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.

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.

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.

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 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.

Balint groups' possible role in self-care and job satisfaction of general practitioners-A qualitative study.

BACKGROUND: Concerns are growing when it comes to the shortage of primary care physicians, therefore it seems necessary to take a closer look at job satisfaction and self-care as one of many influences on career choice. A higher job satisfaction reduces the risk to experience burnout and job-related stress and in addition it will contribute to staying in the profession. The objective of this study is to investigate the impact of regular participation in Balint groups on job satisfaction and self-care among general practitioners. METHODS: Descriptive qualitative study with semi-structured expert interviews of 7 general practitioners. Thematical analysis of data and narrative summary. RESULTS: A total of 402 coded segments were categorized into 8 main themes and 39 subthemes. Interviewees emphasized changes in self-care and job satisfaction as a result of Balint work and mentioned Balint work as a burnout prophylaxis for themselves. Competences that were learnt or improved through Balint work were described as well as aspects such as feedback and connection with colleagues or professional challenges and difficulties. CONCLUSION: The results of the study give rise to the assumption that regular participation in Balint groups might help to improve self-care, resilience, and contribute to job satisfaction. Further research is needed before a general recommendation can be made. Many positive aspects were described by the experts, while no harmful negative influences of Balint work were identified.

Clinical and demographic moderators of self-care and hospitalizations in pre-coronary artery bypass grafting patients: A cross-sectional study.

AIM: To examine the influence of clinical and demographic factors on self-care behaviour and hospitalization rates among patients with coronary heart disease awaiting coronary artery bypass grafting. BACKGROUND: Appropriate self-care behaviour can improve the management of patients with coronary heart disease and reduce hospitalization rates among those awaiting coronary artery bypass graft surgery. However, little is known about the influence of clinical and demographic factors on self-care or hospitalizations in this population. DESIGN: A cross-sectional study. METHODS: A convenience sample of 99 participants diagnosed with coronary heart disease awaiting coronary artery bypass grafting surgery were recruited from an outpatient clinic of a public tertiary hospital in southern Thailand. Data were collected on clinical (left ventricular ejection fraction, symptom severity and comorbid disease) and demographic (age, education level and marital status) factors, self-care behaviour and hospitalization rates. Path analysis using LISREL was performed to examine the influence of self-care on hospitalizations, with clinical and demographic factors as moderators. RESULTS: Path analysis showed that clinical and demographic factors accounted for nearly half of the variance (46%) in self-care, and that self-care accounted for nearly half of the variance (48%) in hospitalization rates. CONCLUSION: Our findings demonstrate that clinical and demographic factors play an important role in self-care behaviour, and in turn hospitalization rates of pre-coronary artery bypass graft surgery patients. It is suggested that the period pre-surgery is an ideal time to introduce programmes designed to bolster self-care and minimize uncertainty among this patient population and that nurses are well-positioned to do so. REPORTING METHOD: Study methods and results reported in adherence to the STROBE checklist. PATIENT OR PUBLIC CONTRIBUTION: Patients contributed their consent, time and data to the study.

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.

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.

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.

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.

Perceived control attitude among heart failure patients in Oman: a multicenter study.

Heart failure (HF) is a global epidemic with a prevalence of over 64.3 million cases worldwide. Several factors account for the increase in the prevalence of HF. The most significant factor is the growing population of older adults. Other factors include improved treatment and survival after myocardial infarction, poorly controlled hypertension (HTN), and diabetes mellitus (DM). As a modifiable construct, perceived control can be improved to promote healthier lifestyle choices, such as self-care, and consequently better health outcomes. A person's perception of control is their conviction that they have the power to deal with adverse circumstances, like receiving an HF diagnosis, and produce favorable results, such as an improvement in symptom status. The objective of this study was to evaluate the factors influencing perceived control attitudes among patients with heart failure in Oman. In this sample of HF patients (N = 180), the mean perceived control attitude was 16.97 ± 2.25. Certain factors had higher effects than others. For example, females (p = 0.006), old age (p < 0.001), those who smoke (p < 0.001), current health compared to one year back (p < 0.001), higher ejection fraction (p = 0.008), and comorbidities (p = 0.026) have significant relationships with perceived control attitude. The perceived control attitude in this sample was found to be adequate. Female gender, old age, smoking, current health, higher EF, and comorbidities were the associated factors of a perceived control attitude. Thus, interventions targeting attitudes, barriers, and social support may improve perceived control. Clinicians should assess and manage perceived control to maintain or improve quality of life.

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.

Path analysis of self-care amongst community-dwelling pre-ageing and older adults with chronic diseases: A salutogenic model.

With the trend towards ageing population globally, the salutogenic model can be integrated in interventions for pre-ageing and older adults to better support healthy ageing. However, there is limited research examining the salutogenic model's pathway amongst pre-ageing and older adults. Hence, this study aims to investigate pathways of the salutogenic model amongst pre-ageing and older adults with chronic diseases. Two hundred and eight pre-ageing and older adults were recruited from 11 Senior Activity Centres in Singapore. Data was collected using a self-reported questionnaire and analysed using path analyses. The indirect pathway from Subjective Cognitive Complaints to self-care abilities via sense of coherence and health practices were significant. Participants with higher sense of coherence may have increased capacities to execute more complex forms of self-care. Future interventions integrating the salutogenic model could enhance pre-ageing and older adults' self-care abilities to cope with chronic diseases and contribute to healthy ageing.

Effect of a self-care promoting program on engagement in self-care behaviors and health-related outcomes among persons with type 2 diabetes and diabetic retinopathy: A single-blind randomized controlled trial.

Background: Diabetic retinopathy (DR) is the most common microvascular complication of diabetes, leading to visual impairment and eventual blindness. Promoting self-care behaviors is crucial in controlling DR progression and preventing blindness. Objective: This study aimed to investigate the effects of a Self-Care Promoting Program (SCPP) on engagement in self-care behaviors, HbA1c levels, visual acuity (VA), severity of DR, and vision-related quality of life (VRQoL) among individuals with type 2 diabetes and DR. Methods: This study employed a single-blind randomized controlled trial design to compare SCPP with conventional diabetic care interventions (standard care). The SCPP was based on the Self-Care of Chronic Illness Theory, Self-efficacy theory, and the Association of Diabetic Care and Education Specialist (ADCES) guidelines incorporating health education, self-care maintenance, monitoring, and management skills training over 12 weeks. Ninety-eight participants were randomly allocated to the experimental or control group (n = 49 per group). While the experimental group received SCPP alongside standard care, the control group received standard care alone. Data collection occurred between May 2022 and March 2023 and included demographic information, the Self-Care of Diabetes Index questionnaire (SCODI), the self-care for diabetes eye care questionnaire (SCFDE), the impact of visual impairment questionnaire (IVI-Thai version), and retinal images for DR severity grading. Data analysis utilized descriptive statistics, Chi-Square tests, t-tests, and MANOVA. Results: Following 8 and 16 weeks of SCPP, the experimental group had significantly higher mean scores in engagement with self-care and eye-care behaviors compared to the control group (p <0.001). The highest scores were observed in self-care and eye-care confidence behaviors, followed by maintenance, monitoring, and management. Furthermore, HbA1c levels and VRQoL significantly decreased and were lower than those of the control group at week 16 (p <0.001 and p <0.05, respectively). However, there were no significant differences in VA, and DR severity increased in both groups by week 16. Conclusion: SCPP benefits individuals with DR, enhancing their confidence and ability to perform, monitor, and manage self-care behaviors. These strategies contribute to improved diabetes management, enhanced quality of life, and reduced DR-related blindness. Integrating SCPP into routine DR management is recommended, with nurses playing a pivotal role in overseeing and driving this integration, highlighting the critical role of nurses in managing this widespread global disease. Trial Registry Number: Thai Clinical Trials Registration (TCTR20230302002).

Generic and disease-specific caregiver contribution to self-care in a population with multiple chronic conditions: A comparative study.

AIM: Describe and compare generic and disease-specific caregiver contribution (CC) to self-care behaviours in the dimensions of self-care maintenance, self-care monitoring and self-care management in multiple chronic conditions (MCCs). DESIGN: Multicentre cross-sectional study. METHODS: We enrolled caregivers of patients with MCC, from April 2017 to November 2022, if they were (a) 18 years of age or older and (b) identified by the patient as the principal unpaid informal caregiver. The Caregiver Contribution to Self-Care of Chronic Illness Inventory, Caregiver Contribution to Self-Care of Heart Failure Index, Caregiver Contribution to Self-Care of COPD Inventory and Caregiver Contribution to Self-care of Diabetes Inventory were used to measure generic and disease-specific contribution to patient self-care. Descriptive statistics, Student's t-tests and Pearson's correlation coefficients were used. RESULTS: We found adequate generic CC for self-care monitoring but inadequate CC in self-care maintenance and management. All CC to disease-specific self-care maintenance, monitoring and management scales' scores were inadequate, except for caregivers of diabetic patients in which we observed an adequate score in the CC to self-care maintenance and self-care management scales in those practice insulin therapy. CONCLUSION: Caregivers experience difficulties in performing behaviours of contribution to their patients affected by chronic conditions. Caregivers of patients with MCCs contribute more to self-care in aspects related to provider prescriptions and less to lifestyle changes. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Healthcare professionals have to know in which behaviours caregivers show gaps and reflect on the reasons for poor CC to self-care to develop interventions to enhance these behaviours. IMPACT: This study underlines the importance of choosing the most appropriate instrument for measuring CC to self-care, considering the caregiver's characteristics. REPORTING METHOD: We adhered to STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION: Caregivers of patients affected by MCCs were enrolled.

Positive affect and self-care mediate the relationship between trait emotional intelligence and academic engagement in Lebanese undergraduates: Lessons learned from an online setting.

This study examined the impact of positive psychology variables, namely trait emotional intelligence (EI), positive affect and self-care, on academic engagement (AE) in an online learning environment during COVID-19. The study involved 717 undergraduates in Lebanon and utilised structural equation modelling for data analysis. The results demonstrated that positive affect and self-care mediated the relationship between trait EI and AE. In women, both self-care and positive affect were mediators, whereas in men, positive affect was the only mediator. For students who received a mix of synchronous and asynchronous lessons, both self-care and positive affect mediated the relationship between trait EI and AE. However, for those who received only synchronous lessons, positive affect was the sole mediator. Furthermore, AE significantly predicted academic performance (AP) in both models. These findings suggest the importance of interventions that enhance trait EI, positive emotions and self-care to improve AE and ultimately AP in online learning.

Value of self-care for sexual and reproductive health.

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

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