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2.
J Gerontol Nurs ; 50(8): 19-28, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39088049

RESUMEN

PURPOSE: To examine the relationship of key individual and family self-management theory (IFSMT) components, including self-management process variables on proximal (self-management behaviors) and distal (falls) outcomes in older adults. METHOD: A secondary data analysis was conducted using data of 99 older adults living in continuing care retirement communities in the U.S. Midwest. Descriptive statistics, multiple regression, and logistic regression were performed to analyze the data. RESULTS: The multiple regression model demonstrated a positive association between self-efficacy for physical activity and steps per day. The logistic regression model showed that high expectations regarding aging are associated with reduced likelihood of meeting daily protein intake. CONCLUSION: Key components of the IFSMT, such as self-efficacy, steps per day, and expectations regarding aging, are important when designing self-management interventions to prevent falls. [Journal of Gerontological Nursing, 50(8), 19-28.].


Asunto(s)
Accidentes por Caídas , Autoeficacia , Automanejo , Humanos , Anciano , Accidentes por Caídas/prevención & control , Accidentes por Caídas/estadística & datos numéricos , Femenino , Masculino , Anciano de 80 o más Años , Autocuidado
3.
Transl Vis Sci Technol ; 13(8): 7, 2024 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-39102241

RESUMEN

Purpose: This pilot study aimed to assess the feasibility, accuracy, and repeatability of unsupervised, at-home, multi-day glaucoma testing using the Olleyes VisuALL Virtual Reality Platform (VRP) and the iCare HOME handheld self-tonometer. Methods: Participants were trained to use two U.S. Food and Drug Administration-registered or approved devices before conducting self-tests at home over 3 consecutive days. The iCare HOME intraocular pressure (IOP) measurements were collected four times daily per eye, and VRP visual field tests were performed once daily. The results were compared with one in-clinic Humphrey Field Analyzer (HFA) visual field test performed on the day of device training, iCare HOME measurements by the trainer, and the last five Goldmann applanation tonometer (GAT) results. Results: Of 15 enrolled participants, nine of them (60%) completed the study. The six excluded participants could not self-measure using iCare HOME. There was significant correlation between the average mean deviation (MD) values of the at-home VRP tests and in-clinic HFA test (r2 = 0.8793, P < 0.001). Additionally, the average of the sensitivities in five of six Garway-Heath sectors were significantly correlated. VRP test duration was also shorter than in-clinic HFA testing (P < 0.001). Finally, at-home tonometry yielded statistically similar values compared to trainer-obtained iCare HOME values. The mean and range of at-home tonometry were also statistically similar to those for in-clinic GAT, but at-home tonometry demonstrated higher maximum IOP values (P = 0.0429). Conclusions: Unsupervised, at-home, multi-day glaucoma testing using two devices resulted in the capture of higher maximum IOPs than in the clinic and good MD correlation of VRP with HFA. However, 40% of participants could not self-measure IOP using iCare HOME. Translational Relevance: The study findings suggest that at-home remote glaucoma monitoring correlates with in-office testing and could provide additional information for glaucoma management, although patients had more difficulty with the iCare HOME than the VRP.


Asunto(s)
Glaucoma , Presión Intraocular , Tonometría Ocular , Pruebas del Campo Visual , Humanos , Proyectos Piloto , Masculino , Femenino , Tonometría Ocular/métodos , Tonometría Ocular/instrumentación , Anciano , Persona de Mediana Edad , Presión Intraocular/fisiología , Glaucoma/diagnóstico , Pruebas del Campo Visual/métodos , Pruebas del Campo Visual/instrumentación , Campos Visuales/fisiología , Reproducibilidad de los Resultados , Autoevaluación , Estudios de Factibilidad , Anciano de 80 o más Años , Autocuidado/métodos , Autocuidado/instrumentación
4.
BMC Health Serv Res ; 24(1): 894, 2024 Aug 05.
Artículo en Inglés | MEDLINE | ID: mdl-39103821

RESUMEN

BACKGROUND: Low health literacy levels among individuals with type 2 diabetes are common and may be a fundamental barrier to increasing self-efficacy and self-care in patients. Therefore, the present study aimed to propose a model for educating health literacy in diabetic patients in hospitals affiliated with the Islamic Azad University of Medical Sciences, Tehran. METHODS: This research was applied in terms of purpose, mixed-methods (qualitative-quantitative) in terms of data type, qualitative content analysis, and cross-sectional survey in the quantitative aspect (fitness of model). The statistical population in the qualitative section included 18 participants from experts in the field of health care. In the quantitative section, 220 educators working in hospitals affiliated with the Islamic Azad University of Medical Sciences, Tehran, were selected using stratified random sampling. Data collection tools included interviews in the qualitative section and research-made questionnaire in the quantitative section. For data analysis, coding was used in the qualitative section, and structural equation modeling was used in the quantitative section. RESULTS: For this model, 6 dimensions, 17 components, and 78 items were identified. The results showed that the basic literacy dimension had a coefficient of 0.729, the specialized literacy dimension had a coefficient of 0.712, diabetes management had a coefficient of 0.654, social literacy dimension had a coefficient of 0.630, cultural literacy dimension had a coefficient of 0.605, and media literacy had a coefficient of 0.535, respectively, contributing the most to the health literacy of diabetic patients. CONCLUSION: Since the "Health Literacy Education" model has a good fitness, it is recommended that this model will be applied in different settings such as hospitals in order to improving the health level of patients.


Asunto(s)
Diabetes Mellitus Tipo 2 , Alfabetización en Salud , Humanos , Irán , Diabetes Mellitus Tipo 2/terapia , Estudios Transversales , Masculino , Femenino , Encuestas y Cuestionarios , Adulto , Persona de Mediana Edad , Investigación Cualitativa , Autocuidado , Educación del Paciente como Asunto/métodos
5.
Cien Saude Colet ; 29(8): e05602024, 2024 Aug.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-39140539

RESUMEN

A long-term indwelling catheter may be indicated in clinical situations, such as chronic diseases of the genitourinary or neurological systems. In addition to the risks of infection, trauma, and bleeding, a catheter's permanence can affect psycho-emotional and socioeconomic dimensions. We aimed to understand how the need to use a long-term indwelling catheter affects this patient's self-perception, interrelationships, and self-care. We carried out a qualitative, descriptive study based on interviews with 17 patients, and applied thematic analysis and complex thinking. The different prognoses and expectations regarding the catheter influenced self-perception, adaptation, acceptance, or denial. The presence of a catheter, whether as a curative measure or for comfort, can affect self-image and sexuality, and generate insecurities and uncertainties, which require understanding the multidimensionality of situations that suffer interference from the personal, family, and social environment, as well as health systems' capacity to deal with it. Despite the challenges, the majority of participants reported a favorable disposition towards self-care, whether to enable catheter removal or to prevent injuries in lifelong indications.


O cateter vesical de longa permanência pode ser indicado em situações clínicas, como nas doenças crônicas do sistema genitourinário ou neurológico. Além dos riscos de infecção, traumas e sangramentos, a permanência do cateter pode afetar dimensões psicoemocionais e socioeconômicas. Objetivamos compreender como a necessidade de uso do cateter urinário por um longo prazo afeta a autopercepção, as interrelações e o autocuidado deste paciente. Realizamos um estudo qualitativo, descritivo, a partir da entrevista de 17 pacientes, e aplicamos a análise temática e o pensamento complexo. Os diferentes prognósticos e as expectativas em relação ao cateter influenciaram a autopercepção, a adaptação, sua aceitação ou negação. A presença do cateter, seja como medida curativa ou para conforto, pode afetar a autoimagem e a sexualidade, gerar inseguranças e incertezas, que requerem compreensão da multidimensionalidade das situações, que sofrem interferências do meio pessoal, familiar e social, bem como da capacidade dos sistemas de saúde para o seu enfrentamento. Apesar dos desafios, a maioria dos participantes relatou disposição favorável para o autocuidado, seja para viabilizar retirada do cateter, ou para prevenir agravos em indicações vitalícias.


Asunto(s)
Catéteres de Permanencia , Autocuidado , Humanos , Masculino , Femenino , Persona de Mediana Edad , Catéteres de Permanencia/efectos adversos , Adulto , Factores de Tiempo , Anciano , Entrevistas como Asunto , Autoimagen , Atención Ambulatoria , Investigación Cualitativa , Pacientes Ambulatorios/psicología , Adulto Joven
6.
Rev Lat Am Enfermagem ; 32: e4227, 2024.
Artículo en Inglés, Portugués, Español | MEDLINE | ID: mdl-39140562

RESUMEN

OBJECTIVE: to describe factors of influence of telenursing on naturalistic decision making about self-care of people with heart failure during COVID-19. METHOD: this is a descriptive study with a qualitative approach, with 16 participants interviewed after hospitalization for decompensated heart failure. The data was collected using audio and video technology and submitted to content analysis, guided by the Situation-Specific Theory of Heart Failure Self-Care. RESULT: two thematic categories emerged from the analysis: Self-care as a decision-making process and Factors influencing decision-making, which describe tele-nursing as a support resource for people with heart failure, during changes in care in the pandemic period. CONCLUSION: it was possible to understand the relationship between telenursing and the establishment of a bond, in order to stimulate naturalistic decision-making by people with heart failure in their daily lives in a coherent way, leading to better health outcomes. HIGHLIGHTS: (1) Different barriers compromise the decision-making of people with heart failure.(2) Nursing theories can guide coherent self-care attitudes.(3) Continuity of care and a support network are necessary after hospitalization.(4) Emotional support for people with heart failure must go hand in hand with conventional treatment.(5) The bond through tele-nursing provides positive health outcomes.


Asunto(s)
COVID-19 , Insuficiencia Cardíaca , Autocuidado , Teleenfermería , Humanos , Insuficiencia Cardíaca/enfermería , Insuficiencia Cardíaca/terapia , COVID-19/enfermería , Femenino , Masculino , Anciano , Persona de Mediana Edad , Investigación Cualitativa , Pandemias , Anciano de 80 o más Años , Toma de Decisiones , Adulto
7.
J Cardiovasc Nurs ; 39(3): 279-287, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39137263

RESUMEN

BACKGROUND: Many patients with heart failure (HF) are repeatedly hospitalized. Heart failure self-care may reduce readmission rates. Hospitalizations may also affect self-care. OBJECTIVE: The purpose of this secondary analysis was to test the hypotheses that better HF self-care is associated with a lower rate of all-cause readmissions and that readmissions motivate patients to improve their self-care. METHODS: This was a prospective cohort study of patients with HF (N = 400) who were enrolled during a stay at an urban teaching hospital between 2014 and 2016. The Self-Care of Heart Failure Index v6.2 was administered during the hospital stay, along with other questionnaires, and repeated at 6-month intervals after discharge. All-cause readmissions and deaths were ascertained for 24 months. RESULTS: A total of 333 (83.3%) were readmitted at least once, and 117 (29.3%) of the patients died during the follow-up period. A total of 1581 readmissions were ascertained. Higher Self-Care of Heart Failure Index Maintenance scores predicted more rather than fewer readmissions (adjusted hazard ratio, 1.09; 95% confidence interval, 1.01-1.17; P < .01). Conversely, more readmissions predicted higher Maintenance scores (b = 0.29; 95% confidence interval, 0.02-0.56; P < .05). CONCLUSIONS: These findings do not support the hypothesis that HF self-care maintenance or management helps to reduce the rate of all-cause readmissions, but they do suggest that the experience of multiple readmissions may help to motivate improvements in HF self-care.


Asunto(s)
Insuficiencia Cardíaca , Readmisión del Paciente , Autocuidado , Humanos , Insuficiencia Cardíaca/terapia , Readmisión del Paciente/estadística & datos numéricos , Masculino , Femenino , Anciano , Estudios Prospectivos , Persona de Mediana Edad , Estudios Longitudinales , Anciano de 80 o más Años
8.
J Cardiovasc Nurs ; 39(3): E72-E79, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39137264

RESUMEN

BACKGROUND: Engaging in self-care behaviors improves outcomes in patients with heart failure. Identifying psychological factors that affect self-care behaviors and the role of resilience may inform interventions that improve outcomes. OBJECTIVES: The study objective was to determine the relationships among depression, anxiety, resilience, and self-care, including whether resilience mediates or moderates the effects of depression and anxiety on self-care. METHODS: Pearson correlation coefficients were computed to estimate the relationships of depression, anxiety, and resilience with self-care behaviors. Mediating and moderating effects of resilience on the relationships of depression and anxiety with self-care were evaluated using multiple linear regression. RESULTS: Depression and anxiety were associated with lower self-care. Higher resilience was associated with lower depression and anxiety, but resilience did not mediate or moderate the relationship of depression and anxiety with self-care. CONCLUSIONS: Interventions that foster resilience may improve outcomes by reducing anxiety and depression in patients with heart failure.


Asunto(s)
Ansiedad , Depresión , Insuficiencia Cardíaca , Resiliencia Psicológica , Autocuidado , Humanos , Insuficiencia Cardíaca/psicología , Insuficiencia Cardíaca/terapia , Autocuidado/psicología , Femenino , Masculino , Depresión/psicología , Ansiedad/psicología , Persona de Mediana Edad , Anciano , Emociones , Adulto
9.
Nutrients ; 16(15)2024 Aug 03.
Artículo en Inglés | MEDLINE | ID: mdl-39125422

RESUMEN

One in ten Americans suffers from type 2 diabetes, which, if not managed well, can result in severe complications, disability, and premature death. Diabetes education classes can play a pivotal role in providing practical education on diabetes and self-care behaviors, with a particular emphasis on dietary management, which is often regarded as the most demanding diabetes self-care behavior. The Texas A&M AgriLife Extension Service developed Cooking Well with Diabetes (CWWD), a four-week interactive diabetes education series, with each week consisting of a lecture on healthy eating coupled with cooking lessons featuring diabetes-friendly recipes. The current study aimed to examine the effectiveness of CWWD in improving the frequency of healthy food preparation and consumption of program participants. Secondary data from 2017 to 2023 was analyzed involving 1574 adults from 59 predominantly rural Texas counties. Data from self-reported pre and post evaluations showed improvements in healthy food preparation and consumption behaviors. The curriculum enabled Extension Educators to introduce healthful dietary behaviors to a diverse group of clients. The curriculum can be adapted by Extension Educators in other states reaching a broader audience. The findings will inform future research aimed at planning and implementing successful diabetes education programs.


Asunto(s)
Culinaria , Diabetes Mellitus Tipo 2 , Dieta Saludable , Humanos , Culinaria/métodos , Diabetes Mellitus Tipo 2/prevención & control , Masculino , Femenino , Texas , Persona de Mediana Edad , Adulto , Curriculum , Anciano , Educación del Paciente como Asunto/métodos , Autocuidado , Conducta Alimentaria
10.
PLoS One ; 19(8): e0300556, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39137206

RESUMEN

INTRODUCTION: Primary Human Papilloma Virus (HPV) testing offers higher sensitivity and specificity over Visual Inspection using Acetic acid (VIA) in cervical cancer screening. Self-sampling is a promising strategy to boost participation and reduce disparities. However, concerns about the initial costs hinder HPV testing adoption in low and middle-income countries. This study assesses the cost-utility of home-based HPV self-sampling versus VIA for cervical cancer screening in India. METHODS: A cross-sectional study was conducted in East district, Sikkim, India, comparing the costs and utility outcomes of population-based cervical cancer screening through VIA and primary HPV screening through self-sampling. Cost-related data were collected from April 2021 to March 2022 using the bottom-up micro-costing method, while utility measures were collected prospectively using the EuroQoL-5D-5L questionnaire. The utility values were converted into quality-adjusted life days (QALDs) for an 8-day period. The willingness to pay threshold (WTP) was based on per capita GDP for 2022. If the calculated Incremental Cost-Effectiveness Ratio (ICER) value is lower than the WTP threshold, it signifies that the intervention is cost-effective. RESULTS: The study included 95 women in each group of cervical cancer screening with VIA & HPV self-sampling. For eight days, the QALD was found to be 7.977 for the VIA group and 8.0 for the HPV group. The unit cost per woman screened by VIA and HPV self-testing was ₹1,597 (US$ 19.2) and ₹1,271(US$ 15.3), respectively. The ICER was ₹-14,459 (US$ -173.6), which was much below the WTP threshold for eight QALDs, i.e. ₹ 4,193 (US$ 50.4). CONCLUSION: The findings support HPV self-sampling as a cost-effective alternative to VIA. This informs policymakers and healthcare providers for better resource allocation in cervical cancer screening in Sikkim.


Asunto(s)
Ácido Acético , Análisis Costo-Beneficio , Detección Precoz del Cáncer , Neoplasias del Cuello Uterino , Humanos , Femenino , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/virología , Neoplasias del Cuello Uterino/economía , Neoplasias del Cuello Uterino/epidemiología , India/epidemiología , Detección Precoz del Cáncer/economía , Detección Precoz del Cáncer/métodos , Estudios Transversales , Adulto , Persona de Mediana Edad , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/virología , Manejo de Especímenes/economía , Manejo de Especímenes/métodos , Autoevaluación , Papillomaviridae/aislamiento & purificación , Autocuidado/economía
11.
BMJ Open ; 14(7): e087005, 2024 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-39089722

RESUMEN

BACKGROUND: Despite the crucial role of mindfulness and self-care in nurses' physical and mental health, as well as their professional well-being, most nurses exhibit low levels of self-care. Moreover, there is a lack of understanding of the diverse subgroups of mindful self-care among nurses. OBJECTIVES: The present study delved into the diverse groups of mindful self-care among nurses and investigated the correlation between these groups and their mental health. METHODS: Convenience sampling was used to select nurses from Guizhou province, China, from August to September 2023. A total of 1020 nurses were investigated, and 1001 questionnaires were included, for an effective return rate of 98.1%. The demographic characteristics questionnaire, Chinese version of the Brief Mindful Self-Care Scale, Patient Health Questionnaire-9, Generalised Anxiety Disorder-7 and Perceived Stress Scale were used. Latent profile analysis was performed on the characteristics of nurses' mindful self-care, and the correlations between the latent profiles, demographic characteristics and mental well-being were identified using chi-square tests, Spearman correlation analyses and non-parametric tests. RESULTS: A total of 1001 nurses were included, and they were divided into four heterogeneous subgroups: the Inconsistent Mindful Self-Care Group (4.40%), Balanced Development Group (43.36%), Moderate Mindful Self-Care Group (39.36%), and High Mindful Self-Care Group (12.89%). Results of single factor analysis showed that the nurses' department and average monthly income were the factors influencing the potential profiles. Mindful self-care negatively correlated with anxiety and depression but was not correlated with perceived stress. There were significant differences in perceived stress, anxiety and depression between different mindful self-care groups. CONCLUSION: The present study used latent profile analysis to identify four distinct subgroups of hospital nurses based on their mindful self-care and revealed varying levels of anxiety, depression and perceived stress between groups. These results emphasise the need for tailored mindful self-care strategies to promote nurses' well-being.


Asunto(s)
Salud Mental , Atención Plena , Autocuidado , Humanos , China/epidemiología , Femenino , Adulto , Masculino , Encuestas y Cuestionarios , Enfermeras y Enfermeros/psicología , Persona de Mediana Edad , Adulto Joven
12.
Front Public Health ; 12: 1410843, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39091531

RESUMEN

Background: To prevent the harmful consequences of hypertension and enhance the quality of life of hypertensive patients, the use of educational models is highly suggested. Therefore, the present study was designed to determine the effect of education based on the PRECEDE-PROCEED on self-care behaviors and the quality of life of hypertensive patients in Kazeroon city, Iran, in 2023. Methods: A total of 120 hypertensive individuals who were referred to Kazeroon city health centers participated in the current quasi-experimental study. The participants were divided into two experimental and control groups using a random sampling technique (60 participants in each group). The self-care behaviors questionnaire, the quality of life questionnaire, and a questionnaire based on the PRECEDE-PROCEED model were used as the data acquisition techniques. Both groups completed the questionnaires before and 2 months after the intervention. The educational program included a six-session, 50-60 min training program using three different teaching methods (speaking, Q&A, group discussion, and peer training) in health facilities. The data were examined using paired t, independent t, and chi-square statistical tests after being entered into the SPSS 24 statistical program. Results: Following the intervention, the experimental group showed significantly higher values in quality of life, knowledge, attitude, enabling and reinforcing factors, and self-care behaviors compared to the control group (p < 0.001 for all comparisons). The experimental group also exhibited a significant reduction in systolic blood pressure measures compared to the control group (p < 0.001). Conclusion: In the present study, education based on the PRECEDE-PROCEED model and focusing on blood pressure self-care behavior in patients with hypertension led to a decrease in their systolic blood pressure measures and improved their quality of life.


Asunto(s)
Hipertensión , Calidad de Vida , Autocuidado , Humanos , Hipertensión/terapia , Masculino , Femenino , Irán , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto , Educación del Paciente como Asunto/métodos , Anciano
13.
Transpl Int ; 37: 13192, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39104837

RESUMEN

After transplantation self-management is essential for graft survival and optimal quality of life. To address the need for home-based support in self-management, we implemented the "SelfCare after Renal Transplantation" (SeCReT) box, containing home-monitoring equipment combined with a smartphone application that was linked to the electronic patient records. This study investigated the uptake and continuation, protocol adherence, and subjective evaluation of this home-monitoring program. All "de novo" kidney recipients who received the SeCReT-box in the study period (Aug 2021-Dec 2022) were eligible for inclusion. Protocol adherence was defined as ≥75%. Subjective evaluation was assessed with a 5-item questionnaire. Of the 297 recipients transplanted, 178 participants (60%) were included in the analysis. Protocol adherence was 83%, 73%, 66%, and 57% respectively at 5, 10, 20, and 40 weeks of the protocol. With regard to continuation, 135 participants were still in the program at the end of the study period (75% retention rate). Regarding subjective evaluations, 82% evaluated the program positively, and 52% reported lower care needs due to home-monitoring. Results are positive among those who entered and continued the program. Qualitative research is needed on barriers to entering the program and facilitators of use in order to promote optimal implementation.


Asunto(s)
Trasplante de Riñón , Autocuidado , Humanos , Femenino , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto , Calidad de Vida , Anciano , Encuestas y Cuestionarios , Teléfono Inteligente , Aplicaciones Móviles , Supervivencia de Injerto , Cooperación del Paciente , Servicios de Atención de Salud a Domicilio
14.
J Dr Nurs Pract ; 17(2): 86-99, 2024 Aug 05.
Artículo en Inglés | MEDLINE | ID: mdl-39103191

RESUMEN

Background: Despite the innovative advancements in diabetes care, providers may not recognize patients with type 2 diabetes mellitus (T2DM) who qualify for a continuous glucose monitoring (CGM) device or the benefits of a telemedicine program for improving self-management behaviors. Objective: This quality improvement (QI) project aimed to determine if an advanced practice registered nurse (APRN)-led telemedicine program using CGM could improve glycemic control and self-management in patients with insulin-dependent T2DM. Methods: A 6-week telemedicine program was developed and implemented using the CGM's time-in-range to deliver patient-specific education. Clinical metrics were collected at each visit. All patients completed a pre- and postintervention Diabetes Self-Management Questionnaire-Revised (DSMQ-R) survey. Results: A repeated measures analysis of variance revealed that the telemedicine program had a statistically significant impact on time-in-range outcomes, F(2, 14) = 18.203, p < .001. Paired-samples t tests indicate that APRN-led education improved body mass index, t(8) = 4.232, p = .002; decreased systolic blood pressure, t(8) = 2.90, p = .010, and diastolic blood pressure, t(8) = 3.21, p = .007; and increased self-management skills as evidenced by DSMQ-R, t(8) = -5.498, p < .001. Conclusions: This QI project highlights multiple interventions for improving diabetes management in a primary care facility. Implications for Nursing: An APRN-led telemedicine program integrating CGM time-in-range data can improve glycemic control and self-management skills in patients with T2DM who administer insulin.


Asunto(s)
Diabetes Mellitus Tipo 2 , Mejoramiento de la Calidad , Telemedicina , Humanos , Diabetes Mellitus Tipo 2/enfermería , Diabetes Mellitus Tipo 2/terapia , Masculino , Persona de Mediana Edad , Femenino , Educación del Paciente como Asunto , Anciano , Adulto , Autocuidado , Automanejo/educación , Automonitorización de la Glucosa Sanguínea , Encuestas y Cuestionarios
15.
Health Expect ; 27(1): e13976, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-39102692

RESUMEN

BACKGROUND: Despite the demonstrated efficacy and potential scalability of self-guided digital treatments for common mental health conditions, there is substantial variability in their uptake and engagement. This study explored the decision-making processes, influences and support needs of people taking up a self-guided digital treatment for anxiety and/or depression. METHODS: Australian-based adults (n = 20) were purposively sampled from a trial of self-guided digital mental health treatment. One-to-one, semistructured interviews were conducted, based on the Ottawa Decision-Support Framework. Interviews were transcribed verbatim and analysed thematically using framework methods. Baseline sociodemographic, clinical and decision-making characteristics were also collected. RESULTS: Analyses yielded four themes. Theme 1 captured participants' openness to try self-guided digital treatment, despite limited deliberation on potential downsides or alternative options. Theme 2 highlighted that immediacy and ease of access were major drivers of uptake, which participants contrasted with gaps in access and continuity of care in face-to-face services, especially rurally. Theme 3 centred on participants as the main agents in their decision-making, with family and health professional attitudes also reportedly influencing decision-making. Theme 4 revealed participants' primary motivations for deciding to take up treatment (e.g., the potential to increase insight and coping skills), while also acknowledging that pre-existing characteristics (e.g., health and digital literacy, insight) determined participants' personal suitability for self-guided digital treatment. CONCLUSION: Findings help to elucidate the decision-making influences and processes amongst people who started a self-guided treatment for depression and anxiety. Additional information and decision support resources appear warranted, which may also improve the accessibility of self-guided treatments. PUBLIC OR PATIENT CONTRIBUTION: Patients were interviewed about their views and experiences of decision-making about accessing and taking up treatment. As such, patient contribution to the research was as study participants.


Asunto(s)
Ansiedad , Toma de Decisiones , Depresión , Investigación Cualitativa , Humanos , Femenino , Masculino , Adulto , Persona de Mediana Edad , Ansiedad/terapia , Australia , Depresión/terapia , Entrevistas como Asunto , Anciano , Autocuidado
16.
Health Expect ; 27(1): e13961, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-39102732

RESUMEN

BACKGROUND: In July 2022, self-collection became universally available as part of Australia's National Cervical Screening Program. This change aims to address screening inequities experienced among underscreened populations, including women of Indian descent. This study explored experiences of cervical screening, alongside the acceptability of self-collection, among women of Indian descent living in Victoria, Australia. We also aimed to articulate the informational needs to promote self-collection among this population. METHODS: Five focus group discussions with 39 women living in Victoria were conducted in English (n = 3) and Punjabi (n = 2). Transcripts were thematically analysed, as informed by the Theoretical Framework of Acceptability. RESULTS: Women were motivated by the choice to self-collect, perceiving the ability to maintain modesty and greater autonomy as key enablers. Healthcare practitioners were seen as central in supporting patient-centred models of care. Perceived barriers to self-collection included concerns around its accuracy and women's confidence in collecting their own sample. Widespread dissemination of culturally tailored promotion strategies communicating concepts such as 'privacy' and 'accuracy' were suggested by women to promote self-collection. CONCLUSION: Self-collection was highly acceptable among women of Indian descent, particularly when assured of its accuracy, and sociocultural norms and previous screening experiences are considered. This study highlights the huge potential that self-collection can play in increasing equity in Australia's cervical screening programme. PATIENT OR PUBLIC CONTRIBUTION: Members of the public were involved in focus group discussions. Findings were summarised and disseminated via a poster. A bicultural worker was involved in all stages of the research.


Asunto(s)
Grupos Focales , Investigación Cualitativa , Neoplasias del Cuello Uterino , Humanos , Femenino , Victoria , Persona de Mediana Edad , Adulto , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/etnología , India/etnología , Aceptación de la Atención de Salud/etnología , Aceptación de la Atención de Salud/psicología , Detección Precoz del Cáncer , Manejo de Especímenes , Autocuidado , Anciano
17.
BMC Res Notes ; 17(1): 224, 2024 Aug 14.
Artículo en Inglés | MEDLINE | ID: mdl-39143621

RESUMEN

OBJECTIVE: Effective management of hypertension requires not only medical intervention but also significant patient self-management. The challenge, however, lies in the diversity of patients' personal barriers to managing their condition. The objective of this research is to identify and categorize personalized barriers to hypertension self-management using the TASKS framework (Task, Affect, Skills, Knowledge, Stress). This study aims to enhance patient-centered strategies by aligning support with each patient's specific needs, recognizing the diversity in their unique circumstances, beliefs, emotional states, knowledge levels, and access to resources. This research is based on observations from a single study focused on eight patients, which may have been a part of a larger project. RESULTS: The analysis of transcripts from eight patients and the Global Hypertension Practice Guidelines revealed 69 personalized barriers. These barriers were distributed as follows: emotional barriers (49%), knowledge barriers (24%), logical barriers (17%), and resource barriers (10%). The findings highlight the significant impact of emotional and knowledge-related challenges on hypertension self-management, including difficulties in home blood pressure monitoring and the use of monitoring tools. This study emphasizes the need for tailored interventions to address these prevalent barriers and improve hypertension management outcomes.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Hipertensión , Automanejo , Humanos , Hipertensión/terapia , Hipertensión/psicología , Automanejo/métodos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Autocuidado/métodos , Adulto , Monitoreo Ambulatorio de la Presión Arterial/métodos
18.
Stud Health Technol Inform ; 315: 569-570, 2024 Jul 24.
Artículo en Inglés | MEDLINE | ID: mdl-39049326

RESUMEN

Intestinal cancer, severe injury, and severe inflammation are most often treated with surgery, and an ostomy will be left in place after surgery[1]. An ostomy is a portion of the intestine that is surgically removed and pulled up to the abdominal wall, creating a temporary or permanent opening that serves as a pathway for intestinal waste to be discharged from the body, usually called a stoma. Stoma may be temporary (2 months to 6 months) or permanent. The goal for people with a stoma is to have the knowledge and ability to care for an ostomy to avoid peristomal moisture-associated skin damage. After patients return home, self-care knowledge and skills can help them adapt to the disease and maintain quality of life. Therefore, this study examined the effects of developing mobile Health applications on improving self-care knowledge and skills in patients who underwent ostomy surgery.


Asunto(s)
Aplicaciones Móviles , Estomía , Autocuidado , Telemedicina , Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Educación del Paciente como Asunto
19.
Stud Health Technol Inform ; 315: 767-768, 2024 Jul 24.
Artículo en Inglés | MEDLINE | ID: mdl-39049420

RESUMEN

Cancer self-management interventions improve symptom management and confidence, but few interventions target the complex needs of older adults with cancer and multi-morbidities. Despite growing evidence of digital health tools in cancer care, many such tools have not been co-designed with older adults to ensure that they are tailored to their specific needs. The objective of the study was to design a self-and symptom-management app to support older adults with cancer and multi-morbidities. Utilizing a user-centered design thinking framework, we recruited 2 caregivers and 18 older adults with lived experiences of cancer to design a medium-fidelity app prototype. Participants highlighted the importance of tracking functions to make sense of the information about their symptoms, clear displays, and reminders to mitigate concerns related to polypharmacy. This app will create a 'home base' for symprtom management and support for older adults with cancer and multi-morbidities.


Asunto(s)
Aplicaciones Móviles , Neoplasias , Automanejo , Humanos , Neoplasias/terapia , Anciano , Femenino , Masculino , Multimorbilidad , Diseño Centrado en el Usuario , Autocuidado , Persona de Mediana Edad , Telemedicina , Anciano de 80 o más Años
20.
Front Public Health ; 12: 1334699, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39050605

RESUMEN

Objective: In this study, we aimed to determine the relationships among perceived social support, mindful self-care, and resilience in a sample of nurses in three provinces of China. Methods: A cross-sectional study was conducted in seven hospitals in Guangdong, Guizhou, and Henan provinces between August and October, 2023; the provinces are located in south, southwest, and central China. A total of 389 nurses were surveyed using a self-designed sociodemographic characteristics questionnaire and the Chinese versions of Multidimensional Scale of the Perceived Social Support, Brief-Mindful Self-Care Scale and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). Results: Of the 389 nurses, the majority were women (n = 365; 93.8%), aged 26-35 years (n = 244; 62.7%) and had bachelor's degrees (n = 337; 86.6%), had worked for 10-20 years (n = 136; 35%), with junior professional titles (n = 331; 85.1%), and had a monthly income in the range 3,001-6,000 yuan in CNY (n = 239; 61.4%). Nurses' resilience was measured using the CD-RISC-10, which ranges from 10 to 40 points. And average score of nurses' resilience was (23.94 ± 6.95). Multiple linear regression showed that scores for resilience were higher among nurses who had higher educational attainment (95% confidence interval: 0.568-3.024, p < 0.01), professional titles (95% confidence interval: 0.009-1.693, p < 0.05), scores of mindful self-care (95% confidence interval: 0.086-0.155, p < 0.01), and scores of perceived social support (95% confidence interval: 0.242-0.328, p < 0.01). Conclusion: Nurses with higher educational attainment and professional titles exhibited higher levels of resilience. Perceived social support and mindfulness self-care are significantly positively correlated with resilience of nurses. The findings of this study are beneficial to further our understanding of nurses' resilience. The identification of associated factors is conducive to providing more support for nurses who tend to have lower resilience earlier, and can provide useful information for research targeted intervention and support plans aimed at improving nurses' resilience in the future.


Asunto(s)
Atención Plena , Resiliencia Psicológica , Autocuidado , Apoyo Social , Humanos , Estudios Transversales , Femenino , China , Adulto , Masculino , Encuestas y Cuestionarios , Enfermeras y Enfermeros/psicología , Enfermeras y Enfermeros/estadística & datos numéricos , Persona de Mediana Edad
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