Smartphone applications for the management of epilepsy in children and adolescents / Aplicativos de smartphone para o gerenciamento de epilepsia em crianças e adolescentes

ABSTRACT Objective: To describe how smartphone applications can contribute to the management of epilepsy in children and adolescents. Data source: This is an integrative review conducted on the Medline, PubMed, and SciELO databases, based on the descriptors "epilepsy" and "smartphone." Original studies published between 2017-2023 in Portuguese or English that addressed the research question were included. Theses and dissertations, duplicate studies, literature reviews, and studies that did not answer the research question were excluded. Data synthesis: A total of 178 studies were located, of which six were selected for this review. The sample included 731 participants (631 children and adolescents with epilepsy and 100 caregivers). The applications allow for the collection of seizure frequency; timing and type of crisis; reminders for medication administration; and information about sleep quality. They can store these data for healthcare professionals, caregivers, and users to monitor the progress of the condition. Conclusions: The use of applications in managing seizures in children and adolescents with epilepsy shows promising results by promoting continuous and personalized monitoring. Further studies are needed to optimize beneficial outcomes and overcome challenges.

RESUMO Objetivo: Descrever como aplicativos de smartphone podem contribuir para o gerenciamento de quadros de epilepsia em crianças e adolescentes. Fontes de dados: Trata-se de uma revisão integrativa realizada nas bases de dados Medline; PubMed e SciELO, com base nos descritores "epilepsy" e "smartphone". Foram incluídos estudos originais publicados entre 2017-2023 em português ou inglês que respondessem à pergunta de investigação. Teses e dissertações, estudos duplicados, revisões de literatura e estudos que não responderam à questão de pesquisa foram excluídos. Síntese dos dados: Foram localizados 178 estudos, dos quais seis foram selecionados para compor esta revisão. A amostra incluiu 731 participantes (631 infantojuvenis com epilepsia e 100 cuidadores). Os aplicativos permitem a coleta da frequência de convulsões; momento e o tipo de crise; lembretes para a administração de medicamentos; e informações sobre a qualidade do sono, sendo capazes de armazenar esses dados para profissionais da saúde, cuidadores e usuários acompanharem a evolução do quadro. Conclusões: O uso de aplicativos no manejo das convulsões de crianças e adolescentes com epilepsia apresenta resultados promissores ao promoverem um monitoramento contínuo e personalizado. Novos estudos são necessários para otimizar os resultados benéficos e superar desafios.

Consulta não presencial do enfermeiro de família: Um estudo pré-experimental com pessoas idosas isoladas / Non-face-to-face consultations with family nurses: A pre-experimental study with older adults living alone in the community / Consultas no presenciales con enfermeros de familia: Un estudio preexperimental con personas mayores aisladas

Resumo Enquadramento: A solidão e/ou isolamento social (IS) representa um problema de saúde pública. Os enfermeiros de família (EF), têm um papel crucial na prevenção, identificação e intervenção dos mesmos. Objetivo: Avaliar o impacte do acompanhamento por consulta não presencial do EF no IS, qualidade de vida (QdV) e autogestão da doença de pessoas idosas (PI) a viver só na comunidade. Metodologia: Estudo pré-experimental com desenho pré e pós, com 24 PI. Utilizou-se na recolha de dados: a escala breve de redes sociais de Lubben, a escala World Health Organization Quality of Life Group e o instrumento de autocuidado terapêutico. Resultados: Após a intervenção verificou-se uma melhoria no acompanhamento pelo EF (p < 0,001), um aumento de 33,3% na gestão do autocuidado e redução do risco de IS (45,8% para 33,3%). Na QdV houve um aumento no score global, contudo não estatisticamente significativo. Conclusão: O acompanhamento por consulta não presencial do EF teve efeito positivo no contacto e acompanhamento pelo EF, mitigação do IS e na melhoria de atividades de autocuidado.

Abstract Background: Loneliness and social isolation are significant public health issues. Family nurses play a vital role in identifying and preventing these phenomena and designing interventions to address them. Objective: To evaluate the impact of non-face-to-face follow-up consultations with family nurses on social isolation, quality of life, and disease self-management of older adults living alone in the community. Methodology: This pre-experimental study utilizes a one-group pretest-posttest design on a sample of 24 older adult patients. The Lubben Social Network Scale-6 (LSNS-6), the World Health Organization Quality of Life Group (WHOQOL) - OLD scale, and the Portuguese Version of the Therapeutic Self-Care Scale were used for data collection. Results: Following the intervention, patients' satisfaction with the family nurse's follow-up improved (p < 0.001). Additionally, there was a 33.3% increase in self-care management and a reduction in the risk of social isolation (45.8% to 33.3%). Although not statistically significant, there was also an increase in the global score of the quality of life variable. Conclusion: The non-face-to-face telenursing consultations positively affected the older adult patients' satisfaction with the family nurse's contact and follow-up, reduced social isolation, and improved self-care activities.

Resumen Marco contextual: La soledad o el aislamiento social (IS) constituyen un problema de salud pública. Los enfermeros de familia (EF) desempeñan un papel crucial en la prevención, identificación e intervención en estos problemas. Objetivo: Evaluar el impacto del seguimiento mediante consulta no presencial del EF en el IS, la calidad de vida (QdV) y la autogestión de la enfermedad en personas mayores (PI) que viven solas en la comunidad. Metodología: Estudio preexperimental con diseño previo y posterior, con 24 PI. Para la recogida de datos se utilizó la escala breve de redes sociales de Lubben, la escala World Health Organization Quality of Life Group y el instrumento de autocuidado terapéutico. Resultados: Tras la intervención, se produjo una mejora de la supervisión por parte de los EF (p < 0,001), un aumento del 33,3% en la gestión del autocuidado y la reducción del riesgo de IS (45,8% para 33,3%). En la QdV hubo un aumento de la puntuación global, pero no fue estadísticamente significativo. Conclusión: El seguimiento mediante consulta no presencial con el EF tuvo un efecto positivo en el contacto y acompañamiento por parte del EF, la reducción del IS y la mejora de las actividades de autocuidado.

Comparison of the effect of SMS-based education and face-to-face teaching on self-care behavior of type 2 diabetic patients in Khorramabad city.

INTRODUCTION: Considering that the adoption of self-care behaviors in patients with type 2 diabetes can reduce the complications caused by this disease, aim of the present study was compared the effect of SMS-based teaching and face-to-face teaching on self-care behavior of type 2 diabetic patients in Khorramabad city. METHODS: This was a pre- and post-test semi-experimental study. The research sample size was composed of 135 diabetic patients referred to the Khorramabad diabetes clinic who were selected using random sampling method and were randomly divided into face-to-face teaching group (n = 45), SMS-based teaching group (n = 45), and control (n = 45). Data collection tools were demographic information questionnaire, Tubert self-care behaviours questionnaire, and self-efficacy questionnaire. The educational intervention in the face-to-face training group included four face-to-face training sessions and in the SMS-based training group included three to four daily training SMS and without training intervention in the control group. For all analysis, SPSS software version 24 was done and at a significance level of 0.05. RESULTS: At the baseline, average score of self-efficacy and self-care, and blood sugar were not significant between the face-to-face teaching, SMS-based and control groups. However, at the end of intervention, the mean score of these variables were significantly more in the face-to-face teaching and SMS-based groups compared to the control group (p-value < 0.001). DISCUSSION: Considering the positive effect of educational intervention in promoting self-care in patients with type 2 diabetic, it is suggested to use empowerment programs with self-care approach to improve the health of diabetic patients.

Imagination, Hope, and Joy: Building Resilience through Trauma-Informed Teaching and Self-Care in Anti-Racist Clinics.

Teaching students to build resilience is necessary to keep imagining and fighting for a path towards social justice. To do so, clinicians can draw from the communities facing oppression and examine how they remain resilient despite oppression.

Diabetic health literacy and associated factors among patients with diabetes attending follow-up in public hospitals of Northeastern Ethiopia: a multicentre cross-sectional study.

OBJECTIVE: To assess the magnitude of diabetic health literacy (DHL) and associated factors among diabetes patients attending follow-up at public hospitals in Northeastern Ethiopia. DESIGN: An institution-based cross-sectional study was conducted from 24 May to 24 June 2022. SETTING: Diabetic clinics of four public hospitals in Northeastern Ethiopia. PARTICIPANTS: 611 adult diabetes patients who have been undergoing follow-up care for at least 6 months were systematically selected. Patients who were unable to communicate, were critically ill and with gestational diabetes mellitus were excluded from the study. OUTCOMES: DHL was assessed using a 15-item tool developed from existing literature. RESULTS: Of all the participants, 300 (49.1%) had low, 174 (28.5%) moderate and 137 (22.4%) had high DHL levels. The significant factors impacting DHL included age (<40 years old: AOR=3.48, 95% CI=2.11-5.77; 40-60 years: AOR=2.79, 95% CI=1.75-4.46), low education (AOR=0.29, 95% CI=0.16-0.56 for those who can't read and write; AOR=0.41, 95% CI=0.23-0.74 for those who can read and write; AOR=0.45, 95% CI=0.27-0.76 for primary education), exposure to diabetic education (AOR=1.84, 95% CI=1.31-2.58), having ≥2 information sources (AOR=2.28, 95% CI=1.57-3.32), moderate social support (AOR=1.94, 95% CI=1.32-2.87), strong social support (AOR=2.73, 95% CI=1.75-4.26) and urban residence (AOR=1.65, 95% CI=1.14-2.39). CONCLUSION: The study showed that less than a quarter of the patients have high DHL, with almost half having low levels of DHL. Tailoring health education programmes to diverse educational levels, incorporating multiple information sources and fostering social support networks could enhance DHL.

Silicone Irregular Hexagon Pessary Versus Polyvinyl Chloride Ring Pessary for Pelvic Organ Prolapse: Randomised Controlled Trial.

INTRODUCTION AND HYPOTHESIS: Vaginal pessaries are the mainstay of the non-surgical management of pelvic organ prolapse (POP). A flexible silicone irregular hexagonal (SIH) pessary was developed based on the results of a prior vaginal case study. We hypothesised that the SIH pessary would have a higher rate of retention and self-management than the polyvinyl chloride (PVC) pessary. METHODS: This was a prospective non-blinded, randomised controlled trial with institutional review board approval. Eligible participants were randomised and fitted with the assigned pessary. They were reviewed 1 week, 6 months and 1 year after the initial pessary fitting. Participants who returned for follow-up completed the study questionnaires. The primary outcome was success, defined as continued use of the allocated pessary at 6 months. Secondary outcomes included the ability to perform pessary self-care, treatment satisfaction and pessary-related complications. Statistical tests were performed with alpha or statistical significance defined as a p value of ≤ 0.05, two-tailed. RESULTS: A total of 104 participants were randomised, with 52 subjects in each arm. Primary outcome data were analysed using per protocol analysis. Continuing pessary usage at 6 months was 68.1% for the PVC pessary group and 65.1% for the SIH group, with no statistically significant differences between the two groups (p = 0.765). Subjects with SIH were more likely to perform pessary self-care. There were no significant differences in subjects' satisfaction, quality-of-life scores or treatment complications between groups. CONCLUSIONS: The pessary continuation rate between the SIH and the PVC pessary groups was similar at 6 months. Participants with an SIH pessary were more likely to self-manage.

[Acceptance and intention to use of a physiological sensor shirt in health field in older patients]. / Aceptación e intención de uso de una camiseta con sensores fisiológicos en el ámbito de la salud en pacientes mayores.

OBJECTIVES: To assess the acceptance and intention to use physiological sensor shirt among older patients in healthcare, as well as to identify the factors that encourage a positive attitude towards its adoption. METHODS: Cross-sectional study using questionnaires addressed to patients between 60 and 85years of age, administered via face-to-face interviews to determine intention to use a shirt with physiological sensors. The extended version of the Technology Acceptance Model (TAM) questionnaire was used in conjunction with administration of the quality of life and perceived stress scales. RESULTS: Forty-eight patients participated in the study, 54.2% were male with a mean age of 70.5years. The mean scores for attitude towards use and intention to use were 3.9 (SD: 0.8) and 3.3 (SD: 0.8), respectively, out of a maximum of 5. The willingness to use the device was positive in 72.9% of patients The patients intending to use wearable technology (n=35) scored significantly higher than those unwilling to wear the shirt (n=13) on perceived ubiquity (P=.031), perceived ease of use (P=.002), and perceived utility (P=.007). CONCLUSIONS: In a sample of independent older adults from the healthcare sector, a high willingness to use a shirt with physiological sensors was found. Through the TAM questionnaire, ubiquity, perceived ease of use, and perceived usefulness were identified as key factors predisposing its adoption.

Effect of Orem's Management Model on Patients Undergoing Percutaneous Nephrolithotomy for Kidney Calculi: A Multicenter Retrospective Trial.

BACKGROUND: Percutaneous nephrolithotomy (PCNL) is the standard procedure for treating upper urinary tract calculi and complex kidney calculi >2 cm in diameter, though it has a high incidence of postoperative complications. This study aimed to investigate the effect of Orem's management model on patients undergoing PCNL. METHODS: This retrospective study included 465 patients who underwent PCNL from February 2022 to February 2023 from two tertiary hospitals. After excluding 16 patients based on exclusion criteria, 449 patients remained. The observation group (n = 227) received Orem's management model, while the control group (n = 222) underwent conventional surgical management. Primary outcomes included postoperative recovery time and the incidence of postoperative complications, while secondary outcomes such as postoperative pain levels (measured via a numerical rating scale) and self-care ability assessed through the exercise of self-care agency were obtained through medical records and physical examinations. RESULTS: Compared to the control group, the observation group achieved faster outcomes for the first anal exsufflation, first ambulation, and discharge, and a lower incidence of postoperative complications (p < 0.05). Post-management, the observation group had lower numerical rating scale scores and higher exercise of self-care agency scores (p < 0.001). CONCLUSIONS: Orem's management model accelerates postoperative recovery, alleviates pain, and reduces postoperative complications in patients undergoing PCNL. Moreover, this model enhances self-care ability, though its effectiveness is limited to patients with non-recurrent renal calculi and normal renal function. Further exploration of its broader application is needed.

Effectiveness of nurse-led self-care interventions on quality of life, social support, depression and anxiety among people living with HIV: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: People living with HIV often face challenges related to quality of life, mental health, and social support. Nurse-led self-care interventions have been proposed as a means to address these issues, but their overall effectiveness needs systematic evaluation. OBJECTIVES: To systematically review and meta-analyze the effectiveness of nurse-led self-care interventions on quality of life, social support, depression, and anxiety among people living with HIV. DESIGN: A systematic review and meta-analysis of randomized controlled trials. METHODS: A systematic search of PubMed, EMBASE, Web of Science (Core Collection), Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Scopus, and PsycINFO (Ovid) was conducted for articles from inception to May 2024. Two authors independently screened studies and extracted data. Randomized controlled trials that investigated the effects of nurse-led self-care interventions on the quality of life, social support, depression, and anxiety in people living with HIV, published in English, were included. The quality of the included studies was assessed using the revised Cochrane risk-of-bias tool for randomized trials. Meta-analyses were conducted using Review Manager 5.3 and Stata17, and the certainty of evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation approach. RESULTS: Nineteen randomized controlled trials published between 2003 and 2024 were included. The meta-analysis showed that compared to the control group, nurse-led self-care interventions significantly improved quality of life (SMD = 0.45, 95 % CI: 0.07 to 0.84, P < 0.05) and reduced depression (SMD = -0.46, 95 % CI: -0.75 to -0.17, P < 0.001; RR = 0.80, 95 % CI: 0.68 to 0.94, P < 0.05). The impact on social support was not statistically significant (SMD = -0.02, 95 % CI: -0.25 to 0.22, P = 0.89). Only two studies reported beneficial effects on anxiety, indicating a need for further high-quality research. CONCLUSION: Nurse-led self-care interventions effectively improve the quality of life and reduce depression in people living with HIV, but current evidence shows these interventions have little impact on social support. The evidence regarding anxiety is limited, indicating a need for more rigorous research to explore the potential benefits of these interventions for anxiety in people living with HIV. These findings support the inclusion of nurse-led self-care interventions in routine HIV care to enhance the well-being of people living with HIV. REGISTRATION NUMBER: (PROSPERO): CRD42024548592.

Engagement challenges in digital mental health programs: hybrid approaches and user retention of an online self-knowledge journey in Brazil.

Digital mental health interventions (DMHIs) have surged in popularity over the last few years. However, adherence to self-guided interventions remains a major hurdle to overcome. The current study utilized a phased implementation design, incorporating diverse samples and contexts to delve into the engagement challenges faced by a recently launched online mental health platform in Brazil with self-evaluation forms. Employing an iterative mixed-methods approach, including focus groups, online surveys, and think-aloud protocols, the research aims to evaluate user satisfaction, identify barriers to adherence, and explore potential hybrid solutions. Engagement in the platform was evaluated by descriptive statistics of the number of instruments completed, and qualitative interviews that were interpreted thematically. In the fully self-guided mode, 2,145 individuals registered, but a substantial majority (88.9%) engaged with the platform for only 1 day, and merely 3.3% completed all activities. In another sample of 50 participants were given a choice between online-only or a hybrid experience with face-to-face meetings. 40% of individuals from the hybrid group completed all activities, compared to 8% in the online-only format. Time constraints emerged as a significant barrier to engagement, with suggested improvements including app development, periodic reminders, and meetings with healthcare professionals. While the study identified weaknesses in the number and length of instruments, personalized results stood out as a major strength. Overall, the findings indicate high satisfaction with the mental health platform but underscore the need for improvements, emphasizing the promise of personalized mental health information and acknowledging persistent barriers in a digital-only setting.

Health-related quality of life and self-care in heart failure patients under telecare-insights from the randomized, prospective, controlled AMULET trial.

Introduction: The growing population of heart failure (HF) patients places a burden on the healthcare system. Patient-centered outcomes such as health-related quality of life (HRQoL) and self-care behaviors are key elements of modern HF management programs. Thus, optimized strategies to improve these outcomes are sought. Purpose: To assess the effects of a new model of medical telecare on HRQoL and self-care in patients with HF (the AMULET study). Methods: The study was prospective, randomized, open-label, and controlled with two parallel groups: telecare and standard care. In the telecare group, HF nurses performed patient clinical assessments with telemedical support by a cardiologist and provided education focused on the prevention of HF exacerbation. In the standard care group, patients were followed according to standard practices in the existing healthcare system. At the baseline and at 12 months, HRQoL was assessed using the Short Form 36 (SF-36) questionnaire and the Minnesota Living with Heart Failure Questionnaire (MLwHF). The level of self-care was assessed with the 12-item standardized European Heart Failure Self-care Behavior Scale (EHFScBS-12). Results: In the overall study group, 79% of the subjects were male, the mean age was 67 ± 14 years, and 59% of the subjects were older than 65 years of age. The majority of the subjects (70%) had a left ventricular ejection fraction below 40%. After 12 months, statistically significant increases in physical component of the SF-36 (43.3 vs. 47.4 for telecare vs. 43.4 vs. 46.6 for standard care) and mental component of SF-36 (58.4 vs. 62 for telecare vs. 60.4 vs. 64.2 for standard care) were noted, with no intergroup differences. However, patients receiving telecare showed improvement in specific domains, such as physical functioning, role-physical, bodily pain, vitality, social functioning, role-emotional, and mental health. There was a significant decrease in MLwHF (29 vs. 35.0; lower is better) at follow-up for both groups. Telecare patients had a statistically significant decrease in EHFScBS-12 (lower is better) at 12 months. Conclusion: AMULET outpatient telecare, which is based on nurse-led non-invasive assessments supported by specialist teleconsultations, improved the HRQoL and self-care of HF patients after an episode of acute HF.

Effect of training based on Orem's self-care deficit theory on breast cancer patients' management of chemotherapy-related side effects and self-care behaviors: A randomized controlled trial.

PURPOSE: To examine the effects of training based on Orem's self-care deficit theory on breast cancer patient's physical, social, and psychological well-being and self-care behaviors during chemotherapy. METHODS: This randomized controlled trial was based on a pretest-posttest experimental design. The study sample consisted of 62 breast cancer patients (n = 31 for each of the intervention and control groups) receiving cyclophosphamide-epirubicin or cyclophosphamide-adriamycin treatment in the medical oncology department of a university hospital in Tekirdag, Turkey. The breast cancer patients in the intervention group received training based on Orem's self-care deficit theory regarding physical, social, and psychological well-being and self-care behaviors during chemotherapy. The researcher conducted two face-to-face follow-ups (during the second and third chemotherapy cycles, 3 weeks apart) and a posttest assessment. Pretest and posttest symptom scores and self-care survey results were compared for both groups. RESULTS: The Nightingale Symptom Assessment Scale (N-SAS) first follow-up, second follow-up, and posttest scores showed that the intervention group experienced fewer negative changes in quality of life than the control group based on the physical, social, and psychological subdimension and total scale scores (p < .05). The most positive changes in the intervention group's self-care behaviors were observed for items about caring for and protecting hair, using protective gloves when doing chores, monitoring weight, and limiting social meetings when blood values were low to protect against possible infection. CONCLUSION: Training based on Orem's self-care deficit theory positively influenced breast cancer patients' management of chemotherapy-related side effects and self-care behaviors. Chemotherapy-related side effects should be evaluated frequently. Moreover, patients' needs should be determined, and training should be tailored to their needs.

Transnational Health and Self-care Experiences of Japanese Women who have taken Oral Contraceptives in South Korea, including Over-the-counter Access: Insights from Semi-structured Interviews.

In an increasingly globalized world, the accessibility of healthcare and medication has expanded beyond local healthcare systems and national borders. This study aims to investigate the transnational health and self-care experiences of 11 Japanese women who have resided in South Korea for a minimum of six months and have utilized oral contraceptives, including those that were acquired over-the-counter (OTC). Data were gathered through semi-structured interviews and analyzed by utilizing the NVivo software. The analysis yielded three significant thematic categories, namely (1) experiences and perceptions of obtaining and utilizing contraceptive pills, including OTC access; (2) individual and social perceptions of pills and their accessibility in Japan, insights from actual users; and (3) enhancing pill accessibility, transnational health and self-care experiences and perspectives. Participants acknowledged that oral contraceptives are a global product and experienced communication challenges with healthcare providers as a result of differing understandings of these medications. Additionally, this study identified transnational strategies, such as purchasing an adequate supply of pills just before departure and seeking pills from local families or acquaintances. This study not only highlights the implications of clinical care for transnational patients but also underscores their critical global perspectives on access to oral contraceptives. Furthermore, it proposes two models for improving accessibility within the Japanese healthcare system, even in prescription-only contexts, by introducing OTC options.

Effects of the PRECEDE-PROCEDE Model on Self-Care Ability and Quality of Life Among Primipara During Puerperium.

Background: Many parturients have poor self-care ability, strong dependence on others, and lack mother-infant related nursing skills and health care knowledge. Due to their lack of pregnancy experience, many primiparas lack the relevant skills and knowledge, which can affect maternal and infant health and maternal quality of life. Purpose: The study aimed to investigate the effects of the PRECEDE-PROCEDE model on self-care ability and quality of life among primipara during puerperium. Methods: This quasi-clinical study selected eligible primaparas from those who gave birth at a Grade A hospital in Hengyang, China between April and July 2019. Eighty puerperium primiparas were divided into a control group receiving standard care and an intervention group following the PRECEDE-PROCEDE model. Comparison of self-care ability and quality of life scores was conducted between the two groups pre-intervention, at 3 weeks, and at 6 weeks postpartum. Statistical analysis using SPSS 18.0 included mean and standard deviation for measurement data, and frequency and constituent ratio for counting data. Tests such as t-test, Chi-squared test, rank-sum test, and repeated measure analysis of variance were applied. Findings: The control group's self-care ability scores were (150.8 ± 9.9), (150.9 ± 9.3), and (152.0 ± 10.2) before intervention, at 3 weeks postpartum, and at 6 weeks postpartum, respectively. For the intervention group, the corresponding scores were (151.1 ± 15.1), (157.8 ± 8.5), and (162.4 ± 7.2). Quality of life scores for the control group were (54.7 ± 8.6), (54.8 ± 7.7), and (55.1 ± 7.7) before intervention, at 3 weeks postpartum, and at 6 weeks postpartum, respectively. At the same time points, while the intervention group saw increases from (55.6 ± 7.6) to (59.2 ± 5.9) and (61.0 ± 5.3). There were statistically significant differences in the time effect and inter-group effect of the total score of self-care ability during puerperium, total score of quality of life, and the score of each dimension between the two groups (P < 0.05), and we also found an interaction effect between grouping and time factors (P < 0.05). After intervention, the incidence of common puerperium health problems except neonatal constipation and diarrhea in the intervention group was lower than that in the control group (P < 0.05). Conclusion: PRECEDE-PROCEDE model may improve self-care ability, reduce the occurrence of common health problems, and improve the quality of life of primiparas during puerperium.

Sustainability of health outcomes of patients with type-2 diabetes mellitus after completing 6 months of remote tele-monitoring: Two-year results from a randomised controlled trial (OPTIMUM).

INTRODUCTION: Meta-analysis shows that home tele-monitoring (HTM) improves glycaemic control in patients with type-2 diabetes mellitus (T2DM) up to 12 months, but their health outcomes after HTM cessation remains unclear. This study aimed to determine the health outcomes of these patients 18 months after completing 6 months of HTM, compared to standard care. METHODS: Patients with T2DM were enrolled in an open-labelled randomised controlled trial, aged 26 to 65 years, and suboptimal glycaemic control (HbA1c = 7.5%-10%). Patients in the intervention group (n = 165) undertook HTM using the OPTIMUM (Optimising care of Patients via Telemedicine In Monitoring and aUgmenting their control of diabetes Mellitus) HTM system for 6 months followed by usual care for another 18 months, while control group (n = 165) had usual care for 24 months. The OPTIMUM HTM system includes in-app video-based tele-education, tele-monitoring of the blood pressure (BP), capillary glucose and weight via Bluetooth devices and mobile applications, followed by algorithm-based telecare by the investigators. They were assessed using the Self-Care Inventory Scale (SCIR) and medication adherence (Medication Adherence Report Scale 5) at baseline, 6-month and 24-month time-points. RESULTS: The data from 146 (intervention) and 152 (control) patients, with comparable baseline demographic profiles were eventually analysed. The decrease in HbA1c over 24 months was comparable between intervention and control group. Those in the intervention group were more likely to maintain their glycemic control (HbA1c ≤ 8%) (adjusted odds ratio (AOR) = 1.9, 95%confidence interval (CI) = 1.1-3.2; p = 0.028), had higher SCIR score (p = 0.004), and less likely to "never forget" (p = 0.022), or "stop medications" (p = 0.048), at 24-month time-point as compared to subjects in the control group. CONCLUSION: The glycaemic control of patients with T2DM continued to be maintained for another 18 months after 6 months of HTM, which were attributed to sustained self-care behaviour and medication adherence.

Integrative nursing interventions: knowledge, attitudes and practice in home nursing services in Germany-a quantitative and qualitative online survey.

Introduction: Integrative nursing interventions (INI) play a significant role in healthcare, particularly in the prevention and treatment of chronic diseases. Integrating evidence-based INI into healthcare aligns with global initiatives such as the WHO's Decade of Healthy Aging 2020-2030. Many INI are low-threshold practices, empowering patients to independently manage health. However, the extent to which INI are used by home-care nursing-services (HNS) remains largely unknown. This study aims to explore the field of INI in German HNS regarding nurses' use of INI as well as attitudes, subjective knowledge, and information needs on the subject. Methods: A cross-sectional anonymous online survey with 29 Likert scale items and two open-ended questions was conducted between April 2023 and July 2023. The survey targeted nurse managers of HNS in Baden-Württemberg, Germany. Descriptive analysis was performed for quantitative data, while content analysis according to Kuckartz was applied to analyze open-ended text responses. Results: In total, n = 68 out of n = 1,331 HNS took part in the survey yielding a response rate of 5.1%. Their overall attitude toward INI was clearly positive (10-point Likert scale M ± SD: 8.37 ± 2.22). The average self-assessed knowledge level about INI was moderate (M ± SD: 5.39 ± 2.76). Almost half of the participants (45.6%) declared to incorporate INI in patient care. Most participants (84.2%) lacked employees with additional qualifications in INI. The INI used most were medicinal herbal teas (61%), compresses (57%), and aromatherapy (48%). Acupressure showed the greatest disparity between actual use in participating HNS (4.3%) and interest in further education (61%). The most common symptoms for which INI are used are pain, respiratory problems, anxiety, and palliative care. The main challenges reported for the use of INI in HNS are financial aspects, qualification and limited resources (staff and time). Discussion: This exploratory study provides the first insights into nurses' attitudes, self-assessed knowledge, and utilization of INI in German HNS. Overall response rate was low (5.1%), therefore, the results should be interpreted with caution. Urgent action is needed to address financial aspects and further education on INI, to promote integration of INI in HNS to the best possible extent.

A Self-Administered Eating Behavior Scale for Patients With Heart Failure Living at Home: Protocol for a Mixed Methods Scale Development Study.

BACKGROUND: The prevalence of heart failure (HF) is increasing worldwide, with the associated mortality rates rising consistently. Preventing HF progression requires adherence to restricted sodium intake alongside sufficient and balanced nutritional consumption. For patients at home, preparing nutritionally balanced meals is essential, either self-assisted or with the aid of close individuals. Patients with HF frequently experience decreased exercise tolerance, depression, anxiety, and social isolation, which interfere with eating behaviors, leading to inadequate dietary habits. However, measures focusing on the determinants of eating behavior among patients with HF are currently lacking. OBJECTIVE: This study aims to develop a self-administered scale to assess the eating behaviors of patients with HF living at home (Self-Administered Eating Behaviors Scale for Heart Failure [SEBS-HF]). METHODS: This study encompasses 3 phases. Phase 1 involves identifying factors influencing eating behaviors in patients with HF. First, a literature review will be conducted using PubMed and CINAHL databases. The specified literature will be analyzed qualitatively and inductively. Additionally, verbatim transcripts obtained from semistructured interviews of patients with HF and medical experts will be qualitatively analyzed. Based on the Phase 1 results, a preliminary scale will be constructed. In Phase 2, cognitive interviews will be conducted with patients with HF and experts; the preliminary scale will be used to qualitatively evaluate its content validity. After validation, the scale will be used in Phase 3 to conduct a cross-sectional study involving patients with HF. In Phase 3, data will be collected from clinical records and self-administered questionnaires or scales. After conducting a preliminary survey, the main survey will be conducted. The reliability and validity of the scale will be assessed using statistical methods. RESULTS: The first phase of this study commenced in September 2023, and by May 2, 2024, a total of 7 patients with HF and 6 expert professionals were enrolled as study participants. The draft creation of the scale will be completed in 2024, and the content validity evaluation of the draft scale is expected to be finished by early 2025. The third phase will begin its investigation in mid-2025 and is expected to be completed by late 2025, after which the SEBS-HF will be published. CONCLUSIONS: The development and use of this scale will enable a more comprehensive evaluation of the factors influencing eating behaviors in patients with HF. Thus, medical and welfare professionals should provide appropriate support tailored to the specific needs of patients with HF. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/60719.

Self-care strategies used by disaster responders after the 2023 earthquake in Turkey and Syria: a mixed methods study.

BACKGROUND: Disaster responders are exposed to several physical and mental health risks. This study aimed to describe self-care strategies used by disaster responders after the earthquake in Syria and eastern Turkey in February 2023. METHODS: A study specific web-based questionnaire survey was used to collect quantitative and qualitative data according to a convergent mixed methods approach. Data from 252 disaster responders responding to the earthquakes in Turkey and Syria were analyzed using both descriptive and analytical statistics and summative content analysis of free-text answers. Data were collected in March to July, 2023. RESULTS: The most used self-care strategies included resting, social support from colleagues in the field, extra intake of food or drink, and intake of medicines. The recovery strategies varied due to previous disaster response experience, indicating that supportive self-care strategies can be developed or learned. CONCLUSION: Given the extreme conditions and limited possibilities of external support, sufficient self-care is an essential competence among disaster responders. Self-care strategies can be both external processed such as intake of medicines, social support from others, and internal processes such as personal reflection. Providing oneself with self-care activities seems to be a skill developed with increasing experience supported by pre-deployment training. Therefore, to enhance resilience, self-care strategies should be encompassed in pre-disaster response training.

Six Basic Rules of Palliative Care and Their Buddhist Counterparts.

As healthcare workers in palliative care, every day brings its share of awfulness and beauty, suffering and connection, meaning and cynicism. Without a way to support ourselves, we cannot help our patients, let alone one another. But how do we cope? Despite the unpredictability inherent in our work, we can discern certain patterns that offer an approach for dealing with these stressors. These patterns can be summarized into six simple rules of palliative care-rules that are coterminous with the teachings of Buddhism. Recognizing the synergy between our role in palliative care and ancient observations about dealing with life's difficulties can help us with the stress of providing conscientious care within a system that relentlessly tries to stop us from doing so. Such considerations offer one of many paths we might choose to cope with this challenging work.

Self-care towards the end of life: A systematic review and narrative synthesis on access, quality and cost.

BACKGROUND: Policy and practice encourages patients to engage in self-care, with individual patient management and remote monitoring of disease. Much is known of the moderate stage of chronic disease, without a clear understanding of how self-care applies towards the end of life. AIM: To review the current evidence on practices of self-care in life-limiting conditions and its impacts on healthcare utilisation, quality of life and associated costs. DESIGN: We systematically searched 10 scientific databases (MEDLINE, CINAHL, Embase, PsycINFO, Cochrane Central, Cochrane Database of Systematic Reviews, Scopus, Sociological Abstracts, Social Work Abstracts and Health Management Information Consortium) from inception to October 2023 with citation and hand searching. A narrative synthesis was undertaken, with quality and relevance assessed using Gough's Weight of Evidence framework. Titles and abstracts were independently screened by three researchers. RESULTS: Findings from 33 studies revealed self-care as increasingly burdensome or unfeasible towards the end of life, with patients delaying use of professional care. Self-care became increasingly burdensome for patients, carers and professionals as illness progressed. Self-monitoring may exacerbate hospitalisations as patients delayed seeking professional help until crises arose. Findings regarding quality were inconclusive, with some evidence suggesting that self-care can decrease care costs. CONCLUSIONS: This review has shown that research on self-care is an evolving area of study, with a current focus on acute care and hospitalisations. Future research should seek to provide a more complete account of the relation between self-care and non-acute care use, and quality, with further efforts to study self-care costs incurred through self-funding.