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O'Donnell S, Hayden J, Quigley E, Adamis D, Gavin B, McNicholas F. "We're seen as part of the supply chain of medicines rather than as the professionals that we are": The wellbeing of community pharmacists during the COVID response. Res Social Adm Pharm 2024; 20:389-400. [PMID: 38350789 DOI: 10.1016/j.sapharm.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/10/2023] [Accepted: 12/13/2023] [Indexed: 02/15/2024]
Abstract
INTRODUCTION Challenges facing community pharmacists in delivering and adapting services during the COVID-19 response have been reported. However, few qualitative studies have examined the impact of these experiences on their wellbeing, and what supports the profession requires in the future. AIM(S) To examine the work-related experiences and psychosocial needs of community pharmacists situated in the Republic of Ireland arising from the COVID-19 response. METHOD 11 pharmacists and 1 representative were interviewed and data analysed through inductive thematic analysis. RESULTS Work experiences were characterised by increased workload linked to multiple roles pharmacists played during the pandemic. Remaining open, meeting the social and medical needs of patients unable to easily access other primary services exerted its toll on pharmacists while at the same time providing a sense of professional fulfilment. Participants felt contributions made to the community during COVID-19 went largely unrecognised by the wider healthcare structure. This added to a prior sense of professional disenchantment arising from long-standing under-resourcing, lack of clinical autonomy and high administrative burden eroding their sense of purpose and meaning. Informal, peer-support networks were preferred over formal psychological support initiatives. CONCLUSIONS The post-pandemic environment is an opportune time for policy makers to reconsider the role of community pharmacists. Greater clinical autonomy beyond dispensing of medicines, for example, for example, would also serve to enhance the sense of purpose and meaning of pharmacists as healthcare professionals. The longer-term well-being of community pharmacists is contingent on recognition of the value that community pharmacy bring both to the healthcare system and wider society as a whole.
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Affiliation(s)
- Shane O'Donnell
- Department of Child & Adolescent Psychiatry, School of Medicine and Medical Science, University College Dublin (UCD), Ireland.
| | - John Hayden
- RCSI School of Pharmacy and Biomolecular Sciences (PBS), Royal College of Surgeons in Ireland, Ireland
| | - Etain Quigley
- National University of Ireland, Maynooth (Maynooth University) - Department of Law, Ireland
| | | | - Blánaid Gavin
- Department of Child & Adolescent Psychiatry, School of Medicine and Medical Science, University College Dublin (UCD), Ireland
| | - Fiona McNicholas
- Department of Child & Adolescent Psychiatry, School of Medicine and Medical Science, University College Dublin (UCD), Ireland; Children Health Ireland, Crumlin, Dublin 12, Ireland; Lucena Clinic Rathgar, Dublin 6, Ireland
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Dineen-Griffin S, Benrimoj SI. The landscape of self-care in Australia: A pharmacy perspective. Explor Res Clin Soc Pharm 2024; 13:100396. [PMID: 38174289 PMCID: PMC10762451 DOI: 10.1016/j.rcsop.2023.100396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 01/05/2024] Open
Abstract
The evolving landscape of self-care in Australia underscores the imperative of recognizing and integrating the crucial role of pharmacists in promoting greater levels of self-care. Although the social and economic justifications for self-care are acknowledged internationally and in the literature, there is very little policy recognition in relation to self-care specifically in Australian health policy. Additionally, the distinct contributions of pharmacies to self-care, i.e., their experiences and accessibility in primary health care, are not consistently highlighted. Community pharmacies in Australia are currently navigating a transformative shift, expanding their scope of practice to deliver highly individualized care, with a special emphasis on the implementation of professional services crucial for the sector's enduring viability. Although pharmacists already play a substantial role in supporting self-care, there exists a compelling demand for a systematic and structured approach. Despite the limited availability of theoretical frameworks or models for pharmacists in self-care support within the existing literature, tangible practical evidence attests to the success of interventions. In an era where patients increasingly assume responsibility for self-managing conditions, the pharmacist's role in facilitating self-care and judicious self-medication is pivotal, promising not only tangible benefits for individuals but also contributing significantly to the long-term sustainability of the healthcare system in Australia. This necessitates a strategic and comprehensive framework that positions pharmacists as essential catalysts in the broader landscape of healthcare, ensuring their contributions are optimally leveraged to enhance patient outcomes and system efficiency.
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Affiliation(s)
- Sarah Dineen-Griffin
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, New South Wales, Australia
| | - Shalom I. Benrimoj
- Pharmaceutical Care Research Group, Faculty of Pharmacy, University of Granada, Spain
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Asiello JD, Kelley CM, Cannone K, McInnis L, Begin A, Dittrich M, Donovan E, Beatty K, Lam N, Taubert A, Wong J. Addressing the functional needs of left ventricular assist device candidates: Development and feasibility of an occupational therapy pre-operative evaluation. Heart Lung 2024; 64:198-207. [PMID: 38301417 DOI: 10.1016/j.hrtlng.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Everyday living with a left ventricular assist device (LVAD) is complex, particularly for people with physical or cognitive impairments or limited social supports. There is a need for standardized pre-operative functional evaluations. OBJECTIVES Our objectives were to describe a pre-operative occupational therapy (OT) evaluation for LVAD candidates, assess its feasibility in routine care, and characterize functional needs. METHODS We retrospectively reviewed electronic medical records of pre-operative OT consultations for LVAD candidates over four years (n = 209). Occupational profile, vision, and sensation were operationalized from documentation narratives. Daily functioning was measured with Activity Measure for Post-Acute Care, grip strength with dynamometer, cognition with Montreal Cognitive Assessment and Allen Cognitive Level Screen-5, and LVAD self-management with a performance-based ordinal scale. RESULTS 89.5 % of consultations were completed, averaging 61.2 min (n = 187): 79.1 % (148/187) inpatient and 20.9 % (39/187) outpatient. Patients completed 87.7 % (164/187) to 100.0 % (187/187) of evaluation components. 21.9 % (41/187) of candidates lived alone. 6.4 % (12/187) and 7.0 % (13/185) had visual and sensory dysfunction. 57.4 % were independent with daily activities (104/181). 17.7 % (32/181) had impaired grip strength. 69.3 % (124/179) had impaired cognition, 29.7 % (51/172) with impaired functional cognition for everyday activities. 88.4 % (145/164) required physical or cueing assistance while practicing LVAD batteries management. OTs interpreted that 20.9 % (39/187) would likely require 24/7 post-operative support with LVAD self-care. CONCLUSION Pre-operative OT evaluations were feasible and emphasized complex functional needs. Assessing LVAD self-care abilities may inform candidacy and facilitate early interventions to optimize functioning. OT should be consulted within interprofessional teams for all LVAD candidates.
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Affiliation(s)
- Jessica D Asiello
- Department of Occupational Therapy, MGH Institute of Health Professions, Charlestown Navy Yard, 36 1st Avenue, Boston, MA 02129, United States; Occupational Therapy Services, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States.
| | - Christina M Kelley
- Occupational Therapy Services, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States
| | - Kellie Cannone
- Department of Occupational Therapy, MGH Institute of Health Professions, Charlestown Navy Yard, 36 1st Avenue, Boston, MA 02129, United States
| | - Lauren McInnis
- Department of Occupational Therapy, MGH Institute of Health Professions, Charlestown Navy Yard, 36 1st Avenue, Boston, MA 02129, United States
| | - Abigail Begin
- Occupational Therapy Services, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States
| | - Marissa Dittrich
- Occupational Therapy Services, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States
| | - Erin Donovan
- Occupational Therapy Services, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States
| | - Kimberly Beatty
- Occupational Therapy Services, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States
| | - Nicole Lam
- Occupational Therapy Services, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States
| | - Alyssa Taubert
- Occupational Therapy Services, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States
| | - John Wong
- Department of Occupational Therapy, MGH Institute of Health Professions, Charlestown Navy Yard, 36 1st Avenue, Boston, MA 02129, United States; School of Nursing, MGH Institute of Health Professions, Charlestown Navy Yard, 36 1st Avenue, Boston, MA 02129, United States
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Mineiro L, Gallo da Silva TT, Valderramas SR, Kowalski SC, Dos Santos Paiva E, Gomes ARS. Translation, transcultural adaptation into Brazilian Portuguese and concurrent validity of the rheumatoid arthritis assessment scale (RAKAS-13/Brazil). Adv Rheumatol 2024; 64:5. [PMID: 38167406 DOI: 10.1186/s42358-023-00341-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 11/24/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Knowledge of patients about Rheumatoid Arthritis (RA) is a necessary aspect to better approach self-management support in a patient-centered manner. The research instrument known as the Rheumatoid Arthritis Knowledge Assessment Scale (RAKAS), consisting of 13 items, is simple, reliable and reproducible, and can be applied in both clinical practice and research protocols. OBJECTIVE This study aimed to translate and culturally adapt the RAKAS vocabulary into Brazilian Portuguese and to evaluate its concurrent validity. METHODS The RAKAS was translated into Brazilian Portuguese and administered to 52 elderly women with RA recruited between May 2021 and May 2022. Concurrent validity was assessed using the Spearman's correlation coefficient between RAKAS and Patient Knowledge Questionnaire (PKQ). RESULTS The participants considered RAKAS-13/BRAZIL easy to understand and did not report any doubts in answering the final version. Concurrent validity of the RAKAS-13/BRAZIL was low compared to the PKQ (ρ = 0.283, p = 0.038). CONCLUSION The Brazilian Portuguese version of the RAKAS (RAKAS-13/BRASIL) proved to be a questionnaire that was easy and quick to administer to assess patient knowledge about Rheumatoid Arthritis, despite its low correlation with the PKQ in the present study.
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Affiliation(s)
- Lindomar Mineiro
- Physical Education Program, Federal University of Paraná, Curitiba, Paraná, Brazil.
| | | | - Silvia Regina Valderramas
- Internal Medicine and Health Sciences, Department of Prevention and Rehabilitation in Physical Therapy, Federal University of Paraná, Curitiba, Paraná, Brazil
| | | | - Eduardo Dos Santos Paiva
- Rheumatology, Internal Medicine Department, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Anna Raquel Silveira Gomes
- Prevention and Rehabilitation in Physical Therapy Department, Masters and PhD Programs in Physical Education, Federal University of Paraná, Curitiba, Paraná, Brazil
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Alexa JM, Bertsche T. An online cross-sectional survey of community pharmacists to assess information needs for evidence-based self-medication counselling. Int J Clin Pharm 2023; 45:1452-1463. [PMID: 37532842 PMCID: PMC10682211 DOI: 10.1007/s11096-023-01624-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/08/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Community pharmacists play an important role in healthcare. They are frequently visited by patients to receive advice on self-medication products. Little research has been conducted to investigate pharmacists' information needs for evidence-based self-medication counselling. AIM To assess community pharmacists' information needs in five predefined areas: general and specific individual needs, quality needs, utilisation needs, implication needs, and access needs for evidence based self-medication counselling. METHOD After ethical approval, we conducted an exploratory, semi-quantitative, cross-sectional online survey. Members of three different chambers of pharmacists in Germany were invited to participate anonymously in the survey. They gave informed consent and received no incentive for their participation. Quantitative outcome: Frequency of relevance / importance of items within predefined information needs areas, except for access needs. Qualitative outcome: Open-text responses concerning all information needs. RESULTS We analysed data from a total of 823 participants who completed the survey. General and specific information such as dosage (74.2% [611/823]) and when to refer to a physician (64.6% [532/823]) as well as an over-the-counter product's effectiveness according to medical guidelines (71.4% [588/823]) were rated as very important. Participants reported to prefer digital information sources (50.5% [416/823] strongly agreed), especially in the form of an easily accessible database (61.6% [507/823] strongly agreed) that contains regularly updated, manufacturer-independent, critically appraised, concise information. CONCLUSION Community pharmacists expressed distinct information needs for evidence-based self-medication counselling. Further information services on essential evidence-based pharmacy knowledge may be necessary to support implementation.
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Affiliation(s)
- J M Alexa
- Department of Clinical Pharmacy, Institute of Pharmacy, Faculty of Medicine, Leipzig University, Leipzig, Germany
- Drug Safety Center, University Hospital Leipzig and Leipzig University, Bruederstr. 32, 04103, Leipzig, Germany
| | - T Bertsche
- Department of Clinical Pharmacy, Institute of Pharmacy, Faculty of Medicine, Leipzig University, Leipzig, Germany.
- Drug Safety Center, University Hospital Leipzig and Leipzig University, Bruederstr. 32, 04103, Leipzig, Germany.
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Batlle A, Aldemira A, Agúndez B, Cabrera I, Esquerdo E, López S, Achotegui A, Villalón C, de Sevilla MF. Home hospitalization of the acute patient: a new approach to care. An Pediatr (Barc) 2023; 99:329-334. [PMID: 37932161 DOI: 10.1016/j.anpede.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/07/2023] [Indexed: 11/08/2023] Open
Abstract
Pediatric hospitalization at home (HAH) aims to provide the patient and his family with an alternative to conventional hospitalization, safely and effectively, improving the quality of life of the patient and his family. The most frequent pathologies in HAH in pediatric acute patients are acute respiratory pathology and bacterial infections that require parenteral antibiotic therapy. The success of an acute patient home hospitalization program relies on the proper selection of patients and exhaustive training of caregivers, as well as good communication and coordination between the different services and levels of care involved.
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Affiliation(s)
- Astrid Batlle
- Unidad de Hospitalización Domiciliaria, Servicio de Pediatría, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Andrea Aldemira
- Unidad de Hospitalización Domiciliaria, Servicio de Pediatría, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Beatriz Agúndez
- Unidad de Hospitalización Domiciliaria. Servicio de Pediatría. Hospital Universitario Niño Jesús, Madrid, Spain
| | - Isabel Cabrera
- Unidad de Hospitalización Domiciliaria. Servicio de Pediatría. Hospital Universitario Niño Jesús, Madrid, Spain
| | - Elisenda Esquerdo
- Unidad de Hospitalización Domiciliaria, Servicio de Pediatría, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Sandra López
- Unidad de Hospitalización Domiciliaria, Servicio de Pediatría, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Ane Achotegui
- Unidad de Hospitalización Domiciliaria, Servicio de Pediatría, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Carmen Villalón
- Unidad de Hospitalización Domiciliaria, Servicio de Pediatría, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Mariona Fernández de Sevilla
- Unidad de Hospitalización Domiciliaria, Servicio de Pediatría, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, Universidad de Barcelona, Barcelona, Spain; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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Rotta I, Lima T, Tonin FS. Role of community pharmacy and pharmacists in self-care in Brazil. Explor Res Clin Soc Pharm 2023; 10:100274. [PMID: 37181500 PMCID: PMC10173763 DOI: 10.1016/j.rcsop.2023.100274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 04/18/2023] [Indexed: 05/16/2023] Open
Abstract
Global healthcare systems, including the National Health System in Brazil - one of the largest public models in the world -, continue to evolve, as well as populations' health needs, currently shaped on individuals feeling a greater desire to manage their own health. Self-care practices are part of several public policies and clinical guidelines in Brazil including the National Policy on Complementary and Integrative Practices, the National AIDS Control Program, the National Policy for Women's Health, and the Guidelines for Care of People with Chronic Diseases. There are over 100,700 community pharmacies, in the country (89.2% privately owned) employing 234,300 pharmacists, representing an important delivery point for self-care, as they are the first point of access to care for most patients. Self-medication is a common practice in Brazil (prevalence rates of self-medication ranging from 16.1% to 35.0%), especially with non-prescription/over-the-counter medicinal products (65.0%). In fact, these products represent over 25% of volume marketed of medicines, summing revenues of USD 1.9 billion per year. Studies demonstrated a positive budget impact as important savings for the National Health System due to reductions of unnecessary medical appointments and loss of working days. In addition to minor ailments management, other self-care services provided by community pharmacies that are frequently sought by Brazilian citizens (20-25% of cases) are smoking cessation and weight management (costs per service ranging from around USD 5.00-12.00). However, pharmacy services are not yet as fully integrated in Brazil to the same extent as in other countries. Barriers such as standardization of processes (from services' design, implementation, and evaluation in practice), pharmacist remuneration for the provision of services and the amount to be charged for the service are still a matter of controversy. For more rapid and sustainable advances in these practices, communication among various stakeholders, professional practice and healthcare regulations, standardization of services and financing of self-care (both publicly and privately) are urgently needed. This paper provides an overview of some self-care services provided by community pharmacies in Brazil and call attention to the ongoing challenges to move the National Health system forward.
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Affiliation(s)
- Inajara Rotta
- Department of Pharmacy, Federal University of Paraná, Curitiba, Brazil
| | - Tácio Lima
- Department of Pharmaceutical Sciences, Federal Rural University of Rio de Janeiro, Seropedica, Brazil
| | - Fernanda S. Tonin
- Pharmaceutical Sciences Postgraduate Research Program, Federal University of Paraná, Curitiba, Brazil
- H&TRC - Health & Technology Research Center, ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal
- Corresponding author at: H&TRC - Health & Technology Research Center, ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Av. D. João II, lote 4.69.01, Parque das Nações, 1990-096 Lisbon, Portugal.
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Lelie-van der Zande R, Koster ES, Teichert M, Bouvy ML. Barriers and facilitators for providing self-care advice in community pharmacies: a qualitative study. Int J Clin Pharm 2023:10.1007/s11096-023-01571-3. [PMID: 37029859 PMCID: PMC10082626 DOI: 10.1007/s11096-023-01571-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 03/03/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND Community pharmacies are easily accessible for self-care advice. Guidelines for providing self-care advice were introduced in several countries, including the Netherlands in the 1990s. Previous studies have indicated room for improvement in self-care advice in daily pharmacy practice. AIM To identify barriers and facilitators for providing self-care advice. METHOD Semi-structured interviews were conducted face-to-face or online with pharmacists and pharmacy assistants using a topic guide based on the Theoretical Domains Framework. The interviews were audio-recorded and transcribed verbatim. The transcripts were deductively analysed to identify barriers and facilitators for self-care counselling. COREQ guidelines were followed. RESULTS In total, 13 pharmacists and 12 pharmacy assistants were interviewed to reach data saturation. In general, most themes addressed by pharmacists and pharmacy assistants belonged to similar domains. The following domains were frequently mentioned: environmental context and resources (e.g. priority for prescription drugs, privacy, collaboration with general practitioners, access to patients' records), intentions (providing reliable advice), skills (communication, decision-making), knowledge (ready guideline knowledge), beliefs about consequences (patient safety), social influences (patient awareness of pharmacist role), reinforcement (lack of reimbursement for relatively time-consuming advice). CONCLUSION This study identifies barriers and facilitators for evidence-based self-care advice. Pharmacists should first support pharmacy assistants by helping them keep their knowledge and skills up to date and creating suitable pharmacy preconditions to facilitate improvements in self-care counselling. Second, collaboration with general practitioners regarding minor ailments should be improved.
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Affiliation(s)
- Rian Lelie-van der Zande
- Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
| | - Ellen S Koster
- Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Martina Teichert
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Marcel L Bouvy
- Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
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Oh EG, Lee JY, Lee HJ, Oh S. Effects of discharge education using teach-back methods in patients with heart failure: A randomized controlled trial. Int J Nurs Stud 2023; 140:104453. [PMID: 36827745 DOI: 10.1016/j.ijnurstu.2023.104453] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/26/2022] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Heart failure is one of the most common causes of hospital readmission. Self-care is an essential but challenging task for patients with heart failure, and inadequate self-care is closely related to unplanned readmission and unnecessary health expenditure. Patient-centered education using the teach-back method emerged as a key strategy to prevent patients' adverse events by improving self-care. OBJECTIVE To evaluate the effects of discharge education using the teach-back method on self-care, self-care efficacy, symptoms of heart failure, caregiver dependency, and unplanned healthcare resource utilization among patients with heart failure. DESIGN A prospective, two-arm randomized controlled trial. SETTING(S) Four adult cardiology units at a tertiary hospital in Seoul, South Korea. PARTICIPANTS A total of 100 patients diagnosed with heart failure and scheduled to be discharged to their homes. METHODS The intervention group received the HEART program® in addition to the usual discharge education by a trained nurse before discharge, while the control group received usual discharge education only. The discharge education included the definition of heart failure, medication, symptom management, diet, physical activity, and other precautions. Data on self-care (self-care maintenance; symptom-perception; self-care management), self-care efficacy, symptoms of heart failure, and caregiver dependency were measured at 7-days after discharge (T1), and unplanned healthcare resource utilization (including readmission, emergency room visit, and healthcare professional contacts) was assessed at 1-month after discharge (T2). Outcomes were analyzed with ANCOVA. RESULTS A total of 94 patients (intervention group = 45, control group = 49) completed outcome measurements at the three-time points. Participants in the intervention group showed a significant improvement in self-care maintenance (F = 11.597, p = 0.001), symptom perception (F = 20.173, p < 0.001), self-care management (F = 7.205, p = 0.009), and self-care efficacy (F = 4.210, p = 0.043) compared to the control group. However, there were no statistically significant differences in symptoms of heart failure, caregiver dependency, and unplanned healthcare resource utilization between the two groups (all ps > 0.05). CONCLUSIONS The findings demonstrated that discharge education using the teach-back method is an effective educational strategy to improve self-care and self-care efficacy in patients with heart failure. We recommend nurses implement discharge education using the teach-back method for patients with heart failure. REGISTRATION This study was registered at the Clinical Research Information Service (KCT0004444) on November 15, 2019, and the participant recruitment was initiated in June 2020.
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Abbasi Ghocham S, Valiee S, Kamyari N, Vatandost S. Level of Self-Care and Patient Care Against COVID-19 Among Emergency Medical Services Personnel; a Cross-sectional Study. Arch Acad Emerg Med 2023; 11:e4. [PMID: 36620741 PMCID: PMC9807949 DOI: 10.22037/aaem.v11i1.1771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Introduction Provision of pre-hospital care by emergency medical services (EMS) requires paying attention to self-care and patient care against possible infections. The present study was conducted with the aim of determining the level of self-care and patient care against COVID-19. Methods The present correlational, descriptive, analytical study was carried out on 301 EMS personnel in Iran. Data were collected using a demographic information form and questionnaires made by the researcher on the level of self-care and patient care against COVID-19. Results The results showed that more than half of the participants (55%) were aged 27 to 34 years. The majority of the participants had an experience of participating in self-care (88.7%) and patient care (83.7%) training courses against COVID-19. The overall score of self-care was 55.96 ± 6.97 out of 72 and that of patient care was 26.86± 3.39 out of 32, both of which revealed a favorable level. However, in some questions, the mean score was lower than the optimal level. The lowest mean score among items related to self-care against COVID-19 was allocated to wearing protective clothing (1.77±1.19). Among items related to patient care against COVID-19, the lowest mean score was related to training the patient about hand hygine after touching contaminated equipment (2.83±1.08 out of 4). There was a positive (r=0.491) and significant correlation between self-care and patient care against COVID-19 (p=0.001) based on our findings. Conclusion Although the general level of self-care and patient care against COVID-19 was favorable, due to the undesired level of some domains, it seems necessary to implement corrective planning through periodical training and monitoring the performance of the personnel.
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Affiliation(s)
- Sirvan Abbasi Ghocham
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Sina Valiee
- Clinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Naser Kamyari
- Department of Biostatistics and Epidemiology, School of Health, Abadan University ofMedical Sciences, Abadan, Iran
| | - Salam Vatandost
- Clinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.,Corresponding author: Salam Vatandost; Kurdistan University of Medical Sciences Campus, Pasdaran Blvd, Sanandaj, Iran. Tel: +988783801405, Fax: + 98 38380448, , ORCID: 0000-0003-4189-0954
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Cangussú LR, Sartori Alho EA, Silva AL, Fonsêca DV, Lopes JM, Barbosa RHDA, Lopes MR. Low health literacy and quality of life in patients with systemic arterial hypertension. Dialogues Health 2022; 1:100036. [PMID: 38515897 PMCID: PMC10953978 DOI: 10.1016/j.dialog.2022.100036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/07/2022] [Accepted: 08/09/2022] [Indexed: 03/23/2024]
Abstract
Purpose Evaluate the level of health literacy and quality of life of patients with hypertension. Methods A cross-sectional, observational study was carried out in the Northeast region of Brazil with 105 patients with hypertension through the SAHLPA-18, S-TOFHLA and MINICHAL tests. Results For both literacy tests applied, it can be observed that about 60% of the interviewed patients did not present adequate health literacy. It was found that factors such as increasing age, lower economic class and lower education were associated with a lower level of health literacy. In the evaluation of the quality of life by the MINICHAL, 46.7% of the patients reported that hypertension interferes with quality of life. It was also possible to show that the time of diagnosis (p = 0.04) and the economic class (p = 0.008) influence the quality of life. Conclusion Hypertension is a chronic condition that requires continuous treatment and has potential risks of evolving with fatal and non-fatal complications that can affect the patients' quality of life. The data presented reflect the difficulty in understanding and processing health information, which may directly impact on the therapeutic management of hypertension.
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Achten JPJ, Mooren-van der Meer S, Pisters MF, Veenhof C, Koppenaal T, Kloek CJJ. Self-management behaviour after a physiotherapist guided blended self-management intervention in patients with chronic low back pain: A qualitative study. Musculoskelet Sci Pract 2022; 62:102675. [PMID: 36332333 DOI: 10.1016/j.msksp.2022.102675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 09/30/2022] [Accepted: 10/12/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Self-management support is considered an important component in the physiotherapeutic treatment of people with chronic low back pain. The stratified blended physiotherapy intervention e-Exercise Low Back Pain is an example of a self-management intervention. More insight may contribute to improving blended interventions to stimulate self-management after treatment and thus hopefully prevent chronicity and/or relapses in patients with chronic low back pain. OBJECTIVES The aim of this study was to gain an in-depth understanding of the self-management behaviour after a physiotherapist guided blended self-management intervention in people with chronic low back pain. DESIGN A qualitative study with semi-structured interviews nested within a randomized controlled trial on the (cost-)effectiveness of e-Exercise Low Back Pain was conducted. METHOD Thematic analysis was used to analyse the transcriptions. A hybrid process of both deductive and inductive approaches was used. RESULTS After 12 interviews, data saturation was reached. Analysis of the data yielded six themes related to self-management behaviour: illness beliefs, coping, cognitions, social support and resource utilization, physiotherapeutic involvement and motivation. CONCLUSIONS In our study the majority of the participants seemed to show adequate self-management behaviour when experiencing low back pain. Most participants first try to gain control over their low back pain themselves when experiencing a relapse before contacting the physiotherapist. Participants struggle in continuing health behaviour in pain free periods between relapses of low back pain. Physiotherapists are recommended to encourage long-term behaviour change. Additionally, better facilitation by the physiotherapist or additional functionalities in the app to stimulate social support might have a useful contribution.
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Abstract
Trabeculectomy still achieves the strongest intraocular pressure (IOP) reduction of all glaucoma surgical techniques, but with the drawback of a significant risk profile. Against this background, canaloplasty has established itself as a much gentler alternative which achieves sufficient IOP reduction and enables a significant reduction in postoperative glaucoma medication. However, approximately half of patients are not completely medication free. In response, a number of modifications have been developed with the goal of further enhancing the IOP-lowering effect of canaloplasty, but without the risk of serious complications. By combining canaloplasty with the newly developed suprachoroidal drainage, a uveoscleral drainage is created in addition to the trabecular outflow improvement, which seems to have an additive effect. Thus, for the first time, an IOP-lowering effect comparable to successful trabeculectomy can be achieved. Numerous other modifications with implants also enhance the potential of canaloplasty or offer other additional benefits such as the possibility of telemetric IOP self-measurement by the patient. The additional creation of a subconjunctival drainage with or without use of cytostatic drugs also seems promising. Ab interno procedures, on the other hand, have limited pressure-lowering potential but may provide some additional benefit in mild glaucoma and in the setting of cataract surgery.
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Affiliation(s)
- Peter Szurman
- Augenklinik Sulzbach, Knappschaftsklinikum Saar, An der Klinik 10, 66280, Sulzbach, Deutschland.
- Klaus Heimann Eye Research Institute (KHERI), Sulzbach, Deutschland.
| | - Karsten Klabe
- Breyer Kaymak Klabe Augenchirurgie, Düsseldorf, Deutschland
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14
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Lovell LMP, Atherley AE, Watson HR, King RD. An exploration of burnout and resilience among emergency physicians at three teaching hospitals in the English-speaking Caribbean: A cross-sectional survey. Lancet Reg Health Am 2022; 15:100357. [PMID: 36778072 PMCID: PMC9903692 DOI: 10.1016/j.lana.2022.100357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Background Burnout is common among doctors working in emergency departments. It has significant consequences and is multifactorial. Self-care and resilience tendencies may contribute to being burnt out, or not. This study explores burnout and resilience amongst physicians working in Caribbean emergency departments. Methods Data were collected from 111 participants using the Maslach Burnout Inventory (MBI) and the Resilience Scale-14 (RS14) as measures of burnout and resilience, respectively. Questions collected data on participant demographics and characteristics related to self-care. The associations between demographic characteristics and total burnout and resilience scales were explored. Findings Among participants, 88.6% had medium to high range emotional exhaustion, 82.8% exhibited medium to high range depersonalization, and 19.6% had low to medium range personal accomplishment. Participants in Barbados had higher emotional exhaustion and depersonalization scores (p=0.009), and those in a postgraduate programme had higher depersonalization scores (p=0.047). The mean RS-14 score was 81.1 out of a maximum of 98.0 with a standard deviation of 13.1 and a range of 26 to 98. Depression correlated with high emotional exhaustion scores (p=0.004) and low resilience scores (p<0.0001). Emotional exhaustion scores increased among participants using alcohol daily (p=0.01), using recreational drugs (p=0.021) and sleeping aids (p=0.028). Interpretation High burnout, despite high resilience, is present in this sample of physicians working in emergency departments of teaching hospitals in the Caribbean. Although resilience scores were high, those with lower resilience tendencies had poorer self-care habits. Funding No external funding.
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Affiliation(s)
- Lynn-Marie P. Lovell
- Emergency Medicine, Queen Elizabeth Hospital; Faculty of Medical Sciences, University of the West Indies, Cave Hill Campus, Barbados,Corresponding author at: Dr. Lynn-Marie Lovell Queen Elizabeth Hospital, Barbados.
| | - Anique E.N. Atherley
- Academy of Teaching and Learning, Academic Learning Environment, Ross University School of Medicine, Barbados
| | - Harold R. Watson
- Emergency Medicine, Queen Elizabeth Hospital; Faculty of Medical Sciences, University of the West Indies, Cave Hill Campus, Barbados
| | - Reginald DaC. King
- Emergency Medicine, Queen Elizabeth Hospital; Faculty of Medical Sciences, University of the West Indies, Cave Hill Campus, Barbados
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Stephen DA, Nordin A, Nilsson J, Persenius M. Using mHealth applications for self-care - An integrative review on perceptions among adults with type 1 diabetes. BMC Endocr Disord 2022; 22:138. [PMID: 35614419 PMCID: PMC9131554 DOI: 10.1186/s12902-022-01039-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 05/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Individually designed interventions delivered through mobile health applications (mHealth apps) may be able to effectively support diabetes self-care. Our aim was to review and synthesize available evidence in the literature regarding perception of adults with type 1 diabetes on the features of mHealth apps that help promote diabetes self-care, as well as facilitators and barriers to their use. An additional aim was to review literature on changes in patient reported outcome measures (PROMs) in the same population while using mHealth apps for diabetes self-care. METHODS Quantitative and qualitative studies focusing on adults aged 18 years and over with type 1 diabetes in any context were included. A systematic literature search using selected databases was conducted. Data was synthesised using narrative synthesis. RESULTS We found that features of mHealth apps designed to help promote and maintain diabetes self-care could be categorized into self-care data monitoring, app display, feedback & reminders, data entry, data sharing, and additional features. Factors affecting the use of mHealth apps reported in the literature were personal factors, app design or usability factors, privacy and safety factors, or socioeconomic factors. Quality of life and diabetes distress were the most commonly reported PROMs in the included studies. CONCLUSION We are unable to reach a conclusive result due to the heterogeneity of the included studies as well as the limited number of studies reporting on these areas among adults with type 1 diabetes. We therefore recommend further large-scale studies looking into these areas that can ultimately improve mHealth app use in type 1 diabetes self-care. SYSTEMATIC REVIEW REGISTRATION Prospero CRD42020157620 .
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Affiliation(s)
- Divya Anna Stephen
- Department of Health Sciences, Faculty for Health, Science And Technology, Karlstad University, Karlstad, Sweden.
| | - Anna Nordin
- Department of Health Sciences, Faculty for Health, Science And Technology, Karlstad University, Karlstad, Sweden
- Department of Health, Learning and Technology, Nursing and Medical Technology, Luleå University of Technology, Luleå, Sweden
| | - Jan Nilsson
- Department of Health Sciences, Faculty for Health, Science And Technology, Karlstad University, Karlstad, Sweden
- Faculty of Health and Social Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Mona Persenius
- Department of Health Sciences, Faculty for Health, Science And Technology, Karlstad University, Karlstad, Sweden
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16
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Ho RS, Ho FF, Adams J, Cramer H, Leung B, Ward L, Zhang Y, Chung VC. Patients' perceptions on non-specific effects of acupuncture: Qualitative comparison between responders and non-responders. Integr Med Res 2022; 11:100771. [PMID: 34660196 PMCID: PMC8503627 DOI: 10.1016/j.imr.2021.100771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/08/2021] [Accepted: 08/04/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Non-specific effect of acupuncture constitutes part of the overall effect generated via clinical encounter beyond needle insertion and stimulation. It is unclear how responders and non-responders of acupuncture experience non-specific effects differently. We aimed to compare their experiences in a nested qualitative study embedded in an acupuncture randomized trial on functional dyspepsia. METHODS Purposive sampling was used to capture experience of responders (n=15) and non-responders (n=15) to acupuncture via individual in-depth interviews. Design and analysis followed a framework analysis approach, with reference to an existing model on acupuncture non-specific effects. Themes emerging outside of this model were purposefully explored. RESULTS Responders had a more trusting relationship with acupuncturist in response to their expression of empathy. In turn they were more actively engaged in lifestyle modifications and dietary advice offered by acupuncturists. Non-responders were not satisfied with the level of reassurance regarding acupuncture safety. They were also expecting more peer support from fellow participants, regarded that as an empowerment process for initiating and sustaining lifestyle changes. CONCLUSIONS Our results highlighted key differences in acupuncture non-specific effect components experienced by responders and non-responders. Positive non-specific effects contributing to overall benefits could be enhanced by emphasizing on empathy expression from acupuncturists, trust-building, offering appropriate explanations on safety, and organizing patient support groups. Further research on the relative importance of each component is warranted.
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Affiliation(s)
- Robin S.T. Ho
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Fai Fai Ho
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jon Adams
- Australian Research Center in Complementary and Integrative Medicine, University Technology Sydney, Australia
| | - Holger Cramer
- Australian Research Center in Complementary and Integrative Medicine, University Technology Sydney, Australia
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Brenda Leung
- Australian Research Center in Complementary and Integrative Medicine, University Technology Sydney, Australia
- Public Health, Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada
| | - Lesley Ward
- Australian Research Center in Complementary and Integrative Medicine, University Technology Sydney, Australia
- Department of Sport, Exercise and Rehabilitation, Faculty of Life Sciences, Northumbria University, Newcastle Upon Tyne, UK
| | - Yan Zhang
- Australian Research Center in Complementary and Integrative Medicine, University Technology Sydney, Australia
- Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, TX, USA
| | - Vincent C.H. Chung
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
- Australian Research Center in Complementary and Integrative Medicine, University Technology Sydney, Australia
- School of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong
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Amador-Fernández N, Benrimoj SI, García-Mochón L, García-Cárdenas V, Dineen-Griffin S, Gastelurrutia MÁ, Gómez-Martínez JC, Colomer-Molina V, Martínez-Martínez F. A cost utility analysis alongside a cluster-randomised trial evaluating a minor ailment service compared to usual care in community pharmacy. BMC Health Serv Res 2021; 21:1253. [PMID: 34798895 PMCID: PMC8605551 DOI: 10.1186/s12913-021-07188-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 10/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Minor ailments are "self-limiting conditions which may be diagnosed and managed without a medical intervention". A cluster randomised controlled trial (cRCT) was designed to evaluate the clinical, humanistic and economic outcomes of a Minor Ailment Service (MAS) in community pharmacy (CP) compared with usual care (UC). METHODS The cRCT was conducted for 6 months from December 2017. The pharmacist-patient intervention consisted of a standardised face-to-face consultation on a web-based program using co-developed protocols, pharmacists' training, practice change facilitators and patients' educational material. Patients requesting a non-prescription medication (direct product request) or presenting minor ailments received MAS or UC and were followed-up by telephone 10-days after the consultation. The primary economic outcomes were incremental cost-utility ratio (ICUR) of the service and health related quality of life (HRQoL). Total costs included health system, CPs and patient direct costs: health professionals' consultation time, medication costs, pharmacists' training costs, investment of the pharmacy and consultation costs within the 10 days following the initial consultation. The HRQoL was obtained using the EuroQoL 5D-5L at the time of the consultation and at 10-days follow up. A sensitivity analysis was carried out using bootstrapping. There were two sub-group analyses undertaken, for symptom presentation and direct product requests, to evaluate possible differences. RESULTS A total of 808 patients (323 MAS and 485 UC) were recruited in 27 CPs with 42 pharmacists (20 MAS and 22 UC). 64.7% (n = 523) of patients responded to follow-up after their consultation in CP. MAS patients gained an additional 0.0003 QALYs (p = 0.053). When considering only MAS patients presenting with symptoms, the ICUR was 24,733€/QALY with a 47.4% probability of cost-effectiveness (willingness to pay of 25,000€/QALY). Although when considering patients presenting for a direct product request, MAS was the dominant strategy with a 93.69% probability of cost-effectiveness. CONCLUSIONS Expanding community pharmacists' scope through MAS may benefit health systems. To be fully cost effective, MAS should not only include consultations arising from symptom presentation but also include an oversight of self-selected products by patients. MAS increase patient safety through the appropriate use of non-prescription medication and through the direct referral of patients to GP. TRIAL REGISTRATION ISRCTN, ISRCTN17235323 . Registered 07/05/2021 - Retrospectively registered.
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Affiliation(s)
- Noelia Amador-Fernández
- Pharmaceutical Care Research Group, University of Granada, Campus de Cartuja, Granada, 18071, Spain.
| | - Shalom I Benrimoj
- Pharmaceutical Care Research Group, University of Granada, Campus de Cartuja, Granada, 18071, Spain
| | | | | | - Sarah Dineen-Griffin
- Health Services Management, School of Biomedical Sciences, Charles Sturt University, Bathurst, NSW, 2795, Australia
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Abstract
Objectives There is extensive literature from various disciplines on self-care, an important aspect of nursing intervention via evaluation and education, but its meaning remains unprecise due to the difficulty integrating the diverse definitions developed over time across disciplines. Therefore, it is vital to clarify the meaning of self-care and formulate the defining attributes, antecedents, and consequences to self-care. Methods Walker and Avant’s concept analysis approach was used to analyze the concept of self-care. A search of the literature was completed using the databases CINAHL, PubMed, and EBSCOhost for years 1975–2020; literature search included peer-review articles, full-text publications, and available in English. A total of 31 articles were reviewed, and saturation was reached. Results An extensive review of the literature revealed salient characteristics that reflected the most frequently used terms associated with the concept. Guided by Walker and Avant’s method, three defining attributes emerged as common themes: awareness, self-control, and self-reliance. Conclusions A clarified definition was identified: the ability to care for oneself through awareness, self-control, and self-reliance in order to achieve, maintain, or promote optimal health and well-being.
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Affiliation(s)
- Nicole Martínez
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, USA
| | - Cynthia D Connelly
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, USA
| | - Alexa Pérez
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, USA
| | - Patricia Calero
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, USA
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19
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Lamônica DAC, Giacheti CM, Dias Hayssi Haduo M, Dias Dos Santos MJ, da Silva NC, Pinato L. Sleep quality, functional skills, and communication in preschool-aged children with autism spectrum disorder. Res Dev Disabil 2021; 116:104024. [PMID: 34245976 DOI: 10.1016/j.ridd.2021.104024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 05/11/2021] [Accepted: 06/29/2021] [Indexed: 06/13/2023]
Abstract
AIM This study aimed to correlate sleep quality, the performance of functional skills (mobility, self-care, and social function), communication, independence, and severity of ASD in children with ASD. METHOD 58 children between 3 and 5 years and 11 months old were investigated. The Childhood Autism Rating Scale was applied to determine the severity of autism; the Sleep Disturbance Scale for Children was used to investigate sleep quality, and the Pediatric Evaluation of Disability Inventory to investigate functional abilities and independence of the children. RESULTS 68.9 % of the children showed indicative of sleep disorders. There was no correlation between the different sleep disorders and communication. Sleep disorders showed a negative correlation with functional performance and a positive correlation with ASD severity. INTERPRETATION The current study offers an exploration between sleep and functional skills in children with ASD. These findings provide important clinical implications in the diagnosis and intervention process of children with ASD and also stimulate reflections on the importance in minimize the impact of sleep disorders and functional abilities on the quality of life of these individuals and their families.
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Affiliation(s)
| | - Celia Maria Giacheti
- Department of Speech, Language and Hearing Sciences, São Paulo State University (UNESP), Marilia, SP, Brazil
| | - Michele Dias Hayssi Haduo
- Department of Speech, Language and Hearing Sciences, University of São Paulo, (USP), Bauru, SP, Brazil
| | | | - Nathani Cristina da Silva
- Department of Speech, Language and Hearing Sciences, São Paulo State University (UNESP), Marilia, SP, Brazil
| | - Luciana Pinato
- Department of Speech, Language and Hearing Sciences, São Paulo State University (UNESP), Marilia, SP, Brazil.
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20
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Slemon A, Jenkins EK, Bailey E. Enhancing conceptual clarity of self-care for nursing students: A scoping review. Nurse Educ Pract 2021; 55:103178. [PMID: 34428724 DOI: 10.1016/j.nepr.2021.103178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/22/2021] [Accepted: 08/04/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This paper aims to explore how self-care is currently defined and conceptualized in nursing education literature and identify gaps in current conceptualizations of self-care for nursing students. BACKGROUND Given the considerable stressors experienced by nursing students, self-care is an important concept for enhancing well-being. However, self-care has been poorly defined in the literature to date, contributing to challenges in integrating self-care into nursing education in support of student mental health and well-being. DESIGN A scoping review was undertaken in accordance with Arksey and O'Malley's (2005) framework and Levac et al.'s (2010) subsequent guidance. METHODS The search was conducted up to 1 September 2020 across three databases: Medline (OVID), PsycINFO and CINAHL. Search terms 'self-care', 'nursing students' and 'nursing education' were used. Criteria for inclusion of articles included peer-reviewed articles published in English that addressed self-care in the context of nursing education and/or nursing students and provided a definition of self-care. Two reviewers independently screened 1181 records by title and abstract, with a third reviewer resolving discrepancies. Subsequently, full-text review was completed for 119 articles. RESULTS Twenty-seven studies were included in the review, including 21 empirical articles and 6 non-empirical articles. Sixteen (59%) articles described an educational intervention, including self-care courses, assignments, or integration of self-care modalities as a classroom activity. Qualitative thematic analysis of article aims, and self-care definitions illustrated three central themes in the conceptualization of self-care: self-care as an aspect of holistic nursing; self-care as practices that ensure a healthy lifestyle; and self-care as activities undertaken in response to stress. CONCLUSIONS There is considerable variability in how self-care for nursing students is conceptualized, contributing to inconsistencies in the integration of this concept into nursing education. Nurse educators are encouraged to support students in identifying their own self-care strategies and engage in reflection and action toward shifting systemic contributors to stress and burnout among nursing students.
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Affiliation(s)
- Allie Slemon
- School of Nursing, University of British Columbia, T201-2211 Westbrook Mall, Vancouver, British Columbia V6T 2B5, Canada.
| | - Emily K Jenkins
- School of Nursing, University of British Columbia, T201-2211 Westbrook Mall, Vancouver, British Columbia V6T 2B5, Canada.
| | - Elisabeth Bailey
- School of Nursing, University of British Columbia, T201-2211 Westbrook Mall, Vancouver, British Columbia V6T 2B5, Canada.
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Stern J, Georgsson S, Carlsson T. Quality of web-based information at the beginning of a global pandemic: a cross-sectional infodemiology study investigating preventive measures and self care methods of the coronavirus disease 2019. BMC Public Health 2021; 21:1141. [PMID: 34126962 PMCID: PMC8201436 DOI: 10.1186/s12889-021-11141-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
Background reducing the spread and impact epidemics and pandemics requires that members of the general population change their behaviors according to the recommendations, restrictions and laws provided by leading authorities. When a new epidemic or pandemic emerges, people are faced with the challenge of sorting through a great volume of varied information. Therefore, the dissemination of high-quality web-based information is essential during this time period. The overarching aim was to investigate the quality of web-based information about preventive measures and self care methods at the beginning of the COVID-19 pandemic. Methods in May 2020, consumer-oriented websites written in Swedish were identified via systematic searches in Google (n = 76). Websites were assessed with inductive content analysis, the JAMA benchmarks, the QUEST tool and the DISCERN instrument. Results seven categories and 33 subcategories were identified concerning preventive measures (md = 6.0 subcategories), with few specifying a method for washing hands (n = 4), when to sanitize the hands (n = 4), and a method for sanitizing the hands (n = 1). Eight categories and 30 subcategories were identified concerning self care methods (md = 3.0 subcategories), with few referring to the national number for telephone-based counseling (n = 20) and an online symptom assessment tool (n = 16). Overall, the median total quality scores were low (JAMA = 0/4, QUEST =13/28, DISCERN = 29/80). Conclusions at the beginning of the pandemic, substantial quality deficits of websites about COVID-19 may have counteracted the public recommendations for preventive measures. This illustrates a critical need for standardized and systematic routines on how to achieve dissemination of high-quality web-based information when new epidemics and pandemics emerge. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11141-9.
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Affiliation(s)
- Jenny Stern
- Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, SE-75185, Uppsala, Sweden.,Sophiahemmet University, Stockholm, Sweden
| | - Susanne Georgsson
- The Swedish Red Cross University College, Huddinge, Sweden.,Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Solna, Sweden
| | - Tommy Carlsson
- Department of Women's and Children's Health, Uppsala University, Uppsala University Hospital, SE-75185, Uppsala, Sweden. .,The Swedish Red Cross University College, Huddinge, Sweden.
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Patel H, Szkinc-Olsson G, Lennartsson Al Liddawi M. A qualitative study of nurses' experiences of self-care counseling in migrant patients with heart failure. Int J Nurs Sci 2021; 8:279-288. [PMID: 34307776 PMCID: PMC8283704 DOI: 10.1016/j.ijnss.2021.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/14/2021] [Accepted: 05/19/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives This study aims to enhance researchers’ and nurses’ understanding of how to best support migrant patients with heart failure in self-care management. Previous research on self-care in heart failure patients has highlighted its importance, particularly among migrant populations. Nurses play an important role in informing and engaging patients with chronic conditions like heart failure to support their active participation in self-care. However, nurses’ experiences of providing self-care counseling to migrant populations with heart failure have not been studied. Methods A qualitative study was conducted. Nurses working with migrant patients with HF (n = 13) from different types of facility in Western Sweden were interviewed between October and December 2020. Data were collected using semi-structured interviews and analyzed using inductive thematic analysis. Results The main theme that emerged from the interviews was the difficulty for nurses “to find balance” in self-care counseling. The nurses during self-care counseling had: “to accept challenges,” “to use creative strategies,” faced “problems related to health literacy,” and “to work according to their (the nurses’) obligations.” It was evident that nurses faced several challenges in counseling migrants in self-care, including language and cultural barriers, time resource constraints, low levels of health literacy, and experienced disharmony between the law and their professional norms. They perceived building caring relationships with their patients to be crucial to fostering health-promoting self-care processes. Conclusions To increase self-care adherence, nurses must become more sensitive to cultural differences and adapt self-care counseling to patients’ health literacy. The findings of this research support and challenge nurses in providing the best counsel to migrant patients with heart failure living in Sweden’s multi-ethnic society. Policymakers in the health care organization should act to facilitate mutual cultural understanding between all involved partners for patient-safe self-care counseling.
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Affiliation(s)
- Harshida Patel
- Institute of Health Care and Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Grazyna Szkinc-Olsson
- Institute of Health Care & Sciences, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Sweden
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Bjertrup PJ, Mmema N, Dlamini V, Ciglenecki I, Mpala Q, Matse S, Kerschberger B, Wringe A. PrEP reminds me that I am the one to take responsibility of my life: a qualitative study exploring experiences of and attitudes towards pre-exposure prophylaxis use by women in Eswatini. BMC Public Health 2021; 21:727. [PMID: 33853575 PMCID: PMC8048211 DOI: 10.1186/s12889-021-10766-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/30/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Pre-exposure-prophylaxis (PrEP) has been heralded for its potential to put women in control of preventing HIV infection, but uptake and continuation rates have been disappointing in high-incidence settings in sub-Saharan Africa. We explored structural and social factors that influenced PrEP use among young women and pregnant or breastfeeding women in rural Eswatini. METHODS We conducted two in-depth interviews with ten women on PrEP, and one-time in-depth interviews with fourteen women who declined or discontinued PrEP. Interviews covered decision-making processes around PrEP initiation and experiences with pill-taking. In-depth interviews were conducted with nine health workers, covering experiences in delivering PrEP services, and two focus group discussions were held with men to elicit their perceptions of PrEP. Interviews and discussions were audio-recorded, translated, transcribed and analysed thematically, using an inductive approach. RESULTS PrEP initiation and use were experienced by many women as empowering them to take control of their health and well-being, and stay HIV free, facilitating them to realise their aspirations relating to motherhood and educational attainment. However, the social norms that defined relationship dynamics with partners or family members either undermined or promoted this empowerment potential. In particular, young women were rarely supported by family members to take PrEP unless it was perceived to be for protecting an unborn child. Stigmatisation of pill-taking through its associations with HIV and the burden of daily pill-taking also contributed to PrEP discontinuation. CONCLUSIONS Unlike many prevention tools, PrEP enabled women to achieve a sense of control over their lives. Nevertheless, women's agency to continue and adhere to PrEP was influenced by social and structural factors including gender norms, family expectations of young women, relationship dynamics and stigma related to HIV. Future interventions should address these barriers to promote PrEP use among sexually-active women.
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Affiliation(s)
- Pia Juul Bjertrup
- Médecins Sans Frontières, Mbabane, Eswatini
- Department of Anthropology, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen, Denmark
| | | | | | | | | | - Sindy Matse
- Eswatini National AIDS Programme, Ministry of Health, Mbabane, Eswatini
| | | | - Alison Wringe
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
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Huesken A, Hoffmann R, Ayed S. Persistent effect of nurse-led education on self-care behavior and disease knowledge in heart failure patients. Int J Nurs Sci 2021; 8:161-167. [PMID: 33997129 PMCID: PMC8105549 DOI: 10.1016/j.ijnss.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 01/23/2021] [Accepted: 03/04/2021] [Indexed: 11/08/2022] Open
Abstract
Purpose The guidelines on the management of patients with heart failure support intensive patient education on self-care. The present study aimed to evaluate the short-term and long-term impacts of a structured education provided by a qualified heart failure nurse on patients’ self-care behavior and disease knowledge. Methods One hundred fifty patients (66 ± 12 years) hospitalized for heart failure participated in a structured one-hour educational session by a heart failure nurse. Patients completed a questionnaire comprising 15 questions (nine questions from the European Heart Failure Self-Care Behavior Scale [EHFScB-9] and six on the patients’ disease knowledge) one day before and one day and six months after the educational session. Possible responses for each question ranged from 1 (complete agreement) to 5 (complete disagreement). Results After the educational session, the total EHFScB-9 score improved from 24.31 ± 6.98 to 14.94 ± 6.22, and the disease knowledge score improved from 18.03 ± 5.44 to 10.74 ± 4.30 (both P < 0.001). Scores for individual questions ranged from 1.26 ± 0.81 (adherence to the medication protocol) to 3.66 ± 1.58 (everyday weighing habits) before the education. The greatest improvement after education was observed on response to weight gain (−2.00±1.57), daily weight control (−1.77 ± 1.64), and knowledge on the cause of patients’ heart failure (−1.53 ± 1.43). At 6-month follow-up, EHFScB-9 score was 17.33 ± 7.23 and knowledge score was 12.34 ± 5.30 (both P < 0.001 compared with baseline). No factor was predictive of an insufficient teaching effect. Conclusions The educational program led by a qualified nurse improves patients’ self-care behavior and disease knowledge with a persistent effect at 6-month follow-up. There are no patient characteristics which preclude the implementation of an educational session.
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Affiliation(s)
- Astrid Huesken
- Department of Cardiology, Angiology and Sleep Medicine, Bonifatius Hospital Lingen, Lingen, Germany
| | - Rainer Hoffmann
- Department of Cardiology, Angiology and Sleep Medicine, Bonifatius Hospital Lingen, Lingen, Germany
| | - Sofien Ayed
- Department of Cardiology, Angiology and Sleep Medicine, Bonifatius Hospital Lingen, Lingen, Germany
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Narasimhan M, Logie CH, Moody K, Hopkins J, Montoya O, Hardon A. The role of self-care interventions on men's health-seeking behaviours to advance their sexual and reproductive health and rights. Health Res Policy Syst 2021; 19:23. [PMID: 33596921 PMCID: PMC7888093 DOI: 10.1186/s12961-020-00655-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/02/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Self-care interventions are influencing people's access to, expectation and understanding of healthcare beyond formal health delivery systems. In doing so, self-care interventions could potentially improve health-seeking behaviours. While many men proactively engage in maintaining and promoting their health, the focus on men's health comes from the recognition, at least partially, that male socialization and social norms can induce men and boys to have a lower engagement in institutionalized public health entities and systems around their sexual and reproductive health and rights, that could impact negatively on themselves, their partners and children. MAIN TEXT A research agenda could consider the ways that public health messaging and information on self care practices for sexual and reproductive health and rights could be tailored to reflect men's lived realities and experiences. Three examples of evidence-based self-care interventions related to sexual and reproductive health and rights that men can, and many do, engage in are briefly discussed: condom use, HIV self-testing and use of telemedicine and digital platforms for sexual health. We apply four core elements that contribute to health, including men's health (people-centred approaches, quality health systems, a safe and supportive enabling environment, and behaviour-change communication) to each intervention where further research can inform normative guidance. CONCLUSION Engaging men and boys and facilitating their participation in self care can be an important policy intervention to advance global sexual and reproductive health and rights goals. The longstanding model of men neglecting or even sabotaging their wellbeing needs to be replaced by healthier lifestyles, which requires understanding how factors related to social support, social norms, power, academic performance or employability conditions, among others, influence men's engagement with health services and with their own self care practices.
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Affiliation(s)
- Manjulaa Narasimhan
- Department of Sexual and Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Switzerland.
| | - Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, ON, M5S 1V4, Canada
| | | | | | - Oswaldo Montoya
- MenEngage Alliance Global Secretariat, 1875 Connecticut Avenue. Floor 10, Washington, D.C., 20009, United States of America
| | - Anita Hardon
- Institute for Advanced Studies and Anthropology Department, University of Amsterdam, Nieuwe Achtergracht 166, 1018 WV, Amsterdam, The Netherlands
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Chan EY, Glass GF Jr, Cheong RQ, Chin GF, Chng DYJ. Patient Activation and its Predictors in Hospitalized Older Adults in Singapore. Geriatr Nurs 2021; 42:336-43. [PMID: 33556900 DOI: 10.1016/j.gerinurse.2021.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 01/16/2021] [Accepted: 01/19/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Patient activation is critical in hospitalized older adults preparing for discharge as it enhances their ability to self-care at home. Little is known about how person-centred care and demographic predictors could influence activation in Asian patients. AIMS To explore patient activation and its predictors in hospitalized older adults in Singapore. METHODS Multi-centre cross-sectional survey of hospitalized older adults. Multivariable analysis conducted with age, gender, education, socioeconomic status, functional dependency and perception of person-centred care as potential predictors to patient activation. RESULTS 300 older adults were surveyed, 65% were at the top two levels of activation. Perception of person-centred nursing care was the strongest predictor with the largest effect on patient activation, (β=0.22, b=3.48, 95% CI:1.70-5.26, p<0.001). Other predictors were age, education, income and independence in care. CONCLUSION Our study highlights the importance of person-centred nursing care in raising patient activation in hospitalized older adults, enhancing their capacity to self-care.
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Chipu M, Downing C. Professional nurses' facilitation of self-care in intensive care units: A concept analysis. Int J Nurs Sci 2020; 7:446-452. [PMID: 32837771 PMCID: PMC7434369 DOI: 10.1016/j.ijnss.2020.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 06/23/2020] [Accepted: 08/17/2020] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE This article aims to provide an in-depth analysis of the concept of self-care in the intensive care unit and outline its defining attributes, antecedents, consequences and empirical referents. METHODS The literature was searched electronically using databases such as CINAHL, Medline, Psych INFO, ERIC, ScienceDirect, Amed, EBSCO (Health Source: Nursing and Academic Edition), Sage, Ujoogle and Google Scholar. Articles from 2013 to 2020 were searched to target recent and up-to-date information about the definitions, attributes, antecedents and consequences of the concept of self-care. Walker and Avant's framework was utilised to analyse the concept of self-care. RESULTS The results of the concept analysis identified seven attributes, namely process, activity, capability, autonomous choice, education, self-control and interaction. The seven identified antecedents are self-motivation, participation, commitment, resources, religious and cultural beliefs, social, spiritual and professional support, and the availability of time. The consequences are the maintenance of health and wellbeing, autonomy, increased self-esteem, disease prevention, empowerment, increased social support and the ability to cope with stress. CONCLUSIONS The result of the concept analysis was used to describe a model to facilitate professional nurses' self-care in the intensive care unit.
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Affiliation(s)
- Mpho Chipu
- Department of Nursing, Faculty of Health Sciences, University of Johannesburg, Doornfontein Campus, Johannesburg, South Africa
| | - Charlene Downing
- Department of Nursing, Faculty of Health Sciences, University of Johannesburg, Doornfontein Campus, Johannesburg, South Africa
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Bodine AJ, Heinemann AW, Carpenter J, Taylor SM, Hansen P, Lieber RL, Sliwa J. Development of a Multidimensional, Multigroup Measure of Self-Care for Inpatient Rehabilitation. Arch Phys Med Rehabil 2020; 102:97-105. [PMID: 33035514 DOI: 10.1016/j.apmr.2020.08.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 08/06/2020] [Accepted: 08/22/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To develop and evaluate a measure of clinician-observed and patient-performed self-care function for use during inpatient rehabilitation. DESIGN Retrospective analysis of self-care assessments collected by therapists using confirmatory factor analysis (CFA) followed by multidimensional item response theory (MIRT). SETTING Freestanding inpatient rehabilitation hospital in the Midwestern United States. PARTICIPANTS Inpatients (N=7719) with stroke, traumatic brain injury, spinal cord injury, neurologic disorders, and musculoskeletal conditions. INTERVENTIONS Not applicable MAIN OUTCOME MEASURES: A total of 19 clinician-selected self-care measures including the FIM and patient-performed, clinician-rated measures of balance, upper extremity function, strength, changing body position, and swallowing. Clinicians completed assessments on admission and at least 1 interim assessment. RESULTS CFA was completed for 3 patient groups defined by their highest level of balance (sitting, standing, walking). We reduced the number of items by 47.5% while maintaining acceptable internal consistency; unidimensionality within each item set required development of testlets. A recursive analysis defined a self-care measure with sensitivity (Cohen dmax-min =1.13; Cohen dlast-first.=0.91) greater than the FIM self-care items (dmax-min.=0.94; dlast-first .=0.83). The CFA models provided good to acceptable fit (root mean square error of approximations 0.03-0.06). Most patients with admission FIM self-care ratings of total assistance (88%, 297 of 338) made improvements on the MIRT self-care measure that were undetected by the FIM; the FIM detected no change for 26% of these patients (78 of 297). The remaining 74% (219 of 297) improved on the MIRT-based measure an average of 14 days earlier than was detected by the FIM. CONCLUSIONS This MIRT self-care measure possesses measurement properties that are superior to the FIM, particularly for patients near its floor or ceiling. Methods assure accommodation for multidimensionality and high levels of sensitivity. This self-care measure has the potential to improve monitoring of self-care and manage therapy effectively during inpatient rehabilitation.
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Affiliation(s)
- Andrew J Bodine
- Shirley Ryan AbilityLab, Outcomes Management: Systems & Analytics, Chicago, Illinois.
| | - Allen W Heinemann
- Shirley Ryan AbilityLab, Center for Rehabilitation Outcomes Research, Chicago, Illinois; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | - Sally M Taylor
- Shirley Ryan AbilityLab, Chicago, Illinois; Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Piper Hansen
- Staff Development, Shirley Ryan AbilityLab, Chicago, Illinois
| | - Richard L Lieber
- Shirley Ryan AbilityLab, Chicago, Illinois; Physiology and Biomedical Engineering, Northwestern University, Chicago, Illinois
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Henderson R, Hagen MG, Zaidi Z, Dunder V, Maska E, Nagoshi Y. Self-care perspective taking and empathy in a studentfaculty book club in the United States. J Educ Eval Health Prof 2020; 17:22. [PMID: 32741159 PMCID: PMC7577880 DOI: 10.3352/jeehp.2020.17.22] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 07/31/2020] [Indexed: 05/24/2023]
Abstract
PURPOSE We aimed to study the impact of a combined faculty-student book club on education and medical practice as a part of the informal curriculum at the University of Florida College of Medicine in the United States. METHODS Sixteen medical students and 7 faculties who participated in the book club were interviewed through phone and recorded. The interview was then transcribed and entered into the qualitative data analysis program QSR NVivo (QSR International, Burlington, MA, USA). The transcripts were reviewed, and thematic codes were developed inductively through collaborative iteration. Based on these preliminary codes, a coding dictionary was developed and applied to all interviews within QSR Nvivo to identify themes. RESULTS Four main themes were identified from interviews: The first theme, the importance of literature to the development and maintenance of empathy and perspective-taking, and the second theme, the importance of the book club in promoting mentorship, personal relationships and professional development, were important to both student and faculty participants. The third and fourth themes, the need for the book club as a tool for self-care and the book club serving as a reminder about the world outside of school were discussed by student book club members. CONCLUSION Our study demonstrated that an informal book club has a significant positive impact on self-care, perspective-taking, empathy, and developing a “world outside of school” for medical school students and faculty in the United States. It also helps to foster meaningful relationships between students and faculty.
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Affiliation(s)
| | - Melanie Gross Hagen
- Division of General Internal Medicine, Department of Medicine, University of Florida College of Medicine, Gainesville, FL, USA
| | - Zareen Zaidi
- Division of General Internal Medicine, Department of Medicine, University of Florida College of Medicine, Gainesville, FL, USA
| | | | - Edlira Maska
- Division of General Internal Medicine, Department of Medicine, University of Florida College of Medicine, Gainesville, FL, USA
| | - Ying Nagoshi
- Division of General Internal Medicine, Department of Medicine, University of Florida College of Medicine, Gainesville, FL, USA
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Opare FY, Aniteye P, Afaya A, Glover-Meni N. "We try our best to offer them the little that we can" coping strategies of Ghanaian community psychiatric nurses: a qualitative descriptive study. BMC Nurs 2020; 19:56. [PMID: 32587474 PMCID: PMC7310546 DOI: 10.1186/s12912-020-00449-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 06/12/2020] [Indexed: 11/10/2022] Open
Abstract
Introduction Community psychiatric nurses work in extremely stressful environments with intense patient relationships as they try to prevent self-harm and manage aggressive behaviors. In order to improve their ability to manage the stressful work environments, community psychiatric nurses need to incorporate formal coping strategies into their daily work routines. With evidence-based coping strategies, community psychiatric nurses can effectively manage the stressful situations in their work environment to increase their work longevity. The purpose of this study was to explore the individual coping strategies currently used by community psychiatric nurses in practice in order to develop an intervention strategy for future implementation. Methods This was an exploratory qualitative study using an interpretative approach. A purposive sampling method was used to identify participants from the community psychiatric nurses in a region of Ghana. Participants were recruited and interviewed, guided by semi-structured questions, until saturation was reached. The interviews were audio-taped, transcribed verbatim, and analyzed thematically. Results A total of 13 participants, 10 women and 3 men ages 26 to 60 years, were interviewed for this study. From the inductive analysis, four coping themes emerged from the data including: 1) self-disguise, 2) reliance on religious faith, 3) self-motivation, and 4) reduction in the number of home visits. The participants described their work environment as stressful, almost to the point of overwhelming. In this regard, they identified the individual coping strategies as critical daily practices for self care to manage their high stress levels. Conclusion Individual coping strategies are often used by community psychiatric nurses in daily practice. The participants identified personal coping strategies as critical interventions to manage stress and to decrease their risk for burnout. However, community psychiatric nurses must develop.personal-mastery in various coping strategies to care for themselves, as well as motivate them despite the challenging working environment. The individual coping strategies adopted by community psychiatric nurses was not only helped them deliver care, but also protected their clients so people would not label them as 'mental patients.' Collectively, the four strategies reported in this study need to be developed into a cohesive and comprehensive intervention.
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Affiliation(s)
- Frederick Yaw Opare
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Patience Aniteye
- Department of Community Health Nursing, School of Nursing and Midwifery, University of Ghana, Legon, Ghana
| | - Agani Afaya
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Nathaniel Glover-Meni
- Department of General and Liberal Studies, University of Health and Allied Sciences, Ho, Ghana
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Costa Pessoa NR, de Souza Soares Lima LH, Dos Santos GA, de Queiroz Frazão CMF, Sousa CN, Ramos VP. Self-care actions for the maintenance of the arteriovenous fistula: An integrative review. Int J Nurs Sci 2020; 7:369-377. [PMID: 32817861 PMCID: PMC7424158 DOI: 10.1016/j.ijnss.2020.06.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 06/02/2020] [Accepted: 06/11/2020] [Indexed: 11/28/2022] Open
Abstract
Objective To identify self-care actions for the maintenance of arteriovenous fistula of renal patients. Method An integrative review study was conducted and literature were searched in Medline/PubMed, Scopus, CINAHL, LILACS, BDENF and SciELO Library databases using the descriptors chronic renal insufficiency, arteriovenous fistula, self-care, and knowledge. The inclusion criteria were that the documents be written in Portuguese, English, and Spanish, full text available, published in the last five years, and that they address the research question. Reflection articles, theses, dissertations, editorials of non-scientific journals, and research studies that did not follow the necessary methodological rigor were excluded. Data were analyzed with the IRAMUTEQ software. Results Fifteen articles were selected and comprised the final sample. Seven classes of self-care actions emerged from the text segments analysis and grouped into three categories: 1) Self-care actions that maintain the arteriovenous fistula; 2) Self-care actions for the prevention and the monitoring of complications with arteriovenous fistula; 3) Self-care actions directed at the perioperative period of arteriovenous fistula preparation. Conclusion The results allowed us to identify important care for the maintenance of arteriovenous fistula functionality. The self-care actions identified in this study can guide a nursing care policy for implementation with protocols that help identify problems related to self-care actions and, thus, subsidize the development of actions aimed at the renal patient. However, more studies with high levels of evidence that identify self-care actions with arteriovenous fistula and the factors involved in its implementation are needed.
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Affiliation(s)
| | | | | | | | - Clemente Neves Sousa
- Center for Health Technology and Services Research, Faculty of Medicine (CINTESIS), Porto University, Nursing School of Porto, Portugal
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Abstract
AIMS AND OBJECTIVES the purpose of this pilot study was to explore the attitudes and perceptions of members of the UK public towards self-care for minor ailments. BACKGROUND with an ageing and increasing population, and an NHS under extreme pressure, methods to reduce demand on health services are vital. Increasing the use of self-care for minor ailments is one way in which this pressure could be alleviated. DESIGN AND METHOD this study used qualitative methods including semi-structured telephone interviews. The data were then evaluated, and key themes drawn out using thematic analysis. FINDINGS the results showed that the public are aware of the notion of self-care, and some are engaging with it. However, for a number of reasons, patients are still likely to want a face-to-face appointment despite the use of online and telephone advice services. CONCLUSION the study highlighted that there are multifactorial aspects impacting on a patient's likelihood of engaging in self-care when faced with a minor illness. The results are not generalisable to every member of the public, but interesting questions are raised with regard to the usefulness of current public health messages in various media when there appears to be a lack of desire from the public to use some recommended services.
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Affiliation(s)
- Ashley Scott
- Lecturer in Adult Nursing, University of Salford
| | - Colin Jones
- Senior Lecturer/Researcher, School of Nursing and Allied Health, Liverpool John Moores University, Liverpool
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Peyman N, Shahedi F, Abdollahi M, Doosti H, Zadehahmad Z. Impact of Self-Efficacy Strategies Education on Self-Care Behaviors among Heart Failure Patients. J Tehran Heart Cent 2020; 15:6-11. [PMID: 32742286 PMCID: PMC7360864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: Self-efficacy in self-care behaviors is an effective framework for measuring patients' degree of ability to perform self-care behaviors that significantly affect their recovery process and quality of life. This study was designed to investigate the effects of education based on self-efficacy strategies on self-care behaviors in heart failure patients. Methods: A semi-experimental study was conducted on 80 heart failure patients divided into 2 equal groups of test and control. The intervention group received three 60-minute practical and theoretical training sessions based on self-care and self-efficacy strategies, while the control group received the usual care services. Self-care behaviors and self-efficacy were evaluated before training, shortly after training, and 3 months after the training program using the Sullivan self-efficacy questionnaire for heart failure patients and the European self-care behaviors questionnaires. Results: The mean age of the patients was 55.00±8.48 and 51.61±8.51 years in the intervention and control groups, respectively. Women comprised 73.7% (n=59) of the study population. The mean score for the self-care and self-efficacy questionnaires in the experimental group was 23.50±6.58 and 18.57±6.64, correspondingly, before the intervention, which increased to 42.64±6.74 (P<0.014) and 32.29±7.06 (P<0.001), respectively, shortly after the intervention. A significant improvement also occurred at 3 months' follow-up (P<0.001). Self-care behaviors also revealed a positive correlation with self-efficacy shortly after the intervention (r=0.82, P<0.001) and 3 months after the intervention (r=0.85, P<0.001). Conclusion: The implementation of educational interventions based on self-efficacy strategies could have positive effects on health-promoting behaviors among heart failure patients.
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Affiliation(s)
- Nooshin Peyman
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Fateme Shahedi
- Department of Radiology, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
| | - Mahbubeh Abdollahi
- Department of Public Health, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,Health Science Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Hassan Doosti
- Health Science Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Zohre Zadehahmad
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,Department of Public Health, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,Corresponding Author: Zohre Zadehahmad, Senior Lecturer in Public Health, Department of Public Health, School of Health, Torbat Heydariyeh University of Medical Sciences, Ferdosi Blvd., Torbat Heydariyeh, Iran. 9519633787. Tel: +98 95 2226013. Fax: +98 95 19633787. E-mail: .
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Javan L, Kazemnejad A, Nomali M, Zakerimoghadam M. Effect of Self-Management Program on Self-efficacy and Medication Adherence in Patients with Mechanical Heart Valve: a Randomized Clinical Trial. J Caring Sci 2019; 8:207-211. [PMID: 31915622 PMCID: PMC6942652 DOI: 10.15171/jcs.2019.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 10/22/2018] [Indexed: 11/28/2022] Open
Abstract
Introduction: Patients with mechanical heart valve need anticoagulant therapy to prevent thrombotic events. The treatment interacts with some foods and drugs. The aim was to evaluate the effect of self- management program on self-efficacy and medication adherence in patients with mechanical heart valve. Methods: This was a randomized controlled trial. eighty eligible patients, with the ability to read and speak in Farsi, aged between 15 to 60, were included in the study from the cardiac surgery clinic in Imam Khomeini hospital affiliated to Tehran University of Medical Sciences (Tehran, Iran) and randomly allocated to intervention and control groups. The participants had no history of psychiatric disorders, had undergone valve replacement surgery at least one year before the study, and were being treated with Warfarin. The intervention was a combination of 2 one- hour self-management education via small groups with 3 to 5 members, self-management educational booklets, and weekly call follow- ups for 8 weeks about 10- 15 minutes. The control group received no intervention. Self- efficacy was the primary outcome and medication adherence, Prothrombin Time (PT), and International Normalized Ratio (INR) were secondary outcomes. Data were analyzed using spss13. Results: Although the mean of self-efficacy and medication adherence, PT, and INR values were not different between the two groups at baseline, they improved significantly following the program. Conclusion: Self-management program had a positive effect on self-efficacy and medication adherence of patients with mechanical heart valve.
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Affiliation(s)
- Leila Javan
- Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Anoshirvan Kazemnejad
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mahin Nomali
- Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Zakerimoghadam
- Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Abstract
This study aimed to determine the effects of daily living activities and self-care capacity on depression of the elderly in northern Turkey. The study was conducted with participation of 451 voluntary elderly individuals. Data were collected via a questionnaire, Geriatric Depression Scale, Exercise of Self-care Agency Scale, Daily Activities Index, and Instrumental Activities of Daily Living Index. The mean Exercise of Self-care Agency Scale score and Geriatric Depression Scale score was 91.44±16.32 and 11.87±5.01, respectively. Negative and highly statistically significant correlations (p=0.000) were found between depression scores and self-care capacity scores (r=-0.470), daily activities scores (r=-0.351), and Instrumental Activity of Daily Life scores (r=-0.270). Study results showed that depression scores of the elderly increased as their daily life activities and self-care capacity scores decreased.
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Affiliation(s)
| | - Zeynep Sağlam
- Ondokuz Mayis University Health Science Faculty, Kurupelit, Samsun, Turkey
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Carlson B, Austel Nadeau C, Glaser D, Fields W. Evaluation of the effectiveness of the healthy heart tracker on heart failure self-care. Patient Educ Couns 2019; 102:1324-1330. [PMID: 30777614 DOI: 10.1016/j.pec.2019.02.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 01/17/2019] [Accepted: 02/09/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE We evaluated the effectiveness of a newly designed patient education booklet, the Health Heart Tracker (HHT), in promoting Heart Failure Self-Care (HFSC) behaviors compared to usual patient discharge handouts. METHODS We conducted a quasi-experimental, comparative two-group study using patients admitted for HF to four intermediate care units. The HHT was instituted on two units; patients on the other units served as control. We analyzed HFSC measured prior to HF discharge education and at two and six weeks post discharge using repeated measures ANOVA. RESULTS Eighty-four 84 patients completed the study. The sample was 72.6 (+ 12.9) years old, white (75%), educated, and retired (85.8%). All HFSC behaviors improved significantly over time, but there were no significant time by group interactions in HFSC maintenance, symptom perception, and confidence. A notable increase in HFSC management in the HHT group between baseline and 2 weeks was evident, but not sustained to 6 weeks. CONCLUSIONS A focused, singular intervention in the form of a patient education booklet designed specifically to improve HFSC did not significantly improve self-care behaviors over time compared to a control group. PRACTICE IMPLICATIONS More work is needed to determine optimal written resources for patients with HF.
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Affiliation(s)
- Beverly Carlson
- San Diego State University, School of Nursing, 5500 Campanile Dr., San Diego, CA, 92182, United States.
| | - Colleen Austel Nadeau
- Sharp Grossmont Hospital, 5555 Grossmont Center Drive, La Mesa, CA, 91942, United States.
| | - Dale Glaser
- Glaser Consulting, 3115 4th Avenue San Diego, CA, 92103, United States.
| | - Willa Fields
- San Diego State University, Sharp Grossmont Hospital, 5500 Campanile Dr., San Diego, CA, 92182, United States.
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Nateqi J, Lin S, Krobath H, Gruarin S, Lutz T, Dvorak T, Gruschina A, Ortner R. [From symptom to diagnosis-symptom checkers re-evaluated : Are symptom checkers finally sufficient and accurate to use? An update from the ENT perspective]. HNO 2019; 67:334-342. [PMID: 30993374 DOI: 10.1007/s00106-019-0666-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Every seventh diagnosis is a misdiagnosis. Each year, 1.5 million lives could be saved worldwide with the correct diagnosis. Physicians have to consider over 20,000 diseases. A study from Harvard University published in 2015 tested 19 symptom checkers and found them to be insufficient, with only 29-71% accuracy in diagnosis. OBJECTIVE The current study investigates the diagnostic accuracy of new symptom checkers from an ENT perspective. MATERIALS AND METHODS The authors update the abovenamed diagnostic accuracy comparison by (1) including the five new symptom checkers Symptoma, Ada, FindZebra, Mediktor, and Babylon; and (2) normalizing results of the previously tested symptom checkers as to reflect each diagnostic accuracy based on the same set of patient vignettes. The winner is then compared to the two symptom checkers with the most scientific evidence, namely Isabel and FindZebra, on the basis of an ENT-specific test with patient vignettes sourced from the British Medical Journal. RESULTS Most of the new symptom checkers demonstrated diagnostic accuracy rates within the previously established range, with the exception of Symptoma, which scored the right diagnosis in 82.2% of cases at the top of the list (+38% points), and in 100% of cases in the top 3 (+29% points) and the top 10 (+16% points), thus raising the bar in this field. The cross-validation with ENT cases resulted in a diagnostic accuracy of 64.3 vs. 21.4 vs. 26.2% (top 1), 92.9 vs. 40.5 vs. 42.9% (top 3), and 100 vs. 61.9 vs. 54.8% (top 10) for Symptoma vs. Isabel vs. FindZebra, respectively. CONCLUSIONS Symptoma is the first and only viable solution in this market. Large-scale studies should be conducted to further validate these results as well as to assess the actual practical performance of the symptom checkers and their ability to diagnose rare diseases.
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Affiliation(s)
- J Nateqi
- Symptoma GmbH, Neuhofen 5, 4864, Attersee am Attersee, Österreich.
| | - S Lin
- Symptoma GmbH, Neuhofen 5, 4864, Attersee am Attersee, Österreich
| | - H Krobath
- Symptoma GmbH, Neuhofen 5, 4864, Attersee am Attersee, Österreich
| | - S Gruarin
- Symptoma GmbH, Neuhofen 5, 4864, Attersee am Attersee, Österreich
| | - T Lutz
- Symptoma GmbH, Neuhofen 5, 4864, Attersee am Attersee, Österreich
| | - T Dvorak
- Symptoma GmbH, Neuhofen 5, 4864, Attersee am Attersee, Österreich
| | - A Gruschina
- Symptoma GmbH, Neuhofen 5, 4864, Attersee am Attersee, Österreich
| | - R Ortner
- Symptoma GmbH, Neuhofen 5, 4864, Attersee am Attersee, Österreich
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Lovell J, Pham T, Noaman SQ, Davis MC, Johnson M, Ibrahim JE. Self-management of heart failure in dementia and cognitive impairment: a systematic review. BMC Cardiovasc Disord 2019; 19:99. [PMID: 31035921 PMCID: PMC6489234 DOI: 10.1186/s12872-019-1077-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 04/11/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The cornerstone of effective management in heart failure (HF) is the ability to self-care. Aims include i) To determine factors influencing self-care in HF patients with cognitive impairment (CI) and ii) to determine the influence of cognitive domains on self-care in patients with HF and CI. METHODS MEDLINE, CINAHL, EMBASE, EBSCOHost, PsychINFO, ProQuest Research Library, Health Technology Assessment Database, The Cochrane Library, Web of Science and Scopus databases were systematically searched. Original research describing the relationship between cognition and HF self-care in community-dwelling older persons with dementia/CI in English, published in a peer-reviewed journal from 1stJanuary(2000)-22ndMarch(2016) was identified. Study and population characteristics, data sources, self-care processes, methods of cognitive assessment, cognitive domains affected, study outcomes, impact of impairment, and other risk factors of self-care impairment were abstracted by two reviewers. RESULTS Of 10,688 studies identified, 14 met the inclusion criteria. Patients with HF and CI ranged from 14 to 73%. Where reported, self-care maintenance adequacy ranged from 50 to 61%; self-care management adequacy ranged from 14 to 36% and self-care confidence adequacy ranged from 0 to 44% on the Self-care of Heart Failure Index (SCHFI). All but one study predicted poor self-care ability according to poor outcome on cognitive testing. Additionally, specific cognitive domain deficits impaired self-care. Subjects with lower cognitive scores were less likely to seek assistance while subjects with depression had poor self-care abilities. CONCLUSIONS Clinicians must consider the type and severity of impairments in cognitive domains to tailor management. Awareness of depression, self-confidence and support access may modulate self-care ability.
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Affiliation(s)
- Janaka Lovell
- Department of Forensic Medicine, Monash University, 65 Kavanagh Street, Southbank, Victoria, 3006, Australia.
| | - Tony Pham
- Department of Forensic Medicine, Monash University, 65 Kavanagh Street, Southbank, Victoria, 3006, Australia
| | - Samer Q Noaman
- Department of Cardiology, Alfred Health, Victoria, 3004, Australia
| | | | - Marilyn Johnson
- Institute of Transport Studies, Monash University, Victoria, 3800, Australia
| | - Joseph E Ibrahim
- Department of Forensic Medicine, Monash University, 65 Kavanagh Street, Southbank, Victoria, 3006, Australia
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Ramos Costa Pessoa N, Nunes Lira M, Monteiro Pereira Maciel AC, Oliveira de Mendonça AE, Queiroz Frazão CMF, Pinheiro Ramos V. Construction and validation of content of a video on self-care with arteriovenous fistula. Enferm Clin (Engl Ed) 2020; 30:317-25. [PMID: 30954393 DOI: 10.1016/j.enfcli.2018.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Accepted: 12/05/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To validate the content of the script of an educational video to promote self-care with arteriovenous fistula in chronic renal patients with nurses and social communicators. METHOD Methodological study that constructed and validated an educational video. Firstly, the demands of self-care were identified through a literature review on self-care with arteriovenous fistula. Then the construction of the video followed the steps of pre-production, production and post-production. The script's content validation occurred in the pre-production phase and counted on 22 nursing judges and media professionals. The study was approved by the Ethics Committee in Research, under opinion 61705516.0.0000.5208. RESULTS The following items received a negative evaluation from the judges: "The scenes described reflect stereotypes or discrimination" (p = 0.008) and "The pace of the scenes is tiring" (p = 0.001/p = 0.034), "The characters/images are appealing to the audience (p = 0.006), "The illustrations reflect important aspects of subject under study" (p = 0.006), "The illustrations promote the understanding of the video message" (p = 0.001) and "The general structure is creative" (p = 0.001). CONCLUSION The educational video was considered valid by the nursing judges and media professionals to promote self-care with arteriovenous fistula among renal patients.
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Juárez-Vela R, Sarabia-Cobo CM, Antón-Solanas I, Vellone E, Durante A, Gea-Caballero V, Pérez-Calvo JI. Investigating self-care in a sample of patients with decompensated heart failure: A cross-sectional study. Rev Clin Esp 2019; 219:351-359. [PMID: 30850119 DOI: 10.1016/j.rce.2018.12.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 11/30/2018] [Accepted: 12/04/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND There is scarce evidence relating to self-care of heart failure (HF) in Spain. In particular, there is a need to establish patients' level of understanding of HF, as well as their ability to recognise signs and symptoms of decompensation. PATIENTS AND METHODS Cross-sectional study to determine the level of self-care in a population of Spanish patients admitted to hospital with a primary diagnosis of decompensated HF. A convenience sample of 108 patients (50 women and 58 men) aged 83±8 were recruited to participate in this study. RESULTS The Self-Care of Heart Failure Index version 6.2 was used to quantify self-care in our sample. Mean and standard deviation from the Self-Care of Heart Failure Index self-care maintenance subscale were: a) "exercise for 30 minutes", 1±1; b) "forget to take one of your medicines", 2±2; c) "ask for low-salt items when eating out or visiting others", 2±1. A percentage of 67.6 had experienced shortness of breath or ankle swelling in the past month. However, the vast majority of our patients were unlikely to independently implement a remedy: a) reduce salt, 2±1; b) reduce fluid intake, 1±1; c) take an extra diuretic, 1±1. Over 50% of our sample felt confident or very confident at following professional advice (3±1), keeping themselves free of symptoms (3±1), recognizing changes in their condition (3±1) and evaluating the significance of such changes (3±1). CONCLUSIONS HF patients have a significantly low level of self-care when compared with HF patients from other countries, especially when it comes to managing their condition. Self-care promotion should be a priority for all healthcare professionals involved in the care and management of HF patients.
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Affiliation(s)
- R Juárez-Vela
- Grupo de Investigación en Insuficiencia Cardiaca e Insuficiencia Fisiopatológica de la Interacción Cardiorrenal (IFICaR), Escuela de Enfermería, Instituto de Investigación Sanitaria de Aragón-ISS, Universidad de La Rioja, Logroño, La Rioja, España
| | - C M Sarabia-Cobo
- Facultad de Enfermería, Universidad de Cantabria, Santander, España
| | - I Antón-Solanas
- Facultad de Ciencias de la Salud, Universidad San Jorge, Zaragoza, España
| | - E Vellone
- Departamento de Biomedicina y Prevención, Universidad de Roma Tor Vergata, Roma, Italia
| | - A Durante
- Departamento de Biomedicina y Prevención, Universidad de Roma Tor Vergata, Roma, Italia
| | - V Gea-Caballero
- Grupo de Investigación Emergente Acreditado en Arte y Ciencia del Cuidado GREIACC, Escuela de Enfermería La Fe (Valencia), IIS La Fe, Valencia, España.
| | - J I Pérez-Calvo
- Grupo de Investigación en Insuficiencia Cardiaca e Insuficiencia Fisiopatológica de la Interacción Cardiorrenal (IFICaR), Servicio de Medicina Interna, Hospital Clínico Lozano Blesa, Facultad de Medicina, Universidad de Zaragoza, Instituto de Investigación Sanitaria de Aragón-ISS, Zaragoza, España
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O'Conor R, Muellers K, Arvanitis M, Vicencio DP, Wolf MS, Wisnivesky JP, Federman AD. Effects of health literacy and cognitive abilities on COPD self-management behaviors: A prospective cohort study. Respir Med 2019; 160:105630. [PMID: 30850277 DOI: 10.1016/j.rmed.2019.02.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 02/05/2019] [Accepted: 02/07/2019] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Low rates of adherence to self-management behaviors are common among patients with COPD. Health literacy and cognitive abilities may influence engagement in self-management behaviors. We sought to assess the association between health literacy and cognitive abilities with self-management behaviors in patients with COPD. METHODS We conducted an observational cohort study among American adults with COPD in New York, New York, and Chicago, Illinois. Outcomes included adherence to COPD medication, metered dose inhaler (MDI) and dry powder inhaler (DPI) technique, receipt of vaccination, and routine healthcare appointments. Health literacy was measured with the Short Test of Functional Health Literacy in Adults. Cognitive function was assessed in terms of global, fluid (working memory, processing speed, executive function) and crystallized (verbal) ability. RESULTS Adequate health literacy was associated with adequate adherence to COPD medications (OR 1.46; 95% CI, 1.02-2.08), correct MDI (OR 1.66; 95% CI, 1.13-2.44) and DPI (OR 2.17; 95% CI, 1.30-3.64) technique. Fluid abilities were also associated with medication behaviors and visiting a regular healthcare provider, while crystalized abilities were not. Global cognitive abilities were associated with correct inhaler technique. No other associations were found with non-medication self-management behaviors. CONCLUSIONS COPD patients with limited health literacy and deficits in fluid cognitive abilities have lower rates of adherence and poorer inhaler technique than individuals with adequate health literacy and greater fluid cognitive abilities. These findings highlight the importance of considering the health literacy level and cognitive ability when caring for and educating patients with COPD.
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Aminuddin HB, Jiao N, Jiang Y, Hong J, Wang W. Effectiveness of smartphone-based self-management interventions on self-efficacy, self-care activities, health-related quality of life and clinical outcomes in patients with type 2 diabetes: A systematic review and meta-analysis. Int J Nurs Stud 2019; 116:103286. [PMID: 30827741 DOI: 10.1016/j.ijnurstu.2019.02.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 01/28/2019] [Accepted: 02/01/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To review the evidence and determine the effectiveness of smartphone-based self-management interventions on self-efficacy, self-care activities, health-related quality of life, glycated hemoglobin, body mass index (BMI), and blood pressure (BP) levels of adults with type 2 diabetes mellitus . METHODS A systematic search of five databases (PubMed, Embase, Cochrane, CINAHL and Scopus) was conducted. Studies published in English from January 2007 to January 2018 were considered. Only randomized controlled trials (RCTs) of smartphone-based self-management interventions for patients with type 2 diabetes mellitus that reported any of the study outcomes were included. Two reviewers independently screened the studies, extracted data and assessed the quality of the studies. Meta-analyses were conducted for the different study outcomes. RESULTS A total of 26 articles, consisting of 22 studies with 2645 participants, were included in the review. The results from meta-analysis on the studies revealed that as compared to control group, participants received smartphone-based self-management intervention had better self-efficacy with large effect size of 0.98 (P < 0.001), self-care activities with effect size of 0.90 (P < 0.001), health related quality of life with effect size of 0.26 (p=0.01), and lower glycated hemoglobin (pooled MD=-0.55; p<0.001). Subgroup analyses were also conducted for self-efficacy as significant heterogeneity was present among the studies. The effects on BMI and BP were not statistically significant. CONCLUSIONS Smartphone-based self-management interventions appear to have beneficial effects on self-efficacy, self-care activities and health-relevant outcomes for patients with type 2 diabetes mellitus. However, more research with good study design is needed to evaluate the effectiveness of smartphone-based self-care interventions for T2DM.
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Affiliation(s)
- Haziqah Binte Aminuddin
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Nana Jiao
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Ying Jiang
- 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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Cooper K, Schofield P, Smith BH, Klein S. PALS: peer support for community dwelling older people with chronic low back pain: a feasibility and acceptability study. Physiotherapy 2019; 106:154-162. [PMID: 30928147 PMCID: PMC7029274 DOI: 10.1016/j.physio.2019.01.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 01/28/2019] [Indexed: 11/21/2022]
Abstract
Objectives (i) Examine the feasibility and acceptability of a peer support intervention (PALS) to facilitate self-management in community dwelling older adults with Chronic Low Back Pain (CLBP), and (ii) examine the feasibility of study methods in order to inform the design of a future randomised controlled trial. Design Mixed methods feasibility and acceptability study. Setting Community. Participants 18 older adults (aged 65 to 79) with CLBP and 6 peer support volunteers (PSVs) aged 34 to 65. Intervention Six sessions of 1 to 3 hours duration, approximately 2 weeks apart, delivered in mutually convenient public places, or by telephone. Each session had a suggested topic and each participant and PSV had a PALS manual detailing aims and target outcomes for each session. Outcome measures Recruitment, retention, integrity, acceptability and feasibility of the PALS intervention, feasibility of study processes, appropriateness and usefulness of outcome measures. Results We recruited to target and retained 2/3 of participants. PALS was delivered as intended and acceptable to people with CLBP and PSVs. Most participants were satisfied with PALS and would recommend it to someone else with CLBP. Study processes worked well, but recruitment procedures need to be refined. Outcome measures were returned and were mostly complete, but further work on the most appropriate measures is required. Conclusions PALS was feasible to deliver and acceptable to the older people and PSVs who took part in this study. We identified amendments to PALS and the study processes that, once implemented, will allow the effectiveness of PALS to be tested in a large-scale study.
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Affiliation(s)
- Kay Cooper
- School of Health Sciences, Robert Gordon University, Aberdeen, UK.
| | - Patricia Schofield
- Faculty of Health, Social Care & Education, Anglia Ruskin University, Chelmsford, UK
| | - Blair H Smith
- Division of Population Health Science, University of Dundee, Dundee, UK
| | - Susan Klein
- Faculty of Health & Social Care, Robert Gordon University, Aberdeen, UK
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Abstract
Context: Pain and depression are two prevalent secondary complications associated with spinal cord injury (SCI) that negatively impact health and well-being. Self-management strategies are growing in popularity for helping people with SCI to cope with their pain and depression. However, there is still a lack of research on which approaches are best suited for this population.Objective: The aim of this scoping review was to determine what is known about the self-management of pain and depression through the use of pharmacological and non-pharmacological therapies in adults with SCI.Methods: Seven electronic databases were searched for articles published between January 1, 1990 and June 13, 2017. Grey literature was searched and additional articles were identified by manually searching the reference lists of included articles.Results: Overall, forty-two articles met the inclusion criteria; with the majority reporting on the self-management of pain, rather than on depression or on both complications. Non-pharmacological interventions were more likely to include self-management strategies than pharmacological interventions. A limited number of studies included all of the core self-management tasks and skills.Conclusions: There are significant knowledge gaps on effective self-management interventions for pain and depression post-SCI. There is a need to develop interventions that are multi-faceted, which include both pharmacological and non-pharmacological therapies to address multimorbidity.
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Affiliation(s)
- Lauren Cadel
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Claudia DeLuca
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Sander L. Hitzig
- St. John’s Rehab, Sunnybrook Research Institute, Toronto, Ontario, Canada,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Tanya L. Packer
- School of Occupational Therapy, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Aisha K. Lofters
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada,Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Tejal Patel
- School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada,Centre for Family Medicine Family Health Team, Kitchener, Ontario, Canada
| | - Sara J. T. Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada,Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, Ontario, Canada,Correspondence to: Sara J. T. Guilcher, Leslie Dan Faculty of Pharmacy, 144 College Street, room 604, Toronto ON M5S 3M2.
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Jeon MK, Park YH. [Structural Equation Modeling of Self-Management of Liver Transplant Recipients]. J Korean Acad Nurs 2018; 47:663-675. [PMID: 29151563 DOI: 10.4040/jkan.2017.47.5.663] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 09/28/2017] [Accepted: 09/28/2017] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to construct and test a structural equation model of self-management of liver transplant recipients based on self-determination theory. METHODS Participants were 275 outpatients who received liver transplantation. A structured self-report questionnaire was used to assess health care providers' autonomy support, transplant-related characteristics, illness consequence perception, autonomy, competence, family relatedness, depression and self-management. Collected data were analyzed using SPSS/WIN 24.0 and AMOS 24.0 program. RESULTS The modified model showed a good fitness with the data: GFI=.96, RMSEA=.06, CFI=.96, NFI=.93, TLI=.93, PGFI=.43, PNFI=.49. The health care providers' autonomy support, competence, family relatedness and depression were factors with a direct influence on the self-management of liver transplant recipients. The health care providers' autonomy support and illness consequence perception had an indirect influence through competence, family relatedness and depression. However, the transplant-related characteristics and autonomy did not have a significant effect on self-management. This model explained 59.4% of the variance in self-management. CONCLUSION The result suggests that continuous education must be done to promote the competence of liver transplant recipients and to encourage the patient to positively perceive their current health condition with a view that enhances one's self-management. Additionally, the liver transplant recipients should be screened for depression, which would affect self-management. Most of all, health care providers, who have the most influence on self-management, should improve therapeutic communication and try to form a therapeutic relationship with the liver transplant recipients.
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Affiliation(s)
| | - Yeon Hwan Park
- College of Nursing · The Research Institute of Nursing Science, Seoul National University, Seoul, Korea.
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Choi JY, Kweon YR. [Effects of Education about Action Plans according to Self-Monitoring on Self-Management Adherence, Knowledge, Symptom Control, and Quality of Life among Adult Asthma Patients: A Randomized Controlled Trial]. J Korean Acad Nurs 2018; 47:613-623. [PMID: 29151559 DOI: 10.4040/jkan.2017.47.5.613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 09/12/2017] [Accepted: 09/14/2017] [Indexed: 11/09/2022]
Abstract
PURPOSE This study was conducted to identify the effects of education regarding action plans according to a self-monitoring program on self-management adherence, knowledge, symptom control, and health-related quality of life (HRQoL) among adults with asthma. METHODS Thirty-four patients were randomly assigned to the intervention group and thirty-two to the control group in this study. A tailored 50-minute intervention based on the contents of self-monitoring and action plans developed by the National Heart Lung and Blood Institute was provided to the intervention group. Structured and well developed questionnaires were used to measure the dependent variables. RESULTS There were no differences in all general and clinical characteristics, and the dependent variables between two groups in the pre-test. In the post-test, there were differences in the level of self-management adherence (t=4.41, p<.001), knowledge (t=2.26, p=.027), symptom control (t=-2.56, p=.013), and total HRQoL (t=2.14, p=.036) between the two groups, although there was a difference only in the sub-domain of emotion (t=2.03, p=.047) in HRQoL. CONCLUSION This study found that action plans according to self-monitoring that enhance a participatory interaction in the treatment and care could help patients with moderate to severe asthma to engagead equately in self-care, to control their symptoms, and to improve their HRQoL. Further studies are still needed to identify longitudinal effects of this program.
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Affiliation(s)
- Ja Yun Choi
- College of Nursing, Chonnam National University, Gwangju, Korea
| | - Young Ran Kweon
- College of Nursing, Chonnam National University, Gwangju, Korea.
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Middleton A, Graham JE, Ottenbacher KJ. Functional Status Is Associated With 30-Day Potentially Preventable Hospital Readmissions After Inpatient Rehabilitation Among Aged Medicare Fee-for-Service Beneficiaries. Arch Phys Med Rehabil 2018; 99:1067-1076. [PMID: 28583465 PMCID: PMC5712486 DOI: 10.1016/j.apmr.2017.05.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 04/27/2017] [Accepted: 05/02/2017] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To determine the association between patients' functional status at discharge from inpatient rehabilitation and 30-day potentially preventable hospital readmissions. A secondary objective was to examine the conditions resulting in these potentially preventable readmissions. DESIGN Retrospective cohort study. SETTING Inpatient rehabilitation facilities submitting claims to Medicare. PARTICIPANTS National cohort (N=371,846) of inpatient rehabilitation discharges among aged Medicare fee-for-service beneficiaries in 2013 to 2014. The average age was 79.1±7.6 years. Most were women (59.7%) and white (84.5%). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES (1) Observed rates and adjusted odds of 30-day potentially preventable hospital readmissions after inpatient rehabilitation and (2) primary diagnoses for readmissions. RESULTS The overall rate of any 30-day hospital readmission after inpatient rehabilitation was 12.4% (n=46,265), and the overall rate of potentially preventable readmissions was 5.0% (n=18,477). Functional independence was associated with lower observed rates and adjusted odds ratios for potentially preventable readmissions. Observed rates for the highest versus lowest quartiles within each functional domain were as follows: self-care: 3.4% (95% confidence interval [CI], 3.3-3.5) versus 6.9% (95% CI, 6.7-7.1), mobility: 3.3% (95% CI, 3.2-3.4) versus 7.2% (95% CI, 7.0-7.4), and cognition: 3.5% (95% CI, 3.4-3.6) versus 6.2% (95% CI, 6.0-6.4), respectively. Similarly, adjusted odds ratios were as follows: self-care: .70 (95% CI, .67-.74), mobility: .64 (95% CI, .61-.68), and cognition: .84 (95% CI, .80-.89). Infection-related conditions (44.1%) were the most common readmission diagnoses followed by inadequate management of chronic conditions (31.2%) and inadequate management of other unplanned events (24.7%). CONCLUSIONS Functional status at discharge from inpatient rehabilitation was associated with 30-day potentially preventable readmissions in our sample of aged Medicare beneficiaries. This information may help identify at-risk patients. Future research is needed to determine whether follow-up programs focused on improving functional independence will reduce readmission rates.
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Affiliation(s)
- Addie Middleton
- Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX.
| | - James E Graham
- Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX
| | - Kenneth J Ottenbacher
- Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX
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Sung KW, Kang HS, Nam JR, Park MK, Park JH. [The Effects of a Health Mentoring Program in Community-dwelling Vulnerable Elderly Individuals with Diabetes]. J Korean Acad Nurs 2018; 48:182-194. [PMID: 29735878 DOI: 10.4040/jkan.2018.48.2.182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 03/20/2018] [Accepted: 03/20/2018] [Indexed: 11/09/2022]
Abstract
PURPOSE This study aimed to estimate the effects of a health mentoring program on fasting blood sugar, total cholesterol, triglyceride, physical activity, self care behavior and social support changes among community-dwelling vulnerable elderly individuals with diabetes. METHODS A non-equivalent control group pre-post-test design was used. Participants were 70 community-dwelling vulnerable elderly individuals with diabetes. They were assigned to the experimental (n=30) or comparative (n=30) or control group (n=28). The experimental group participated in the health mentoring program, while the comparative group participated in health education program, the control group did not participate in any program. Data analyses involved a chi-square test, Fisher's exact test, a generalized linear model, and the Bonferroni correction, using SPSS 23.0. RESULTS Compared to the control group, the experimental and comparative groups showed a significant decrease in fasting blood sugar, total cholesterol, and triglyceride. Compared to the comparative and control groups, the experimental group showed significant improvement in self care behavior. However, there were no statistical differences in physical activity or social support among the three groups. CONCLUSION These findings indicate that the health mentoring program is an effective intervention for community-dwelling vulnerable elderly individuals with diabetes. This program can be used as an efficient strategy for diabetes self-management within this population.
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Affiliation(s)
- Ki Wol Sung
- College of Nursing, Daegu Catholic University, Daegu, Korea
| | | | - Ji Ran Nam
- Department of Nursing, Gumi University, Gumi, Korea
| | - Mi Kyung Park
- College of Nursing, Yeungnam University College, Daegu, Korea
| | - Ji Hyeon Park
- Department of Nursing, Catholic Sangji College, Andong, Korea
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Hapunda G, Abubakar A, Pouwer F, van de Vijver F. Depressive Symptoms Are Negatively Associated with Glucose Testing and Eating Meals on Time among Individuals with Diabetes in Zambia. Diabetes Metab J 2017; 41:440-448. [PMID: 29199409 PMCID: PMC5741553 DOI: 10.4093/dmj.2017.41.6.440] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 06/27/2017] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Depression is an established risk factor for cardiovascular diseases and mortality among individuals living with diabetes, and impaired self-care behaviors may play a mediating role. In Africa, this association is not very well known. In this study, we examined the associations between depressive symptoms and different aspects of diabetes self-care in Zambian individuals with diabetes mellitus. METHODS A total of 157 individuals with diabetes mellitus participated. The sample was drawn from four city hospitals in Zambia. Diabetes self-care was assessed using the diabetes self-care inventory, and depression was assessed using the major depression inventory. RESULTS Fifty-nine percent of the sample had type 1 diabetes mellitus. Variations in self-care activities and behaviors were reported as least adhered to by individuals with type 1 and type 2 diabetes mellitus, in adolescent and adult patients. Regression analysis indicated that there was no association between total diabetes self-care and the depression total score. However, depression was associated with poor glucose testing and not eating meals on time by patients with diabetes. CONCLUSION Some variance on poor self-care was explained by demographic characteristics, specifically age, body mass index, and to some extent, socioeconomic status. Recognition and successful treatment of depression in patients with diabetes might help to optimize self-care behaviors, especially glucose testing and eating meals on time. However, this hypothesis needs further testing.
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Affiliation(s)
- Given Hapunda
- Department of Psychology, University of Zambia, Lusaka, Zambia.
| | - Amina Abubakar
- Department of Culture Studies, Tilburg University, Tilburg, The Netherlands
- Department of Public Health, Pwani University, Kilifi, Kenya
- Neuroassessment, Center for Geographic Medicine Research, Neurosciences Research Group, Kilifi, Kenya
| | - Frans Pouwer
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Fons van de Vijver
- Department of Culture Studies, Tilburg University, Tilburg, The Netherlands
- Work Well Unit, North-West University, Potchefstroom, South Africa
- School of Psychology, University of Queensland, Brisbane, Australia
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Bidwell JT, Higgins MK, Reilly CM, Clark PC, Dunbar SB. Shared heart failure knowledge and self-care outcomes in patient-caregiver dyads. Heart Lung 2018; 47:32-9. [PMID: 29153759 DOI: 10.1016/j.hrtlng.2017.11.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/03/2017] [Accepted: 11/06/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND Patient's knowledge about heart failure (HF) contributes to successful HF self-care, but less is known about shared patient-caregiver knowledge. OBJECTIVES The purpose of this analysis was to: 1) identify configurations of shared HF knowledge in patient-caregiver dyads; 2) characterize dyads within each configuration by comparing sociodemographic factors, HF characteristics, and psychosocial factors; and 3) quantify the relationship between configurations and patient self-care adherence to managing dietary sodium and HF medications. METHODS This was a secondary analysis of cross-sectional data (N = 114 dyads, 53% spousal). Patient and caregiver HF knowledge was measured with the Atlanta Heart Failure Knowledge Test. Patient dietary sodium intake was measured by 3-day food record and 24 h urine sodium. Medication adherence was measured by Medication Events Monitoring System caps. Patient HF-related quality of life was measured by the Minnesota Heart Failure Questionnaire; caregiver health-related quality of life was measured by the Short Form-12 Physical Component Summary. Patient and caregiver depression were measured with the Beck Depression Inventory-II. Patient and caregiver perceptions of caregiver-provided autonomy support to succeed in heart failure self-care were measured by the Family Care Climate Questionnaire. Multilevel and latent class modeling were used to identify dyadic knowledge configurations. T-tests and chi-square tests were used to characterize differences in sociodemographic, clinical, and psychosocial characteristics by configuration. Logistic/linear regression were used to quantify relationships between configurations and patient dietary sodium and medication adherence. RESULTS Two dyadic knowledge configurations were identified: "Knowledgeable Together" (higher dyad knowledge, less incongruence; N = 85, 75%) and "Knowledge Gap" (lower dyad knowledge, greater incongruence; N = 29, 25%). Dyads were more likely to be in the "Knowledgeable Together" group if they were White and more highly educated, if the patient had a higher ejection fraction, fewer depressive symptoms, and better autonomy support, and if the caregiver had better quality of life. In unadjusted comparisons, patients in the "Knowledge Gap" group were less likely to adhere to HF medication and diet. In adjusted models, significance was retained for dietary sodium only. CONCLUSIONS Dyads with higher shared HF knowledge are likely more successful with select self-care adherence behaviors.
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