Background: Hip osteoarthritis (HOA) causes joint destruction, resulting in hip pain, limited range-of-motion, claudication, and joint deformity. In the conservative treatment of HOA, self-management is important to m...Background: Hip osteoarthritis (HOA) causes joint destruction, resulting in hip pain, limited range-of-motion, claudication, and joint deformity. In the conservative treatment of HOA, self-management is important to manage symptoms and control disease progression. In a previous study, the researchers conducted a conceptual analysis of 43 foreign studies on self-management during conservative therapy for patients with HOA. The results revealed a definition of self-management during conservative therapy for patients with HOA. However, because that study analyzed only the foreign literature, it remains unclear whether the findings reflect the characteristics of the Japanese health-care delivery system, health-care insurance system, or the lifestyles and cultural characteristics of Japanese patients with HOA. Objective: We aimed to clarify the self-management behaviors of patients with HOA. Methods: Semi-structured interviews were conducted with five patients diagnosed with HOA, and the results were subjected to inductive qualitative analysis. Results: Six categories of self-management behaviors were extracted for patients with HOA: [active information gathering about HOA], [personalized pain and weight management, and strategies for reducing hip joint load], [reflection on living conditions with individuals and professionals, and determination for future efforts], [continuation of exercise and weight management based on personal strengths and achievements, and mutual support with others], [coexistence with HOA while managing negative feelings], and [choosing treatment methods by trusting doctors while struggling with personal needs]. Conclusion: These findings suggest the need to develop health guidance and educational programs for patients with HOA that focus on how to prevent disease progression and cope with symptoms.展开更多
Background:Falls are a significant public health concern among older adults,often leading to severe injuries and decreased quality of life.Fall prevention self-management behaviors are critical in reducing fall risk.H...Background:Falls are a significant public health concern among older adults,often leading to severe injuries and decreased quality of life.Fall prevention self-management behaviors are critical in reducing fall risk.However,the status and influencing factors of these behaviors among community-dwelling older adults in China remain poorly understood.This study aimed to investigate fall prevention self-management behaviors and their influencing factors among community-dwelling older adults in Fuzhou,China.Methods:From June to December 2022,we used multi-stage cluster random sampling and invited 675 community-dwelling older adults from Fujian as participants.We conducted a questionnaire survey using the general information questionnaire,Fall Prevention Self-management Behavior among Older Adults Questionnaire,Questionnaire on Knowledge,Belief,and Practice of Falls Prevention among Older Adults in Community,Modified Falls Efficacy Scale,Social Support Rating Scale,and Chinese Version of the Self-Assessment Fall Risk Scale for Older Adults.Multivariate linear regression was used to identify the factors influencing fall prevention self-management behavior among older adults.Results:The overall score of fall prevention self-management behaviors was 146.81±34.22,indicating a moderate level.Key influencing factors included education level,pre-retirement occupation,income,medication type,self-assessed physical condition,fear of falling,knowledge and practices in fall prevention,social support,and fall risk.These factors collectively explained 34.3%of the variance in self-management behaviors.Conclusion:The findings highlight the need for targeted interventions to enhance fall prevention self-management among community-dwelling older adults.Interventions should focus on improving knowledge,strengthening social support,and addressing psychological barriers such as fear of falling.This study provides valuable insights for developing community-based strategies to reduce fall risks and promote healthy aging.展开更多
Objective:To investigate the association between the health locus of control and selfmanagement behaviors in patients receiving hemodialysis.Methods:Patients receiving hemodialysis in Xiamen,Fujian province,from Decem...Objective:To investigate the association between the health locus of control and selfmanagement behaviors in patients receiving hemodialysis.Methods:Patients receiving hemodialysis in Xiamen,Fujian province,from December 2014 to March 2015 answered the Chinese version of the Multidimensional Health Locus of Control scale and the self-management behavior questionnaire.Results:The participants in this study indicated that they believed others exerted more control over their health than themselves or chance.In addition,the majority of participants had a medium to low level of self-management behaviors.Positive correlations were also observed between a participant's health locus of control and their level of selfmanagement behaviors.Internal health locus of control and external(others)health locus of control were significant predictors of self-management behaviors controlling for the effect of payment method.Conclusion:The results of this study provided evidence that there is a strong relationship between the health locus of control and self-management behaviors in hemodialysis patients.This study provides important information for medical professionals as they design strategies to educate hemodialysis patients on their health locus of control and selfmanagement behaviors.展开更多
Objective:To describe the self-management(SM)behavior among persons with mild-to-moderate chronic obstructive pulmonary disease(COPD),and it examines the correlation between COPD knowledge,self-efficacy,perceived soci...Objective:To describe the self-management(SM)behavior among persons with mild-to-moderate chronic obstructive pulmonary disease(COPD),and it examines the correlation between COPD knowledge,self-efficacy,perceived social support,and SM behavior among persons with mild-to-moderate COPD in Wenzhou,China.Methods:A simple random sampling technique was used to recruit 121 persons with mild-to-moderate COPD who visited the respiratory outpatient department of the First Affiliated Hospital of Wenzhou Medical University in Wenzhou,China.Research instruments include a demographic data questionnaire,COPD SM scale,COPD knowledge questionnaire,6-item chronic disease self-efficacy scale,and perceived social suppor t scale.Descriptive statistics and Pearson's Correlation were used for data analysis.Results:The findings show that the mean score of COPD SM scale was 2.70(SD=0.45).The Pearson correlation analysis revealed that the COPD knowledge(r=0.47,P<0.001),self-efficacy(r=0.28,P=0.001),and perceived social support(r=0.48,P<0.001)were positively correlated to the COPD SM behavior among persons with mild-to-moderate COPD in Wenzhou,China.Conclusions:The findings indicate that disease knowledge,self-efficacy,and perceived social support were related to SM behavior in persons with mild-to-moderate COPD,which provides a theoretical basis for developing SM interventions for persons with mildto-moderate COPD and improving this population's SM behavior.展开更多
Objective:To determine the effects of the Self-Management Training Program on self-management behavior and blood pressure(BP)levels among elderly people with hypertension(HT).Methods:This study was based on a quasi-ex...Objective:To determine the effects of the Self-Management Training Program on self-management behavior and blood pressure(BP)levels among elderly people with hypertension(HT).Methods:This study was based on a quasi-experimental design using sampling groups composed of elderly residents of Pathum Thani Province with HT.Simple random sampling was applied to two sampling groups,an experimental group and a control group.However,the experimental group had been on the Self-Management Training Program based on the Creer concept.The Program’s contents included small-group health-education sessions and the patients’manual,Self-Management Training Skills for Self-Management Behavior.Small group discussions were held for self-reflection,to stimulate follow-up for self-management behavior training during home visits.The Self-Management Training Program was compared with programs involving the more usual care.Data were collected using the Self-Management Behavior for Hypertension Control Questionnaire and BP assessment tests.Data were analyzed using a descriptive statistic,chi-square test,pair t-test,repeated-measures Analysis of Variance(ANOVA),and repeated-measures Analysis Covariance(ANCOVA).Results:It was found that at 13 weeks after entering the program,the experimental group demonstrated a significantly lower systolic and diastolic BP with a baseline statistical significance(P<0.005),and that at the 4th week and the 13th week,there was a decrease in BP in the experimental group.The experimental group also had above-baseline self-management behavior scores that were higher than in the control group(P<0.01).Conclusions:Results from this study show that the Self-Management Program was useful for BP control and promoted sustainable self-management behavior.展开更多
Objectives:This study aimed to develop a self-management behavior questionnaire for Chinese enter-ostomy patients and examine its reliability and validity.Methods:Guided by the theory of self-management,an initial que...Objectives:This study aimed to develop a self-management behavior questionnaire for Chinese enter-ostomy patients and examine its reliability and validity.Methods:Guided by the theory of self-management,an initial questionnaire was generated through literature review,group meetings,and two rounds of an expert consultation.Finally,the reliability and validity of the questionnaire were validated through a questionnaire survey of 200 enterostomy patients were selected from the Affiliated Hospital of Medical University from June 2016 to March 2017.Results:The content validity index was 0.80e1.00.The exploratory factor analysis yielded a five-factor(dietary behavior,psychosocial behavior,symptom management behavior,medical compliance behavior,information management behavior),consisting of 40 items.The cumulative variance contri-bution rate was 65.42%.The Cronbach’s a coefficient for the total questionnaire was 0.972,and for the five factors ranged from 0.797 to 0.939,indicating a good internal consistency.The test-retest reliability was 0.867(P<0.01).The self-management behavior questionnaire score was negatively related to the Ostomy Skin Tool score(r=-0.800,P<0.01).Conclusions:The self-management behavior questionnaire developed in this study showed good reli-ability and validity and can be used to assess the self-management behavior of Chinese enterostomy patients.展开更多
Objective： The aims of this study were to investigate the status quo of self-management behaviors in stroke patients at the recovery stage and to explore its influencing factors.Methods： A total of 440 hospitaliz...Objective： The aims of this study were to investigate the status quo of self-management behaviors in stroke patients at the recovery stage and to explore its influencing factors.Methods： A total of 440 hospitalized convalescent stroke patients were recruited and investigated using the Basic Situation Questionnaire, Self-management Behavior Scale of Stroke, Stroke Prevention Knowledge Questionnaire and Social Support Rating Scale.Results： The mean self-management behavior score was （151.95±23.58）, and dimensions in descending order were as follows： dietary management, drug safety management, social function and interpersonal relationships, life management, emotion management, rehabilitation exercise management and disease management. Five regional self-management behavior scores were statistically significant, and the scores from Minnan and Minzhong of the Fujian province, China, were higher than the others. Gender, age, family income and self-management behavior were significantly correlated （P〈0.05）; educational level, stroke knowledge level, social support level and self-management behavior were positively correlated, and the difference was statistically significant （P〈0.01）. Conclusions： The overall self-management level of convalescent stroke patients should be improved to strengthen health education; focus on the educational level, which is relatively low; strengthen the social support system of patients; stimulate the enthusiasm and initiative of self-management disease patients to promote disease rehabilitation and improve the quality of life.展开更多
AIM To determine the relationship between chronic kidney disease(CKD) awareness(CKD-A), self-management behaviors(CKD-SMB) knowledge, performance of CKDSMBs, health literacy(HL) and kidney function. METHODS Participan...AIM To determine the relationship between chronic kidney disease(CKD) awareness(CKD-A), self-management behaviors(CKD-SMB) knowledge, performance of CKDSMBs, health literacy(HL) and kidney function. METHODS Participants were eligible patients attending an outpatient nephrology clinic. Participants were administered: Newest Vital Sign to measure HL, CKD self-managementknowledge tool(CKD-SMKT) to assess knowledge, past performance of CKD-SMB, CKD-A. Estimated GFR(e GFR) was determined using the MDRD-4 equation. Duration of clinic participation and CKD cause were extracted from medical charts. RESULTS One-hundred-fifty patients participated in the study. e GFRs ranged from 17-152 m L/min per 1.73 m2. Majority(83%) of respondents had stage 3 or 4 CKD, low HL(63%), and were CKD aware(88%). Approximately 40%(10/25) of patients in stages 1 and 2 and 6.4%(8/125) in stages 3 and 4 were unaware of their CKD. CKD-A differed with stage(P < 0.001) but not by HL level, duration of clinic participation, or CKD cause. Majority of respondents(≥ 90%) correctly answered one or more CKD-SMKT items. Knowledge of one behavior, "controlling blood pressure" differed significantly by CKD-A. CKD-A was associated with past performance of two CKD-SMBs, "controlling blood pressure"(P = 0.02), and "keeping healthy body weight"(P = 0.01). Adjusted multivariate analyses between CKD-A and:(1) HL; and(2) CKD-SMB knowledge were nonsignificant. However, there was a significant relationship between CKD-A and kidney function after controlling for demographics, HL, and CKD-SMB(P < 0.05). CONCLUSION CKD-A is not associated with HL, or better CKD-SMBs. CKD-A is significantly associated with kidney function and substantially lower e GFR, suggesting the need for focused patient education in CKD stages 1.展开更多
Background: In a rapidly aging Japanese society, the number of patients with hypertension has seen a steady increase. The basic treatments for hypertension are maintaining blood pressure through medication and prevent...Background: In a rapidly aging Japanese society, the number of patients with hypertension has seen a steady increase. The basic treatments for hypertension are maintaining blood pressure through medication and preventing complications. It is important for patients with hypertension to perform self-management. This improves their lifestyle while controlling their blood pressure to prevent complications and maintain good health. Purpose: This study aimed to examine the actual self-management behavior ability of patients with hypertension and to clarify the factors involved in their self-management behavior. Methods: A total of 150 patients with hypertension were included in this study. The following data were obtained from the patients as background information: sex, age, years with disease, whether they are receiving antihypertensive agents, type of antihypertensive agent, blood test data, heart thoracic ratio, left ventricular ejection fraction, pulse wave, pulse wave velocity, and height. The levels of self-management skills of the patients were also assessed using the “Instrument to Measure the Self-care of patients with Hypertension” developed by Tsuboi et al. Results: The associations among self-management behaviors in daily life, such as diet, exercise, stress, medication, alcohol intake, and smoking, were analyzed in patients with hypertension. The subjects were classified into the following three groups: aged 65 years or below (Group A), early stage elderly individuals (Group B), and late-stage elderly individuals aged 75 years or over (Group C). The results showed that the subjects in Group C had higher self-management scores for diet, exercise, stress, medication, and drinking than the subjects in the other two groups. The scores of smoking and self-management of the subjects in Group A were high but their other self-management scores were low. All the subjects were taking between 1 to 3 types of oral antihypertensive drugs. The rate of achievement of the target blood pressure was 50% or more in all the three groups. However, the pulse wave velocity was high in all the three groups. Conclusion: The results indicate that the risk of developing disorders of the brain and cardiovascular system is high in all the three groups, owing to the high degree of arteriosclerosis. Therefore, increasing the number of nursing interventions is expected to reduce blood pressure, maintain and promote self-management behavior in daily life, and prevent the onset of complications. The results suggest that nursing interventions involving lifestyle guidance for improving the self-management skills of patients are urgently needed by patients under 65 years of age.展开更多
Background: Hypertension is a lifestyle-related disease that has no subjective symptoms but could lead to severe complications. The goals of treatment for hypertension are to maintain blood pressure with medications a...Background: Hypertension is a lifestyle-related disease that has no subjective symptoms but could lead to severe complications. The goals of treatment for hypertension are to maintain blood pressure with medications and prevent complications. Measuring blood pressure at home regularly is critical for patients with hypertension. Purpose: This study aimed to 1) clarify the status of patients’ understanding of hypertension and self-management, 2) identify nursing practices that could support patients with hypertension in making them aware of the need for understanding hypertension, monitoring blood pressure at home, and engaging in self-management. Method: A questionnaire survey on understanding of the disease and self-management behavior was conducted among patients with hypertension who regularly visited outpatient clinics. As for data analysis, descriptive statistics were computed for patients’ attributes, clinical findings, understanding of the disease, and self-management behavior. Cross-tabulation and the chi-square test were used for each item on understanding of the disease and self-management behaviors. Results: Data were obtained from 150 participants (93 males and 57 females) with a mean age of 70 years. Patients with a higher understanding of the disease and those who were aware of the target blood pressure were more likely to engage in self-management behavior, including monitoring blood pressure at home, ensuring regular outpatient visits, and consulting with nurses or physicians. In addition, the percentage of patients who recognized the need to achieve their target blood pressure was higher among those who had a spouse and lived with their family. Discussion: Regular monitoring and recording of blood pressure at home are the most important self-management behaviors. Understanding of the disease and self-management behavior and support from the family are critical for maintaining appropriate self-management. Therefore, in cooperation with physicians, nurses should provide health education to patients and their families to enable them to perform appropriate self-management. Health expenditures increase with age, especially in those aged 65 years and over. The prevalence of hypertension increases with age;patients aged 65 years and over need to engage in self-management to maintain their target blood pressure. Nurses should provide patients with hypertension aged 65 years and over with appropriate nursing care to enable them to measure and record their blood pressure at home appropriately and regularly. Appropriate nursing care may help reduce the health expenditure. This may help reduce the health expenditure.展开更多
Objectives:This study aimed to explore the preferences and influencing factors of self-management behaviors in patients with recurrent gout and provide a theoretical basis for developing targeted strategies to improve...Objectives:This study aimed to explore the preferences and influencing factors of self-management behaviors in patients with recurrent gout and provide a theoretical basis for developing targeted strategies to improve self-management preferences.Methods:A total of 10 patients with recurrent gout were recruited from the gout specialist outpatient clinic at a tertiary hospital in Shenyang,Liaoning Province,China.Semi-structured interviews were conducted with these patients,and the Kawakita Jiro(KJ)method was used to analyze the interview data.Results:After four rounds of screening by five researchers,35 codes were selected from an initial 132.After three rounds of discussion and induction,the KJ method identified seven domains of selfmanagement behavior preferences in patients with recurrent gout:1)extensive knowledge of gout,yet difficulty in distinguishing between accurate and inaccurate information;2)a passive attitude of“no pain,no management”;3)the challenge of changing entrenched daily habits;4)the optimistic but unrealistic belief of“self-delusion”;5)a tendency to seek medical attention late due to hopelessness of cure and familiarity with recurrences;6)preference for analgesics for gout recurrences while neglecting long-term urate-lowering therapy(ULT);and 7)gout-related stigma.Conclusion:The results of this study showed that the self-management behavior of patients with recurrent gout could be improved,especially in the aspects of medical seeking behavior,medication compliance,daily management and emotional management.At the same time,we found that gout stigma,difficulty in distinguishing true and false knowledge of gout and negative attitude of“ignoring pain”were significantly associated with self-management behavior.展开更多
This study examined the differences and primary factors from the impact of autonomous motivation and controlled motivation on the self-management behavior of hemodialysis patients.Anonymous,self-describing questionnai...This study examined the differences and primary factors from the impact of autonomous motivation and controlled motivation on the self-management behavior of hemodialysis patients.Anonymous,self-describing questionnaires were used for research on nine different dialysis facilities of 413 people who regularly visit.From using the primary factor results of multiple regression analysis,that took autonomous motivation and controlled motivation as the dependent variable,a path diagram was created that led to each motivation.The acknowledgement of autonomy support facilitated whether it was autonomous motivation or controlled motivation(The standardized coefficient was 0.385,0.346,p<0.0001).Positive evaluation coping skills were a primary factor that promoted autonomous motivation,while trait anxiety,disorders of social activities,and lack of motivation were primary factors that promoted controlled motivation.In order to raise the autonomous motivation to promote self-management behavior in patients with hemodialysis treatment,situations that easily cause amotivation and anxiety,as well as tendencies for depression should be assessed.Also the encouragement to attain positive evaluation coping skills to support patient autonomy appears to be effective.展开更多
<strong>Background:</strong> Self-management is important for post-renal transplant recipients to resolve renal dysfunction, heart failure, and post-transplant psychosocial issues, and to maintain transpla...<strong>Background:</strong> Self-management is important for post-renal transplant recipients to resolve renal dysfunction, heart failure, and post-transplant psychosocial issues, and to maintain transplant kidney function, etc. However, because recipients may be unable to adequately self-manage, healthcare providers need to provide self-management support for recipients to improve their skills and confidence in managing their disease. However, it is difficult to comprehensively assess the self-management behaviors in a busy outpatient support setting. Furthermore, since there are no uniform standards for assessment, it is based on the experience and abilities of medical personnel. Therefore, self-management behavior of post-renal transplant recipients is not sufficiently evaluated. <strong>Objective:</strong> This study aimed to evaluate content validity of a tool that can assess self-management behaviors of adult post-renal transplant recipients, consisting of consensus components from experts familiar with the follow-up of adult post-renal transplant recipients. <strong>Methods:</strong> A three-round modified Delphi method was used to assess the self-management behaviors of adult post-renal transplant recipients by a panel of experts consisting of certified transplant recipient coordinators, physicians, outpatient nurses, and researchers familiar with the follow-up of post-renal transplant recipients. Regarding management behaviors of adult post-renal transplant recipients, the experts rated the appropriateness and validity of each item using a Likert scale. Consensus ratings from the experts were made by calculating the median, interquartile range, and interquartile range percentage. In the third round, an item-level content validity index was calculated to assess content validity. <strong>Conclusions: </strong>The 41-item self-management behavior scale for kidney transplant recipients assessed self-management behaviors in five domains: medication, exercise, fluids and diet, disease and symptom prevention and management, and psychosocial adjustment. The content validity of this tool was confirmed, and it can be used to more easily assess the recipients’ self-management behaviors in the post-renal transplant follow-up. This tool can potentially contribute to the maintenance of transplant kidney function and high QOL in recipients.展开更多
BACKGROUND Despite societal guidelines recommending targeted screening for Barrett’s esophagus(BE)and esophageal adenocarcinoma(EAC)in individuals with gastroesophageal reflux symptoms(GERS),screening adherence is su...BACKGROUND Despite societal guidelines recommending targeted screening for Barrett’s esophagus(BE)and esophageal adenocarcinoma(EAC)in individuals with gastroesophageal reflux symptoms(GERS),screening adherence is suboptimal.Current screening approaches fail to identify individuals not seeking medical consultation for GERS or whose GERS are managed with‘over-the-counter’(OTC)acid suppressant therapies.AIM To assess patients’self-management and help-seeking behavior for GERS.METHODS This cross-sectional study collected data from the Dutch general population aged 18-75 years between January and April 2023 using a web-based survey.The survey included questions regarding self-management(e.g.,use of acid suppressant therapy with or without prescription)and help-seeking behavior(e.g.,consulting a primary care provider)for GERS.Simple random sampling was performed to select individuals within the target age group.In total,18156 randomly selected individuals were invited to participate.The study protocol was registered in ClinicalTrials.gov(identifier:NCT05689918).RESULTS Of the 18156 invited individuals,3214 participants(17.7%)completed the survey,of which 1572 participants(48.9%)reported GERS.Of these,904 participants(57.5%)had never consulted a primary care provider for these symptoms,of which 331 participants(36.6%)reported taking OTC acid suppressant therapy in the past six months and 100 participants(11.1%)fulfilled the screening criteria for BE and EAC according to the European Society of Gastrointestinal Endoscopy Guideline.CONCLUSION The population fulfilling the screening criteria for BE and EAC is incompletely identified,suggesting potential underutilization of medical consultation.Raising public awareness of GERS as a risk factor for EAC is needed.展开更多
BACKGROUND The correlation conclusions between self-management,frailty,and quality of life(QoL)of chronic obstructive pulmonary disease(COPD)patients are inconsistent.AIM To comprehensively assess the current status o...BACKGROUND The correlation conclusions between self-management,frailty,and quality of life(QoL)of chronic obstructive pulmonary disease(COPD)patients are inconsistent.AIM To comprehensively assess the current status of self-management,psychological cognitive impairment,and QoL in elderly patients with COPD.METHODS Convenient sampling was employed to select 312 elderly patients with COPD who were receiving treatment in the respiratory and critical care medicine department of a tertiary grade A hospital from November 2023 to February 2024.The study utilized demographic information and clinical characteristics,selfmanagement behavior,occurrence of psychological cognitive impairment,and QoL as evaluated through general information questionnaires,the COPD patient self-management scale,simple frailty scale,simple mental status scale,clinical dementia assessment scale,and the clinical COPD assessment test questionnaire.This research aims to describe the current status and correlations among selfmanagement behavior,cognitive impairment occurrence,and QoL.RESULTS The average score for self-management behavior in elderly COPD patients was 136.00(119.00,164.50),indicating a moderate level overall.There were 98 cases of cognitive impairment,accounting for 31.4%,with a mental status score of 3(2,3.75).The average QoL score was 24(19,28),indicating a low level.Additionally,there was a negative correlation between total self-management behavior score and cognitive impairment occurrence(r=-0.589,P<0.001),and QoL total score(r=-0.409,P<0.001).Cognitive impairment occurrence was positively correlated with QoL total score(r=0.345,P<0.001).Disease course and self-management behavior score were independent factors affecting the total QoL score in elderly COPD patients(P<0.05).CONCLUSION The self-management behavior of elderly patients with COPD is at a moderate level.However,the occurrence of cognitive impairment is high and significantly influenced by disease course,level of self-management,and mental status.The QoL is low,emphasizing the urgent need to intervene in the self-management behaviors of elderly COPD patients,actively reduce the occurrence of cognitive impairment,and mitigate the impact of the disease on QoL.展开更多
Background Tuberculosis(TB)is one of the top 10 causes of death in the world.Since Directly Observed Therapy(DOT)as a core strategy for the global TB control are not applicable to all types of TB patients,and self-man...Background Tuberculosis(TB)is one of the top 10 causes of death in the world.Since Directly Observed Therapy(DOT)as a core strategy for the global TB control are not applicable to all types of TB patients,and self-management of TB patients(SMTP)as a patient-centered supervision type is a supplement to DOT and can improve TB case management.However,the factors related to SMTP are complex and need more study.This study aimed at identifying the determinants of SMTP and examining the direct/indirect effects of these determinants.Methods The purposive sampling technique was used to select study sites and participants were recruited from the study sites by the consecutive sampling method.The PRECEDE model was used as the framework to analyze the determinants of SMTP.The responses of TB patients were acquired via a questionnaire survey for data collection.A Pearson correlation analysis was used to define the relationship between the predisposing,enabling,reinforcing factors with SMTP behaviors.A regression-based path analysis was used to determine the action paths of the predisposing,enabling,and reinforcing factors on SMTP behaviors.Results The predisposing(TB knowledge),enabling[health education and healthcare workers(HCWs)support],reinforcing factors(family support)had significant positive correlations with SMTP behaviors(P<0.05).The predisposing,enabling,reinforcing factors were positively correlated with each other(r=0.123‒0.918,P<0.05),except for family support and HCWs support.The predisposing factors(TB knowledge,β=0.330)and the enabling factors(HCWs support,β=0.437)had direct effects on SMTP behaviors.The enabling factors(health education and HCWs support)and the reinforcing factors(family support)had indirect effects on SMTP behaviors.Conclusions This study revealed the effects and action path of TB knowledge,health education,HCWs support,and family support on SMTP behaviors via a path analysis.Assessing patient’s needs for SMTP along with promoting effective TB health education and providing firm support from HCWs and family members are potential strategies to promote SMTP behaviors.展开更多
BACKGROUND At present,China has become the country with the largest number of individuals with diabetes mellitus(DM)in the world,with a total of approximately 140 million patients,the majority of whom have type 2 DM(T...BACKGROUND At present,China has become the country with the largest number of individuals with diabetes mellitus(DM)in the world,with a total of approximately 140 million patients,the majority of whom have type 2 DM(T2DM).Based on conven-tional nursing methods,community home care has important clinical significance in controlling blood sugar and disease progression.AIM To explore the impact of community public health nursing on treatment effect,health cognition,and self-management in patients with T2DM.METHODS One hundred patients with T2DM were selected as the research subjects.The patients were divided into either a conventional nursing group or community nursing(CN)group using the random number table method.The conventional nursing group(50 cases)received routine care,while the CN group(50 cases)received community public health care in addition to routine care as that for the conventional nursing group.The rate of excellent and good blood glucose control,fasting blood glucose before and after care,2-h postprandial blood glucose,health cognition,and self-management ability,and patient satisfaction were compared between the two groups.RESULTS The CN group had a higher rate of excellent blood sugar control than the conventional nursing group(88%vs 70%,P<0.05).Before care,there was no significant difference in fasting blood glucose or 2-h postprandial blood glucose between the two groups of patients(P>0.05).After nursing,fasting blood glucose and 2-h postprandial blood glucose were reduced to varying degrees in both groups,and both blood glucose levels in the CN group were lower than those of the conventional nursing group(P<0.05).Compared with the scores before care,the cognitive level score for diabetes and self-management ability score improved after care in both groups.The cognitive level and self-management ability of patients in the CN group were higher than those of the conventional nursing group(P<0.05).The overall satisfaction of the CN group was better than that of the conventional nursing group(98%vs 86%,P<0.05).CONCLUSION Community public health care based on conventional care of T2DM can achieve better blood sugar control,and improve patients’health cognitive level and self-management ability.展开更多
BACKGROUND Esophageal cancer(EC)is an aggressive malignancy with low survival(10%-30%).Nutritional problems are present throughout the perioperative period and are key to prognosis.Home enteral nutrition appears to im...BACKGROUND Esophageal cancer(EC)is an aggressive malignancy with low survival(10%-30%).Nutritional problems are present throughout the perioperative period and are key to prognosis.Home enteral nutrition appears to improve the nutritional status of patients with EC.Few studies have addressed the experience of patients administering their own nutritional fluids and managing their own feeding tubes at home.The aim of this study was to explore the real-life experience of self-management of feeding tubes in patients at home after EC surgery in the first 3 months after discharge following surgery.AIM To explore feeding tube self-management experience of patients at home 3 months after discharge following EC surgery.METHODS Face-to-face semi-structured interviews were conducted with 18 patients using a feeding tube at home after EC surgery.Thematic analysis of the recordings identified themes related to feeding tube self-management.RESULTS Patients expressed similar feelings about their tube management experiences concerning three contextualized themes:Self-management dilemmas,distressing experiences,and self-management facilitators.CONCLUSION There are many dilemmas and problems in self-managing feeding tubes in postoperative homebound patients with EC.Clinical staff should provide guidance to promote a positive change in self-management behavior.展开更多
Diabetes is a major public health concern worldwide. Low and middle-income countries are the most affected. Diabetes self-management can significantly reduce the burden of diabetes complications and mortality. This cr...Diabetes is a major public health concern worldwide. Low and middle-income countries are the most affected. Diabetes self-management can significantly reduce the burden of diabetes complications and mortality. This cross-sectional study was conducted at the outpatient department of a county referral hospital in Kenya, from 1st August 2022 to 30th October 2022. Patients with known type II diabetes of age ≥ 20 years visiting the hospital for routine follow-up visits were included. A 7-tem Summary of Diabetes Self-care Activities (SDSAC) Questionnaire was used to assess Diabetes self-care activities. For data entry and statistical analysis, SPSS for Windows version 27.0 was used. There were 96 (39.2%) males and 149 (60.8%) females. Most of the participants were more than 61 years, 148 (60.4%). Significant association was found between the sum scale scores of dietary activities, blood glucose testing, physical activity, foot care, and neuropathy at 95% CI and (p Conclusions: Diabetes self-management activities have an impact on microvascular complications in patients with diabetes.展开更多
Objective:The objective of this study is to explore the current situation of nurses’participant activation for self-management of low back pain,analyze its influencing factors,and provide a reference for improving th...Objective:The objective of this study is to explore the current situation of nurses’participant activation for self-management of low back pain,analyze its influencing factors,and provide a reference for improving the participant activation for self-management of low back pain.Materials and Methods:A cross-sectional study was conducted with 5,120 nurses recruited through convenience sampling from hospitals across 25 provinces and municipalities in China.Participants completed two standardized instruments:General Information Questionnaire which collected demographic characteristics and work-related factors,and the Participant Activation for Self-Management of Back Pain Questionnaire which measured activation levels across three dimensions(including self-management beliefs,self-management awareness,and knowledge related to low back pain).Results:The score of nurses’participant activation for low back pain self-management was 38.00(33.00,44.00).The results of multiple linear regression showed that nurses of different gender,age,and professional titles,whether they had administrative positions,and whether they had back pain in the past year were influencing factors of nurses’participant activation for low back pain management.Conclusion:The overall participant activation for self-management of low back pain is at a medium level.Their self-management awareness is strong,but their beliefs about management of low back pain are insufficient.Targeted intervention measures can be taken to improve their activation for management of back pain and reduce the incidence of occupational low back pain.展开更多
文摘Background: Hip osteoarthritis (HOA) causes joint destruction, resulting in hip pain, limited range-of-motion, claudication, and joint deformity. In the conservative treatment of HOA, self-management is important to manage symptoms and control disease progression. In a previous study, the researchers conducted a conceptual analysis of 43 foreign studies on self-management during conservative therapy for patients with HOA. The results revealed a definition of self-management during conservative therapy for patients with HOA. However, because that study analyzed only the foreign literature, it remains unclear whether the findings reflect the characteristics of the Japanese health-care delivery system, health-care insurance system, or the lifestyles and cultural characteristics of Japanese patients with HOA. Objective: We aimed to clarify the self-management behaviors of patients with HOA. Methods: Semi-structured interviews were conducted with five patients diagnosed with HOA, and the results were subjected to inductive qualitative analysis. Results: Six categories of self-management behaviors were extracted for patients with HOA: [active information gathering about HOA], [personalized pain and weight management, and strategies for reducing hip joint load], [reflection on living conditions with individuals and professionals, and determination for future efforts], [continuation of exercise and weight management based on personal strengths and achievements, and mutual support with others], [coexistence with HOA while managing negative feelings], and [choosing treatment methods by trusting doctors while struggling with personal needs]. Conclusion: These findings suggest the need to develop health guidance and educational programs for patients with HOA that focus on how to prevent disease progression and cope with symptoms.
基金the community of older adults who participated in this study.Ministry of Education Science and Technology Industry-University Co-operation Collaborative Education Project(230806630292310).
文摘Background:Falls are a significant public health concern among older adults,often leading to severe injuries and decreased quality of life.Fall prevention self-management behaviors are critical in reducing fall risk.However,the status and influencing factors of these behaviors among community-dwelling older adults in China remain poorly understood.This study aimed to investigate fall prevention self-management behaviors and their influencing factors among community-dwelling older adults in Fuzhou,China.Methods:From June to December 2022,we used multi-stage cluster random sampling and invited 675 community-dwelling older adults from Fujian as participants.We conducted a questionnaire survey using the general information questionnaire,Fall Prevention Self-management Behavior among Older Adults Questionnaire,Questionnaire on Knowledge,Belief,and Practice of Falls Prevention among Older Adults in Community,Modified Falls Efficacy Scale,Social Support Rating Scale,and Chinese Version of the Self-Assessment Fall Risk Scale for Older Adults.Multivariate linear regression was used to identify the factors influencing fall prevention self-management behavior among older adults.Results:The overall score of fall prevention self-management behaviors was 146.81±34.22,indicating a moderate level.Key influencing factors included education level,pre-retirement occupation,income,medication type,self-assessed physical condition,fear of falling,knowledge and practices in fall prevention,social support,and fall risk.These factors collectively explained 34.3%of the variance in self-management behaviors.Conclusion:The findings highlight the need for targeted interventions to enhance fall prevention self-management among community-dwelling older adults.Interventions should focus on improving knowledge,strengthening social support,and addressing psychological barriers such as fear of falling.This study provides valuable insights for developing community-based strategies to reduce fall risks and promote healthy aging.
基金This study was funded by Nanjing Military Region,China
文摘Objective:To investigate the association between the health locus of control and selfmanagement behaviors in patients receiving hemodialysis.Methods:Patients receiving hemodialysis in Xiamen,Fujian province,from December 2014 to March 2015 answered the Chinese version of the Multidimensional Health Locus of Control scale and the self-management behavior questionnaire.Results:The participants in this study indicated that they believed others exerted more control over their health than themselves or chance.In addition,the majority of participants had a medium to low level of self-management behaviors.Positive correlations were also observed between a participant's health locus of control and their level of selfmanagement behaviors.Internal health locus of control and external(others)health locus of control were significant predictors of self-management behaviors controlling for the effect of payment method.Conclusion:The results of this study provided evidence that there is a strong relationship between the health locus of control and self-management behaviors in hemodialysis patients.This study provides important information for medical professionals as they design strategies to educate hemodialysis patients on their health locus of control and selfmanagement behaviors.
文摘Objective:To describe the self-management(SM)behavior among persons with mild-to-moderate chronic obstructive pulmonary disease(COPD),and it examines the correlation between COPD knowledge,self-efficacy,perceived social support,and SM behavior among persons with mild-to-moderate COPD in Wenzhou,China.Methods:A simple random sampling technique was used to recruit 121 persons with mild-to-moderate COPD who visited the respiratory outpatient department of the First Affiliated Hospital of Wenzhou Medical University in Wenzhou,China.Research instruments include a demographic data questionnaire,COPD SM scale,COPD knowledge questionnaire,6-item chronic disease self-efficacy scale,and perceived social suppor t scale.Descriptive statistics and Pearson's Correlation were used for data analysis.Results:The findings show that the mean score of COPD SM scale was 2.70(SD=0.45).The Pearson correlation analysis revealed that the COPD knowledge(r=0.47,P<0.001),self-efficacy(r=0.28,P=0.001),and perceived social support(r=0.48,P<0.001)were positively correlated to the COPD SM behavior among persons with mild-to-moderate COPD in Wenzhou,China.Conclusions:The findings indicate that disease knowledge,self-efficacy,and perceived social support were related to SM behavior in persons with mild-to-moderate COPD,which provides a theoretical basis for developing SM interventions for persons with mildto-moderate COPD and improving this population's SM behavior.
文摘Objective:To determine the effects of the Self-Management Training Program on self-management behavior and blood pressure(BP)levels among elderly people with hypertension(HT).Methods:This study was based on a quasi-experimental design using sampling groups composed of elderly residents of Pathum Thani Province with HT.Simple random sampling was applied to two sampling groups,an experimental group and a control group.However,the experimental group had been on the Self-Management Training Program based on the Creer concept.The Program’s contents included small-group health-education sessions and the patients’manual,Self-Management Training Skills for Self-Management Behavior.Small group discussions were held for self-reflection,to stimulate follow-up for self-management behavior training during home visits.The Self-Management Training Program was compared with programs involving the more usual care.Data were collected using the Self-Management Behavior for Hypertension Control Questionnaire and BP assessment tests.Data were analyzed using a descriptive statistic,chi-square test,pair t-test,repeated-measures Analysis of Variance(ANOVA),and repeated-measures Analysis Covariance(ANCOVA).Results:It was found that at 13 weeks after entering the program,the experimental group demonstrated a significantly lower systolic and diastolic BP with a baseline statistical significance(P<0.005),and that at the 4th week and the 13th week,there was a decrease in BP in the experimental group.The experimental group also had above-baseline self-management behavior scores that were higher than in the control group(P<0.01).Conclusions:Results from this study show that the Self-Management Program was useful for BP control and promoted sustainable self-management behavior.
文摘Objectives:This study aimed to develop a self-management behavior questionnaire for Chinese enter-ostomy patients and examine its reliability and validity.Methods:Guided by the theory of self-management,an initial questionnaire was generated through literature review,group meetings,and two rounds of an expert consultation.Finally,the reliability and validity of the questionnaire were validated through a questionnaire survey of 200 enterostomy patients were selected from the Affiliated Hospital of Medical University from June 2016 to March 2017.Results:The content validity index was 0.80e1.00.The exploratory factor analysis yielded a five-factor(dietary behavior,psychosocial behavior,symptom management behavior,medical compliance behavior,information management behavior),consisting of 40 items.The cumulative variance contri-bution rate was 65.42%.The Cronbach’s a coefficient for the total questionnaire was 0.972,and for the five factors ranged from 0.797 to 0.939,indicating a good internal consistency.The test-retest reliability was 0.867(P<0.01).The self-management behavior questionnaire score was negatively related to the Ostomy Skin Tool score(r=-0.800,P<0.01).Conclusions:The self-management behavior questionnaire developed in this study showed good reli-ability and validity and can be used to assess the self-management behavior of Chinese enterostomy patients.
基金supported by 2016 Fujian Provincial Science and Technology Department of the Pilot Project(No.2016Y0047)
文摘Objective： The aims of this study were to investigate the status quo of self-management behaviors in stroke patients at the recovery stage and to explore its influencing factors.Methods： A total of 440 hospitalized convalescent stroke patients were recruited and investigated using the Basic Situation Questionnaire, Self-management Behavior Scale of Stroke, Stroke Prevention Knowledge Questionnaire and Social Support Rating Scale.Results： The mean self-management behavior score was （151.95±23.58）, and dimensions in descending order were as follows： dietary management, drug safety management, social function and interpersonal relationships, life management, emotion management, rehabilitation exercise management and disease management. Five regional self-management behavior scores were statistically significant, and the scores from Minnan and Minzhong of the Fujian province, China, were higher than the others. Gender, age, family income and self-management behavior were significantly correlated （P〈0.05）; educational level, stroke knowledge level, social support level and self-management behavior were positively correlated, and the difference was statistically significant （P〈0.01）. Conclusions： The overall self-management level of convalescent stroke patients should be improved to strengthen health education; focus on the educational level, which is relatively low; strengthen the social support system of patients; stimulate the enthusiasm and initiative of self-management disease patients to promote disease rehabilitation and improve the quality of life.
文摘AIM To determine the relationship between chronic kidney disease(CKD) awareness(CKD-A), self-management behaviors(CKD-SMB) knowledge, performance of CKDSMBs, health literacy(HL) and kidney function. METHODS Participants were eligible patients attending an outpatient nephrology clinic. Participants were administered: Newest Vital Sign to measure HL, CKD self-managementknowledge tool(CKD-SMKT) to assess knowledge, past performance of CKD-SMB, CKD-A. Estimated GFR(e GFR) was determined using the MDRD-4 equation. Duration of clinic participation and CKD cause were extracted from medical charts. RESULTS One-hundred-fifty patients participated in the study. e GFRs ranged from 17-152 m L/min per 1.73 m2. Majority(83%) of respondents had stage 3 or 4 CKD, low HL(63%), and were CKD aware(88%). Approximately 40%(10/25) of patients in stages 1 and 2 and 6.4%(8/125) in stages 3 and 4 were unaware of their CKD. CKD-A differed with stage(P < 0.001) but not by HL level, duration of clinic participation, or CKD cause. Majority of respondents(≥ 90%) correctly answered one or more CKD-SMKT items. Knowledge of one behavior, "controlling blood pressure" differed significantly by CKD-A. CKD-A was associated with past performance of two CKD-SMBs, "controlling blood pressure"(P = 0.02), and "keeping healthy body weight"(P = 0.01). Adjusted multivariate analyses between CKD-A and:(1) HL; and(2) CKD-SMB knowledge were nonsignificant. However, there was a significant relationship between CKD-A and kidney function after controlling for demographics, HL, and CKD-SMB(P < 0.05). CONCLUSION CKD-A is not associated with HL, or better CKD-SMBs. CKD-A is significantly associated with kidney function and substantially lower e GFR, suggesting the need for focused patient education in CKD stages 1.
文摘Background: In a rapidly aging Japanese society, the number of patients with hypertension has seen a steady increase. The basic treatments for hypertension are maintaining blood pressure through medication and preventing complications. It is important for patients with hypertension to perform self-management. This improves their lifestyle while controlling their blood pressure to prevent complications and maintain good health. Purpose: This study aimed to examine the actual self-management behavior ability of patients with hypertension and to clarify the factors involved in their self-management behavior. Methods: A total of 150 patients with hypertension were included in this study. The following data were obtained from the patients as background information: sex, age, years with disease, whether they are receiving antihypertensive agents, type of antihypertensive agent, blood test data, heart thoracic ratio, left ventricular ejection fraction, pulse wave, pulse wave velocity, and height. The levels of self-management skills of the patients were also assessed using the “Instrument to Measure the Self-care of patients with Hypertension” developed by Tsuboi et al. Results: The associations among self-management behaviors in daily life, such as diet, exercise, stress, medication, alcohol intake, and smoking, were analyzed in patients with hypertension. The subjects were classified into the following three groups: aged 65 years or below (Group A), early stage elderly individuals (Group B), and late-stage elderly individuals aged 75 years or over (Group C). The results showed that the subjects in Group C had higher self-management scores for diet, exercise, stress, medication, and drinking than the subjects in the other two groups. The scores of smoking and self-management of the subjects in Group A were high but their other self-management scores were low. All the subjects were taking between 1 to 3 types of oral antihypertensive drugs. The rate of achievement of the target blood pressure was 50% or more in all the three groups. However, the pulse wave velocity was high in all the three groups. Conclusion: The results indicate that the risk of developing disorders of the brain and cardiovascular system is high in all the three groups, owing to the high degree of arteriosclerosis. Therefore, increasing the number of nursing interventions is expected to reduce blood pressure, maintain and promote self-management behavior in daily life, and prevent the onset of complications. The results suggest that nursing interventions involving lifestyle guidance for improving the self-management skills of patients are urgently needed by patients under 65 years of age.
文摘Background: Hypertension is a lifestyle-related disease that has no subjective symptoms but could lead to severe complications. The goals of treatment for hypertension are to maintain blood pressure with medications and prevent complications. Measuring blood pressure at home regularly is critical for patients with hypertension. Purpose: This study aimed to 1) clarify the status of patients’ understanding of hypertension and self-management, 2) identify nursing practices that could support patients with hypertension in making them aware of the need for understanding hypertension, monitoring blood pressure at home, and engaging in self-management. Method: A questionnaire survey on understanding of the disease and self-management behavior was conducted among patients with hypertension who regularly visited outpatient clinics. As for data analysis, descriptive statistics were computed for patients’ attributes, clinical findings, understanding of the disease, and self-management behavior. Cross-tabulation and the chi-square test were used for each item on understanding of the disease and self-management behaviors. Results: Data were obtained from 150 participants (93 males and 57 females) with a mean age of 70 years. Patients with a higher understanding of the disease and those who were aware of the target blood pressure were more likely to engage in self-management behavior, including monitoring blood pressure at home, ensuring regular outpatient visits, and consulting with nurses or physicians. In addition, the percentage of patients who recognized the need to achieve their target blood pressure was higher among those who had a spouse and lived with their family. Discussion: Regular monitoring and recording of blood pressure at home are the most important self-management behaviors. Understanding of the disease and self-management behavior and support from the family are critical for maintaining appropriate self-management. Therefore, in cooperation with physicians, nurses should provide health education to patients and their families to enable them to perform appropriate self-management. Health expenditures increase with age, especially in those aged 65 years and over. The prevalence of hypertension increases with age;patients aged 65 years and over need to engage in self-management to maintain their target blood pressure. Nurses should provide patients with hypertension aged 65 years and over with appropriate nursing care to enable them to measure and record their blood pressure at home appropriately and regularly. Appropriate nursing care may help reduce the health expenditure. This may help reduce the health expenditure.
文摘Objectives:This study aimed to explore the preferences and influencing factors of self-management behaviors in patients with recurrent gout and provide a theoretical basis for developing targeted strategies to improve self-management preferences.Methods:A total of 10 patients with recurrent gout were recruited from the gout specialist outpatient clinic at a tertiary hospital in Shenyang,Liaoning Province,China.Semi-structured interviews were conducted with these patients,and the Kawakita Jiro(KJ)method was used to analyze the interview data.Results:After four rounds of screening by five researchers,35 codes were selected from an initial 132.After three rounds of discussion and induction,the KJ method identified seven domains of selfmanagement behavior preferences in patients with recurrent gout:1)extensive knowledge of gout,yet difficulty in distinguishing between accurate and inaccurate information;2)a passive attitude of“no pain,no management”;3)the challenge of changing entrenched daily habits;4)the optimistic but unrealistic belief of“self-delusion”;5)a tendency to seek medical attention late due to hopelessness of cure and familiarity with recurrences;6)preference for analgesics for gout recurrences while neglecting long-term urate-lowering therapy(ULT);and 7)gout-related stigma.Conclusion:The results of this study showed that the self-management behavior of patients with recurrent gout could be improved,especially in the aspects of medical seeking behavior,medication compliance,daily management and emotional management.At the same time,we found that gout stigma,difficulty in distinguishing true and false knowledge of gout and negative attitude of“ignoring pain”were significantly associated with self-management behavior.
文摘This study examined the differences and primary factors from the impact of autonomous motivation and controlled motivation on the self-management behavior of hemodialysis patients.Anonymous,self-describing questionnaires were used for research on nine different dialysis facilities of 413 people who regularly visit.From using the primary factor results of multiple regression analysis,that took autonomous motivation and controlled motivation as the dependent variable,a path diagram was created that led to each motivation.The acknowledgement of autonomy support facilitated whether it was autonomous motivation or controlled motivation(The standardized coefficient was 0.385,0.346,p<0.0001).Positive evaluation coping skills were a primary factor that promoted autonomous motivation,while trait anxiety,disorders of social activities,and lack of motivation were primary factors that promoted controlled motivation.In order to raise the autonomous motivation to promote self-management behavior in patients with hemodialysis treatment,situations that easily cause amotivation and anxiety,as well as tendencies for depression should be assessed.Also the encouragement to attain positive evaluation coping skills to support patient autonomy appears to be effective.
文摘<strong>Background:</strong> Self-management is important for post-renal transplant recipients to resolve renal dysfunction, heart failure, and post-transplant psychosocial issues, and to maintain transplant kidney function, etc. However, because recipients may be unable to adequately self-manage, healthcare providers need to provide self-management support for recipients to improve their skills and confidence in managing their disease. However, it is difficult to comprehensively assess the self-management behaviors in a busy outpatient support setting. Furthermore, since there are no uniform standards for assessment, it is based on the experience and abilities of medical personnel. Therefore, self-management behavior of post-renal transplant recipients is not sufficiently evaluated. <strong>Objective:</strong> This study aimed to evaluate content validity of a tool that can assess self-management behaviors of adult post-renal transplant recipients, consisting of consensus components from experts familiar with the follow-up of adult post-renal transplant recipients. <strong>Methods:</strong> A three-round modified Delphi method was used to assess the self-management behaviors of adult post-renal transplant recipients by a panel of experts consisting of certified transplant recipient coordinators, physicians, outpatient nurses, and researchers familiar with the follow-up of post-renal transplant recipients. Regarding management behaviors of adult post-renal transplant recipients, the experts rated the appropriateness and validity of each item using a Likert scale. Consensus ratings from the experts were made by calculating the median, interquartile range, and interquartile range percentage. In the third round, an item-level content validity index was calculated to assess content validity. <strong>Conclusions: </strong>The 41-item self-management behavior scale for kidney transplant recipients assessed self-management behaviors in five domains: medication, exercise, fluids and diet, disease and symptom prevention and management, and psychosocial adjustment. The content validity of this tool was confirmed, and it can be used to more easily assess the recipients’ self-management behaviors in the post-renal transplant follow-up. This tool can potentially contribute to the maintenance of transplant kidney function and high QOL in recipients.
文摘BACKGROUND Despite societal guidelines recommending targeted screening for Barrett’s esophagus(BE)and esophageal adenocarcinoma(EAC)in individuals with gastroesophageal reflux symptoms(GERS),screening adherence is suboptimal.Current screening approaches fail to identify individuals not seeking medical consultation for GERS or whose GERS are managed with‘over-the-counter’(OTC)acid suppressant therapies.AIM To assess patients’self-management and help-seeking behavior for GERS.METHODS This cross-sectional study collected data from the Dutch general population aged 18-75 years between January and April 2023 using a web-based survey.The survey included questions regarding self-management(e.g.,use of acid suppressant therapy with or without prescription)and help-seeking behavior(e.g.,consulting a primary care provider)for GERS.Simple random sampling was performed to select individuals within the target age group.In total,18156 randomly selected individuals were invited to participate.The study protocol was registered in ClinicalTrials.gov(identifier:NCT05689918).RESULTS Of the 18156 invited individuals,3214 participants(17.7%)completed the survey,of which 1572 participants(48.9%)reported GERS.Of these,904 participants(57.5%)had never consulted a primary care provider for these symptoms,of which 331 participants(36.6%)reported taking OTC acid suppressant therapy in the past six months and 100 participants(11.1%)fulfilled the screening criteria for BE and EAC according to the European Society of Gastrointestinal Endoscopy Guideline.CONCLUSION The population fulfilling the screening criteria for BE and EAC is incompletely identified,suggesting potential underutilization of medical consultation.Raising public awareness of GERS as a risk factor for EAC is needed.
文摘BACKGROUND The correlation conclusions between self-management,frailty,and quality of life(QoL)of chronic obstructive pulmonary disease(COPD)patients are inconsistent.AIM To comprehensively assess the current status of self-management,psychological cognitive impairment,and QoL in elderly patients with COPD.METHODS Convenient sampling was employed to select 312 elderly patients with COPD who were receiving treatment in the respiratory and critical care medicine department of a tertiary grade A hospital from November 2023 to February 2024.The study utilized demographic information and clinical characteristics,selfmanagement behavior,occurrence of psychological cognitive impairment,and QoL as evaluated through general information questionnaires,the COPD patient self-management scale,simple frailty scale,simple mental status scale,clinical dementia assessment scale,and the clinical COPD assessment test questionnaire.This research aims to describe the current status and correlations among selfmanagement behavior,cognitive impairment occurrence,and QoL.RESULTS The average score for self-management behavior in elderly COPD patients was 136.00(119.00,164.50),indicating a moderate level overall.There were 98 cases of cognitive impairment,accounting for 31.4%,with a mental status score of 3(2,3.75).The average QoL score was 24(19,28),indicating a low level.Additionally,there was a negative correlation between total self-management behavior score and cognitive impairment occurrence(r=-0.589,P<0.001),and QoL total score(r=-0.409,P<0.001).Cognitive impairment occurrence was positively correlated with QoL total score(r=0.345,P<0.001).Disease course and self-management behavior score were independent factors affecting the total QoL score in elderly COPD patients(P<0.05).CONCLUSION The self-management behavior of elderly patients with COPD is at a moderate level.However,the occurrence of cognitive impairment is high and significantly influenced by disease course,level of self-management,and mental status.The QoL is low,emphasizing the urgent need to intervene in the self-management behaviors of elderly COPD patients,actively reduce the occurrence of cognitive impairment,and mitigate the impact of the disease on QoL.
文摘Background Tuberculosis(TB)is one of the top 10 causes of death in the world.Since Directly Observed Therapy(DOT)as a core strategy for the global TB control are not applicable to all types of TB patients,and self-management of TB patients(SMTP)as a patient-centered supervision type is a supplement to DOT and can improve TB case management.However,the factors related to SMTP are complex and need more study.This study aimed at identifying the determinants of SMTP and examining the direct/indirect effects of these determinants.Methods The purposive sampling technique was used to select study sites and participants were recruited from the study sites by the consecutive sampling method.The PRECEDE model was used as the framework to analyze the determinants of SMTP.The responses of TB patients were acquired via a questionnaire survey for data collection.A Pearson correlation analysis was used to define the relationship between the predisposing,enabling,reinforcing factors with SMTP behaviors.A regression-based path analysis was used to determine the action paths of the predisposing,enabling,and reinforcing factors on SMTP behaviors.Results The predisposing(TB knowledge),enabling[health education and healthcare workers(HCWs)support],reinforcing factors(family support)had significant positive correlations with SMTP behaviors(P<0.05).The predisposing,enabling,reinforcing factors were positively correlated with each other(r=0.123‒0.918,P<0.05),except for family support and HCWs support.The predisposing factors(TB knowledge,β=0.330)and the enabling factors(HCWs support,β=0.437)had direct effects on SMTP behaviors.The enabling factors(health education and HCWs support)and the reinforcing factors(family support)had indirect effects on SMTP behaviors.Conclusions This study revealed the effects and action path of TB knowledge,health education,HCWs support,and family support on SMTP behaviors via a path analysis.Assessing patient’s needs for SMTP along with promoting effective TB health education and providing firm support from HCWs and family members are potential strategies to promote SMTP behaviors.
文摘BACKGROUND At present,China has become the country with the largest number of individuals with diabetes mellitus(DM)in the world,with a total of approximately 140 million patients,the majority of whom have type 2 DM(T2DM).Based on conven-tional nursing methods,community home care has important clinical significance in controlling blood sugar and disease progression.AIM To explore the impact of community public health nursing on treatment effect,health cognition,and self-management in patients with T2DM.METHODS One hundred patients with T2DM were selected as the research subjects.The patients were divided into either a conventional nursing group or community nursing(CN)group using the random number table method.The conventional nursing group(50 cases)received routine care,while the CN group(50 cases)received community public health care in addition to routine care as that for the conventional nursing group.The rate of excellent and good blood glucose control,fasting blood glucose before and after care,2-h postprandial blood glucose,health cognition,and self-management ability,and patient satisfaction were compared between the two groups.RESULTS The CN group had a higher rate of excellent blood sugar control than the conventional nursing group(88%vs 70%,P<0.05).Before care,there was no significant difference in fasting blood glucose or 2-h postprandial blood glucose between the two groups of patients(P>0.05).After nursing,fasting blood glucose and 2-h postprandial blood glucose were reduced to varying degrees in both groups,and both blood glucose levels in the CN group were lower than those of the conventional nursing group(P<0.05).Compared with the scores before care,the cognitive level score for diabetes and self-management ability score improved after care in both groups.The cognitive level and self-management ability of patients in the CN group were higher than those of the conventional nursing group(P<0.05).The overall satisfaction of the CN group was better than that of the conventional nursing group(98%vs 86%,P<0.05).CONCLUSION Community public health care based on conventional care of T2DM can achieve better blood sugar control,and improve patients’health cognitive level and self-management ability.
文摘BACKGROUND Esophageal cancer(EC)is an aggressive malignancy with low survival(10%-30%).Nutritional problems are present throughout the perioperative period and are key to prognosis.Home enteral nutrition appears to improve the nutritional status of patients with EC.Few studies have addressed the experience of patients administering their own nutritional fluids and managing their own feeding tubes at home.The aim of this study was to explore the real-life experience of self-management of feeding tubes in patients at home after EC surgery in the first 3 months after discharge following surgery.AIM To explore feeding tube self-management experience of patients at home 3 months after discharge following EC surgery.METHODS Face-to-face semi-structured interviews were conducted with 18 patients using a feeding tube at home after EC surgery.Thematic analysis of the recordings identified themes related to feeding tube self-management.RESULTS Patients expressed similar feelings about their tube management experiences concerning three contextualized themes:Self-management dilemmas,distressing experiences,and self-management facilitators.CONCLUSION There are many dilemmas and problems in self-managing feeding tubes in postoperative homebound patients with EC.Clinical staff should provide guidance to promote a positive change in self-management behavior.
文摘Diabetes is a major public health concern worldwide. Low and middle-income countries are the most affected. Diabetes self-management can significantly reduce the burden of diabetes complications and mortality. This cross-sectional study was conducted at the outpatient department of a county referral hospital in Kenya, from 1st August 2022 to 30th October 2022. Patients with known type II diabetes of age ≥ 20 years visiting the hospital for routine follow-up visits were included. A 7-tem Summary of Diabetes Self-care Activities (SDSAC) Questionnaire was used to assess Diabetes self-care activities. For data entry and statistical analysis, SPSS for Windows version 27.0 was used. There were 96 (39.2%) males and 149 (60.8%) females. Most of the participants were more than 61 years, 148 (60.4%). Significant association was found between the sum scale scores of dietary activities, blood glucose testing, physical activity, foot care, and neuropathy at 95% CI and (p Conclusions: Diabetes self-management activities have an impact on microvascular complications in patients with diabetes.
文摘Objective:The objective of this study is to explore the current situation of nurses’participant activation for self-management of low back pain,analyze its influencing factors,and provide a reference for improving the participant activation for self-management of low back pain.Materials and Methods:A cross-sectional study was conducted with 5,120 nurses recruited through convenience sampling from hospitals across 25 provinces and municipalities in China.Participants completed two standardized instruments:General Information Questionnaire which collected demographic characteristics and work-related factors,and the Participant Activation for Self-Management of Back Pain Questionnaire which measured activation levels across three dimensions(including self-management beliefs,self-management awareness,and knowledge related to low back pain).Results:The score of nurses’participant activation for low back pain self-management was 38.00(33.00,44.00).The results of multiple linear regression showed that nurses of different gender,age,and professional titles,whether they had administrative positions,and whether they had back pain in the past year were influencing factors of nurses’participant activation for low back pain management.Conclusion:The overall participant activation for self-management of low back pain is at a medium level.Their self-management awareness is strong,but their beliefs about management of low back pain are insufficient.Targeted intervention measures can be taken to improve their activation for management of back pain and reduce the incidence of occupational low back pain.
