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Chen M, Wang M, Qiao M, Huang X, Li D, Yu L, Gan L, Chen W, Weng Y, Zhang J, Yu B, Liu J, Zhang L. Determinants influencing health-promoting behaviors in individuals at high risks of stroke: a cross-sectional study. Front Public Health 2024; 12:1323277. [PMID: 38912268 PMCID: PMC11190076 DOI: 10.3389/fpubh.2024.1323277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 05/20/2024] [Indexed: 06/25/2024] Open
Abstract
Background Quit smoking, moderate drinking, exercise, and healthy eating habits are all known to decrease the risk of stroke. As a result, understanding the health behaviors of high risk groups for stroke is crucial. Health behavior is influenced by knowledge, social environment, and health beliefs. However, little research has been done on these relationships. For a better grasp of the relationships mentioned above, consider using the COM-B model (capability, opportunity, motivation, and behavior). The purpose of this study was to investigate the variables related to health behavior and to test the mediating effect of health beliefs. Methods The cross-sectional study was carried out at a physical examination center of a tertiary hospital in Shanghai, China. 986 high-risk populations of stroke have been tested using the Health Behavior Scale (HBS-SP), Stroke Knowledge Questionnaire (SKQ), Health Beliefs Questionnaire (HBS), and Multidimensional Scale of Perceived Social Support (MSPSS). The structural equation modeling was used in this study. Results The scores for MSPSS, SKQ, HBS, and HBS-SP were 60.64 ± 13.72, 26.60 ± 9.77, 157.71 ± 34.34, and 2.46 ± 0.41, respectively. The revised model fits well (approximate root mean square error = 0.042; comparative fit index = 0.946). The health behavior was obviously and positively correlated to social Support, stroke knowledge, and health beliefs. Moreover, health belief has a mediating effect on the relation of social support, stroke knowledge, and health behavior. Conclusion Chinese high risk groups for stroke have a mediate level of health behaviors. Factors associated with health behaviors are knowledge of stroke, health beliefs, and social support. The COM-B-based model can be used to explain the health behavior of individuals at risk of stroke and to guide the formulation of effective health management programs.
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Affiliation(s)
- Mengxia Chen
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital, Shanghai, China
| | - Mengdi Wang
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital, Shanghai, China
| | - Mengting Qiao
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital, Shanghai, China
| | - Xiaorong Huang
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital, Shanghai, China
| | - Dongmei Li
- Neurovascular Center, Changhai Hospital, Shanghai, China
| | - Longjuan Yu
- Neurovascular Center, Changhai Hospital, Shanghai, China
| | - Lifen Gan
- Neurovascular Center, Changhai Hospital, Shanghai, China
| | - Wenyao Chen
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital, Shanghai, China
- Shanghai Quality Control Center of Geriatric Care, Shanghai, China
| | - Yanqiu Weng
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital, Shanghai, China
- Shanghai Quality Control Center of Geriatric Care, Shanghai, China
| | - Jingwen Zhang
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital, Shanghai, China
| | - Bing Yu
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital, Shanghai, China
| | - Jianmin Liu
- Neurovascular Center, Changhai Hospital, Shanghai, China
| | - Lingjuan Zhang
- Education and Scientific Research Department of Clinical Nursing, Changhai Hospital, Shanghai, China
- Shanghai Quality Control Center of Geriatric Care, Shanghai, China
- Key Laboratory of Geriatric Long-term Care (Naval Medical University), Ministry of Education, Shanghai, China
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Almomani HY, Almomani EY, Qablan A, Al-Momany A. Pharmacists' perspectives and perceived barriers to counselling patients with kidney stones. Res Social Adm Pharm 2024; 20:123-133. [PMID: 38462437 DOI: 10.1016/j.sapharm.2024.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/20/2024] [Accepted: 02/25/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND The global increase in kidney stone incidence and its complications emphasise the need for effective management. While pharmacists can play a significant role in counselling and guiding patients, their practices in managing patients with kidney stones remain unclear. OBJECTIVE(S) To explore counselling practices and experiences of pharmacists when dealing with patients with kidney stones and to identify the barriers they face while providing counselling. METHODS A qualitative study was performed using semi-structured phone interviews with pharmacists practising in Jordan. Pharmacists were selected using quota sampling from those who took part in a previous study focused on pharmacists' knowledge of kidney stone aetiology and treatment. The COM-B Model of Behaviour Change was used to develop the interview guide and the analytical framework. Interviews were transcribed verbatim and analysed using a deductive thematic approach based on the pre-specified analytical framework. RESULTS Seven pharmacists (85.7% female; 57.1% working in community pharmacies) were interviewed. Counselling practices of patients with kidney stones were categorised into five themes: (1) Pharmacists' beliefs about patient counselling: perceived importance and desire to improve health through counselling; (2) Most priority patients: Types of patients mostly counselled; (3) Content of kidney stones-specific counselling: patient assessment and recommendations about kidney stones management; (4) Duration of the counselling sessions: time offered and influencing factors; (5) Barriers to patient counselling: patient-related, and pharmacist- and doctor-related challenges. CONCLUSIONS Pharmacists recognise the crucial role of kidney stones counselling but face gaps in their practices, including incomplete dietary education, limited knowledge of medication prescriptions, inconsistent patient-specific approaches, and potential communication challenges. These gaps can be overcome by enhancing training, standardising protocols of kidney stone treatment, promoting interprofessional communication, and improving communication strategies. Future research, including quantitative assessments, is needed to inform strategies that optimise patient counselling practices and facilitate improved outcomes.
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Affiliation(s)
- Huda Y Almomani
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan.
| | - Ensaf Y Almomani
- Department of Basic Medical Sciences, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
| | - Ahmad Qablan
- Department of Curriculum and Methods of Instruction, United Arab Emirates University, Al Ain, United Arab Emirates; Faculty of Educational Sciences, Hashemite University, Zarqa, Jordan
| | - Abass Al-Momany
- Department of Clinical Laboratory Sciences, University of Jordan, Amman, Jordan
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Sugebo ES, Kassie TW, Gobena T, Tibore TK, Sebro SF, Ermolo TL. Self-care behavior and associated factors among adult heart failure patients in outpatient cardiac follow-up unit at Wachemo University Nigist Eleni Comprehensive Specialized Hospital, Southern Ethiopia. BMC Cardiovasc Disord 2024; 24:238. [PMID: 38714943 PMCID: PMC11075198 DOI: 10.1186/s12872-024-03901-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 04/24/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Heart failure is a serious medical condition that occurs when the heart is unable to pump sufficient blood to meet the needs of the tissues. Good self-care is an essential behavior in long term management and maintenance of physiologic stability, better medical and person-centered outcomes. Poor self-care behavior deteriorates the outcomes of heart failure patients. However, there were no sufficient evidences that illustrate the topic in the country, including the study area. METHODOLOGY Institutional based cross-sectional study was conducted among 250 heart failure patients from July 5-August 4, 2021. All adult heart failure patients who fulfill the inclusion criteria and have appointment during study period were included in the study. Interview and medical chart review was used to collect data. Epidata version 3.1 and SPSS version 20 were used for data entry and analysis respectively. Bivariate and multivariable analysis was computed. The model fitness was checked by Hosmer and Lemeshow test. RESULTS From the total patients, 240 were interviewed with the response rate of 96%. Among these, 140(58.3%) [95% CI: 52.6, 64.9] had poor self-care behavior. Age>54: 9.891 [2.228, 43.922], poor knowledge: 6.980[1.065, 45.727], depression: 4.973[1.107, 22.338], low social support: 6.060[1.373, 26.739], insomnia: 4.801[1.019, 22.622] and duration with heart failure <1 year: 5.782[1.438, 23.247] were factors associated with poor self-care behavior. CONCLUSION In this study, more than half of participants attending at Wachemo University Nigist Eleni Comprehensive Specialized Hospital in outpatient cardiac follow-up unit had poor self-care behavior. Of the study variables, older age, poor knowledge, depressive symptoms, low social support, insomnia and short duration with heart failure were related with poor self-care behavior. Thus, the findings highlight importance of assessing level of self-care behavior and implicate direction to take action to enhance level of self-care behavior.
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Affiliation(s)
- Ermias Sigebo Sugebo
- Department of Nursing, Wachemo University College of Medicine and Health Science, Hosaena, Southern, Ethiopia.
| | - Teshager Worku Kassie
- Department of Nursing, Haramaya University College of Health and Medical Science, Harar, Ethiopia
| | - Tesfaye Gobena
- Department of Public Health, Haramaya University College of Health and Medical Science, Harar, Ethiopia
| | - Temesgen Kechine Tibore
- Department of Nursing, Wachemo University College of Medicine and Health Science, Hosaena, Southern, Ethiopia
| | - Sisay Foga Sebro
- Department of Nursing, Wachemo University College of Medicine and Health Science, Hosaena, Southern, Ethiopia
| | - Tadesse Lelago Ermolo
- Department of Nursing, Wachemo University College of Medicine and Health Science, Hosaena, Southern, Ethiopia
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Kalantari M, Hollywood A, Lim R, Hashemi M. Co-designing an intervention using the COM-B model to change an eating behaviour in people living with achalasia. Front Med (Lausanne) 2024; 11:1216209. [PMID: 38745739 PMCID: PMC11091317 DOI: 10.3389/fmed.2024.1216209] [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: 05/03/2023] [Accepted: 04/15/2024] [Indexed: 05/16/2024] Open
Abstract
Background Achalasia is a rare motility disorder affecting the oesophagus, leading to difficulties with eating and drinking. Participants in previous studies reported that they needed more social, clinical and behavioural support in the long-term management of achalasia. This study, therefore aimed to 1) identify the most challenging eating behaviour for people living with achalasia and 2) co-design a behaviour change intervention to help address the challenges they experience. Methods This study used a qualitative approach involving online focus groups. The COM-B model was the theoretical framework, with behaviour change techniques (BCTs) as the active ingredients that target a mixture of capability, opportunity and/or motivation. Three focus groups were undertaken to obtain a range of input from different people living with achalasia. Participants in this study identified the target behaviour, prioritised the different BCTs which most resonated with them to design an intervention and decided on the mode of delivery. The research team analysed the techniques that helped participants with their eating behaviour using the COM-B model as a framework to create the intervention. Results The 24 participants in this study identified "eating in a social setting" as the target behaviour for the intervention. A workbook that can be personalised by the individual was the most suitable intervention. The workbook structure aligns with the constructs of the COM-B model. It includes reflection, activities and goal-setting sections based on what was indicated to be useful for the majority of the participants. Key techniques to overcome the challenges with eating in a social setting included social support, regulation to reduce negative emotions, goals and planning. Conclusion Using a focus group approach with the COM-B model as the theoretical framework, the participants in this study developed an intervention to support people living with achalasia. In order to achieve long-term behaviour change, engagement with a personalised workbook could facilitate eating in a social setting. Future work will need to pilot the workbook to ensure it can support people to improve their quality of life and complement the ongoing care they receive from health services.
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Affiliation(s)
- Melika Kalantari
- School of Pharmacy, University of Reading, Reading, United Kingdom
| | - Amelia Hollywood
- School of Pharmacy, University of Reading, Reading, United Kingdom
| | - Rosemary Lim
- School of Pharmacy, University of Reading, Reading, United Kingdom
| | - Majid Hashemi
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
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Kleman C, Turrise S, Winslow H, Alzaghari O, Lutz BJ. Individual and systems-related factors associated with heart failure self-care: a systematic review. BMC Nurs 2024; 23:110. [PMID: 38336711 PMCID: PMC10854154 DOI: 10.1186/s12912-023-01689-9] [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: 05/24/2023] [Accepted: 12/25/2023] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Heart failure (HF) is a prevalent condition worldwide. HF self-care is a set of behaviors necessary for improving patient outcomes. This study aims to review and summarize the individual and system-related factors associated with HF self-care published in the last seven years (Jan 2015 - Dec 2021) using the Socioecological Model as a review framework. METHODS An experienced nursing librarian assisted authors in literature searches of CINAHL Plus with Full Text, Ovid Nursing, PsychINFO, and PubMed databases for peer-reviewed descriptive studies. Inclusion criteria were HF sample with self-care as the outcome variable, and a quantitative descriptive design describing individual and/or system-level factors associated with self-care. Exclusion criteria were interventional or qualitative studies, reviews, published before 2015, non-English, and only one self-care behavior as the outcome variable. The search yielded 1,649 articles. Duplicates were removed, 710 articles were screened, and 90 were included in the full-text review. RESULTS A subset of 52 articles met inclusion and exclusion criteria. Study quality was evaluated using modified STROBE criteria. Study findings were quantitated and displayed based on socioecological levels. Self-care confidence, HF knowledge, education level, health literacy, social support, age, depressive symptoms, and cognitive dysfunction were the most frequently cited variables associated with self-care. Most factors measured were at the individual level of the Socioecological Model. There were some factors measured at the microsystem level and none measured at the exosystem or macrosystem level. CONCLUSION Researchers need to balance the investigation of individual behaviors that are associated with HF self-care with system-level factors that may be associated with self-care to better address health disparities and inequity.
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Affiliation(s)
- Carolyn Kleman
- College of Health & Human Services School of Nursing, University of North Carolina Wilmington, 601 South College Road, Wilmington, NC, 28403, USA.
| | - Stephanie Turrise
- College of Health & Human Services School of Nursing, University of North Carolina Wilmington, 601 South College Road, Wilmington, NC, 28403, USA
| | - Heidi Winslow
- Manager of Nurse Residencies, Novant New Hanover Regional Medical Center, 2131 S. 17th Street, Wilmington, NC, 28401, USA
| | - Omar Alzaghari
- College of Health & Human Services School of Nursing, University of North Carolina Wilmington, 601 South College Road, Wilmington, NC, 28403, USA
| | - Barbara J Lutz
- College of Health & Human Services School of Nursing, University of North Carolina Wilmington, 601 South College Road, Wilmington, NC, 28403, USA
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Niriayo YL, Yemane B, Asgedom SW, Teklay G, Gidey K. Prevalence and predictors of poor self-care behaviors in patients with chronic heart failure. Sci Rep 2024; 14:1984. [PMID: 38263418 PMCID: PMC10805850 DOI: 10.1038/s41598-024-52611-5] [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: 07/13/2023] [Accepted: 01/21/2024] [Indexed: 01/25/2024] Open
Abstract
Despite the indispensable role of self-care behavior in managing heart failure, the practice of self-care behavior remains poor, especially in developing countries. There is a scarcity of research focusing on poor self-care behavior and its determinants within our specific context. Therefore, the objective of this study was to investigate the prevalence and predictors of poor self-care behavior among ambulatory heart failure patients. A facility-based cross-sectional study was conducted at a tertiary care hospital in Ethiopia, involving patients with heart failure. We utilized the European Heart Failure Self-Care Behavior Scale (EHFScBS-9) to evaluate adherence to self-care behaviors. Data were gathered through patient interviews and a review of medical records. A binary logistic regression analysis was performed to identify predictors of poor self-care behavior in heart failure patients. We included a total of 343 participants in the final analysis of this study. The findings revealed that a majority of the patients (73.8%) demonstrated poor overall self-care behavior. Specifically, the majority of patients did not engage in regular exercise (76.1%), failed to consult doctors in case of rapid weight gain (75.6%), did not monitor weight daily (71.5%), did not restrict fluid intake (69.9%), and did not contact doctors in case of experiencing fatigue (68.6%). Additionally, 32.4% of patients did not reach out to doctors when experiencing shortness of breath, 30% did not restrict salt intake, 29% did not adhere to prescribed medication, and only 7% did not consult doctors if edema occurred. Our findings indicated that rural residence (AOR: 5.76, 95% CI: 2.47-13.43), illiteracy (AOR: 2.64, 95% CI: 1.52-6.31), prior hospitalization (AOR: 2.09, 95% CI: 1.21-3.61), and taking five or more medications (AOR: 1.83, 1.01-3.33) were significant predictors of poor self-care behavior. In conclusion, a majority of the participants in our study demonstrated poor self-care behavior. Risk factors for this behavior included rural residence, illiteracy, prior hospitalization, and taking five or more medications. Therefore, it is crucial to prioritize these high-risk patients and implement interventional programs aimed at improving self-care behaviors and overall treatment outcomes in heart failure patients.
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Affiliation(s)
- Yirga Legesse Niriayo
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia.
| | - Bisrat Yemane
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Solomon Weldegebreal Asgedom
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Gebrehiwot Teklay
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Kidu Gidey
- Department of Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
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Tang F, Zhong X, Liu S, Guo X, Li D. Pathway analysis of the impact of health literacy, social support and self-efficacy on self-management behaviors in pregnant women with gestational diabetes mellitus. Front Public Health 2023; 11:1188072. [PMID: 38026370 PMCID: PMC10667905 DOI: 10.3389/fpubh.2023.1188072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Objective The purpose of this study was to investigate the pathways by which health literacy (HL), social support, and self-efficacy influence self-management behaviors of pregnant women with Gestational diabetes mellitus (GDM) and the interrelationships between the variables. Methods A total of 565 pregnant women with GDM was recruited. The Demographic Characteristics Form, Health Literacy Scale, Perceived Social Support Scale, General Self-efficacy Scale and GDM Self-management Behavior Scale were used for data collection. Descriptive statistics, zero-ordered correlation analysis, and multiple linear regression analysis were performed on the variables; Structural Equation Model (SEM) were constructed for pathway analysis. Results A positive correlation was found between health literacy, social support, self-efficacy, and self-management behaviors among pregnant women with GDM after adjusting for age, education level, income level, work status, parity, and family history of diabetes (r ranging from 0.203 to 0.533). A further multiple linear regression analysis showed that functional HL, communicative HL, critical HL, social support, and self-efficacy were all independent influences on self-management behaviors and accounted for 36.3% of the variance. Communicative HL and critical HL explained the strongest self-management behaviors (β = 0.316 and 0.255, respectively, p < 0.001). The SEM model was suitable for χ2/DF = 2.860, RMSEA = 0.060, IFI = 0.953, TLI = 0.943, and CFI = 0.952. The results showed direct positive effects of health literacy on self-management behaviors and self-efficacy, direct positive effects of social support on health literacy and self-efficacy. Social support and self-efficacy have had no significant direct impact on self-management behaviors, but social support may indirectly influence self-management behaviors through the health literacy mediation role. Conclusion Healthcare providers should pay attention to the positive impacts of health literacy and social support on self-management behaviors of pregnant women with GDM. Improving the health literacy level of pregnant women with GDM should be the key point of intervention in practice, and the social support system should be fully mobilized to enhance emotional support and life support to promote the improvement of self-management behaviors.
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Affiliation(s)
- Fangmei Tang
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- Department of Nursing, Zigong Fourth People’s Hospital, Zigong, China
| | - Xiaoying Zhong
- Department of Nursing, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, China
| | - Sixu Liu
- Nursing Department, YAAN People’s Hospital, Yaan, China
| | - Xiujing Guo
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Dehua Li
- Department of Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
- Office of Operations Management and Evaluation, West China Second University Hospital, Sichuan University, Chengdu, China
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Jiang Y, Zhang C, Hong J, Tam WWS, Ramachandran HJ, Wang W. Relationships of person-related, problem-related, and environment-related factors to self-care behaviours and the mediating role of self-confidence among patients with heart failure: Cross-sectional analysis of structural equation modelling. Int J Nurs Stud 2023; 147:104590. [PMID: 37741260 DOI: 10.1016/j.ijnurstu.2023.104590] [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: 11/23/2022] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Promoting self-care behaviours in heart failure management is an important goal and challenge for healthcare systems worldwide. Using the situation-specific theory of heart failure self-care, this study examined the relationships of person-related, problem-related, and environment-related factors to self-care behaviours and the mediating role of self-care confidence in these relationships. METHOD We analysed the baseline data from a previous randomised controlled trial study involving 213 patients with heart failure. Structural equation modelling was used to test our hypothesised model that included age, income, education, depression, anxiety, number of comorbidities, social support, self-care confidence, and self-care behaviours. Depression and anxiety were measured by the Hospital Anxiety and Depression Scale. Social support was measured by the Short Form of the Social Support Questionnaire satisfaction subscale. The Self-Care of Heart Failure Index (version 6.2) was used to assess self-care confidence and self-care behaviours (i.e., self-care maintenance and self-care management). RESULT The final model included age, depression, social support, and self-care confidence as independent variables. Age had a direct relationship with self-care maintenance (β = 0.235, p < 0.001) but not self-care management (β = 0.067, p = 0.179); better social support was directly associated with higher levels of self-care confidence (β = 0.267, p < 0.001); and higher levels of self-care confidence were associated with better self-care maintenance (β = 0.573, p < 0.001) and self-care management (β = 0.683, p < 0.001). The result showed an indirect relationship between social support and self-care maintenance through the mediator of self-care confidence (β = 0.153, p < 0.001), as well as an indirect relationship between social support and self-care management through self-care confidence (β = 0.182, p < 0.001). CONCLUSION Satisfactory social support can increase self-care confidence, thereby increasing self-care maintenance and management. The findings of this study also implied that self-care maintenance can increase with increasing age. Future interventions directly targeting assessment and management of self-care confidence, available social support, and the age of patients may help enhance their heart failure self-care behaviours.
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Affiliation(s)
- Ying Jiang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Ci Zhang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Jingfang Hong
- School of Nursing, Anhui Medical University, Hefei, China.
| | - Wilson Wai San Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Hadassah Joann Ramachandran
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Almomani H, Raza A, Patel N, Donyai P. Reasons that lead people to buy prescription medicines on the internet: a systematic review. Front Pharmacol 2023; 14:1239507. [PMID: 37719862 PMCID: PMC10501782 DOI: 10.3389/fphar.2023.1239507] [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: 06/13/2023] [Accepted: 08/15/2023] [Indexed: 09/19/2023] Open
Abstract
Aim: This systematic review explores the factors that could influence consumer's decision of purchasing prescription medicines using the Internet. Methods: Relevant databases were searched to retrieve studies published from 2012 to 2021. The studies selected for inclusion were those focused on the consumer's perspective and the purchase of prescription medicines. A narrative synthesis was employed. The Capability Opportunity Motivation-Behaviour (COM-B) and the Theoretical Domains Framework (TDF) were employed as conceptual lenses that guided the analysis. Results: Seventeen studies were included. These studies have adopted various methodologies: qualitative method (n = 4), quantitative method (n = 12), and mixed methods (n = 1). The studies were based in Europe (n = 8), North America (n = 3), Middle East (n = 4), and 2 studies were conducted in several countries (multinational). The analysis of these studies revealed 7 themes that represent the reasons that lead people to buy prescription medicines via the Internet. These themes were the consumers' beliefs about the outcomes of the purchase (perceived benefits and risks of the purchase), consumer's emotions that could influence the purchasing decision, the factors that increase or decrease consumer's level of behavioural control over the purchase (facilitators and barriers of the purchase), consumers knowledge about the purchase, the trusting beliefs that lead consumers to trust the online sellers of medicines, the social influencing factors, and the external environmental factors that could encourage the purchase. Discussion: This study provides a comprehensive review of the breadth of reasons that drive people to buy prescription medicines via the Internet. Identifying those reasons could provide the basis for regulators to design evidence-based awareness campaigns to minimise the purchase of prescription medicines via the Internet. Furthermore, future research directions have been provided in this review to build upon the existing knowledge and address the research gaps in this area.
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Affiliation(s)
- Hamzeh Almomani
- School of Pharmacy, University of Reading, Reading, United Kingdom
| | - Amna Raza
- School of Pharmacy, University of Reading, Reading, United Kingdom
| | - Nilesh Patel
- School of Pharmacy, University of Reading, Reading, United Kingdom
| | - Parastou Donyai
- Department of Pharmacy and Forensic Science, Faculty of Life Science and Medicine, King’s College London, London, United Kingdom
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Liu X, Liu L, Li Y, Cao X. The association between physical symptoms and self-care behaviours in heart failure patients with inadequate self-care behaviours: a cross-sectional study. BMC Cardiovasc Disord 2023; 23:205. [PMID: 37087429 PMCID: PMC10122378 DOI: 10.1186/s12872-023-03247-2] [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: 09/07/2022] [Accepted: 04/18/2023] [Indexed: 04/24/2023] Open
Abstract
BACKGROUND Patients with heart failure frequently report inadequate self-care behaviours. Physical symptoms can impact patients' ability to perform self-care behaviours. However, studies investigating the association between physical symptoms and heart failure self-care behaviours have produced inconsistent findings, potentially due to variations in the determinants of self-care behaviours among patients with differing levels of self-care proficiency. Understanding the association between physical symptoms and self-care behaviours in heart failure patients with inadequate self-care behaviours could improve care for this subpopulation. The study aimed to explore the association between physical symptoms and self-care behaviours in Chinese heart failure patients with inadequate self-care behaviours. METHODS This analysis was based on primary data from a cross-sectional study that aimed to investigate factors associated with self-care in heart failure patients. Physical symptoms were measured using the Heart Failure Somatic Perception Scale. Self-care behaviours (i.e., self-care maintenance and management) of heart failure were measured using the Self-Care of Heart Failure Index (version 6.2). Patients who reported scores < 70 on both self-care maintenance and management behaviours were eligible and included in the analysis. Hierarchical regression analysis was performed to explore the association between physical symptoms and self-care behaviours. RESULTS A total of 189 patients were included in the analysis, with a mean age of 65 years and a median duration of living with heart failure of 24 months. Most participants were classified as New York Heart Association class III or IV. Dyspnoea symptoms were the most frequently reported physical symptoms. The results of the hierarchical regression analysis showed that the severity of physical symptoms was positively associated with self-care management behaviours (β = 0.157, 95% CI: 0.010, 0.368, p = 0.039) but not significantly associated with self-care maintenance behaviours (β = -0.133, 95% CI: -0.316, 0.026, p = 0.097). CONCLUSIONS Based on the data collected in Changsha, China, we found that patients with HF with poor self-care experienced more dyspnoea symptoms. Severe HF physical symptoms might serve as drivers for better self-care management in patients with inadequate self-care behaviours. Effective care and support should be provided when physical symptoms worsen to facilitate patients' engagement in self-care behaviour in this subpopulation.
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Affiliation(s)
- Xu Liu
- Department of Infectious Disease, The Fifth Affiliated Hospital, Sun Yat-Sen University, Zhuhai, Guangdong Province, China
| | - Li Liu
- Xiangya Nursing School, Central South University, Changsha, Hunan Province, China
| | - Yan Li
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong S.A.R, China
| | - Xi Cao
- School of Nursing, Sun Yat-Sen University, NO. 74, Zhongshan 2nd Rd., Guangzhou, 510080, China.
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11
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Factors influencing self-management behavior during the "Blanking Period" in patients with atrial fibrillation: A cross-sectional study based on the information-motivation-behavioral skills model. Heart Lung 2023; 58:62-68. [PMID: 36403555 DOI: 10.1016/j.hrtlng.2022.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Atrial fibrillation (AF) is becoming increasingly common. Effective self-management during the "Blanking Period" is critical. The Information-Motivation-Behavioral skills (IMB) model can be used to study health behaviors in chronic disease patients, but it has not been studied in AF patients. OBJECTIVE The goal of this study was to explore the influencing factors and interaction pathways of self-management behavior in AF patients during the "Blanking Period" using the IMB model. METHODS From June to December 2021, a cross-sectional design was conducted. Patients with AF during the "Blanking Period" (N=220) were recruited. They filled out several quantitative questionnaires, including the Jessa Atrial Fibrillation Knowledge Questionnaire, the Confidence in Atrial Fibrillation Management Scale, the Perceived Social Support Scale, the All Aspects of Health Literacy Scale, and the Self-care Scale for Chronic Atrial Fibrillation Patients. Data were analyzed using correlation analysis, multiple regression analysis, and path analysis. RESULTS Total score of self-management behavior was (33.83 ± 10.66). AF knowledge (β = 0.252, P < 0.001), self-management confidence (β = 0.219, P < 0.001), social support (β = 0.291, P < 0.001), and health literacy (β = 0.262, P < 0.001) were all positively correlated with patients' self-management behavior, accounting for 66.50 percent of the total variance. CONCLUSIONS During the "Blanking Period", the IMB model can be used to predict the factors that influence self-management behavior in AF patients. By using IMB model, interventions targeting patient-specific influencing factors could improve self-management behavior and quality of life in AF patients.
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12
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Chen D, Zhang H, Shao J, Tang L, Cui N, Wang X, Wu J, Wang D, Ye Z. Determinants of adherence to diet and exercise behaviours among individuals with metabolic syndrome based on the Capability, Opportunity, Motivation, and Behaviour model: a cross-sectional study. Eur J Cardiovasc Nurs 2023; 22:193-200. [PMID: 35672276 DOI: 10.1093/eurjcn/zvac034] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 11/14/2022]
Abstract
AIMS Adherence to diet and exercise recommendations is crucial among metabolic syndrome (MetS) individuals. However, no studies have focused on comprehensive behavioural changes of diet and exercise among individuals with MetS. The present study aimed to explore determinants of adherence to diet and exercise behaviours among people with MetS based on the Capability, Opportunity, Motivation, and Behaviour (COM-B) model. METHODS AND RESULTS A cross-sectional study was conducted in a health promotion centre of a large and general university hospital in Zhejiang Province, China, in 2021. A total of 241 individuals with MetS completed all scales. The mediation model was tested using structural equation modelling with bootstrapped samples. In the regression-based path analysis, MetS knowledge (β = 0.140), socioeconomic status (β = 0.162), and social support (β = 0.143) directly positively influenced diet behaviour. In addition, social support indirectly positively influenced exercise behaviour through coping and adaptation (β = 0.090). The final theoretical model showed a good fit (root mean square error of approximation = 0.057, comparative fit index = 0.946). CONCLUSION Factors associated with diet behaviour were knowledge of MetS, socioeconomic status, and social support. Adaptation may be a mediator between social support and exercise behaviour. Intervention programmes targeting increased adherence to diet and exercise could include these factors for individuals with MetS.
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Affiliation(s)
- Dandan Chen
- Nursing Department, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3 East Qingchun Road, Shangcheng District, Hangzhou 310020, China
| | - Hui Zhang
- Department of Cardiology, Guizhou Provincial People's Hospital, No. 83 East Zhongshan Road, Nanming District, Guiyang 550002, China
| | - Jing Shao
- Institute of NursingResearch, Zhejiang University School of Medicine, No.866 Yuhangtang Road, Xihu District, Hangzhou 310058, China
| | - Leiwen Tang
- Nursing Department, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3 East Qingchun Road, Shangcheng District, Hangzhou 310020, China
| | - Nianqi Cui
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 310009, China
| | - Xiyi Wang
- School of Nursing, Shanghai Jiao Tong University, No. 227 South Chongqing Road, Shanghai 200025, China
| | - Jingjie Wu
- Nursing Department, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3 East Qingchun Road, Shangcheng District, Hangzhou 310020, China
| | - Dan Wang
- Nursing Department, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3 East Qingchun Road, Shangcheng District, Hangzhou 310020, China
| | - Zhihong Ye
- Nursing Department, Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3 East Qingchun Road, Shangcheng District, Hangzhou 310020, China
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13
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Kim J, Hwang SY, Kim SH, Shim JL. Structural Relationships Between Cognitive Function, Depressive Symptoms, Self-Care Confidence, and Maintenance in Patients With Heart Failure. SAGE Open Nurs 2023; 9:23779608231196665. [PMID: 37691722 PMCID: PMC10483967 DOI: 10.1177/23779608231196665] [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: 02/04/2022] [Revised: 07/31/2023] [Accepted: 08/05/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction In order to promote self-care maintenance behavior in patients with heart failure (HF), it is necessary to identify the direct and indirect effects of major latent variables. Objective This study aimed to identify structural relationships between different domains of cognitive function, depression and self-care confidence, and self-care maintenance. Methods This descriptive study involved a secondary analysis using data of 201 patients with HF from two observational studies in three hospitals in Korea. The structural equation model using AMOS version 24.0 was constructed to assess the relationships among the variables. The Seoul Neuropsychological Screening Battery was used to assess global cognition, immediate/delayed memory, and executive function, and the Self-Care of HF Index v.6.2. was used for self-care confidence and maintenance. Results Self-care maintenance was affected by memory function with a significant direct effect (β=.43, p = .006), as well as self-care confidence (β=.70, p < .001). Memory function and global function indirectly affected self-care maintenance through self-care confidence (β = -.37, p = .002; β = .14, p = .030). Depressive symptoms also had an indirect effect through self-care confidence on self-care maintenance (β = -.21, p = .005). Conclusion This study confirmed that it is important to increase self-care confidence through supportive care and to maintain memory function for maintaining self-care in the chronic course of HF patients. In particular, this study suggests that it is necessary to perform periodic memory check-ups for chronic HF patients on an outpatient basis, and counseling and education are needed to improve memory and increase confidence in self-care.
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Affiliation(s)
- JinShil Kim
- College of Nursing, Gachon University, Incheon, South Korea
| | - Seon Young Hwang
- College of Nursing, Gachon University, Incheon, South Korea
- College of Nursing, Hanyang University, Seoul, South Korea
| | - Sun Hwa Kim
- Department of Nursing, Hanyang University Medical Center, Seoul, South Korea
| | - Jae Lan Shim
- Department of Nursing, Dongguk University, Gyeongju, South Korea
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14
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Lima FMA, Jamas MT, Miot HA, Garcia de Avila MA. Heart Disease Knowledge Questionnaire: Psychometric Properties in Brazilian Adults. AMERICAN JOURNAL OF HEALTH EDUCATION 2022. [DOI: 10.1080/19325037.2022.2120121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
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15
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Qi H, Chen S, Chen T, Gan W, Yang D, Wang Y, Zhang Q. Reliability and validity of the Chinese version of the instrument of health literacy competencies for health professionals. Nurs Open 2022; 10:926-938. [PMID: 36106612 PMCID: PMC9834528 DOI: 10.1002/nop2.1360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/27/2022] [Accepted: 08/25/2022] [Indexed: 01/16/2023] Open
Abstract
AIMS This study aimed to evaluate the reliability and validity of the Chinese version of an instrument of health literacy competencies for health professionals. DESIGN This study utilized a cross-sectional design. METHODS Authorization was obtained from the authors of the original scale to translate the scale and perform cross-cultural debugging. From August 2020 to November 2020, 573 health professionals were randomly selected from primary, secondary and tertiary hospitals in Huzhou to examine the reliability and validity of the Chinese version of an instrument of health literacy competencies for health professionals. RESULTS The Chinese version of the scale contains 49 items. The internal consistency Cronbach's α was 0.958 for the total scale and 0.791-0.956 for each dimension. The test-retest reliability was 0.973. Confirmatory factor analysis showed that the fitness degree of the model is good (χ2 /df = 1.347, IFI = 0.924, TLI = 0.913, CFI = 0.922, GFI = 0.841, AGFI = 0.815, RMR = 0.011, RMSEA = 0.035). CONCLUSION The Chinese version of an instrument of health literacy competencies is reliable and valid, which is a credible and effective tool to assess the level of health literacy competencies in Chinese health professionals. PATIENT OR PUBLIC CONTRIBUTION Health professionals with good health literacy competencies can provide patient-specific treatment and guidance to promote healthy outcomes for patients.
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Affiliation(s)
- Huan Qi
- School of NursingGannan Medical UniversityGanzhouChina
| | - Shengguang Chen
- School of Medicine & Nursing SciencesHuZhou UniversityHuzhouChina
| | - Ting Chen
- Department of Nursing and OptometryJiangxi Teachers CollegeYingtanChina
| | - Wei Gan
- School of Medicine & Nursing SciencesHuZhou UniversityHuzhouChina
| | - Dan Yang
- School of Medicine & Nursing SciencesHuZhou UniversityHuzhouChina
| | - Yujie Wang
- School of Medicine & Nursing SciencesHuZhou UniversityHuzhouChina
| | - Qinghua Zhang
- School of Medicine & Nursing SciencesHuZhou UniversityHuzhouChina
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16
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Abrams HB, Callahan C. Health Behavior and Motivational Engagement Models Can Explain and Modify Teleaudiology Uptake. Am J Audiol 2022; 31:1043-1051. [PMID: 36048627 DOI: 10.1044/2022_aja-21-00204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The remote delivery of health care services (i.e., telehealth) has steadily increased across the health care landscape over the past decade with a dramatic increase following the onset of the COVID-19 pandemic. Remote audiology delivery (i.e., teleaudiology), by contrast, has traditionally been characterized by relatively low utilization. While teleaudiology services increased during the COVID-19 lockdown period, most of those services were generally limited to follow-up care and postfitting consultations to existing patients. Furthermore, there is reason to believe that, despite the benefits that remote care provides, the use of teleaudiology services has decreased as in-person care has increased following the lifting of mandatory COVID-related lockdowns. The purpose of this viewpoint article is to posit that existing theories of health behavior, usually applied to patient-specific behaviors (e.g., hearing aid uptake) may explain the reluctance of audiologists to "uptake" a teleaudiology model of care. We also explore the potential of motivational engagement strategies as a means to allow audiologists to examine their sources of ambivalence as they consider adopting a remote service-delivery model. CONCLUSIONS Health behavior models such as the Health Belief, Transtheoretical, and capability, opportunity, motivation, and behavior (COM-B) models represent theories that may help to explain audiologists' resistance to adopting remote delivery services. Motivational engagement strategies, such as decisional balance, can provide useful tools for audiologists to examine their attitudes toward the adoption of teleaudiology.
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Affiliation(s)
- Harvey B Abrams
- Department of Communication Sciences and Disorders, University of South Florida, Tampa, FL.,Lively Hearing Corporation, New York, NY
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17
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Wilson AMMM, Almeida GSMD, Santos BDCFD, Nakahara-Melo M, Conceição APD, Cruz DDALMD. Factors associated with caregivers' contribution to self-care in heart failure. Rev Lat Am Enfermagem 2022; 30:e3632. [PMID: 35976358 DOI: 10.1590/1518-8345.5838.3632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 04/26/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to analyze the caregiver's contribution to self-care in heart failure and the predictor variables of this contribution. METHOD a cross-sectional descriptive and analytical study, with the participation of 140 dyads (patients and caregivers). The contribution to self-care was assessed using the Caregiver Contribution to Self-Care of Heart Failure Index. Caregivers and patients were interviewed separately to obtain the data. Multiple linear regressions were used to verify predictor variables of caregiver contribution. RESULTS the mean score for contribution to maintenance self-care was 62.7 (SD=7.1), for management, 62.9 (SD=20.4) and for confidence was 63.3 (SD=22.1). The variables number of patient's medications, caregiver being related to the patient, social perception of caregiver, health-related quality of life of the patient and caregiver's confidence in contributing to self-care were predictors of caregiver's contribution to maintenance or management self-care. CONCLUSION the caregiver's contribution was insufficient. The social support perceived by the caregiver, the type of relationship the caregiver to the patient, the number of medications used by the patient, as well as the caregiver's confidence in contributing to self-care are variables that should be considered to assess the risk of insufficient contribution of the caregiver.
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Affiliation(s)
| | - Glauber Silva Mendes de Almeida
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil.,Universitatsklinikum Duesseldorf, Kardiochirurgie, Duesseldorf, NRW, Alemanha
| | - Bruna de Cassia Ferreira Dos Santos
- Hospital Municipal Dr Moysés Deutsch, Pronto-Socorro, São Paulo, SP, Brasil.,Universidade Federal de Juiz de Fora, Departamento de Enfermagem Aplicada, Juiz de Fora, MG, Brasil
| | - Michele Nakahara-Melo
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil.,Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
| | - Ana Paula da Conceição
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil.,Instituto Dante Pazzanese de Cardiologia, Unidade de Internação Adulto, São Paulo, SP, Brasil
| | - Diná de Almeida Lopes Monteiro da Cruz
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil.,Bolsista do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brasil
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18
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Getachew A, Assefa T, Negash W. Self-care behavior and associated factors among patients with heart failure in public hospitals of Southeast Ethiopia. J Int Med Res 2022; 50:3000605221119367. [PMID: 36002989 PMCID: PMC9421238 DOI: 10.1177/03000605221119367] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective This study was performed to assess self-care behavior and associated factors
among patients with heart failure attending public hospitals in Southeast
Ethiopia in 2021. Methods An institutional-based cross-sectional study was conducted among 420 patients
with heart failure from 15 May to 30 June 2021 using a simple random
sampling technique. A multivariable binary logistic model was used to
identify factors associated with self-care behavior. Statistical
significance was declared at p < 0.05. Results The magnitude of good self-care behavior among patients with heart failure
was 53.6% [95% confidence interval (CI), 48.9–58.3]. Factors associated with
self-care behavior were treatment with a beta blocker [adjusted odds ratio
(AOR), 0.49; 95% CI, 0.27–0.89], treatment with digitalis (AOR, 0.11; 95%
CI, 0.05–0.24), the level of social support (AOR, 0.07; 95% CI, 0.03–0.15),
and the presence of depressive symptoms (AOR, 0.21; 95% CI, 2.70–8.33). Conclusion Slightly more than half of the respondents had good self-care behavior.
Attention should be given to enhancing good self-care practice through
integration of health education as routine care.
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Affiliation(s)
- Almaz Getachew
- Nursing Department, Madda Walabu University Goba Referral Hospital
| | - Tesfaye Assefa
- Nursing Department, School of Health Science, Madda Walabu University Goba Referral Hospital
| | - Wogene Negash
- Nursing Department, School of Health Science, Madda Walabu University Goba Referral Hospital
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19
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Chang YW, Hsu Y. Beauty Consumption Matchmaking Mechanism for Confirming the Requirement Specification of App Development in the Post-COVID-19 Era. Front Psychol 2022; 13:925905. [PMID: 35747682 PMCID: PMC9211766 DOI: 10.3389/fpsyg.2022.925905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/10/2022] [Indexed: 11/13/2022] Open
Abstract
COVID-19 began to spread worldwide in early 2020. Various governments have taken measures such as isolation, travel bans, and evacuation, mandating people to wear masks and go out less, in an attempt to prevent the spread of the virus. Governments also restrict human contact service industries, including beauty and hair salons. When the pandemic was very serious, consumers had great doubts about going for hairdressing so the beauty industry was greatly affected. This study designed and developed an app platform that considers the COVID-19 and is used for the psychological role of consumer safety. The methodology of this research is a qualitative study. Based on the Capability, Opportunity, Motivation, Behavior (COM-B) model, and presenting the context of capabilities, opportunities, and motives of the theoretical framework, this study investigates the factors that identify the demand for the development of the platform for the beauty industry app matching mechanism. Four groups of people including consumers, beauty technicians, store managers, and application development engineers all conduct interviews based on their ability, opportunity, and motivation after experiencing the using application of OpenBeautiful. The results found that all groups of people already had the knowledge and ability to avoid infection in a pandemic, so it was possible to establish the need and feasibility of using the app platform. The use of the beauty industry app platform can bring new consumption patterns and career opportunities, and can trigger more business behavior activities. Therefore, this study starts from the COM-B model, and then explores the user needs of the platform according to the COM-B model framework, and proposes the mechanism and platform of app matching. Finally, based on the conclusion of the study, we propose practices and suggestions for the future operation of the app matching platform.
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Affiliation(s)
- Yang-Wen Chang
- The Graduate Institute of Design Science, Tatung University, Taipei, Taiwan
| | - Yen Hsu
- The Graduate Institute of Design Science, Tatung University, Taipei, Taiwan
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20
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The Situation-Specific Theory of Heart Failure Self-care: An Update on the Problem, Person, and Environmental Factors Influencing Heart Failure Self-care. J Cardiovasc Nurs 2022; 37:515-529. [PMID: 35482335 PMCID: PMC9561231 DOI: 10.1097/jcn.0000000000000919] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Many studies of heart failure (HF) self-care have been conducted since the last update of the situation-specific theory of HF self-care.
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21
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Predictors of Self-care Among Chinese Patients With Chronic Heart Failure. J Cardiovasc Nurs 2022; 38:E87-E97. [PMID: 35467581 DOI: 10.1097/jcn.0000000000000918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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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22
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Davis J, Olazo K, Sierra M, Tarver ME, Caldwell B, Saha A, Lisker S, Lyles C, Sarkar U. Do patient-reported outcome measures measure up? A qualitative study to examine perceptions and experiences with heart failure proms among diverse, low-income patients. J Patient Rep Outcomes 2022; 6:6. [PMID: 35032226 PMCID: PMC8760874 DOI: 10.1186/s41687-022-00410-9] [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: 07/29/2021] [Accepted: 01/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a Patient-Reported Outcome Measure (PROM) used to evaluate the health status of patients with heart failure (HF) but has predominantly been tested in settings serving predominately white, male, and economically well-resourced populations. We sought to examine the acceptability of the shorter version of the KCCQ (KCCQ-12) among racially and ethnically diverse patients receiving care in an urban, safety-net setting.
Methods We conducted cognitive interviews with a diverse population of patients with heart failure in a safety net system to assess their perceptions of the KCCQ-12. We conducted a thematic analysis of the qualitative data then mapped themes to the Capability, Opportunity, Motivation Model of Behavior framework. Results We interviewed 18 patients with heart failure and found that patients broadly endorsed the concepts of the KCCQ-12 with minor suggestions to improve the instrument’s content and appearance. Although patients accepted the KCCQ-12, we found that the instrument did not adequately measure aspects of health care and quality of life that patients identified as being important components of managing their heart failure. Patient-important factors of heart failure management coalesced into three main themes: social support, health care environment, and mental health. Conclusions Patients from this diverse, low-income, majority non-white population experience unique challenges and circumstances that impact their ability to manage disease. In this study, patients were receptive to the KCCQ-12 as a tool but perceived that it did not adequately capture key health components such as mental health and social relationships that deeply impact their ability to manage HF. Further study on the incorporation of social determinants of health into PROMs could make them more useful tools in evaluating and managing HF in diverse, underserved populations. Supplementary Information The online version contains supplementary material available at 10.1186/s41687-022-00410-9.
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Affiliation(s)
- Jonathan Davis
- Division of Cardiology, Department of Medicine, Zuckerberg San Francisco General Hospital, University of California, 1001 Potrero Avenue, 94110, San Francisco, CA, USA
| | - Kristan Olazo
- Division of General Internal Medicine, Department of Medicine, Zuckerberg San Francisco General Hospital, University of California San Francisco, 1001 Potrero Avenue, Building 10, Ward 13, San Francisco, CA, 94110, USA.,Center for Vulnerable Populations, Department of Medicine, University of California, San Francisco, CA, USA
| | - Maribel Sierra
- Division of General Internal Medicine, Department of Medicine, Zuckerberg San Francisco General Hospital, University of California San Francisco, 1001 Potrero Avenue, Building 10, Ward 13, San Francisco, CA, 94110, USA.,Center for Vulnerable Populations, Department of Medicine, University of California, San Francisco, CA, USA
| | - Michelle E Tarver
- Food and Drug Administration, Center for Devices and Radiological Health, Silver Spring, MD, USA
| | - Brittany Caldwell
- Food and Drug Administration, Center for Devices and Radiological Health, Silver Spring, MD, USA
| | - Anindita Saha
- Food and Drug Administration, Center for Devices and Radiological Health, Silver Spring, MD, USA
| | - Sarah Lisker
- Division of General Internal Medicine, Department of Medicine, Zuckerberg San Francisco General Hospital, University of California San Francisco, 1001 Potrero Avenue, Building 10, Ward 13, San Francisco, CA, 94110, USA.,Center for Vulnerable Populations, Department of Medicine, University of California, San Francisco, CA, USA
| | - Courtney Lyles
- Division of General Internal Medicine, Department of Medicine, Zuckerberg San Francisco General Hospital, University of California San Francisco, 1001 Potrero Avenue, Building 10, Ward 13, San Francisco, CA, 94110, USA.,Center for Vulnerable Populations, Department of Medicine, University of California, San Francisco, CA, USA.,Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Urmimala Sarkar
- Division of General Internal Medicine, Department of Medicine, Zuckerberg San Francisco General Hospital, University of California San Francisco, 1001 Potrero Avenue, Building 10, Ward 13, San Francisco, CA, 94110, USA. .,Center for Vulnerable Populations, Department of Medicine, University of California, San Francisco, CA, USA. .,Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
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Wilson AMMM, Almeida GSMD, Santos BDCFD, Nakahara-Melo M, Conceição APD, Cruz DDALMD. Factores asociados a la contribución de los cuidadores para el autocuidado de la insuficiencia cardiaca. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.5838.3634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumen Objetivo: analizar la contribución del cuidador para el autocuidado en la insuficiencia cardiaca y las variables predictoras de esa contribución. Método: estudio transversal descriptivo y analítico, con la participación de 140 díadas (pacientes y cuidadores). La contribución para el autocuidado fue evaluada por medio del Caregiver Contribution to Self-Care of Heart Failure Index. Los cuidadores y pacientes fueron entrevistados separadamente para obtención de los datos. La regresión linear múltiple fue utilizada para verificar variables predictoras de la contribución del cuidador. Resultados: la puntuación media de contribución para el autocuidado de manutención fue 62,7 (DE=7,1), de administración fue 62,9 (DE=20,4) y de confianza fue 63,3 (DE=22,1). Las variables: número de medicamentos del paciente, cuidador tener parentesco con el paciente, percepción social del cuidador, calidad de vida relacionada a la salud del paciente y la confianza del cuidador en la contribución para el autocuidado, fueron predictoras de la contribución del cuidador para el autocuidado de manutención o de administración. Conclusión: la contribución del cuidador fue insuficiente. El apoyo social percibido por el cuidador, el cuidador tener o no parentesco con el paciente, el número de medicamentos utilizados por el paciente y la confianza del cuidador en contribuir para el autocuidado, son variables que deben ser consideradas para evaluar el riesgo de contribución insuficiente del cuidador.
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Affiliation(s)
| | | | | | - Michele Nakahara-Melo
- Universidade de São Paulo, Brazil; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
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Wilson AMMM, Almeida GSMD, Santos BDCFD, Nakahara-Melo M, Conceição APD, Cruz DDALMD. Factors associated with caregivers’ contribution to self-care in heart failure. Rev Lat Am Enfermagem 2022. [PMID: 35976358 PMCID: PMC9364777 DOI: 10.1590/1518-8345.5838.3633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective: to analyze the caregiver’s contribution to self-care in heart failure and the predictor variables of this contribution. Method: a cross-sectional descriptive and analytical study, with the participation of 140 dyads (patients and caregivers). The contribution to self-care was assessed using the Caregiver Contribution to Self-Care of Heart Failure Index. Caregivers and patients were interviewed separately to obtain the data. Multiple linear regressions were used to verify predictor variables of caregiver contribution. Results: the mean score for contribution to maintenance self-care was 62.7 (SD=7.1), for management, 62.9 (SD=20.4) and for confidence was 63.3 (SD=22.1). The variables number of patient’s medications, caregiver being related to the patient, social perception of caregiver, health-related quality of life of the patient and caregiver’s confidence in contributing to self-care were predictors of caregiver’s contribution to maintenance or management self-care. Conclusion: the caregiver’s contribution was insufficient. The social support perceived by the caregiver, the type of relationship the caregiver to the patient, the number of medications used by the patient, as well as the caregiver’s confidence in contributing to self-care are variables that should be considered to assess the risk of insufficient contribution of the caregiver.
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Affiliation(s)
| | | | | | - Michele Nakahara-Melo
- Universidade de São Paulo, Brazil; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
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Implementing advance care planning in heart failure: a qualitative study of primary healthcare professionals. Br J Gen Pract 2021; 71:e550-e560. [PMID: 33947665 PMCID: PMC8103928 DOI: 10.3399/bjgp.2020.0973] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/19/2021] [Indexed: 02/06/2023] Open
Abstract
Background Advance care planning (ACP) can improve the quality of life of patients suffering from heart failure (HF). However, primary care healthcare professionals (HCPs) find ACP difficult to engage with and patient care remains suboptimal. Aim To explore the views of primary care HCPs on how to improve their engagement with ACP in HF. Design and setting A qualitative interview study with GPs and primary care nurses in England. Method Semi-structured interviews were conducted with a purposive sample of 24 primary care HCPs. Data were analysed using reflexive thematic analysis. Results Three main themes were constructed from the data: ACP as integral to holistic care in HF; potentially limiting factors to the doctor–patient relationship; and approaches to improve professional performance. Many HCPs saw the benefits of ACP as synonymous with providing holistic care and improving patients’ quality of life. However, some feared that initiating ACP could irrevocably damage their doctor–patient relationship. Their own fear of death and dying, a lack of disease-specific communication skills, and uncertainty about the right timing were significant barriers to ACP. To optimise their engagement with ACP in HF, HCPs recommended better clinician–patient dialogue through question prompts, enhanced shared decision-making approaches, synchronising ACP across medical specialties, and disease-specific training. Conclusion GPs and primary care nurses are vital to deliver ACP for patients suffering from HF. HCPs highlighted important areas to improve their practice and the urgent need for investigations into better clinician–patient engagement with ACP.
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Aghajanloo A, Negarandeh R, Janani L, Tanha K, Hoseini-Esfidarjani SS. Self-care status in patients with heart failure: Systematic review and meta-analysis. Nurs Open 2021; 8:2235-2248. [PMID: 33619877 PMCID: PMC8363344 DOI: 10.1002/nop2.805] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/10/2020] [Accepted: 01/29/2021] [Indexed: 12/14/2022] Open
Abstract
Aim To systematically review the status of self‐care in patients with heart failure through the Self‐Care of Heart Failure Index scale. Design A systematic review and meta‐analysis. Methods Following national and international databases were searched to retrieve eligible studies: PubMed, Web of Science, Embase, Google Scholar, Scientific Information Database and Magiran. The studies were screened and selected by two researchers. Data analysed through the random‐effects model, and the I2 index was used to assess heterogeneity. Stata software version 12.0 was used for analysis. The PRISMA statement was used to report systematic review and meta‐analysis. Results Of the 5,953 articles initially identified, 39 studies were included. The average score was estimated at 58.16 (CI: 54.39–61.94) for self‐care maintenance, 53.11 (CI: 49.17–57.05) for self‐care management and 58.66 (CI: 54.32–63.00) for self‐care confidence. Despite the high heterogeneity of the studies, the results indicated that self‐care practice is inadequate in all the three dimensions of self‐care (maintenance, management and confidence).
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Affiliation(s)
- Ali Aghajanloo
- Medical Surgical Nursing Department, Faculty of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Reza Negarandeh
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Janani
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Kiarash Tanha
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Sara-Sadat Hoseini-Esfidarjani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Oliwa JN, Nzinga J, Masini E, van Hensbroek MB, Jones C, English M, Van't Hoog A. Improving case detection of tuberculosis in hospitalised Kenyan children-employing the behaviour change wheel to aid intervention design and implementation. Implement Sci 2020; 15:102. [PMID: 33239055 PMCID: PMC7687703 DOI: 10.1186/s13012-020-01061-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/30/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The true burden of tuberculosis in children remains unknown, but approximately 65% go undetected each year. Guidelines for tuberculosis clinical decision-making are in place in Kenya, and the National Tuberculosis programme conducts several trainings on them yearly. By 2018, there were 183 GeneXpert® machines in Kenyan public hospitals. Despite these efforts, diagnostic tests are underused and there is observed under detection of tuberculosis in children. We describe the process of designing a contextually appropriate, theory-informed intervention to improve case detection of TB in children and implementation guided by the Behaviour Change Wheel. METHODS We used an iterative process, going back and forth from quantitative and qualitative empiric data to reviewing literature, and applying the Behaviour Change Wheel guide. The key questions reflected on included (i) what is the problem we are trying to solve; (ii) what behaviours are we trying to change and in what way; (iii) what will it take to bring about desired change; (iv) what types of interventions are likely to bring about desired change; (v) what should be the specific intervention content and how should this be implemented? RESULTS The following behaviour change intervention functions were identified as follows: (i) training: imparting practical skills; (ii) modelling: providing an example for people to aspire/imitate; (iii) persuasion: using communication to induce positive or negative feelings or stimulate action; (iv) environmental restructuring: changing the physical or social context; and (v) education: increasing knowledge or understanding. The process resulted in a multi-faceted intervention package composed of redesigning of child tuberculosis training; careful selection of champions; use of audit and feedback linked to group problem solving; and workflow restructuring with role specification. CONCLUSION The intervention components were selected for their effectiveness (from literature), affordability, acceptability, and practicability and designed so that TB programme officers and hospital managers can be supported to implement them with relative ease, alongside their daily duties. This work contributes to the field of implementation science by utilising clear definitions and descriptions of underlying mechanisms of interventions that will guide others to do likewise in their settings for similar problems.
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Affiliation(s)
- Jacquie Narotso Oliwa
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.
- Department of Paediatrics and Child Health, School of Medicine, University of Nairobi, Nairobi, Kenya.
- The Academic Medical Centre, Department of Global Health, Faculty of Medicine, University of Amsterdam, Amsterdam, The Netherlands.
| | | | | | - Michaël Boele van Hensbroek
- The Academic Medical Centre, Department of Global Health, Faculty of Medicine, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
| | - Caroline Jones
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, Oxford University, Oxford, UK
| | - Mike English
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, Oxford University, Oxford, UK
| | - Anja Van't Hoog
- The Academic Medical Centre, Department of Global Health, Faculty of Medicine, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
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Wang B, Xia L, Yu J, Feng Y, Hong J, Wang W. The multiple mediating effects of health literacy and self-care confidence between depression and self-care behaviors in patients with heart failure. Heart Lung 2020; 49:842-847. [PMID: 33011463 DOI: 10.1016/j.hrtlng.2020.09.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/10/2020] [Accepted: 09/15/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Previous researchers have found that depression can influence self-care behaviors of patients with heart failure (HF). However, the specific path of depression on self-care behaviors remains unclear. OBJECTIVES To determine the multiple mediating effects of health literacy and self-care confidence between depression and self-care behaviors in patients with HF. METHODS A cross sectional study on HF patients (n = 310) was conducted at a tertiary hospital in China. The Chinese versions of the Hospital Anxiety and Depression Scale (HADS-D), Health Literacy Scale for Patients with Chronic Disease and Self-care of Heart Failure Index (C-SCHFI) were used to assess depression, health literacy, self-care confidence and self-care behaviors of the HF patients respectively. RESULTS Depression had significant negative correlations with health literacy (r = -0.40, P < 0.01), self-care confidence (r = -0.41, P < 0.01), self-care maintenance (r = -0.18, P < 0.01) and management (r = -0.19, P < 0.01). After controlling for covariates, mediation modeling analysis showed that health literacy and self-care confidence were mediating variables between depression and self-care management and all the three paths were significant. A higher level of depression debilitated health literacy (β = -0.23, P < 0.001), and a higher degree of health literacy was associated with better self-care confidence (β = 0.31, P < 0.001) which contributed to better self-care management (β = 0.43, P < 0.001). Total mediation effect was -0.1940 with 95% CI from -0.2702 to -0.1266. However, self-care confidence did not mediate between depression and self-care maintenance. CONCLUSION Health literacy and self-care confidence exert a multiple mediating effect on the relationship between depression and self-care management. The relationship between variables should be considered when developing the tailored interventions for patients with HF to enhance their self-care behaviors.
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Affiliation(s)
| | - Lili Xia
- School of Nursing, Anhui Medical University, China
| | - Jia Yu
- School of Nursing, Anhui Medical University, China
| | - Yuan Feng
- School of Nursing, Anhui Medical University, China
| | | | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Zhang X, Zou H, Hou D, He D, Fan X. Functional status mediates the association of nutritional status with depressive symptoms in patients with heart failure. J Adv Nurs 2020; 76:3363-3371. [PMID: 32932558 DOI: 10.1111/jan.14522] [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: 02/16/2020] [Revised: 06/15/2020] [Accepted: 07/14/2020] [Indexed: 11/28/2022]
Abstract
AIMS The decline of nutritional status and depressive symptoms are pandemic in heart failure patients and functional status may play a pivotal role between these. This study aimed to determine whether nutritional status is associated with depressive symptoms and whether functional status mediates this relationship in heart failure patients. DESIGN This was a secondary analysis of a cross-sectional study. METHODS The data were collected from November 2015-April 2016. Heart failure patients (N = 254) being hospitalized were included in this secondary analysis. The Depression Sub-Scale of the Hospital Anxiety and Depression Scale and the Duke Activity Status Index were used to assess patients' depressive symptoms and functional status. The nutritional status of patients was calculated using the Geriatric Nutritional Risk Index. RESULTS In this study, the average scores of depressive symptoms, nutritional status and functional status were 4.91 (SD 3.12), 102.38 (SD 6.57) and 20.58 (SD 8.96) respectively. Out of the 254 patients, 46 patients (18.1%) had significant depressive symptoms (the score of Depression Sub-Scale of the Hospital Anxiety and Depression Scale ≥ 8) and 55 (21.7%) suffered from malnutrition (the score of Geriatric Nutritional Risk Index ≤ 98). In the multiple regression analyses, nutritional status was negatively associated with depressive symptoms (β = -0.142, p = .02) and functional status mediated the relationship between nutritional status and depressive symptoms. CONCLUSIONS Many patients with heart failure have malnutrition and depressive symptoms. Functional status plays a mediating role in the relationship between nutritional status and depressive symptoms. IMPACT To relieve depressive symptoms in patients with heart failure, it is of importance to improve the functional status, especially for those with poor nutritional status.
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Affiliation(s)
- Xiuting Zhang
- School of Nursing, Shandong University, Jinan, China
| | - Huijing Zou
- School of Nursing, Shandong University, Jinan, China
| | - Danhua Hou
- School of Nursing, Shandong University, Jinan, China
| | - Dengxin He
- School of Nursing, Shandong University, Jinan, China
| | - Xiuzhen Fan
- School of Nursing, Shandong University, Jinan, China
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Cruz DDALMD, Wilson AMMM, Melo MN, Conceição APD, Diaz LJR. SCHFI 6.2 Self-Care Confidence Scale - Brazilian version: psychometric analysis using the Rasch model. Rev Lat Am Enfermagem 2020; 28:e3313. [PMID: 32876285 PMCID: PMC7458570 DOI: 10.1590/1518-8345.3378.3313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 03/31/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to evaluate the psychometric properties of the Self-Care Confidence Scale in heart failure in the Brazilian version of the Self Care Heart Failure Index, version 6.2, using the Rasch model criteria. METHOD secondary study, of psychometric analysis, using the Rasch model, of the six items of the scale. The sample consisted of 409 patients with heart failure undergoing outpatient treatment [mean age 57.9 (standard deviation = 11.6) years, 54.8% male]. RESULTS of the total of six items, one ("De maneira geral, você está confiante sobre estar livre dos sintomas de insuficiência cardíaca?") presented maladjustment to the model (Infit = 1.84 and Outfit = 1.99). After the exclusion of this item, the others showed a good fit, composed one dimension and explained 55% of the variance in the data; the categories of response to the items were adequate, the values of separation and reliability of person were 2.13 and 0.82, respectively, and Cronbach's alpha was 0.87. Items of extreme difficulty were identified and there is no differential functioning of the items in relation to sex. CONCLUSION with the exclusion of the first item, the Self-Care Confidence Scale showed good psychometric properties, with caution in interpreting the results of the six-item scale.
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Affiliation(s)
| | | | - Michele Nakahara Melo
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Varisco TJ, Downs CG, Rathburn KR, Fleming ML, Thornton JD. Applying the capability, opportunity, motivation, and behavior model to identify opportunities to increase pharmacist comfort dispensing naloxone in Texas: A structural equation modeling approach. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 83:102827. [DOI: 10.1016/j.drugpo.2020.102827] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 05/14/2020] [Accepted: 06/07/2020] [Indexed: 11/25/2022]
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Oliwa JN, Odero SA, Nzinga J, van Hensbroek MB, Jones C, English M, van’t Hoog A. Perspectives and practices of health workers around diagnosis of paediatric tuberculosis in hospitals in a resource-poor setting - modern diagnostics meet age-old challenges. BMC Health Serv Res 2020; 20:708. [PMID: 32738917 PMCID: PMC7395417 DOI: 10.1186/s12913-020-05588-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 07/27/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Detection of tuberculosis (TB) in children in Kenya is sub-optimal. Xpert MTB/RIF® assay (Xpert®) has the potential to improve speed of TB diagnosis due to its sensitivity and fast turnaround for results. Significant effort and resources have been put into making the machines widely available in Kenya, but use remains low, especially in children. We set out to explore the reasons for the under-detection of TB and underuse of Xpert® in children, identifying challenges that may be relevant to other newer diagnostics in similar settings. METHODS This was an exploratory qualitative study with an embedded case study approach. Data collection involved semi-structured interviews; small-group discussions; key informant interviews; observations of TB trainings, sensitisation meetings, policy meetings, hospital practices; desk review of guidelines, job aides and policy documents. The Capability, Opportunity and Motivation (COM-B) framework was used to interpret emerging themes. RESULTS At individual level, knowledge, skill, competence and experience, as well as beliefs and fears impacted on capability (physical & psychological) as well as motivation (reflective) to diagnose TB in children and use diagnostic tests. Hospital level influencers included hospital norms, processes, patient flows and resources which affected how individual health workers attempted to diagnose TB in children by impacting on their capability (physical & psychological), motivation (reflective & automatic) and opportunity (physical & social). At the wider system level, community practices and beliefs, and implementation of TB programme directives impacted some of the decisions that health workers made through capability (psychological), motivation (reflective & automatic) and opportunity (physical). CONCLUSION We used comprehensive approaches to identify influencers of TB case detection and use of TB diagnostic tests in children in Kenya. These results are being used to design a contextually-appropriate intervention to improve TB diagnosis, which may be relevant to similar low-resource, high TB burden countries and can be feasibly implemented by the National TB programme.
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Affiliation(s)
- Jacquie Narotso Oliwa
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya
- Department of Global Health, The Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | | | | | - Michaël Boele van Hensbroek
- Department of Global Health, The Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
| | - Caroline Jones
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, Oxford University, Oxford, UK
| | - Mike English
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, Oxford University, Oxford, UK
| | - Anja van’t Hoog
- Department of Global Health, The Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
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Chang WT, Wang ST, Hsu CH, Tsai LM, Chan SH, Chen HM. Effects of illness representation-focused patient education on illness representations and self-care in patients with heart failure: A randomised clinical trial. J Clin Nurs 2020; 29:3461-3472. [PMID: 32562433 DOI: 10.1111/jocn.15384] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 05/24/2020] [Accepted: 06/05/2020] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To examine the effect of an illness representation-focused patient education intervention on illness representations and self-care behaviours in patients with heart failure 3 months after discharge from the hospital. BACKGROUND Few intervention studies have examined the effect of illness representation-focused interventions on illness representations and self-care in patients with heart failure. DESIGN A randomised clinical trial based on the Consolidated Standard of Reporting Trials-CONSORT 2010-guidelines was employed. The Clinical Trial Registry number is TCTR20190903002. METHODS One hundred and seven participants were randomly assigned to 2 groups, and 62 participants (n = 30 in the intervention group and n = 32 in the usual care group) completed the baseline and one- and three-month postdischarge follow-up assessments. The instruments included the Survey of Illness Beliefs in Heart Failure and the Self-care of Heart Failure Index. The intervention group received illness representation-focused patient education while hospitalised and telephone follow-ups after discharge. Data were analysed with linear mixed-effects model analysis. RESULTS The 107 participants had a mean age of 62.17 years and a mean left ventricular ejection of 53.03%. At baseline, the two groups tended to have accurate illness beliefs but insufficient self-care confidence and self-care maintenance. The analysis showed no significant differences between groups in the illness representation total scores, dimension scores or self-care maintenance scores but did show a significant difference in the self-care confidence scores (F = 3.42, p < .05) over the three months. CONCLUSION The study did not show an effect of the intervention on illness representations or self-care maintenance behaviours. However, the intervention did maintain participants' self-care confidence three months after discharge. RELEVANCE TO CLINICAL PRACTICE It is necessary to conduct long-term follow-ups of patients' illness representations, discuss the implementation of self-care behaviours with patients, enhance patients' self-care confidence, and involve family members or caregivers in self-care practices when needed.
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Affiliation(s)
- Wan-Tzu Chang
- Department of Nursing, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Shan-Tair Wang
- Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi City, Taiwan.,Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Hsin Hsu
- Division of Cardiology, Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Liang-Miin Tsai
- Department of Internal Medicine, Tainan Municipal Hospital, Tainan, Taiwan
| | - Shih-Hung Chan
- Division of Cardiology, Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsing-Mei Chen
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Ma C, Zhou W. Predictors of rehospitalization for community-dwelling older adults with chronic heart failure: A structural equation model. J Adv Nurs 2020; 76:1334-1344. [PMID: 32056280 DOI: 10.1111/jan.14327] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 01/19/2020] [Accepted: 02/04/2020] [Indexed: 12/15/2022]
Abstract
AIMS To examine the effects of health literacy, activities of daily living, frailty and self-care on rehospitalization for older adults with chronic heart failure using a structural equation model. DESIGN This was a cross-sectional study. METHODS Two hundred and seventy-one older patients with chronic heart failure were recruited using a convenience sampling method from three community healthcare centres in Guangzhou, Southern China. The data were collected using a questionnaire survey between April 2018 and October 2018 by three research assistants. FINDINGS The proposed model revealed a good fit to the data (χ2 /d.f. = 2.39, root mean square error of approximation = 0.06, goodness of fit index = 0.93, comparative fit index = 0.91, normed fit index = 0.91). Health literacy (β = 0.21), activities of daily living (β = 0.43), frailty (β = 0.29) and self-care (β = 0.40) directly affected the rehospitalization of older patients with chronic heart failure. Health literacy (β = 0.19), activities of daily living (β = 0.36) and frailty (β = 0.33) indirectly affected rehospitalization through self-care. Frailty (β = 0.16) indirectly affected rehospitalization by activities of daily living. Activities of daily living had the highest direct and total effects on rehospitalization; the effect values were 0.43 and 0.57, respectively. CONCLUSION Community-dwelling older adults with chronic heart failure who had limited health literacy, frailty, declined activities of daily living and lower self-care were eligible for rehospitalization. Self-care and activities of daily living were considered mediators between rehospitalization and its predictors. A future longitudinal study is required to validate the results. IMPACT Tailored and targeted measures aiming to enhance self-care and activities of daily living have been developed for older patients with chronic heart failure because they are not only predictors but also mediators. Assessment of health literacy level of this population is the first step before developing health education. Frailty of patients with chronic heart failure should be reduced to a minimum level.
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Affiliation(s)
- Chunhua Ma
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Wei Zhou
- School of Nursing, Guangzhou Medical University, Guangzhou, China
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Cudjoe J, Delva S, Cajita M, Han HR. Empirically Tested Health Literacy Frameworks. Health Lit Res Pract 2020; 4:e22-e44. [PMID: 32053206 PMCID: PMC7015262 DOI: 10.3928/24748307-20191025-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 03/20/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Health literacy is a significant determinant of health behaviors, but the pathways through which health literacy influences health behaviors are not completely clear nor consistent. The purpose of this systematic review is to critically appraise studies that have empirically tested the potential pathways linking health literacy to health behavior. Methods: We performed searches of the electronic databases PubMed, Embase, and CINAHL to identify studies that proposed a conceptual framework and empirically tested the proposed mechanism through which health literacy influences certain health behaviors. Twenty eligible studies were included for analysis. Key Results: The 20 studies addressed various health behaviors: chronic disease self-management (n = 8), medication adherence (n = 2), overall health status (n = 4), oral care (n = 1), cancer screening (n = 1), shared decision-making (n = 1), health information sharing (n = 1), physical activity and eating behaviors (n = 1), and emergency department visits (n = 1). Most studies were conducted in the United States (n = 13) and used a cross-sectional design (n = 15). The Short Test of Functional Health Literacy in Adults was commonly used to assess health literacy levels. Selection of variables and their operationalization were informed by a theoretical model in 12 studies. Age, gender, race/ethnicity, and insurance status were reported antecedents to health literacy. The most commonly tested mediators were self-efficacy (n = 8) and disease knowledge (n = 4). Fit indices reported in the studies ranged from acceptable to excellent. Discussion: Current evidence supports self-efficacy as a mediator between health literacy and health behavior. Further research is needed to identify how health literacy interplays with known psychosocial factors to inform people's use of preventive care services. Future studies should include more disadvantaged populations such as immigrants with high disease burden and those with low health literacy. Theory-based, empirically tested health literacy models can serve as the conceptual basis for developing effective health interventions to improve health behaviors and ultimately decrease the burden of disease in such vulnerable populations. [HLRP: Health Literacy Research and Practice. 2020;4(1):e21–e44.] Plain Language Summary: This review systemically compiles, and critically appraises 20 existing studies that test conceptual frameworks that propose potential pathways through which health literacy affects health behaviors. The findings from this review can help inform the development of health literacy-focused interventions to improve the health behaviors of populations with disease burdens.
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Affiliation(s)
- Joycelyn Cudjoe
- Address correspondence to Joycelyn Cudjoe, PhD, RN, Inova Health System, 8110 Gatehouse Road, Suite 200W, Falls Church, VA 22042;
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Qiu R, Schick-Makaroff K, Tang L, Wang X, Zhang Q, Ye Z. Chinese Hospitalized Cardiovascular Patients' Attitudes Towards Self-Management: A Qualitative Study. Patient Prefer Adherence 2020; 14:287-300. [PMID: 32109995 PMCID: PMC7034970 DOI: 10.2147/ppa.s236348] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 02/01/2020] [Indexed: 11/24/2022] Open
Abstract
PURPOSE This study is aiming to investigate cardiovascular patients' attitudes towards self-management during hospitalization in China. PATIENTS AND METHODS Twenty-nine individuals living with cardiovascular disease from one designated Cardiology Department in Hangzhou, China, were recruited through a purposive sampling procedure. A qualitative descriptive methodology was used. Semi-structured interviews were also used to gain attitudes toward self-management. The interviews were audio-recorded, transcribed and analyzed by thematic analysis to develop the results. RESULTS Four themes were identified from the qualitative data: (1): Responsibilities of self-management; (2): Reflections on self-management; (3): Acknowledgement of self-management support; (4): Challenges in implementing and adherence to self-management. Additionally, interview data were also given to illustrate these main themes emerging during the analysis. Patients gradually took their responsibilities to manage chronic symptoms. During their self-management process, they did reflections to help correct their regiments through supportive interactions. Health system responsiveness, health disparities, social capital, and cultural setting were the main external factors influencing better self-management implementation and adherence. CONCLUSION This study revealed the hospitalized cardiovascular patients' attitudes towards self-management in China. These findings emphasized the importance of patients' responsibility, reflections, and various social support receiving and pointed out specific external factors influencing the health outcomes and their quality of life. This study also proves the guide for the policymakers and health system better instructions to develop individually and culturally tailored advanced self-management interventions and programs.
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Affiliation(s)
- Ruolin Qiu
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China
| | | | - Leiwen Tang
- Zhejiang University School of Medicine, Affiliated Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, People’s Republic of China
| | - Xiyi Wang
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China
| | - Qi Zhang
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China
| | - Zhihong Ye
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China
- Correspondence: Zhihong Ye Faculty of Nursing, Zhejiang University School of Medicine, #704, Administrative Building, 3 East Qingchun Road, Hangzhou, Zhejiang310016, People’s Republic of ChinaTel +86 136 0661 2119 Email
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Qiu C, Zhang X, Zang X, Zhao Y. Acceptance of illness mediate the effects of health literacy on self-management behaviour. Eur J Cardiovasc Nurs 2019; 19:411-420. [DOI: 10.1177/1474515119885240] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: Self-management is crucial for blood pressure control and subsequent disease prevention. Health literacy and acceptance of illness may contribute to self-management behaviour; in addition, acceptance of illness may mediate the effects of health literacy on self-management behaviour among patients with hypertension. Objective: The aims of the research were to examine whether health literacy and acceptance of illness were associated with both pharmacological and non-pharmacological management behaviour and examine the possible mediating effects of the acceptance of illness in patients with hypertension. Methods: Hierarchical regression analysis was conducted to analyse the relationships between health literacy, acceptance of illness, pharmacological and non-pharmacological management behaviours. Mediation effects were examined by the PROCESS macro. Results: This was a cross-sectional study. A total of 478 hypertensive patients completed measures of health literacy, acceptance of illness, self-management, social support, depression, physical function and demographic and clinical characteristics. Functional, communicative, critical health literacy and acceptance of illness showed positive associations to pharmacological and non-pharmacological management behaviour. Acceptance of illness mediated the relationships between three types of health literacy, pharmacological and non-pharmacological management but the effects size and pathway differed. In detail, functional health literacy influenced pharmacological and non-pharmacological management behaviour mainly by indirect effects mediated by the acceptance of illness, but communicative and critical health literacy influenced pharmacological and non-pharmacological management behaviour mainly by direct effects. Conclusions: Acceptance of illness mediated the relationships between three types of health literacy and self-management. Health literacy and acceptance of illness should be addressed when taking measures to improve patients’ self-management behaviour.
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Affiliation(s)
- Chen Qiu
- Department of Medical Nursing, School of Nursing, Shandong First Medical University, China
- School of Nursing, Tianjin Medical University, China
| | - Xiaonan Zhang
- School of Nursing, Tianjin Medical University, China
| | - Xiaoying Zang
- School of Nursing, Tianjin Medical University, China
| | - Yue Zhao
- School of Nursing, Tianjin Medical University, China
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Self-care in Chinese heart failure patients: Gender-specific correlates. Heart Lung 2019; 48:496-501. [DOI: 10.1016/j.hrtlng.2019.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 04/27/2019] [Accepted: 05/02/2019] [Indexed: 11/23/2022]
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Effect of health literacy on quality of life among patients with chronic heart failure in China. Qual Life Res 2019; 29:453-461. [DOI: 10.1007/s11136-019-02332-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2019] [Indexed: 10/25/2022]
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Ma C. Rehospitalisation rates and associated factors within 6 months after hospital discharge for patients with chronic heart failure: A longitudinal observational study. J Clin Nurs 2019; 28:2526-2536. [DOI: 10.1111/jocn.14830] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 01/21/2019] [Accepted: 02/09/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Chunhua Ma
- School of Nursing; Guangzhou Medical University; Guangzhou China
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Gender differences in self-care maintenance and its associations among patients with chronic heart failure. Int J Nurs Sci 2018; 6:58-64. [PMID: 31406870 PMCID: PMC6608650 DOI: 10.1016/j.ijnss.2018.11.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 09/28/2018] [Accepted: 11/29/2018] [Indexed: 12/28/2022] Open
Abstract
Objectives To identify the gender differences in self-care maintenance and its associations among chronic heart failure patients using the Information-Motivation-Behavioral Skills model. Methods Two hundred and ten patients (54.0% female) with chronic heart failure participated in this cross-sectional study. Self-care, knowledge of heart failure, social support and illness perception were measured using the Self-Care of Heart Failure Index, the questionnaire of heart failure knowledge, the Perceived Social Support Scale, and the Revised Illness Perception Questionnaire, respectively. Results Mean scores for self-care maintenance were 51.4 ± 14.8 in men and 55.6 ± 14.1 in women (t = -2.066, P < 0.05). Associated factors of self-care maintenance were social support and self-care confidence in men and the knowledge of heart failure, self-care management and self-care confidence in women. The relationship between social support and self-care maintenance was meditated by self-care confidence in men, whereas the relationship between knowledge of heart failure and self-care maintenance was meditated by self-care management and self-care confidence in women. Conclusions Self-care maintenance were inadequate in both genders with chronic heart failure. Interventions for enhancing social support and self-care confidence in men patients, and strengthening knowledge of heart failure, self-care management and self-care confidence in women patients, may facilitate self-care maintenance.
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Jacobson AF, Sumodi V, Albert NM, Butler RS, DeJohn L, Walker D, Dion K, Tai HLL, Ross DM. Patient activation, knowledge, and health literacy association with self-management behaviors in persons with heart failure. Heart Lung 2018; 47:447-451. [PMID: 29910065 DOI: 10.1016/j.hrtlng.2018.05.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/26/2018] [Indexed: 01/26/2023]
Abstract
BACKGROUND More evidence is needed about factors that influence self-management behaviors in persons with heart failure. OBJECTIVE To test a correlational mediation model of the independent variables of health literacy, patient activation, and heart failure knowledge with heart failure self-management behaviors. METHODS The study used a prospective, cross-sectional, correlational design. Correlation and multiple regression were used to analyze associations among variables. RESULTS Of 151 participants, 57% were male, and mean age was 68 years. Heart failure self-management behaviors was positively correlated with patient activation level (p = .0008), but not with health literacy or heart failure knowledge. CONCLUSIONS Persons with heart failure may better manage their condition if sufficiently activated, regardless of their level of health literacy or knowledge of heart failure disease and management processes.
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Affiliation(s)
- Ann F Jacobson
- Cleveland Clinic Hillcrest Chronic Care, 6801 Mayfield Rd., Mayfield Heights, OH 44124.
| | - Veronica Sumodi
- Cleveland Clinic Hillcrest Chronic Care, 6801 Mayfield Rd., Mayfield Heights, OH 44124
| | - Nancy M Albert
- Cleveland Clinic, 9500 Euclid Avenue, Mail code J3-4, Cleveland OH 44195
| | - Robert S Butler
- Cleveland Clinic Quantitative Health Sciences, 9500 Euclid Avenue/JJN3-01, Cleveland, OH 44195
| | - Lori DeJohn
- Cleveland Clinic Hillcrest Chronic Care, 6801 Mayfield Rd., Mayfield Heights, OH 44124
| | - Donna Walker
- Cleveland Clinic Euclid Hospital Chronic Care, 18901 Lakeshore Blvd, Euclid, OH 44119
| | - Kelly Dion
- Cleveland Clinic South Pointe Hospital Chronic Care, 20000 Harvard Ave, Warrensville Heights, OH 44122
| | - Hua-Li Lin Tai
- Cleveland Clinic South Pointe Hospital Chronic Care, 20000 Harvard Ave, Warrensville Heights, OH 44122
| | - Donna M Ross
- Cleveland Clinic Lakewood Chronic Care, 14519 Detroit Ave., Lakewood, OH 44107
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Chen Y, Funk M, Wen J, Tang X, He G, Liu H. Effectiveness of a multidisciplinary disease management program on outcomes in patients with heart failure in China: A randomized controlled single center study. Heart Lung 2017; 47:24-31. [PMID: 29103661 DOI: 10.1016/j.hrtlng.2017.10.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 10/03/2017] [Accepted: 10/03/2017] [Indexed: 01/21/2023]
Abstract
BACKGROUND Multidisciplinary disease management programs (MDMP) for patients with heart failure (HF) have been delivered, but evidence of their effectiveness in China is limited. OBJECTIVE To determine if a MDMP improves quality of life (QoL), physical performance, depressive symptoms, self-care behaviors and mortality or rehospitalization in patients with HF in China. METHODS This is a randomized controlled single center trial in which patients with HF received either MDMP with discharge education, physical training, follow-up visits and telephone calls for 180 days (n = 31) or standard care (SC, n = 31). RESULTS Compared with SC, QoL, depressive symptoms, and self-care behaviors were significantly improved by MDMP from baseline to 180 days (37% vs 66%, 20% vs 61%, and 8% vs 33%, respectively, all p < 0.001). There were no differences in physical performance and mortality or rehospitalization during follow-up. CONCLUSIONS A HF MDMP can improve QoL, depressive symptoms and self-care behaviors in China.
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Affiliation(s)
- Yiyin Chen
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Middle Renmin Rd., Furong District, Changsha, Hunan, 410011, China.
| | - Marjorie Funk
- Yale School of Nursing, Yale University West Campus, Building 400, 300 Heffernan Drive, West Haven, CT 06516, USA.
| | - Jia Wen
- Cardiology Department, The Third Xiangya Hospital of Central South University, Western Tongzipo Rd, Yuelu District, Changsha, Hunan, 410013, China.
| | - Xianghua Tang
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Middle Renmin Rd., Furong District, Changsha, Hunan, 410011, China.
| | - Guixiang He
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Middle Renmin Rd., Furong District, Changsha, Hunan, 410011, China.
| | - Hong Liu
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Middle Renmin Rd., Furong District, Changsha, Hunan, 410011, China.
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