The impact of hypertension education on self-care management in hypertensive patients in Senderak village health centre.

Objectives: To determine the effect of hypertension education on self-care management in hypertensive patients in a rural setting. METHODS: The quasi-experimental study was conducted in January and February 2022 at the Senderak Village Health Centre, Bengkalis, Indonesia, and comprised hypertension patients without any complications referred to the community health centre between August 2021 and January 2022. The subjects underwent self-care education intervention. The knowledge level was assessed at baseline and post-intervention using the Hypertension Self-Management Behaviour Questionnaire. Data was analysed using IBM SPSS Statistic v23 software. RESULTS: All the 30(100%) patients were females, 12(40%) were aged 46-55 years, 20(66.7%) had received elementary school education and 25(83.3%) were housewives. There were 21(70%) respondents with stage II hypertension having systolic blood pressure ≥160mmHg. The mean level of knowledge about self-care management of hypertension increased significantly post-intervention (p<0.0001). Conclusion: Health education could improve knowledge on self-care management of hypertension in hypertensive patients.

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.

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.

The Impact of Self-Care Recommendations with and without Tilt-Training on Quality of Life in Children and Adolescents with Vasovagal Syncope: A Randomized Clinical Trial.

Background: Syncope is among the most common paroxysmal disorders in children and adolescents. Vasovagal syncope is the most common syncope in children and adolescents. The aim of this study was to evaluate the impact of self-care recommendations with and without tilt training on the Quality of Life (QoL) of children and adolescents with syncope. Materials and Methods: This randomized controlled clinical trial was conducted in Isfahan, Iran, from April 2017 to June 2021 and included 120 patients with syncope. Eligible children and adolescents (aged 6-18 years) who met inclusion criteria were recruited by the simple sampling method and then assigned randomly into two groups. The intervention group (n = 60) received routine self-care recommendations such as dietary advice, behaviors to prevent syncope, and counter-pressure maneuvers along with tilt training, while the control group (n = 60) received self-care recommendations without tilt training. The education training included two face-to-face sessions, each of which lasted for 45-60 min. Then, both groups were followed up by telephone (once a month) for six months. A researcher-made self-care questionnaire and Pediatric Quality of Life Inventory (PedsQL™ 4.0) were completed for both groups before and after the intervention. Data were analyzed using descriptive and inferential statistical methods. Results: The Wilcoxon test results showed a significant difference in the mean scores of physical functioning, emotional functioning, social functioning, school functioning, psychosocial functioning, understanding of health, and total QoL in the intervention and control groups before and after the intervention (p < 0.05). Also, the paired t-test results showed a significant difference in the mean scores of self-care domains and total self-care in the intervention and control groups before and after the intervention (p < 0.05). Conclusions: Self-care recommendations with and without tilt training can improve QoL in children and adolescents with syncope.

Optimal Self-Care for Surgeons: Sleep, Diet, and Exercise.

BACKGROUND: Surgeons face intense stress, causing hormonal imbalances that harm their health, leading to burnout, chronic illness, and shorter lifespans due to their demanding careers. PURPOSE: This study explores self-care strategies focusing on sleep, nutrition, and exercise to help surgeons reduce stress and improve their overall well-being and quality of life. RESEARCH DESIGN: A thorough literature review of physiological, metabolic, and psychological principles informed the development of a structured self-care approach. DATA COLLECTION AND/OR ANALYSIS: We reviewed existing research on brain-body interactions, highlighting hormonal balance, nutrition, and exercise to mitigate chronic stress. RESULTS: The review underscores the importance of quality sleep for hormonal balance and overall health. Proper nutrition, emphasizing balanced macronutrients and meal timing, supports health. Exercise should be 80% low-intensity aerobic activities, with 20% high-intensity. Combining these elements strengthens resistance to chronic stress and enhances health. CONCLUSIONS: A structured self-care approach, prioritizing sleep, followed by nutrition and exercise, effectively reduces stress among surgeons. This sequence improves well-being and quality of life. Surgeons should focus on consistent sleep, balanced nutrition, and regular low-intensity exercise to enhance resilience and achieve a fulfilling professional life.

Between principles and pragmatism - primary healthcare and social services professionals' experiences and perceptions of self-care for older adults with home care: a qualitative study.

OBJECTIVE: To explore the experiences of healthcare and social services professionals and their perceptions of using Certificate for self-care with support (CSS) for preventive self-care for older adults with home care, including the CSS process and collaborations between primary healthcare and social services. DESIGN: An inductive qualitative study including seven focus group interviews analyzed with reflexive thematic analysis. SETTING AND SUBJECTS: The study was conducted in the Stockholm Region 2022/23. In total, 23 informants were recruited from four key partners involved in the CSS process: professionals from primary care rehabilitation and primary healthcare, social services officers, and home care staff. RESULT: The analyses resulted in five interconnected themes: 'Guidelines with scope for interpretation,' 'Support for self-care is needed, but complicated in practice,' 'To trust the other professions' competence,' 'There is a transfer of responsibility,' and 'Communication is key.' The overarching theme 'Principles or pragmatism for safe person-centered care,' anchoring the other themes, revealed a common goal of achieving safe and individualized care within available resources, but from two conflicting perspectives: the importance of following the process according to the guidelines or taking a more pragmatic approach. CONCLUSION: This study highlights the need to establish structures facilitating safe self-care among frail groups, such as older persons dependent on home care. Our findings emphasize that the demarcation between, and responsibilities of, organizations need to be discussed and clarified to offer person-centered support. Comprehensible guidelines and functioning communication channels must be established so that all important perspectives can be heard, not least the patient's.

The support of a patient's self-care is an important part of health promotion and preventive efforts.Collaboration between social services and healthcare services is crucial when supporting an older person in performing their self-care.The boundaries and responsibilities of organizations regarding person-centered support for self-care need to be discussed and clarified.Clear guidelines and functioning communication channels must be established to ensure all important perspectives are heard, especially the patient's.

Self-care styles of patients with chronic obstructive pulmonary disease: A mixed methods case study.

BACKGROUND: In people affected by chronic obstructive pulmonary disease (COPD), self-care is crucial for improving quality of life, decreasing symptom burden, and reducing health care-related costs. Unlike other chronic conditions, little is known about the factors that influence different self-care styles in COPD patients. OBJECTIVES: To explore the factors that could influence the self-care styles of patients with COPD. METHODS: A mixed methods case study design was used. Quantitative and qualitative data were collected at the same stage in a purposive sample of patients with COPD through questionnaires, interviews, and focus groups. Data were analyzed separately and then integrated to compare the cases. RESULTS: Thirty-seven patients with COPD were recruited from an outpatient clinic, pulmonary rehabilitation unit and online in a patient support group. On average, participants scored below the level of adequacy in all self-care dimensions. Self-care maintenance was influenced by patient age, education level, and economic status. Most participants reported performing self-care behaviors, while some did not because they found it difficult or because they did not recognize their importance. When the quantitative and qualitative data of patients with higher and lower levels of self-care were integrated, four different styles of self-care were identified according to COPD severity, psychological distress and level of self-efficacy: proactive, inactive, reactive, and hypoactive. CONCLUSIONS: Personal, clinical, psychological, and social factors not only influence the level of self-care performed by COPD patients but also contribute to the understanding of different self-care styles. This knowledge could support health care professionals in tailoring educational interventions.

Health outcomes of telemonitoring of patients with type-2 diabetes mellitus: One-year results from a randomized controlled trial (Optimizing care of Patients via Telemedicine In Monitoring and aUgmenting their control of diabetes Mellitus).

INTRODUCTION: Telehealth increases care accessibility to patients with type-2 diabetes mellitus but the duration of its implementation to sustain optimal glycaemic control remains unclear. This study aimed to assess the health outcomes of these patients using the Optimizing care of Patients via Telemedicine In Monitoring and aUgmenting their control of diabetes Mellitus (OPTIMUM) home tele-monitoring (HTM) system 6 months post-intervention, compared to standard care. METHODS: An open-labelled randomized controlled trial involving 330 participants with type-2 diabetes mellitus, aged 26-65 years, and suboptimal glycaemic control (HbA1c = 7.5%-10%) was conducted. Intervention group received OPTIMUM HTM for 6 months followed by usual care for another 6 months, while control group received usual care for 12 months. OPTIMUM HTM includes in-app video-based tele-education, tele-monitoring of the blood pressure, capillary glucose and weight via Bluetooth devices and mobile applications, followed by algorithm-based tele-management by the OPTIMUM HTM team. Assessments using self-care inventory scale and medication adherence were administered for both groups at baseline, 6-month, and 12-month timepoints. RESULTS: Complete data from 156 (intervention) and 159 (control) participants, with comparable demographic profiles, were analysed. Both groups showed a significant reduction in HbA1c from baseline (p < 0.001). From 6-month to 12-month time-points, the intervention group was twice as likely to maintain their HbA1c ≤ 8% (adjusted odds ratio = 2.02, 95%CI = 1.18-3.49; p < 0.011). The intervention group demonstrated higher scores for self-care behaviours (adjusted odds ratio = 3.83 [95%CI = 1.68-5.97], p = 0.001) and not skipping medications (adjusted odds ratio = 2.32 [95%CI = 1.09-4.97], p = 0.030) at 12 months. DISCUSSION: The OPTIMUM HTM system enabled patients to maintain their glycaemic control beyond the intervention period. The favourable outcomes could be the effect of telehealth in sustaining self-care behaviour and medication adherence.

Latent profile analysis of mindful self-care and associations with mental health among nurses in China.

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

The effect of educational intervention based on the PRECEDE-PROCEED model on self-care behaviors and quality of life of hypertensive patients.

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

The effect of self-care education with smart phone applications on the severity of nausea and vomiting after stem cell transplantation in leukemia patients.

INTRODUCTION: Common side effects after stem cell transplantation (SCT), such as anorexia, nausea, and vomiting, can disrupt the quality of life of patients. Therefore, this study aimed to determine the effect of self-care education with smart phone applications on the severity of nausea and vomiting after SCT in leukemia patients. MATERIALS AND METHODS: In this clinical trial study, using the blocked randomization method 104 leukemia patients undergoing SCT were assigned to two groups, intervention and control. The patients of the Control Group received routine care, and the Intervention Group received self-care education with a smart mobile phone application, in addition to routine care. Two weeks, one month, and three months after the start of the intervention, the severity of nausea and vomiting was evaluated using the visual analog scale (VAS) and the Khavar Oncology scale, both of which were completed by both Control and Intervention Groups. Data were analyzed using chi-square, Fisher's exact, Mann-Whitney, and Friedman tests using the Statistical Package for Social Sciences version 25 software. RESULTS: The severity of nausea and vomiting in leukemia patients undergoing SCT was significantly different in the two groups at all three timepoints (two weeks, one month, and three months) after transplantation (p-value = 0.000). CONCLUSION: The severity of nausea and vomiting after SCT in leukemia patients was improved by self-care education with a smart phone application. Therefore, this method is recommended to reduce the severity of nausea and vomiting in leukemia patients who undergo transplantation.

Diabetes self-care activities and its correlates in patients with diabetic neuropathy.

BACKGROUND: Diabetic neuropathy is the most common chronic complication observed in patients with diabetes and has significant clinical implications, such as decreased quality of life and increased morbidity and mortality rates. Studies on the factors affecting diabetes self-care activities pertaining to patients with diabetic neuropathy are limited. Therefore, a more in-depth study targeting individuals with diabetic neuropathy is required to develop patient-centred nursing interventions. AIM: This study aimed to identify diabetes self-care activities among patients with diabetic neuropathy and determine their correlates. METHODS: This study employed a descriptive correlational design and the study subjects consisted of 99 patients with diabetic neuropathy. Descriptive statistics and hierarchical regression analyses were used to analyse the factors affecting diabetes self-care activities. This study follows the STROBE guidelines to ensure rigorous reporting of cross-sectional studies. RESULTS: Our findings revealed positive correlations between diabetes self-care activities and factors including knowledge of diabetes foot care, diabetes foot care practices, interpretation of diabetic neuropathy and foot care confidence. Foot care confidence positively correlated with diabetes foot care knowledge, practices and interpretation of neuropathy, but negatively related to diabetic stress. In determining the impact of these factors on diabetes self-care activities, hierarchical regression analysis revealed that patients with higher diabetes foot care practices and foot care confidence demonstrated higher levels of diabetes self-care activities. CONCLUSION: The study findings confirmed that diabetic foot care practices and foot care confidence significantly influenced self-care activities in patients with diabetic neuropathy. Considering these results, customizing the intervention content to match diabetic foot care practices and diabetic foot care confidence can enhance self-care activities in patients with diabetic neuropathy. PATIENT OR PUBLIC CONTRIBUTION: Survey questionnaires were completed by patients with diabetic neuropathy in this study.

Health-related outcomes of structured home-based rehabilitation programs among older adults: A systematic literature review.

The aging population reveals the need to develop self-care interventions that promote autonomy and well-being. The current systematic review aimed to assess the association between the implementation of structured home-based rehabilitation programs to promote self-care in older adults and health-related outcomes among people aged 60 years or older. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature review was performed. Three electronic databases (MEDLINE, CINAHL and Psychology and Behavioral Sciences Collection) were searched. Randomized experimental studies, that implemented a home-based rehabilitation program to promote self-care in older adults, and were published between 2019 and 2024, were retrieved. Data on health-related outcomes were collected. Eight studies were included; all eight studies implemented a monitored, progressive and customized rehabilitation program. The studies varied greatly regarding the sample size, the duration of the intervention, the rehabilitation program implemented and the instruments used. The implementation of structured home-based rehabilitation programs may contribute to improve physical and psychological health-related outcomes among older adults by promoting functional capacity, self-care and knowledge.

Differential impacts of self-care behavior on clinical outcomes in patients with and without recent heart failure hospitalization.

BACKGROUND: Although clinical guidelines recommend self-care assessment for patients with chronic heart failure (CHF), its prognostic significance remains controversial. This study aimed to compare the prognostic significance of self-care behavior on mortality between patients with and without a history of recent hospitalization for heart failure (HF). METHODS: We analyzed consecutive 1907 CHF patients from a Japanese multicenter registry (January 2020-June 2023) using the 9-item European Heart Failure Self-care Behavior Scale (EHFScBS-9) at enrolment. Suboptimal self-care behavior was defined as a score < 70 on the EHFScBS-9. Patients were divided into recent (within 30 days post-discharge, n = 664) and no recent hospitalization for HF groups (n = 1263), respectively. The primary outcome was a composite of all-cause death and rehospitalization for HF. RESULTS: During a median follow-up period of 427 (interquartile range 273-630) days, the primary outcome occurred in 100 patients. Patients with suboptimal self-care behavior exhibited a higher incidence of the primary outcome in the recent hospitalization for HF group (p = 0.020) but not in the no recent hospitalization for HF group (P = 0.16). Multivariable regressions showed suboptimal self-care behavior was independently associated with the primary outcome in the recent hospitalization for HF group with a significant interaction (P = 0.029). CONCLUSION: In patients recently hospitalized for HF, but not in those without a recent hospitalization history for HF, suboptimal self-care behavior was associated with adverse events. This indicates the importance of self-care education for these patients.

Determinants of self-care among Jordanian children with type 1 diabetes mellitus.

BACKGROUND: Diabetes Self-Care Management (DSCM) is crucial for managing diabetes mellitus and improving patients' well-being. Research on the young age group in Jordan is limited, and there is a lack of studies using an evaluation tool for understanding diabetes pharmacotherapy. This study intends to fill the information gap by examining young Jordanian patients' knowledge and comprehension of type 1 diabetes mellitus (T1DM) and its treatment modalities, evaluating their psychological well-being, and examining the relationship between children's psychological health and self-care. METHODS: This cross-sectional study was conducted in the Jordanian Ministry of Health hospitals in Amman from June 2021 to January 2022. A convenience sampling method was used to select Arabic-speaking diabetic patients aged 11-a8 years who provided signed consent. A sample size of 400 was estimated. A self-administered questionnaire was developed based on a literature review to assess sociodemographic characteristics and diabetes and insulin knowledge, and validated scales were used to assess self-management (SMOD-A) and psychological well-being (ChilD-S). RESULTS: Analysis of the questionnaire responses revealed varying levels of knowledge among the participants. Approximately half of the children (49.0%) demonstrated a lack of knowledge of diabetes pharmacotherapy. Psychological well-being indicators indicated moderate levels of happiness and feeling fine. The analysis of self-management indicators highlighted areas for improvement. Positive weak but significant correlations were found between children's knowledge about diabetes (r = 0.255, p < 0.01), diabetes pharmacotherapy knowledge (r = 0.125, p < 0.05), psychological well-being (r = 0.112, p < 0.05), and their diabetic self-management scores. A multivariate regression analysis identified predictors of self-management, including the child's school year (p = 0.035), ability to express feelings (p = 0.039), recent HbA1c levels (p = 0.028), and diabetes knowledge score (p < 0.001). CONCLUSION: Participants exhibited varying levels of knowledge about diabetes pharmacotherapy and self-management. Knowledge about diabetes was identified as a predictor for effective self-management. Moreover, glycemic control and diabetes mellitus awareness majorly impact overall self-management behaviors. Tailored education programs are necessary to fill knowledge gaps and enhance diabetes management among children.

Survey of community pharmacists' opinions on drug scheduling in Ontario and Québec.

Background: Over the past decade, Canada has witnessed a shift of several drugs from prescription-only to behind-the-counter (BTC) and over-the-counter (OTC) status. This work examined community pharmacists' agreement with the current scheduling of agents used in the management of allergic rhinitis, heartburn, and vulvovaginitis. Methods: From September to October 2022, an online survey was administered to pharmacists practicing in in Ontario and Québec. The survey aimed to gather insights into their preferred scheduling for 15 medicines commonly used to manage the three selected conditions. Pharmacists were asked whether they agreed with the current scheduling status of each and, if not, how they feel it should be scheduled. Results: 715 pharmacists completed the survey, 462 from Ontario and 253 from Québec. Most were staff pharmacists working 30 or more hours per week, having been a pharmacist for 1-10 years. Ontario pharmacists expressed a preference for scheduling change for five drugs (four prescription [terconazole for intravaginal use, famotidine, rupatadine, mometasone nasal spray] and one unscheduled [ranitidine 75 mg]), while Québec pharmacists expressed preference for scheduling change for three prescription drugs (terconazole for intravaginal use, famotidine, rupatadine). Discussion: As pharmacy practice continues to evolve, pharmacists' comfort with initiating previously prescription-only therapy independently or assisting patients with self-selection may similarly evolve. Of the five drugs identified as having a discrepancy between current status and pharmacist preference, four are prescription and may be candidates to consider for prescription to OTC switch. Conclusion: Pharmacists in Ontario and Québec have expressed preference for most products used in the treatment of allergic rhinitis, heartburn, and vulvovaginitis to be categorised as Schedule II (BTC) or Schedule III (OTC) available only in pharmacies.

Examining the effectiveness of education based on social learning theory in fostering self-care and social skills in school children: A randomized controlled trial.

PURPOSE: This study was conducted to examine the effectiveness of a training program prepared on the basis of the Social Learning Theory for teaching self-care and social competence behaviors in preschool children. DESIGN AND METHOD: The sample of the study consisted of 41 in the intervention, 41 in the control group. Data were collected with Demographic Assessment Form, the Self-Care Skills Assessment Scale and the Social Competence and Behavior Evaluation-30 Scale. Using five animated films created on the basis of the Social Learning Theory for fostering children self-care and social competence behaviors. RESULTS: The scores of the children in the intervention group on the three sub-dimensions of the self-care scale and the total score of the scale were found to be significantly higher than the control group (p < 0.05). The intervention group scored significantly higher on the self-care scale and social competence and behavior scales than the control group (p < 0.05). CONCLUSION: As a result of the research, it was seen that the applied training significantly affected the self-care and social competence behaviors in the intervention group. It was seen that using Social Learning Theory in teaching health behaviors has been effective in the learning process of preschool children. IMPLICATIONS TO PRACTICE: In preschool period, children learn by observing and imitating their adopted role models. Since, we suggest that health training program should be based on the stages of Social Learning Theory. Animated films that focus on the target health behaviors can be used as training tools.

Generic and disease-specific self-care instruments in older patients affected by multiple chronic conditions: A descriptive study.

AIMS: To describe and compare generic and disease-specific self-care measures in patients with multiple chronic conditions (MCCs) in the three dimensions of self-care maintenance, monitoring, and management. DESIGN: Multicentre cross-sectional study. METHODS: Patients aged 65 and over with MCCs. We used Self-Care of Chronic Illness Inventory to measure generic self-care, Self-care of Diabetes Inventory to measure self-care in diabetes mellitus, Self-Care of Heart Failure (HF) Index to measure self-care in HF, and Self-Care of Chronic Obstructive Pulmonary Disease Inventory to measure self-care in chronic lung diseases. RESULTS: We recruited 896 patients. Multimorbid patients with diabetes had lower scores on the self-care maintenance scale, and diabetic patients in insulin treatment on the generic management scale than on the disease-specific instrument. Multimorbid patients with HF or chronic lung diseases scored higher on generic self-care maintenance and monitoring scales than disease-specific ones. There was a partial consistency between the generic and disease-specific self-care maintenance and management. Inadequate behaviours were recorded in disease-specific self-care monitoring rather than generic ones. CONCLUSIONS: Older patients affected by MCCs scored differently in the generic and disease-specific instruments, showing inadequate self-care in some of the three self-care dimensions. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The choice between generic and disease-specific instruments to use in clinical practice and research should be made considering the specific aims, settings, patients characteristics, and knowledge of the different performance of the instruments by users. IMPACT: No study has described and compared generic and specific self-care measures in patients affected by MCCs. Knowing these differences can help nurses choose the most suitable measure for their aims, context, and patients and plan generic and disease-specific self-care educational interventions for those behaviours in which MCCs patients perform poorly. PATIENT CONTRIBUTION: Patients were informed about the study, provided informed consent, and answered questionnaires through interviews.

Glucometric parameter changes in patients with type 2 diabetes during ramadan fasting: A prospective comparative real-world study.

Background: This study assessed glucometric changes in Type 2 diabetes mellitus (T2DM) patients before, during, and after Ramadan fasting using an intermittently scanned continuous glucose monitoring system (isCGMS). Methods: This prospective comparative study included T2DM patients aged 30-70 years who were receiving nonintensive insulin in Riyadh, Saudi Arabia. In addition to the baseline characteristics, glycated hemoglobin (HbA1c) and ambulatory glucose profile (AGP)-derived metric data were collected at three specific points: pre-, during-, and post-Ramadan. Self-care activities during Ramadan were evaluated using the Diabetes Self-Management Questionnaire (DSMQ). Results: Overall, a total of 93 T2DM patients were enrolled in the study. Their mean age ±SD age was 47.9 ± 7.5 years, and 51.6 % of them were males. Compared with pre- and post-Ramadan, there was a significant decrease in HbA1c (p < 0.001 for both periods), average glucose level (p = 0.001 and p = 0.026, respectively), glucose variability (p = 0.043 and p = 0.005, respectively), and % time above the range of 181-250 mg/dL (p < 0.001 for both periods), as well as a significant increase in % time in target (70-180 mg/dL) during Ramadan (p < 0.001 for both periods). However, the % time below 54 mg/dL was slightly greater during Ramadan than both pre- and post-Ramadan (p < 0.001 and p = 0.002, respectively). Furthermore, 32.3 % reported inadequate self-care behaviors during Ramadan. Conclusions: Ramadan fasting could improve glucose levels in T2DM patients who were not on intensive insulin, with a relatively low incidence of hypoglycemia.

Portuguese validation of the foot health status Questionnaire in patients with diabetic foot disease.

PURPOSE: This study aims to adapt and validate the Foot Health Status Questionnaire, developed by Bennett et al., in Portuguese patients with diabetic foot. MATERIALS AND METHODS: A cross-sectional study was conducted with 143 patients with diabetic foot. A principal component analysis with oblique rotation and a confirmatory factor analysis using structural equation modeling were performed. RESULTS: The Portuguese version of the FHSQ (FHSQ-PT) in patients with diabetic foot remains equal to the original version, although with all factors correlated with each other. All scales presented high internal consistency values (pain: ω = 0.884; function: ω = 0.890; general foot health: ω = 0.910; and footwear: ω = 0.702), except for the footwear scale, although with a minimum acceptable coefficient. The FHSQ-PT scales showed good convergent validity and good discriminant validity. The FHSQ-PT scales were also able to discriminate between male and female patients as well as between patients with an active diabetic foot ulcer from those who did not. CONCLUSIONS: The results of the validated FHSQ-PT for Portuguese patients with diabetic foot showed good psychometric properties, being a useful, objective, and small instrument that may be used in clinical practice by health professionals without consuming too much time.

Diabetic foot ulcer has been consistently reported to be associated to lower health-related quality of life, impairing the patient's everyday function.Validated comprehensive measures that assess specific dimensions related to foot health in patients with diabetic foot are needed.The Portuguese version of the Foot Health Status Questionnaire (FHSQ-PT) showed good psychometric properties.FHSQ-PT is a useful short instrument that may be used to measure foot health status in clinical practice by health professionals who provide care to patients with diabetic foot.