How Does the Psychological Impact of COVID-19 Affect the Management Strategies of Individuals with Type 1 and Type 2 Diabetes? A Mixed-Method Study.

(1) Background: During and after the pandemic, individuals with type 1 and type 2 diabetes struggled to maintain a healthy lifestyle due to psychological distress and the struggle to accommodate contextual challenges and changes in their family and work obligations and expectations. This study aims to explore the long-term impacts of the pandemic on proactive self-management behaviors and outcomes that consider contextual and environmental factors, such as family and work dynamics. (2) Methods: In this mixed-method study, data were collected from 418 participants using the Hospital Anxiety and Depression Scale (HADS) and the Insomnia Severity Index (ISI), followed by 16 individual interviews. (3) Results: The prevalence of depression was 37.1%, that of anxiety was 59.1%, and that of insomnia was 66.3%. Significant differences were observed in anxiety by age (p = 0.02), while individuals with other comorbidities were more likely to report insomnia (p = 0.3). Overall, various challenges during the pandemic have exacerbated emotional distress and complicated self-care routines and adherence to healthy lifestyles. (5) Conclusions: The COVID-19 pandemic has prompted individuals with type 1 and 2 diabetes to adopt alternative health-management methods, such as self-care, proactive initiatives, and daily challenges. Enhancing proactiveness, awareness, and an understanding of individuals' needs is crucial for alleviating stress, controlling disease, and preparing for potential future health crises in the wake of the pandemic's long-term effects.

Caring for the Caregivers: Improving Mental Health among Health Professionals Using the Behavioral Health Professional Workforce Resilience ECHO Program.

Behavioral health professionals are at high risk for burnout and poor mental health. Our objective was to understand the impact of the Behavioral Health Providers Workforce Resiliency (BHPWR) ECHO Program on the resilience and burnout of participating behavioral health professionals. We assessed the first two years (March 2022 to March 2024) of the BHPWR ECHO, a national program operating from the University of New Mexico (N = 1585 attendees), using a mixed-methods design. We used a retrospective pre/post survey (n = 53 respondents) and focus interviews with 1-3 participants (n = 9 participants) to assess for changes in knowledge and confidence and assess changes in burnout and resilience. We found that participants increased their knowledge of how to respond when (1) their workload was more than they could manage, (2) they felt that they lacked control, (3) their work did not feel rewarding, and (4) they were experiencing compassion fatigue. They increased their confidence in (1) building a support system and (2) using the wellness tools taught in the course. Respondents were less burnt out (score: 26.0 versus 17.8, p < 0.01) and more resilient (29.9 versus 34.9, p < 0.01) compared to when they started attending the program. Tele-mentoring programs like the BHPWR ECHO Program may improve wellness among health care professionals.

Integrated Psycho-Socio-Educational Programmes for Women Victims of Gender-Based Violence.

Although women victims of gender-based violence suffer health and self-care issues, there is still a lack of coordinated integrated support programmes aimed at mitigating the socio-health impact of gender-based violence on women that are suitably adapted to new social contexts. Given the importance of analysing the effectiveness of integrated psycho-socio-educational interventions and self-care programmes, this study reviews the interventions and programmes implemented in Spain, focusing specifically on their implementation and impact in the autonomous region of Navarra. The data reviewed were extracted from official publications and websites pertaining to the 17 Spanish autonomous regions and the corresponding Spanish government ministries. Additionally, 18 reports on psycho-socio-educational interventions (n = 63) for the whole of Spain centring on integrated support for self-care were analysed. In the case of the autonomous region of Navarra, four psycho-socio-educational intervention programmes (n = 4) involving self-care were analysed. The analysis found that there are a number of diverse integrated psycho-socio-educational programmes focusing on self-care that provide support and interventions. The results indicate that the women who benefit from the services, especially those relating to self-care (self-esteem, healthcare, personal image, and health), report improvements in their general wellbeing.

Comparison of Self-Care Practices and BMI between Celiac and Non-Celiac Adolescent Populations.

Celiac disease (CD) is a chronic gastrointestinal disorder that is most frequently found in Western countries, and the only treatment available today is a lifelong gluten-free diet (GFD). The main aim of the present study is to compare the self-care practices and body mass index (BMI) of adolescents with CD and without CD in different dimensions (physical, psychological, social, and management). The non-probabilistic sample included 236 participants (118 with CD) aged between 12 and 16 years old, who were part of the project "Role of the family in the perception of youth self-care". The data were obtained through the self-administration of the Practice and Management of Youth Self-care questionnaire, while the celiac population also completed the Adherence to a Gluten-Free Diet (GFD) questionnaire. The celiac population analyzed showed significant correlations between the Physical Practices and Management with adherence to a GFD, and between a GFD and Psychological Practices. Differences were observed between the celiac and the non-celiac populations in the dimensions of Physical Practices, Social Practices, and Management. With respect to BMI, age and CD showed a significant influence of a GFD on BMI (p < 0.001). In conclusion, the application of multi-dimensional questionnaires and their relationship with the adherence to a GFD provide valuable information to propose interventions directed to this population.

Hybrid model of care for older persons for improvement of frailty index-a community-based interventional study in an urban setting.

BACKGROUND: An older person undergoes a 'disablement' process with aging. A comprehensive geriatric assessment centered around the functional status informs the healthcare provider of their frailty status, based on which tailored interventions may be designed to help prevent/reverse frailty. This study was conducted to assess the improvement in frailty index by training older persons for self-care practices using a multi-domain behavioural intervention, assisted by their caregivers. METHODS: It is a community-based interventional trial among older persons aged ≥ 60 years and their primary caregivers conducted in an urban community for a period of 15 months. A hybrid model, which exploits the advantages of every indigenous geriatric model of care, in providing a holistic care to old persons, was developed and adopted. Intervention was designed to incorporate all domains of frailty assessed, based upon self-efficacy and social interdependence theory. Frail-VIG scale and SPPB scores were used to measure the outcomes. RESULTS: 128 older persons and their primary caregivers were recruited. Median age was 70 and 67 years in the intervention and control group respectively, with majority being males. The median frailty index at baseline was 0.36 in both the groups, with improvement in intervention group (0.20) and worsening in control group (0.44) at end-line. From the DID analysis, a reduction of 0.19 points of frailty index was observed (even after adjustment for co-variates) in the intervention group, as compared to the control group. Also, it was observed that age and gender of the old person, their per capita income and the family support played an interactive effect in improvement of the frailty index. There was a significant difference in SPPB scores as well, between the groups [5 (1) in CG vs. 7 (2) in IG, p < 0.001]. CONCLUSION: Frailty could be reversed with appropriate interventions designed on the pillars of self-efficacy, and social interdependence among family members. The hybrid model of care delineates the role of caregivers, who reinforce the old persons to follow prescribed interventions.

Predictors of self-care behaviors in patients with hypertension: The integrated model of theories of "planned behavior" and "protection motivation".

BACKGROUND: Assessment of self-care behaviors in patients with hypertension may provide clinicians and practitioners with important information about how to better control hypertension. Therefore, the present study aimed to explore the predictors of self-care behaviors in patients with hypertension based on an integrated model of theories of planned behavior and protection motivation. MATERIALS AND METHODS: The present cross-sectional study was part of a larger study, conducted in 2022 on 344 hypertensive patients from Khamir County in Hormozgan Province in Iran. The sample was selected through a systematic random sampling. The patients completed a researcher-made questionnaire based on constructs of the theory of planned behavior and protection motivation theory. They also completed, Hypertension Self-Care Activity Level Effects (H-SCALE), Hypertension Knowledge-Level Scale (HK-LS), and a demographic questionnaire. The data were analyzed in SPSS 21 using the Pearson correlation coefficient, independent-samples T test, one-way ANOVA, and linear regression analysis. RESULTS: The participants' mean age was 47.34 ± 13.68 years. Adherence to medication, physical activity, weight management, diet, and nonsmoking scores were 42.7, 27.3, 66.3, 14.2, and 81.1, respectively. The linear regression model showed that behavioral beliefs (ß = 0.366, P < 0.001), perceived rewards (ß = -0.248, P < 0.001), control beliefs (ß = 0.133, P = 0.013), and normative beliefs (ß = 0.143, P = 0.025) were the major predictors of self-care behaviors in patients with hypertension. CONCLUSION: In light of the present findings, it can be concluded that it is crucial to change patients' attitudes toward self-care behaviors and improve the social acceptance of behavior and its development in society, and improve patients' control beliefs through goal-oriented education that develops resistance against the perceived rewards of the unfavorable behavior. Considering these constructs can act as strategies to promote self-care behaviors among patients.

Investigating the effect of an Orem-based self-care educative supportive nursing system on the joint function of patients with knee osteoarthritis.

BACKGROUND: Osteoarthritis is the most common form of arthritis. It is a common progressive joint disease characterized by chronic pain and functional disability, which disturbs functional movements, body balance, and quality of life in patients with knee osteoarthritis. This study investigates the effect of an Orem-based self-care educative supportive nursing system on the joint function of patients with knee osteoarthritis. MATERIALS AND METHODS: This semi-experimental paper studies 130 patients with knee osteoarthritis. The patients are selected using convenience sampling and randomly assigned to intervention and control groups equally. The K00S questionnaire was used to collect patients' demographic information and other information relating to their knees' function. We carried out interventions for six weeks, with a session of 45 to 60 minutes each week. Data were collected before the intervention and three months after the intervention. SPSS 21.0 and descriptive and inferential statistics were used to analyze the collected data at the significance level of 0.05. RESULTS: The results show significant differences between the two groups in terms of joint symptoms (P = 0.001), pain (P = 0.001), daily activities (P = 0.001), sports and recreational activities (P = 0.001), and quality of life (P = 0.02). In other words, there was a significant difference in the average subscale scores of activities in all five dimensions between the intervention and control groups (P < 0.05). CONCLUSION: Orem's self-care model has a positive and significant effect on the functional movement of patients with knee osteoarthritis and improves their joint function.

Predictive influence of disease knowledge and hope on self-care behavior among adults with heart failure.

Background: Self-care, disease knowledge, and hope are critical concepts in health-related studies. Therefore, all three are considered solutions for controlling heart failure (HF) and reducing its complications. This study aimed to identify the predictive influence of disease knowledge and hope on self-care behavior among adults with HF. Materials and Methods: This descriptive-analytical and cross-sectional study examined the data of 113 HF patients referred to the Imam Reza Clinic in Shiraz, Iran, in 2021. This study used HF patients' self-care instruments based on Orem's self-care theory, the HF Knowledge Scale-Persian version, and the Heart Hope Index-Persian version. The data were analyzed using the general linear model (GLM) and Pearson's correlation coefficients. Results: Of the 113 HF patients, 54.90% (n = 62) were male, and 45.10% (n = 51) were female. The analysis of the Pearson correlation coefficient indicated the presence of a positive and significant correlation between "self-care and hope" (r = 0.532, P = 0.0001), "HF knowledge and hope" (r = 0.432, P = 0.0001), and "self-care and HF knowledge" (r = 0.410, P = 0.0001). GLM showed that HF knowledge symptoms (P = 0.0001), hope (P = 0.0001), unemployed patients (P = 0.042), and housewife patients (P = 0.0001) predicted self-care behavior of HF patients. Conclusion: Considering the positive and significant correlation between "self-care and HF knowledge," "self-care and hope," and "HF knowledge and hope," it seems necessary for doctors and nurses should pay attention to providing educational programs to increase HF knowledge to improve self-care and hope in HF patients.

Knowledge and self-care practice among patients with hypertension in tertiary public hospitals of Addis Ababa, Ethiopia: A multicenter cross-sectional study.

Introduction: Globally, hypertension is the leading cause of death due to its related complications. Patients' knowledge and self-care practice in hypertension is crucial for achieving optimal blood pressure control and prevention of related complications. This study aimed to evaluate the level of knowledge and self-care practice among hypertensive patients in Addis Ababa, Ethiopia. Methods: A facility-based cross-sectional study was conducted among 413 hypertensive patients using simple random sampling methods. A face-to-face interview was administered using a structured questionnaire. Data was analyzed using SPSS version 27.0. Frequency percentage, and mean were calculated. Multivariable logistic regression was used to identify the association between predictors and outcome variables. Results: Out of 413 respondents, 46.0 % (95 % CI: 40-50 %) and 40.9 % (95 % CI: 36-46 %) had poor knowledge and self-care practice respectively. Being married (AOR = 1.92, 95 % CI:1.19-3.06, P = 0.007), higher education [AOR = 7.38 (95 % CI: 2.29-23.78), P < 0.001); family history (AOR = 3.68, 95 % CI: 2.28-5.94, P < 0.001); getting information from healthcare providers (AOR = 3.17, 95 % CI: 1.46-6.87, P = 0.003) were significantly associated with knowledge of hypertension. Being female (AOR: 0.62,95 % CI: 0.39-0.97, P = 0.033), owing sphygmomanometer (AOR: 4.41,95 % CI: 2.40-8.13, P < 0.001) were associated with self-care practice towards hypertension. Conclusion: The overall knowledge and self-care practice of respondents was low. Gender, marital status, educational level, family history, source of information, and owing sphygmomanometer were determinant factors. Improving patients' awareness and self-care practice is essential for prevention and control of hypertension.

Predicting cervical cancer screening participation using self-care behaviors among women in Iran.

BACKGROUND: Cervical cancer screening is an effective and accessible method for preventing this cancer. However, low participation rates among women have been reported. Self-care is one of the solutions to improve access to health services. This study was conducted to determine the prediction of cervical cancer screening participation using self-care behaviors among women in Iran. MATERIALS AND METHODS: This cross-sectional study was conducted on 310 eligible women who were referred to comprehensive health centers and women's clinics in teaching hospitals in Isfahan, Iran, from November 2020 to April 2021. Participants were enrolled using convenience sampling. The data collection tool included researcher-made questionnaires on personal and fertility characteristics, participation in cervical cancer screening, and self-care behaviors related to cervical cancer and its screening. Descriptive and inferential statistical methods were used for data analysis using the Statistical Package for the Social Sciences (SPSS) version 22 software. RESULTS: The results showed that the intention to undergo screening was low among individuals who had not undergone screening. Lack of awareness and not having enough time were the most common barriers to screening. The results of logistic regression analysis indicated that self-efficacy was the significant predictor of cervical cancer screening. With an increase in the self-care score, the 12% chance of doing a Pap smear increases significantly (P = 0.002). Furthermore, the results of multiple regression showed that with an increase in the self-care score, the chance of women who refer to screening every year, every 2-3 years, and every 4-5 years is increased to 25% (P = 0.001), 34% (P < 0.001), and 11% (P = 0.032), respectively, compared with non-referral. DISCUSSION: According to the results, self-care was a predictor of performing a Pap smear, and it was related to its regular performance of Pap smear too. Therefore, designing and implementing necessary interventions to increase self-care behaviors can improve women's participation in cervical cancer screening and its regularity.

What Do Younger and Well-Educated Adults Think about Self-Medication? Results of a Survey during a Public Science Event at Leipzig University.

BACKGROUND: Consecutive visitors to a public science event at Leipzig University were asked about their opinions/attitudes regarding their personal use of self-medication. METHODS: A written questionnaire survey addressed (i) participants' characteristics, (ii) frequency of self-medication use in the last 12 months, (iii) symptoms/complaints most frequently considered applicable, (iv) preconditions, (v) limitations, (vi) risks, (vii) fears, (viii) medication information sources, (ix) influencing factors, and (x) reasons for decision making. RESULTS: (i) A total of 189 visitors (median age: 29.0 years; Q25/Q75: 22.0/44.0) participated, of whom 64.0% were female, 38.6% had a university degree, 20.1% were in training, and 14.8% were licensed in a healthcare profession. (ii) A total of 59.3% of participants stated that they had used self-medication regularly in the last 12 months. The most common answers in the respective questions were (iii) headache, 86.2%; (iv) mild complaints/symptoms, 94.7%; (v) duration, 91.6%; (vi) "self-medication may cause adverse drug reactions", 94.2%; (vii) "developing a habituation effect", 58.7%; (viii) pharmacists, 93.7%; (ix) "physician's recommendation", 89.3%; (x) "intensity of complaints", 92.6%; and (vi) 61.3% believed that they could choose an appropriate self-medication. CONCLUSION: Younger and well-educated adults report using self-medication frequently and rate their expertise as high. Healthcare professionals are the preferred source of information.

Examining the Impact of the Design-Thinking Intergenerational Service-Learning Model on Older Adults' Self-Care Behaviors and Well-Being.

The Design-Thinking Intergenerational Service-Learning Model (DTISLM), rooted in the biopsychosocial model, aims to empower older adults to improve their chronic-disease management behavior through tailored programs addressing their specific healthcare needs. This study, conducted in Taiwan, used a convenience sampling method (n = 172) to evaluate the impact of DTISLM on Taiwan's adult day center participants' perception of self-care behaviors, feelings of happiness, depression, and perceived social support using pretest-posttest surveys. The results indicated a significant enhancement in participants' perception of self-care behaviors, reduction in depression score, and improvements in perceived social support following the completion of the program. The findings underscore the efficacy of applying a design-thinking framework in an intergenerational context. Future studies should investigate how the DTISLM can be scaled to various demographics and healthcare settings to enhance its applicability and understand its long-term effects.

Determining the predictors of preventive behaviors adopted by pregnant women against COVID-19 based on the Health Belief Model constructs: a cross sectional study.

BACKGROUND: Pregnant women face great challenges during the coronavirus disease 2019(COVID-19) pandemic. The purpose of this study was to explain the main dimensions of adoption of self-care behaviors against COVID-19 based on the health belief model(HBM) in pregnant women. METHODS: This cross-sectional and analytical study was conducted in Iran, at the end of the third wave of the COVID-19 pandemic, between January and April 2021. Two hundred and thirty pregnant women who referred to Urmia health centers were selected using multi-stage random sampling. The data were collected using an online questionnaire including items that measured the participants' demographic characteristics, the knowledge questionnaire, the HBM items, and questions assessing the adoption of self-care behaviors against COVID-19. The data were analyzed using SPSS software version 20. Descriptive statistics, bivariate Pearson's correlation test, and multiple linear regression were used to analyze the data. RESULTS: The results of this study showed that the rate of self-care behaviors against COVID-19 in the pregnant women participating in the present study was not very favorable. It was also shown that among the constructs of the HBM, knowledge, self-efficacy, and perceived barriers were the most important predictors of adopting self-care behaviors with a variance of 24% change among the pregnant women. CONCLUSION: Knowledge, self-efficacy, and perceived barriers were found in this study as the strongest predictors of self-care behaviors among pregnant women. Thus, it is suggested to implement interventions commensurate with the results of this study.

Patient-clinician interactions in shared diabetes/nephrology consultations - A qualitative observation study.

BACKGROUND: The incidence of chronic disease is increasing worldwide which, in turn, increases the demand for healthcare services. To meet these demands, healthcare systems are adapting their services in order to reduce treatment costs and ensure coherence for patients with multiple diseases. One form of adaptation is shared outpatient consultations between internal medical specialties. However, little is known about how patients interact with multiple clinicians in shared consultations. AIM: This project aimed to explore how patients with diabetes and chronic kidney disease interact with multiple clinicians in a shared outpatient setting. RESEARCH METHODS: We performed a qualitative ethnographic study, combining focused participant observations with informal field interviews. We included 17 participants, nine males and eight females with a mean age of 67.3 in the project. The data analysis was guided by Braun and Clarke's reflexive thematic analysis and Arthur Kleinman's theory of illness and disease. RESULTS: We found one over-arching theme: 'A consultation which encompassed both illness and disease' and four subthemes: (1) 'The medical focal point' pertained to the focus on physiological measurements in dialogue between patients and clinicians. (2) 'The possibility of negotiations' illustrated how decisions about dialysis and pharmacological treatment were based on negotiations. (3) 'Speaking different languages' displayed how patients used alternative illness-based explanations whereas clinicians tended to use biomedical language. (4) 'Perceptions of everyday life' concerned what patients considered was best for them when managing their illness and everyday lives. CONCLUSION: Patients present information on how they balance life with physiological and psychosocial challenges. When clinicians employ a biomedical perspective, opportunities to gain information on patients' illness behaviours or cues to negotiate are missed. Patients prioritise functioning on a daily level over following treatment regimes. These findings are tenuous and require verification in similar studies in similar settings. SHORT PHRASES: Shared Outpatient Clinic, Patient-clinician interactions.

Enhancing daily living and cognitive functions in traumatic brain injury patients through Orem's self-care theory.

Introduction: This research seeks to investigate how early rehabilitation nursing, guided by Orem's self-care theory, affects cognitive function, neurological function, and daily living skills in individuals who have suffered a traumatic brain injury (TBI). Methods: A study was conducted with 108 patients with traumatic brain injury who were hospitalized at our facility from January 2021 to March 2023. Based on their admission dates, the participants were separated into a control group (n = 56) and an observation group (n = 52). The control group received standard nursing care, while the observation group received a combination of conventional treatment and nursing interventions based on Orem's self-care model. The research assessed alterations in the ability to perform daily tasks (Activities of Daily Living, ADL), neurological health (National Institutes of Health Stroke Scale, NIHSS; Glasgow Coma Scale, GCS), and cognitive abilities (Montreal Cognitive Assessment Scale, MoCA; Mini-Mental State Examination, MMSE) in both sets of participants prior to and following 4 and 8 weeks of nursing assistance. Results: Following the intervention, the group being observed showed notably increased ADL scores at 4 weeks (p < 0.001) and 8 weeks (p < 0.001) in comparison to the control group. At 4 weeks and 8 weeks after nursing, the observation group had significantly lower NIHSS scores compared to the control group (4 weeks after nursing, p = 0.03; 4 weeks after nursing, p < 0.001). GCS score comparison showed the similar results (4 weeks after nursing, p = 0.013; 4 weeks after nursing, p = 0.003). Moreover, the participants in the observation group had notably higher MoCA and MMSE scores in comparison with the control group 4 and 8 weeks after nursing (all p < 0.001). Conclusion: Orem's self-care theory improves patients' cognitive, neurological, and daily living functions of TBI patients during early rehabilitation nursing. This method helps enhance the level of care given by healthcare professionals, leading to more thorough and compassionate nursing care for patients.

Assessing the impact of educational eHealth and mHealth interventions on health outcomes in continuity of care for enterostomy patients: A meta-analysis.

PURPOSE: To evaluate the effectiveness of educational eHealth and mHealth interventions on self-care ability, quality of life (QoL), ostomy complications and other health outcomes in enterostomy patients. METHODS: A comprehensive database search yielded 7385 records, which were narrowed down to 13 RCTs through stringent PRISMA-guided selection. These studies, conducted globally from 2015 to 2023, involved a total of 1530 participants and employed various eHealth and mHealth platforms, from mobile apps to telehealth systems. Primary outcomes assessed were self-care ability, QoL, and ostomy complications, mostly analyzed using a random-effects model due to inherent study heterogeneity. RESULTS: The meta-analysis showed significant improvements in self-care ability (SMD = 0.85, CI = [0.23, 1.47], P = 0.007) and QoL (SMD = 0.64, CI = [0.50, 0.79], P < 0.001) among participants receiving eHealth and mHealth interventions compared to those receiving standard care. eHealth and mHealth interventions also led to a reduction in ostomy complications (SMD = 0.18, CI = [0.12, 0.27], P < 0.001). Secondary outcomes revealed significant improvements in stoma adjustment (SMD = 1.13, CI = [0.70, 1.56], P < 0.001) and self-efficacy (SMD = 0.51, CI = [0.38, 0.64], P < 0.001). The effects on psychological well-being were mixed, with some studies showing benefits in reducing depression and anxiety symptoms, albeit with high heterogeneity. CONCLUSIONS: eHealth and mHealth interventions appear effective in improving essential health outcomes for enterostomy patients, though the heterogeneity among studies suggests that results should be interpreted with caution. The effectiveness of these interventions underscores the need for their integration into routine care, tailored to individual patient needs and local healthcare settings. Further research is required to determine the most effective eHealth and mHealth modalities and to explore their long-term benefits and scalability.

Self-care for maternal and reproductive health in conflict settings: qualitative case study in Nuba Mountains, Sudan.

Introduction: Self-care is a critical component of Reproductive, Maternal, and Neonatal Health (RMNH), offering women the knowledge, skills, and autonomy needed for well-being throughout the reproductive cycle. This paper explores the significance of self-care in conflict-affected regions, where access to formal healthcare is limited. Such areas place pregnant women at higher risk due to increased incidents of adverse events during pregnancy and childbirth. Self-care interventions have the potential to enhance access to quality healthcare services. Methods: Employing a qualitative approach, this study explores RMNH self-care practices among pregnant and post-natal women in the Nuba Mountains. The methods included in-depth semi-structured interviews with 24 participants, comprising pregnant women, recent mothers, and healthcare providers. Purposive sampling was used to capture the experiences of mothers, and thematic analysis identified key patterns and themes in self-care practices. The perspectives of healthcare professionals were included to understand the context of RMNH care in conflict settings. Results: The study revealed the crucial role of community cohesion in providing emotional and practical support in pregnancy, childbirth, and in the post-natal period. Limited healthcare infrastructure and ongoing conflict-related challenges provided important drivers for self-care practices. A spectrum of self-care interventions ranged from personal hygiene practices to community-supported childbirth and postnatal care. Significant reliance on elder women's wisdom and traditional midwifery was observed, particularly in the absence of formal healthcare facilities. Some women moved to live with family close to the hospital in the weeks before their due dates in order to mitigate the risks of early deliveries, complications, or general insecurity in their home areas. Discussion: The findings present a compelling narrative of communal self-care, challenging the conventional notion of self-care as solely individualistic. In this setting, the community's role is fundamental, with knowledge sharing and mutual support forming the bedrock of maternal health practices. Elder women, embodying repositories of perceived traditional wisdom, emerge as central figures, guiding pregnant and postpartum women through shared experiences and practices. This collective approach is not merely a cultural characteristic but a necessity born out of the region's limited healthcare infrastructure and ongoing conflict. The study underscores the need to recognize and integrate these communal self-care strategies into broader health interventions.

Addressing the 2021 Essentials with new approaches for developing leadership, resilience, and self-care/well-being in undergraduate baccalaureate nursing students.

INTRODUCTION: New graduate nurses are not always prepared for the challenges of the chaotic clinical environment or to exercise leadership skills in a clinical capacity. Resilience and self-care are essential facets of successful leadership, as well as necessary components to prevent burnout in nurses. PURPOSE: The purpose of this article is to demonstrate how this School of Nursing implemented approaches to prepare the next generation of nurses with strong skills in the areas of leadership, resilience, and self-care/well-being while addressing the Essentials. METHODS: Faculty explored new ideas, as well as showcased teaching strategies they had already successfully implemented, that aligned with the Essentials with the undergraduate baccalaureate pilot student cohort. RESULTS: Two "Essential" Competencies, Domain 9 Professionalism and Domain 10 Personal, Professional and Leadership Development, as well as related sub-competencies, were addressed by the thirteen teaching strategies. Anecdotal student reflection comments supported high levels of satisfaction with these strategies. CONCLUSIONS: Preparing student nurses to meet the Essentials is critical to helping nurses thrive in contemporary practice settings. Equipping a generation of nurses with self-care practices to protect their own well-being, while at the same time meeting the Essentials expectations, is crucial to cultivating a sustainable nursing workforce.

Exploring the Level of Self-Care Behavior, Motivation, and Self-Efficacy among Individuals With Hypertension: A Cross-Sectional Study.

Introduction: Hypertension is a serious public health issue. It is a significant but controllable factor in the emergence of cardiovascular disease. Controlling hypertension is a main target for individuals to prevent further illness. Objective: This study aims to explore the level of self-care behaviors, motivation, and self-efficacy among individuals with hypertension. Methods: A cross-sectional, descriptive, correlational design was used to recruit (n = 121) participants utilizing the Hypertension Self-Care Profile (HTN-SCP) questionnaire. Results: The analysis revealed that the mean score of self-care behavior was 49.7 (SD = 10.0) out of 20-80, which indicates that they are likely to have good self-care behavior. The mean score of motivation for self-care was 59.7 (SD = 11.8) out of 20-80, reflecting that individuals with hypertension have a good level of motivation for self-care, and the mean score of self-efficacy was 70.0 (SD = 9.8) out of 20-80, which means that individuals with hypertension have a high level of self-efficacy. Also, there was a significant positive correlation between self-care behavior and motivation for self-care (r = .527, p < .001), between motivation for self-care and self-efficacy (r = .554, p < .001), and between self-efficacy and self-care behavior (r = .572, p < .001). Conclusion: The study revealed that Jordanian patients with hypertension have good self-care practices, motivation, and high self-efficacy. Patients should therefore be strongly recommended to be compliant with self-care practices. The government should prioritize hypertensive patients by making it easier for them to receive information about self-management practices to improve their quality of care.

Effects of a Short-time health literacy promotion program (HeLPP) on biochemical factors, self-care and quality of life among rural patients with type-2 diabetes: A field trial with Solomon four-group design.

Background: Current evidence suggests that health literacy (HL) impacts self-care behaviors and quality of life (QOL) in patients with type 2 diabetes mellitus (T2DM). This study aimed to evaluate the impact of a short-time health literacy promotion program (HeLPP) on self-care behaviors and QOL in rural patients with type 2 diabetes. Methods: Conducted from 2018 to 2019 in Chaldoran county, Iran, this randomized controlled trial followed the Solomon four-group design. Participants included 160 rural individuals with T2DM, who were divided into two intervention (A and C) and two control (B and D) groups. Pre-tests were conducted for intervention group A and control group B, with post-tests administered to all groups at three and six months. Interventions, consisting of five training sessions lasting 45 to 55 minutes, were planned and executed based on pre-test analyses. Primary outcomes were QOL and self-care behaviors, and secondary outcomes were glycated hemoglobin (HbA1c), HL and patients' awareness of the disease. Results: Prior to the intervention, there was no significant difference in awareness, HL, self-care behaviors, HbA1c, and QOL between intervention group A and control group B (P>0.05). However, at three and six months after the educational program, intervention group A exhibited significantly increased average scores in awareness, HL, self-care behaviors, and QOL, along with reduced HbA1c levels (P<0.05) compared to control group B. No interaction was detected between the pre-test and the primary and secondary outcome scores after intervention. Conclusion: Implementing intervention programs like HeLPP focusing on enhancing practical HL and empowering T2DM patients seems to be promising in improving patients' self-care behaviors and QOL, while reducing their HbA1c levels. Trial Registration: Identifier: IRCT20131116015422N7; https://irct.behdasht.gov.ir/trial/35569.