Chronic Illness Resources Survey Research Articles

Telenursing needs and influencing factors in patients with type 2 diabetes mellitus: A cross-sectional study.

This study aimed to determine the relationship between the demand for telenursing and the chronic illness resources available to patients with type 2 diabetes mellitus (T2DM), as well as the factors that affect this requirement. Cross-sectional. This study included 586 participants with T2DM. A telenursing needs questionnaire developed by the research team was used to assess the telenursing needs of patients with T2DM, and the Chinese version of the Chronic Illness Resources Survey was used to assess the participants' community chronic disease resources. A one-way ANOVA and multiple regression analysis were used to determine the factors influencing the demand for telenursing and to estimate the relationship between chronic illness resources and the need for telenursing. The STROBE checklist was followed. The patients' telenursing needs, ranked from high to low, are as follows: individualized skills and safety; basic disease care; psychological and spiritual needs; respect and social support; and high-level health management. The chronic disease resource score was 3.47 ± .02, which suggested that patients with T2DM have relatively rich disease resources. Multiple regression analyses showed that resources for chronic diseases, the course of diabetes and complications, family income and other chronic diseases accounted for 79.6% of the variance in T2DM patients' telenursing needs. The telenursing needs of patients with T2DM are prominent, and primarily focus on basic nursing needs for the disease. To some extent, chronic disease resources affect the telenursing needs of patients with T2DM. It is crucial to pay attention to research on telenursing for T2DM patients from the patients' perspective. Enhancing resources for chronic diseases may help meet the telenursing needs of T2DM patients. Parents and diabetes management specialists participated in designing the telenursing needs questionnaire.

Chronic Disease Management Behaviours among Malaysian Low-Income Workers: A Descriptive Study

Chronic disease is a global issue and is a growing concern in the world, including Malaysia. It is one of the most common causes of decreased quality of life, disability, and mortality [1]. Moreover, it has become a common problem in the community, especially among low-income households in Malaysia. Some evidence demonstrates that health problems associated with low-income workers are obesity, high body mass index (BMI), waist circumference (WC), cardiovascular disease, hypertension, diabetes, kidney disease, coronary heart disease and cancer [2-12]. Prevention is better than cure; therefore, chronic disease management behaviours play a pivotal role dealing with the diseases and improving quality of life. Given the above scenario, it is crucial to understand chronic disease management behaviours. This study aims to assess the level of chronic disease management behaviours among low-income workers in Malaysia. This cross-sectional study was conducted among 280 support staff in the selected ministries in Putrajaya, Malaysia. The sampling technique was random cluster sampling, and the data was collected via online platforms from July 2021 to November 2021. Respondents received a questionnaire comprising two sections: (1) Sociodemographic data, (2) Self-management disease by the Chronic Illness Resources Survey (CRIS). Socio-demographic data included gender, age, ethnicity, level of education, marital status, and total monthly household income. Chronic Illness Resources Survey (CRIS) adapted from (13), which requires the respondents to rate their self-management disease from (1) Not at all to (5) A great deal consists of eight items. The items were measured on health care, planning and disease management goals. Descriptive statistics were used to analyse the data using IBM SPSS version 26.0. The quantitative data were analysed descriptively for frequency, percentages, mean and standard deviation. Most of the respondents were females (73.6%), Malay (95.0%), married (72.5%), aged between 30 to 39 years old (61.8%), had monthly household incomes ranging from RM 2501 – RM3000 (25.0%) and had educational levels of STPM/ Matriculation/ Diploma (43.6%). Table 2 indicates that more than half of the respondents (53.2%) had a high level of chronic disease management behaviours. This finding indicates that most respondents had good non-communicable disease management behaviours (Mean =3.73, SD =0.769). Table 3 shows that respondents had a higher score for items such as ‘I use prayer/ worship or meditation in managing the disease’, ‘I spend time taking care of my health and doing the things I enjoy’, ‘Chronic disease behaviours management is important to me in managing disease’ and ‘I focus on the things I do well to manage the disease’. Whereas the moderate score is ‘I reward myself for managing illness’, ‘I share with others about disease management’, ‘I evaluate or think about my accomplishments in achieving goals for disease management” and I arrange the schedule so that it is easy to manage the disease’. From these data, it is clear the respondents taking care of their health.
 
 It can be concluded that most respondents had good non-communicable disease management behaviours. The reason for these findings may be due to the current health issues about non-communicable diseases and communicable diseases, leading them to possibly adopting a new normative lifestyle in daily life. While their chronic disease management behaviours are good, they still need to be improved. Therefore, it is important to continuously apply chronic disease management behaviours in daily life for improving health. This step will ensure longer life expectancy and better quality of life. Besides, the government should continue their efforts in raising awareness on health management among the community, especially among the low-income in Malaysia. The study has contributed additional knowledge to the current literature about chronic disease management behaviours. This finding showed that respondents had good non-communicable disease management behaviours. The reason for these findings may be due to the current health issues about non-communicable diseases and communicable diseases have led to them possibly adopting a new normative lifestyle in daily life. Nonetheless, chronic disease management behaviours are good, but they still need to be improved. Therefore, it is important to continuously apply chronic disease management behaviour in daily life for improving health. This will ensure longer life expectancy as well as better quality of life. Besides that, the government should continue their efforts in raising awareness on health management among the community, especially low-income in Malaysia.

Blood Pressure Control and Its Determinants among Patients with Non-Dialysis Chronic Kidney Disease in Myanmar

Background: Controlling blood pressure is critical for patients with non-dialysis chronic kidney disease to prevent the rapid progression to end-stage renal disease and sudden cardiac death. However, only a limited number of these patients achieve the blood pressure target. No previous study has been observed to evaluate the status of blood pressure control and its determinants among Myanmar patients with non-dialysis chronic kidney disease.Purpose: This study aimed to identify the rate of blood pressure control and its determinants among patients with non-dialysis chronic kidney disease in Myanmar.Methods: A total of 150 patients with non-dialysis chronic kidney disease attending the clinics at a tertiary hospital in Myanmar participated in this cross-sectional, correlational predictive study. They were recruited by a convenience sampling method. Data were collected by using Sodium Consumption Behavior Questionnaire, Family-Friends Support Subscale and Doctor-Health Care Team Support Subscale of Chronic Illness Resources Survey, demographic and clinical characteristics data form, and by measuring blood pressure against the target level of less than 130/80 mmHg. Descriptive statistics, Chi-square, Fisher’s exact test, and binary logistic regression analysis were performed.Results: Only 44% of the participants had their blood pressure controlled. Overweight (OR=0.170, 95% CI: 0.058-0.495), obese (OR=0.071, 95% CI: 0.017-0.305), and chronic kidney disease stage 5 (OR=0.070, 95% CI: 0.020-0.244) were the determinants associated with poorly controlled blood pressure. Low sodium consumption behavior (OR=9.065, 95% CI: 3.251-25.277) and high family support (OR=7.799, 95% CI: 2.738-22.215) were the determinants associated with well-controlled blood pressure.Conclusion: The blood pressure control rate in Myanmar patients with non-dialysis chronic kidney disease was suboptimal. Determinant findings serve as an input to endorse family-based lifestyle modification interventions such as weight control and low sodium dietary for optimizing blood pressure control. Further investigation of other determinants and of lifestyle intervention programs is warranted.

Determining the Predictors of Self-Management Behaviors in Patients With Type 2 Diabetes: An Application of Socio-Ecological Approach.

BackgroundType 2 diabetes complications are responsible for 2% of hospital emergency visits. Self-management practices are one of the most essential approaches to control type 2 diabetes. The goal of this study was to use an ecological approach to investigate the predictors of self-management behaviors in diabetes patients referred to the emergency department in Ardabil in 2020.MethodsIn this cross-sectional study, 273 individuals with type 2 diabetes who were sent to the emergency department of Imam Khomeini Educational and Medical Center in Ardabil were included using the available sample method. Demographic information questionnaires, including the Diabetes Distress Screening Tool (DDS2), General Diabetes Knowledge (DKT2), Diabetes Empowerment Questionnaire (DES-SF), Patient Health Questionnaire 9 (PHQ 9), Beliefs to Treatment Effectiveness Scale (BTES), Diabetes Self-Efficacy Scale (DSES), Chronic Illness Resources Survey (CIRS), Situational Effects Questionnaire, and Diabetes self-management support (DSMS), were all used to collect data. The independent t-test, one-way ANOVA, Pearson correlation coefficient, and multiple regression were used to analyze the data.ResultsThe results of the study showed that in the framework of ecological approach, predictors of self-management behaviors at the four levels are as follows: at the individual level—gender (p = 0.025), education (p = 0.002), duration of diabetes (p = 0.38), having a glucometer at home (p < 0.001), diabetes empowerment (p < 0.001), personal support (p = 0.002), and self-efficacy (p = 0.047); at the interpersonal level—the main health support (p < 0.001), membership in social networks (p < 0.005), family/friends support (p < 0.001), and neighborhoods support (p < 0.001); at the group and organizational level—organizational support (p = 0.013); at the community and policy level—the impact of mass media in health (p < 0.001) and situational influence (p < 0.001).ConclusionThe impact of non-individual levels, such as the environment, on a person's decision to manage diabetes is crucial. Diabetes management necessitates a significant amount of effort, which involves maintaining the health of diabetes patients and the community while also minimizing emergency department workload.

Association between chronic illness resources and health behaviors in hypertensive stroke patients at 6 months after discharge: a cross-sectional study.

BackgroundThe adoption of appropriate health behaviors can prevent the recurrence of stroke. Previous research found a downward trend in hypertensive stroke patients’ health behaviors from 3 to 6 months after discharge. The provision of appropriate support by chronic illness resources has been shown to predict patients’ engagement in appropriate health behaviors in other chronic illness populations. This study sought to explore the association between chronic illness resources and health behaviors in hypertensive stroke patients in order to provide a foundation for the secondary prevention of stroke.MethodsUsing convenience sampling method, we enrolled 133 hypertensive stroke patients at 6 months after discharge in Guangzhou, China. All the patients completed a demographic and disease-specific questionnaire, the Health Behavior Scale for Stroke Patients (HBS-SP) and the Chronic Illness Resources Survey (CIRS). A multiple stepwise regression analysis was conducted to test the association of chronic illness resources with health behaviors.ResultsThe total scores of the HBS-SP and CIRS were (2.89±0.38) and (2.94±0.66), respectively. The correlation coefficient for chronic illness resources and health behaviors was 0.517 (P<0.001). The positive association between chronic illness resources and health behaviors remained statistically significant after controlling for gender, education level, and the Barthel Index (unstandardized coefficient: 0.317, P<0.001).ConclusionsThe chronic illness resources has positive association with health behaviors in hypertensive stroke patients at 6 months after discharge. A good support provided by chronic illness resources may contribute to promote positive health behaviors, and thus prevent the recurrence of stroke.

Influencing factors of resource utilisation in haemodialysis patients-Based on socioecological pyramid model.

Aims and objectivesTo describe the current situation and analyse influencing factors of resource utilisation in maintenance haemodialysis patients.BackgroundThe self‐management level of patients undergoing maintenance haemodialysis in China is low. The applicability of the Chronic Illness Resources Survey in Chinese maintenance haemodialysis patients has been validated, and this survey can be used to assess the utilisation of self‐management support resources among haemodialysis patients. Determining the influencing factors of resource utilisation can help improve the self‐management behaviour of haemodialysis patients and control the progression of the disease.DesignA descriptive study design was chosen.MethodsA convenience sample of 314 patients undergoing haemodialysis was recruited from dialysis centres in three hospitals in western Xinjiang from June 2018–April 2019. SPSS19.0 software was used to describe the current situation of resource utilisation. Moreover, t test, analysis of variance and multivariate linear regression were applied to explore the influencing factors of patients’ resource utilisation. Standards for observational studies STROBE Statement checklist‐v4 were chosen on reporting the study process.ResultsThe average score of the total resource utilisation was 2.95 ± 0.51. The average item score of seven dimensions from high to low was 3.46 for medical staff, 3.32 for personal, 3.22 for family and friends, 3.16 for work‐related, 3.12 for media policy, 2.55 for neighbourhood/community and 2.23 for organisation. Multiple linear regression showed that there have six main factors, which explained 65.4% of the variance of haemodialysis patients’ resource utilisation.ConclusionsThe personal, family and friends, work and media and policy subscales were rated the highest, with support from neighbourhood/community and organisation rated the lowest. In general, participants perceived moderate levels of support. Government and healthcare team should pay more attention on haemodialysis patients who had low level of education, poor economic conditions and poor mental condition.Relevance to clinical practiceESRD has caused a burden on healthcare expenditure and has become a critical public health problem worldwide. Self‐management is particularly important for dialysis patients which have attracted extensive interest. In the future research, we can use this questionnaire to evaluate the related resources of disease management of dialysis patients, encourage patients to make full use of the resources around them and focus on those patients with low education and monthly income level and bad mental state.

A cross-sectional study of readiness for discharge, chronic illness resources and postdischarge outcomes in patients with diabetic foot ulcer.

AimTo investigate the correlation of readiness for hospital discharge, the chronic illness resources, and postdischarge outcomes of diabetic foot ulcer patients, which can be help for discharged patient rehabilitation.DesignA cross‐sectional study.MethodsOne hundred and seventy‐nine patients were recruited from the Endocrinology units of two tertiary hospitals between November 2018–September 2019, in Guangdong, China. The methods used were Readiness for Hospital Discharge Scale, The Chronic Illness Resources Survey and one‐on‐one telephone interviews.ResultsPearson correlation coefficients indicated moderate correlation between the readiness for discharge and resource availability for chronic illnesses (r = .446, p < .001). Multiple linear regression analysis showed that Chronic Illness Resources Survey, self‐care ability, methods of wound treatments after discharge, and living alone were the main predictors of readiness for hospital discharge among diabetic foot ulcer patients (F = 12.272, p < .001, R 2 = .621, Rad2 = .571). The study was limited by location, patient's recall bias and lack of BADL scale, which can be further improved in subsequent studies by developing multi‐centre clinical study and adopting more objective assessment tools.

Patient-centered communication and outcomes in heart failure.

To measure the impact of patient-centered communication on mortality and hospitalization among patients with heart failure (HF). This was a survey study of 6208 residents of 11 counties in southeast Minnesota with incident HF (first-ever International Classification of Diseases, Ninth Revision code 428 or International Classification of Diseases, Tenth Revision code I50) between January 1, 2013, and March 31, 2016. Perceived patient-centered communication was assessed with the health care subscale of the Chronic Illness Resources Survey and measured as a composite score on three 5-point scales. We divided our cohort into tertiles and defined them as having fair/poor (score < 12), good (score of 12 or 13), and excellent (score ≥ 14) patient-centered communication. The survey was returned by 2868 participants (response rate: 45%), and those with complete data were retained for analysis (N = 2398). Cox and Andersen-Gill models were used to determine the association of patient-centered communication with death and hospitalization, respectively. Among 2398 participants (median age, 75 years; 54% men), 233 deaths and 1194 hospitalizations occurred after a mean (SD) follow-up of 1.3 (0.6) years. Compared with patients with fair/poor patient-centered communication, those with good (HR, 0.70; 95% CI, 0.51-0.97) and excellent (HR, 0.70; 95% CI, 0.51-0.96) patient-centered communication experienced lower risks of death after adjustment for various confounders (Ptrend = .020). Patient-centered communication was not associated with hospitalization. Among community patients living with HF, excellent and good patient-centered communication is associated with a reduced risk of death. Patient-centered communication can be easily assessed, and consideration should be given toward implementation in clinical practice.

Cross-cultural adaptation of the Chronic Illness Resources Survey in Japanese patients with diabetes.

The Chronic Illness Resources Survey (CIRS) is a tool for assessing multiple levels of resources for self-management in people with chronic illnesses. This study aimed to examine the reliability and validity of the Japanese version of the CIRS (CIRS-J) among patients with diabetes. This study included 102 Japanese patients with diabetes. Patients completed the CIRS-J on two occasions with additional measurements, including the multidimensional scale of perceived social support (MSPSS), the summary of diabetes self-care activities (SDSCA), and the perceived health competence scale (PHCS). The construct validity, internal consistency reliability, and test-retest reliability were evaluated. Factor analysis resulted in six factors. The Cronbach's α coefficient was 0.82, indicating a high internal consistency. The intraclass correlation coefficient was 0.87, indicating that the CIRS-J is stable over time. The CIRS-J showed a positive moderate association with MSPSS, SDSCA, and PHCS, with a correlation coefficient value ranging from .34 to .44. This study showed preliminary support for the reliability and validity of the CIRS-J. The availability of this instrument will help identify the spectrum of resources available for Japanese people with diabetes in both research and practical settings.

Help-seeking behavior among community-dwelling adults with chronic pain

ABSTRACT Background Some individuals with chronic pain do not seek care. This decision may be due to characteristics of the individual, pain, and/or their health professional(s). Aims This study aimed to identify and compare features of individuals with chronic pain, their pain and general health, and their health care professional between community-dwelling adults who did and did not seek care. Methods Randomly selected adults were mailed a study questionnaire that screened for chronic pain (pain persisting ≥3 months) and asked about their general well-being (Short Form [SF]-36), pain location (body diagram), pain intensity and characteristics (Leeds Assessment of Neuropathic Symptoms and Signs), experiences with health care professionals (Chronic Illness Resources Survey), and visits made to health professionals over the past year. Respondents were categorized as help-seeking (≥1 visit in the past year) and non-help-seeking (zero visits in the past year). Results Six percent of respondents (44/696) were non-help-seeking. These respondents differed in individual, pain, and health care professional characteristics when compared to those who did seek care. Specifically, when other variables were controlled, non-help-seeking individuals were less likely to be male (relative risk [RR] = 0.39, 95% confidence interval [CI], 0.18–0.86), report comorbid conditions (RR = 0.46, 95% CI, 0.22–0.98), report being treated as an equal partner in decision making (RR = 0.40, 95% CI, 0.18–0.93), and rate their health care professional as important to their pain management (RR = 0.39, 95% CI, 0.18–0.85). They were more likely to use over-the-counter medication to manage their pain (RR = 2.52, 95% CI, 1.14–5.58). Conclusions Experiences with health professionals play a role in determining whether an individual manages his or her pain independently. Future research should explore the safety of those who do not seek care.

Correlation between utilization of chronic disease resources and quality of life in chronic obstructive pulmonary disease patients

Objective To investigate the status quo of utilization of chronic disease resources and quality of life in chronic obstructive pulmonary disease (COPD) patients, and explore the correlation between them. Methods A total of 394 patients with COPD were investigated by the general information question, the Chronic Illness Resources Survey and COPD Assessment Test (CAT). Results The CAT score of COPD patients was (21.33 ± 7.14) points. Among 394 COPD patients, 63 patients (16.0%) had ideal utilization of chronic disease resources, and 331 patients (84.0%) did not, the highest dimension of each dimension score was 3.33 points for the health care team (interquartile range 2.67-3.67 points), and the lowest score was 1.67 points for the organization (interquartile range 1.00-2.00 points). Except media policy and quality of life were not relevant, all other dimensions were negatively correlated with CAT scores in COPD patients (r=-0.368--0.169, all P<0.05). Linear regression analysis showed that the factors affecting the quality of life of COPD patients were: health care team, family and friends, individual coping (P<0.05). Conclusions COPD patients with quality of life and chronic disease resources should be improved, medical staff should pay more attentions to patients in communication and guidance, and encourage the support of family and friends, in particular, pay attentions to patients with poor attitude, thus improving the quality of life of patients. Key words: Quality of life; Pulmonary disease, chronic obstructive; Inpatients

Abstract P161: Self-Management Resources in Heart Failure: A Prospective Community Study

Introduction: Little is known about the characteristics and resources that enable patients with heart failure (HF) to engage in effective self-management. To address this gap in knowledge, we measured personal and health care resources for self-management and examined associations with mortality among patients with HF. Methods: We surveyed 5543 residents of 11 counties in Southeast Minnesota with a first-ever code for HF [International Classification of Disease, Ninth Revision code 428 or Tenth Revision code I50] between 1/1/2013 and 3/31/2016. Self-management resources were measured with the health care and personal subscales of the Chronic Illness Resources Survey (CIRS), both of which included 3 questions on a 5-point scale. The responses were averaged and participants were categorized as low if the mean score was below the median of the distribution (range from 1 to 5). The survey was returned by 2866 participants (response rate 52%) and those with complete data on the main items of interest were retained for analysis (N=2212). Cox proportional hazards regression was used to determine the association between each subscale and mortality. Results: Among 2212 participants (mean age 72.8 years, 54.1% men) the median health care score was 4, while the personal score was 3. Those with low health care resources were older and less educated than those with a higher score (p&lt;0.05), while those with low personal resources had less comorbidities and lower education attainment compared to those with a higher score (p&lt;0.05). After a mean (SD) follow-up of 1.3 ± 0.6 years, 207 deaths occurred. Low levels of both self-management resources were associated with an increased risk of death compared with patients with high levels (Table). Conclusions: Having limited self-management resources is associated with an increased risk of mortality among patients with HF. Thus, interventions aimed at supporting self-management among patients with HF may improve outcomes.

Correlation between resource utilization and oral health of elderly patients with diabetes mellitus

Objective To explore the status of resource utilization and oral health of elderly with diabetes mellitus, and to analyze the correlation between the two. Methods Totals of 659 elderly with diabetes mellitus were surveyed by the chronic illness resources survey (CIRS) and the geriatric oral health assessment index (GOHAI) . Results Total scores of resource utilization of the elderly with diabetes mellitus were (71.69±15.86) points, and quality evaluation scores of oral health were (47.12±9.05) . Dimensions in resource utilization were positively correlated with dimensions in oral health (P<0.05) . Conclusions For the elderly patients with diabetes mellitus, the higher the resource utilization is, the better oral health is. Key words: Diabetes mellitus; Aged; Oral health; Resources utilization

Predictors of diabetes self-management among type 2 diabetics in Indonesia: Application theory of the health promotion model

ObjectiveThis study aimed to identify factors predicting diabetes self-management among adults with type 2 diabetes mellitus in Malang City, East Java, Indonesia. MethodsA cross-sectional design was used in this study. Participants were selected from five primary health centers in Malang City, East Java, Indonesia using the multistage sampling method. A total of 127 adults with type 2 diabetes mellitus were recruited. Data were collected by questionnaires which were the general diabetes knowledge, the Beliefs of Treatment Effectiveness, the Diabetes Distress Scale, the Self-efficacy for Diabetes Scale, the brief Chronic Illness Resources Survey, the Situational Questionnaire and the Summary of Diabetes Self-care Activities. A self-administered questionnaire was used to collect the data. Multiple linear regression with stepwise method was used toanalyze the data. ResultsThe scores of seven questionnaires (i.e, diabetes knowledge, perceived benefit of diabetes self-management, diabetes distress, perceived self-efficacy, social support, situational influence, and diabetes self-management) were 13.75 ± 3.59, 34.9 ± 4.89, 3.03 ± 0.86, 3.60 ± 0.53, 27.79 ± 5.56, 3.27 ± 0.58,3.81 ± 1.08, respectively. The significant predictors of diabetes self-management were treatment, perceived self-efficacy, and situational influences. These variables explained 20.8% (adjusted R2 = 0.208) of the variance in diabetes self-management among adults with type 2 diabetes mellitus in Malang City. ConclusionDiabetes self-management among adults with type 2 diabetes mellitus could be improved by enhancing their perceived self-efficacy to achieve their self-management behavior, such as having a healthy diet, exercising regularly, actively monitoring blood glucose level, taking medication and foot care, and providing support to promote good situational influence.

What Are the Barriers and Facilitators for the Self-Management of Chronic Pain with and without Neuropathic Characteristics?

Chronic pain requires affected individuals to self-manage their health. This study compared barriers and facilitators of self-management in two groups of people with chronic pain: those with and without neuropathic characteristics. A cross-sectional survey study of community-dwelling Canadians was conducted. The sample (n = 710) included randomly selected participants who reported chronic pain. The Self-Report Leeds Assessment of Neuropathic Symptoms and Signs was used to screen for neuropathic characteristics. Barriers and facilitators of self-management included self-efficacy (Pain Self-Efficacy Questionnaire), depression (Patient Health Questionnaire 9), social support and relationship with health care provider (Chronic Illness Resources Survey), and pain intensity (numeric rating scale). Participants were asked which factors they felt made pain management easier or harder. Statistical analyses included frequency, percent, relative risk (RR), and 95% confidence intervals (CI). Self-confidence to manage pain was the most commonly perceived self-management barrier/facilitator by both groups; however, participants with neuropathic characteristics (n = 188) were more likely to report low self-efficacy than those without neuropathic characteristics (n = 522) (RR = 2.1, CI = 1.62-2.72, ref = high self-efficacy). Participants with neuropathic characteristics were also more likely to screen positive for depression (RR = 2.30, CI = 1.73-3.06, ref = no/mild depression). There were no group differences in social support and relationship with health professional, but 40.8% felt they were not involved as equal partners in decision making and goal setting related to their care. Health professionals should consider collaborative decision making when seeking to support self-management abilities. Addressing low self-efficacy and depression may be especially important for supporting self-management by individuals with neuropathic characteristics.

Perceived resource support for chronic illnesses among diabetics in north-western China.

A high level of social support can improve long-term diabetes self-management. Support from a single source has been evaluated. This study aims to analyze support from multiple and multilevel sources for diabetic patients by using the Chronic Illness Resources Survey (CIRS). Factors influencing the utilization of the CIRS were also evaluated. A total of 297 patients with diabetes were investigated using the CIRS and Perceived Diabetes Self-management Scale in Shihezi City, China. Descriptive statistics were used to explain demographic variables and scores of the scales. Factors affecting the utilization of chronic illness resources were determined through univariate analysis and then examined by multivariate logistic regression analysis. Of the 297 diabetic patients surveyed, 67% failed to reach the standard (more than 3 points) of utilizing chronic illness resources. Moreover, utilization of chronic illness resources was positively moderately correlated with self-management of diabetes (r = 0.75, P < 0.05). According to the multivariate logistic regression analysis, age (OR, 3.42; 95%CI, 1.19-9.84) and monthly income (OR, 5.27; 95%CI, 1.86-14.90) were significantly positively associated with the CIRS score. Individuals with high school (OR, 2.61; 95%CI, 1.13-6.05) and college (OR, 3.02; 95%CI, 1.13-8.04) degrees obtained higher scores in the survey than those with elementary school education. Results indicated that utilization of resources and support for chronic illness self-management, particularly personal adjustment and organization, were not ideal among diabetics in the communities of north-western China. Improved utilization of chronic illness resources was conducive for proper diabetes self-management. Furthermore, the level of utilization of chronic illness resources increased with age, literacy level, and monthly income.

Do Personal Resources Influence Health-Related Quality of Life for People Receiving Hemodialysis Treatment in Latin America?

We used the Kidney Disease Quality of Life Survey and Chronic Illness Resources Survey to determine the personal resources that influence health-related quality of life (HRQOL) of 128 individuals receiving treatment for end-stage renal disease in Antofagasta, Chile. The results showed that personal and community resources protect against disability and physical deterioration among individuals receiving hemodialysis. Further, these resources had a direct influence on HRQOL, especially in relation to the burden of the disease and for those who are not in paid employment. Our findings show the importance of the availability and use of measures required for the community to improve HRQOL, and to protect the physical health of people undergoing hemodialysis.

Beverage consumption, and its associations with BMI and lifestyle factors in rural community participants

Beverages with little nutritional value, such as carbonated beverages, may negatively impact nutrition and have long-term health implications, including but not limited to obesity. This study examined the risks for beverage consumption choices and intake of participants living in a rural community. Multiple questionnaires adapted from the Chronic Illness Resources Survey, the Harvard Food Frequency Questionnaire, Michigan Alcohol Screening Test (MAST), the Alcohol Use Disorders Identification Test Questionnaire and 24 Hour Food Recall were administered to a cross sectional sample (n=706) using trained interviewers. The mean age of participants was 23.67 years of age (SD +/- 7.32) with 49.7% females and 50.1% males. Results indicated that carbonated beverages and alcohol consumption were related to increased caloric intake and Body Mass Index (BMI) in the sample (p&lt; 0.05). Calories derived from carbonated beverages and alcohol consumption in younger persons (below age 35) exceeded (p &lt; 0.5) weight and age recommendations for intake as determined by the National Research Council. Older persons (34-53 and &gt; 53 years old), both male and female, drank fewer carbonated beverages and consumed significantly (p &lt; .05) more caffeinated beverages such as coffee, tea and hot chocolate. The study results suggest an increased need for research into beverage consumption and its relationship to BMI.

Validation of the spanish-language version of the chronic Illness resources survey

This article describes the reliability and validity of the Spanish-language version of the Chronic Illness Resources Survey (CIRS-Spanish), an instrument used to tailor and evaluate behaviorally focused chronic disease self-management interventions. Forty Spanish-speaking adults with 1 or more chronic conditions completed the CIRSSpanish on 2 occasions, separated by 2 weeks. They also completed a series of 5 other measures to evaluate criterion, convergent validity, and divergent validity. The 22-item CIRS-Spanish demonstrated reasonable levels of reliability and validity similar to the previously validated English-language version and was easily understood by patients. The CIRS-Spanish is a reliable and valid instrument for measurement of multilevel support for chronic illness management in low-income, Spanish-speaking patients with a variety of chronic conditions.

The Chronic Illness Resources Survey: cross-validation and sensitivity to intervention

There is great interest in, but few instruments to assess, multiple levels of support and community resources from a social-ecological perspective. This study evaluated the psychometric characteristics of the Chronic Illness Resources Survey (CIRS) and its sensitivity to a multifaceted social-ecological intervention to enhance personally relevant community resources supportive of healthful lifestyles. Participants were 293 post-menopausal women having type 2 diabetes who were part of a multiple-behavior lifestyle change program. Key measures included the CIRS, a validated Food Frequency Questionnaire, the Kristal Fat and Fiber Behavior Questionnaire, the CHAMPS Activities Questionnaire for Older Adults, and other measures of social support. Results revealed that the CIRS displayed good psychometric characteristics in this new sample, was significantly correlated as predicted with established measures of social support, was sensitive to intervention, and partially mediated the effects of intervention on both dietary and physical activity outcomes. The 22-item CIRS scale appears useful for assessing multilevel support resources, predicting successful behavior change and detecting social-ecological intervention effects.