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Youssef A, Amin MEK. Egyptian community pharmacies and self-care: Context, challenges and opportunities. Explor Res Clin Soc Pharm 2023; 12:100384. [PMID: 38146318 PMCID: PMC10749267 DOI: 10.1016/j.rcsop.2023.100384] [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: 11/25/2023] [Accepted: 11/25/2023] [Indexed: 12/27/2023] Open
Abstract
Community pharmacists are ideally positioned to play a key role in promoting self-care behaviors through judicious use of self-care interventions. As highlighted by the International Pharmaceutical Federation, supporting effective self-care is a key strategy for pharmacists to contribute to the sustainability of healthcare systems. Despite recent positive developments in national health policies, Egypt does not have a clear self-care strategy and policy. It also has no national programs focusing on community pharmacists and self-care, important components that future health policy initiatives should tackle. This commentary explores self-care policies, strategies, and developments in the Egyptian community pharmacy practice context. It describes national research, roles, and challenges within the current model of community pharmacy practice and education concerning self-care. It addresses opportunities that Egyptian community pharmacy has to support self-care in light of the anticipated changes in the Egyptian healthcare system. Noting that success in the delivery of self-care interventions within community pharmacies is associated with key factors, recommendations are suggested for community pharmacy stakeholders to address such factors guided by the World Health Organization's implementation considerations for individuals' health needs and self-care-related health system challenges (agency, availability, quality, cost, information, accessibility, utilization, social support, acceptability, and efficiency).
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Affiliation(s)
- Amr Youssef
- Alamein International University Faculty of Pharmacy, AlAlamein City Main Road, Matrouh, Egypt
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Kamath D, Abdullakutty J, Granger B, Kulkarni S, Bhuvana K, Salazar L, Shifra S, Idiculla J, Narendra J, Varghese K, Xavier D. A randomized controlled trial evaluating a theory driven, complex intervention centered on task sharing and mobile health to improve selfcare and outcomes in heart failure - The PANACEA-HF RCT: Design and rationale. Am Heart J Plus 2023; 34:100310. [PMID: 38510948 PMCID: PMC10945930 DOI: 10.1016/j.ahjo.2023.100310] [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] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/15/2023] [Accepted: 07/15/2023] [Indexed: 03/22/2024]
Abstract
Background We developed a three-pronged complex intervention to improve selfcare and deliver whole person care for patients with heart failure, underpinned by the 'extant cycle' theory - a theory based on our formative work. Methods This is a 3 centre, 2-arm, 1:1, open, adaptive stratified, randomized controlled trial. We included patients aged ≥ 18 years with heart failure, taking any of the key guideline directed medical treatments, with a history of or currently on a high ceiling diuretic. We excluded end stage renal disease, clinically diagnosed severe mental illness or cognitive dysfunction and having no caregivers. Interventions included, (i) trained hospital based lay health worker mediated assessment of patients' current selfcare behaviour, documenting barriers and facilitators and implementing a plan to 'transition' the patient toward optimal selfcare. (ii) m-health mediated remote monitoring and (iii) dose optimization through a 'physician supervisor'. Results We recruited 301 patients between Jan 2021 and Jan 2022. Mean age was 59.8 (±11.7) years, with 195 (64.8 %) from rural or semi-urban areas and 67.1 % having intermediate to low health literacy. 190 (63.1 %) had an underlying ischemic cardiomyopathy. In the intervention arm, 142 (94.1 %) had a Selfcare in Heart Failure Index (SCHFI) score of ≤70, with significant barriers being 'lack of knowledge' 105 (34.5 %) and 'behavioural passivity' 23 (7.5 %). Conclusion This is the first South Asian trial evaluating a complex intervention underpinned by behaviour change theory for whole person heart failure care. These learnings can be applied to heart failure patient care in other resource constrained health systems.
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Affiliation(s)
- D.Y. Kamath
- Pharmacology, St. John's Medical College, Bengaluru, India
| | | | - B.B. Granger
- Duke University School of Nursing, Durham, NC, USA
| | - S. Kulkarni
- Medicine, St. John's Medical College, Bengaluru, India
| | - K.B. Bhuvana
- Pharmacology, St. John's Medical College, Bengaluru, India
| | - L.J. Salazar
- Psychiatry, St. John's Medical College, Bengaluru, India
| | - S. Shifra
- Pharmacology, St. John's Medical College, Bengaluru, India
| | - J. Idiculla
- Internal Medicine, St. John's Medical College, Bengaluru, India
| | - J. Narendra
- Cardiology, Nanjappa Hospital, Shivamogga, Karnataka, India
| | - K. Varghese
- Cardiology, St. John's Medical College, Bengaluru, India
| | - D. Xavier
- Pharmacology, St. John's Medical College, Bengaluru, India
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McKellar L, Steen M, Charlick S, Andrew J, Altieri B, Gwilt I. Yourtime: The development and pilot of a perinatal mental wellbeing digital tool using a co-design approach. Appl Nurs Res 2023; 73:151714. [PMID: 37722781 DOI: 10.1016/j.apnr.2023.151714] [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: 12/21/2022] [Revised: 07/12/2023] [Accepted: 07/17/2023] [Indexed: 09/20/2023]
Abstract
INTRODUCTION Maternal anxiety and depression are major public health issues with prevalence as high as one in five women. There is a need to focus on preventative strategies to enable women to self-monitor their mental health status during pregnancy and postnatally. AIM To co-design and test a perinatal mental health digital tool to enable women to self-monitor their mental wellbeing during pregnancy and early parenting and promote positive self-care strategies. METHODS AND ETHICS A sequential mixed methods study utilising two stages 1) co-design workshops; 2) fit for purpose pilot with women through a purpose designed survey to evaluate acceptability, useability, functionality, and satisfaction. FINDINGS Mothers, midwives, design researchers and students, participated in co-designing a digital tool and prototype application, YourTime. Fourteen participants engaged in the pilot, with all women agreeing that the tool would be beneficial in alerting them to changes in mental wellbeing. Seventy-seven percent agreed that this prototype had the potential to positively affect wellbeing during the perinatal period. DISCUSSION The need to develop a perinatal mental health digital tool that enables women to self-monitor their wellbeing was identified. Women reported the YourTime app offered an acceptable and effective means to self-assess and monitor their wellbeing. CONCLUSION The YourTime app responds to the growing agenda for digital approaches to address perinatal mental health challenges. The pilot study demonstrated that the app offered potential to alert women to changes in mental wellbeing, but functionality need further development.
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Affiliation(s)
- Lois McKellar
- School of Health and Social Care, Edinburgh Napier University, United Kingdom of Great Britain and Northern Ireland.
| | - Mary Steen
- Department of Nursing, Midwifery and Health, Northumbria University, United Kingdom of Great Britain and Northern Ireland. http://twitter.com/ProfMarySteen
| | - Samantha Charlick
- UniSA Health and Clinical Sciences, University of South Australia, Australia
| | - Jane Andrew
- UniSA Creative, Match Studio, University of South Australia, Australia
| | - Benjamin Altieri
- UniSA Creative, Match Studio, University of South Australia, Australia
| | - Ian Gwilt
- UniSA Creative, Australian Research Centre for Interactive and Virtual Environments University of South Australia, Australia
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Zhou J, Sherrill CH, Hwang AY, Lee S. Association between mental health and self-care behavior among older adults with diabetes according to Behavioral Risk Factor Surveillance System 2019. Prim Care Diabetes 2023; 17:250-254. [PMID: 36898951 DOI: 10.1016/j.pcd.2023.02.005] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 02/09/2023] [Accepted: 02/26/2023] [Indexed: 03/11/2023]
Abstract
AIM To assess the association of mental health burden with diabetes-related self-care behaviors and healthcare utilization among older adults. METHOD This cross-sectional 2019 Behavioral Risk Factor Surveillance System (BRFSS) study included ≥ 65 years old adults with self-reported diabetes. Three groups were used based on the number of days in the past month affected by mental health: 0 days (no burden), 1-13 days (occasional burden), and 14-30 days (frequent burden). Primary outcome was performing ≥ 3 of 5 diabetes-related self-care behaviors. Secondary outcome was performing ≥ 3 of 5 healthcare utilization behaviors. Multivariable logistic regression was used in Stata/SE 15.1. RESULTS Of 14,217 included individuals, 10.2 % reported frequent mental health burden. Compared to 'no burden', 'occasional' and 'frequent burden' groups included more female, obese, not married persons with younger age of diabetes diagnosis, and reported more comorbidities, insulin use, cost-related barriers to see doctors, and diabetes-related eye issues (p < 0.05). 'Occasional/frequent burden' groups reported less self-care and healthcare utilization behaviors, except 30 % higher healthcare utilization was observed in the 'occasional burden' group compared to no burden (aOR 1.30, 95 %CI 1.08-1.58, p = 0.006). CONCLUSIONS Overall, mental health burden was associated with reduced participation in diabetes-related self-care and healthcare utilization behaviors in a stepwise manner, except occasional burden was associated with higher healthcare utilization.
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Affiliation(s)
- Jenny Zhou
- University of North Carolina Eshelman School of Pharmacy, 301 Pharmacy Ln, Chapel Hill, NC 27599, United States
| | - Christina H Sherrill
- High Point University Fred Wilson School of Pharmacy, 602 International Ave, High Point, NC 27262, United States
| | - Andrew Y Hwang
- High Point University Fred Wilson School of Pharmacy, 602 International Ave, High Point, NC 27262, United States; MCPHS University School of Pharmacy, 179 Longwood Ave, Boston, MA 02115, United States.
| | - Sun Lee
- High Point University Fred Wilson School of Pharmacy, 602 International Ave, High Point, NC 27262, United States; Analysis Group, 111 Huntington Ave, Boston, MA 02199, United States
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Yanardağ CH, Çürük GN, Karayurt Ö. Effects of selfcare and selected factors on the quality of life in women with breast cancer-related lymphedema. Support Care Cancer 2022; 31:22. [PMID: 36513943 DOI: 10.1007/s00520-022-07499-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 11/11/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND This study was performed to examine the effects of selfcare and selected factors on the quality of life in women with breast cancer-related lymphedema (BCRL). METHODS The study was descriptive and cross-sectional and included 101 women with BCRL. Data were gathered with a descriptive characteristics questionnaire, the Lymphedema Quality of Life Scale-Arm and the Breast Cancer-Related Lymphedema Selfcare Scale. Obtained data were analyzed with numbers, percentages, mean, and multiple regression analysis. RESULTS The lowest and the highest scores of the women with lymphedema (LE) on the Lymphedema Quality of Life Scale-Arm were 35 and 71 respectively with a mean of 52.63 ± 11.81. The lowest and the highest scores to be obtained from this scale are 20 and 80 respectively. The quality of life was predicted significantly and positively by time elapsing after the diagnosis of breast cancer and significantly and negatively by time elapsing after the diagnosis of LE and selfcare (p < 0.05). Other variables did not individually affect the quality of life (p > 0.05). CONCLUSION Since selfcare influences the quality of life, patients with BCRL should be given education and support for selfcare, the quality of their lives should be regularly evaluated, and interventions that enhance the quality of their lives should be conducted.
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Affiliation(s)
- Cansu Hazal Yanardağ
- Department of Operating Room Services Program, İzmir Kavram Vocational School, Izmir, Turkey
| | - Gülsüm Nihal Çürük
- Department of Nursing, Faculty of Health Sciences, Izmir University of Economics, Izmir, Turkey.
| | - Özgül Karayurt
- Department of Nursing, Faculty of Health Sciences, Izmir University of Economics, Izmir, Turkey
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Khayati R, Rezaee N, Shakiba M, Navidian A. The Effect of Cognitive-Behavioral Training Versus Conventional Training on Self-care and Depression Severity in Heart Failure Patients with Depression: A Randomized Clinical Trial. J Caring Sci 2020; 9:203-211. [PMID: 33409164 PMCID: PMC7770393 DOI: 10.34172/jcs.2020.31] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 10/01/2019] [Indexed: 12/11/2022] Open
Abstract
Introduction: Psychological factors including depression and anxiety are the most critical risk factors in the treatment and prognosis of heart failure which should be addressed in treatment and care programs. The purpose of this study was to examine the effect of cognitive-behavioral training (CBT) on depression severity and self-care ability of patients with heart failure. Methods: This study was a randomized clinical trial that carried out on 80 patients with heart failure who had been hospitalized in 2018. The participants were divided into the CBT group (n= 40) and the conventional training (CT) group (n= 40), randomly. Data were collected using Beck Depression Inventory (BDI) and the Self-Care of Heart Failure Index (SCHFI) version 6.2 before and 8 weeks after the educational interventions. Data were analyzed in SPSS 21 using paired t-test, independent t-test, chi-square test, and covariance analysis. Results: The mean score of self-care in the CBT group turned out to be significantly higher than the CT group after receiving the intervention. Also, the mean depression score of the CBT group 26.95 (5.53) after intervention was significantly lower than the CT group 36.04 (8.45). Conclusion: Cognitive-behavioral intervention, compared with conventional training, had a greater positive impact on improving self-care and alleviating the severity of depression symptoms. Therefore, it is recommended that the principles of cognitive-behavioral therapy be integrated into routine educational programs.
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Affiliation(s)
- Reyhane Khayati
- Department of Nursing, Nursing and Midwifery School, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Nasrin Rezaee
- Department of Nursing, Nursing and Midwifery School, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mansour Shakiba
- Department of Psychiatry, Medicine School, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Ali Navidian
- Department of Nursing, Nursing and Midwifery School, Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan , Iran
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Boman LE, Sandelin K, Wengström Y, Silén C. Patients' participation during treatment and care of breast cancer - a possibility and an imperative. Eur J Oncol Nurs 2018; 37:35-42. [PMID: 30473049 DOI: 10.1016/j.ejon.2018.09.002] [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: 03/13/2018] [Revised: 07/11/2018] [Accepted: 09/17/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE To explore how patients experience participation during treatment and care for breast cancer related to their understanding. METHOD Semi-structured individual interviews with 16 women diagnosed with breast cancer. Interpretative qualitative content analysis was performed. RESULTS Three main themes describe patient participation. Theme 1 Respectful and personal encounters illustrates how the treatment from health care staff contributed to feelings of being "seen" as a human, a basis for participation. Theme 2 Part-owner in decision making describes the women's varied wishes of participating in treatment decisions. Theme 3 Striving to manage treatment, care and self-care concerns the need to manage self-care for well-being. CONCLUSIONS Patient participation is both a possibility and an imperative. Patients must be recognized as unique human beings with varying needs of participation. Shared learning and understanding in dialogue with health care staff is a prerequisite. A novel approach where patients and health care staff are both partners and participants is presented. PRACTICAL IMPLICATION The results call for an initiation of training programs supporting pedagogical competence in staff and patients' learning in breast cancer care. Access to health care in the outpatient and the hospital settings is needed long term after treatment to support patient participation.
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Affiliation(s)
- Lena Engqvist Boman
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18 A, 171 77, Stockholm, Sweden.
| | - Kerstin Sandelin
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Solna, P9:03, 171 76, Stockholm, Sweden.
| | - Yvonne Wengström
- Theme Cancer, Karolinska University Hospital, Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 83, Huddinge, Sweden.
| | - Charlotte Silén
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18 A, 171 77, Stockholm, Sweden.
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