Appraisal Of Self-care Agency Research Articles

Self-Care and Sense of Coherence: A Salutogenic Model for Health and Care in Nursing Education.

Background: Effective advocacy on self-care and the enhancement of a sense of coherence among nurses don’t only benefit control over one’s health and personal performance, but it may have a direct impact on clinical care and on the entire healing system. In this regard, nursing curricula grounded on a salutogenic model of health (SMH) operate with strategies to engage students in self-care and contribute to improving their mental health and wellbeing. The aim of this study was to explore the relationships between self-care agency and a sense of coherence as dependent variables and the age and self-reported academic performance as independent variables in nursing assistant students. Methods: For this cross-sectional study, data were collected from a full sample of 921 Certified Nursing Assistant (CNA) Spanish students. A self-administered questionnaire, including sociodemographic variables, the ‘appraisal of self-care agency’ (ASA), and the ‘sense of coherence’ (SOC) constructs, was administered. Results: Older participants presented significantly stronger values of both constructs. Apart from a significant and positive correlation between ASAS and SOC, ANOVA analyses indicate significant differences in terms of academic performance according to different ASAS and SOC degrees. Conclusions: The findings of this study endorse the assumption that there is a consistent relationship between ASA and SOC constructs that might, indeed, have a potential effect on students’ academic performance. In practical terms, it seems relevant to try to recognise the students’ self-care agency and the sense of coherence as forceful predictive variables of mental health and wellbeing, in addition to academic success as a strength implied in the future career achievement.

Supporting health literacy using an interactive app for symptom management during radiotherapy for prostate cancer

ObjectivePatients’ ability to self-monitor symptoms and engage in self-care activities is dependent upon their level of health literacy. Health literacy and self-care ability was compared in men with prostate cancer undergoing radiotherapy that used an app for symptom management with a control group. MethodsIncluded were an intervention group (n = 66), who used an app for symptom reporting and support for self-care, and a control group (n = 64). Outcomes were Functional Health Literacy, Communicative and Critical Health Literacy and Appraisal of Self-Care Agency (ASA-A). ResultsThe intervention group had improved regarding “ability to select information needed from a variety of information sources” (p = .020), “ability to determine the information credible” (p = .041), and “being able to plan and decide what to do to improve health” (p = .004). No inter-group difference was found for ASA-A. ConclusionsWith the support of an app for reporting and managing symptoms, important advanced health literacy skills of selecting, determining, and judging information credible may improve. Practice implicationsPatients undergoing treatment for prostate cancer may benefit from an individualized approach, such as an app, for communication with health care providers and as a source of health information to make decisions about their own health.

Relation of socio-economic status to the independent application of self-care in older persons of South Africa

Background: Many older persons in South Africa (SA) are affected by a poor socio-economic status, leading to an increase in the use of the public healthcare sector. However, the public healthcare sector is burdened by high volumes of patients and long waiting periods. As a result, professional nurses in primary healthcare (PHC) facilities are not able to spend enough time on proper physical examinations and assessment of needs, including health education and support to older persons to help them apply independent self-care.Aim: To determine if the socio-economic status of older persons affects their ability to apply self-care independently without support from professional nurses in the PHC facility.Design: Quantitative, descriptive research design.Methods: Older persons (N = 198; n = 192 respondents) were asked to complete the Appraisal of Self-care Agency (ASA-A) and Exercise of Self-care Agency (ESCA) questionnaires. Seven self-care deficits were identified through deductive logic after analysis of the two questionnaires. These seven self-care deficits were compared to the socio economic status of the same sample.Results: Seven self-care deficits were identified after analysis of the ASA-A and ESCA questionnaires. One self-care deficit was found to have a relationship with the socioeconomic status of the older persons.Conclusions: Low literacy levels of older persons with a low socio-economic status affect their ability to apply self-care independently without the support from a professional nurse in the PHC facility. Data analysis of the ASA-A and ESCA revealed that these older persons suffer from a “lack of knowledge and ability to acquire knowledge with regard to self-care” which had a relationship with the socio-economic status of older persons with specific reference to low literacy levels and poverty. Implications for practice: More attention should be given to older persons with a low socioeconomic status as their ability to apply self-care independently without the support from a professional nurse is limited. This would lead to less frequent visits to PHC facilities by older persons for minor ailments, decrease healthcare costs, relieve overcrowding in PHC facilities and prevent possible unintentional self-neglect.

Guidelines to facilitate self-care among older persons in South Africa

Background: The number of older persons is growing at an alarming rate, yet the South African healthcare sector is not giving this issue the required attention. Moreover, the healthcare sector serves four-fifths of the country's population and primary healthcare (PHC) facilities are overcrowded, and thus professional nurses are prevented from providing sufficient self-care health education to older persons.Aim: To develop guidelines for the three role players — the public health sector, professional nurse and older person — to facilitate self-care among older persons in South Africa.Design: Quantitative, descriptive, explorative and contextual research design.Methods: A literature review followed by a self-care assessment of a sample of older persons using the Appraisal of Self-care Agency (ASA-A) and Exercise of Self-care Agency (ESCA) questionnaires which led to the identification of conclusions and self-care deficits.Results: Based on Menon's psychological health empowerment model, and from the conclusions and self-care deficits, nine self-care guidelines were developed for the public health sector, professional nurses and older persons.Conclusion: This is the first systematic development of guidelines to facilitate self-care among older persons in South Africa.Implications for practice: The implementation of the self-care guidelines by the public health sector, professional nurses and older persons will improve the healthcare of older persons at home which will in turn improve their quality of life, reduce unintentional self-neglect, as well as assist in alleviating overcrowding in clinics because unnecessary visits to the clinic will drop.

Relation of socio-economic status to the independent application of self-care in older persons of South Africa

BackgroundMany older persons in South Africa (SA) are affected by a poor socio-economic status, leading to an increase in the use of the public healthcare sector. However, the public healthcare sector is burdened by high volumes of patients and long waiting periods. As a result, professional nurses in primary healthcare (PHC) facilities are not able to spend enough time on proper physical examinations and assessment of needs, including health education and support to older persons to help them apply independent self-care. AimTo determine if the socio-economic status of older persons affects their ability to apply self-care independently without support from professional nurses in the PHC facility. DesignQuantitative, descriptive research design. MethodsOlder persons (N = 198; n = 192 respondents) were asked to complete the Appraisal of Self-care Agency (ASA-A) and Exercise of Self-care Agency (ESCA) questionnaires. Seven self-care deficits were identified through deductive logic after analysis of the two questionnaires. These seven self-care deficits were compared to the socio economic status of the same sample. ResultsSeven self-care deficits were identified after analysis of the ASA-A and ESCA questionnaires. One self-care deficit was found to have a relationship with the socio-economic status of the older persons. ConclusionsLow literacy levels of older persons with a low socio-economic status affect their ability to apply self-care independently without the support from a professional nurse in the PHC facility. Data analysis of the ASA-A and ESCA revealed that these older persons suffer from a “lack of knowledge and ability to acquire knowledge with regard to self-care” which had a relationship with the socio-economic status of older persons with specific reference to low literacy levels and poverty. Implications for practiceMore attention should be given to older persons with a low socio-economic status as their ability to apply self-care independently without the support from a professional nurse is limited. This would lead to less frequent visits to PHC facilities by older persons for minor ailments, decrease healthcare costs, relieve overcrowding in PHC facilities and prevent possible unintentional self-neglect.

Reliability and validity of Chinese version of the appraisal of Self-Care Agency Scale-Revised in the elderly hospitalized patients

Objective To explore the reliability and validity of the Chinese version of Self-Care Agency Scale-Revised (ASAS-R-C) in application of elderly hospitalized patients. Methods Totally 420 elderly inpatients were recruited from two tertiary first-class hospital in Jinzhou, Liaoning province and were investigated using ASAS-R-C. SPSS 17.0 and AMOS 17.0 software were used to analyze the reliability and validity of the scale. Results The three-factor 15-item ASAS-R-C had a Cronbach's alpha (α) of 0.78 and the retest reliability was 0.83. The content validity index (CVI) was 0.97, χ2/df=2.34, root mean square residual (RMR)=0.02, root-mean-square error of approximation (RMSEA)=0.07, goodness-offit index (GFI)=0.93, adjusted goodness-of-fit indes (AGFI)=0.91, Tacker-Lewis index (TLI)=0.93, incremental fit index (IFI)=0.92, comparative fit index (CFI)=0.94, parsimonious goodness-of-fit index (PGFI)=0.65, the ASAS-R-C had a good fit. Conclusions The ASAS-R-C is a short, reliable and valid instrument to measure self-care ability among the old inpatients, and further study is needed before being widely used. Key words: Self care; Inpatients; Scale; Reliability; Validity

Guidelines to facilitate self-care among older persons in South Africa

BackgroundThe number of older persons is growing at an alarming rate, yet the South African healthcare sector is not giving this issue the required attention. Moreover, the healthcare sector serves four-fifths of the country's population and primary healthcare (PHC) facilities are overcrowded, and thus professional nurses are prevented from providing sufficient self-care health education to older persons. AimTo develop guidelines for the three role players – the public health sector, professional nurse and older person – to facilitate self-care among older persons in South Africa. DesignQuantitative, descriptive, explorative and contextual research design. MethodsA literature review followed by a self-care assessment of a sample of older persons using the Appraisal of Self-care Agency (ASA-A) and Exercise of Self-care Agency (ESCA) questionnaires which led to the identification of conclusions and self-care deficits. ResultsBased on Menon's psychological health empowerment model, and from the conclusions and self-care deficits, nine self-care guidelines were developed for the public health sector, professional nurses and older persons. ConclusionThis is the first systematic development of guidelines to facilitate self-care among older persons in South Africa. Implications for practiceThe implementation of the self-care guidelines by the public health sector, professional nurses and older persons will improve the healthcare of older persons at home which will in turn improve their quality of life, reduce unintentional self-neglect, as well as assist in alleviating overcrowding in clinics because unnecessary visits to the clinic will drop.

Agencia de Autocuidado y Adherencia al Tratamiento en Personas con Factores de Riesgo Cardiovascular

Determining the relationship between self-care agency and adherence to pharmacological and non-pharmacological treatment in patients having cardiovascular risk factors at the Tunjuelito hospital in Bogota. This study involved a descriptive and correlational design which evaluated self-care agency ability and adherence to treatment in a random sample of 201 people having the following cardiovascular risk factors: being obese, having a sedentary lifestyle, arterial hypertension and diabetes mellitus. The patients being studied were attending Tunjuelito hospital's chronic-patient programme. Appraisal of self-care agency (ASA) scale and a questionnaire for evaluating behaviour regarding adherence to pharmacological and non-pharmacological treatment from the NOC taxonomy were carried out in the research. 62.6 % of the people having cardiovascular risk factors had regular self-care agency ability, whilst 77 % presented good adherence to pharmacological and nonpharmacological treatment. Spearman's coefficient revealed a 0.413 correlation between self-care agency ability and adherence to pharmacological and non-pharmacological treatment, indicating moderate and positive correlation. Self-care agency involves an individual's active and tacit participation in discerning, decision-making and taking self-care action for maintaining and improving her/his health (i.e. adhering to prescribed treatment).

Contextualising the Appraisal of Self-care Agency Scale in Hong Kong

Published reports on the use of the Appraisal of Self-care Agency (ASA) Scale among Chinese people are scarce, the procedure of testing the ASA Scale is thus necessary before it is used clinically on Chinese population. The objective of this study was to test the validity and reliability of the ASA Scale on the Chinese population. Qualitative and quantitative approaches were adopted in testing the Scale. A panel of 4 experts was invited to examine the content of the Scale and 128 elderly people from 3 elderly centers in Hong Kong were employed to examine its construct validity. Item analysis was conducted using Cronbach’s Alpha coefficient to examine the reliability of the Scale. Content validity index of 0.88 was achieved resulting from the assessment of the 4 experts. Seven factors were extracted from the factor analysis representing approximately 70% of variance. The reliability coefficient for the entire Scale was 0.72. It was evident that the ASA Scale was a valid and reliable research instrument that can be used in the Chinese communities.

The Effect of Item Observability, Clarity and Wording on Patient/Nurse Ratings when using the ASA Scale

Many studies show discrepancies between patients' and professionals' ratings on the same questionnaire regarding the patient's health. A relevant question is whether the differences in ratings reflect real differences between patients and professionals or whether they are caused by characteristics of the instrument. In this study, we address the latter option by examining the effects of 3 item characteristics (item wording, observability and clarity) on the degree of patient/nurse discrepancies in ratings of the items of the Appraisal of Self-care Agency (ASA) scale. Secondary analysis on 252 patient/nurse ratings showed that item wording (positively and negatively formulated items), and the observability of the items have a significant effect on the mean absolute difference score. No effect was found for clarity. These results were generally confirmed by subgroup analyses.

Self-care agency in two groups of pregnant women.

Self-care agency, a multidimensional concept in Orem's self-care deficit nursing theory, includes motivation, decision-making, energy, and knowledge necessary to perform self-care actions. Basic conditioning factors affect individuals' development and exercise of self-care agency. Secondary analysis of Appraisal of Self-Care Agency (ASA) scores in two groups of pregnant women, (1) a childbirth education group (n = 119) and (2) a clinic group (n = 127) was completed. Group 2 had significantly higher ASA scores. Several basic conditioning factors influenced ASA scores. Results offer implications for Orem's theory and maternity nursing practice.

Muscle weakness is related to utilization of health care resources in COPD patients.

The factors determining utilization of health care resources in patients with chronic obstructive pulmonary disease (COPD) are poorly understood. In order to obtain insight into these factors, we studied the utilization of health care resources in 57 stable COPD patients with a forced expiratory volume in one second (FEV1) of 36 +/- 9% predicted. Patients were divided into two groups: admitted at least twice in the last year (high medical consumption; n = 23) or not admitted in the last year (low medical consumption; n = 34). Other variables related to utilization of health care resources studied were; the number of hospital days; the number of out-patient visits to a pulmonary department in the last year; and the average daily dose (ADD) of corticosteroids taken in the last 6 months. The actual cost of utilization of health care resources, however, was not studied. In addition, pulmonary function, serum electrolytes, blood gas values, 6 min walking distance, respiratory and peripheral muscle force, and appraisal of self-care agency (ASA score) were studied. Pulmonary function, serum electrolytes, blood gas values, ASA score and walking distance were not different between the two groups (e.g. FEV1 36 +/- 8 vs 36 +/- 10% pred). Respiratory muscle forces tended to be lower in the high medical consumption group, this tendency almost reaching statistical significance for maximal expiratory pressure (PE,max) (p = 0.08). Peripheral muscle force, however, was clearly reduced in the high medical consumption group (quadriceps force 63 +/- 20 vs 82 +/- 26% pred; p < 0.05). The number of admissions, the number of hospital days, the number of out-patient visits, and ADD were interrelated and also related to ventilatory and peripheral muscle force (r -0.18 to -0.38). This relationship was statistically significant for PE,max, whilst a similar tendency was present for maximal inspiratory pressure (PI,max). In stepwise multiple regression analysis, only quadriceps force was a significant determinant of utilization of health care services. We conclude that utilization of health care services in patients with chronic obstructive pulmonary disease is related to ventilatory and peripheral muscle force. Whether or not reduced muscle force is simply an expression of disease severity remains to be determined.

A Swedish version of the appraisal of Self-Care Agency (ASA) scale.

The "Appraisal of Self-care Agency" scale (the ASA scale) is designed to measure self-care agency in accordance with Orem's self-care deficit theory of nursing. The aim of this study was to obtain a reliable Swedish version of the ASA scale by measuring the internal consistency. ASA-A for self-appraisal and ASA-B for appraisal of another were tested with a convenience sample of 52 elderly in-patients and 53 caregivers in six geriatric care units. Cronbach's alpha reliability coefficient was 0.59 for the ASA-A scores, 0.77 for ASA-B scores obtained by caregivers comprising different professions, and 0.87 for scores obtained by registered nurses. Further testing of both validity and reliability is needed if this version of the scale is to be used in nursing research and practice.

Cross-cultural testing of the “appraisal of self-care agency: ASA scale” in Norway

The purpose of this study was to test the discriminant validity and interrater reliability of an instrument that measures aspects of self-care agency using Norwegian populations. The ASA scale forms A and B, which had been tested in the Netherlands previously, were translated into Norwegian and administered to two groups of elderly subjects and to a sample of geriatric nurses and nursing assistants in Norway. The subjects, one group from two geriatric rehabilitation units, and another from those living independently who were attending activity centres, completed the ASA-A scale. The nurses filled out the ASA-B scale. The results were supportive of the validity and reliability. Discriminant validity of the ASA scales was demonstrated.