Concept Of Self-care Research Articles

Self-care activities among patients with diabetes attending a tertiary care hospital in mangalore karnataka, India.

Background:Increasing prevalence of diabetes in India is resulting in an epidemiological transition. The care of the people with diabetes is traditionally seen as doctor centered, but the concept of self-care of people with diabetes is a new domain and is proven beneficial.Aim:The aim was to determine the practice of self-care activities among people with diabetes attending a tertiary care hospital in Mangalore.Subjects and Methods:A facility-based cross-sectional study was conducted in Government Wenlock Hospital, Mangalore during September–October 2012. A total of 290 patients with >1-year duration of diabetes mellitus (DM) were asked to respond to summary diabetes self-care activities questionnaire after obtaining the consent from them. The statistical analysis was performed in terms of descriptive statistics and association between the variables was tested using Mann–Whitney U-test.Results:A healthy eating plan on a daily basis was followed by 45.9% (133/290) of the participants, daily exercises for 30 min were followed by 43.4% (126/290), and regular blood sugar monitoring was done by 76.6% (222/290). Regarding the adherence to oral hypoglycemic agents and insulin, daily adherence to medication was seen among 60.5% (155/256) and 66.9% (138/206) were found to be adherent to insulin injections on a daily basis.Conclusions:Self-care practices were found to be unsatisfactory in almost all aspects except for blood sugar monitoring and treatment adherence. As these practices are essential for prevention of complications and better quality-of -life, more efforts should be put to educate the people with diabetes.

Self-Care Hub in Kirklees

Kirklees Council has taken up the strategic challenge to develop a Self-Care Hub, making the best use of technology to support local citizens living with a variety of long-term health conditions (LTCs). With increasing pressure on budgets and time, some service users with a LTC may see professionals for as little as an hour a year. It is therefore important to facilitate more self-care by service users. But many of them simply can’t do this at present without support, and the Self-Care Hub aims to take the service user further on the journey than they could manage on their own, while still being supported by professionals when appropriate. It aims to shift the balance towards individual responsibility. Supported by Advanced Digital Innovation (UK) Ltd, and through an extensive consultation with potential users, service provider representatives and professional clinicians, Kirklees Council has developed the Self-Care Hub concept into a rich mix of facilities for educating and informing citizens, optimising access to available services, and encouraging and developing the abilities of citizens to take more responsibility to manage their care packages themselves. The service is being developed by a consortium of public health and NHS organisations in West Yorkshire and incorporates live information drawn down from national services such as NHS Choices. The Self-Care Hub is an online resource that helps people assess their own care needs, using an interactive Virtual Assistant to guide them through their options and create their own care plan. It acts as a signpost to information and a portal into health and social services, with the aim of minimising routine and straightforward caseload on professionals such as GPs and AE professionals and informal carers will also be able to access metrics where appropriate to assist in the journey. It is expected that over time, professionals will adapt the way they work, building self-care journeys into their workflows, enabling more service-user involvement. The Self-Care Hub may be expanded to offer users holding their own records (PHR), online or video and telephone access to clinicians, and online access to the information held about them on professional systems. The concept and tools could be adapted for use outside Kirklees, potentially both enhancing the business case for further developing the Hub, and reducing the cost of similar provision elsewhere in England. The service goes live from summer 2014.

Present situation and influencing factors of self-care ability of patients with systemic lupus erythematosus

Objective To analyze the present situation and the influencing factors of self-care ability in patients with systemic lupus erythematosus （ SLE） .Methods Totals of 206 patients with SLE were included in our hospital.The relevant information was recorded and the self-care ability scale, social support scale, Hamilton Depression Scale and Hamilton depressive scale were used to survey .Risk factors were analyzed by the multi-factor logistic regression .Results The self-care ability of SLE patients were at the middle level , with a score of （103.65 ±15.64）.The scores of concept of self care , self care responsibility, health knowledge level and self-care skills were （23.34 ±4.56）,（20.65 ±5.46）,（32.46 ±5.43）,（24.64 ±5.65）, respectively. The total scores of social support , subjective support and utilization degree were （33.53 ±7.54）,（19.37 ± 3.36） and （7.48 ±1.75）, at the medium level.The score of objective support was （7.54 ±2.35）, at the low level.Self-care ability, state of marriage, education year, depression, objective support and subjective support were the independent risk factors （ r =0.961, 0.699, 0.577, 1.102, 1.079, respectively;P 〈0.05 ）. Conclusions The self-care ability of SLE patients are at the middle level , which are effected by marital status , education, depression, objective support, subjective support . We need to actively give corresponding intervention in clinical work , in order to improve their self-care ability. Key words: Systemic lupus erythematosus; Self-care; Influencing factors

Assessment of an educational intervention on nurses' knowledge and retention of heart failure self-care principles and the Teach Back method

BackgroundNurses must have optimum knowledge of heart failure self-care principles to adequately prepare patients for self-care at home. However, study findings demonstrate that nurses have knowledge deficits in self-care concepts for heart failure. MethodsA quasi-experimental, repeated measures design was used to assess nurses' knowledge of heart failure self-care before, immediately after, and 3-months following an educational intervention, which also included the Teach Back method. Follow-up reinforcement was provided after the educational intervention. ResultsOne hundred fifty nurses participated in the study. Significant differences were found between pre-test (65.1%) and post-test (80.6%) scores (p < 0.001). Teach Back proficiency was achieved by 98.3%. Only 61 participants completed the 3-month assessment of knowledge. In this group, mean knowledge scores increased significantly across all three measurements (p < 0.001): 66.5% (pre-test); 82.1% (post-test); 89.5% (follow up post-test). ConclusionsParticipation in a comprehensive educational program resulted in increased nurses' knowledge of heart failure self-care principles and the knowledge was sustained and increased over time.

Introducing the Adherence Strategy Engineering Framework (ASEF)

Patients performing self-care in the unsupervised setting do not always adhere to the instructions they were initially provided with. As a consequence, a patient's ability to successfully comply with the treatment plan cannot be verified by the treating healthcare professional, possibly resulting in reduced data quality and suboptimal treatment. The aim of this paper is to introduce the Adherence Strategy Engineering Framework (ASEF) as a method for developing novel technology-based adherence strategies to assess and improve patient adherence levels in the unsupervised setting. Key concepts related to self-care and adherence were defined, discussed, and implemented as part of the ASEF framework. ASEF was applied to seven self-care case studies, and the perceived usefulness and feasibility of ASEF was evaluated in a questionnaire study by the case study participants. Finally, we reviewed the individual case studies usage of ASEF. A range of central self-care concepts were defined and the ASEF methodological framework was introduced. ASEF was successfully used in seven case studies with a total of 25 participants. Of these, 16 provided answers in the questionnaire study reporting ASEF as useful and feasible. Case study reviews illustrated the potential of using context-aware technologies to support self-care in the unsupervised setting as well as ASEF's ability to support this. Challenges associated with moving healthcare to the unsupervised setting can be overcome by applying novel context-aware technology using the ASEF method. This could lead to better treatment outcomes and reduce healthcare expenditures.

Effect of self nursing mode on ability of self-care and daily activities of postoperative TKA patients during rehabilitation

Objective To investigate the effect of health education about self nursing on the ability of self-care and daily activities of postoperative total knee arthroplasty (TKA) patients during rehabilitation.Methods Sixty-one patients after TKA between March 2010 and March 2011 were randomly divided into self nursing group (n =31) and control group (n =30).In self nursing group,the patients were educated about self nursing knowledge.while in control groups,the paticnts wcre educated about general health knowledge.Questionnaire of self nursing capacity determination and questionnaire of activities of daily living were used to assess the patients.Results Before the intervention,the scores of self-care abilities and activities of daily living of two groups has no significant different (P ＞ 0.05).After the intervention,the scores of self-care responsibility (13.48 ±4.66 vs 10.87±4.73),self-care concept (25.25 ± 3.65 vs 20.97 ± 4.45),self-care skills (38.98 ± 5.73 vs 33.57 ± 6.06),level of health knowledge (48.00 ± 8.26 vs 42.84 ± 6.60),self-care abilities(125.81 ± 17.59 vs 108.23 ± 16.30) and ADL(76.25 ± 14.80 vs 62.30 ± 15.55) of observational group were significantly higher than that of control group (t =2.287,4.139,3.610,2.730,4.073,3.606,respectively;P ＜0.05).Conclusions Self nursing education can be more effective in improving TKA patients'self-care ability and the activities of daily living. Key words: Self nursing; Artrmoplastry,replacement,knee ; Rehabilitation; Activities of daily living

The Role of Philosophy, the Truth of Appearance-Centered of the Concept of Foucault's Self-care

The Role of Philosophy, the Truth of Appearance-Centered of the Concept of Foucault's Self-care

Patient Care Heart Failure Model

This article details a heart failure care model at North East Veterans Affairs (VA) Medical Center. The North East VA health system has been involved in quality improvement of heart failure care for many years. This involves continuous quality improvement in the full spectrum of treatment from admission through discharge and outpatient follow-up. Improving patient care is always the main goal. Assisting patients to better understand self-care concepts is key to avoiding heart failure exacerbations. Educating patients to identify problematic symptoms early and access the system for help can often avoid costly readmissions. The case study provided in this article highlights the journey of a heart failure patient treated at this VA hospital and the care coordination process, which is necessary for good patient care through use of multidisciplinary team members.

A Strategic Thinking on Multi-Level Business Development in Wellness Foods

More people are accepting the self-care concept in natural health regimens as the complementary and alternative medicine has become a key driver for wellness foods industry business. Many wellness food companies rely on multi-level marketing—directly selling products through individuals’ social networks—frothier business development. Few people are able to succeed in promoting this complex perception-change about the benefits of natural health regimens to consumers and making this as a steady income stream. Current, the success of direct-selling model requires the individuals who possess similar personal attributes and capabilities. This paper argues a novel way—a holistic approach—to elaborate the strategy and to give the business development guidelines to the wellness food industries.

Delineation of Self-Care and Associated Concepts

The purpose of this paper is to delineate five concepts that are often used synonymously in the nursing and related literature: self-care, self-management, self-monitoring, symptom management, and self-efficacy for self-care. Concepts were delineated based on a review of literature, identification of relationships, and examination of commonalities and differences. More commonalities than differences exist among self-care, self-management, and self-monitoring. Symptom management extends beyond the self-care concepts to include healthcare provider activities. Self-efficacy can mediate or moderate the four other concepts. Relationships among the concepts are depicted in a model. A clearer understanding of the overlap, differences, and relationships among the five concepts can provide clarity, direction and specificity to nurse researchers, policy makers, and clinicians in addressing their goals for health delivery. Concept clarity enables nurses to use evidence that targets specific interventions to individualize care toward achieving the most relevant goals.

Disease resilience in rural Bangladesh: the adoption and practice of curative self-care

The importance of resilience and people-centred risk reduction of disease have led to growing interest in local coping strategies in disease management. These ideas resonate strongly with the concept of self-care which has been identified as a primary public health resource and a predominant response to ill health in disease endemic environments such as Bangladesh. A series of qualitative and quantitative methods were employed to examine the adoption of self-care in rural Bangladesh to understand how human coping and resilience is achieved. Findings identify how self-care is implemented as part of resilience to disease through the utilisation of finite natural resources and seeking cost-effective healthcare solutions. It is advocated that self-care acts as an effective disease management strategy enabling households to cope with endemic disease. Although it does not represent a panacea for health equity, self-care could provide a mechanism for achieving better equity and social justice in health.

Care of self - care by other - care of other: the meaning of self-care from research, practice, policy and industry perspectives

Currently, no single definition of self-care is broadly accepted in the literature. Definitions vary as to (i) who engages in self-care behaviour; (ii) what motivates self-care behaviours; and (iii) the extent to which healthcare professionals are involved. Perspectives of self-care differ between healthcare professionals and the general public, and between healthcare professionals in different disciplines and different roles. As different professions view self-care within their own domain of practice, we are left with a multitude of explanations and descriptions. This variety of conceptualisations does impact and complicate research on self-care. As part of a larger enquiry focused on the clarification of this complex concept, this study provides a content analysis of documented definitions of self-care, and a summary of the evolution of the definition of self-care over time. To examine the diversity of definitions of self-care from the perspectives of research, practice, policy and industry, and to identify themes or trends in the evolution of the definition of self-care over time. The search strategy was designed in consultation with a library scientist to find both published and unpublished papers. A three-step search strategy was used to locate the literature. The databases searched included CINAHL, Medline, EMBASE, PsycINFO, AMED, Cochrane Library, Scirus and Mednar. The definition of self-care was extracted from each paper included in the study. Using an inductive process, a content analysis was performed identifying common terms and phrases from the definitions. The definitions were then divided into four decades, 1970s, 1980s, 1990s and 2000s, and the evolution of the definition of self-care was examined. In this study we sought to clarify the concept of self-care by examining in detail the definition of self-care. Content analysis of 139 definitions identified seven components of the definition and a range of terms that were applicable to each component. Evolution of the definition over time showed a more expansive definition by the end of the 2000s. Current and evolving definitions of self-care would benefit by being comprehensive and encompassing as many facets of the concept as possible. Healthcare professionals assess, guide, instruct and support individuals as they initiate or engage in self-care. Using a comprehensive definition of self-care would provide an anchor linking each discipline as they interact not only with the individual but also among themselves. The concept of self-care is a many-layered one. Identifying the components in the definition of the term delineates the different areas for potential research in this area. When planning a research project, the definition of the key concept guides the research and shapes the approach to the investigation. For researchers in this area, this study illustrates the wealth and diversity of the definitions of self-care.

Can self-care become an integrated part of end-of-life care? Implications for palliative nursing

This article will explore the concept of self-care in end-of-life care, drawing on data from a 2-year post-doctoral study conducted in Scotland.

Diabetes Mellitus and the Importance of Self-care

Self-care is believed to play an important role in diabetes mellitus (DM) management, and the relationship between DM self-care and glycemic control has been extensively examined in the literature. However, most existing DM self-care literature focuses on patients' routine health behaviors. The literature has not examined in detail the relationship between health outcomes and patient decision making/nonroutine responses to signs and symptoms of DM. This article adopted Riegel and Dickson's situation-specific theory of heart failure self-care [J Cardiovasc Nurs. 2008;23(3):190-196], which incorporates an examination of patient decision making and nonroutine behaviors in their working concept of self-care, and used it as a framework for reviewing the research literature relevant to how DM self-care influences health outcomes.

Asthma 1-2-3: A Low Literacy Multimedia Tool to Educate African American Adults About Asthma

Asthma 1-2-3 is a newly-developed low-literacy multimedia education tool designed to promote asthma self-care concepts among African American adults. An expert panel (n = 10) informed content development for the tool. The video script and storyboard imagery were shown to 30 African Americans recruited from the American Lung Association, whose reactions and comments guided further revisions. The final version was pilot tested in three diverse community settings in Chicago to determine the efficacy of Asthma 1-2-3 at improving patient understanding of asthma and its symptoms. In all, 130 adults participated in the pilot test. Knowledge scores significantly improved from pretest to posttest following presentation of the developed tool for subjects across all literacy levels (Pretest: Mean = 4.2 [SD = 1.6]; Posttest: M = 6.8 [SD = 2.0], P < 0.001). Symptom pathophysiology concepts were the least understood. Individuals with low literacy had less total knowledge score gains compared to those with marginal and adequate literacy (1.8, 2.6, and 3.2 respectively; P = 0.002). The multimedia tool significantly improved understanding of asthma. Individuals with limited literacy may require additional instruction, repeated viewing, or added tangible cues (i.e. supplementary print materials) to support knowledge retention. In general, feedback from the target population was particularly helpful in the development of the tool and its initial evaluation, and should be considered as a necessary step in the creation of other patient education materials.

Complementary medicines regulatory reform

AUSTRALIANS ARE BEING encouraged to take greater responsibility for their own health care. The concept of self-care is being promoted widely, including the recent paper released by the National Health and Hospitals Reform Commission1 and, more commercially, by the Australian Self Medication Industry (ASMI).2 Self-care in health refers to the activities individuals, families and communities undertake with the intention of enhancing health, preventing disease, limiting illness, and restoring health. These activities are derived from knowledge and skills from the pool of both professional and lay experience. They are undertaken by lay people on their own behalf, either separately or in participative collaboration with professionals.3 To enable Australian consumers to assume this responsibility, they should have the right to know and have access to the evidence-based status of any treatment they are considering, to enable them to make well-informed choices. This especially applies to medicines.

Learning to live with type 1 diabetes from the perspective of young non-western immigrants in Denmark.

To explore how young adults with a non-western immigrant background and type 1 diabetes since childhood/adolescence have perceived learning to live with the disease, with special focus on health education and support. A national Danish study found significantly poorer metabolic control in non-western immigrant children and adolescents as compared with ethnic Danes. Subsequent studies have primarily focused on immigrant parents, whereas little is known about how immigrant children/adolescents have perceived the diagnosis and the diabetes care and support provided. A mixed quantitative and qualitative design was applied. This included data on metabolic control for 2002-2006 and semi-structured interviews in 2006 with eleven strategically selected young immigrants. Data were analysed using qualitative content analysis. The findings are described in three thematic categories: Perceptions and reactions at the time of diagnosis; Learning to manage the disease; Present and future life with diabetes. Some findings were similar to those in studies describing children and adolescents of western origin, but the participants also shared perceptions which appeared to be related to their immigrant background. Above all, they described their parents as having difficulty coping with the disease and providing them with sufficient support. The diagnosis of diabetes in immigrant children and adolescents requires special pedagogic and psychosocial approaches to bridge the gaps related to culture and traditions and introduce the concept of diabetes management, not least to the parents, in a more optimum way. Diabetes care should be a continuous and holistic process, constantly aiming to explore existing knowledge and the need for additional education and support for both the patient and his/her family. Special attention should be paid to the fact that immigrants may have limited pre-knowledge of chronic diseases in childhood, including the concept of selfcare.

Oral health in Brazil - Part II: Dental Specialty Centers (CEOs)

The concepts of health promotion, self-care and community participation emerged during the 1970s and, since then, their application has grown rapidly in the developed world, showing evidence of effectiveness. In spite of this, a major part of the population in the developing countries still has no access to specialized dental care such as endodontic treatment, dental care for patients with special needs, minor oral surgery, periodontal treatment and oral diagnosis. This review focuses on a program of the Brazilian Federal Government named CEOs (Dental Specialty Centers), which is an attempt to solve the dental care deficit of a population that is suffering from oral diseases and whose oral health care needs have not been addressed by the regular programs offered by the SUS (Unified National Health System). Literature published from 2000 to the present day, using electronic searches by Medline, Scielo, Google and hand-searching was considered. The descriptors used were Brazil, Oral health, Health policy, Health programs, and Dental Specialty Centers. There are currently 640 CEOs in Brazil, distributed in 545 municipal districts, carrying out dental procedures with major complexity. Based on this data, it was possible to conclude that public actions on oral health must involve both preventive and curative procedures aiming to minimize the oral health distortions still prevailing in developing countries like Brazil.

Factors affecting self-care in heart failure: A literature review

The concept of self-care is now well established in government policy and guides the clinical management of patients with long-term conditions, including those with heart failure. Self-care is defined here as adherence to medication and recommended lifestyle advice (self-care maintenance), and recognising, monitoring and responding to symptoms (self-care management). In this literature review, the influence of biological, psychological and social factors on self-care in heart failure are considered. Levels of social support, the patient provider relationship, functional and cognitive ability, depression, personal beliefs, knowledge and psychological factors such as motivation and self-efficacy have all been shown to influence self-care in this patient group. The implications for practice in the light of this review are considered.

History and Vision: What is Important for Patients with Diabetes?

Up to the mid-1950s, evaluating the degree of glycemic control relied upon determining the concentration of glucose in the urine while acknowledging the inherent difficulties in interpretation. Progress was made from the original Benedict's test, when Benedict's solution was added to the urine sample to be tested, followed by the addition of the urine sample to a reagent tablet (Clinitest) or powder (Gelatest), and finally, in the 1960s, to a variety of urine glucose test strips, i.e., test-tape/Glukotest, Clinistix, Dreypak, and Combur-Test (glucose, protein, and pH value). The quest to produce blood glucose test strips was realized later in the 1960s, with refinements made during the following decade resulting in the introduction of Dextrostix and the Reflotest strips for use with reflectance meters and then the Haemo-Glukotest for visual determination. It was soon realized that patients were capable of using such meters, thereby introducing the concept of self-monitoring of blood glucose (SMBG). Initially, there was considerable opposition by the profession, which soon evaporated when the benefits of SMBG were clearly demonstrated in the mid- to late 1970s by Sînksen et al. (1978), Walford et al. (1978), and Cohen et al. (1980) in their pivotal publications. Early experience of introducing the patient to the concept of self-care using SMBG achieved a dramatic and sustained improvement in glycemic control, being preferred to urine testing in terms of both its execution and meaningfulness of the test result. Despite early concerns, SMBG's value in the management of the pregnant woman with diabetes was quickly realized and universally adopted. Further developments have centered on refining the test strips, blood sampling techniques (thereby reducing the volume of blood samples required), accuracy of glucose determination, and time from sampling to results. Currently there is reasonable consensus, based on evidence, about the use of SMBG in insulin-treated persons with diabetes, whereas considerable debate continues about its role in non–insulin-treated subjects with type 2 diabetes.