Promoting Self-Management and Independent Living of Older Individuals with Chronic Diseases through Technology: A Study of Self-Reported Needs, Priorities, and Preferences.

Background and Objectives: Older patients' needs are rarely examined beforehand, and thus, although technology-based tools can enhance self-management, acceptability rates are still low. This study aimed to examine and compare self-reported needs, priorities, and preferences of older patients with heart failure (HF), diabetes mellitus type II (DM2), and chronic obstructive pulmonary disease (COPD) toward technology use to enhance self-management. Materials and Methods: A convenience sample of 473 participants over 60 s (60.5% females), diagnosed with HF (n= 156), DM2 (n = 164), or COPD (n = 153) was recruited. They were administered a questionnaire about the usefulness of technology in general and in specific areas of disease management. Results: Most participants (84.7%) admitted that technology is needed for better disease management. This was equally recognized across the three groups both for the overall and specific areas of disease management (in order of priority: "Information", "Communication with Physicians and Caregivers", and "Quality of Life and Wellbeing"). Sociodemographic differences were found. Cell phones and PCs were the devices of preference. The four common features prioritized by all three groups were related to 'information about disease management' (i.e., monitoring symptoms, reminders for medication intake, management and prevention of complications), whereas the fifth one was related to 'communication with physicians and caregivers (i.e., in case of abnormal or critical signs). The top disease-specific feature was also monitoring systems (of respiratory rate or blood sugar or blood pressure, and oxygen), whereas other disease-specific features followed (i.e., maintaining normal weight for HF patients, adjusting insulin dose for DM2 patients, and training on breathing exercises for COPD patients). Conclusions: Older individuals in these three groups seem receptive to technology in disease management. mHealth tools, incorporating both common and disease-specific features and addressing different chronic patients, and also being personalized at the same time, could be cost-saving and useful adjuncts in routine clinical care to improve self-management.

Anxiety-Depression of Dialysis Patients and Their Caregivers.

Background and Objectives: Anxiety-depression of patients undergoing hemodialysis has a strong relation with the levels of anxiety-depression of their caregivers. The aim of this study was to evaluate anxiety-depression of dialysis patients and their caregivers. Materials and Methods: In this cross-sectional study, 414 pairs of patients and caregivers from 24 hemodialysis centers of Greece completed the Hospital Anxiety and Depression Scale (HADS). The statistical analysis of the data was performed through the Statistical Program SPSS version 20.0. The statistical significance level was set up at 5%. Results: The mean age of patients was 64 (54.06-72.41) years old and the mean duration of hemodialysis was 36 (16-72) months. The mean age of caregivers was 54 (44-66) years old. Of the total sample, 17.1% (n = 71) of patients had high levels of anxiety and 12.3% (n = 51) had high levels of depression. Additionally, 27.8% (n = 115) of caregivers had high levels of anxiety and 11.4% (n = 47) had high levels of depression. Caregivers had higher levels of anxiety when their patients had high levels of anxiety as well (42.3%). Additionally, they had higher levels of depression when their patients had high levels of depression as well (17.6%). Conclusions: The results of this study showed a significant association between the levels of anxiety and depression among patients and caregivers. There is a necessity for individualized assessment of dialysis patients and their caregivers and the implementation of specific interventions for reducing the levels of anxiety and depression among them.

Injuries and Persistent Pain in Elite Adolescent Archery Athletes: A Cross-Sectional Epidemiological Study.

This cross-sectional epidemiological study aimed to evaluate the prevalence of injuries among young archers engaged in high-intensity training during the European Youth Championship. A total of 200 participants (104 males/96 females) from 34 countries were included, with a mean age of 16.9 years and average competitive experience of 6.5 years. Structured questionnaires, administered by four physiotherapist interviewers, gathered comprehensive data. Results revealed that 43.5% of participants experienced shoulder pain during training, highlighting the vulnerability of upper limbs in archers. Additionally, 30% required medications to facilitate training, underscoring the impact of injuries on continued participation. Physiotherapy was utilized by 52.3% of participants, emphasizing the need for therapeutic intervention. Furthermore, 31.8% had to cease training due to injuries, indicating a substantial hindrance to athletic progression. The mean pain duration was 3.9 months, with an average intensity of 5.94, and 8% exhibited symptoms of central sensitization. In conclusion, this study demonstrates a noteworthy prevalence of injuries, particularly in the upper limbs, among young archers undergoing intensive training. The findings underscore the importance of targeted injury prevention strategies and comprehensive rehabilitation approaches to ensure the well-being and sustained participation of young athletes in competitive archery.

What Quality of Care Means? Exploring Clinical Nurses' Perceptions on the Concept of Quality Care: A Qualitative Study.

Quality is a multidimensional issue involving various features that depend on service performance and personal assessment. Clarifying the concept of quality is essential in order to further facilitate the understanding and improvement of quality in healthcare. The purpose of this study was to investigate how clinical nurses, providing care to adult medical patients, perceive and define the concept of quality nursing care. A descriptive qualitative research design was applied. A purposive sampling strategy was used to recruit nurses from the clinical sector of a general public hospital in Athens, Greece. Ten female nurses from the medical sector participated the study. Data collection was conducted through in-depth, semi-structured interviews. Conventional content analysis was used to analyze the verbatim data. Four categories were revealed from the data analysis, namely: (a) "Quality care is holistic care", (b) "Good care is an interpersonal issue", (c) "Leadership is crucial", and (d) "Best care is our responsibility". Quality care was defined as holistic care, addressing all patient needs with competency and aiming for the best patient outcomes. It was associated with communication, teamwork, good leadership, and personal commitment. By developing an in-depth and mutual understanding about what quality means, nurse leaders and practitioners may collaborate in finding common paths to support quality interventions and enhance quality nursing care in clinical practice.

Hemodialysis Patients' Information and Associated Characteristics.

INTRODUCTION: of this study was to explore characteristics associated with hemodialysis patients' degree of information. MATERIAL AND METHODS: The sample of the study included 650 patients undergoing hemodialysis. For data collection a questionnaire specially designed for the needs of the research was used. More specifically, socio-demographic, clinical and other patients' characteristics were associated with the degree of information as it was reported by patients. RESULTS: of the 650 participants, 55.4% was men while 58.6% of the sample was aged over 60 years. Regarding information level, results showed that only 9.8% was "little" or "not all" informed about their health problem, 61,7% was "enough" informed whereas 28.5% were "very" informed. Statistically significant association was observed between degree of information and age (p=<0.001), family status (p=0.005), education (p=0.001), job (p=0.005) and number of children (p=0.019). In terms of clinical characteristics, statistically significant association was observed between the degree of information and whether patients had other disease or not (p=0.037), whether patients reported adherence to treatment guidelines (p=<0.001). Finally, statistically significant association was observed between the degree of information and relations with nursing staff (p=<0.001), doctors (p=0.007) and other patients (p=0.003), and whether patients faced difficulties in social (p=0.001) and family environment (p=0.002). CONCLUSION: Health professionals when planning information interventions for orienting hemodialysis patients is increasingly important to evaluate socio-demographic, clinical and other patients ' characteristics and incorporate them in their project.