Effective Self-care Strategies Research Articles

Investigation of Treatment-Related Symptoms and Self-Care Strategies in Lung Cancer Patients

This study aimed to investigate treatment-related symptoms in lung cancer patients undergoing chemotherapy and radiotherapy, as well as effective self-care strategies to alleviate these symptoms. A total of 202 lung cancer patients were surveyed using a treatment-related symptom checklist, Karnofsky Performance Status scale, and a self-care symptom relief questionnaire. The results showed that the most common treatment-related symptoms included fatigue (93.07%), loss of appetite (88.12%), nausea (82.67), hair loss (74.75%), vomiting (66.83%), pain (64.85%), taste changes (62.87%) and constipation (60.89%). The study also gathered patients' self-care methods that they found effective in alleviating these symptoms. Findings suggest that lung cancer patients bear a significant burden of treatment-related symptoms, and various self-care strategies reported by the patients were effective in managing these symptoms.

Factors related to self-care in Korean patients with tuberculosis: A systematic review and meta-analysis.

Tuberculosis (TB) remains a major public health challenge in South Korea which has one of the highest TB incidence rates among the Organisation for Economic Co-operation and Development (OECD) countries. Effective self-care, including medication adherence and regular hospital visits, is crucial for successful TB treatment and the prevention of drug resistance. TB self-care in South Korea is influenced by cultural, social, and systemic factors. This study aimed to systematically review and conduct a meta-analysis of factors influencing self-care among Korean patients with TB, providing evidence-based insights for developing effective self-care promotion programs. A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, focusing on quantitative studies published since 2000 involving Korean patients with TB. Twenty studies were included in the final analysis, and 44 factors related to self-care were categorized into sociodemographic, TB-related, psychological, environmental, and educational characteristics. Effect sizes were calculated using Comprehensive Meta-Analysis (CMA) 4.0, with the assessment of heterogeneity and publication bias. The meta-analysis ranked the effect sizes of the different characteristic categories as follows: environmental > educational > psychological. Among the individual factors, social support had the greatest influence on self-care, followed by quality of life, self-efficacy, nonfamily support, family support, and perceived health benefits. These findings underscore the critical role of sustained social support from the community, medical staff, and family in enhancing self-care among TB patients. Effective self-care strategies for patients with TB should focus on interventions that strengthen the environmental, educational, and psychological aspects. These findings suggest that similar approaches can be applied in other countries facing comparable healthcare challenges. This study acknowledges limitations including potential publication bias and the exclusion of older studies and non-Korean patient studies, highlighting the need for further research across diverse settings and populations.

Experiences of facilitators and barriers for fulfilment of human needs when living with restless legs syndrome: a qualitative study

ABSTRACT Purpose Restless Legs Syndrome (RLS) is a widespread condition that affects sleep leading to daytime sleepiness, depression, and reduced quality of life. This study aims to determine and describe how patients with RLS experience their everyday life, with a focus on facilitators and barriers related to Maslow’s hierarchical theory of human needs. Method Semi-structured interviews were analysed with qualitative content analysis resulting in facilitators and barriers affecting the fulfilment of the five human needs. Results Addressing RLS symptoms through medications and a quiet sleep environment fulfils psychological needs. Control over RLS symptoms, engagement in activities, trust in treatments, and social support meet safety and security needs. Social inclusion, close relationships, and meaningful interactions fulfil a sense of belongingness and love needs despite RLS. Competence in managing RLS, effective self-care strategies, confident communication, and trust-building support esteem needs. Finally, comprehensive understanding through person-centred interventions and coping fulfils the self-actualization needs in managing RLS. Conclusion Holistic and person-centred interventions, including facilitators for the fulfilment of physiological, psychological, and social needs could help healthcare professionals to provide holistic care.

Factors influencing self-care management in adult hemodialysis patients: An integrative review.

Background: End-stage renal disease (ESRD) poses a significant health challenge, with hemodialysis (HD) being the most prevalent therapy. Patients undergoing HD must comply with a strict therapeutic regimen, including dietary control, fluid restriction, and medication adherence. Successful disease management and improved outcomes rely on patients' involvement and participation in their care. Aim: To identify the factors that hinder or facilitate self-care management (SCM) in HD patients. Methodology: This review followed Whittemore and Knafl's integrative review framework. A comprehensive literature search of articles published between 2017 and 2022 was conducted in CINAHL, Medline, and PubMed using the keywords end-stage renal disease, hemodialysis, self-care management, self-care, and self-management. This search yielded 21 suitable articles for review. Results: SCM is influenced by three main factors: facilitators, barriers, and outcomes. Facilitators of SCM include self-care management interventions, patient knowledge, socio-demographic factors, family support, healthcare professionals, peer support, and psychological factors. Barriers encompass psychological and physical conditions. Outcomes include both physiological and psychological aspects. Conclusion: Understanding the factors influencing SCM in HD patients is vital for developing reliable and effective self-care strategies and interventions to enhance both physical and psychological outcomes.

Towards Shared and Effective Self-Care: A User-Centric Framework for Enhancing HIV Prevention

Background: Despite a declining trend in Human immunodeficiency virus (HIV) prevalence across sub-Saharan Africa, specific vulnerable groups continue to be disproportionately impacted (29.9% for sex workers, 12.9% for gay men having sex with men (MSM) vs 5.9% for adults). In the face of this challenge, it is critical to tailor demand creation for prevention, in particular self-care, for maximum impact and cost-efficiency. This study seeks to provide a behavioral understanding towards HIV prevention that shape the efficacy of prevention strategies among priority populations (female sex workers, MSM and adolescent girls and young women) in southern and eastern Africa. Methods: This study involved a literature review of 110 articles, focusing on HIV prevention in priority populations, behavioral interventions, and policy priorities from governments and funders. Additionally, insights were gained from 11 in-depth interviews and a workshop with 10 experts at the AIDS Impact 2023 conference. Participants included behavioral researchers and program leaders from Global Fund, United States Agency for International Development (USAID), U.S. President's Emergency Plan for AIDS Relief (PEPFAR), Bill and Melinda Gates Foundation, FHI360, Population Services International and Genesis Analytics. A user-centric behavioral framework was devised to identify actionable drivers and barriers in HIV prevention during the consultation exercise. Results: The study highlights the importance of shared and effective self-care in enhancing HIV prevention, particularly in vulnerable groups. The behavioral framework integrates the decision-making contexts and the health ecosystem layers to inform research and demand strategy. Key findings include: (1) effective self-care is not the same as continuous use of Pre-exposure prophylaxis and therefore, programs and policies need to measure them differently; (2) users exercise choice through a combination of prevention products and focus on a few may be sub-optimal, and (3) perceived risk is transient and hence risk-based messaging lacks sustained relevance. Conclusion: Effective self-care strategies extend beyond overcoming access and availability issues. Examining the underlying factors causing the barriers is essential. The behavioral framework presented here suggests that: (a) Self-care is a shared responsibility between the user and healthcare system and (b) demand creation should be de-medicalised, away from products and towards meeting the needs and preferences of users.

Stress reduction for paid home care aides: A feasibility study of mindfulness meditation and Tai Chi interventions

ABSTRACT Evidence of effective self-care strategies to support Home Care Aides’ (HCAs) mental health is limited. This study compares the feasibility of implementing one of two non-clinical, evidence-based stress-reduction treatments: mindful awareness practices (MAPs) meditation versus Korean-style Tai Chi. Program effectiveness was assessed on a range of self-reported health and mental health quantitative outcomes at three time-points. Both groups showed statistically significant improvements in depression, insomnia, and negative affect during the six weeks (all p. <0.05), but only the MAPs group demonstrated a sustained improvement in negative affect at three-month follow-up (p. <0.05). At three-month follow-up, 55% of Tai Chi participants continued practicing learned techniques, compared to 75% of MAPs participants. MAPs were found to be more practical and amenable to integration in daily life compared to Tai Chi. Showing positive results on both feasibility and effectiveness assessment, MAPs were chosen over Tai Chi to be scaled as a benefit to HCAs.

Self-Care for Nurses Who Care for Others: The Effectiveness of Meditation as a Self-Care Strategy

Self-care is how nurses promote their own physical and mental health. Effective self-care is any strategy practiced on a regular basis to prevent stress and anxiety and to enhance the health and well-being. Self-care ranges from getting more rest to seeking professional help. Meditation practice is known to be an effective self-care strategy. The purpose of this study is to assess the effect of meditation as a self-care strategy among Korean nurses. Two groups of nurses at the university hospital, one with meditation experience and the other without, were selected as study participants, and their depression and resilience were analyzed. The results of the study show that, first, depressive symptoms were more prevalent among the nurses in the non-meditative group (62.2%) than the ones in the meditative group (15.6%), and resilience positivity was higher in the meditative group (4.01 ± 0.44) than in non-meditative group (3.04 ± 0.41). Second, nurses with depressive symptoms demonstrated particularly low resilience in both groups, indicating that resilience is inversely associated with other metal disorders. Third, after one and a half years since the study, the turnover rate of the non-meditative group (17.8%) was twice that of meditative group (8.9%). As stated in the earlier self-care literature that stressed the benefits of meditation, this study confirms that consistent meditation experience on a regular basis has an effect on nurses’ well-being via lower depression and promotes higher psychological well-being via resilience. This study is expected to provide the data collected from the field, including personal narratives, to establish more effective self-care strategies in personal and professional settings.

Self-management of pain crisis in patients with sickle cell disease

Introduction: Sickle cell disease, while it is the most common genetic disease in France, is little known to caregivers and the general public.Context: Only a few studies have examined the daily lives of people suffering from this disease.Objectives: The purpose of this project was to describe the specific strategies helping adult patients to manage the symptoms of their disease.Method: To reach this objective, a qualitative study was conducted among eight homozygous (SS) people over 30 years old living in the Ile-de-France region of France. The semi-structured interviews took place at the patients' homes, selected from several regional competence centers and on social media. An inductive methodology and a thematic analysis were used to draw the conclusions of this research.Results: They show that pain and suffering are patients' main complaints. Patients suffering from sickle cell disease seek numerous effective self-care strategies to manage their long-term pain: preventive measures and drugs, as well as complementary and alternative medicine.Discussion: A sociological approach shows us the considerable work that patients undertake to manage symptoms daily.Conclusion: The findings support interventions that would increase the feeling of control over the disease through better self-awareness and appropriate physical activity.

Non-cancer-related lower limb lymphoedema in complex decongestive therapy: the patient experience.

Lymphoedema is a debilitating condition that results in the swelling of one or more limbs, leading to a significant impairment of mobility. From a psychosocial perspective, body image and quality of life (QoL) are also adversely affected. To date, non-cancer lymphoedema has been under-researched. The primary objectives of this study were to explore QoL and limb volume in patients with primary and secondary non-cancer-related lower limb lymphoedema during the intensive, maintenance and self-care phases of complex decongestive therapy over a 24-week period. Secondary objectives included exploring patients' experiences of living with lymphoedema and the challenges of self-care maintenance. A sequential mixed methodology, using quantitative and qualitative methods, was used. The quantitative part of the study involved the use of tape measurements at 4cm intervals to ascertain limb volume alterations. Measurements were taken during the intensive phase at weeks 1, 2, 3 and 4; and during the maintenance phase at weeks 8, 16 and 24. QoL was measured using the lymphoedema QoL (LYMQOL) leg, at baseline and weeks 8 and 24. The qualitative part of the study involved the use of semi-structured interviews with patients at week 8. Interviews explored the experiences of patients living with lymphoedema and their experiences of complex decongestive therapy. A total of 20 patients were recruited, two male and 18 female, with a mean age of 58.8 years (standard deviation (SD): 16 years), and all receiving complex decongestive therapy. At baseline, for all patients, the mean QoL score was 4.3 (SD: 2.4); and 8 (SD: 1.5) after 8 weeks of complex decongestive therapy. Mean difference was 4.00 (95% confidence interval: 2.76-5.24; p=0.00001) indicating a positive treatment effect. Limb volume measurements demonstrated a reduction in oedema from baseline to week 8. However, there were fluctuations in limb volume over the maintenance period of four months after treatment as the patients endeavoured to engage in self-care. Analysis of the interviews identified themes pertaining to lack of knowledge of lymphoedema among health professionals, a negative impact of living with lymphoedema and the positive therapeutic effect of complex decongestive therapy. Lower limb lymphoedema is a chronic condition that impacts negatively on the individual. Complex decongestive therapy improves QoL and reduces oedema. However, given the fluctuations in oedema post-treatment, individuals need greater support to maintain active engagement in effective self-care strategies.

Patients' needs and perspectives for using mobile phone interventions to improve heart failure self-care: A qualitative study.

To explore heart failure patients' needs and perspectives for using mobile health technology at home before developing a mobile phone-based heart failure self-care intervention. A qualitative interview study. Purposive sampling was used to conduct semi-structured individual interviews with patients diagnosed with chronic heart failure (N=20). Data were collected from November 2018 - May 2019. All interviews were audio-recorded and transcribed verbatim and data were analysed using qualitative content analysis. The four themes that emerged from the interviews were as follows: 'The demand for reliable and customized health information', 'Valuable features of mobile phone applications', 'Barriers to adopting mobile health service', and 'Expected benefits of using mobile health technology'. Participants in this study required personalized health-related information and reminders for improving their self-care behaviours. However, while difficulties in using mobile phone applications posed the main obstacle, users expected mobile health services to improve their overall quality of life. Despite mobile phone technology's potential benefits for effective self-care strategies at home, there were some obstacles such as security issues, application costs, and the need for user friendly designs and reliable information for patients' optimal use. This study highlights that healthcare professionals should consider patients' needs and preferences to promote the acceptability of mobile health technology. This study's findings can guide the future design and implementation of mobile health interventions for improving self-care among patients with heart failure.

Self-care Strategies to Combat Burnout Among Pediatric Critical Care Nurses and Physicians.

Professional burnout is a widespread phenomenon in health care. The health of patients and organizations begins with the well-being of health care professionals. Identifying and understanding self-care strategies that professionals perceive to be helpful is crucial to combat burnout. To determine perceptions of self-care strategies to combat professional burnout among nurses and physicians in pediatric critical care settings. This was a qualitative descriptive study with a phenomenological overtone. The study was conducted in a 20-bed pediatric intensive care unit and an 8-bed intermediate care unit of a children's hospital in the United States. Information flyers and emails were used to introduce the study. A combination of convenience and purposive sampling methods was used to recruit participants who were full-time nurses and physicians in the 2 units. Information saturation was used to regulate sample sizes, resulting in 20 participants. Data were collected through a onetime face-to-face interview with each participant. A qualitative descriptive approach was used to analyze the data. The first author was the primary coder and discussed the codes with the coauthors throughout the coding process. Six major self-care strategies were identified: finding meaning in work, connecting with an energy source, nurturing interpersonal connections, developing an attitude of positivity, performing emotional hygiene, and recognizing one's uniqueness and contributions at work. Developing effective self-care strategies helps promote health care professionals' physical and psychological well-being and reduce burnout. It is vital for health care professionals to care for themselves so that they can best care for others.

Exploring the meaning and practice of self-care among palliative care nurses and doctors: a qualitative study

BackgroundSelf-care practice within the palliative care workforce is often discussed, yet seemingly under-researched. While palliative care professionals are required to implement and maintain effective self-care strategies, there appears little evidence to guide them. Moreover, there is an apparent need to clarify the meaning of self-care in palliative care practice. This paper reports qualitative findings within the context of a broader mixed-methods study. The aim of the present study was to explore the meaning and practice of self-care as described by palliative care nurses and doctors.MethodsA purposive sample of 24 palliative care nurses and doctors across Australia participated in semi-structured, in-depth interviews. Interviews were digitally recorded and transcribed prior to inductive qualitative content analysis, supported by QSR NVivo data management software.ResultsThree overarching themes emerged from the analysis: (1) A proactive and holistic approach to promoting personal health and wellbeing to support professional care of others; (2) Personalised self-care strategies within professional and non-professional contexts; and (3) Barriers and enablers to self-care practice.ConclusionsThe findings of this study provide a detailed account of the context and complexity of effective self-care practice previously lacking in the literature. Self-care is a proactive, holistic, and personalised approach to the promotion of health and wellbeing through a variety of strategies, in both personal and professional settings, to enhance capacity for compassionate care of patients and their families. This research adds an important qualitative perspective and serves to advance knowledge of both the context and effective practice of self-care in the palliative care workforce.

Luna Yoga: A Wellness Program for Female Counselors and Counselors-in-Training to Foster Self-Awareness and Connection

ABSTRACTYoga has gained popularity as a way to relieve stress and maintain well-being. It may also be a helpful resource for counselors to learn effective self-care strategies to sustain personal wellness and professional competence. This pilot study examined the impact of Luna Yoga, a four-week program created specifically for women to enhance creativity, connection, and self-awareness, and facilitate a socially supportive environment unlike traditional yoga sessions. This pilot study employed a delayed treatment control group design to test the impact of the Luna Yoga intervention on reported levels of wellness, resulting in an increase in social wellness among female professional counselors and counselors-in-training.

Self-Care in Palliative Care Nursing and Medical Professionals: A Cross-Sectional Survey.

Self-care is an important consideration for palliative care professionals. To date, few details have been recorded about the nature or uptake of self-care practices in the palliative care workforce. As part of a broader mixed methods study, this article reports findings from a national survey of nurses and doctors. The objective of this study was to examine perceptions, education, and practices relating to self-care among palliative care nursing and medical professionals. A cross-sectional survey using REDCap software was conducted between April and May 2015. Perceived importance of self-care, self-care education and planning, and self-care strategies most utilized were explored. Descriptive statistics were calculated and content analysis used to identify domains of self-care. Three hundred seventy-two palliative care nursing and medical professionals practicing in Australia. Most respondents regarded self-care as very important (86%). Some rarely practised self-care and less than half (39%) had received training in self-care. Physical self-care strategies were most commonly reported, followed closely by social self-care and inner self-care. Self-care plans had been used by a small proportion of respondents (6%) and over two-thirds (70%) would consider using self-care plans if training could be provided. Self-care is practised across multiple health related domains, with physical self-care strategies used most frequently. Australian palliative care nurses and doctors recognize the importance of self-care practice, but further education and training are needed to increase their understanding of, and consistency in, using effective self-care strategies. These findings carry implications for professional practice and future research.

The Development of a Nurse-Led Internet-Based Learning and Self-care Program for Cancer Patients With Symptoms of Anxiety and Depression—A Part of U-CARE

Having access to information about the disease and being encouraged to participate in self-care activities may reduce anxiety and depression symptoms in cancer patients. Internet-based interventions may be one way to support effective self-care strategies to improve emotional well-being and health-related quality of life. The aim of this study was to describe the development and acceptance of an Internet-based program intended to support cancer patients with anxiety and depression symptoms. A structured collaboration between patients, clinicians, and researchers was used to develop a theory- and evidence-based interactive health communication application (IHCA) based on Orem's self-care deficit nursing theory with influences from Bandura's social learning theory and psychoeducation. The result is an IHCA described as a Nurse-led, Internet-based Learning and Self-care program that helps patients to perform self-care using different types of material in interaction with patients and healthcare staff. The acceptance of the program is consistent with the results of similar studies. Collaboration between patients, clinicians, and researchers seems to be a fruitful approach in the development of an IHCA aiming to support cancer patients' self-care strategies. Well-designed intervention studies are needed to evaluate the effects of the IHCA. This article suggests a theoretical foundation for an IHCA and allows researchers and healthcare providers to take part in the discussion regarding format and content of IHCAs.

Self-management for adult patients with cancer: an integrative review.

Individuals with cancer are surviving long term, categorizing cancer as a chronic condition, and with it, numerous healthcare challenges. Symptoms, in particular, can be burdensome and occur from prediagnosis through many years after treatment. Symptom severity is inversely associated with functional status and quality of life. Management of these millions of survivors of cancer in a stressed healthcare system necessitates effective self-care strategies. The purpose of this integrative review is to evaluate intervention studies led by nurse principal investigators for self-care management in patients with cancer. PubMed, CINAHL (Cumulative Index to Nursing and Allied health Literature), and the Cochrane Database were searched from January 2000 through August 2012. Search terms included "symptom management and cancer," "self-management and cancer," and "self-care and cancer." All articles for consideration included intervention studies with a nurse as the primary principal investigator. Forty-six articles were included yielding 3 intervention areas of educational and/or counseling sessions, exercise, and complementary and alternative therapies. Outcomes were predominately symptom focused and often included functional status and quality of life. Few studies had objective measures. Overarching themes were mitigation, but not prevention or elimination of symptoms, and improved quality of life related to functional status. No one intervention was superior to another for any given outcome. Current interventions that direct patients in self-care management of symptoms and associated challenges with cancer/survivorship are helpful, but incomplete. No one intervention can be recommended over another. Guiding patients with cancer in self-care management is important for overall functional status and quality of life. Further investigation and tailored interventions are warranted.

Patients’ bowel symptom experiences and self‐care strategies following sphincter‐saving surgery for rectal cancer

To investigate patients' bowel symptom experiences and self-care strategies following sphincter-saving surgery for rectal cancer and the relationship between bowel symptom experiences and the self-care strategies used. Earlier diagnosis of rectal cancer allows for less invasive surgical treatments such as sphincter-saving procedures to be performed. Although a permanent stoma is generally not required, patients experience changes in bowel function following this surgery. However, limited research exists on patients' bowel symptom experiences and the self-care strategies used to manage symptoms following sphincter-saving surgery of rectal cancer. Quantitative descriptive correlational. A convenience sample of 143 patients aged 30 to over 70years was used. Data were collected (April 2010-December 2010) using the Illness Perception Questionnaires, the Difficulties of Life Scale and a researcher developed Self-care Strategy Measure. The research was underpinned by the Symptom Management Theory. Relating to the four most effective self-care strategies used respondents reporting more bowel symptom were more likely to use the self-care strategy proximity/knowing the location of a toilet at all times. Females, respondents with high timeline cyclical scores and respondents with high physiological responses scores were more likely to use protective clothing. Respondents reporting more bowel symptom and with high social responses scores were more likely to use bowel medication. Females were more likely to wear incontinence pads. This research provides insights into the daily bowel symptom experiences of patients following sphincter-saving surgery for rectal cancer. It demonstrates the range of self-care strategies that individuals use to manage their bowel symptoms and the self-care-strategies that were most effective for them. Patients should be encouraged to report on-going bowel problems following sphincter-saving surgery for rectal cancer. Supportive care for patients should be comprehensive and tailored to meet individual needs.

Feasibility of a Symptom Management Intervention for Adolescents Recovering From a Hematopoietic Stem Cell Transplant

Adolescents undergoing a hematopoietic stem cell transplantation (HSCT) experience a variety of adverse effects and eating difficulties. Few interventions exist to assist patients with self-care after HSCT hospitalization. The Eating After Transplant (EAT!) program is a mobile phone applications developed to assist adolescents with self-management of common eating-related issues during HSCT recovery. This study examined the acceptability and usability of the EAT! program among adolescents and assessed the competency of the participants using the program after hospital discharge through the first 100 days after HSCT. A repeated-measures design was used to evaluate the EAT! application with 16 adolescent patients recovering from an allogeneic HSCT. Participants provided verbal feedback and used a Likert scale to rate acceptability and usability of the application. In addition, a tracking device monitored use of the application. Competency was measured with orientation time and independent demonstration of use of the application. Acceptability remained high throughout the study, but use significantly decreased over time. Patients reported familiarity with the program's content as the reason for the declining use. Competency was excellent with a short orientation period and independent demonstration throughout the study. A mobile phone application is a feasible intervention to educate adolescents with symptom management strategies. Future research needs to examine factors affecting sustainability of use over time. Healthcare providers need to continue to develop and evaluate innovative methods to educate adolescents on effective self-care strategies throughout HSCT recovery.

A randomized controlled trial of an HIV/AIDS Symptom Management Manual for depressive symptoms

Depressive symptoms are highly prevalent, underdiagnosed, and undertreated in people living with HIV/AIDS (PLWH), and are associated with poorer health outcomes. This randomized controlled trial examined the effects of the HIV/AIDS Symptom Management Manual self-care symptom management strategies compared with a nutrition manual on depressive symptoms in an international sample of PLWH. The sample consisted of a sub-group (N=222) of participants in a larger study symptom management study who reported depressive symptoms. Depressive symptoms of the intervention (n=124) and control (n=98) groups were compared over three months: baseline, one-month, and two-months. Use and effectiveness of specific strategies were examined. Depressive symptom frequency at baseline varied significantly by country (χ 2 12.9; p=0.04). Within the intervention group there were significant differences across time in depressive symptom frequency [F(2, 207) = 3.27, p=0.05], intensity [F(2, 91) = 4.6, p=0.01], and impact [F(2, 252) = 2.92, p= 0.05), and these were significantly lower at one month but not at two months, suggesting that self-care strategies are effective in reducing depressive symptoms, however effects may be short term. Most used and most effective self-care strategies were distraction techniques and prayer. This study suggests that people living with HIV can be taught and will employ self-care strategies for management of depressive symptoms and that these strategies are effective in reducing these symptoms. Self-care strategies are noninvasive, have no side-effects, and can be readily taught as an adjunct to other forms of treatment. Studies are needed to identify the most effective self-care strategies and quantify optimum dose and frequency of use as a basis for evidence-based practice.

Nonpharmacologic Strategies for Managing Common Chemotherapy Adverse Effects: A Systematic Review

Adverse effects of chemotherapy can be severe and can have a significant impact on a person's quality of life. With chemotherapy treatment increasingly administered in the ambulatory setting, there is a need for patients to be informed about effective self-care strategies to manage treatment adverse effects. Advice for patients needs to be based on evidence. This systematic review provides an overview of the intervention research in this area as well as an effectiveness review of nonpharmacologic (self-care) strategies evaluated in high-quality randomized controlled trials (RCTs). An extensive literature search was conducted to identify RCTs relating to self-care strategies for reducing nausea/vomiting, constipation, diarrhea, fatigue, hair loss, or mucositis. Relevant studies published in peer-reviewed journals between 1980 and August 2007 were included. Study characteristics, results and methodologic quality were examined. High-quality RCTs were further analyzed to establish the effectiveness of specific self-care strategies. The search identified 77 RCTs. Findings from RCTs of reasonable quality provide limited support for cognitive distraction, exercise, hypnosis, relaxation, and systematic desensitization to reduce nausea and vomiting, psycho-education for fatigue, and scalp cooling to reduce hair loss. Although some strategies seem promising, the quality of the RCTs was generally quite low, making it difficult to draw conclusions about the effectiveness of self-care strategies. Future studies require better design and reporting of methodologic issues to establish evidence-based self-care recommendations for people receiving chemotherapy.