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BACKGROUND: Living with an ostomy is a chronic condition, and self-care in such cases improves patient outcomes. PURPOSE: To adapt and test the psychometric properties of the Turkish version of the Ostomy Self-Care Index (T-OSCI) and the Turkish version of the Caregiver Contribution to Self-Care in Ostomy Patient Index (T-CC-OSCI). METHODS: A psychometric study was conducted on a convenience sample of 202 adult patients with an ostomy and their 165 caregivers. Translation and back translation, face and content validity, construct validation, and reliability assessment of the T-OSCI and the T-CC-OSCI were performed. Exploratory factor analysis was used to evaluate the construct validity. Reliability was established using Cronbach α coefficients, ceiling and floor effects, and the Hotelling T2 test, Wilcoxon signed rank test, and intraclass correlation coefficient. RESULTS: Content validity values were in the range of 0.85 to 1 for both the T-OSCI and the T-CC-OSCI. Exploratory factor analysis demonstrated generally acceptable factor loadings. The overall index revealed a high level of internal consistency (T-OSCI = 0.968, T-CC-OSCI = 0.862). No statistically significant difference was found between test-retest measurements. There was no indication of either ceiling or floor effects, or response bias. CONCLUSION: The T-OSCI and the T-CC-OSCI are valid and reliable indexes to measure the self-care of patients with an ostomy and their caregivers. These indexes may allow health care professionals to evaluate self-care in research and clinical settings, identify educational needs, and collaborate in developing and supporting appropriate self-care initiatives for patients with an ostomy and their caregivers.
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Cuidadores , Estomía , Psicometría , Autocuidado , Humanos , Psicometría/instrumentación , Psicometría/métodos , Autocuidado/métodos , Autocuidado/estadística & datos numéricos , Masculino , Femenino , Cuidadores/psicología , Cuidadores/estadística & datos numéricos , Reproducibilidad de los Resultados , Estomía/psicología , Estomía/enfermería , Estomía/estadística & datos numéricos , Persona de Mediana Edad , Turquía , Encuestas y Cuestionarios , Adulto , AncianoRESUMEN
Background: The reallocation of health resources, epidemic prevention and control measures during the COVID-19 pandemic triggered widespread restricted health service utilization, some residents and patients tried positive self-care behavior to maintain their health, yet the efficacy of this intervention remains unclear. Object: Based on the reasoned action approach (RAA) theory, this study aimed to investigate the correlation between self-care behavior and restricted health service utilization among adults in China, trying to discover the vulnerable groups and external and intrinsic factors that affect self-care behavior among Chinese adults. Methods: Data on demographics, socioeconomic, health status, and self-care behavior were collected in "The Early China COVID-19 Survey," a cross-sectional anonymous online survey of the general population in China. Self-care behavior was measured by four indicators: weight control (WC), physical activity (PA), prevention behavior (PB), and online medical consultation (OMC). The multiple linear models and binary logistic regression were used to examine whether restricted health service utilization (RHSU) is associated with self-care behaviors; also, adjusted multivariate logistic regression was used to analyze subgroup heterogeneity. Results: In total, 8,428 adult participants completed the survey, the mean OMC score was 1.51 (SD 1.34), the mean PB score was 18.17 (SD 3.44), and the proportion of participants who engaged in WC and PA was 42.30 and 62.57%, respectively. According to the multiple regression model, the RHSU was significantly positively correlated with all four indicators of self-care (WC: OR = 1.34, p < 0.001, PA: OR = 1.34, p < 0.05, MC: OR = 1.30, p < 0.001, PB: coef = 0.16, p < 0.05). We also observed some significant differences in the intensity of this relationship by subgroup analysis, precisely, OMC (high vs. moderate vs. low infection-risk level: OR = 1.48; 1.41; 1.19, p < 0.1), PA (male vs. female: OR = 1.27;1.06; p < 0.05, high vs. Moderate and low infection-risk level: OR = 1.51; 1.17; 1.02, p < 0.05), PB (Chronic disease groups vs. no: coef = 0.46; 0.1, p < 0.05). Conclusion: Restricted health service utilization predicts more positive self-care behavior, and the intensity of partial correlation was significantly different in the subgroups of sex, actual infection risk level of the living area, and chronic diseases. These findings highlight the urgent demand for self-care behavior among Chinese adults during the pandemic and provide new insights for developing self-care and reducing the burden on the healthcare system in the long term.
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COVID-19 , Conductas Relacionadas con la Salud , Aceptación de la Atención de Salud , Autocuidado , Humanos , COVID-19/prevención & control , Femenino , Masculino , China/epidemiología , Adulto , Autocuidado/estadística & datos numéricos , Persona de Mediana Edad , Estudios Transversales , Aceptación de la Atención de Salud/estadística & datos numéricos , Encuestas y Cuestionarios , SARS-CoV-2 , Anciano , Pandemias , Adulto JovenRESUMEN
OBJECTIVES: to evaluate the contribution of informal caregivers to the self-care of individuals with heart failure. METHODS: a cross-sectional study was conducted with 87 caregivers from March to October 2022 in the city of João Pessoa/PB. The caregivers' contribution was assessed using the Caregiver Contribution to Self-Care of Heart Failure Index instrument. Scores ≥ 70 points indicate adequate contribution. Data were analyzed using descriptive statistics and Spearman's correlation. RESULTS: the sample consisted of 81.6% female caregivers. Median scores obtained for the self-care contribution scales were: 63.3 for maintenance; 55.5 for management; and 66.6 for confidence. Caregivers never or rarely recommended monitoring body weight, regular physical exercise, extra use of diuretics, and fluid restriction. CONCLUSIONS: informal caregivers showed inadequate contribution in the areas of maintenance, management, and confidence in self-care of individuals with heart failure.
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Cuidadores , Insuficiencia Cardíaca , Autocuidado , Humanos , Insuficiencia Cardíaca/terapia , Insuficiencia Cardíaca/psicología , Femenino , Autocuidado/métodos , Autocuidado/estadística & datos numéricos , Estudios Transversales , Cuidadores/psicología , Cuidadores/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Anciano , Encuestas y Cuestionarios , Adulto , BrasilRESUMEN
BACKGROUND: The primary screening technique for precancerous lesions and cervical cancer is human papillomavirus (HPV) testing, and HPV self-sampling has been shown to be consistent with clinician sampling in terms of the accuracy of the results and may improve cervical cancer screening rates. The aim of this study was to understand the level of awareness, experience, acceptability, and preference for vaginal HPV self-sampling among women in Jiangsu, Zhejiang, and Shanghai, China, and to analyze the possible influencing factors to determine the feasibility of implementing self-sampling. METHODS: Overall, 1793 women were included in the data analysis. A self-administered questionnaire was utilized. In addition to descriptive analysis, univariate and multivariate analyses were used to explore the associations between sociodemographic features, history of cervical cancer screening, and the level of awareness, experience, acceptability, and preference for HPV self-samples. RESULTS: The participants' level of awareness of and experience with HPV self-sampling were moderate. A total of 88.8% of participants rated the acceptability as "high", and self-sampling was preferred by 64.2% of them for cervical cancer screening. People aged 45 to 54 years showed a preference for both clinician sampling(OR = 1.762 (1.116-2.163)) and self-sampling (OR = 1.823 (1.233-2.697)). Those who had graduated from high school or above (OR = 2.305 (1.517-3.503), OR = 2.432 (1.570-3.768), OR = 3.258 (2.024-5.244)) preferred clinician-sampling, and those with a bachelor's degree or above (OR = 1.664 (1.042-2.657)) preferred self-sampling. Middle- and high-income individuals showed no preference for either sampling method (OR < 1). CONCLUSIONS: HPV self-sampling is widely accepted, but awareness, experience and preferences need to be improved. These results may help to adjust public health strategies for the early inclusion of HPV self-sampling as a screening method in national initiatives to prevent cervical cancer.
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Detección Precoz del Cáncer , Conocimientos, Actitudes y Práctica en Salud , Infecciones por Papillomavirus , Aceptación de la Atención de Salud , Neoplasias del Cuello Uterino , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Adulto Joven , China/epidemiología , Estudios Transversales , Detección Precoz del Cáncer/métodos , Detección Precoz del Cáncer/psicología , Virus del Papiloma Humano , Infecciones por Papillomavirus/diagnóstico , Aceptación de la Atención de Salud/estadística & datos numéricos , Aceptación de la Atención de Salud/psicología , Prioridad del Paciente/estadística & datos numéricos , Autocuidado/métodos , Autocuidado/estadística & datos numéricos , Manejo de Especímenes/métodos , Encuestas y Cuestionarios , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/virología , Frotis Vaginal/métodos , Frotis Vaginal/estadística & datos numéricosRESUMEN
BACKGROUND: Health disparities in osteoarthritis (OA) outcomes exist both in the occurrence and treatment of functional limitation and disability for Mexican Americans. Although the effect of self-management of chronic illness is well established, studies demonstrate little attention to self-management of function or disability, despite the strong potential effect on both and, consequently, on patients' lives. OBJECTIVE: The purpose of this study pilot was to develop and test key variable relationships for a measure of disability self-management among Mexican Americans. METHODS: In this sequential, two-phased, mixed-methods, biobehavioral pilot study of Mexican American women and men with OA, a culturally tailored measure of disability self-management was created, and initial relationships among key variables were explored. RESULTS: First, a qualitative study of 19 adults of Mexican American descent born in Texas (United States) or Mexico was conducted. The Mexican American Disability Self-Management Scale was created using a descriptive content analysis of interview data. The scale was tested and refined, resulting in 18 items and a descriptive frequency of therapeutic management efforts. Second, correlations between study variables were estimated: Disability and function were negatively correlated. Disability correlated positively with social support and activity effort. Disability correlated negatively with disability self-management, pain, and C-reactive protein. Function was positively correlated with age, pain, and depression. Liver enzymes (alanine transaminase) correlated positively with pain and anxiety. DISCUSSION: This mixed-methods study indicates directions for further testing and interventions for disability outcomes among Mexican Americans.
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Personas con Discapacidad , Americanos Mexicanos , Osteoartritis , Automanejo , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Personas con Discapacidad/estadística & datos numéricos , Personas con Discapacidad/rehabilitación , Americanos Mexicanos/estadística & datos numéricos , Americanos Mexicanos/psicología , Osteoartritis/etnología , Osteoartritis/terapia , Proyectos Piloto , Investigación Cualitativa , Autocuidado/estadística & datos numéricos , Autocuidado/métodos , Autocuidado/psicología , Automanejo/métodos , TexasRESUMEN
PURPOSE: To examine the prevalence and cancer-specific patterns of functional disabilities among US cancer survivors. METHODS: Data from 47,768 cancer survivors and 2,432,754 noncancer adults age 18 years and older from the 2017 to 2022 Behavioral Risk Factor Surveillance System were analyzed. Functional disabilities assessed included mobility disability (ie, serious difficulty walking or climbing stairs) and self-care disability (ie, self-reported difficulty dressing or bathing). Multivariable logistic regression models were used to assess the associations between functional disabilities and sociodemographic, lifestyle, and health-related factors. RESULTS: Cancer survivors tended to be older and non-Hispanic White than noncancer adults. The prevalence of mobility disability (27.9% v 13.4%) and self-care disability (7.4% v 3.8%) were higher among cancer survivors compared with noncancer adults. After multivariable adjustments, cancer survivors were more likely to report mobility (odds ratio [OR], 1.21 [95% CI, 1.16 to 1.26]) and self-care (OR, 1.19 [95% CI, 1.10 to 1.29]) disability than noncancer adults. The prevalence of mobility (34.9% v 26.3%) and self-care disability (9.8% v 6.7%) was higher in cancer survivors who were receiving active cancer treatment than in those who had completed cancer treatment. Higher prevalence of mobility and self-care disabilities was observed in cancer survivors who were racial/ethnic minorities and with higher BMI, low physical activity, lower levels of education and/or income, comorbidities, and those experiencing cancer/treatment-related pain. Patterns of mobility and self-care disabilities varied across cancer types. CONCLUSION: Over a quarter of US cancer survivors reported mobility disability, and nearly 10% reported self-care disability, with patterns varying across cancer types and treatment status. Racial/ethnic minorities, along with underserved groups and individuals with unhealthy lifestyles or comorbidities, were notably more affected by functional disabilities, underscoring the need for targeted disability prevention efforts.
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Supervivientes de Cáncer , Personas con Discapacidad , Limitación de la Movilidad , Neoplasias , Humanos , Supervivientes de Cáncer/estadística & datos numéricos , Masculino , Femenino , Persona de Mediana Edad , Prevalencia , Adulto , Anciano , Neoplasias/epidemiología , Estados Unidos/epidemiología , Personas con Discapacidad/estadística & datos numéricos , Adulto Joven , Adolescente , Autocuidado/estadística & datos numéricos , Actividades Cotidianas , Sistema de Vigilancia de Factor de Riesgo ConductualRESUMEN
BACKGROUND: The global burden of type 2 diabetes (T2D) is growing, and the age of onset is widening, resulting in increasing numbers of young adults and elderly patients with T2D. Age-specific diabetes care needs have yet to be fully explored. AIMS: This study examined (1) differences in patient-reported and clinical characteristics by age group and (2) the effect of age on two proxy measures assessing psychological health and self-care adherence after adjusting for potential mediators. METHODS: A cross-sectional, correlational design was used. Adults with type 2 diabetes (T2D) were recruited from a university hospital in Korea between 2019 and 2020. Participants were divided into four groups based on years of age (40s and younger group [n = 27]; 50s group [n = 47]; 60s group [n = 54]; and 70s and older group [n = 48]) to compare patient-reported and clinical characteristics. Chi-square tests, ANOVA, Kruskal-Wallis tests, and logistic regression analysis were performed to assess group differences and effect of age on psychological health and self-care adherence. RESULTS: Of 178 participants, two-thirds were men (n = 114; 64.41%). The mean ages in the 40s and younger, 50s, 60s, and 70s and older groups were 39.4, 54.7, 63.9, and 76.0 years, respectively. There were significant differences in patient-reported and clinical characteristics by age group. The youngest group reported the poorest psychological health and self-care behaviors. Although the oldest group showed the poorest physical functioning, this group also showed the highest self-care adherence and the best psychological health. Regarding clinical characteristics, traditional diabetes-related blood test results showed no significant group differences. LINKING EVIDENCE TO ACTION: Age-specific diabetes care needs were identified in adults with T2D. Interventions to improve psychological health and priming effects of behavioral adherence need to be developed. Furthermore, meticulous investigation to detect potential complications early is essential in adults with T2D.
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Diabetes Mellitus Tipo 2 , Humanos , Diabetes Mellitus Tipo 2/psicología , Masculino , Femenino , Estudios Transversales , Persona de Mediana Edad , Anciano , República de Corea , Adulto , Factores de Edad , Autocuidado/psicología , Autocuidado/métodos , Autocuidado/estadística & datos numéricos , Encuestas y Cuestionarios , Medición de Resultados Informados por el Paciente , Anciano de 80 o más AñosRESUMEN
Importance: The End-Stage Renal Disease Treatment Choices (ETC) model randomly selected 30% of US dialysis facilities to receive financial incentives based on their use of home dialysis, kidney transplant waitlisting, or transplant receipt. Facilities that disproportionately serve populations with high social risk have a lower use of home dialysis and kidney transplant raising concerns that these sites may fare poorly in the payment model. Objective: To examine first-year ETC model performance scores and financial penalties across dialysis facilities, stratified by their incident patients' social risk. Design, Setting, and Participants: A cross-sectional study of 2191 US dialysis facilities that participated in the ETC model from January 1 through December 31, 2021. Exposure: Composition of incident patient population, characterized by the proportion of patients who were non-Hispanic Black, Hispanic, living in a highly disadvantaged neighborhood, uninsured, or covered by Medicaid at dialysis initiation. A facility-level composite social risk score assessed whether each facility was in the highest quintile of having 0, 1, or at least 2 of these characteristics. Main Outcomes and Measures: Use of home dialysis, waitlisting, or transplant; model performance score; and financial penalization. Results: Using data from 125â¯984 incident patients (median age, 65 years [IQR, 54-74]; 41.8% female; 28.6% Black; 11.7% Hispanic), 1071 dialysis facilities (48.9%) had no social risk features, and 491 (22.4%) had 2 or more. In the first year of the ETC model, compared with those with no social risk features, dialysis facilities with 2 or more had lower mean performance scores (3.4 vs 3.6, P = .002) and lower use of home dialysis (14.1% vs 16.0%, P < .001). These facilities had higher receipt of financial penalties (18.5% vs 11.5%, P < .001), more frequently had the highest payment cut of 5% (2.4% vs 0.7%; P = .003), and were less likely to achieve the highest bonus of 4% (0% vs 2.7%; P < .001). Compared with all other facilities, those in the highest quintile of treating uninsured patients or those covered by Medicaid experienced more financial penalties (17.4% vs 12.9%, P = .01) as did those in the highest quintile in the proportion of patients who were Black (18.5% vs 12.6%, P = .001). Conclusions: In the first year of the Centers for Medicare & Medicaid Services' ETC model, dialysis facilities serving higher proportions of patients with social risk features had lower performance scores and experienced markedly higher receipt of financial penalties.
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Disparidades en Atención de Salud , Fallo Renal Crónico , Reembolso de Incentivo , Diálisis Renal , Autocuidado , Determinantes Sociales de la Salud , Anciano , Femenino , Humanos , Masculino , Negro o Afroamericano/estadística & datos numéricos , Población Negra/estadística & datos numéricos , Estudios Transversales , Disparidades en Atención de Salud/economía , Disparidades en Atención de Salud/etnología , Disparidades en Atención de Salud/estadística & datos numéricos , Hispánicos o Latinos/estadística & datos numéricos , Fallo Renal Crónico/economía , Fallo Renal Crónico/epidemiología , Fallo Renal Crónico/etnología , Fallo Renal Crónico/terapia , Trasplante de Riñón/estadística & datos numéricos , Medicaid/economía , Medicaid/estadística & datos numéricos , Pacientes no Asegurados/estadística & datos numéricos , Modelos Económicos , Reembolso de Incentivo/economía , Reembolso de Incentivo/estadística & datos numéricos , Diálisis Renal/economía , Diálisis Renal/métodos , Diálisis Renal/estadística & datos numéricos , Determinantes Sociales de la Salud/economía , Determinantes Sociales de la Salud/etnología , Determinantes Sociales de la Salud/estadística & datos numéricos , Estados Unidos/epidemiología , Poblaciones Vulnerables/estadística & datos numéricos , Listas de Espera , Autocuidado/economía , Autocuidado/métodos , Autocuidado/estadística & datos numéricosRESUMEN
OBJECTIVES: The objective of the study was to describe the occurrence and associations of oral self-care by dependent older New Zealanders. BACKGROUND: Dependent older adults who require some level of assisted daily care have been shown to have poorer oral health than their independent counterparts, yet national estimates are lacking. MATERIALS AND METHODS: A secondary analysis was conducted of data from New Zealand's 2012 Older People's Oral Health Survey, a national survey that interviewed and examined a representative sample of 2,218 dependent older adults living in aged residential care or receiving home-based care. Survey data were weighted for statistical analyses, and modelling was carried out using a modified Poisson approach. RESULTS: Overall, 59.5% (95% CI: 55.1, 63.7) of participants brushed their teeth twice a day, with this rate higher among women, Asians and those without cognitive or physical impairment. Cleaning interdentally at least once a week was less common than brushing, at 25.9% (95% CI: 21.5, 30.9), and that proportion was significantly lower among those with higher dependency or who were cognitively or physically impaired. Almost 9 in 10 (87.8%; 95% CI 83.1, 91.4) used fluoride toothpaste, and adults of high socio-economic status had lower rates of fluoride toothpaste use. Only 15.0% (95% CI 12.4, 18.0) used mouthwash, with this being most prevalent in Pasifika. More than half of those who wore dentures also wore them at night. CONCLUSION: Oral self-care was sub-optimal among dependent older New Zealanders. Improving the situation should be a high priority.
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Pueblos de Australasia , Higiene Bucal , Anciano , Femenino , Humanos , Fluoruros , Nueva Zelanda , Salud Bucal/estadística & datos numéricos , Autocuidado/estadística & datos numéricos , Pastas de Dientes , Higiene Bucal/estadística & datos numéricos , Estado FuncionalRESUMEN
AIM: To explore whether the acute 30-day burden of COVID-19 on health care use has changed from February 2020 to February 2022. METHODS: In all Norwegians (N = 493 520) who tested positive for SARS-CoV-2 in four pandemic waves (February 26th, 2020 -February 16th, 2021 (1st wave dominated by the Wuhan strain), February 17th-July 10th, 2021 (2nd wave dominated by the Alpha variant), July 11th-December 27th, 2021 (3rd wave dominated by the Delta variant), and December 28th, 2021 -January 14th, 2022 (4th wave dominated by the Omicron variant)), we studied the age- and sex-specific share of patients (by age groups 1-19, 20-67, and 68 or more) who had: 1) Relied on self-care, 2) used outpatient care (visiting general practitioners or emergency ward for COVID-19), and 3) used inpatient care (hospitalized ≥24 hours with COVID-19). RESULTS: We find a remarkable decline in the use of health care services among COVID-19 patients for all age/sex groups throughout the pandemic. From 83% [95%CI = 83%-84%] visiting outpatient care in the first wave, to 80% [81%-81%], 69% [69%-69%], and 59% [59%-59%] in the second, third, and fourth wave. Similarly, from 4.9% [95%CI = 4.7%-5.0%] visiting inpatient care in the first wave, to 3.6% [3.4%-3.7%], 1.4% [1.3%-1.4%], and 0.5% [0.4%-0.5%]. Of persons testing positive for SARS-CoV-2, 41% [41%-41%] relied on self-care in the 30 days after testing positive in the fourth wave, compared to 16% [15%-16%] in the first wave. CONCLUSION: From 2020 to 2022, the use of COVID-19 related outpatient care services decreased with 29%, whereas the use of COVID-19 related inpatient care services decreased with 80%.
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COVID-19/terapia , Hospitalización/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Autocuidado/estadística & datos numéricos , Adolescente , Adulto , Factores de Edad , Anciano , Atención Ambulatoria/estadística & datos numéricos , COVID-19/epidemiología , Niño , Preescolar , Costo de Enfermedad , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Noruega/epidemiología , Factores Sexuales , Adulto JovenRESUMEN
BACKGROUND: Self-care is a multicomponent set of capacities that influence beliefs about health and well-being. OBJECTIVES: We examined the relationship between self-care capacity, age, and disability status with two perceptions of well-being in a cohort of Medicare beneficiaries. METHODS: The current study is part of a multisite research project to determine factors associated with cross-sectional and longitudinal morbidity and mortality trajectories observed in Medicare beneficiaries. Variable selection was informed by the health disparities and outcomes model. Using data from the 2013 Medicare Current Beneficiary Survey and logistic regression models, we determined associations between self-care capacity, including indicators of self-care ability and self-care agency and two perceptions of well-being. Participants were divided into four groups based on how they qualified for Medicare: (a) over 65 years of age, and below 65 years of age and disabled because of (b) physical or (c) mental disorder, or (d) disabled and could not be classified as physically or mentally disabled as the primary cause of eligibility. RESULTS: Self-care ability limitations in activities of daily living (ADL), instrumental activities of living (IADL), and social activity participation were associated with both health perceptions. Those with physical disabilities reported more ADL and IADL limitations when compared with the other eligibility groups and were significantly more likely to have negative health perceptions. Those with serious mental illness were most likely to report the most severe IADL limitations. The over 65 years of age group reported less self-care incapacity than the other three eligibility types. Other components of self-care, including health literacy, agency, and health behaviors, significantly influenced perceptions of health. Women and people identifying as non-Whites were more likely to have negative health perceptions. DISCUSSION: Self-care capacity is a complex construct, and its varied elements have differential relationships with perceptions of well-being. Those with physical disabilities reported more self-care limitations, poorer perceived health, and more health worries than the other groups. Still, there were different patterns of self-care capacities in the serious mental illness type-especially in IADL limitations. The study adds empirical evidence to previous research documenting inequities in health outcomes for women and non-Whites. Findings provide empirical support for the health disparities and outcomes model.
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Factores de Edad , Personas con Discapacidad/psicología , Percepción , Autocuidado/normas , Actividades Cotidianas/psicología , Anciano , Anciano de 80 o más Años , Estudios Transversales , Personas con Discapacidad/estadística & datos numéricos , Femenino , Humanos , Masculino , Medicare/organización & administración , Medicare/estadística & datos numéricos , Autocuidado/psicología , Autocuidado/estadística & datos numéricos , Encuestas y Cuestionarios , Estados UnidosRESUMEN
INTRODUCTION: MASK-air® is an app whose aim is to reduce the global burden of allergic rhinitis and asthma. A transfer of innovative practices was performed to disseminate and implement MASK-air® in European regions. The aim of the study was to examine the implementation of the MASK-air® app in older adults of the Puglia TWINNING in order to investigate (i) the rate of acceptance in this population, (ii) the reasons for refusal and (iii) the evaluation of the app after its use. METHODS: All consecutive geriatric patients aged between 65 and 90 years were included by the outpatient clinic of the Bari Geriatric Immunoallergology Unit. After a 1-h training session, older adults used the app for 6 months. A 6-item questionnaire was developed by our unit to evaluate the impact of the app on the management of the disease and its treatment. RESULTS: Among the 174 recruited patients, 102 accepted to use the app (mean age, SD: 72.4 ± 4.6 years), 6 were lost to follow-up, and 63 had a low education level. The reasons given not to use the app included lack of interest (11%), lack of access to a smartphone or tablet (53%), low computer literacy (28%), and distrust (8%). At follow-up, the overall satisfaction was high (89%), the patient considered MASK-air® "advantageous" (95%), compliance to treatment was improved (81%), and the rate of loss to follow-up had decreased to 6%. CONCLUSION: Older adults with a low level of education can use the MASK-air® app after a short training session.
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Asma/epidemiología , Aplicaciones Móviles , Rinitis Alérgica/epidemiología , Factores de Edad , Anciano , Anciano de 80 o más Años , Asma/prevención & control , Europa (Continente)/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Aceptación de la Atención de Salud , Proyectos Piloto , Rinitis Alérgica/prevención & control , Autocuidado/métodos , Autocuidado/estadística & datos numéricosRESUMEN
Background: The number of type 2 diabetes mellitus (T2DM) cases among empty-nest elderly increases with increasing aging in China. Self-care plays an important role in preventing and reducing adverse outcomes of diabetes; however, few studies focus on self-care experiences of empty-nest elderly with T2DM. Objective: To explore self-care experiences for a chronic disease among empty-nest elderly patients with T2DM in mainland China. Methods: A descriptive phenomenological design was used in this study. Semi-structured interviews were conducted for 15 empty-nesters with T2DM. Interviews were implemented in department of endocrinology at a tertiary teaching hospital located in Shandong province, east of China. Results: The participants were poorly adept with monitoring their blood glucose and lacked the ability to deal with abnormal blood glucose levels. Most participants had a good relationship with medication and physical activity. Living without children was perceived as a benefit that improved dietary management and is a disadvantage in terms of economic and emotional support and access to medical resources. Elderly empty-nesters also lacked knowledge about diabetes and paid little attention to potential complications. Conclusion: Empty-nest elderly patients with T2DM value medication compliance and lifestyle modification more than blood glucose monitoring, complication prevention, and coping with negative emotions. Friends and spouses play indispensable roles in patients' self-care motivation and maintenance. Diabetes education on self-care, access to medical resources, and social support is needed for better diabetes management.
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Envejecimiento , Diabetes Mellitus Tipo 2/terapia , Autocuidado , Aislamiento Social , Anciano , Envejecimiento/fisiología , Envejecimiento/psicología , China/epidemiología , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/psicología , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Características de la Residencia , Autocuidado/psicología , Autocuidado/estadística & datos numéricos , Aislamiento Social/psicología , Encuestas y CuestionariosRESUMEN
OBJECTIVES: Little is known about medical students' attitudes regarding the healthy lifestyle habits they are taught to recommend to patients and whether they believe they have a professional responsibility to live a healthy lifestyle. Understanding students' attitudes and practices regarding healthy lifestyles may provide insights into the personal and professional challenges that students face as they navigate the ethical tension between obligations to care for others (altruism) and for themselves (self-care). METHODS: The authors conducted a cross-sectional, anonymous, online survey of all medical students at the University of Iowa Carver College of Medicine in fall 2019, using descriptive statistics for analysis. RESULTS: A total of 351 students participated (response rate, 52.0%). Most agreed that physicians (85.5%) and medical students (77.8%) have a responsibility to try to live a healthy lifestyle; that physicians who practice healthy behaviors are more confident in counseling patients (94.0%), more likely to counsel patients (88.3%), and more likely to have their advice followed (86.9%); that as students they are more likely to counsel patients if they practice the healthy behavior (90.0%); and that their medical school workload resulted in exercise (69.7%), sleeping (69.4%), and eating (60.2%) practices that were less healthy than they should be. CONCLUSIONS: Most medical students support the professional responsibility to live a healthy lifestyle and believe doing so increases their effectiveness in counseling patients about healthy lifestyle habits. The medical school workload may limit some students' ability to live healthy lifestyles, however. Medical students need educational opportunities in ethics and professionalism to discuss challenges and expectations for living healthy lifestyles, with an eye toward practical approaches to living the life of a medical student that are professionally responsible and personally realistic.
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Estilo de Vida Saludable , Autocuidado/ética , Estudiantes de Medicina/psicología , Actitud del Personal de Salud , Estudios Transversales , Educación Médica/métodos , Educación Médica/normas , Educación Médica/estadística & datos numéricos , Humanos , Motivación , Autocuidado/psicología , Autocuidado/estadística & datos numéricos , Estudiantes de Medicina/estadística & datos numéricos , Encuestas y CuestionariosRESUMEN
BACKGROUND: Melanoma incidence has quadrupled since 1970 and melanoma is now the second most common cancer in individuals under 50. Targeted immunotherapies for melanoma now potentially enable long-term remission even in advanced melanoma, but these melanoma survivors require ongoing surveillance, with implications for NHS resources and significant social and psychological consequences for patients. Total skin self-examination (TSSE) can detect recurrence earlier and improve clinical outcomes but is underperformed in the UK. To support survivors, the Achieving Self-directed Integrated Cancer Aftercare (ASICA) intervention was developed to prompt and improve TSSE performance, with subsequent reporting of concerns and submission of skin photos to a Dermatology Nurse Practitioner (DNP). ASICA was delivered as a randomized pilot trial. METHODS: This paper reports on process evaluation. Data on participants' demographics and the concerns they reported during the trial were tabulated and displayed using Microsoft Excel and SPSS. We explored which participants used ASICA, and how frequently, to report any skin concerns. We also determined how the interactions had worked in terms of quality of skin photographs submitted, clinical assessments made by the DNP, and the assessments and decisions made for each concern. Finally, we explored significant events occurring during the trial. Data on participants' demographics and the concerns they reported during the trial were tabulated and displayed using SPSS. A semi-structured interview was undertaken with the DNP to gain perspective on the range of concerns presented and how they were resolved. RESULTS: Of 121 recruited melanoma patients receiving ASICA for 12 months, 69 participants submitted a total of 123 reports detailing 189 separate skin-related concerns and including 188 skin photographs. Where participants fully complied with follow-up by the DNP, concerns were usually resolved remotely, but 19 (10.1%) were seen at a secondary care clinic and 14 (7.4%) referred to their GP. 49 (25.9%) of concerns were not completely resolved due to partial non-compliance with DNP follow-up. CONCLUSION: Melanoma patients randomized to the ASICA intervention were able to report skin-related concerns that could be resolved remotely through interaction with a DNP. Feasibility issues highlighted by ASICA will support further development and optimization of this digital tool. TRIAL REGISTRATION: Clinical Trials.gov , NCT03328247 . Registered on 1 November 2017.
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Cuidados Posteriores/métodos , Melanoma/diagnóstico , Recurrencia Local de Neoplasia/diagnóstico , Autoexamen/métodos , Neoplasias Cutáneas/diagnóstico , Piel , Cuidados Posteriores/estadística & datos numéricos , Supervivientes de Cáncer , Computadoras de Mano , Estudios de Factibilidad , Femenino , Humanos , Masculino , Melanoma/terapia , Persona de Mediana Edad , Aplicaciones Móviles , Enfermeras Practicantes , Enfermería Oncológica , Fotograbar , Proyectos Piloto , Autocuidado/métodos , Autocuidado/estadística & datos numéricos , Autoexamen/estadística & datos numéricos , Neoplasias Cutáneas/terapia , Reino UnidoRESUMEN
BACKGROUND: As the burden of cardiovascular disease increases in sub-Saharan Africa, there is a growing need for low-cost interventions to mitigate its impact. Providing self-care health education to patients with chronic heart failure (CHF) is recommended as an intervention to prevent complications, improve quality of life, and reduce financial burdens on fragile health systems. However, little is known about health education's effectiveness at improving CHF self-management adherence in sub-Saharan Africa. Therefore the present study aimed to assess the effectiveness of an educational intervention to improve self-care adherence among patients with CHF at Debre Markos and Felege Hiwot Referral Hospitals in Northwest Ethiopia. METHODS: To address this gap, we adapted a health education intervention based on social cognitive theory comprising of intensive four-day training and, one-day follow-up sessions offered every four months. Patients also received illustrated educational leaflets. We then conducted a clustered randomized control trial of the intervention with 186 randomly-selected patients at Debre Markos and Felege Hiwot referral hospitals. We collected self-reported data on self-care behavior before each educational session. We analyzed these data using a generalized estimating equations model to identify health education's effect on a validated 8-item self-care adherence scale. RESULTS: Self-care adherence scores were balanced at baseline. After the intervention, patients in the intervention group (n = 88) had higher adherence scores than those in the control group (n = 98). This difference was statistically significant (ß = 4.15, p < 0.05) and increased with each round of education. Other factors significantly associated with adherence scores were being single (ß = - 0.25, p < 0.05), taking aspirin (ß = 0.76, p < 0.05), and having a history of hospitalization (ß = 0.91, p < 0.05). CONCLUSIONS: We find that self-care education significantly improved self-care adherence scores among CHF patients. This suggests that policymakers should consider incorporating self-care education into CHF management. TRIAL REGISTRATION NUMBER: PACTR201908812642231.
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Insuficiencia Cardíaca/terapia , Cooperación del Paciente , Educación del Paciente como Asunto/métodos , Autocuidado/métodos , Adulto , Etiopía , Femenino , Humanos , Masculino , Estado Civil , Persona de Mediana Edad , Autocuidado/estadística & datos numéricos , Automanejo/educación , Factores SocioeconómicosRESUMEN
ABSTRACT: Poor oral hygiene can be potentially life-threatening in inpatients. However, no basic protocol on oral hygiene customized for inpatients exists, and lack of oral care related knowledge, attitude, and skills among caregivers could be detrimental to the general health of patients. This study sought to identify the oral care practices and oral health status of inpatients with varying physical activity limitations in a rehabilitation ward.Sixty-one inpatients in a rehabilitation ward were evaluated for their medical and physical conditions and oral health status. These were assessed using the bedside oral exam, decayed, missing, filled teeth index, plaque index, gingival index, and caries activity test.In total, 40 men and 21 women (mean age, 56.6âyears) were included in this study. Among them, 50.8% of the patients could brush their teeth unassisted, whereas 49.2% required assistance from an assistant for oral care. The proportion of patients receiving nasogastric tube feeding was higher in the group that could not provide oral self-care; 36.7% and 33.3% of these patients showed moderate and severe dysfunction, respectively, based on bedside oral exam. Scores for the swallowing, tongue, and total domains of bedside oral exam were poorer for patients who could not provide oral self-care (Pâ<â.01). The caries activity test indicated a moderate risk for both groups.Our findings suggest that an oral care protocol that considers the physical activity limitations in inpatients in rehabilitation wards is necessary to minimize negative influences on the systemic health of these patients.
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Actividades Cotidianas , Caries Dental , Salud Bucal/normas , Higiene Bucal , Autocuidado , Cuidadores/educación , Caries Dental/diagnóstico , Caries Dental/prevención & control , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Pacientes Internos/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Evaluación de Necesidades , Higiene Bucal/educación , Higiene Bucal/métodos , Índice Periodontal , Rendimiento Físico Funcional , Centros de Rehabilitación/estadística & datos numéricos , República de Corea/epidemiología , Autocuidado/métodos , Autocuidado/estadística & datos numéricosRESUMEN
BACKGROUND AND AIMS: The present study was conducted to determine the situation of foot self-care practice among Iranian women with diabetes. METHODS: In this cross-sectional study, 475 women completed the Diabetic Foot Self-Care Questionnaire (DFSQ) along with other questions. The overall and three components scores including personal care, podiatric care, and foot wearing, were calculated and their relationship with other factors was analyzed. RESULTS: The average total DFSQ score was 60.38 ± 9.9, and 16.98 ± 7, 5.95 ± 2.11, and 12.26 ± 3.95 for personal care, podiatric care, and footwear respectively. Education level, self-reported health status, and life satisfaction had a significant relationship with footwear score, and smoking and life satisfaction were related to personal care and podiatric care respectively. In Pearson regression, DM self-care was correlated with all three components and total DFSQ score. Also, depression and SCS (Social Capital Status) correlated with DFSQ scores except with personal self-care and footwear respectively. Body Mass Index (BMI) and Quality of Life (QoL) were significantly correlated with footwear and podiatric care scores. CONCLUSION: In this study, the DFSQ result was almost acceptable, however, it highlights the importance of suitable interventions to establish better self-care practice among Iranian diabetic women.