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1.
Hu Li Za Zhi ; 66(5): 32-43, 2019 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-31549379

RESUMO

BACKGROUND: Self-efficacy plays an important role in maintaining health-related behaviors in humans. Nursing staffs should understand the factors that influence self-efficacy in end-of-life (EOL) care in order to ensure their ability to provide appropriate palliative care to EOL-stage patients. PURPOSE: To explore the important variables affecting the self-efficacy of nursing staffs in providing EOL care and the correlations between self-efficacy and these variables. METHODS: This study adopted a descriptive, correlational design. The participants were convenience sampled from registered nurses employed at a teaching hospital in southern Taiwan. The data collection was cross-sectional and 214 registered nurses completed a structured questionnaire on knowledge, attitudes, and self-efficacy with regard to providing EOL care. RESULTS: The results indicated that that participants had (1) an average knowledge level of EOL care (13.99 ± 1.63), demonstrating that nursing staff need to improve their knowledge of EOL care, (2) an average level of attitude (46.74 ± 4.39), demonstrating a slightly positive attitude toward EOL care, and (3) an average level of self-efficacy (48.46 ± 10.37), demonstrating inadequate confidence in providing EOL care. A Pearson product-moment correlation analysis was conducted, showing significant and positive correlations between self-efficacy and the variables of EOL-care knowledge and attitude. Multiple regression analyses revealed that work unit, experience providing EOL care, knowledge regarding EOL care, and attitude toward providing EOL care together explained 42.54% of the variance in EOL care self-efficacy. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Accurate knowledge about and positive attitude toward providing EOL care are important in fostering confidence in nurses to help patients and their family make appropriate medical decisions and to provide appropriate EOL care. Hospital administrations should provide onsite or offsite continuous education and, when appropriate, arrange interdisciplinary and cross-training programs to enhance the EOL-care-related experience and self-efficacy of nurses.


Assuntos
Recursos Humanos de Enfermagem no Hospital/psicologia , Autoeficácia , Assistência Terminal , Estudos Transversais , Hospitais de Ensino , Humanos , Taiwan
2.
Shanghai Kou Qiang Yi Xue ; 28(3): 293-296, 2019 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-31489419

RESUMO

PURPOSE: To design an oral health self-efficacy scale for patients with dental implants and to evaluate their reliability and validity. METHODS: Based on literature review, we designed and developed a self-efficacy energy table that met the characteristics of implant patients. The scale consisted of 16 items which were divided into 3 dimensions, including self-efficacy of dental implant surgery, self-efficacy of postoperative supportive care, and self-efficacy of oral hygiene habits. The reliability and validity of the scale were evaluated by factor analysis in 102 outpatients with dental implants using SPSS 13.3 software package. RESULTS: A total of 4 common factors were extracted from the scale, and the cumulative contribution rate was 75.35%. The overall Cronbach's α coefficient of the scale was 0.910, and the retest correlation coefficient was 0.882, which belonged to high-signal scale. CONCLUSIONS: The oral health self-efficacy energy scale for implant patients with independent design has high reliability and validity. It can provide targeted guidance for oral health education for implant patients and improve the success rate of implant surgery.


Assuntos
Implantes Dentários , Saúde Bucal , Autoeficácia , Inquéritos e Questionários , Humanos , Higiene Bucal , Psicometria , Reprodutibilidade dos Testes
3.
Stud Health Technol Inform ; 264: 1169-1173, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438109

RESUMO

A learning management system (LMS) used for the initial training of health professionals has been rejected by students. Our study aimed to explain the reason of this rejection. We performed this evaluation on a sample of health students in 2012 and 2017 (n = 144). We used scales from the literature (Technology Acceptance Model, General Self-Efficacy Scale, LMS-Self-Efficacy Scale), and studied the social representation of the LMS. The system seemed accessible and useful, but unfortunately with similarities to the system used in a traumatic student environment. Health students using the system did not have a lower self-efficacy. Although the LMS seemed relevant to students, its initial rejection might have been due to a confounding context that created confusion in the acceptability of the tool. To conclude, there is a need to create new dematerialized course formats but with strong tutorship to improve the usage of the technologies by students.


Assuntos
Instrução por Computador , Autoeficácia , Pessoal de Saúde , Humanos , Aprendizagem , Estudantes
4.
Medicine (Baltimore) ; 98(33): e16697, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415361

RESUMO

BACKGROUND: Patient-centered care should be the focus of health services, where improvements in the communication skills of health professionals promote excellent health and quality care. Thus, this study is a protocol for a systematic review and meta-analysis to evaluate the effectiveness of training programs in communication skills to promote self-efficacy in the communication of health personnel. METHODS: This systematic review protocol is conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) statement guidelines and the Cochrane Handbook of Systematic Reviews of Interventions. The review should include studies carried out with health professionals who have undergone training in communication skills aimed at promoting their self-efficacy. Clinical trials (randomized, non-randomized), community trials, and quasi-experimental studies should be included. Therefore, the comprehensive search strategy will be conducted in the following databases: PubMed/Medline, Scopus, Web of Science, EMBASE, Science Direct, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials (CENTRAL). Two independent reviewers will conduct all study selection procedures, data extraction, and methodological evaluation, and disagreements will be referred to a third reviewer. RevMan 5.3 software will be used to gather data and perform the meta-analysis if possible. RESULTS: This systematic review will provide evidence on more effective programs for communication skills training and will consider information such as duration, educational strategies, assessment measures, and outcomes that promote health worker self-efficacy. DISCUSSION: This systematic review should provide evidence for effective communication skills training for health professionals in order to guide new strategies for quality care. DISSEMINATION AND ETHICS: The findings of this scoping review will be disseminated in print, at conferences, or via peer-reviewed journals. Ethical approval is not necessary as this paper does not involve patient data. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019129384.


Assuntos
Comunicação , Educação/métodos , Pessoal de Saúde/educação , Pessoal de Saúde/psicologia , Autoeficácia , Adulto , Feminino , Humanos , Masculino , Metanálise como Assunto , Avaliação de Programas e Projetos de Saúde , Projetos de Pesquisa , Revisão Sistemática como Assunto
5.
J Natl Black Nurses Assoc ; 30(1): 40-47, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31465684

RESUMO

The purpose of this article was to help healthcare practitioners understand the dynamics of Alzheimer's care giving and to introduce an evidence-based practice intervention to improve the caregiver's self-efficacy. Over 5 million people in the United States are afflicted with Alzheimer's disease and require a caregiver to assist with all areas of daily activity. Adult care giving is challenging for the caregiver, who is often a family member with little to no knowledge or skill in rendering care. African-American caregivers encounter an even greater challenge by overcoming cultural bias inherent in racial disparity. Evidence-based practice interventions are helpful in successfully rendering care while minimizing stress and burden. Healthcare providers must consider the caregiver, the dynamics of care giving, and cultural norms, in the plan of care to successfully care for the Alzheimer's patient along the trajectory of the disease.


Assuntos
Doença de Alzheimer/terapia , Cuidadores/psicologia , Planejamento de Assistência ao Paciente/organização & administração , Adulto , Afro-Americanos/psicologia , Características Culturais , Prática Clínica Baseada em Evidências , Humanos , Autoeficácia
6.
Saude e pesqui. (Impr.) ; 12(2): 283-294, maio/ago 2019. tab
Artigo em Português | LILACS | ID: biblio-1015854

RESUMO

Analisar a relação entre autoeficácia e estratégias de enfrentamento em usuários abstinentes de drogas. Estudo descritivo, correlacional, com abordagem quantitativa, de campo e transversal. Aplicaram-se a Escala de Autoeficácia para Abstinência de Drogas, o Inventário de Habilidades de Enfrentamento Antecipatório para a Abstinência de Álcool e outras Drogas e um Questionário Sociodemográfico. Participaram 100 homens. Evidenciou-se que a crença de ser autoeficaz diante das emoções negativas obteve correlação positiva e significativa ao ser Assertivo na Recusa de Drogas, no Autocontrole de Emoções e na Expressão de Emoções Positivas. Já ser Assertivo na Recusa de Drogas apresentou correlação positiva e significativa com a crença de ser eficaz frente a Emoções Negativas, Situações Sociais Positivas, Preocupações com outros, e estados fisiológicos como a Síndrome de Abstinência ou Fissura. Tais relações demonstram a necessidade da utilização destes fenômenos quando se busca a abstinência de usuários de drogas.


To analyze the relationship between self-efficaciousness and coping strategies in drug-abstaining people. Descriptive, co-relational, quantitative, transversal field study. Auto-efficaciousness Scale for Drug Abstinence, Inventory of Anticipatory Coping Abilities for Alcohol and Drug Abstinence and a Socio-demographic Questionnaire, with one hundred males. Belief in auto-efficaciousness with negative emotions had a positive and significant co-relationship with regard to Assertion in Drug Refusal, Self-control in Emotions and in Expression of Positive Emotions. Assertion in Drug Refusal had a positive and significant co-relationship with belief in efficiency to cope with Negative Emotions, Positive Social Situations, Concern for Others, and physiological states such as Abstinence Syndrome or Fissure. Relationships demonstrated the need for these phenomena when drug users seek abstinence.


Assuntos
Humanos , Masculino , Adaptação Psicológica , Transtornos Relacionados ao Uso de Substâncias , Autoeficácia
7.
Clin Nurse Spec ; 33(5): 217-227, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31404000

RESUMO

PURPOSE: This study aimed to determine the core competencies of Chinese gerontological nurse specialists and test the psychometric properties of a core competency self-evaluation instrument. METHODS: This study consisted of 2 stages. A literature review, theoretical analysis, and the Delphi methods involving 28 experts were performed to identify the core competencies required of gerontological nurse specialists in China. Then, a self-evaluation instrument developed based on the results of stage I was tested among 225 certified gerontological nurse specialists. An exploratory factor analysis was applied to test the construct validity, and the content validity and reliability were also evaluated. RESULTS: The core competencies of gerontological nurse specialists comprised 3 first-level domains, 9 second-level dimensions, and 69 third-level items. The average scale-level content validity, overall instrument's Cronbach's α, and test-retest reliability were 0.963, 0.983, and 0.834, respectively. The results of the exploratory factor analysis indicated that the factors in the 3 first-level domains (attitude, skill, and knowledge) explained 68.579%, 69.599%, and 75.872% of the variance, respectively. CONCLUSION: The results showed that the core competencies of Chinese gerontological nurse specialists were reliable and that gerontological nurse specialists could use this self-evaluation instrument to assess their core competencies.


Assuntos
Competência Clínica , Enfermagem Geriátrica , Enfermeiras Clínicas/psicologia , Inquéritos e Questionários , Adulto , China , Técnica Delfos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras Clínicas/estatística & dados numéricos , Pesquisa em Avaliação de Enfermagem , Psicometria , Reprodutibilidade dos Testes , Autoeficácia
8.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 41(3): 367-372, 2019 Jun 30.
Artigo em Chinês | MEDLINE | ID: mdl-31282331

RESUMO

Objective To describe the status of hope,self-efficacy,and self-management in patients with chronic kidney disease(CKD)(stages 1-3)and to explore the interactions between these three variables.Methods Herth Hope Index,self-efficacy scale,and CKD self-management instrument were used to evaluate the patients with CKD(stages 1-3)in PUMC Hospital(n=153). Structural equation modeling was used to establish the structural equation model of hope,self-efficacy,and self-management.Results The median score of hope was 40.0(36.0,44.5),and 85.0% of patients were in higher level of hope. The median score of self-efficacy was 8.3(7.1,9.4)and the overall score of self-management was 89.0±13.4. There were no significant differences in level of hope and self-management among patients with different age,gender,marital status,educational level,course of disease,and CKD stages(all P>0.05). Age and marriage status were significantly associated with self-efficacy. Self-efficacy was significantly higher in >65 years group than in other age groups(P<0.05)and was significantly higher in married group than in single group(P<0.05).The level of hope had direct effect on self-efficacy(ß=0.67,P<0.05)and self-management(ß=0.46,P<0.05).Conclusions The levels of hope,self-efficacy,and self-management are high in patients with CKD(stages 1-3). Hope directly affects the self-efficacy and self-management of these patients.


Assuntos
Esperança , Insuficiência Renal Crônica/psicologia , Insuficiência Renal Crônica/terapia , Autoeficácia , Autogestão , Humanos
9.
J Music Ther ; 56(3): 265-286, 2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31346625

RESUMO

Family caregivers often feel ill-equipped to handle bothersome behavioral and psychological symptoms of dementia, such as agitation, apathy, and sleep disturbances, leading to increased caregiver distress and nursing home placement for people with dementia. Therapies for such symptoms are currently limited and non-pharmacological options are preferred, given potential side effects of medications. Neurologic music therapy (NMT) could provide an additional treatment option for managing behavioral and psychological symptoms for community-dwelling people with dementia and their caregivers. This pilot study sought to evaluate the feasibility, acceptability, and effectiveness of home-based NMT for behavioral and psychological symptoms of dementia. Eighteen persons with dementia-caregiver dyads were enrolled to receive one-hour weekly sessions of home-based NMT for 6 weeks. Demographic, quality of life, neuropsychiatric symptom, and caregiver burden and self-efficacy information was collected at baseline, 6 weeks, and 12 weeks. Seven dyads (38.9%) withdrew from therapy before completing all sessions; these participants had higher Neuropsychiatric Inventory scores and were of older age at baseline. For those who completed therapy, neuropsychiatric symptom scores improved at 6 weeks, an effect that was sustained at 12 weeks. No other outcome measures changed significantly after therapy. Initiating NMT too late in the course of dementia, when behavioral symptoms are already present, may be impractical for people with dementia and increase caregiver stress, even when provided within the home. Introducing and incorporating the principles of NMT earlier in the course of dementia could allow for increased comfort and benefit for people with dementia and their caregivers.


Assuntos
Sintomas Comportamentais/terapia , Cuidadores/psicologia , Demência/terapia , Musicoterapia , Qualidade de Vida/psicologia , Adaptação Psicológica , Idoso , Idoso de 80 Anos ou mais , Ansiedade , Sintomas Comportamentais/etiologia , Sintomas Comportamentais/psicologia , Demência/complicações , Demência/psicologia , Estudos de Viabilidade , Feminino , Humanos , Música , Projetos Piloto , Autoeficácia , Transtornos do Sono-Vigília/etiologia , Resultado do Tratamento
10.
BMC Public Health ; 19(1): 917, 2019 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-31288781

RESUMO

BACKGROUND: Specialized, individualized exercise programs that increase self-efficacy (SE) are essential for the development and maintenance of regular exercise. The objective of this study is to examine the effect of customized exercise programs (CEPs) implemented by physical therapists in improving exercise-related SE and promoting behavioral changes among elderly individuals who do not exercise regularly compared with commonly prescribed exercises. METHODS: In this randomized controlled study, the sampling frame consisted of participants in an annual town-sponsored medical check-up. The inclusion criteria were no regular exercise and age of 65-74 years at enrollment. The subjects in the intervention group (CEP group) were instructed to perform individualized exercises prescribed based on an original algorithm. Data collection was performed at baseline and 3, 6, 9, and 12 months after exercise instruction. The primary outcome was SE for exercise at the last time point. Secondary outcomes were SE for exercise, stage of change in exercise behavior, knee pain, and low back pain at each evaluation time point. RESULTS: Fifty subjects (CEP group n = 26; control group n = 24) were randomized. In the CEP group, 25 of 26 subjects were analyzed at 3 months, 26 of 26 subjects were analyzed at 6 and 9 months, and 25 of 26 subjects were analyzed at 12 months. In the control group, 23 of 24 subjects were analyzed at 3, 6, 9, and 12 months. SE for exercise improved 24.0% (CEP group 30.8%; control group 16.7%) compared to baseline. No significant differences were observed in the primary outcome. SE for exercise was significantly lower at 9 and 12 months compared with baseline in the control group. Stage of change for exercise behavior was significantly higher at 3 months compared with baseline in the CEP group and at 6 months in the control group. Knee pain was worse at 3 months compared with baseline in the control group. CONCLUSIONS: This study suggested that exercise instruction with CEPs contributes to the maintenance of SE for exercise and is useful for changing exercise behavior in elderly individuals who do not regularly exercise. TRIAL REGISTRATION: UMIN000027240 , registered on 03/05/2017.


Assuntos
Terapia por Exercício/organização & administração , Exercício/psicologia , Fisioterapeutas , Autoeficácia , Idoso , Feminino , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde
11.
Br J Nurs ; 28(13): 842-847, 2019 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-31303043

RESUMO

BACKGROUND: advanced clinical practitioners (ACPs) are expected to be competent in their holistic assessment and management of individuals, which includes those with both physical and mental health problems. A mental health component was introduced within a generic advanced practitioner programme to support the development of mental health skills required by advanced clinical practitioners in training (ACPiTs). AIMS: this research investigated the efficacy of content specific to mental health within an MSc ACP generic programme. METHODS: a single case study approach was adopted, which used a purposive sample of 10 ACPiTs to explore personal beliefs and experiences using semistructured interviews. Verbatim transcription was undertaken followed by content and thematic analysis. FINDINGS: Themes emerged included communication skills, and increased competence and self-awareness. CONCLUSION: insights provided by the ACPiTs showed they recognised the value of mental health teaching and exposure within their training programme in advancing their knowledge and skillset and, ultimately, increasing confidence in their clinical practice.


Assuntos
Prática Avançada de Enfermagem/educação , Competência Clínica , Transtornos Mentais/enfermagem , Comunicação , Humanos , Pesquisa em Educação de Enfermagem , Pesquisa em Avaliação de Enfermagem , Pesquisa Qualitativa , Autoeficácia
12.
BMC Med ; 17(1): 127, 2019 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-31311573

RESUMO

BACKGROUND: Smartphone apps are becoming increasingly popular for supporting diabetes self-management. A key aspect of diabetes self-management is appropriate medication-taking. This study aims to systematically assess and characterise the medication management features in diabetes self-management apps and their congruence with best-practice evidence-based criteria. METHODS: The Google Play and Apple app stores were searched in June 2018 using diabetes-related terms in the English language. Apps with both medication and blood glucose management features were downloaded and evaluated against assessment criteria derived from international medication management and diabetes guidelines. RESULTS: Our search yielded 3369 Android and 1799 iOS potentially relevant apps; of which, 143 apps (81 Android, 62 iOS) met inclusion criteria and were downloaded and assessed. Over half 58.0% (83/143) of the apps had a medication reminder feature; 16.8% (24/143) had a feature to review medication adherence; 39.9% (57/143) allowed entry of medication-taking instructions; 5.6% (8/143) provided information about medication; and 4.2% (6/143) displayed motivational messages to encourage medication-taking. Only two apps prompted users on the use of complementary medicine. Issues such as limited medication logging capacity, faulty reminder features, unclear medication adherence assessment, and visually distracting excessive advertising were observed during app assessments. CONCLUSIONS: A large proportion of diabetes self-management apps lacked features for enhancing medication adherence and safety. More emphasis should be given to the design of medication management features in diabetes apps to improve their alignment to evidence-based best practice.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Adesão à Medicação , Aplicativos Móveis , Autocuidado/métodos , Autogestão/métodos , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/psicologia , Humanos , Adesão à Medicação/psicologia , Adesão à Medicação/estatística & dados numéricos , Aplicativos Móveis/normas , Aplicativos Móveis/estatística & dados numéricos , Autocuidado/normas , Autocuidado/estatística & dados numéricos , Autoeficácia , Autogestão/estatística & dados numéricos , Smartphone
13.
Rehabil Nurs ; 44(4): 221-229, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31265440

RESUMO

PURPOSE: The aim of the study was to assess the feasibility, safety, and preliminary estimates of effectiveness of Tai Chi on functional outcomes in stroke survivors. DESIGN: A mixed-method study with a single-group repeated-measure design and in-depth interviews. METHODS: Fourteen stroke survivors with hemiplegia were recruited to participate in a Tai Chi program, twice weekly for 12 months. Outcomes included physical function, self-efficacy, and activity of daily living measured at 3-month intervals for 12 months. FINDINGS: Ten participants (mean age, 68.5 years) completed all assessments with significantly improved balance (χ = 14.08, p = .007), flexibility (χ = 11.70, p = .020), and self-efficacy (χ = 21.84, p < .001) over 12 months. Qualitative results highlighted the positive impact on physical improvement, psychological well-being, social support, and improved confidence in performing activities of daily living. CONCLUSION: An adapted Tai Chi program was safe, feasible, and well received in community-dwelling stroke survivors. CLINICAL RELEVANCE: The Tai Chi-based rehabilitation program shows promise for improving function and balance outcomes related to fall prevention in stroke survivors.


Assuntos
Reabilitação do Acidente Vascular Cerebral/normas , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/terapia , Tai Ji/métodos , Atividades Cotidianas , Idoso , Feminino , Humanos , Entrevistas como Assunto/métodos , Masculino , Pessoa de Meia-Idade , Autoeficácia , Reabilitação do Acidente Vascular Cerebral/métodos , Resultado do Tratamento
14.
Nurse Educ Today ; 80: 78-84, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31280009

RESUMO

BACKGROUND: Effective communication by nurses is crucial to ensure patient safety. A structured communication program increases communication clarity, education satisfaction, and positivity during interprofessional collaboration among students. In an effort to facilitate effective communication between nurses and physicians, the well-known structured communication tool SBAR (Situation, Background, Assessment, and Recommendation) has been extensively used in clinical and educational settings. OBJECTIVES: The purpose of the study is to investigate the impact of an SBAR communication program on communication performance, perception, and practicum-related outcomes in senior-year nursing students. METHOD: The study employed a non-equivalent control group quasi-experimental design and implemented the tool in the pediatric nursing practicum of a nursing school. The experimental group participated in a SBAR program, where role playing using SBAR techniques for different scenarios was used to improve practical communication among nursing students. The SBAR program was developed based on Kolb's Experiential Learning Theory. Communication performance was assessed via the SBAR communication tool and the communication clarity scale. Communication perception was measured by handover confidence level. Practicum-related outcomes of clinical practice self-efficacy, perceived nurse-physician collaboration, and practicum satisfaction, were also evaluated. RESULTS: The experimental group demonstrated significantly higher SBAR communication (p < .001), communication clarity (p < .001), and handover confidence (p < .001) than the control group. Clinical practice self-efficacy, perceived nurse-physician collaboration, and practicum satisfaction did not differ. CONCLUSIONS: The SBAR program in a pediatric nursing practicum improves SBAR communication, communication clarity, and perceived handover confidence in senior-year nursing students.


Assuntos
Existencialismo/psicologia , Modelos Educacionais , Enfermagem Pediátrica/educação , Estudantes de Enfermagem/psicologia , Comunicação , Bacharelado em Enfermagem/métodos , Bacharelado em Enfermagem/normas , Humanos , Aprendizagem Baseada em Problemas/métodos , Autoeficácia , Estudantes de Enfermagem/estatística & dados numéricos
15.
BMC Public Health ; 19(1): 907, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31286927

RESUMO

BACKGROUND: Novel interactive and pictorial health education tool named Diabetes Conversation Map (DCM) might be effective for the improvement of diabetes management self-efficacy (DMSE) and diabetes distress (DD) among diabetic patients in lower middle-income setting. This study protocol will assess the effectiveness of DCM as compared to routine care (RC) to improve DMSE, decrease DD and glycated hemoglobin (HbA1c) among patients with type 2 diabetes (T2DM). METHODS: This will be two arms randomized controlled trial, conducted at national institute of diabetes and endocrinology (NIDE) in Karachi, Pakistan. A sample of 120 T2DM patients of age 30-60 years with suboptimal diabetes control will be screened through eligibility criteria and DD screening tool. Patients who fulfill the eligibility criteria and have diabetes distress will be randomized into interventional and control arm. The intervention arm will receive four education sessions (40 min each) using DCM for 4 weeks duration of enrollment. Controlled arm will receive RC. DMSE and DD will be measured using the validated Likert tools at baseline and after 3 months of enrollment. Latest results of HbA1c will be retrieved from the respective medical record files at baseline and 3 months. Change in DMSE, DD scores and HbA1c levels within groups (pre-post) and between the groups after 3 months of enrollment will be compared. Multivariable linear regression will be conducted to adjust for any potential confounders. DISCUSSION: In a study in UK, 70% of the patients with diabetes reported DCM had helped them in controlling their diabetes and recommended this method to teach other patients with diabetes also. In China, a study found that patients with diabetes who received DCM based education had significantly lower DD and significantly higher diabetes empowerment score after six months of the intervention as compared to the traditional counselling. A cross sectional study conducted in Pakistan also demonstrated that teaching based on DCM was useful in improving the knowledge, attitude and practices of patients with T2DM. Besides, no other study has evaluated the effectiveness of these novel tools for DMSE and diabetes distress DD in well-designed, sufficiently powered clinical trials. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03747471 . Date of registration: Nov 20. 2018. Version and Date of Protocol: Version 1, IRB Approval date 28 June 2018.


Assuntos
Diabetes Mellitus Tipo 2/psicologia , Educação de Pacientes como Assunto/métodos , Autoeficácia , Autogestão/psicologia , Estresse Psicológico/psicologia , Adulto , China , Comunicação , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/terapia , Feminino , Hemoglobina A Glicada/análise , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão , Ensaios Clínicos Controlados Aleatórios como Assunto , Estresse Psicológico/sangue
16.
Health Qual Life Outcomes ; 17(1): 121, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31307472

RESUMO

BACKGROUND: Muscle weakness is a defining characteristic of Muscular Dystrophy (MD); however, yet while speculated, objective measures of muscle weakness has not been reported in relation to quality of life in adults with MD. OBJECTIVES: 1) compare the self-reported QoL of adults with Duchenne MD (DMD), Beckers MD (BMD), Limb-Girdle MD (LGMD) and Fascioscapulohumeral MD (FSHD, and a non-MD (CTRL) group; 2) present and compare between groups measures of Impairment (Muscle Strength and Activities of Daily Living) and Perception (Fatigue, Pain and Self-Efficacy); and 3) identify associations between QoL domains and measures of Impairment and Perception (See above). METHODS: Seventy-Five males, including MD classifications DMD, BMD, LGMD, FSHD and CTRL, completed measures for QoL, Knee-Extension Maximal Voluntary Contraction (KEMVC), Fatigue, Pain, Self-Efficacy and Activities of Daily Living (ADL). RESULTS: QoL was lower across many domains in MD than CTRL. FSHD scored lower than DMD for mental wellbeing domains. KEMVC associated with Physical-Function domain for BMD. Pain, Self-Efficacy and ADLs associated with QoL domains, with Fatigue the most consistently associated. CONCLUSION: The present study identified differences between MD classifications within self-perceptions of mental-health. Muscle weakness is a defining feature of MD; however, it doesn't define QoL in adults with MD. A greater understanding of mental wellbeing, independence, and management of fatigue and pain, are required to improve QoL for adults with MD.


Assuntos
Atividades Cotidianas/psicologia , Força Muscular , Distrofia Muscular de Duchenne/psicologia , Qualidade de Vida , Adulto , Estudos Transversais , Fadiga/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Debilidade Muscular , Dor/psicologia , Autoeficácia , Autorrelato , Adulto Jovem
17.
Public Health ; 173: 50-57, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31254678

RESUMO

OBJECTIVES: The aim of this study was to explore factors which mediated or moderated the effect of the Time2bHealthy online program for parents of preschool-aged children on body mass index (BMI) change. STUDY DESIGN: Mediation and moderation analyses of data from a two-arm parallel randomised controlled trial. METHODS: Randomisation was conducted after baseline measures. The intervention group received an 11-week online program, and the comparison group received emailed links to information from an evidence-based parenting website. Data on the primary outcome (child BMI), potential mediators (energy intake, fruit and vegetable intake, discretionary food intake, physical activity, screen-time, sleep, child feeding, parent self-efficacy or parent role-modelling) and potential moderators (child age, parent age, parent income, parent education or parent living situation) were collected at baseline, 3 months and 6 months. PROCESS macro for SPSS was used to analyse possible mediators and moderators on BMI outcomes. RESULTS: Despite significant food-related outcomes in the main analysis of this trial, no significant mediating or moderating effects were found for any hypothesised mediators or moderators. CONCLUSIONS: This study's null results could be explained by the high proportion of children in the healthy weight range, the study period not being long enough to detect change, the multicomponent nature of the intervention or the relatively small number of outcomes measured. Future childhood obesity interventions should continue to explore the effects of mediators and moderators on BMI and consider collecting data on a wide range of mediating and moderating factors to allow for comparison between studies to develop a better understanding of the factors contributing to successful interventions.


Assuntos
Instrução por Computador/métodos , Promoção da Saúde/métodos , Promoção da Saúde/organização & administração , Estilo de Vida Saudável , Pais/educação , Obesidade Pediátrica/prevenção & controle , Obesidade Pediátrica/terapia , Índice de Massa Corporal , Peso Corporal , Pré-Escolar , Dieta , Exercício , Comportamento Alimentar , Feminino , Humanos , Masculino , Poder Familiar , Comportamento Sedentário , Autoeficácia , Sono/fisiologia
18.
Nurse Educ Pract ; 38: 7-13, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31170627

RESUMO

The aim of this randomized controlled trial was to develop a web-based acute pain management education program for nurses and to evaluate its effectiveness. The developed program consisted of a total duration of 400 min with eight modules and 29 topics in pain management. Fifty nurses from the post-anesthesia care unit in two university-affiliated hospitals in Seoul, Korea were randomly assigned to either the experimental group (n = 25) or the control group (n = 25) and a total of 46 nurses, 23 for each group, completed the pre and post-tests. The pre and post-tests were performed to evaluate the changes of the nurses' knowledge, attitude, and self-efficacy regarding acute pain management. The experimental group showed a significant increase in knowledge and in self-efficacy about pain management compared to the control group (u = 389.0, p = .006; u = 360.0, p = .030, respectively). The results support the effective use of these web-based modules as part of a continuing education program on pain management for nurses working in an acute care setting. The findings of this study can be the basis for the development of evidence-based guidelines and training tailored to the Korean culture and similar settings.


Assuntos
Enfermeiras e Enfermeiros/psicologia , Manejo da Dor/enfermagem , Adulto , Competência Clínica/normas , Educação Continuada em Enfermagem/métodos , Feminino , Humanos , Internet , Masculino , Manejo da Dor/tendências , República da Coreia , Autoeficácia , Inquéritos e Questionários
19.
Nurse Educ Pract ; 38: 45-51, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31176243

RESUMO

With increasing needs for evidence-based practice, the well-designed EBP education is necessary to enhance the critical thinking and decision-making skills of nursing undergraduates. This study is to evaluate the effectiveness of an evidence-based practice education program with blended learning on undergraduate nursing students. In this preliminary experimental study, 45 senior nursing undergraduates were recruited from a university in Seoul, Korea. Self-selection was used to create two groups: an intervention group and a control group consisting of 21 and 24 students, respectively. The intensive 30-hours evidence-based practice education program was provided to the intervention group. Evidence-based practice knowledge, self-efficacy, and evidence utilization were evaluated as outcome variables at baseline and two months after the intervention. There were no significant differences between the intervention and control groups on the background characteristics and outcome variables (p > .05). There were significant increases in evidence-based practice knowledge (Z = -5.28), self-efficacy (t = -6.42), resource utilization (Z = -2.60), and databases utilization (t = -2.98) in the intervention group, when compared with the control group (p < .01). Further studies are recommended to develop the evidence-based practice train-the-trainer program for nursing educators and to maximize the effectiveness of utilizing blended learning in evidence-based practice education.


Assuntos
Bacharelado em Enfermagem/métodos , Enfermagem Baseada em Evidências/educação , Distribuição de Qui-Quadrado , Competência Clínica/normas , Competência Clínica/estatística & dados numéricos , Currículo/normas , Currículo/tendências , Feminino , Humanos , Masculino , República da Coreia , Autoeficácia , Estatísticas não Paramétricas , Adulto Jovem
20.
BMC Public Health ; 19(1): 757, 2019 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-31200763

RESUMO

BACKGROUND: To better understand health-related quality of life (HRQOL) in adolescents, it is important to gain knowledge about factors associated with HRQOL. Being involved in bullying is a significant threat to health, and social and psychological well-being; further, such problems can last into adulthood. The aim of this study was to explore the role of general self-efficacy (GSE) and bullying in relation to HRQOL. We specifically sought to study the prevalence of bullying, as well as the associations between both bullying and self-efficacy and HRQOL in a sample of adolescents. METHODS: This was a cross-sectional study of 723 adolescents (12-18 years) attending schools selected using randomized cluster sampling. HRQOL was measured using the KIDSCREEN-52, self-efficacy was measured with the GSE scale, and bullying was measured using the two global questions from the Olweus bullying questionnaire. Multiple regression analyses were performed to explore how being bullied, bullying, and GSE were associated with variations in self-reported HRQOL. RESULTS: Of the 723 adolescents, 13% reported being bullied; there were no gender differences within this finding. However, more boys than girls reported that they had bullied others. Both being bullied, and bullying others, were associated with lower HRQOL; however, being bullied was associated with the lowest scores. Higher self-efficacy was associated with better HRQOL. Self-efficacy contributed significantly to predicting variation in HRQOL. CONCLUSIONS: Being involved in bullying, as a victim or a bully, is associated with lower HRQOL. The association between GSE and HRQOL indicates that self-efficacy might be a resource for increasing HRQOL among adolescents. Our findings highlight the importance of targeting self-efficacy beliefs as an intervention strategy to improve GSE and HRQOL in adolescents involved in bullying.


Assuntos
Bullying/estatística & dados numéricos , Qualidade de Vida , Autoeficácia , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Noruega/epidemiologia , Prevalência , Instituições Acadêmicas , Inquéritos e Questionários
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