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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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Yogesh M, Makwana N, Trivedi N, Damor N. Multimorbidity, health Literacy, and quality of life among older adults in an urban slum in India: a community-based cross-sectional study. BMC Public Health 2024; 24:1833. [PMID: 38982428 PMCID: PMC11234527 DOI: 10.1186/s12889-024-19343-7] [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: 01/17/2024] [Accepted: 07/02/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND India is experiencing a rising burden of chronic disease multimorbidity due to an aging population and epidemiological transition. Older adults residing in urban slums are especially vulnerable due to challenges in managing multimorbidity amid deprived living conditions. This study aimed to assess the prevalence of multimorbidity, associated health literacy, and quality of life impact in this population. METHODS A community-based cross-sectional study was conducted among 800 adults aged ≥ 65 years in an urban slum in Gujarat, India. Data on sociodemographics, physical and mental health conditions, health literacy (HLS-SF-47), quality of life (Short Form-12 scale), and social determinants of health were collected. Multimorbidity is ≥ 2 physical or mental health conditions in one person. RESULTS The prevalence of multimorbidity was 62.5% (500/800). Multimorbidity was significantly associated with lower physical component summary (PCS) and mental component summary (MCS) scores on the SF-12 (p < 0.001). After adjusting for sociodemographic variables, the odds ratio of 0.81 indicates that for every 1 unit increase in the health literacy score, the odds of having multimorbidity decrease by 19%. Older age within the older adult cohort (per year increase) was associated with greater odds of multimorbidity (AOR 1.05, 95% CI 1.02-1.09). Physical inactivity (AOR 1.68, 95% CI 1.027-2.77) and lack of social support (AOR 1.57, 95% CI 1.01-2.45) also increased the likelihood of multimorbidity. CONCLUSION There is a substantial burden of multimorbidity among urban slum dwellers aged ≥ 65 years in India, strongly linked to modifiable risk factors like poor health literacy and social determinants of health. Targeted interventions are essential to alleviate this disproportionate burden among urban slum older adults.
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Affiliation(s)
- M Yogesh
- Department of Community Medicine, Shri M P Shah Government Medical College, Jamnagar, Gujarat, India.
| | - Naresh Makwana
- Department of Community Medicine, Shri M P Shah Government Medical College, Jamnagar, Gujarat, India
| | - Nidhi Trivedi
- Department of Community Medicine, Shri M P Shah Government Medical College, Jamnagar, Gujarat, India
| | - Naresh Damor
- Department of Community Medicine, Shri M P Shah Government Medical College, Jamnagar, Gujarat, India
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Dobarrio-Sanz I, Chica-Pérez A, López-Entrambasaguas OM, Martínez-Linares JM, Granero-Molina J, Hernández-Padilla JM. Promoting the empowerment and emancipation of community-dwelling older adults with chronic multimorbidity through a home visiting programme: a hermeneutical study. BMC Nurs 2024; 23:444. [PMID: 38943097 PMCID: PMC11212443 DOI: 10.1186/s12912-024-02117-2] [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: 03/05/2024] [Accepted: 06/20/2024] [Indexed: 07/01/2024] Open
Abstract
INTRODUCTION Nurse-led preventive home visiting programmes can improve health-related outcomes in community-dwelling older adults, but they have not proven to be cost-effective. Home visiting programmes led by nursing students could be a viable alternative. However, we do not know how community-dwelling older adults with chronic multimorbidity experience home visiting programmes in which nursing students carry out health promotion activities. The aim of the study is to understand how community-dwelling older adults with chronic multimorbidity experience a home visiting programme led by nursing students. METHODS A qualitative study based on Gadamer's hermeneutics. Thirty-one community-dwelling older adults with chronic multimorbidity were interviewed in-depth. Fleming's method for conducting hermeneutic, Gadamerian-based studies was followed and ATLAS.ti software was used for data analysis. RESULTS Two main themes were generated: (1) 'The empowering experience of a personalised health-promoting intervention', and (2) 'The emancipatory effect of going beyond standardised self-care education'. CONCLUSIONS The home visiting programme contributed to the community-dwelling older adults feeling more empowered to engage in health-promoting self-care behaviours. It also improved the older adults' sense of autonomy and self-efficacy, while reducing their loneliness and addressing some perceived shortcomings of the healthcare system. CLINICAL RELEVANCE Older adults participating in a home visiting programme led by nursing students feel empowered to implement self-care behaviours, which has a positive impact on their perceived health status. Nurse leaders and nursing regulatory bodies could collaborate with nursing faculties to integrate preventive home visiting programmes led by nursing students into the services offered to community-dwelling older adults with chronic multimorbidity.
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Affiliation(s)
- Iria Dobarrio-Sanz
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, 04120, Spain
| | - Anabel Chica-Pérez
- Emera Nursing and Residential Home for Older Adults, Almería, 04007, Spain.
| | | | | | - José Granero-Molina
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, 04120, Spain
- Facultad de Ciencias de la Salud. Universidad Autónoma de Chile, Santiago de Chile, Chile
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Andrade A, Nascimento T, Cabrita C, Leitão H, Pinto E. Potentially Inappropriate Medication: A Pilot Study in Institutionalized Older Adults. Healthcare (Basel) 2024; 12:1275. [PMID: 38998810 PMCID: PMC11241476 DOI: 10.3390/healthcare12131275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Revised: 06/09/2024] [Accepted: 06/24/2024] [Indexed: 07/14/2024] Open
Abstract
Institutionalized older adults often face complex medication regimens, increasing their risk of adverse drug events due to polypharmacy, overprescribing, medication interactions, or the use of Potentially Inappropriate Medications (PIM). However, data on medication use and associated risks in this population remain scarce. This pilot study aimed to characterize the sociodemographic, clinical and pharmacotherapeutic profiles, and the use of PIM among institutionalized elders residing in Residential Structures for Elderly People (ERPI) in the Faro municipality, located in the Portuguese region of the Algarve. We conducted a cross-sectional study in a non-randomized sample of 96 participants (mean age: 86.6 ± 7.86 years) where trained researchers reviewed medication profiles and identified potentially inappropriate medications using the EU(7)-PIM list. Over 90% of participants exhibited polypharmacy (≥5 medications), with an average of 9.1 ± 4.15 medications per person. About 92% had potential drug interactions, including major and moderate interactions. More than 86% used at least one potentially inappropriate medication, most commonly central nervous system drugs. This pilot study demonstrates that institutionalized older adults may be at high risk of potential medication-related problems. Implementing comprehensive medication review programs and promoting adapted prescribing practices are crucial to optimize medication use and improve the well-being of this vulnerable population.
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Affiliation(s)
- Amanda Andrade
- Escola Superior de Saúde, Universidade do Algarve (ESSUAlg), Campus de Gambelas, Edifício 1, 8005-139 Faro, Portugal; (A.A.); (T.N.); (C.C.)
| | - Tânia Nascimento
- Escola Superior de Saúde, Universidade do Algarve (ESSUAlg), Campus de Gambelas, Edifício 1, 8005-139 Faro, Portugal; (A.A.); (T.N.); (C.C.)
- Algarve Biomedical Center Research Institute (ABC-RI), Universidade do Algarve, Campus de Gambelas, Edifício 2, 8005-139 Faro, Portugal;
| | - Catarina Cabrita
- Escola Superior de Saúde, Universidade do Algarve (ESSUAlg), Campus de Gambelas, Edifício 1, 8005-139 Faro, Portugal; (A.A.); (T.N.); (C.C.)
| | - Helena Leitão
- Algarve Biomedical Center Research Institute (ABC-RI), Universidade do Algarve, Campus de Gambelas, Edifício 2, 8005-139 Faro, Portugal;
- Faculdade de Medicina e Ciências Biomédicas, Universidade do Algarve, Campus de Gambelas, Edifício 2, 8005-139 Faro, Portugal
| | - Ezequiel Pinto
- Escola Superior de Saúde, Universidade do Algarve (ESSUAlg), Campus de Gambelas, Edifício 1, 8005-139 Faro, Portugal; (A.A.); (T.N.); (C.C.)
- Algarve Biomedical Center Research Institute (ABC-RI), Universidade do Algarve, Campus de Gambelas, Edifício 2, 8005-139 Faro, Portugal;
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James I, Pejner MN, Kihlgren A. Nurse assistants' experiences and knowledge of how they create a meaningful daily life for older persons receiving municipal home healthcare. Scand J Caring Sci 2024; 38:159-168. [PMID: 37815122 DOI: 10.1111/scs.13219] [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: 02/10/2023] [Revised: 09/07/2023] [Accepted: 09/18/2023] [Indexed: 10/11/2023]
Abstract
AIMS AND OBJECTIVES To explore nurse assistants' experiences and knowledge of how they create a meaningful daily life for older people receiving municipal home healthcare. DESIGN A participatory appreciative action reflection approach. METHODS Interviews, participant observations and informal conversations with 23 nurse assistants in municipal home healthcare generated the data. A thematic analysis was used. RESULTS Two main themes were developed. The first main theme, building a reciprocal relationship, was structured by three subthemes: To strengthen the older person's self-esteem, to co-create care and to create equality. The second main theme, creating meaning, was structured by two subthemes: To create closeness and to receive appreciation. The two main themes are each other's prerequisite. Nursing assistants' building reciprocal relationships gives meaning; through the meaning, reciprocal relationships are achieved, and by that, meaningful daily lives for both the older people and the nurse assistants. CONCLUSION Nurse assistants built a reciprocal relationship both for the older people and for the nurse assistant. This contributes to create a meaningful daily life for the older people. The older person was the main character, and it seems that the nurse assistants apply person-centred care, which can represent a shared common vision that can be used in the encounter.
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Affiliation(s)
| | - Margaretha Norell Pejner
- Department of Home Care, Halmstad Municipality, Halmstad, Sweden
- Örebro University, Örebro, Sweden
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Yoo HJ, Shim J, Kim MS. Validity and reliability of the self-care behaviour scale for patients with left ventricular assist device. Nurs Open 2024; 11:e2102. [PMID: 38530867 DOI: 10.1002/nop2.2102] [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: 06/28/2023] [Revised: 12/27/2023] [Accepted: 01/05/2024] [Indexed: 03/28/2024] Open
Abstract
AIMS To evaluate the validity and reliability of the self-care behaviour scale for patients with left ventricular assist devices. DESIGN Methodological study. METHODS The English version of the scale was translated into Korean, and it was then back-translated into English. Survey data were collected from 32 patients with left ventricular assist device in South Korea, and construct validity, content validity and reliability were analysed. RESULTS The original self-care behaviour scale comprises three domains and 33 items, whereas the Korean self-care behaviour scale comprises 27 items and five domains: device management, wound management, symptom monitoring, activated healthcare system and self-care management. Cronbach's alpha for the overall scale was 0.94, and that for the five domains ranged from 0.36 to 0.90. The intraclass correlation coefficient for the overall scale was 0.89, and the five domains ranged from 0.71 to 0.88. CONCLUSION The newly evaluated scale would be valid and reliable in measure self-care behaviour for patients with a left ventricular assist device. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Patients can manage the left ventricular assist device on their own based on evidence and use it as a tool for effective communication with medical professionals.
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Affiliation(s)
- Hye Jin Yoo
- College of Nursing, Dankook University, Cheonan, South Korea
| | - JaeLan Shim
- College of Nursing, Dongguk University, Gyeongju, South Korea
| | - Min-Seok Kim
- Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Hernández-Padilla JM, Dobarrio-Sanz I, Fernández-Sola C, Del Mar Jiménez-Lasserrotte M, Correa-Casado M, Ruiz-Fernández MD. Spanish version of the Self-Care of Chronic Illness Inventory: A validation study amongst community-dwelling older adults with chronic multimorbidity. J Adv Nurs 2024; 80:807-820. [PMID: 37727056 DOI: 10.1111/jan.15868] [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: 01/12/2023] [Revised: 08/12/2023] [Accepted: 08/30/2023] [Indexed: 09/21/2023]
Abstract
AIM To psychometrically assess the Spanish version of the Self-Care of Chronic Illness Inventory (SC-CII-Sp) in community-dwelling older adults with chronic multimorbidity. DESIGN A methodological study. METHOD A total of 1260 older adults participated in the study between May 2020 and February 2022. The data were analysed using SPSS Statistics® 26 and AMOS® 24. The items' content validity index and the Fleiss' kappa were calculated to assess the SC-CII-Sp's content validity. Convergent validity was assessed by calculating the Pearson correlation coefficient between the participants' scores on the SC-CII-Sp and their scores on the Spanish Chronic Disease Self-Efficacy scale (SCD-SE). Construct validity was tested by performing a confirmatory factor analysis (CFA). The SC-CII-Sp's reliability was tested by computing the Cronbach's alpha. RESULTS The SC-CII-Sp showed good content and convergent validity. The CFA showed that the SC-CII-Sp has three sub-scales. The 8-item Self-Care Maintenance sub-scale has good internal consistency and is comprised of two dimensions: illness-related and health-promoting behaviour. The Self-Care Monitoring sub-scale had excellent internal consistency and its five loaded items belonged to a single dimension. The 6-item Self-Care Management sub-scale has adequate internal consistency and two dimensions: autonomous and consulting behaviour. CONCLUSION The Spanish version of SC-CII is a valid and reliable instrument to be used in the assessment of self-care behaviours amongst Spanish-speaking, community-dwelling older adults with chronic multimorbidity. IMPLICATIONS FOR THE PROFESSION Nurses need valid and reliable tools to assess self-care behaviours in Spanish-speaking community-dwelling older adults with chronic multimorbidity. This study provides a 19-item tool that allows for the comprehensive evaluation of self-care behaviours in healthy and ill states. IMPACT Using the SC-CII-Sp in clinical or research settings could help nurses to examine the effects of different interventions on self-care behaviours amongst Spanish-speaking, community-dwelling older adults with chronic multimorbidity. PATIENT OR PUBLIC CONTRIBUTION None to be reported.
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Affiliation(s)
| | - Iria Dobarrio-Sanz
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, Spain
| | - Cayetano Fernández-Sola
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago, Chile
| | | | - Matías Correa-Casado
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, Spain
- Andalusian Health Service, Almeria Health District, Almeria, Spain
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Kordi Z, Khosravi A, Fotouhi A. Depression and self-care in diabetes; adjustment for misclassification bias: application of predictive weighting method. BMC Public Health 2023; 23:2540. [PMID: 38114954 PMCID: PMC10729342 DOI: 10.1186/s12889-023-17412-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: 09/03/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023] Open
Abstract
OBJECTIVE This study aimed to investigate the association between depression and self-care in diabetic patients potentially influenced by biases in depression measurement using weighting the positive and negative predictive values. METHODS In this cross-sectional study, 1050 patients informedly consented to participate in the study. Using a WHO-5 well-being index, the participants were examined for depressive mood as exposure. The sensitivity and specificity of this index in a systematic review study were 0.86 and 0.81, respectively. Self-care (that is outcome) was assessed using the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire. To correct the misclassification bias of exposure, the predictive weighting method was used in the multivariable logistic regression model adjusted for covariates. Bootstrap sample with replacement and simulation was used to deal with random error. RESULTS The mean age of patients was 42.8 ± 7.5 years. In this study, 70.1% of diabetic patients (n = 720) were depressed based on the questionnaire score and only 52.7% (n = 541) of them had appropriate self-care behaviors. Our study revealed a close relationship between self-care and covariates such as gender, depression, having comorbidities, abdominal obesity, economic status and education. The odds ratio of the association between depressive mood and lack of self-care in primary multivariable logistic regression was 2.21 (95% CI: 1.62-3.00, p < 0.001) and after misclassification bias adjusting, it was equal to 3.4 (95% CI: 1.7-6.6, p < 0.001). The OR percentage of bias was - 0.55. CONCLUSION After adjusting for depression misclassification bias and random error, the observed association between depression and self-care was stronger. According to our findings, psychiatric interventions, and counseling and education along with self-care interventions are necessary for these patients. Special attention should be paid to male, low economic classes, less educated and those having a history of comorbidities along with psychological assessment when improving the care and progress of treatment in diabetic patients is expected. Future studies are needed to clarify the role of other psychological disorders on self-care of diabetics.
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Affiliation(s)
- Zahra Kordi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Vice-chancellery for Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Ahmad Khosravi
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran.
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Mikkonen U, Tusa N, Sinikallio S, Kautiainen H, Mäntyselkä P. A short tool to screen self-care preparedness: cross-sectional study in general practice. Fam Pract 2023:cmad107. [PMID: 37975623 DOI: 10.1093/fampra/cmad107] [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] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Self-care is crucial in the prevention and treatment of chronic diseases. It is important to identify patients who need support with self-care. OBJECTIVES This study introduces a self-care preparedness index (SCPI) and examines its associations with health-related quality of life (HRQoL) and other outcomes. METHODS A cross-sectional study of adults (n = 301) with hypertension, coronary artery disease, or diabetes in primary health care. Based on the self-care questionnaire, SCPI was formed. A higher SCPI value indicated better self-care preparedness. We examined correlations and a hypothesis of linearity between SCPI and HRQoL (15D), depressive symptoms (BDI), patient activation (PAM), and health-related outcomes (self-rated health, life satisfaction, physical activity, body mass index [BMI], waist, low-density lipoprotein). Exploratory factor analysis was used to test the construct validity of SCPI. RESULTS A total of 293 patients with a mean age of 68 (54.3% women) were included in the analysis. BDI, BMI, and waist had a negative linear trend with SCPI. Self-rated health, physical activity, patient activity, and life satisfaction had a positive linear trend with SCPI. SCPI correlated with HRQoL (r = 0.31 [95% CI: 0.20 to 0.41]). Exploratory factor analysis of the SCPI scores revealed 3 factors explaining 82% of the total variance. CONCLUSIONS SCPI seems to identify individuals with different levels of preparedness in self-care. This provides means for health care providers to individualize the levels of support and counselling. SCPI seems to be a promising tool in primary health care but needs further validation before use in large scale trials or clinical practice.
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Affiliation(s)
- Ulla Mikkonen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Wellbeing Services County of North Savo, Health services, Kuopio, Finland
| | - Nina Tusa
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Wellbeing Services County of North Savo, Educational services, Kuopio, Finland
| | | | | | - Pekka Mäntyselkä
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Clinical Research and Trials Centre, Kuopio University Hospital, Wellbeing Services County Of North Savo, Kuopio, Finland
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Zheng C, Liu F, Zheng Y, Chen P, Zhou M, Zhang H. Psychometric properties of the Chinese version of the self-care scale for older adults undergoing hip fracture surgery: A translation and validation study. Front Public Health 2023; 11:1119630. [PMID: 37006555 PMCID: PMC10050582 DOI: 10.3389/fpubh.2023.1119630] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/20/2023] [Indexed: 03/17/2023] Open
Abstract
ObjectiveThe purpose of this study was to translate and verify the reliability and validity of the Chinese version of the self-care scale for older adults undergoing hip fracture surgery.MethodsA total of 502 older adult/adults patients after hip fracture surgery were recruited from Liaoning, Shanxi, and Beijing, China. The reliability of the Chinese version of the scale was measured by internal consistency, split-half reliability, and retest reliability, and the validity was evaluated by the content validity index and structure validity index.ResultsThe Chinese version of the HFS-SC scale had a Cronbach's alpha coefficient of 0.848, and the Cronbach's alpha coefficients for the five dimensions ranged from 0.719 to 0.780. The split-half reliability of the scale was 0.739, and the retest reliability was 0.759. The content validity index (S-CVI) was 0.932. The five-factor structure, supported by the eigenvalues, total variance explained, and the scree plot accounted for 66.666% of the total variance. In confirmatory factor analysis, the model fit results were as follows, X2/df = 1.847, GFI = 0.914, AGFI = 0.878, PGFI = 0.640, IFI = 0.932, TLI = 0.912, CFI = 0.931, RMSEA = 0.058, PNFI = 0.679. The indicators of the model's fit were within reasonable bounds.ConclusionThe Chinese version of the self-care scale for older adults undergoing hip fracture surgery has suitable reliability and validity. The scale can be used to assess the level of older adult/adults self-care in China following hip replacement surgery and serves as a useful benchmark for identifying potential intervention targets to raise the level of older adult/adults self-care following hip replacement surgery.
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Affiliation(s)
- Chen Zheng
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - FangLin Liu
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Yan Zheng
- Operating Room of People's Hospital, Xinzhou, Shanxi, China
| | - Ping Chen
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - MingYue Zhou
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Huijun Zhang
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
- *Correspondence: Huijun Zhang
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Jobst S, Stadelmaier J, Zöller P, Grummich K, Schmucker C, Wünsch A, Kugler C, Rebafka A. Self-management in adults after solid-organ transplantation: a scoping review protocol. BMJ Open 2023; 13:e064347. [PMID: 36693696 PMCID: PMC9884941 DOI: 10.1136/bmjopen-2022-064347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION After solid-organ transplantation (SOTx), recipients must adhere to a lifelong medical regimen, change their lifestyle and cope with physiological and psychosocial challenges. This requires active participation in their care and self-management abilities. The concept of self-management after SOTx has only been described regarding specific organs and focused on adherence to medical treatment. A comprehensive conceptualisation of self-management entailing all solid organs and beyond medical aspects does not exist. This might lead to unmet self-management support needs of SOTx recipients and hinder a more holistic and integrative approach in self-management support. Therefore, a better understanding of the concept of self-management after SOTx is needed to facilitate a comprehensive evidence base for healthcare providers and researchers. The purpose of this scoping review is to explore existing evidence on self-management in adults after SOTx. METHODS AND ANALYSIS To identify relevant evidence, six electronic databases and three study registers will be searched, supplemented by handsearches, reference checking and expert recommendations. Screening and selection of available evidence will be carried out in a two-step process by two independent reviewers. International evidence published in English or German reporting on adults after heart, lung, liver, pancreas, kidney or small bowel transplantation will be considered. To meet inclusion criteria, articles have to focus on either: self-management, self-management support or recipients' or healthcare providers' perspectives of challenges and needs potentially addressable by self-management. Data extraction will be performed by two reviewers independently using a structured form. Data will be analysed descriptively and using content analysis procedures. Findings will be summarised narratively and presented in tabular format. ETHICS AND DISSEMINATION The consultation and approval of an ethics committee is not required for this scoping review. Findings of the scoping review will be published in a peer-reviewed open-access journal and presented at conferences.
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Affiliation(s)
- Stefan Jobst
- Institute of Nursing Science, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Julia Stadelmaier
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Petra Zöller
- Dean's Office, University of Freiburg Faculty of Medicine, Freiburg, Germany
| | - Kathrin Grummich
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
- Cochrane Germany, Cochrane Germany Foundation, Freiburg, Germany
| | - Christine Schmucker
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany
| | - Alexander Wünsch
- Freiburg university Medical Center, Department of Psychosomatic Medicine and Psychotherapy, Freiburg, Germany
| | - Christiane Kugler
- Institute of Nursing Science, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Anne Rebafka
- Institute of Nursing Science, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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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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Abstract
BACKGROUND Self-care is important for improving the health outcomes of individuals with chronic heart failure (CHF). However, predictors of self-care behaviors remain unclear in Chinese society. OBJECTIVE The aims of this study were to explore predictors of self-care in Chinese patients with CHF and clarify the complex relationships between predictors and self-care behaviors guided by the Situation-Specific Theory of Heart Failure Self-Care. METHODS A cross-sectional study was conducted among individuals hospitalized with CHF in China. Person, problem, and environmental factors pertaining to self-care were collected by a questionnaire survey. Self-care was assessed by the Self-Care of Heart Failure Index version 6. Direct and indirect relationships between factors and self-care behaviors and the mediating role of self-care confidence were analyzed by the structural equation model. RESULTS In total, 204 participants were involved in this study. The Situation-Specific Theory of Heart Failure Self-Care model demonstrated a good fit (root mean square error of approximation, 0.046; goodness of fit index, 0.966; normed fit index, 0.914; comparative fit index, 0.971). Inadequate self-care capabilities were common among Chinese patients with CHF. Person-related factors (female gender, higher monthly income and educational level), problem-related factors (severe New York Heart Association function class and better instrumental activities of daily living), and environmental factors (better social support and living in more developed areas) were significant predictors of better self-care behaviors ( P < .05). These associations were partly or fully mediated by self-care confidence. CONCLUSION The Situation-Specific Theory of Heart Failure Self-Care can be used to guide research and practice in patients with CHF. Interventions and policies on promoting self-care in Chinese population living with CHF are encouraged, particularly for underserved populations.
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Social Influences on Perceptions of Sense of Control and Attributed Dignity Among Older People Managing Multiple Chronic Conditions. Rehabil Nurs 2022; 47:92-98. [DOI: 10.1097/rnj.0000000000000369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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LeBlanc RG, Chiodo L, Jacelon CS. Social relationship influence on self-care and health among older people living with long term conditions: A mixed-methods study. Int J Older People Nurs 2022; 17:e12450. [PMID: 35191193 DOI: 10.1111/opn.12450] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 01/19/2022] [Accepted: 01/22/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Social relationships influence health, yet less is known on how social relationships influence self-care among older people living with multiple long-term conditions. OBJECTIVES The purpose of this study was to determine how social networks influence therapeutic self-care behaviours and health among community dwelling older people living with multiple long-term conditions. DESIGN Explanatory sequential mixed-methods. SETTING/SAMPLE Community dwelling older people living in the Northeast United States. METHODS A cross-sectional sample of eighty-nine people aged sixty-five and older participated in telephone surveys. A nested sample of twelve participants completed a follow-up open-ended interview. Descriptive statistics, bivariate correlations and regression statistics were used to examine the associations between social network features and functions with the dependent variables of therapeutic self-care behaviours and health. Qualities that emphasised the contexts of the relationships were integrated in the data analysis. RESULTS The strength of the social network and level of social support influenced the outcomes of therapeutic self-care and mental health. Thematic analysis expanded this explanation of self-care in relation to social network size, psycho-social support, activation of support, interaction frequency and type. CONCLUSION In supporting older people living with multiple long-term conditions, this nursing research offers new ways to understand close social relationships influence on self-care in developing systems of care at the community level. IMPLICATIONS FOR PRACTICE Designing care systems that include small trusted formal and informal caregivers that integrate social network members could improve health outcomes and improve access to supportive resources.
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Affiliation(s)
| | - Lisa Chiodo
- University of Massachusetts, Amherst, Massachusetts, USA
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Mendoza-Catalán G, Rodríguez-Santamaría Y, Domínguez-Chávez CJ, Juárez-Medina LL, Villa-Rueda AA, González-Ramírez J, Gutiérrez-Valverde JM. Personality Traits and Self-Care Behaviors in Adults with Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes 2022; 15:1-6. [PMID: 35018104 PMCID: PMC8742583 DOI: 10.2147/dmso.s340277] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 12/14/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Personality traits are an important factor in health behaviors. However, personality traits and self-care in T2DM in the Mexican population are not yet explored due to this; the purpose of this work was to explore the relationship of personality traits with self-care in Mexican adults with type 2 diabetes mellitus. PATIENTS AND METHODS A cross-sectional study was carried out in a sample of 197 T2DM patients from a primary care center in Oaxaca, Mexico. The Big Five Inventory and the Summary of Diabetes Self-care Activities (SDSCA) were the tools used. Correlation models and multiple linear regression models were used for the analysis. RESULTS Most of the study participants were women (74.6%). The mean age was 53.1 years (SD = 8.4). The average years of schooling of the participants were 5.7 (SD = 4.3). The number of years lived with T2DM was 9.0 (SD = 6.5). The waist circumference was 96.3 (SD = 14.2), and the BMI was 27.5 kg/m2 (SD = 4.1). The traits of conscientiousness (r = 0.283) and openness (r = 0.259) were positively correlated with self-care activities, while neuroticism was inversely correlated (r = -0.144). In the multiple linear regression models, only the conscientiousness and openness traits were predictors of self-care; they explained 19% of the variance. CONCLUSION People with greater openness and conscientiousness were associated with greater compliance with self-care. Conversely, neuroticism was inversely associated with self-care in patients with T2DM.
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Affiliation(s)
- Geu Mendoza-Catalán
- Faculty of Nursing, Autonomous University of Baja California, Mexicali, Baja California, Mexico
| | | | | | | | | | - Javier González-Ramírez
- Faculty of Nursing, Autonomous University of Baja California, Mexicali, Baja California, Mexico
- Correspondence: Javier González-Ramírez Facultad de Enfermería, Universidad Autónoma de Baja California, Av. Álvaro Obregón y Calle “G” S/N, Col. Nueva, C.P., Mexicali, 21100, Baja California, MéxicoTel +52 686 905-8257 Email
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Muniz VDO, Braga LDCA, Araujo POD, Santana PPC, Pereira GS, Sousa ARD, Pedreira LC, Carvalho ESDS. Self-care deficit among older men in the COVID-19 pandemic: implications for nursing. Rev Bras Enferm 2022; 75Suppl 4:e20210933. [DOI: 10.1590/0034-7167-2021-0933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 05/18/2022] [Indexed: 11/07/2022] Open
Abstract
ABSTRACT Objectives: to analyze self-care deficit among older men in the COVID-19 pandemic in Brazil and to discuss the implications for nursing practice. Methods: web survey, multicentric, qualitative. A total of 120 older men participated, applying a form from April to June 2020 and April to August 2021. Reflective Thematic Analysis, interpreted by Orem’s Self-Care Deficit Theory, was used. Results: temporally, the self-care of older men was manifested in the self-care requirements - affective bonds, self-care for development - meditation and self-care with health deviations - remote consultations. Fully, partially compensatory, educational/support systems mobilized self-care. Final Considerations: as care managers, nurses can strengthen the support network for older men by activating professionals from the multidisciplinary team, family members, caregivers and the community to promote self-care and correct health deviations in times of crisis.
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Yang Z, Chen F, Zhang Y, Pan S, Lu Y, Zhang H. Translation of the Chinese version of the Self-Care for Aspiration Pneumonia Prevention Scale and its validation among Chinese community dwelling elderly with risk of dysphasia. Nurs Open 2021; 9:1902-1911. [PMID: 34019332 PMCID: PMC8994966 DOI: 10.1002/nop2.940] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/29/2021] [Accepted: 04/28/2021] [Indexed: 12/03/2022] Open
Abstract
Aim To translate the Self‐Care for Aspiration Pneumonia Prevention Scale into the Chinese and validate its reliability and validity among community dwelling elderly with risk of dysphasia. Design A cross‐sectional survey. Methods A total of 430 elderly with risk of dysphasia were recruited. The reliability was measured by internal consistency, split half reliability, and test–retest reliability. The validity was evaluated by expert consultation and factor analysis. Results The translated scale had ideal reliability. The content validity index (S‐CVI) was 0.952. The 3‐factor structure, supported by the eigenvalues, total variance explained, and scree plot, was obtained by using exploratory factor analysis. And as a result of a confirmatory factor analysis, the model fitting indexes were all in the acceptable range. The Chinese version of the Self‐Care for Aspiration Pneumonia Prevention scale can contribute to clinical practice and education to improve self‐care for aspiration pneumonia prevention among elderly at risk of dysphasia.
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Affiliation(s)
- Zhen Yang
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
| | - Fengmin Chen
- The First Affiliated Hospital, Jinzhou Medical University, Jinzhou, China
| | - Yibo Zhang
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
| | - Sien Pan
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
| | - Yingying Lu
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
| | - Huijun Zhang
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
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Abstract
Abstract
Introduction: European gerontological research confirms that accelerated aging of the population will lead to a pronounced occurrence of target groups of functionally capable older people. Lifelong learning is a tool that enables an active post-retirement period in order to enhance cognitive mental capacities, prevent dementia, and overcome the intergenerational gap. The aim of this paper is to develop strategies in the field of lifelong learning for older adults through SWOT analysis.
Methods: A qualitative study on lifelong learning for older adults was conducted during the month of November 2019 using 4 SWOT matrices which were subsequently analyzed and integrated into one common matrix. Four strategies were developed based on this template.
Results: The analysis of the SWOT matrix showed that lifelong learning contributes most to a sense of belonging, prevention of social isolation, prevention of dementia, and better personal satisfaction. The biggest obstacles for older people when it comes to participating in lifelong learning programs are finances, physical illness, and a lack of understanding from their family members and the wider society for this kind of activity.
Discussion: Lifelong learning contributes to a long-term maintenance of cognitive processes of participants involved in education processes. Lifelong learning provides the opportunity to promote older people’s health regardless of the formal education they received in early adulthood.
Conclusion: Learning and further education are not only the indicators of active aging, but also a need for older people to master new tools so that they can actively participate and contribute to the society.
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Adebusoye LA, Cadmus EO, Labaeka EO, Ajayi SA, Olowookere OO, Otegbayo JA. Caring for older adults during the COVID pandemic and beyond: experience from a specialized tertiary facility for the care of older persons in a low resource setting. Pan Afr Med J 2020; 35:99. [PMID: 33623623 PMCID: PMC7875791 DOI: 10.11604/pamj.supp.2020.35.2.24521] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 06/30/2020] [Indexed: 01/08/2023] Open
Abstract
The ongoing Coronavirus disease (COVID-19) pandemic has markedly changed health care provisions and arrangements for patient care. Older adults are most susceptible to worse outcomes. The public health impact of the disease in terms of morbidity and mortality has necessitated the evolution of management protocols for effective care of older persons. This review describes our experience during this period attending to the healthcare needs of both the acutely ill and clinically stable patients at the first purpose-built facility for the care of older persons in Nigeria, the Chief Tony Anenih Geriatric Centre (CTAGC), University College Hospital, Ibadan. A major strategy recommended by the World Health Organization was a lockdown with restricted movements and laid down rules for engagement. As such, the CTAGC also embarked on steps to ensure patient safety as well as effective care. Prior to the lockdown, targeted activities included fumigation of the centre as well as health education and promotional activities. Measures were put in place to care for up to 95% of our patients at home. Thus, a "Care in Place" approach was adopted to enable them to take ownership of their care. Ambulatory older patients were seen on an out-patient basis following scheduled appointments after a telephone consultation through the hospital's designated lines. Clients were managed for their routine health conditions which were mostly non-communicable diseases (NCDs). Also, acutely ill older patients were admitted for acute exacerbation and/or complications of their chronic morbidities. Importantly, 60% of admitted patients presented with COVID like symptoms but they all tested negative for COVID 19. Based on our experience at the CTAGC, older persons can be successfully managed through a "Care in place" approach in a resource-poor setting during pandemics with high infectivity rates such as COVID 19. The information hereby generated is beneficial for future practice.
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Affiliation(s)
| | - Eniola Olubukola Cadmus
- Chief Tony Anenih Geriatric Center, University College Hospital, Ibadan.,Department of Community Medicine, College of Medicine, University of Ibadan, Oyo State, Nigeria
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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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Cadorin L, Grassetti L, Paoletti E, Cara A, Truccolo I, Palese A. Evaluating self-directed learning abilities as a prerequisite of health literacy among older people: Findings from a validation and a cross-sectional study. Int J Older People Nurs 2019; 15:e12282. [PMID: 31631519 DOI: 10.1111/opn.12282] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 09/07/2019] [Accepted: 09/16/2019] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To validate a tool measuring self-directed learning (SDL) abilities and to determine these abilities among older individuals attending the University of the Third Age. BACKGROUND Health literacy (HL) and SDL abilities have been documented as being closely linked to each other and as prerequisites in enhancing self-management competences required by older people to protect their health and to manage health issues. Furthermore, individuals with SDL abilities have been documented to have a full understanding of their health treatment prescriptions, to be able to demonstrate increased compliance and to further develop self-care competences. DESIGN A validation and a cross-sectional study design. METHODS A consecutive sample of 313 older people (68.7% female) who attended lessons in two Italian Universities of the Third Age and who were willing to participate in the study were enrolled. The Self-Rating Scale of Self-Directed Learning (SRSSDL) validated previously in the healthcare context, was used. RESULTS At the exploratory and confirmatory factor analysis, the SRSSDL in Older people (SRSSDLO) has demonstrated good psychometric properties: the tool is composed by four factors ("Awareness," "Attitudes," "Availability" and "Motivation") and 13 items. According to the findings, the average SDL score was 54.27 ± 6.69 out of 65, and women achieved significantly higher scores compared with men (54.81 ± 6.69 vs. 53.08 ± 6.54, p = .033), while participants with a university degree (55.95 ± 6.56) or secondary education (54.75 ± 6.13) had higher scores than those with lower secondary education (50.37 ± 7.34, p = .002). CONCLUSIONS Participants were responsible for their learning processes and were capable of identifying learning needs and goals. They were also internally motivated to develop learning methods and to organise learning activities. However, they were less able to keep up to date with the learning resources available. IMPLICATIONS FOR PRACTICE The SRSSDLO can help nurses identify healthy older people that lack SDL abilities and design tailored educational interventions to prevent health conditions and/or promote self-care management in chronic conditions.
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Affiliation(s)
- Lucia Cadorin
- Continuing Education Center, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Pordenone, Italy
| | - Luca Grassetti
- Department of Economics and Statistics, University of Udine, Udine, Italy
| | - Eva Paoletti
- Department of Medical Sciences, University of Udine, Udine, Italy
| | - Angelisa Cara
- Department of Medical Sciences, University of Udine, Udine, Italy
| | - Ivana Truccolo
- Scientific & Patients' Library, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Pordenone, Italy
| | - Alvisa Palese
- Department of Medical Sciences, University of Udine, Udine, Italy
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Lhussier M, Dalkin S, Hetherington R. Community care for severely frail older people: Developing explanations of how, why and for whom it works. Int J Older People Nurs 2019; 14:e12217. [PMID: 30592173 DOI: 10.1111/opn.12217] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 10/15/2018] [Accepted: 11/19/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND A Community Wellness Team was implemented in North East England in 2014, in line with national policy directives to support frail older people in the community. The service provides a comprehensive and integrated care package, which aims to reduce avoidable admissions, inappropriate service use and enable patients to stay at home. DESIGN A realist design combining a review of the literature and primary data collection from service providers and patients was used to develop programme theories explaining the links between the Team interventions and expected outcomes. RESULTS Five programme theories were developed, detailing: trust development and relationship building; risk minimisation in the home environment; advice on self-management; referral to preventative services; and coordination of services. DISCUSSION The programme theories explain the role and impact of the Community Wellness Team. These programme theories are interrelated and impact one another; a hypothesised progression of programme theories indicating how the Community Wellness Team "works" is discussed. Of particular importance was the comprehensive initial assessment, which leads to the alteration of the social and physical environment within which older people live. CONCLUSION Severely frail older people present cases that are complex socially, medically, financially and environmentally. In order to meet these needs, the Team coordinators are adopting a complex and flexible person-centred approach. IMPLICATIONS FOR PRACTICE This study paves the way for further research into the care networks surrounding severely frail older people living in the community, and how they can most effectively be implemented.
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Affiliation(s)
- Monique Lhussier
- Faculty of Health and Life Sciences, Public Health and Wellbeing, Northumbria University, Newcastle upon Tyne, UK
| | - Sonia Dalkin
- Faculty of Health and Life Sciences, Public Health and Wellbeing, Northumbria University, Newcastle upon Tyne, UK
| | - Ross Hetherington
- Station View Medical Centre, Durham Dales Health Federation, Bishop Auckland, Co. Durham, UK
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