Autonomy and Care in Context: The Paradox of Sex Workers' Acceptability of HIV Self-Tests in São Paulo, Brazil

Cisgender female sex workers (CFSW) continue to face structural barriers to HIV prevention. We analyzed the acceptability of the oral HIV self-test (HIV-ST) among CFSW as part of a pragmatic trial on HIV prevention in Brazil. Data from in-depth interviews conducted with 12 women from diverse sex worker contexts and participant observation were analyzed using thematic analysis. CFSW valued autonomy in their workplaces and saw the HIV-ST as a possibility for self-care. Some feared clients' reactions, manager reprimands, and a positive result. HIV and sex work stigma largely drove self-care practices and perceived acceptability of the self-test. We argue that the autonomy offered by the self-test presents a paradox: increasing autonomy on the one hand while risking sidestepping structural dimensions of HIV vulnerability on the other. These nuances must be considered in interventions promoting the HIV-ST by considering the specificities of sex worker contexts, addressing stigma, and effectively involving CFSW and their organizations in intervention development.

The role of emotional intelligence and self-care in the stress perception during COVID-19 outbreak: An intercultural moderated mediation analysis

Background

The relationship between emotional intelligence (EI) and stress has been widely studied, as well as the beneficial role of self-care to maintain health and wellbeing. However, the joint contribution of EI and self-care in predicting stress has not been examined during COVID-19 lockdown. This study aimed to examine the mediating role of self-care in the relationship between EI and stress and the potential moderator role of gender.

Methods

A sample of 1082 participants from four Hispanic countries completed measures related to socio-demographic, trait emotional intelligence (Trait Meta-Mood Scale), self-care activities (Self-care Activities Screening Scale) and stress (Perceived Stress Scale).

Results

Mediation analyses revealed that self-care increased the explained variance of the prediction of stress by EI dimensions after controlling gender and age. However, gender only moderated the relationship between self-care and stress in the mediation model corresponding to emotional attention.

Conclusions

Data supported a general model for the interaction of EI and self-care as contributing factors of stress. Further research is needed to replicate it in more culturally distant samples and to fully explore the potential role of gender differences. Future intervention programs should include a balanced combination of EI and self-care to increase their benefits on people's health.

Factors influencing self-management in adults with diabetes: an umbrella review protocol

REVIEW OBJECTIVES

The aim of this umbrella review is to identify and describe factors influencing diabetes self-management (DSM) in adults with diabetes. More specifically, we will address DSM-related factors and their relationships, considering both qualitative and quantitative components of available literature.The review question for the qualitative component of the umbrella review is:The review questions for the quantitative component of the umbrella review are:An additional question will be applied to both the qualitative and quantitative components of the overview.

[Spanish cultural adaptation and psychometric validation of the Summary of Diabetes Self-Care Activities measure (SDSCA) among persons with type 2 diabetes mellitus]

Objetivo

Llevar a cabo la adaptación cultural y la validación psicométrica del Summary of Diabetes Self-Care measure (SDSCA) en población española con diabetes mellitus tipo 2.

Diseño

Estudio de validación clinimétrica.

Emplazamiento

Centros de atención primaria del Distrito Sanitario Málaga-Valle del Guadalhorce.

Participantes

331 personas con diabetes mellitus tipo 2.

Mediciones principales

La versión validada en población mexicana del SDSCA fue sometida a equivalencia semántica y de contenido mediante un Delphi de expertos, su legibilidad fue determinada mediante la escala INFLESZ. Posteriormente se llevó a cabo la validación psicométrica, evaluándose validez de constructo mediante análisis factorial exploratorio y confirmatorio (en adelante AFE y AFC), consistencia interna, fiabilidad test-retest y validez discriminante.

Resultados

Dos rondas fueron necesarias para alcanzar consenso entre los miembros del panel, posteriormente INFLESZ aportó una buena legibilidad. El modelo trifactorial (dieta, ejercicio físico y autoanálisis) con 7 ítems explicaba un 79,16% de la varianza. El análisis confirmatorio mostró un buen ajuste del modelo del SDSCA-Sp. La consistencia interna fue moderada-baja (α-Cronbach = 0,62) y la fiabilidad test-retest fue evaluada en 198 pacientes (t = 0,462-0,796, p < 0,001) con una correlación global de 0,764 (p < 0,0001).

Conclusiones

El SDSCA-Sp en una versión válida en la práctica clínica y en investigación para evaluar autocuidados en diabetes mellitus tipo 2 con propiedades clinimétricas similares a las obtenidas en estudios previos.

Systematic review of the psychometric properties and theoretical grounding of instruments evaluating self-care in people with type 2 diabetes mellitus

AIM

To determine the psychometric properties and theoretical grounding of instruments that evaluate self-care behaviour or barriers in people with type 2 diabetes.

BACKGROUND

There are many instruments designed to evaluate self-care behaviour or barriers in this population, but knowledge about their psychometric validation processes is lacking.

DESIGN

Systematic review.

DATA SOURCES

We conducted a search for psychometric or validation studies published between January 1990-December 2012. We carried out searches in Pubmed, CINAHL, PsycINFO, ProQuolid, BibliPRO and Google SCHOLAR to identify instruments that evaluated self-care behaviours or barriers to diabetes self-care.

REVIEW METHODS

We conducted a systematic review with the following inclusion criteria: Psychometric or clinimetric validation studies that included patients with type 2 diabetes (exclusively or partially) and which analysed self-care behaviour or barriers to self-care and proxies like self-efficacy or empowerment, from a multidimensional approach. Language: Spanish or English. Two authors independently assessed the quality of the studies and extracted data using Terwee's proposed criteria: psychometrics properties, dimensionality, theoretical ground and population used for validation through each included instrument.

RESULTS

Sixteen instruments achieved the inclusion criteria for the review. We detected important methodological flaws in many of the selected instruments. Only the Self-management Profile for Type 2 Diabetes and Problem Areas in Diabetes Scale met half of Terwee's quality criteria.

CONCLUSION

There are no instruments for identifying self-care behaviours or barriers elaborated with a strong validation process. Further research should be carried out to provide patients, clinicians and researchers with valid and reliable instruments that are methodologically solid and theoretically grounded.