Health Behaviors Of Patients Research Articles

Nudge theories and strategies influencing adult health behaviors and outcomes in COPD management: a systematic review

ObjectiveChronic obstructive pulmonary disease (COPD) is a chronic respiratory disease with high prevalence and mortality, and self-management is a key component for better outcomes of COPD. Recently, nudging has shown promising potential in COPD management. In the present study, we conducted a systematic review to collate the list of nudges and identified the variables that influence nudging.MethodsWe undertook a systematic review. We employed database searches and snowballing. Data from selected studies were extracted. The risk of bias was assessed using the Cochrane Effective Practice and Organization of Care risk of bias tool. The study is registered with PROSPERO, CRD42023427051.ResultsWe retrieved 4,022 studies from database searches and 38 studies were included. By snowballing, 5 additional studies were obtained. Nudges were classified into four types: social influence, gamification, reminder, and feedback. Medication adherence, inhalation technique, physical activity, smoking cessation, vaccination administration, exercise capacity, self-efficacy, pulmonary function, clinical symptoms, and quality of life were analyzed as targeted health behaviors and outcomes. We found medication adherence was significantly improved by reminders via mobile applications or text materials, as well as feedback based on devices. Additionally, reminders through text materials greatly enhance inhalation techniques and vaccination in patients.ConclusionThis review demonstrates nudging can improve the health behaviors of patients with COPD and shows great potential for certain outcomes, particularly medication adherence, inhalation techniques, and vaccination. Additionally, the delivery modes, the patient characteristics, and the durations and seasons of interventions may influence the successful nudge-based intervention.Clinical trial registrationThis review has been registered in the international Prospective Registry of Systematic Evaluation (PROSPERO) database (identifier number CRD42023427051).

Mediating Effect of Perceived Health Competence on the Association Between Mindfulness and Adherence to Health Behaviors in Patients with Acute Coronary Syndrome: A Cross-Sectional Study.

Given the importance of adherence to health behaviors in patients with acute coronary syndrome (ACS) and the potential influence of mindfulness, it is important to determine the association between mindfulness and adherence to health behaviors and its potential mechanisms in this population. Perceived health competence is a person's confidence in his/her ability to achieve health goals successfully and may explain how mindfulness influences adherence to health behaviors. This study aimed to examine the association between mindfulness and adherence to health behaviors and whether this association was mediated by perceived health competence. A cross-sectional study (N = 555) was conducted at the First Affiliated Hospital of Soochow University from September 2022 to January 2024. Patients' sociodemographic and clinical data, mindfulness (Mindful Attention Awareness Scale [MAAS]), and perceived health competence (Perceived Health Competence Scale [PHCS]) were assessed one-two days before discharge, and adherence to health behaviors (Medical Outcomes Study Specific Adherence Scale [MOSSAS]) was assessed one month after discharge. Good adherence to health behaviors was defined as achieving a cumulative score of ≥ 80%. A mediating effect model was used to analyze data. The mean score of adherence to health behaviors was 42.58 ± 7.13 and only 27.39% (152/555) of the patients had good adherence. Mindfulness positively predicted adherence to health behaviors (β = 0.13, P < 0.01). Perceived health competence partially mediated the association between mindfulness and adherence to health behaviors, with the mediating effect accounting for 7.00% of the total effect (P = 0.03). The adherence to health behaviors in patients with ACS was very low. Mindfulness positively predicted adherence to health behaviors, and perceived health competence partially mediated the association between mindfulness and adherence to health behaviors. Healthcare providers could intervene patients' mindfulness or perceived health competence to improve adherence to health behaviors.

Patient Demographics and Factors Influencing Access to General Practitioner Services for Musculoskeletal Pain in the United Kingdom.

Access to general practitioner (GP) services is essential for managing musculoskeletal pain. This study investigates the relationship between patient demographics, co-morbidities, health behaviours and difficulty in accessing GP services in the United Kingdom. Significant associations were explored between age, co-morbidities and ease of securing GP appointments. This analysis provides insights into the barriers patients face and suggests targeted interventions for improving access to primary care. A cross-sectional study was conducted using survey data from participants of various ages, ethnicities and socioeconomic statuses with either localised or generalised musculoskeletal pain. Relationships between key variables, such as age, co-morbidities and difficulty in accessing GP services, were examined using chi-square tests (for nominal variables) and Kruskal-Wallis tests (for nominal and ordinal variables). A total of 503 respondents participated in the online questionnaire. In all, 66% of the respondents were female. The majority of participants were Caucasian (69%), followed by South Asians (19%), with the remainder identifying as Black or of mixed ethnicity. Most respondents (62%) reported experiencing musculoskeletal pain for over 2years. Significant associations were found between the age of the participants and difficulty in accessing GP services (χ2(20)=39, p=0.006), co-morbidities and the impact of delayed GP reviews on patients' musculoskeletal pain (χ2(10)=31, p=0.001), employment status and alternative care choices (χ2(4)=10.99, p=0.027). These results highlight the multifaceted nature of healthcare access for patients of various ages with musculoskeletal pain. Age, co-morbidities and employment status significantly influence access to GP services. Future studies should explore additional systemic healthcare barriers and develop personalised interventions to improve access for high-risk populations.

Assessing the use of activity trackers in clinical practice: a survey of cardiac rehabilitation clinicians from Australia, Brazil, and Canada

Abstract Background The use of wearable activity trackers has been found to significantly improve health profile and cardiorespiratory fitness, as well as to reinforce positive health behaviours in patients participating in cardiac rehabilitation (CR) programs. However, clinicians’ perceptions of activity trackers and their use in clinical practice have not been widely explored. Purpose To describe perceptions, attitudes, and behaviours of CR clinicians towards the use and usefulness of activity trackers in CR programs, and identify barriers and enablers associated with their personal and clinical use. Methods Descriptive cross-sectional survey. Data were collected using Research Electronic Data Capture (REDCap) from April to December 2023. Clinicians working in CR programs were recruited in each country via social media, email and digital flyers, group chats and author networks. A purpose-built 44-item digital survey comprising four sections was constructed: (1) socio-demographic details, (2) personal and professional use of activity trackers, (3) perspectives on the use of activity trackers for CR, and (4) perceptions of factors affecting the use of activity trackers in CR. Results In total, 199 clinicians from Australia (n=44), Brazil (n=102) and Canada (n=53) responded to the survey. Most were women (74%), physiotherapists (37%), working at a metropolitan hospital (55%), with a median age of 35 years (range 22-71). The majority found activity trackers helpful for patients with goal setting and monitoring exercise (89%) and promoting patient engagement and autonomy beyond structured, supervised CR (75%). Activity trackers were also perceived to be useful in engaging patients in their own health (94%), improving patient-provider communication (73%), boosting patient adherence with directed exercise (87%), and improving patient’s understanding of their own health conditions (79%). Furthermore, activity trackers were perceived to enable a more personalised care (69%), increase accessibility to CR (45%) and be time- and cost-effective for CR programs (49%). Sixty percent were motivated to use activity trackers and 69% recommended the use of trackers to their patients. On the other hand, the use of activity trackers was reported to be related to dependence (44%) and excessive obsession of one’s own health (55%); 50% reported a lack of relevant policies on activity trackers for clinical use in their respective institutions and limited funding for purchasing activity trackers by health services (78%). Only 30% reported that there was support from leadership and/or peers for the use of activity trackers. Conclusion In general, clinicians held positive attitudes towards the use of activity trackers in CR. However, a lack of relevant policies, funding and support from leadership are important barriers to the adoption and use of activity trackers in CR programs. Development of guidelines for the use of activity trackers in clinical practice is warranted.

Scoring Health Behaviors of Patients with Type 2 Diabetes.

Background and Objectives: Millions of people worldwide suffer from diabetes. The ever-increasing number of patients poses a huge challenge to healthcare systems. The purpose of this study was to evaluate the lifestyle and self-monitoring of type 2 diabetes patients using the Healthy Lifestyle and Self-Monitoring Questionnaire. Material and Methods: The analyses conducted were based on data collected using the Polish version of the Healthy Lifestyle and Self-Control Questionnaire among 104 patients diagnosed with type 2 diabetes who were treated at the Diabetes Outpatient Clinic. The in-house study also included an analysis of the relationship between lifestyle habits and disease acceptance and chronic disease functioning. Results: Respondents scored statistically significantly higher for the Healthy Lifestyle and Self-Monitoring Questionnaire than the norms assume, and the largest differences were observed in terms of the healthy dietary choices subscale (t = 8.07; p < 0.05). Only for the subscale of organized exercise were no statistically significant differences found (t = 0.50; p = 0.620). Conclusions: Type 2 diabetes is one of the diseases in which lifestyle not only contributes to its development but is also associated with its course and treatment outcomes. Reinforcing a health-promoting lifestyle is one of the cornerstones of treating patients with type 2 diabetes.

Post-pandemic persistence of adverse health behaviors in patients with psychotic disorders: A follow-up study

ObjectiveThe ramifications of the COVID-19 pandemic on patients with psychotic disorders have been previously documented by the authors of this study. The aim of study is to investigate whether the effects of the pandemic continued among the same cohort of patients with psychotic disorders who participated in the initial study. Methods232 of the 255 participants in the initial study participated in this follow-up study. The assessment covered sociodemographic data, changes in physical and mental health since the pandemic, new diagnoses of physical illnesses, smoking, medication adherence, suicidal behavior. ResultsThe body weight of the patients before, during, and after the pandemic was 77.6 ± 13.1,81.3 ± 14.1,and 83.1 ± 14.3, respectively and there was increase in BW in the post-pandemic compared to before the pandemc and the during the pandemic (Z: - 8.658, p < 0.001, r: -0.57; Z: −6.852, p < 0.001, r: ‐0.45 respectively). The mean number of cigarettes smoked daily by the patient's before the pandemic, during the pandemic, and after the pandemic was 11.1 ± 14.2,14.9 ± 16.2,and 12.9 ± 14.9, respectively. There was a decrease in the number of cigarettes smoked daily in the post-pandemic compared to the during the pandemic (Z: −4753, p < 0.001, r: −0.45). Both suicidal ideations and attempts were significantly higher during the pandemic compared to after the pandemic (p < 0.001,p < 0.001). Medication adherence in the post-pandemic period was not different compared to the pandemic levels (Z: −0.621, p:0.535). ConclusionThe study confirmed the continuation of adverse outcomes noted previously, such as increased body weight, increased daily cigarette consumption, and diminished medication adherence.

Quality of life and health behaviors of patients diagnosed with cardiovascular disease

Background: Cardiovascular diseases are the leading cause of death, both in Poland and worldwide, significantly impacting patients' quality of life. Health behaviors, whether positive or negative, play a crucial role in influencing the incidence of cardiovascular diseases. This study aims to analyze the correlation between health behaviors and the quality of life among patients with cardiovascular diseases. Materials and Methods: The study was conducted among 120 patients (116 eligible) at the Independent Public Provincial Hospital in Poland. Standardized tools including the Health-Related Behavior Inventory (HBI) questionnaire developed by Zygfryd Juczyński, the WHOQOL-BREF Questionnaire, and an original questionnaire with metric data were employed for diagnostic survey. Statistical analysis was performed using the Statistica 10.0 program, with a significance level set at p ≤ 0.05. Results: The respondents' average HBI score was 5.09, while the average overall quality of life score was 3.42, and the average overall health score in the study group was 3.07. Statistically significant correlations were observed between health practices and the assessment of general health, the general index of health behaviors and the level of quality of life in the physical domain, as well as positive mental attitude and quality of life in the psychological domain. Lower quality of life and poorer health status among patients with cardiovascular diseases were associated with increased preventive behaviors and intensified health practices. Conclusions: Despite having a good quality of life on average, individuals with cardiovascular diseases demonstrated moderate health behavior scores. The coexistence of lower quality of life and poorer health status with intensified preventive activities and health behaviors suggests a need for support in mental functioning, as well as adequate education and motivation regarding diet and eating habits. Moreover, it's essential to utilize appropriate techniques to motivate patients to adopt healthier behaviors.

Health Behaviours after Returning to Work in Patients Who Experienced Hand Finger Amputation as a Result of Work Accidents

Background: Many organizations face health behavior related issues such as anxiety, depression, traumatic stress disorder in their employee performance, particularly in those who had experienced hand-finger amputation as a result of work accidents. Such issues reduce their overall productivity when they return to work. Aim: The objective of this research was to measure the impact of rehabilitation program participation, psychological support, workplace accommodations and self-efficacy in daily tasks on the health behaviour of patients who experienced hand finger amputation as a result of work accidents. Method: The study used cross-sectional data, collected from 210 respondents across organizations in Adana, Turkey. The empirical results were checked using Statistical Package for Social Science (SPSS) version 21. Results: The findings of this study confirmed that rehabilitation participation program, psychological support, and self-efficacy in daily tasks had a significant and direct impact on the health behaviour of patients who experienced hand-finger amputation as a result of work accidents. However, the study also reported there was no significant and direct impact of workplace accommodations on the health behaviour of patients who experienced hand-finger amputation as a result of work accidents. Conclusion: The findings of this research would contribute to the body of literature in the form of new rationale development and would provide practical solutions to improve employees' health behaviour.

Recurrence Risk Perception, Fear of Progression, and Health Behaviors Among Patients With Ischemic Stroke.

The relationship between recurrence risk perception, fear of progression, and health behaviors in patients with ischemic stroke is unclear. To explore the effect of accuracy and level of recurrence risk perception on health behaviors and the mediating role of fear of progression. We conducted a 2-wave survey. Patients with ischemic stroke (N = 261) were recruited from 2 hospitals in Guangzhou, China. Before discharge, demographic information, objective recurrence risk, perceived recurrence risk, fear of progression, and health behaviors were investigated. After 1 month, the patient's health behaviors were followed up. The median (quartiles 1-3) scores for recurrence risk perception and fear of progression were 43.0 (39.0-46.0) and 22.0 (18.0-28.0), respectively. Only 22.2% of the patients correctly perceived the risk of recurrence, 23.0% underestimated the risk, and 30.7% overestimated the risk. Patients who overestimated the risk of recurrence (β = 0.421, P = .002) or had a higher perceived level of recurrence risk (β = 0.446, P < .001) had a higher fear of progression, which contributed to better health behaviors at 1 month (β = 0.197, P = .001). Fear of progression played a partial and full mediating role, respectively. Patients who underestimated the recurrence risk had worse health behaviors than those who accurately perceived it (β = -0.296, P = .033). Both accuracy and level of recurrence risk perception were independent predictors of future health behaviors, and fear of progression was mediating. Health care professionals should develop individualized risk education programs to help stroke patients properly understand and cope with the risk of recurrence.

The relationship between hope level and self-management behaviors in Chinese patients with type 2 diabetes mellitus: a chain-mediated role of social support and disease perception

BackgroundType 2 diabetes mellitus is a chronic disease and one of the fastest- growing global health emergencies of the 21st century. The relationships between hope level, social support, disease perception, and self-management behaviors are still unclear. Therefore, this study aimed to create a structural equation model to investigate the underlying mechanisms of self-management behaviors in patients with type 2 diabetes mellitus and provide a theoretical basis for future interventions.MethodsBy using cross-sectional studies and convenience sampling methods. A survey was conducted from June 2023 to April 2024 on 404 patients with type 2 diabetes mellitus at the First and Third Hospitals of Jinzhou Medical University. Data were collected using scales, including the General Information Questionnaire, the Herth Hope Scale, the Social Support Rating Scale, the Brief Disease Perception Questionnaire, and the Diabetes Self-Management Behavior Scale. Data were analyzed using descriptive analysis, Harman’s one-way analysis of variance, Pearson’s correlation test, structural equation modeling, and the bootstrap method to verify mediating effects.ResultsCorrelation analyses showed that all four variables were significantly correlated with each other (p < 0.01). Social support had the strongest correlation with self-management behavior (β = 0.554, p < 0.01), followed by hope level (β = 0.543, p < 0.01), and disease perception (β = -0.505, p < 0.01). The structural equation model indicated a strong overall fit (χ2/df = 3.378, GFI = 0.926, CFI = 0.924, IFI = 0.925, TLI = 0.903, RMSEA = 0.077).ConclusionOverall, the chain mediation of social support and disease perception was significant. In developing targeted intervention strategies, future research should prioritize enhancing hope, optimizing social support, and reducing negative perceptions of disease by patients as key areas of focus. At the same time, strengthening self-management abilities and health behaviors in patients with type 2 diabetes should not be neglected.

Relationship Between Self-Management and Health Behavior of Hypertension Patients in Romana Tanjung Anom Clinic

Background: Health problems in patients at the Romana Tanjung Anom clinic arise as a result of health behaviors that have a negative impact. Health problems are the result of human behavior in interacting with themselves and their environment, both biological, psychological, socio-cultural, and even political environments. Efforts to overcome health problems are by changing health behavior in self-management. This study aimed to find out whether there is a relationship between self-management and health behaviour behavior of hypertensive patients. Methods: Methods of the research conducted was correlational with a cross-sectional approach, involving 79 respondents.The sampling method employed was purposive sampling.Researchers used the first 2 questionnaires, namely self-management with 40 questions.The second questionnaire is behavior with 17 questions. Questionnaires are filled out and submitted offline or directly at the place of research. This study used bivariate analysis and with statistical tests of spearman rank. Results: The result of the study were obtained Self-management of hypertensive patients at Romana Tanjung Anom Clinic had good self-management of 47 respondents (59.5%) from 79 respondents. The health behavior of hypertensive patients at Romana Tanjung Anom Clinic in 2023 has good health behavior of 68 respondents (86.1%) from 79 respondents. There is a significant relationship between self-management and health behavior hypertensive patients at Romana Tanjung Anom Clinic in 2023 with p-value=0.019 (p&lt;0.05) and a correlation of 0.264. Conclusion: The conclusion of this study is that there is a significant relationship between self-management and health behavior of hypertensive patients at Romana Tanjung Anom Clinic and have good health behaviors

Romantic relationships and type 2 diabetes: The role of invisible social control.

This study aimed to determine whether invisible social control provided by a romantic partner is associated with improved objective glucose outcomes for patients with Type 2 diabetes. Social control reflects a partner's attempt to modify or influence a patient's health behaviors. We hypothesized that the best outcome for all continuous glucose monitoring measures would be captured by an interaction condition reflecting invisible social control. Patients with Type 2 diabetes and their partners (N = 63 couples) completed an 8-day daily diary period between 2016 and 2017. Self-report measures of social control receipt and provision were obtained each evening from patients and partners and patients wore a continuous glucose monitor throughout the diary period. Outcomes of daily glucose mean, standard deviation, time in range, and coefficient of variation were computed and two-way interactions between social control receipt and social control provision were probed and plotted. The two-way interaction significantly predicted daily glucose mean, standard deviation, and time in range, such that when patients reported no social control receipt, but partners reported social control provision, patients showed improvements in objective glucose measures. We found no significant effect for coefficient of variation. This study was the first to use an invisible social control framework to examine the daily dyadic associations between partner social control provision, patient social control receipt, and four objectively measured continuous glucose monitoring outcomes. Findings suggest that the visibility of social control provided by a romantic partner may be predictive of glycemic control in patients with Type 2 diabetes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Oral discomfort and health behavior of patients with typical vs. atypical antipsychotic drugs.

Psychiatric patients suffer from oral diseases and side effects of antipsychotic medication. In particular, the typical antipsychotic drugs may cause severe hyposalivation with subsequent oral symptoms. We therefore aimed to compare oral health behavior and oral side effects of in-hospital patients taking typical vs. atypical antipsychotic drugs with the hypothesis that the former drugs cause more oral pain than the newer drugs. This cross-sectional questionnaire and interview study investigated subjective oral symptoms and their health behavior in 170 hospitalized psychiatric patients, comparing those taking typical vs. atypical antipsychotic drugs. Cross-tabulations and chi-square tests were used for analyses. Persistent oral pain lasting throughout the day was reported by 46% in the typical, and 5% in the atypical antipsychotic group patients, respectively. In both groups, the pain was mainly in the tongue and buccal mucosa and was described as a burning sensation. A significantly higher prevalence of xerostomia was reported in the typical antipsychotic medication group (66%) compared with the atypical antipsychotic medication group (53%, p<0.01). Self-assessed dental health was assessed as poor by two-thirds of the patients of whom 69% reported toothbrushing once daily. Approximately half of them reported having had a visit to a dentist within the previous year. Of the women 28%, and of the men 17%, respectively, had received professional consultations for oral symptoms. The current results on psychiatrically hospitalized patients emphasize the need for awareness of oral discomfort and its subsequent effects on the quality of life in this challenging patient group. Focus should also be placed on a wide range of support encouraging the patients to maintain good daily oral hygiene and seek professional dental help when needed.

Factors Influencing Autonomy in Middle-Aged and Elderly Women with Urinary Incontinence.

Urinary incontinence (UI) is relatively common among middle-aged and elderly women and can have significant impacts on patients' physiological, psychological, and quality-of-life aspects. A higher level of autonomy can encourage better health behaviors in patients, so as to promote rehabilitation of the disease and improve their quality of life. The study is aimed at exploring the level of autonomy and influencing factors among middle-aged and elderly women with UI. A cross-sectional study was conducted at a tertiary hospital in Shenzhen, China. Middle-aged and elderly women were asked to complete the Index of Autonomous Functioning scale (IAF), the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), and the Urinary Incontinence Quality of Life (I-QOL) scale. Data were collected in January 2024 to March 2024. Descriptive statistics, univariate analysis, bivariate correlation and multivariate linear regression were used to analyze data. A total of 646 women completed the questionnaire. The means and standard deviations (SD) of the IAF section were 45.40 ± 8.92, those of the ICIQ-UI SF section were 11.54 ± 3.67, and those of the I-QOL section were 43.95 ± 9.83. Multivariate linear regression models for the IAF revealed that questionnaire scores were independently associated with family's monthly income, education level, regular exercise, UI severity, and I-QOL score (p < 0.05). The factors influencing the level of autonomy among middle-aged and elderly women with UI include family's monthly income, education level, regular exercise, UI severity, and I-QOL score. Higher levels of autonomy were observed among women with high family income, high education level, regular exercise habits, mild to moderate UI, and high quality of life.

Oral health education strategies for patients living with cardiovascular disease within hospital settings: a scoping review.

To identify and describe the impact of current oral health education programmes provided to patients in cardiology hospital wards and outpatient clinics. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews statement. Searches were conducted using electronic databases: Cochrane, Medline, and Scopus, as well as grey literature searching. Three eligible studies were identified. All included studies reported generalised poor oral health in their participants at baseline, with significant improvement at follow-up. They all reported significant reductions in plaque deposits and gingival bleeding. One study reported significantly less bacteria on participant tongues, as well as fewer days with post-operative atrial fibrillation in the intervention group. Furthermore, in this study, one patient in the intervention group developed pneumonia, whilst four patients in the control group did. Oral health education for patients with cardiovascular disease is limited and many have poor oral health. Educational programmes to improve oral health behaviours in patients with cardiovascular disease can improve both oral and general health outcomes. Oral disease is a modifiable risk factor for cardiovascular disease. Integrating oral health education into cardiology hospital settings is a simple strategy to improve access to oral health information and improve both oral and cardiovascular outcomes.

Evaluation of a Cardiovascular Disease/Diabetes Mellitus Expansion Program for Community Health Workers Employed by Rhode Island Community Health Teams.

The integration of certified community health workers (CCHWs) with specialty chronic disease training into clinical care teams has demonstrated improvements in chronic disease quality of care, management, and outcomes. Rhode Island Department of Health's Diabetes, Heart Disease, and Stroke Program expanded the roles of CCHWs employed by Community Health Teams for chronic disease with a focus on cardiovascular disease (CVD) and diabetes mellitus (DM) from 2020 to 2023. Rhode Island Department of Health's Diabetes, Heart Disease, and Stroke Program sought to determine whether patient health behaviors and clinical outcomes improved with specialty trained CCHW support. Community Health Teams identified high-risk or rising-risk patients with hypertension, high cholesterol, and/or diabetes. During an infrastructure phase, patients were assigned a CCHW who had not received CVD/DM specialty training. During a performance phase, a separate cohort of patients was assigned a CVD/DM specialty-trained CCHW. In each phase, patients were seen by the CCHWs at least twice and completed baseline and follow-up health assessments. The trained CCHWs utilized the baseline assessment to offer health coaching specific to the patient's chronic disease-related needs. Improvements in blood pressure readings and cholesterol were observed at an individual level for CVD patients. However, a significant difference was not observed for hypertension or high cholesterol when comparing phases. Individual-level results indicated improved HbA1c values for DM patients; however, the differences in clinical values were not significant. Although there were no significant differences for clinical values between the phases, the proportion of patients who reported confidence in managing their condition(s) increased from baseline to follow-up for both phases. It cannot be concluded that specialty-trained CCHWs have significant impact on patient behaviors and clinical outcomes. However, overall CCHW intervention did result in improved self-efficacy in patients to manage their chronic conditions. Further evaluation is needed to understand what factors led to improved patient confidence levels.

Outcome of Abdominal Tuberculosis Complicated by Portal Hypertension, Pulmonary Tuberculosis, and Severe Acute Malnutrition

Background: Abdominal tuberculosis (TB) is a form of extrapulmonary TB that can present with or without involvement of the lungs. The diagnosis is difficult to establish, which may lead to diagnostic delays. Effective management of adolescent TB requires a holistic approach from various medical disciplines and interventions. This case presented a rare case 13-year-old girl diagnosed with abdominal TB Case: A 13-year-old girl presented with seven-months history of subfebrile fever, lymph node enlargement, abdominal distention, pallor, and severe weight loss. She was diagnosed with abdominal TB. The diagnosis was further complicated by portal hypertension, pulmonary TB, and severe acute malnutrition. To address these challenges, a multidisciplinary treatment plan was implemented and closely monitored for a period of 12 months Discussion: Multiple factors are significantly contributing to the successful outcome of the treatment for abdominal tuberculosis, including good adherence to the prescribed anti-tuberculous medications, absence of side effects from the drugs, the patient's positive knowledge, attitude and health behaviours, and housing and environmental health. Conclusion: This case highlights the importance of factors influencing disease outcomes of abdominal TB. Proper management of the factors would lead to significant clinical and nutritional status improvement, reduce TB transmission, and improved the overall quality of life.

PENGARUH PENDIDIKAN, PENGETAHUAN DAN PENYULUHAN KESEHATAN TERHADAP PENURUNAN GLUKOSA DARAH PADA PASIEN DM TIPE 2 DIPUSKESMAS PAKUHAJI KABUPATEN TANGERANG

ABSRACT Background: According to WHO, diabetes mellitus is a degenerative disease that is experienced by many Indonesians, and its prevalence continues to increase from year to year along with its complications. Good knowledge of disease is a provision as the basis for the application of health behavior of DM patients in managing themselves to achieve a better quality of life. Health education has a goal to change behavior starting from changes in education and knowledge. Purpose: To determine the effect of education, knowledge and health education on reducing blood glucose in type 2 DM patients at the Pakuhaji Public Health Center, Tangerang Regency. Research method: : this research used quantitative causal with a cross sectional approach, the technique used is sampling jenuh as many as 65 respondents. Result of the research: Based on the results of the T test, the effect of education has no effect on the decrease in blood glucose, knowledge has an effect on the decrease in blood glucose, and counseling has an effect on the decrease in blood glucose. Based on the results of the F test, the effect of education, knowledge and health education on the decrease in blood glucose results in F table 2.36 with a sig value of 0.000. Conclusion: The results showed that there was an effect of education, knowledge and health education on reducing blood glucose.

Pandeminin Toplumun ve Sağlık Çalışanlarının Ruh Sağlığına Etkileri

We read the article “Effect of COVID-19 Pandemic on Anxiety and Treatment Adherence in Orthodontic and Dental Patient” with great interest, which was prepared by Elhalık and Trakyalı and published in the third issue of your magazine in 2023 (1). We thank the author and the editorial board for the article discussing the impact of the pandemic on the health behavior of orthodontic and dental patients, considering current literature. We would like to mention a few points to contribute to the discussion of the study.

Cerebrovascular insult as a consequence of poor health behaviour in patients with schizophrenia and bipolar disorder

IntroductionCerebrovascular insult (CVI) in patients with psychiatric diseases is to a large extent more prevalent and is accompanied by a worse prognosis after a incident. Despite the higher mortality, these patients are less frequently subjected to CT angiography and interventional intervention on the blood vessels of the brain.ObjectivesTo show the frequency of cerebrovascular insults in patients with schizophrenia (SCH), bipolar affective disorder (BP), and depression, depending on age, gender, socioeconomic characteristics, professional qualifications, and dietary habits.MethodsA total of 1200 patients with SCH, BD and depression were treated over a period of five years.Results11.1% SCH patients had CVI and 3,7% a cases of bipolar afective diseases. CVI was most often experienced by patients who were married, employed, or retired, and who lived in urban areas. Smoking, elevated blood pressure values, elevated BMI do not have a significant impact on the occurrence of CVI in all groups. Patients with elevated values of glucose, total cholesterol and LDL cholesterol and CRP had a higher incidence of cerebrovascular insult.ConclusionsIt is necessary to work on raising the awareness of people suffering from psychiatric diseases regarding lifestyle and eating habits, and to conduct periodic health examinations. It is important to recognize high-risk patients and educate them about preventive measures.Disclosure of InterestNone Declared