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1.
Health Qual Life Outcomes ; 19(1): 1, 2021 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-33388064

RESUMO

BACKGROUND: In a context where there is no treatment for the current COVID-19 virus, the combination of self-care behaviours together with confinement, are strategies to decrease the risk of contagion and remain healthy. However, there are no self-care measures to screen self-care activities in general population and which, could be briefly in a lockdown situation. This research aims to build and validate a psychometric tool to screen self-care activities in general population. METHODS: Firstly, an exploratory factor analysis was performed in a sample of 226 participants to discover the underlying factorial structure and to reduce the number of items in the original tool into a significant pool of items related to self-care. Later a confirmatory factor analyses were performed in a new sample of 261 participants to test for the fit and goodness of factor solutions. Internal validity, reliability, and convergent validity between its score with perceived stress and psychological well-being measures were examined on this sample. RESULTS: The exploratory analyses suggested a four-factor solution, corresponding to health consciousness, nutrition and physical activity, sleep, and intra-personal and inter-personal coping skills (14 items). Then, the four-factor structure was confirmed as the best model fit for self-care activities. The tool demonstrated good reliability, predictive validity of individuals' perception of coping with COVID-19 lockdown, and convergent validity with well-being and perceived stress. CONCLUSIONS: This screening tool could be helpful to address future evaluations and interventions to promote healthy behaviours. Likewise, this tool can be targeted to specific population self-care's needs during a scalable situation.


Assuntos
Adaptação Psicológica , Qualidade de Vida/psicologia , Autocuidado/psicologia , Inquéritos e Questionários/normas , Adulto , Análise Fatorial , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Autocuidado/normas
2.
Res Nurs Health ; 44(1): 250-259, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33341950

RESUMO

Individuals with heart failure (HF) typically live in the community and are cared for at home by family caregivers. These caregivers often lack supportive services and the time to access those services when available. Technology can play a role in conveniently bringing needed support to these caregivers. The purpose of this article is to describe the implementation of a virtual health coaching intervention with caregivers of HF patients ("Virtual Caregiver Coach for You"-ViCCY). A randomized controlled trial is currently in progress to test the efficacy of the intervention to improve self-care. In this trial, 250 caregivers will be randomly assigned to receive health information via a tablet computer (hereafter, tablet) plus 10 live health coaching sessions delivered virtually (intervention group; n = 125) or health information via a tablet only (control group; n = 125). Each tablet has specific health information websites preloaded. To inform others embarking on similar technology projects, here we highlight the technology challenges encountered with the first 15 caregivers who received the ViCCY intervention and the solutions used to overcome those challenges. Several adaptations to the implementation of ViCCY were needed to address hardware, software, and network connectivity challenges. Even with a well-designed research implementation plan, it is important to re-examine strategies at every step to solve implementation barriers and maximize fidelity to the intervention. Researcher and interventionist flexibility in adapting to new strategies is essential when implementing a technology-based virtual health coaching intervention.


Assuntos
Cuidadores/psicologia , Insuficiência Cardíaca/complicações , Tutoria/normas , Autocuidado/instrumentação , Gravação de Videoteipe/normas , Adulto , Efeitos Psicossociais da Doença , Feminino , Insuficiência Cardíaca/psicologia , Humanos , Masculino , Tutoria/métodos , Qualidade de Vida/psicologia , Autocuidado/métodos , Autocuidado/normas
4.
J Med Internet Res ; 22(9): e19716, 2020 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-32975521

RESUMO

BACKGROUND: Most people who experience a potentially traumatic event (PTE) recover on their own. A small group of individuals develops psychological complaints, but this is often not detected in time or guidance to care is suboptimal. To identify these individuals and encourage them to seek help, a web-based self-help test called Mobile Insight in Risk, Resilience, and Online Referral (MIRROR) was developed. MIRROR takes an innovative approach since it integrates both negative and positive outcomes of PTEs and time since the event and provides direct feedback to the user. OBJECTIVE: The goal of this study was to assess MIRROR's use, examine its psychometric properties (factor structure, internal consistency, and convergent and divergent validity), and evaluate how well it classifies respondents into different outcome categories compared with reference measures. METHODS: MIRROR was embedded in the website of Victim Support Netherlands so visitors could use it. We compared MIRROR's outcomes to reference measures of PTSD symptoms (PTSD Checklist for DSM-5), depression, anxiety, stress (Depression Anxiety Stress Scale-21), psychological resilience (Resilience Evaluation Scale), and positive mental health (Mental Health Continuum Short Form). RESULTS: In 6 months, 1112 respondents completed MIRROR, of whom 663 also completed the reference measures. Results showed good internal consistency (interitem correlations range .24 to .55, corrected item-total correlations range .30 to .54, and Cronbach alpha coefficient range .62 to .68), and convergent and divergent validity (Pearson correlations range -.259 to .665). Exploratory and confirmatory factor analyses (EFA+CFA) yielded a 2-factor model with good model fit (CFA model fit indices: χ219=107.8, P<.001, CFI=.965, TLI=.948, RMSEA=.065), conceptual meaning, and parsimony. MIRROR correctly classified respondents into different outcome categories compared with the reference measures. CONCLUSIONS: MIRROR is a valid and reliable self-help test to identify negative (PTSD complaints) and positive outcomes (psychosocial functioning and resilience) of PTEs. MIRROR is an easily accessible online tool that can help people who have experienced a PTE to timely identify psychological complaints and find appropriate support, a tool that might be highly needed in times like the coronavirus pandemic.


Assuntos
Inquéritos Epidemiológicos , Aplicativos Móveis , Encaminhamento e Consulta , Resiliência Psicológica , Autocuidado/métodos , Autocuidado/normas , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Ansiedade/diagnóstico , Lista de Checagem , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Depressão/diagnóstico , Análise Fatorial , Feminino , Humanos , Internet , Masculino , Países Baixos/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Psicometria , Reprodutibilidade dos Testes , Estresse Psicológico/diagnóstico
6.
Diabetes Res Clin Pract ; 168: 108379, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32853692
7.
Gerokomos (Madr., Ed. impr.) ; 31(2): 98-106, jun. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-193891

RESUMO

OBJETIVO: Determinar la prevalencia hospitalaria de lesiones relacionadas con la dependencia (LRD) en la provincia de Burgos. Determinar las características de las LRD. Identificar las valoraciones del riesgo de padecer lesión por presión (LPP) y el uso de dispositivos de prevención de LPP. Cuantificar los registros de enfermería de LRD. METODOLOGÍA: Estudio observacional, descriptivo, transversal y multicéntrico, realizado mediante observación directa y revisión de la historia clínica de adultos ingresados en unidades de hospitalización. Realizado en tres hospitales de Burgos en 2018. RESULTADOS: La población sumó 511 pacientes; presentaron LRD: 188. Se detectaron 328 LRD: 176 (53,65%) LPP, 48 (14,63%) lesiones por humedad, 81 (24,69%) lesiones por fricción, 11 (3,35%) lesiones combinadas y 12 (3,65%) lesiones multicausales. Las LPP de categoría 1 fueron las más numerosas, sumando un 35,36%. El 78,96% de las LRD se consideraron adquiridas en el hospital. La prevalencia de LRD es del 36,79%. Las prevalencias por tipos de LRD son: LPP 20,93%, lesiones por humedad 9%, fricción 12,72%, combinadas 1,76% y multicausales 1,56%. El 35,61% de los pacientes presentaba algún tipo de dispositivo preventivo; el 60,07% presentaba valoración del riesgo de padecer LPP; el 30,31% presentaba registro de la lesión, y el 18,37% contaba con plan de cuidados específico. CONCLUSIONES: La prevalencia e LRD, obtenida por inspección directa, cuadruplica los resultados nacionales, pero parece reflejar con mayor exactitud la realidad que los datos obtenidos mediante los registros de enfermería. Es aconsejable universalizar la valoración del riesgo de padecer LPP a todos los pacientes, la mejora de los registros de enfermería y reforzar los esfuerzos preventivos


AIM: To determine the hospital prevalence of dependence-related lesions (DRL) in the province of Burgos. Determine the characteristics of the DRL. Identify the risk assessments of pressure ulcer (PU) and the use of PU prevention devices. Quantify the DRL nursing records. METHODOLOGY: Observational, descriptive, cross-sectional and multicenter study, performed through direct observation and review of the health record of adults admitted to hospitalization units. RESULTS: The population totaled 511 patients, of wich 188 presented DRL. 328 DRL were detected: 176 (53.65%) PU, 48 (14.63%) moisture lesions, 81 (24,69%) friction lesions, 11 (3.35%) combined lesions, and 12 (3.65%) multifactorial lesions. The most numerous was PU category 1 totaling 35.36%. 78.96% of the DRL were determined to be hospital acquired. The prevalence of DRL is 36.79%. The prevalences for DRL types are: PU 20.93%, moisture lesions 9%, friction 12.72%, combined 1.76% and multifactorial 1.56%. 35.61% of patients had some type of preventive device, 60.07% had a risk assessment for PU, 30.31% had a record of the lesion and 18.37% had a specific care plan. CONCLUSIONS: The prevalence of DRL, obtained by direct inspection, quadruples national results, but it seems to be more accurate than the data obtained through nursing records. It is advisable to universalize the assessment of the risk of suffering PU to all patients, to improve nursing records and to reinforce preventive efforts


Assuntos
Humanos , Masculino , Feminino , Idoso , Lesão por Pressão/complicações , Úlcera Cutânea/classificação , Úlcera Cutânea/prevenção & controle , Segurança do Paciente , Registros de Enfermagem/normas , Enfermagem Geriátrica , Autocuidado/métodos , Autocuidado/normas , Enfermagem Geriátrica/métodos
8.
Rev Med Suisse ; 16(694): 1026-1033, 2020 May 20.
Artigo em Francês | MEDLINE | ID: mdl-32432419

RESUMO

Today, there are more and more self-test kits available on the high street. With a few exceptions (HIV, FIT), it is currently unclear whether they are effective, neither beneficial for the consumer, nor useful for the Swiss healthcare system. Is there a favorable impact for the health system? This article tries to help doctors find their way among the many self-test available, providing them a reading grid and recommendations for their patients.


Assuntos
Atitude do Pessoal de Saúde , Testes Diagnósticos de Rotina/normas , Médicos , Autocuidado/métodos , Humanos , Autocuidado/normas , Suíça
9.
Holist Nurs Pract ; 34(4): 199-209, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32404723

RESUMO

One of the most critical disorders among patients with colorectal cancer is a change in their body image. This study aimed to examine the effect of a self-care program based on the modeling and role-modeling theory on nurturing body image of patients with colorectal cancer. In 2018, a 2-group randomized clinical trial was conducted in Mashhad, Iran. According to the modeling and role-modeling theory, 27 patients allocated in the experimental group received five 30- to 45-minute sessions at the hospital and 4 sessions of phone counseling within 2 weeks. Twenty-seven patients randomly allocated in the control group received the routine care. Data were collected by demographic and body image scales 3 times with the patients. The mean age of the patients in experimental and control groups was not significantly different (P = .46). The mean scores of the body image at the admission time were 26.8 ± 2.6 in the experimental and 27.9 ± 3.1 in control groups (P = .12). However, the mean scores of body image of the experimental group were 24.3 ± 4.6 at the discharge time and 28.1 ± 2.1 during the follow-up phase. In the control group, the body image scores were 21.0 ± 5.6 at discharge time and 22.9 ± 6.1 during the follow-up phase. Repeated-measures analysis of variance revealed significant differences between the 2 groups (P ≤ .001). Application of the self-care program based on the modeling and role-modeling theory can play a critical role in nurturing the body image of patients with colorectal cancer.


Assuntos
Imagem Corporal/psicologia , Neoplasias Colorretais/psicologia , Autocuidado/psicologia , Adulto , Neoplasias Colorretais/complicações , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Psicometria/métodos , Autocuidado/normas , Autocuidado/estatística & dados numéricos
10.
Med J Aust ; 212(11): 514-519, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32391611

RESUMO

OBJECTIVES: To investigate the quality of diagnostic and triage advice provided by free website and mobile application symptom checkers (SCs) accessible in Australia. DESIGN: 36 SCs providing medical diagnosis or triage advice were tested with 48 medical condition vignettes (1170 diagnosis vignette tests, 688 triage vignette tests). MAIN OUTCOME MEASURES: Correct diagnosis advice (provided in first, the top three or top ten diagnosis results); correct triage advice (appropriate triage category recommended). RESULTS: The 27 diagnostic SCs listed the correct diagnosis first in 421 of 1170 SC vignette tests (36%; 95% CI, 31-42%), among the top three results in 606 tests (52%; 95% CI, 47-59%), and among the top ten results in 681 tests (58%; 95% CI, 53-65%). SCs using artificial intelligence algorithms listed the correct diagnosis first in 46% of tests (95% CI, 40-57%), compared with 32% (95% CI, 26-38%) for other SCs. The mean rate of first correct results for individual SCs ranged between 12% and 61%. The 19 triage SCs provided correct advice for 338 of 688 vignette tests (49%; 95% CI, 44-54%). Appropriate triage advice was more frequent for emergency care (63%; 95% CI, 52-71%) and urgent care vignette tests (56%; 95% CI, 52-75%) than for non-urgent care (30%; 95% CI, 11-39%) and self-care tests (40%; 95% CI, 26-49%). CONCLUSION: The quality of diagnostic advice varied between SCs, and triage advice was generally risk-averse, often recommending more urgent care than appropriate.


Assuntos
Aplicativos Móveis/normas , Qualidade da Assistência à Saúde/estatística & dados numéricos , Autocuidado/normas , Avaliação de Sintomas/normas , Triagem/normas , Algoritmos , Inteligência Artificial , Austrália , Humanos , Autocuidado/métodos , Avaliação de Sintomas/métodos , Triagem/métodos
11.
Drugs Aging ; 37(7): 483-501, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32342431

RESUMO

BACKGROUND: Managing a medication regimen is a complex self-care activity that requires a high level of integration and coordination between cognitive and physical skills. This scoping review aims to identify available instruments designed to assess an adult individual's ability to manage a medication regimen independently and to identify reliable and valid tools to be used in clinical practice and research. METHODS: Five databases (PubMed/MEDLINE, CINAHL Complete, PsycINFO, Embase, and International Pharmaceutical Abstracts) were searched to identify articles reporting the development of an instrument to assess medication self-management capacity in adults. The process included a broad initial search of the databases, followed by screening of titles and abstracts, and full review of relevant articles. For each instrument identified, characteristics, including validity and reliability assessments, were summarized. RESULTS: Sixteen papers were identified that reviewed or described the development and/or validation of 26 instruments designed to assess medication self-management capacity. Most instruments were designed to identify cognitive and physical barriers to successful medication management, but there was inconsistency across instruments in the specific skills assessed and the assessment method used. Most instruments were validated by testing at least one related construct, such as cognitive function, activities of daily living or instrumental activities of daily living performance, or medication adherence. CONCLUSION: Development of standardized instruments to quantify medication self-management capacity is still growing. The choice of instrument for use in a specific clinical or research setting will depend on the purpose for making the assessment and the population that it will be applied to. Results of this review can assist in selecting an appropriate instrument or guiding the development of new instruments for assessment of medication self-management capacity for specific clinical or research purposes.


Assuntos
Cognição , Adesão à Medicação/psicologia , Autocuidado , Autogestão/psicologia , Atividades Cotidianas , Humanos , Autocuidado/psicologia , Autocuidado/normas
12.
Arch Endocrinol Metab ; 64(2): 190-194, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32236311

RESUMO

Objective The aim of this study was to cross-culturally adapt and validate the Brazilian Portuguese version of SCI-R to adults with type 2 diabetes. Materials and methods The SCI-R is a 15-question survey that reflects how well patients with diabetes have adhered to treatment recommendations. A pretest (n = 40) was first performed to improve comprehension of the survey items. A final version was then self-administered in another 75 adults with type 2 diabetes to determine the survey's reliability and validity according to its association with HbA1c. Finally, we conducted a test-retest reliability analysis over three weeks to stabilize the sample and determine intra-observer variability. Results After the pretest phase, the final sample's (N = 75) mean age was 59.9 ± 7.5 years and mean HbA1c level was 8.6 ± 1.5% (70 ± 16.4 mmol/mol). The initial Cronbach's alpha was 0.61; however, further analysis showed that four items had low item correlation and were excluded from the final version, which increased the Cronbach's alpha to 0.63. In predictive validity analysis, HbA1c levels correlated significantly with total survey scores (r = -0.38, P = 0.001). The intra-class correlation coefficient between baseline and three-week scores was 0.93, which indicates high reproducibility. Conclusions The Brazilian Portuguese version of the SCI-R is a valid tool for measuring treatment adherence in adults with type 2 diabetes.


Assuntos
Diabetes Mellitus Tipo 2/terapia , Autocuidado/normas , Inquéritos e Questionários , Adulto , Idoso , Brasil , Características Culturais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Tradução
13.
Bull World Health Organ ; 98(3): 161-169, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32132750

RESUMO

Objective: To evaluate the effect of a disease management programme in Kazakhstan on quality indicators for patients with hypertension, diabetes and chronic heart failure. Methods: A supportive, interdisciplinary, quality improvement programme was implemented between November 2014 and November 2015 at seven polyclinics in Pavlodar and Petropavlovsk. Quality improvement teams were established at each clinic and quality improvement tools were introduced, including patient flowsheets, decision support tools, patient registries, a patient recall process, support for patient self-management and patient follow-up with intensity adjusted for level of disease control. Clinic teams met for four 3-day interactive learning sessions within 1 year, with additional coaching visits. Implementation was managed by five local coordinators and consultants trained by international consultants. National and regional steering committees monitored progress. Findings: Between July and October 2015, the proportion of hypertensive patients with the recommended blood pressure increased from 24% (101/424) to 56% (228/409). Among patients with diabetes, the proportion who recently underwent eye examinations increased from 26% (101/391) to 71% (308/433); the proportion who had their low-density lipoprotein cholesterol measured increased from 57% (221/391) to 85% (369/433); and the proportion who had their albumin : creatinine ratio measured increased from 11% (44/391) to 49% (212/433). The proportion of chronic heart failure patients who underwent echocardiography rose from 91% (128/140) to 99% (157/158). All patients set themselves self-management goals. Conclusion: This intensive, supportive, multifaceted programme was associated with significant improvements in quality of care for patients with chronic disease. Further investment in coaching capacity is needed to extend the programme nationally.


Assuntos
Diabetes Mellitus/terapia , Insuficiência Cardíaca/terapia , Hipertensão/terapia , Qualidade da Assistência à Saúde , Autocuidado/normas , Doença Crônica , Feminino , Humanos , Cazaquistão , Masculino , Tutoria , Melhoria de Qualidade , Autocuidado/métodos
14.
J Clin Nurs ; 29(9-10): 1457-1476, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31944439

RESUMO

AIMS AND OBJECTIVES: To evaluate the effectiveness of self-care programmes in type 2 diabetes mellitus (T2DM) population in primary health care. BACKGROUND: The impact of educational interventions on T2DM has been evaluated in various contexts, but there is uncertainty about their impact in that of primary care. DESIGN: Systematic review and meta-analysis. METHODS: A search was conducted in PubMed, CINAHL, WOS and Cochrane databases for randomised controlled trials carried out in the period January 2005-December 2017, including studies with at least one face-to-face educational interventions. The quality of the evidence for the primary outcome was evaluated using the GRADE System. A meta-analysis was used to determine the effect achieved although only the results classified as critical or important were taken into consideration. Checklist of Preferred Reporting Items for Systematic Reviews and Meta-analyses has been followed. PROSPERO registration Number: CRD42016038833. RESULTS: In total, 21 papers (20 studies) were analysed, representing a population of 12,018 persons with T2DM. For the primary outcome, HbA1 c, the overall reduction obtained was -0.29%, decreasing the effect in long-term follow-up. The quality of the evidence was low/very low due to very serious risk of bias, inconsistency and indirectness of results. Better results were obtained for individual randomised trials versus cluster designs and in those programmes in which nurses leaded the interventions. The findings for other cardiovascular risk factors were inconsistent. CONCLUSIONS: Educational interventions in primary care addressing T2DM could be effective for metabolic control, but the low quality of the evidence and the lack of measurement of critical results generates uncertainty and highlights the need for high-quality trials. RELEVANCE TO CLINICAL PRACTICE: Most of self-care programmes for T2DM in primary care are focused on metabolic control, while other cardiovascular profile variables with greater impact on mortality or patient-reported outcomes are less intensely addressed.


Assuntos
Diabetes Mellitus Tipo 2/terapia , Autocuidado/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Atenção Primária à Saúde/organização & administração , Avaliação de Programas e Projetos de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa/normas
15.
J Wound Ostomy Continence Nurs ; 47(1): 39-44, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31800566

RESUMO

PURPOSE: The purpose of this quality improvement project was to design and validate a multimedia educational software program for patients with fecal diversions. PARTICIPANTS AND SETTING: Ten individuals who had fecal diversion surgery and 10 experts including nurses, physicians, nutritionists, and information technologists from Imam Khomeini and Rasule Akram Hospitals, Tehran, Iran, the 2 main centers in which fecal diversion surgery took place, were included in the study. APPROACH: The multimedia educational software for patients with ostomy was developed in 3 phases including development and creation, validity, and modification of the software. Data for phase 1 were collected using 2 questionnaires, the Multimedia Survey Questionnaire for Clients and the Multimedia Survey Questionnaire for Experts, and several open-ended questions to further determine the content and face validity of the multimedia content for the education prototype. OUTCOMES: The mean ± standard deviation [SD] of multimedia evaluation by the 10 patients was 60 ± 3.27, indicating high user satisfaction. The mean ± SD of multimedia evaluation by the 10 experts was 171.1 ± 19.2, suggesting the content was of high quality. Content and face validity were reported to be 0.91 and 0.96, respectively. The program was then created and called "Self-Care of Ostomy," which consisted of 8 computer-based modules with 22 short videos and slide presentations available for viewing by patients with newly created ostomies. IMPLICATIONS FOR PRACTICE: This multimedia program can provide patients with simple, portable, understandable, objective, user-friendly information about ostomy care. Future studies should address the effectiveness of ostomy management among patients, families, and care providers.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/métodos , Fezes , Multimídia/normas , Adulto , Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Procedimentos Cirúrgicos do Sistema Digestório/estatística & dados numéricos , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Multimídia/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde/métodos , Melhoria de Qualidade , Autocuidado/métodos , Autocuidado/normas , Inquéritos e Questionários
16.
J Clin Nurs ; 29(3-4): 645-652, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31770472

RESUMO

BACKGROUND: The Self-Care of Heart Failure Index is an empirically tested instrument to measure self-care of heart failure patients across different populations and cultures. AIMS: To develop and evaluate the psychometric properties of the Nepali Self-Care of Heart Failure Index. DESIGN: This psychometric study used a cross-sectional, observational, study design to collect data. The study was guided and reported following the Strengthening the Reporting of Observational Studies in Epidemiology guideline. METHODS: To develop and culturally validate Nepali Self-Care of Heart Failure Index, a combination of the recommended methods for cross-cultural validation studies were applied such as translation, back translation, expert committee review of the translated version and validity/reliability testing. Face and content validity were ensured using expert review. Construct validity was examined using exploratory factor analysis and confirmatory factor analysis. Composite reliability scores were calculated for each sub-scale of the Nepali Self-Care of Heart Failure Index. RESULTS: A total of 221 heart failure patients in Nepal were enrolled in the study. Adequate face and content validity were ensured through expert review. Exploratory factor analysis and confirmatory factor analysis supported the original three-factor model. Although the three factors explained only 41% of the variance, confirmatory factor analysis fit indexes and error measures were found reasonable. The composite reliability coefficients for self-care maintenance, management and confidence scale were 0.6, 0.7 and 0.8, respectively. CONCLUSIONS: The Nepali Self-Care of Heart Failure Index is a theoretically based, culturally acceptable and appropriate instrument for use among Nepali heart failure patients. However, further studies are needed to refine its psychometric properties. RELEVANCE TO CLINICAL PRACTICE: Access to reliable, valid and culturally appropriate instruments is crucial in describing the state of the problem as well as for developing and evaluating tailored and targeted self-care practice interventions for Nepali patients living with heart failure.


Assuntos
Indicadores Básicos de Saúde , Insuficiência Cardíaca/diagnóstico , Autocuidado/normas , Inquéritos e Questionários/normas , Adulto , Comparação Transcultural , Estudos Transversais , Análise Fatorial , Feminino , Insuficiência Cardíaca/enfermagem , Humanos , Masculino , Pessoa de Meia-Idade , Nepal , Psicometria , Reprodutibilidade dos Testes , Traduções
17.
Nurs Philos ; 21(1): e12291, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31883181

RESUMO

Self-care, or self-management, is presented in healthcare policy as a precursor to patient empowerment and improved patient outcomes. Alternatively, critiques of the self-care agenda suggest that it represents an over-reliance on individual autonomy and responsibility, without adequate support, whereby 'self-care' is potentially unachievable and becomes 'care left undone'. In this sense, self-care contributes to a blame culture where ill-health is attributed to personal behaviours or lack thereof. Furthermore, self-care may represent a covert form of rationing, as the fiscal means to enable effective self-care and supplement, or replace, self-care capacities, is not provided. This paper explores these arguments through a contemporary ethical analysis of the self-care agenda. The terms self-care and self-management are used interchangeably throughout whereby self-management is understood as a point in the wider self-care continuum.


Assuntos
Política de Saúde/tendências , Autocuidado/normas , Humanos , Autonomia Pessoal , Autocuidado/ética , Autocuidado/métodos
18.
Int J Artif Organs ; 43(2): 137-140, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31560241

RESUMO

An increase in number of peritoneal dialysis patients and demand for peritoneal dialysis products following implementation of "PD First" policy in Thailand has led to logistics supply chain challenges and inherent product quality problems. Available evidences suggested that defective peritoneal dialysis products may predispose the patients to peritonitis. Thailand Clinical Practice Guideline for Peritoneal Dialysis 2017 recommends the patients to check peritoneal dialysis products themselves before use. In this report, we present our early experience from the Check List to Improve Patient Self-care and Product Defect Report in Continuous Ambulatory Peritoneal Dialysis study, a cluster randomized trial conducted in 22 peritoneal dialysis centers in Thailand. Patients from 11 randomly selected sites were asked to use the check list to report any product quality defects. The peritoneal dialysis product check list required patients to check the expiration date, glucose concentration, clarity, color, and integrity of bags of peritoneal dialysis fluid as well as the peritoneal dialysis connectors prior to each use. Among 338 patients who had received the check list from 5 centers, 28 returned the reports, detecting 8 defects out of 3960 products in total (0.2%). Although the obtained check list reports were not perfectly completed, they were comprehensible and provided important information on product defects which meant that the check list was simple enough for the patients and/or caregivers to follow. In conclusion, despite low response rate and incomplete report in this early phase analysis, the check list provides important information on product defects while an impact of these defects on peritoneal dialysis outcomes requires a further investigation.


Assuntos
Lista de Checagem/métodos , Soluções para Diálise , Diálise Peritoneal Ambulatorial Contínua/efeitos adversos , Peritonite/prevenção & controle , Autocuidado , Soluções para Diálise/efeitos adversos , Soluções para Diálise/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Diálise Peritoneal Ambulatorial Contínua/instrumentação , Diálise Peritoneal Ambulatorial Contínua/métodos , Peritonite/etiologia , Autocuidado/métodos , Autocuidado/normas
19.
J Transcult Nurs ; 31(3): 294-303, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31359818

RESUMO

Introduction: Self-care is recognized as a means for improving outcomes of heart failure (HF), yet studies have not addressed what predicts successful self-care in collectivist cultures like Lebanon. Methodology: Self-care was measured, using the Arabic Self-Care of HF index, in 100 participants with HF (76% males; mean age 67.59) recruited from a tertiary medical center. Results: Self-care was suboptimal, with mean scores of 67.26, 66.96, and 69.5 for self-care maintenance, management, and confidence. Better HF knowledge, social support, and self-care confidence and lower New York Heart Association score predicted better self-care maintenance. Better knowledge, social support, and self-care maintenance, no recent hospitalization, and being unemployed predicted better self-care confidence. Better self-care confidence, maintenance, and HF knowledge predicted better self-care management. Discussion: HF self-care in Lebanon is suboptimal. Nurses need to identify facilitators of and barriers to self-care particular to this population. Interventions targeting HF knowledge, confidence, and caregiver support are expected to improve self-care in Lebanese patients.


Assuntos
Países em Desenvolvimento/estatística & dados numéricos , Insuficiência Cardíaca/complicações , Autocuidado/normas , Idoso , Estudos Transversais , Feminino , Insuficiência Cardíaca/psicologia , Humanos , Líbano , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Psicometria/métodos , Pesquisa Qualitativa , Autocuidado/métodos , Autocuidado/estatística & dados numéricos , Apoio Social
20.
Epilepsy Behav ; 102: 106668, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31739100

RESUMO

The National Clinical Programme for Epilepsy (NCPE) in Ireland aims to deliver a holistic model of integrated person-centered care (PCC) that addresses the full spectrum of biomedical and psychosocial needs of people with epilepsy (PwE). However, like all strategic plans, the model encompasses an inherent set of assumptions about the readiness of the environment to implement and sustain the actions required to realize its goals. In this study, through the lens of PwE, the Irish epilepsy care setting was explored to understand its capacity to adopt a new paradigm of integrated PCC. Focus groups and semi-structured one-to-one interviews were employed to capture the qualitative experiences of a sample of Irish PwE (n = 27) in the context of the care that they receive. Participants were from different regions of the country and were aged between 18 and 55 years with 1 to 42 years since diagnosis (YSD). Highlighting a gap between policy intent and action on the ground, findings suggest that patient readiness to adopt a new model of care cannot be assumed. Expectations, preferences, behaviors, and values of PwE may sustain the more traditional constructions of healthcare delivery rather than the integrated PCC goals of reform. These culturally constituted perceptions illustrate that PwE do not instinctively appreciate the goals of healthcare reform nor the different behavior expected from them within a reformed healthcare system. Recalibrating deep-rooted patient views is necessary to accomplish the aspirations of integrated PCC. Patient engagement emphasizing the meaningful role that they can play in shaping their healthcare services is vital.


Assuntos
Epilepsia/psicologia , Epilepsia/terapia , Participação do Paciente/psicologia , Assistência Centrada no Paciente/normas , Pesquisa Qualitativa , Adolescente , Adulto , Epilepsia/epidemiologia , Feminino , Grupos Focais , Humanos , Irlanda/epidemiologia , Pessoa de Meia-Idade , Participação do Paciente/métodos , Assistência Centrada no Paciente/métodos , Autocuidado/métodos , Autocuidado/psicologia , Autocuidado/normas , Adulto Jovem
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