.s447320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/01/2024] [Indexed: 03/20/2024] Open
Abstract
Purpose To test a hypothetical pathway model to estimate the links between health literacy, social support, illness perception, and disease management self-efficacy. Methods This cross-sectional study, conducted from June to October 2022, involved the recruitment of 210 patients with chronic diseases at two primary care facilities. Participants completed the Health Literacy Management Scale, Self-Efficacy for Managing Chronic Disease 6-Item Scale, Social Support Rating Scale and Brief Illness Perception Questionnaire. We used the PROCESS macro for R to determine the hypothetical pathway model. Results The direct effect of health literacy on self-efficacy was significant (β=0.1792, 95% CI: 0.0940-0.2644), and social support played a partial mediating role between health literacy and self-efficacy (ES=0.0761, 95% CI: 0.0398-0.1204). Illness perception moderated the relationship between social support and self-efficacy (β=-0.0153, 95% CI: -0.0268- -0.0039). Conclusion Proposed a conceptual model including the mediating effect of social support and the moderating effect of illness perception, which helps to clarify the underlying mechanisms between health literacy and self-efficacy.
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Affiliation(s)
- Hao Zou
- Nursing Department, The Second Affiliated Hospital of Xi’an Medical University, Shanxi, People’s Republic of China
| | - Jianrong Liu
- Nursing Department, The Second Affiliated Hospital of Xi’an Medical University, Shanxi, People’s Republic of China
| | - Dongxu Jiang
- Department of Nursing, Harbin Medical University, Heilongjiang, People’s Republic of China
| | - Linlin Hou
- Nursing Department, The second Affiliated Hospital of Xi’an Jiaotong University, Shanxi, People’s Republic of China
| | - Weiliang Wang
- Nursing Department, Xuzhou Medical university, Jiangsu, People’s Republic of China
| | - Linlin Zhang
- Department of Nursing, School of Pharmacy, Changzhou University, Jiangsu, People’s Republic of China
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Guo Y, Zhao P, Zeng B, Su M, Zhou Y, Liu X, Zhou Y. Current status and influencing factors of self-management in knee joint discomfort among middle-aged and elderly people: a cross-sectional study. BMC Geriatr 2023; 23:612. [PMID: 37773113 PMCID: PMC10541685 DOI: 10.1186/s12877-023-04334-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 09/20/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND This study aims to identify the current status and factors influencing self-management of knee discomfort in middle-aged and elderly people in China. METHODS A stratified multistage cluster sampling method was used to select participants from communities in China from January 15 to May 31, 2020. A cross-sectional survey was conducted using the general information questionnaire and the Knee Joint Discomfort Self-management Scale. Univariate analysis and a generalized linear model were used to analyze the factors influencing self-management. RESULTS The prevalence of knee discomfort was 77%. Moderate to severe discomfort accounted for 30.5%. The average item score of self-management in 9640 participants was 1.98 ± 0.76. The highest and lowest levels were: 'daily life management' and 'information management'. Gender, ethnicity, education level, economic source, chronic disease, knee pain in the past month, and the degree of self-reported knee discomfort were significant predictors of self-management. CONCLUSION The self-management of knee discomfort in middle-aged and elderly people is poor, and the degree of discomfort is a significant predictor. Healthcare providers should consider socioeconomic demographic and clinical characteristics to help these individuals improve their self-management skills. Attention should also be given to improving their ability to access health information and making them aware of disease risks.
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Affiliation(s)
- Yabin Guo
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, China
- Xiang Ya Nursing School, Central South University, Changsha, China
| | - Peipei Zhao
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, China
| | - Biyun Zeng
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, China
| | - Manman Su
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, China
| | - Yang Zhou
- Xiang Ya Nursing School, Central South University, Changsha, China
| | - Xiaotong Liu
- Xiang Ya Nursing School, Central South University, Changsha, China
| | - Yang Zhou
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, China.
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Wu X, Tang F, Li H, Chen C, Zhang H, Liu X, Lai H, Li Q, Deng L, Ye Z. Development and validation of a nomogram model for medication non-adherence in patients with chronic kidney disease. J Psychosom Res 2023; 171:111385. [PMID: 37301180 DOI: 10.1016/j.jpsychores.2023.111385] [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: 01/07/2023] [Revised: 05/17/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The high prevalence of medication non-adherence in patients with chronic kidney disease places a tremendous burden on healthcare resources. The study was designed to develop and validate a nomogram model of medication non-adherence in patients with chronic kidney disease in China. METHODS A multicenter cross-sectional study was conducted. 1206 chronic kidney disease patients were consecutively enrolled from Be Resilient to Chronic Kidney Disease (registration number: ChiCTR2200062288) between September 2021 and October 2022 in four tertiary hospitals in China. The Chinese version of four-item Morisky Medication Adherence Scale was used to assess the medication adherence of the patients and associated factors consisted of socio-demographic information, self-designed medication knowledge questionnaire, the 10-item Connor-Davidson Resilience Scale, the Beliefs about Medicine questionnaire, the Acceptance Illness Scale, and the Family Adaptation Partnership Growth and Resolve Index. Least Absolute Shrinkage and Selection Operator regression was performed to select significant factors. Concordance index, Hosmer-Lemeshow test and decision curve analysis were estimated. RESULTS The prevalence of medication non-adherence was 63.8%. Area under the curves ranged from 0.72 to 0.96 in internal and external validation sets. The predicted probabilities of the model were consistent with those of the actual observations by Hosmer-Lemeshow test (all P > .05). The final model included educational level, occupational status, duration of chronic kidney disease, medication beliefs (perceptions of the need to take medications and concerns about adverse effects), and illness acceptance (adaptation and acceptance of the disease). CONCLUSIONS There is a high prevalence of medication non-adherence among Chinese patients with chronic kidney disease. A nomogram model based on five factors has been successfully developed and validated and could be incorporated into long-term medication management.
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Affiliation(s)
- Xiaona Wu
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Fang Tang
- Chronic Disease Management Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
| | - Huanhuan Li
- Department of Nephrology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Cuiqing Chen
- Department of Nephrology, Foshan Hospital of Traditional Chinese Medicine, Foshan, China
| | - Haiyan Zhang
- Department of Rheumatology and Immunology, The Second Affiliated Hospital of Shaoyang University, Shanoyang, China
| | - Xiuzhu Liu
- Department of Gastroenterology, Puning People's Hospital, Puning, China
| | - Huijing Lai
- Department of Pulmonology, Foshan Hospital of Traditional Chinese Medicine, Foshan, China
| | - Qiang Li
- Department of Nephrology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Lili Deng
- Nursing Department, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
| | - Zengjie Ye
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China.
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Hu N, Wang A, Chang T. Social support mediates the relationship between illness perception and psychosocial adaptation among young and middle-aged kidney transplant recipients in China. Front Psychol 2023; 14:1062337. [PMID: 36910788 PMCID: PMC9998938 DOI: 10.3389/fpsyg.2023.1062337] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 02/08/2023] [Indexed: 03/14/2023] Open
Abstract
Background No research has yet been done on social support's influence on the association between illness perception and psychosocial adaptation among young and middle-aged kidney transplant recipients in China. Accordingly, it remains unclear how medical personnel can assist patients in successfully adjusting to the early postoperative period and improving their health. Objective This study sought to explore the influence of illness perception and social support on the psychosocial adaptation of young and middle-aged recipients of kidney transplants in China during the early postoperative period. Methods This study adopted a cross-sectional design. The study included 236 young and middle-aged kidney transplant recipients from a tertiary hospital in China. Demographic and disease-related data were collected. Additionally, the Psychosocial Adjustment to Illness Scale-Self-Report, the Brief Illness Perception Questionnaire, and the Multidimensional Scale of Perceived Social Support were used to assess participants' psychosocial adaptation, illness perception, and social support, respectively. The model was examined using descriptive analysis, Pearson's correlation analysis, hierarchical multiple regression analysis, and the PROCESS Macro in SPSS 26.0. Results A total of 176 (74.56%) participants reported an average psychosocial adaptation score >50, which is relatively negative. Marital status, education level, residence, per capita monthly income (in Chinese yuan), medical insurance, work status, post-transplant time, body mass index, creatinine status, and complications were all related to psychosocial adaptation (p < 0.05). The more negative their illness perception and the worse their social support, the worse the psychosocial adaptation of young and middle-aged kidney transplant recipients. Further, the effect of illness perception on psychosocial adaptation was partially mediated by social support (36.56%). Conclusion In general, the psychosocial adaption level of young and middle-aged kidney transplant recipients was negative during the early postoperative period. Healthcare teams should assist patients in building a positive illness perception shortly following kidney transplantation, while also providing psychological care and support to help them cope with the onset of psychosocial issues.
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Affiliation(s)
- Na Hu
- Transplantation Department, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Aiping Wang
- Department of Public Service, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Tiantian Chang
- Transplantation Department, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
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Xu G, Xu Y, Tu X, Hao S, Liu T. The Association between Self-Rated Health and Health Self-Management Ability of Healthcare Undergraduates: The Chain Mediating Roles of eHealth Literacy and Resistance to Peer Influence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14501. [PMID: 36361377 PMCID: PMC9656272 DOI: 10.3390/ijerph192114501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 10/28/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
Health self-management is important for healthcare undergraduates who are at the late adolescent or early adulthood stage, and will play an important part in health promotion for the general population. Previous research has shown that perceived health status affects health self-management. However, few studies have uncovered the mechanism between self-rated health and health self-management among healthcare undergraduates. Based on social ecology theory and Pender's health promotion model, this study aimed to explore the associations between health self-management ability, self-rated health, eHealth literacy and resistance to peer influence of healthcare undergraduates, with a focus on identifying the mediating effects of eHealth literacy and resistance to peer influence. A cross-sectional study was conducted among 515 healthcare undergraduates in Eastern China between July and September 2021. Serial mediation analysis was performed using Haye's Model 6 PROCESS macro to examine the mediating effects. The study found that health self-management ability was significantly and positively correlated with eHealth literacy, resistance to peer influence and self-rated health. Self-rated health had a direct and positive predictive effect on health self-management, with a direct effect value of 0.654. eHealth literacy and resistance to peer influence played both an independent mediating and a chain-mediating role in the mechanism of self-rated health affecting health self-management among healthcare undergraduates, with indirect effect values of 0.085, 0.101, and 0.013, respectively. The results suggest that eHealth literacy and resistance to peer influence could be intervention targets in programs for improving these students' health self-management ability.
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Cui Y, Li R, Yang T, Wang H, Jin S, Liu N, Liu H, Zhang Y. Influence of positive and negative affect on self-management among patients with early chronic kidney disease during the COVID-19 pandemic: The mediating and suppressing effect of ego depletion. Front Psychiatry 2022; 13:992404. [PMID: 36245863 PMCID: PMC9556950 DOI: 10.3389/fpsyt.2022.992404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Self-management in patients with early chronic kidney disease (CKD) can effectively delay damage to renal function. However, with the continuous spread of COVID-19, patients cannot receive timely treatment, which can lead to different affects, resulting in ego depletion and serious challenges to self-management. This study aimed to investigate the mediating and suppressing roles of ego depletion on the relationship between positive and negative affect and self-management among patients with early CKD during the COVID-19 pandemic in China. METHODS A total of 383 patients with early CKD from three tertiary hospitals were enrolled by convenience sampling in our cross-sectional study from September 2021 to March 2022. Participants completed the Sociodemographic Questionnaire, Positive Affect and Negative Affect Scale, Self-Regulating Fatigue Scale and Chronic Kidney Disease Self-Management Instrument. A structural equation model was conducted to test the mediating and suppressing effects of ego depletion on the relationship between positive and negative affect and self-management. RESULTS The average score of the participants' self-management was 84.54 (SD: 19.72), and nearly 60% of them were at low and moderate levels. The mediating effect of positive affect on self-management through ego depletion was significant (β = 0.248, 95% CI: 0.170 to 0.376), accounting for 53.22% of the total effect. The suppressing effect of negative affect on self-management through ego depletion was significant (β = -0.191, 95% CI: -0.310 to -0.118), and the absolute value of the ratio of the suppressing effect to the direct effect was 66.55%. CONCLUSIONS Ego depletion partially mediated the relationship between positive affect and self-management while suppressing the relationship between negative affect and self-management among patients with early CKD during the COVID-19 pandemic. The reduction of patients' ego depletion must be taken as the intervention target to improve self-management and delay the progression of CKD.
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Affiliation(s)
- Yi Cui
- Department of Nursing, Air Force Medical University, Xi'an, China
| | - Rong Li
- Department of Nephrology, The First Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Tianqi Yang
- Department of Military Medical Psychology, Air Force Medical University, Xi'an, China
| | - Hua Wang
- Department of Nephrology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Shasha Jin
- Department of Nephrology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Na Liu
- Department of Nursing, Air Force Medical University, Xi'an, China
| | - Hongbao Liu
- Department of Nephrology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, China
| | - Yinling Zhang
- Department of Nursing, Air Force Medical University, Xi'an, China
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