Fatores clínicos do bem-estar de mulheres em parturição: perspectivas deontológicas e da bioética principialista / Clinical factors of women in labor well-being: deontological and bioethical principlism perspectives / Factores clínicos del bienestar de la mujer en trabajo de parto: perspectivas deontológicas y de la bioética principialista

Objetivo: avaliar os fatores clínicos associados ao bem-estar das mulheres durante o trabalho de parto e parto à luz da bioética principialista e da deontologia. Método: estudo transversal com abordagem quantitativa. Participaram 396 puérperas internadas em um hospital municipal do sudoeste da Bahia, e os dados foram coletados no período de janeiro a maio de 2023, após aprovação do comitê de ética em pesquisa. Os dados foram organizados no software Excel e analisados via SPSS v.25. a partir da regressão logística multinomial. Resultados: a maior parte da amostra apresentou bem-estar com assistência em saúde, mulheres que tiveram parto realizado por profissionais não médicos apresentaram mais chances de níveis de bem-estar "adequado". E mulheres que não tiveram a via de parto cesárea apresentaram aumento de chances de bem-estar. Conclusão: é necessário que os profissionais reflitam sobre suas ações, condicionando-as à humanização no parto, em observância aos princípios bioéticos.

Objective: to evaluate the clinical factors associated with women's well-being during labor and delivery in the light of bioethics principlism and deontology. Method: a cross-sectional study with a quantitative approach was conducted. It involved 396 postpartum women admitted to a municipal hospital in the southwest of Bahia. Data were collected from January to May 2023, after approval from the research ethics committee. The data were tabulated using Excel software and analyzed using SPSS v.25 through Multinomial Logistic Regression. Results: majority of the sample exhibited well-being with health care assistance. Women who underwent delivery performed by non-medical professionals showed higher chances of "adequate" levels of well-being. Additionally, women who did not undergo cesarean delivery showed increased chances of well-being. Conclusion: It is necessary for professionals to reflect on their actions, conditioning them to the humanization of childbirth, according to bioethical principles.

Objetivo: evaluar los factores clínicos asociados al bienestar de la mujer durante el trabajo de parto y parto a la luz de la bioética y la deontología principialista. Método: estudio transversal con enfoque cuantitativo. Incluyó 396 puérperas ingresadas en un hospital municipal del suroeste de Bahía. Recolección de datos de enero a mayo de 2023, con aprobación del comité de ética en investigación. Los datos se tabularon en el software Excel y se analizaron mediante SPSS v.25. utilizando regresión logística multinomial. Resultados: la mayoría de las participantes de la muestra presentó bienestar con la atención para la salud; las que tuvieron partos realizados por profesionales no médicos tenían más probabilidades de tener niveles "adecuados" de bienestar; las que no tuvieron parto por cesárea tenían mayores probabilidades de tener bienestar. Conclusión: es necesario que los profesionales reflexionen sobre sus acciones y las adecuen para humanizar el parto, respetando los principios bioéticos.

Peer-to-peer training among health care professionals working in dialysis clinics: an education approach from the GoodRENal project.

BACKGROUND: Lifestyle interventions aiming to improve dietary habits, increase physical activity level, and improve emotional well-being can positively impact clinical outcomes in patients with chronic kidney disease (CKD). Educational material for health care professionals working with CKD patients that focuses on why and how to promote lifestyle changes is lacking. The present study aims to depict the material and dissemination methods for the peer-to-peer training program developed for health care professionals working in the dialysis clinics of the four countries engaged in the GoodRENal project: Spain, Greece, Sweden, and Belgium. METHODS: This is an ERASMUS + project funded by the European Union (number 2020-1-ES01-KA2014-083141, http://goodrenal.eu/ ) named GoodRENal. The educational material was developed in English by a multidisciplinary team integrating the GoodRENal project (dietitian, physiotherapist, psychologist, and nephrologist). The material was then translated to Greek, Spanish, Swedish and Dutch and is available for download at the GoodRENal webpage ( https://goodrenal.es/results-3/ ). After training, the health care professionals filled in an anonymous questionnaire regarding their degree of satisfaction with the training. RESULTS: In total, 138 health care professionals in the four dialysis clinics joined the peer-to-peer training, representing 50% to 92% of the health care professionals in each clinic. From the total sample, 78 health care professionals responded to the satisfaction questionnaire. The answers showed that most participants were very satisfied or satisfied with the peer-to-peer training and that they found this approach useful in their clinical practice. CONCLUSION: The educational material developed for health care professionals working with patients on hemodialysis (HD) obtained good satisfaction scores from the participants.

Emotional well-being in Charles Bonnet syndrome: exploring associations with negative affect, loneliness and quality of life.

Background: Charles Bonnet syndrome (CBS) is a condition characterised by the occurrence of vivid and complex visual hallucinations in individuals with visual impairment. Objective: To explore the relationship between emotional distress and the perceived impact of CBS symptoms on participants' lives. We tested the hypothesis that heightened negative affect was associated with a more negative appraisal of CBS symptoms, increased self-reported loneliness, and poorer quality of life (QOL). Design: Cross-sectional. Methods: Participants recruited predominantly via vision-related charities rated their hallucinations and their impact on a Likert scale. Loneliness and negative affect were assessed with the Three-Item Loneliness Scale and Positive and Negative Affect Schedule. Health index (EQ-5D-3L) and vision-related QOL (VF-9) were also assessed. Correlation analysis and multi-variable regression determined the relation between survey responses. Results: The majority of 126 respondents (81%) were aged 65+ years and 84% reported active CBS symptoms. Fifty-five percent of respondents rated impact of CBS as negative and no-one rated the impact as 'very pleasant'. A statistically significant correlation was found between impact of CBS and negative affect (p ⩽ 0.001; rho = -0.34) and impact of CBS and loneliness (p = 0.017; rho = -0.21). The relation between negative affect and CBS impact remained statistically significant when accounting for the impact of loneliness and the relationship between loneliness and CBS effect (p = 0.002, adj R 2 = 0.1). A statistically significant correlation between loneliness and negative affect (p ⩽ 0.001; rho = 0.55) was also found. Conclusion: Respondents experiencing negative emotions were more likely to perceive the impact of CBS symptoms as negative and report greater feelings of loneliness. Negative affect is an important consideration when assessing people with CBS.

Understanding the impact of visual hallucinations in Charles Bonnet syndrome Charles Bonnet Syndrome (CBS) is a condition where people with vision problems experience vivid and complex visual hallucinations. In this study, we wanted to see how feeling upset or lonely might affect how people with CBS view their symptoms. We asked 126 adults, most of whom were over 65 years old, about their hallucinations and how they felt about them. We also asked about feelings of loneliness and general emotional well-being. We found that the more negative emotions people felt, the more they tended to see their CBS symptoms in a negative light and feel lonelier. This suggests that understanding and addressing negative emotions is crucial when helping people with CBS.

The mediating roles of psychological resilience and psychological well-being of caregivers for the older adults.

Objective: This study aimed to investigate the mediating effects of psychological resilience and psychological well-being for caregivers at nursing homes on the relationship between insomnia and elder maltreatment. As the world is aging quickly and the number of older individuals cared for by formal caregivers has been increasing, this study's results could help create intervention programs to minimize the occurrence of older people's maltreatment. Materials and Methods: A total of 431 care workers who met all criteria, from 21 care service centers for older adults in Fukuoka, Japan, completed the Conditions of Maltreatment Scale, Caregivers' Belief in Ideal Care, Insomnia Severity Index, WHO-5 Well-Being Index, and Connor-Davidson Resilience Scale-10. Results: A multivariate analysis of variance revealed that participants with no insomnia had greater resilience, higher psychological well-being, and greater belief in ideal care and to treated older clients less roughly compared to participants with insomnia. Psychological resilience and well-being were significant mediators in the relationship between insomnia, rough care, and beliefs in ideal care. Conclusion: As formal caregivers are in urgent demand, society should take care of them. The most effective and successful intervention for improving their physical and psychological well-being should be initiated at the individual and organizational levels.

Setting the Game Agenda: Reviewing the Emerging Literature on Video Gaming and Psychological Well-Being of Sexual and Gender Diverse Youth.

Video gaming is a popular youth pastime that has prompted scholarship into its relationship with psychological well-being. However, sexual and gender diverse youth (SGDY) who play video games are largely overlooked in this research. SGDY experience significant mental health challenges, but utilize coping strategies mediated by digital technologies, necessitating an examination of their video game playing and its effects on well-being. This literature review synthesizes the emerging evidence base by identifying key constructs related to SGDY well-being and video gaming. Five themes were derived from the literature: (a) SGDY identity development and self-expression in video games; (b) SGDY video gaming and coping skills; (c) Social support in SGDY video gaming communities; (d) SGDY digital microaggressions in video gaming; and (e) SGDY civic engagement through video gaming. The findings establish multiple risks and opportunities for harnessing video games to support SGDY's well-being. Recommendations for practice, research, and industry collaborations are presented.

Social ties and social identification: Influences on well-being in young adults.

Research highlights the positive impact of social connectedness on subjective well-being. In this paper, we test a model in which an identity-based mechanism links a structural form of connectedness (significant social ties) with two psychological well-being outcomes, life satisfaction and self-esteem. Using data from the LIVES Longitudinal Lausanne Youth Study (LIVES-LOLYS, N = 422), a longitudinal mediation path model tests direct and indirect effects, via the strength of social identification, of the number of significant social ties in two life domains (friends and family) on life satisfaction and self-esteem. Results showed positive associations between the number of significant ties and social identification in the concordant domain, empirically linking the structural and subjective forms of social connectedness. Moreover, our model displays significant indirect effects in the friend domain, but not in the family domain. Having more friends as significant social ties predicted higher social identification with friends, and this was longitudinally associated with higher life satisfaction and self-esteem. Findings show a new mechanism linking structural and subjective forms of social connectedness, unpacking their concerted impact in protecting well-being. The differences between the friend and family domains are discussed in the framework of both life-course and social identity perspectives.

Promoting long-lasting changes in student well-being through a pharmacy general education course: A pilot study.

OBJECTIVE: Colleges and universities need effective strategies to help students develop medication-use behaviors that positively support their well-being. This pilot study evaluated the utility of Fink's Taxonomy of Significant Learning (FTSL), an evidence-based instructional strategy, to create long-lasting changes in students' well-being during a pharmacy general education course. PARTICIPANTS AND METHODS: Using a mixed methods survey design, we assessed 84 undergraduate students' changes in self-reported well-being at three different time points (pre-intervention, post-intervention, and 6-month follow-up) through five variables (safe medication practices, general healthcare behaviors, healthcare self-efficacy, safe medication storage, and safe medication disposal). RESULTS: The results of multiple repeated-measures ANCOVAs, four McNemar chi-square tests, and qualitative thematic analysis showed significant positive changes in several variables over time. CONCLUSIONS: This pilot study demonstrated that intentional integration of FTSL during the course design process helped students develop long-lasting general healthcare and safe medication-use behavior intentions. We discuss holistic approaches for promoting student well-being.

How work engagement and workaholism relate to individuals' and their intimate partners' mental well-being: a test of the spillover-crossover model among Indonesian dual-earner couples.

This study investigated the relationship between work engagement, workaholism, and mental well-being of individuals and their intimate partners. This association was explored in the context of Indonesian dual-earner couples, using the Spillover-Crossover Model (SCM). The study examined how work-to-family spillover (i.e. work-to-family conflict and facilitation) and recovery experiences (i.e. psychological detachment, relaxation, mastery, and control) mediate these relationships. A cross-sectional survey was conducted among 186 Indonesian dual-earner couples with preschool children. Structural equation modeling was used to test the hypothesized model and bootstrap method was conducted to evaluate the indirect relationships. As hypothesized, among male and female workers, work engagement was positively related to individual's mental well-being through work-to-family facilitation and recovery experiences. In contrast, workaholism was negatively related to individual's mental well-being through work-to-family conflict and recovery experiences excluding psychological detachment. Individual's mental well-being, in turn, was positively related to intimate partner's mental well-being. These findings suggested that work engagement and workaholism were related to intimate partner's mental well-being differently. These results further supported the SCM, suggesting that higher work engagement could increase workers' and their intimate partners' mental well-being through work-to-family facilitation and their recovery experiences, while workaholism acts oppositely.

Digital entanglements: Medical drones in African healthcare systems.

The intensified scramble for the digitalisation of healthcare across Africa, coupled with the general drive for digital economies, has ushered in digital health innovations that are reconfiguring national discourses on humanitarian and development contexts. Through these innovations, imaginaries of health have become entangled with aspirations for universal health coverage (UHC) and the actualisation of the health-related sustainable development goals (SDGs). Among these innovations, drones promise to leapfrog and transform conventional African healthcare systems, which have suffered from structural bottlenecks for years, offering citizens on the margins of care critical biomedical gazes. By using drones, African states hope to improve revenue collection, curb corruption, redress health insecurities and deliver life-saving medicines, vaccines and laboratory diagnostics through a last-mile distribution schedule. Ethnographic fieldwork from 2022 to 2023 in Ghana and Malawi on the use of drones found distortions to the health workforce, disruptions to health work, and a pervasive internal brain drain, all exacerbating health-worker shortages. This paper explores how drones are reconfiguring health work and its available labour force in practice amid persistent shortages of health-workers.

Subclinical attention-deficit hyperactivity disorder symptoms and unhealthy lifestyle behaviours.

BACKGROUND: Literature emphasises the importance of identifying and intervening in the adoption of unhealthy lifestyle behaviours (ULBs) during adolescence at an early stage, to mitigate their long-term detrimental effects. Among the possible associated factors contributing to ULBs, attention-deficit hyperactivity disorder (ADHD) has been shown to play an important role. However, little is known about ADHD subclinical manifestations. AIMS: The present study aimed to bridge the gap in the literature and shed light on the relationship between subclinical ADHD and early adoption of ULBs during adolescence. Through a clinimetric approach, prevalence of ULBs, severity of ADHD symptoms and psychosocial factors (i.e. allostatic overload, abnormal illness behaviour, quality of life, psychological well-being) were investigated among adolescents. The associations between different degrees of ADHD, ULBs and psychosocial factors were also explored. METHOD: This multicentre cross-sectional study involved 440 adolescents (54.5% females; mean age 14.21 years) from six upper secondary schools. Participants completed self-report questionnaires on sociodemographic characteristics, ULBs, ADHD symptoms and psychosocial factors. RESULTS: The most common ULBs were energy drinks/alcohol consumption and problematic smartphone use. Of the sample, 22% showed subclinical ADHD and 20.2% showed clinical ADHD. The subclinical ADHD group showed several ULBs (i.e. altered mindful eating, impaired quality of sleep, problematic technology use) and psychosocial factors, akin to those of ADHD group and different from peers without ADHD symptoms. CONCLUSIONS: Since subclinical ADHD manifestation is associated with ULBs, similarly to clinical ADHD, identifying subthreshold symptoms during adolescence is crucial, as it could improve health-related outcomes in adulthood across different domains.

The Effect of a Physical Activity Program on Subjective Well-Being, Happiness and Problem-Solving Skills in Patients with Schizophrenia: A Randomized Controlled Trial.

The aim of this randomized controlled trial was to examine the effect of Physical Activity Program applied to patients with schizophrenia on subjective well-being, happiness and problem-solving skills levels. This study was conducted with a total of 86 individuals diagnosed with schizophrenia (43 intervention and 43 control) registered in a family health center. Subjective Well-Being Scale, the Short Form of the Oxford Happiness Questionnaire and Problem-Solving Inventory were used to collect the data at baseline and, post-intervention. Significant increases in subjective well-being, happiness, and problem-solving skills were found in the intervention group after the total of 12 weeks of the Physical Activity Program, which included walking and exercises, compared to the control group. Accordingly, it can be said that the Physical Activity Program is an effective method that increases subjective well-being, happiness and problem-solving skills. ClinicalTrials.gov Identifier number is NCT15976921 and date of registration is 21/11/2023, retrospectively registered.

Anxiety and depression in cancer patients and survivors in the context of restrictions in contact and oncological care during the COVID-19 pandemic.

Treatment modifications and contact restrictions were common during the COVID-19 pandemic and can be stressors for mental health. There is a lack of studies assessing pandemic-related risk factors for anxiety and depression of cancer patients and survivors systematically in multifactorial models. A total of 2391 participants, mean age 65.5 years, ≤5 years post-diagnosis of either lung, prostate, breast, colorectal cancer, or leukemia/lymphoma, were recruited in 2021 via the Baden-Württemberg Cancer Registry, Germany. Sociodemographic information, pandemic-related treatment modifications, contact restrictions, and anxiety/depression (Hospital Anxiety and Depression Scale, HADS) were assessed via self-administered questionnaire. Clinical information (diagnosis, stage, and treatment information) was obtained from the cancer registry. Overall, 22% of participants reported oncological care modifications due to COVID-19, mostly in follow-up care and rehabilitation. Modifications of active cancer treatment were reported by 5.8%. Among those, 50.5% had subclinical anxiety and 55.4% subclinical depression (vs. 37.4% and 45.4%, respectively, for unchanged active treatment). Age <60 years, female sex, lung cancer, low income, and contact restrictions to peer support groups or physicians were identified as independent risk factors for anxiety. Risk factors for depression were lung cancer (both sexes), leukemia/lymphoma (females), recurrence or palliative treatment, living alone, low income, and contact restrictions to relatives, physicians, or caregivers. The study demonstrates that changes in active cancer treatment and contact restrictions are associated with impaired mental well-being. The psychological consequences of treatment changes and the importance for cancer patients to maintain regular contact with their physicians should be considered in future responses to threats to public health.

Predictive role of spiritual health, resilience, and mental well-being in treatment adherence among hemodialysis patients.

BACKGROUND: End-stage renal disease (ESRD) causes numerous physical and psychological problems in patients, so that they must adhere to their treatment regimen to recover their disease, alleviate these problems, and increase their lifespan. The present study aimed to determine the predictive role of spiritual health, resilience, and mental well-being in treatment adherence among hemodialysis patients. METHODS: This correlational cross-sectional study investigated some variables related to treatment adherence in 184 patients undergoing hemodialysis referred to two dialysis centers in Kerman, southeastern Iran. A census method was used to select the participants and data were collected using socio-demographic characteristics questionnaire, Adherence to Treatment Questionnaire (ATQ), Conner-Davidson Resilience Scale, Reef Psychological well-being Questionnaire, and Spiritual Well-Being Scale (SWBS). RESULTS: The overall treatment adherence score was 155.42 ± 27.98 and we found a positive significant correlation between spiritual health, resilience, psychological well-being, and treatment adherence (p < 0.001). The mean scores of resilience, spiritual health and psychological well-being were 70.59 ± 17.02, 90.09 ± 12.01, and 77.88 ± 11.72, respectively. Spiritual health, psychological well-being, resilience, gender and marital status predicted 54% of the variance of treatment adherence, with psychological well-being being the best predictor (p < 0.001). CONCLUSIONS: Spiritual health, psychological well-being, and resilience are factors that influence treatment adherence of the patients undergoing hemodialysis, with psychological well-being having the greatest contribution to improving patient's treatment adherence. Interventions effective in improving psychological well-being, spiritual health and resilience can improve treatment adherence of patients undergoing hemodialysis. Healthcare workers must pay more attention to the factors affecting treatment adherence of patients undergoing hemodialysis.

Chinese women's years of education and subjective well-being: an empirical analysis based on ordered Logit model and coupling coordination model.

In modern society, the improvement of women's education level has become one of the important indicators of national development and social progress. Although there are many useful explorations on the relationship between education and subjective well-being, the research on women's years of education and subjective well-being is very limited. The article focuses on women's years of education to determine whether and how to affect subjective well-being. This study is based on the China general social survey in 2021. The ordered Logit model was used to analyze the impact of women's years of education on subjective well-being, and a binary coupling coordination model was constructed to test the above two variables. The results show that the longer the education years of women, the stronger the subjective well-being. The benchmark regression results show that women's years of education have positive and negative effects on subjective well-being through economic status, physical and mental health, ecological environment, social cognition and personal cognition. The analysis of coupling coordination degree shows that the coupling between the years of education and subjective well-being of women in coastal areas and economically developed areas is the strongest, and the subjective well-being is better realized by increasing the years of education. Based on the above research results, this paper provides some practical suggestions for improving women's subjective well-being, and provides some valuable references for women to effectively balance husband-wife relationship, family relationship and work relationship, improve women's years of education and better obtain happiness.

A scoping review of interventions targeting HIV stigma in women living with HIV.

Since its initial detection in the 1980s, AIDS has become a significant global health threat, disproportionately affecting women. Stigma constitutes the substantial barrier to accessing healthcare for women living with HIV (WLWH). This scoping review based on the Population, Concept, and Context (PCC) framework aimed to provide evidence-based guidance for clinical caregivers to develop intervention strategies and assess their effectiveness. From database inception to May 2023, research on stigma interventions for WLWH was searched in databases including Embase (OVID), MEDLINE (OVID), CINAHL (EBSCO), ProQuest, Scopus, WANFANG, VIP, CNKI, and SinoMed. Literature was screened based on inclusion and exclusion criteria, and results were extracted for scoping review. Twelve studies were included featuring information-based, skills-based interventions, and a combination of both, targeting individuals and institutions. Six studies reported significant reduction in stigma. Assessment tools used included the 7-item Questionnaire on Attitudes toward AIDS Victims (AQAV-7), the 40-item HIV Stigma Scale (HSS-40), the 14-item Chronic Illness Stigma Scale (SSCI-14), the 28-item Internalization HIV-Related Stigma Scale (IHSS-28), the 57-item Internalized Stigma Scale (IS-57), and the 6-item Internalized AIDS-Related Stigma Scale (IA-RSS-6). Validation of existing intervention and the development of mechanisms linking interventions to stigma reduction are needed.

A Latent Class Analysis on Indicators of Early Prolonged Grief Disorder and Well-Being Among Dutch Adults Bereaved During the First Year of the COVID-19 Pandemic.

Most studies examining prolonged grief disorder (PGD) in people bereaved during the COVID-19 pandemic are focused on psychopathology. However, mental health encompasses both absence of psychopathology and presence of well-being. This is the first study examining symptom profiles of early PGD and subjective mental well-being in 266 Dutch adults recently bereaved during the pandemic. Early PGD and well-being indicators were assessed with the Traumatic Grief Inventory-Self Report Plus and the World Health Organization-Five Well-Being Index, respectively. Latent class analysis identified four classes: low PGD/high well-being (32%), low PGD/moderate well-being (24%), moderate PGD/high well-being (23%) and high PGD/low well-being class (21%). People in the poorer mental health classes were more likely to be female, lower educated, suffering from a mental disorder, have a poor health status, closer kinship to the deceased, and higher risk of severe COVID-19. Classifying adults according to symptom profiles of negative and positive outcomes provides a more complete picture of mental health in bereaved people and offers potential intervention targets.

Purpose in life and grip strength: An individual-participant meta-analysis of 115,972 participants from 24 countries across four continents.

This research examines the replicability and generalizability of the association between purpose in life and grip strength. An individual-participant meta-analysis of 27 samples (total N=115,972) from 24 countries that spanned four continents (Asia, Europe, North and South America) with self-reported purpose in life and dynamometer-assessed grip strength. Purpose in life was associated with stronger grip strength in every sample and aggregated in a random-effects meta-analysis (meta-analytic estimate=.06, p<.001). The association was similar across samples from different world regions and not moderated by methodological factors (e.g., scale content). The association was apparent across age, sex, race, and education and slightly stronger among males and participants with relatively less education. Every standard deviation in purpose was associated with a 23% lower likelihood of weak grip strength (meta-analytic OR=.81, 95% CI=.79-.84, p<.001) based on a standard threshold. Purpose in life is associated with grip strength, a marker of overall musculoskeletal health. The association replicates across diverse locations around the world and generalizes across sociodemographic groups.

Dance for Parkinson, multifaceted experiences of persons living with Parkinson's Disease.

BACKGROUND: Dance classes for people with Parkinson's Disease (PD) are offered worldwide; however, further studies are needed to explore patients' experiences of how dance affects well-being. PURPOSE: To explore how Dance for Parkinson (Dance for PD) is experienced, and how it contributes to the well-being and health of participants in Sweden. METHODS: This qualitative study collected data from four focus groups. Participants were asked how dance classes impacted their well-being, and their ability to perform activities of daily life. The focus groups were recorded and transcribed. Data were analysed using content analysis, meaning units were coded, and codes were coalesced into categories from which themes were abstracted. RESULTS: Dance for PD provided a multifaceted experience related to social relationships, aesthetic context, feelings of wellbeing and the physical experience of dancing. The main theme contained four sub-themes: Connectedness, Pleasure and glamour, Well-being in mind and body and Customized movements. CONCLUSION: The present study highlights that health and well-being are improved by Dance for PD. It is an enjoyable activity that meets the specific needs of persons living with the consequences of PD and should therefore be promoted by occupational therapists.

Understanding the struggle: Unique challenges of adherence in male diabetic patients in Tshwane.

BACKGROUND:  Type 2 diabetes prevalence is steadily increasing worldwide, and South Africa is one of the countries in Africa with the highest prevalence of this disease, along with other non-communicable diseases. The adherence to treatment in male patients with type 2 diabetes is influenced by their attitudes towards medication and how they perceive their condition. To some extent, these factors impact the treatment outcomes for patients undergoing type 2 diabetes treatment. The purpose of this study was to investigate the perceptions of male patients with type 2 diabetes on their adherence to diabetic therapy. The study was conducted in the clinics of the City of Tshwane Metropolitan municipality in Gauteng. METHODS:  This study followed a qualitative, exploratory design. Data were gathered from 15 male patients who were purposefully sampled through in-person, one-on-one interviews with the principal investigator. The eight steps outlined by Tesch were used to analyse the participant data. RESULTS:  Emergent themes indicated that there were barriers to adherence to diabetic treatment and also factors that promoted adherence to diabetic treatment among the participants. Several factors were found to affect treatment uptake among the participants. CONCLUSION:  Patients demonstrated various reactions to diabetic treatment, highlighting the need for reinforcing education at the time of diagnosis and treatment initiation. Additionally, regular patient follow-up may be essential to improve adherence among patients.Contribution: The study highlights the importance of health promotion and the need to develop materials for medication-specific counselling for patients receiving diabetic treatment, in order to promote adherence.

Promoting mental health in higher education: towards a model of well-being factors in emerging adulthood.

PURPOSE: This study aims to contribute to the development of a theoretical model that is useful for enhancing well-being/positive mental health with pedagogical resources that enable the acquisition of skills and knowledge, particularly during Emerging Adulthood. METHODS: This paper enquires into the role of well-being promotion in higher education following the dual-factor model of mental health difficulties and wellbeing. The study narratively reviews the main well-being models and presents a compared theoretical synthesis examining the dimensions that promote or facilitate the presence of well-being using a promotion approach. RESULTS: The study identifies 14 dimensions involved in wellbeing-emotional, psychological and social factors-that can be potentially improved through learning processes. Drawing on empirical and theoretical studies on emerging adult population, a factorial model is proposed. Preliminary factor interactions are examined paying close attention to the cognitive processes that explain or affect their relationship with well-being, the possible correlations between them and particularities of emerging adults. CONCLUSION: Wellbeing factors can be particularly targeted by educational promotion, as they can be developed through learning processes. An integrative model that provides a broad perspective can assist in pedagogical design and defining educational goals for these learning processes involved in wellbeing promotion.