The Development of a Situation-Specific Nurse-Led Culturally Tailored Self-Management Theory for Chinese Patients With Heart Failure

Self-management theories, models and frameworks in patients with chronic heart failure: A scoping review

AIM

The aim of this study was to synthesize the self-management theory, model and frameworks of patients with chronic heart failure, focusing on construction process, methods and existing problems.

BACKGROUND

Although the self-management theories have been created and verified for those patients with chronic heart failure, no reviews have been performed to integrate these theories.

DESIGN

A scoping review of recent literature (without a date limit) was conducted.

METHODS

A comprehensive literature search was performed. If the study reported the construction of a self-management theory, model or framework about chronic heart failure cases, it would be included in the review.

RESULTS

Fourteen studies were included, which could be categorized into situation-specific theory, middle-range theory and other theory models (including conceptual model, hypothetic regression model and identity description model). It also includes the update and validation of theories, the situation-specific theoretical of caregiver contributions extended from situation-specific theories and the nurse-led situation-specific theory in different contexts.

CONCLUSION

Self-management might contribute to start an education programme before patients with chronic heart failure (CHF) begin their chronic disease live as an individual. Our scoping review indicates that a series of self-management theories, models and frameworks for CHF patients have been developed, but more studies are still needed to validate and support these theories according to their cultural contexts.

Assessment of spiritual needs in cancer patients: A cross-sectional study

Introduction

Addressing the spiritual needs of patients is an essential component of holistic care in nursing. Acknowledging the spiritual needs of cancer patients enhances the performance of clinical caregivers in providing quality services to such patients. Therefore, caregivers successfully fulfill or decrease the patients' needs and thus increase their adaptation to crises.

Methods

The present cross-sectional study was conducted to determine the spiritual needs of cancer patients. In this study, 96 cancer patients were selected from Ayatollah Khansari Hospital in Arak, Iran. The required data were collected through a demographic information form and the Persian version of the Spiritual Needs Questionnaire.

Ethical Considerations

Participants' verbal consent to participate in the study was obtained, and they were assured of anonymity and confidentiality.

Results

In the present study, the mean age of the participants was 47.82 ± 14.34 years. The frequency distribution of respondents by gender was 36 males (37.5%) and 60 females (62.5%). The mean scores of spiritual needs in the domains of religious needs, need for inner peace, existential needs, and need for giving/generativity were 12.03 ± 3.18, 7.26 ± 3.26, 4.61 ± 2.96, and 4.06 ± 2.32, respectively. The highest and lowest mean values were associated with religious needs and need for giving/generativity, respectively. Religious needs showed a significantly positive relationship with gender, occupation, and the type of treatment (P < 0.05). Moreover, a significant relationship was observed between the need for peace and level of education (P < 0.05).

Conclusion

The recognition of the spiritual needs of cancer patients is the first step in prioritizing and planning to provide spiritual care to these patients and supporting them in adapting to and coping with the disease. Therefore, nurses need to acquire the fundamental knowledge and skills required to identify these needs.

Psychometric properties of the self-care of chronic illness inventory in Chinese older adults with multiple chronic conditions

BACKGROUND

Existing self-care measures for the Chinese population are specific to single chronic conditions. No generic self-care measures exist for the Chinese population with multiple chronic conditions.

OBJECTIVES

To test the structural validity, concurrent validity and reliability of the Self-care of Chronic Illness Inventory (SC-CII) in Chinese older adults with multiple chronic conditions.

METHODS

This cross-sectional study was reported following the Strengthening the Reporting of Observational Studies in Epidemiology guideline. A diverse sample of Chinese older adults with multiple chronic conditions (n = 240) was recruited. Structural validity was assessed with confirmatory factor analysis. Concurrent validity was investigated with hypotheses testing of the relationships between perceived stress, resilience and self-care. Reliability was assessed with Cronbach's alpha and McDonald's omega. Finally, a simultaneous confirmatory factor analysis was conducted to test the general model with all items and all three subscales.

RESULTS

Confirmatory factor analysis supported the two-factor structure of the self-care maintenance and self-care management subscales and the one-factor structure of the self-care monitoring subscale. Concurrent validity was supported by the significant negative correlation (r ranged from -0.18 to -0.38, p < .01) with perceived stress and the significant positive correlation (r ranged from 0.31 to 0.47, p < .01) with resilience. Reliability estimates ranged from 0.77 to 0.82 across the three subscales. The simultaneous confirmatory factor analysis did not support the more general model with the combined set of items.

CONCLUSION

The SC-CII is valid and reliable for Chinese older adults with multiple chronic conditions. Future cross-cultural assessment should be conducted to investigate the measurement equivalence of the SC-CII in individuals from Western and Eastern cultural groups.

IMPLICATIONS FOR PRACTICE

With the increasing number of older adults in China who are living with multiple chronic conditions and the call for culturally tailored self-care interventions, this self-care measure can be used in geriatric primary care settings, long-term facilities and homes to improve the understanding and practice of self-care in older Chinese adults.

Designing a Future eHealth Service for Posthospitalization Self-management Support in Long-term Illness: Qualitative Interview Study

BACKGROUND

For patients with noncommunicable diseases (NCDs; eg, heart failure [HF] and colorectal cancer [CRC]), eHealth interventions could meet their posthospital discharge needs and strengthen their ability to self-manage. However, inconclusive evidence exists regarding how to design eHealth services to meet the complex needs of patients. To foster patient acceptability and ensure the successful development and implementation of eHealth solutions, it is beneficial to include different stakeholders (ie, patients and health care professionals) in the design and development phase of such services. The involvement of different stakeholders could contribute to ensuring feasible, acceptable, and usable solutions and that eHealth services are developed in response to users' supportive care needs when transitioning to home after hospitalization. This study is the first step of a larger complex intervention study aimed at meeting the postdischarge needs of 2 NCD populations.

OBJECTIVE

This study aimed to explore the perspectives of patients with HF and CRC and health care professionals on patient self-management needs following hospital discharge and investigate how a future nurse-assisted eHealth service could be best designed to foster patient acceptability, support self-management, and smooth the transition from hospital to home.

METHODS

A qualitative, explorative, and descriptive approach was used. We conducted 38 semistructured interviews with 10 patients with HF, 9 patients surgically treated for CRC with curative intent, 6 registered nurses recruited as nurse navigators of a planned eHealth service, and 13 general practitioners experienced in HF and CRC treatment and follow-up care. Patients were recruited conveniently from HF and CRC outpatient clinics, and the nurses were recruited from the cardiology and gastro-surgical departments at a university hospital in the southwest of Norway. The general practitioners were recruited from primary care in surrounding municipalities. Semistructured interview guides were used for data collection, and the data were analyzed using thematic analysis.

RESULTS

In total, 3 main themes were derived from the data analysis: expecting information, reassurance, and guidance when using eHealth for HF and CRC self-management; expecting eHealth to be comprehensible, supportive, and knowledge promoting; and recognizing both the advantages and disadvantages of eHealth for HF and CRC self-management. The data generated from this interview study depicted the diverse needs for self-management support of patients with CRC and HF after hospital discharge. In addition, valuable suggestions were identified regarding the design and content of the eHealth service. However, participants described both possible advantages and disadvantages of a remote eHealth service.

CONCLUSIONS

This study is the first step in the development of an eHealth service for posthospitalization self-management support for long-term illnesses. It concerns patients' supportive care needs and user requirements of an eHealth service. The findings of this study may add value to the planning and development of eHealth interventions for patients with NCDs.