Experiences of Self-Sampling and Future Screening Preferences in Non-Attenders Who Returned an HPV Vaginal Self-Sample in the YouScreen Study: Findings From a Cross-Sectional Questionnaire.

BACKGROUND: We assessed experiences of human papillomavirus (HPV) vaginal self-sampling and future screening preferences in an ethnically and socio-economically diverse group of women overdue for cervical screening. SETTING AND PARTICIPANTS: A postal questionnaire was embedded in the YouScreen self-sampling trial in England: 32.5% (2712/8338) of kit completers returned the survey. Kit non-completers were encouraged to return a questionnaire, but no responses were received. Participants were ethnically diverse (40.3% came from ethnic minority backgrounds), and 59.1% came from the two most deprived quintiles. Differences in confidence in kit completion, trust in the test results and intention to attend a follow-up test if HPV-positive were evaluated using Pearson's χ2 analyses. Binary logistic regression models explored predictors of a future screening choice and preferences for urine versus vaginal self-sampling. RESULTS: Most kit-completers reported high confidence in self-sampling (82.6%) and high trust in the results (79.9%), but experiences varied by ethnicity and screening status. Most free-text comments were positive but some reported difficulties using the device, pain or discomfort. Most women would opt for self-sampling in the future (71.3% vs. 10.4% for a clinician-taken test) and it was more often preferred by ethnic minority groups, overdue screeners and never attenders. Urine self-tests were preferred to vaginal tests (41.9% vs. 15.4%), especially among women from Asian, Black or Other Ethnic backgrounds. CONCLUSIONS: Kit-completers were confident, found the test easy to complete, and trusted the self-sample results. However, experiences varied by ethnic group and some women highlighted difficulties with the kit. Most women would prefer self-sampling in the future, but it was not a universal preference, so offering a choice will be important. PATIENT OR PUBLIC CONTRIBUTION: We did not have direct patient and public involvement and engagement (PPIE) in the questionnaire design. However, patients and public representatives did input into the design of the YouScreen trial and reviewed the wider study materials (e.g. participant information sheet). TRIAL REGISTRATION: This questionnaire study was embedded in the YouScreen trial. The protocol for the YouScreen trial is available at https://www.isrctn.com/ISRCTN12759467. The National Institute for Health Research 43 Clinical Research Network (NIHR CRN) Central Portfolio Management System (CPMS) ID is 4441934.

Self-care practice and associated factors among patients with diabetes on follow-up at Yirgalem General Hospital, Sidama, Ethiopia: a cross-sectional study.

BACKGROUND: Self-care practice is an integral and efficient part of comprehensive diabetes management, which could be influenced by various socio-demographic, clinical, and lifestyle factors. OBJECTIVE: The study aimed to assess the level of diabetes self-care practice and its associated factors among patients with diabetes on follow-up at Yirgalem General Hospital, Yirgalem, Sidama, Ethiopia. METHODOLOGY: An Institution-based cross-sectional study was conducted from February 15 to May 10, 2022, involving 298 patients with diabetes on follow-up at Yirgalem General Hospital. A pre-tested interviewer-administered questionnaire was utilized to collect data from patients. A descriptive analysis was conducted to determine the level of good self-care practice. Bivariate and multivariable binary logistics regression were performed to determine factors associated with good diabetic self-care practice. Associations with a p-value < 0.05 were considered statistically significant. RESULT: The overall good diabetic self-care practice among patients was 59.4%. Regarding the specific domains of care, 15 (5%) participants had good self-glucose monitoring care, 228 (76.5%) had good exercise self-care, 268 (89.9%) had good dietary self-care, 228 (76.5%) had good foot self-care, and 260 (87.2%) had good diabetic medication adherence. Single marital status (AOR = 5.7, 95% CI: (1.418, 22.915), urban residence (AOR = 2.992, 95% CI: (1.251, 7.153)), and having a glucometer (AOR = 2.273, 95% CI: (1.083, 4.772)) were factors that were significantly associated with good diabetic self-care practice. CONCLUSION: Good diabetic self-care practices among participants was low. Marital status, place of residence, and having a glucometer were statistically significant predictors of good diabetic self-care practices. Targeted intervention addressing those patients from rural areas to increase awareness and practice of self-care, as well as the promotion of having a glucometer at home for self-glucose monitoring is recommended.

Nurses' perspectives on the provision of self-care management education to patients with heart failure: A qualitative study at Cardiac Hospital, Dar es Salaam Tanzania.

BACKGROUND: Patients' education along with a motivation for developing self-care management skills is an essential component in the management of heart failure(HF). Self-care management education has been practiced by nurses in many hospitals. However, there is inadequate evidence for the provision of self-care management education in low-income countries including Tanzania. Lack of self-care management education to patients with HF during discharge is the most common reason for re-admission to hospitals. AIM: This study aimed to explore nurses' perspectives focusing on facilitators and barriers to the provision of self-care management education to patients with heart failure at Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania. MATERIALS AND METHODS: This study used a qualitative descriptive design. Purposive sampling was used to recruit 12 study participants. In-depth interviews were used to collect the data. We used thematic analysis to come up with the themes and sub-themes. RESULTS: The two major themes emerged from this study; The first theme is "Improved patient quality of life and health outcome" which describes factors that motivate nurses to continue giving self-care management education to heart failure patients. The second theme is "Reduced effective uptake of self-care management education" which describes nurses'perspectives on barriers for providing self-care management education to heart falure patients. Nurses highlight some barriers while providing self-care management education to patients with heart failure including;inadequate knowledge of self-care management among nurses, lack of privacy during the provision of self-care education, poor communication skills among nurses, and lack of learning materials. Also, nurses pointed out facilitators that influence the provision of self-care management education such as increased involvement of family members and the use of peer educators. CONCLUSIONS AND RECOMMENDATIONS: Poor self-care management for patients with heart failure results in readmission and prolonged hospital stay. Family involvement and the use of peer educators are the key steps in the improvement of self-care management for patients with HF. However, patient cognitive impairment and poverty which contribute to poor health outcomes, should be taken into consideration when planning for discharge for patients with HF. Self-care management education should be part of routine health care.

Clinical effect of nursing methods integrating health belief models on self-care of maintenance hemodialysis patients: A retrospective study.

This study aimed to explore the clinical effectiveness of nursing methods that incorporate health belief models on the self-care practices of maintenance hemodialysis patients. The objective was to enhance patients' health beliefs, strengthen their healthy behaviors and habits, improve their unhealthy daily behaviors, and provide robust theoretical and practical foundations for future nursing practices in this area. A retrospective analysis was conducted on 150 hemodialysis patients from our hospital, from January 2019 to February 2023. The participants were divided into 2 groups: a control group (N = 75) using routine nursing methods, and an experimental group (N = 75) using methods integrated with health belief models. Both groups were comparable in terms of demographic and baseline clinical characteristics such as gender, marital status, age, education level, total scores of self-care ability, and dialysis duration, with no significant differences observed (P > .05). Data collection tools included a general information questionnaire and a self-care ability scale, and clinical effectiveness was measured through specific indicators such as parathyroid hormone, blood phosphorus, urea, potassium, calcium, and IWGR%. Post-intervention, the experimental group demonstrated significant improvements in self-care capabilities across various dimensions and most clinical indicators compared to the control group, with the exception of parathyroid hormone and blood urea levels. The study concludes that integrating health belief models into nursing practices significantly enhances the self-care abilities of maintenance hemodialysis patients, improves several clinical parameters, and holds promise for fostering better patient outcomes and guiding future clinical nursing practices.

A cross-sectional study on the self-management of asthma and asthma control among adult asthmatic patients in the Aseer region, KSA.

Proper management of asthma is crucial for maintaining control over the disease and has a significant impact on the patient's overall condition. The purpose of this study was to determine the extent of self-management and the level of Asthma control in the patients from the Aseer region of Saudi Arabia, as well as to investigate determinants of illness control. A study was conducted using quantitative cross-sectional methods. Researchers utilised a web-based, self-administered structured questionnaire to gather data. The questionnaire included three sections: a socio-demographic section, an Asthma Self-Management Questionnaire (ASMQ), and Asthma Control Test (ACT). An analysis using the chi-square test was conducted to determine if there was a notable connection between the socio-demographic characteristics of the participants and the level of asthma control. A total of 305 responses were collected. The average score for the Asthma Self-Management Questionnaire was 5.72, which corresponds to 40.9%. Based on the scores from the Asthma Control Test, it was found that 60 patients (20.0%) had asthma that was not under control, 94 (30.0%) had asthma that was partially controlled, and 151 (50.0%) had asthma that was well controlled. Factors such as gender, non-smoking status, and having asthma for over 10 years (p ˂0.05) were found to be strongly correlated with improved disease control. Significant gaps were found in patients' awareness of the most important and critical aspects concerning the condition, medications, and preventative actions that limit asthma aggravation. To address the current situation, hospitals and clinics must make substantial efforts.

Diabetic foot self-care knowledge and practice among patients with diabetes attending diabetic clinic in the Gambia.

Diabetic foot ulcer is the most common complication causing lots of admissions among diabetic patients. Understanding patients' level of foot self-care knowledge, practice and associated factors is important for planning interventions to control and prevent diabetic foot complications. This study aimed to assess the level of knowledge and practice of foot self-care among diabetic patients attending diabetic clinics in The Gambia. Two hundred and seventeen patients attending diabetic clinics in two public hospitals were selected using a successive sampling technique. Data were collected using a validated interviewer-administered questionnaire. Descriptive statistics were used to summarize the demographic and clinical data. Multivariate logistic regression was used to identify factors associated with foot self-care knowledge and practice. The findings showed a poor level of foot self-care knowledge (n = 114; 52.5%) and practice (n = 149; 68.7%). Patients' educational level was statistically significantly association with diabetic foot self-care knowledge (p = 0.02). Diabetic foot ulcer history (aOR = 0.23, 95% CI: 0.08-0.63; p < 0.001), diabetic hospitalization (aOR = 2.41, 95% CI: 1.23-4.75, p = 0.01) and diabetic foot care education (aOR = 2.65, 95% CI: 1.39-5.06, p < 0.001) were statistically significantly associated with foot self-care practice. The poor diabetic foot self-care knowledge and practice among these patients emphasize the need for a diabetic health education program in these clinics.

Value of self-care for sexual and reproductive health.

It is opportune for the Journal to contribute to Self-Care Month and Self-Care Day, as proclaimed by the World Health Organization (WHO) in its efforts to promote self-care which is increasingly prominent in discourses in resource-limited settings for attaining universal health coverage. With sexual and reproductive health and rights facing hindrances, such as cultural barriers, self-care should facilitate access to services whilst maintaining privacy. Largely limited to pregnancy beforehand, self-care can now be promoted for the self-management of medical abortion, self-administration of injectable contraceptives and gender-affirming hormones besides self-collection of samples for infection testing.

Il est opportun pour le Journal de contribuer au Mois et à la Journée des soins personnels, comme l'a proclamé l'Organisation mondiale de la santé dans ses efforts visant à promouvoir les soins personnels, qui occupent une place de plus en plus importante dans les discours dans les contextes à ressources limitées pour atteindre la couverture sanitaire universelle. . La santé et les droits sexuels et reproductifs étant confrontés à des obstacles, tels que des barrières culturelles, les soins personnels devraient faciliter l'accès aux services tout en préservant la vie privée. Largement limités à la grossesse préalable, les soins personnels peuvent désormais être encouragés pour l'autogestion de l'avortement médicamenteux, l'auto-administration de contraceptifs injectables et d'hormones d'affirmation de genre, en plus de l'auto-collecte d'échantillons pour les tests d'infection.

Development of Fewer Falls in MS-An Online, Theory-Based, Fall Prevention Self-Management Programme for People With Multiple Sclerosis.

OBJECTIVE: The aim of this study was to describe the process used to develop a theory-based, online fall prevention self-management programme for ambulatory and non-ambulatory people with multiple sclerosis (pwMS). METHODS: The development process was guided by the Medical Research Council framework of complex interventions and began with a scoping review of the literature on self-management of falls in pwMS. Subsequent phases of development were performed through iterative and concurrent processes and were informed by the perspectives of pwMS and healthcare professionals with MS expertise. RESULTS: Through a systematic and iterative process in close collaboration with pwMS and healthcare professionals, a theory-based online fall prevention self-management programme, Fewer Falls in MS, for ambulatory and non-ambulatory pwMS was developed. The programme is grounded in theory and pedagogical models and features utilization of action plans to address diverse influences on fall risks. CONCLUSIONS: A carefully operationalized definition of self-management and an iterative co-development process were essential to the creation of the Fewer falls in MS programme. Continuation of the co-development process and collaboration with end users was needed to refine the programme. PATIENT OR PUBLIC CONTRIBUTION: PwMS and healthcare professionals were involved throughout the development process of the programme. The patient organization Neuro Sweden was contacted in the initial phase to discuss the relevance of a self-management programme to prevent falls in MS. They supported the research group (all authors) in identification of and contact with pwMS with interest to participate. Three members of the research group (S.T.J., M.F. and C.Y.), that is, the operative group, met neuro Sweden and one pwMS to further discuss the relevance of a self-management programme to prevent falls. To develop the process and content of the fall prevention programme, a co-design process was performed together with pwMS and healthcare professionals. The results of the co-design process are presented in this manuscript. In addition to participating in the co-design process, pwMS and healthcare professionals provided feedback to the research group on programme process and content on several occasions during the subsequent programme development process. In a pretest (Beta version) of the programme, four pwMS acted as test subjects and provided additional feedback on the programme to the research group. TRIAL REGISTRATION: NCT04317716.

Voices of Wisdom: Geriatric Interviews on Self-Management of Type 2 Diabetes in the United States-A Systematic Review and Metasynthesis.

This review is aimed at unraveling the intricacies of diabetic self-management among geriatric people, drawing on current insights and understanding the complex paths geriatric people navigate. A wide search was conducted in health-oriented databases, including CINAHL, Embase, PsycINFO, MEDLINE, PubMed, Web of Science, and Cochrane Library, while gray literature was excluded. The search combined keywords and subject headings, focusing on the geriatric population, diabetes, self-management, and qualitative research. A three-tiered screening process was employed, with titles and then abstracts initially reviewed. Full-text analysis followed, with disagreements resolved among reviewers. In total, there were 248 participants included across these eight studies. Positive attitudes and perceptions were found to play a significant role in optimizing diabetes self-care outcomes. Support from family and friends was identified as crucial for self-care, while healthcare professionals often lacked adequate support and encouragement. Participants emphasized the importance of listening to their bodies and acknowledging hidden issues. These themes collectively highlight the multifaceted aspects of diabetes self-care and the impact of various factors on the self-management experiences of geriatric individuals with diabetes. The goal of this review is not to objectify self-management as a treatment strategy but to emphasize the importance of cultivating positive attitudes, respecting individual values, and addressing cultural and ethnic differences in healthcare practices to enhance self-management in this population. By embracing cultural diversity, understanding barriers, and respecting individual values, healthcare professionals and policymakers can improve the quality of life for the geriatric population living with diabetes.

Loneliness and its correlation with self-care and activities of daily living among older adults: a partial least squares model.

BACKGROUND: The growing elderly population worldwide is accompanied by an increased disrupting daily activities and self-care. Neglecting the multifaceted needs of the elderly can lead to detrimental effects such as loneliness or social isolation, threatening healthy aging. Self-care is a key strategy to enhance daily functioning and mitigate feelings of loneliness among the elderly. This study was conducted with the aim of investigating the feelings of loneliness and its relationship with self-care and Activities of Daily Living (ADL) among the older adults of Tabriz city. METHODS: In this observational cross-sectional study, we engaged 315 older adults using a simple random sampling. Participants were selected randomly from Iran's Integrated Health System (IIHS) framework. Three questionnaires including de Jong Gierveld Loneliness Scale, Persian version of self-care scale, and ADL-Katz were used for data collection. The Partial Least Squares and Spearman's correlation were used to investigate the relationships between demographic characteristics, loneliness, self-care, and ADL. RESULTS: The sample comprised 315 respondents 51.1% were female, 49.5% had a middle school literacy and 86% were married. A significant negative relationship was observed between loneliness and self-care (P < 0.001 and r =-0.311). Demographic characteristics, including age and marital status, were found to negatively moderate the relationship between self-care (path coefficient - 0.07, P = 0.044) and positively moderate the relationship with loneliness (path coefficient 0.29, p < 0.001). ADL was positively associated with self-care (path coefficient 0.41, p = 0.046) and also a direct and significant relationship was observed between ADL and daily self-care (P < 0.001 and r = 0.335). CONCLUSION: This study underscores the complex interplay between loneliness, self-care, and ADL. It highlights the need for interventions that address emotional health and daily living skills as part of comprehensive self-care strategies. Further research is needed to explore these relationships in more detail and to develop targeted interventions for different demographic groups.

Can an Online Course, Life101: Mental and Physical Self-Care, Improve the Well-Being of College Students?

Unlabelled: The COVID-19 pandemic has had a significant impact on the mental health of college students worldwide. As colleges shifted to online instruction, students faced disruptions and increased stressors, leading to a decline in mental health that appears to continue in the postpandemic era. To alleviate this problem, academic institutions have implemented various interventions to address mental health issues; however, many of these interventions focus on a single approach and lack diverse delivery methods. This viewpoint introduces the concept of a multimodal self-care online course, Life101: Mental and Physical Self-Care, and discusses the potential effectiveness of such an intervention in improving students' well-being. The course combines evidence-based interventions and incorporates interactive lectures, workshops, and guest speakers. Pre- and postcourse surveys were conducted over a span of 4 academic terms to evaluate the impact of this course on the well-being and self-care practices of students. The survey data suggest positive outcomes in students taking Life101, including the adoption of healthier habits, reduced stress levels, and increased knowledge and practice of self-care techniques. Life101 represents a novel multimodality intervention to address the epidemic of mental health issues faced by students today. By implementing similar evidence-based multimodal didactic curricula across campuses, academic institutions may be able to better equip students to navigate challenges and promote their overall well-being.

Investigation and Correlation Analysis of Self-Care Ability and Fatigue Among Primary Caregivers of Postoperative Patients With Liver Cancer in China.

BACKGROUND: In the postoperative period, patients mainly rely on caregivers, who experience their own physical and mental fatigue. Caregiver fatigue may affect patient outcomes. OBJECTIVES: This study explored the fatigue status and influencing factors of primary caregivers of patients after liver cancer surgery. METHODS: A baseline information questionnaire, the Fatigue Scale-14, and the Barthel Index were used to investigate the self-care ability and fatigue status of 191 primary caregivers of patients with hepatic carcinoma who had had surgery. FINDINGS: The postoperative hospitalization time and self-care level of patients, whether the primary caregiver had health insurance, subjective feelings of fatigue, the perception that health was affected, and the patients' desired level of postoperative care were correlated with the occurrence of primary caregiver fatigue.

Implementing Self-Measured Blood Pressure Monitoring With Clinical Support: A Qualitative Study of Federally Qualified Health Centers.

CONTEXT: Self-measured blood pressure monitoring (SMBP) with clinical support is effective at reducing blood pressure for people with hypertension. Although strengths and challenges around SMBP are well-documented, few studies describe the complexities of real-world implementation of SMBP with clinical support in the Federally Qualified Health Center (FQHC) setting. PROGRAM: Between 2019 and 2023, the Ohio Department of Health funded the Ohio Association of Community Health Centers to manage a multiyear quality improvement (QI) project with 21 FQHCs. The project aimed to improve the identification and management of patients with hypertension, diabetes, and prediabetes. This study focuses on the activities implemented to provide SMBP support to patients with hypertension. IMPLEMENTATION: FQHCs implemented clinical SMBP support using multiple roles, approaches, and resources. FQHCs established a process to identify patients eligible for SMBP support, provide blood pressure monitors, train patients on SMBP, track blood pressure readings, follow up with patients, and connect patients to resources. EVALUATION: External evaluators interviewed 13 staff members within seven FQHCs from the QI project. Interviewed FQHCs were located across Ohio and represented urban, rural, suburban, and Appalachian areas. Clinical activities to support SMBP, facilitators, and barriers were identified with thematic analysis. The National Association of Community Health Centers SMBP Implementation Toolkit was used as a framework to assess SMBP activities. Facilitators included team-based care, health information technology capacity, funding for blood pressure monitors and staff time, leadership and staff support, and external support. Barriers included technology challenges, staffing shortages, low patient engagement, sustainability, and the COVID-19 pandemic. DISCUSSION: This study demonstrates how FQHCs can use a variety of staff, processes, and resources to implement clinical SMBP support across a range of geographic regions. To facilitate this, FQHCs and patients may need more comprehensive insurance coverage of blood pressure monitors, reimbursement for staff time, and technology support.

Evaluating the Effectiveness of a Patient-Centered, Nonphysician Led Self-Monitoring Blood Pressure Program in a Rural Federally Qualified Health Center.

CONTEXT: Uncontrolled hypertension can lead to an increased risk of cardiovascular disease, myocardial infarction, stroke, or death. Self-monitoring blood pressure (SMBP) programs have been associated with blood pressure (BP) reduction, particularly among rural, minority, and low-income individuals. There is limited literature about nonphysician SMBP programs. OBJECTIVES: To evaluate the effectiveness of an SMBP program designed to engage nonphysician team members in hypertension management within a federally qualified health center (FQHC). DESIGN: Self-monitoring blood pressure program activities were implemented using a Plan, Do, Study, Act model. The University of Washington Health Promotion Research Center evaluated processes and patient-level outcomes in a mixed-methods design. Quantitative analysis examined clinical outcomes related to hypertension, and qualitative analysis relied on interviews with clinical staff examining program implementation, adoption, and sustainability. SETTING: Family Health Centers (FHCs), a FQHC located in rural Washington, serving medically underserved populations. PARTICIPANTS: Two hundred five active SMBP patients out of 2600 adult patients (over 18 years old) who had a diagnosis of hypertension within the last 12 months. INTERVENTION: Patients with uncontrolled hypertension were given a BP cuff to log their daily BP. Patients met with community health workers (CHWs) and medical staff to review logs and set self-management goals over 3 to 4 months. MAIN OUTCOME MEASURE: Controlled BP measurements and factors to implementation and sustainment. RESULTS: Facilitators to implementation included expanded telehealth reimbursement during the COVID-19 pandemic, integration of CHWs, and linguistically adapted resources. Barriers included a lack of reimbursement for nonphysician time and BP monitors. Quantitative results demonstrated an effort to reach minoritized populations but did not show an improvement in BP outcomes. CONCLUSIONS: Family Health Center implemented an SMBP program adapted to meet the linguistic and social needs of their patients. The successful integration of CHWs and the need for reimbursement policies to support SMBP programs were key factors for implementation and sustainability.

Impact of the COVID-19 pandemic on the self-care and health condition of the older adults. CUIDAMOS+75. A mixed methods study protocol.

Aims: To assess the impact of the COVID-19 pandemic on the health condition of people ≥75 years of age and on their family caregivers in Spain. Design: Multicentric, mixed method concurrent study. Methods: This work, which will be conducted within the primary care setting in 11 administrative regions of Spain, will include three coordinated studies with different methodologies. The first is a population-based cohort study that will use real-life data to analyze the rates and evolution of health needs, care provision, and services utilization before, during, and after the pandemic. The second is a prospective cohort study with 18 months of follow-up that will evaluate the impact of COVID-19 disease on mortality, frailty, functional and cognitive capacity, and quality of life of the participants. Finally, the third will be a qualitative study with a critical social approach to understand and interpret the social, political, and economic dimensions associated with the use of health services during the pandemic. We have followed the SPIRIT Checklist to address trial protocol and related documents. This research is being funded by the Instituto de Salud Carlos III since 2021 and was approved by its ethics committee (June 2022). Discussion: The study findings will reveal the long-term impact of the COVID-19 pandemic on the older adults and their caregivers. This information will serve policymakers to adapt health policies to the needs of this population in situations of maximum stress, such as that produced by the COVID-19 pandemic. Trial Registration: Identifier: NCT05249868 [ClinicalTrials.gov].

The psychometric properties of the Turkish version of the Ostomy Self-Care Index and the Caregiver Contribution to Self-Care in Ostomy Patient Index.

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.

Development and validation of the chronic obstructive pulmonary disease self-care assessment scale: a concise and comprehensive instrument to assess self-management, decision-making, and coping.

The purpose of this study was to develop and test the reliability and validity of a brief and comprehensive instrument to assess self-management, decision-making, and coping by chronic obstructive pulmonary disease (COPD) patients. A web-based questionnaire was administered to 300 COPD patients and a retest was administered to 100 COPD patients. Cronbach's alpha was used to assess internal consistency, and an intraclass correlation coefficient was calculated to test the reliability of the retest. The convergent and discriminant validities were also examined. Valid responses were obtained from 279 participants in the first survey and 70 participants in the retest. From our analysis, a COPD self-care assessment scale (CSCS) was developed, consisting of seven subscales and 14 items. Cronbach's alpha for the total CSCS score, intraclass correlation coefficient, and scale success rate were 0.80, 0.79, and 100%, respectively. A multivariate analysis showed that CSCS was associated with current smoking (standardized partial regression coefficient [std ß] = -0.30; p < 0.001), long-term oxygen therapy (std ß = 0.23; p < 0.001), and social support (std ß = 0.24; p < 0.001), but not psychological symptoms or quality of life. The CSCS is also useful in assessing self-management, decision-making, and coping in Japanese COPD patients, and the scale has high reliability and validity.

Qualitative exploration of home life experiences and care needs among elderly patients with temporary intestinal stomas.

BACKGROUND: This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs. Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer. However, the ileostomy is susceptible to peri-stoma skin complications, as well as fluid, electrolyte, and nutritional imbalances, posing challenges to effective management. The successful self-management of patients is intricately linked to their adjustment to temporary colostomy; nonetheless, there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront. AIM: To investigate the lived experiences, perceptions, and care requirements of temporary colostomy patients within their home environment, with the ultimate goal of formulating a standardized management protocol. METHODS: Over the period of June to August 2023, a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai, China. Employing a phenomenological research approach, a semi-structured interview guide was developed, and qualitative interviews were conducted using in-depth interview techniques. The acquired data underwent coding, analysis, organization, and summarization following Colaizzi's seven-step method. RESULTS: The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes: Firstly, Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression; secondly, patients exhibit limited self-care capabilities and face information deficits, resulting in heightened reliance on healthcare professionals; thirdly, patients demonstrate the potential for internal motivation through proactive self-adjustment; and finally, patients express a significant need for emotional and social support. CONCLUSION: Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens, inadequate self-care abilities, informational deficits, and emotional needs. Identifying factors influencing patients' self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.

Psychological First Aid.

In this communication, we discuss the concept of psychological first aid, as relevant to diabetes management. Psychological first aid, in the diabetes care context, is defined as "the empathic support, counselling and education to improve coping skills, and optimize selfcare of persons living with diabetes, so that psychological well-being can be optimized." Various models can help provide structured psychological first aid. We feel that each and every health care provider should be able to provide effective first aid, including psychological first aid.