Health-promoting Self-care Behaviors Research Articles

Designing and Evaluating the Effectiveness of an Educational Intervention Based on the Health Belief Model (HBM) in Promoting Self-Care Behavior Among Healthcare Workers

Background: Self-care is a fundamental aspect of health, encompassing conscious and purposeful actions by individuals for themselves, their children, and their families to maintain health. Objectives: This study aimed to determine the effect of an educational intervention based on the Health Belief Model (HBM) on self-care behaviors among health workers in comprehensive urban health service centers in Rudbar in 2019. Methods: In this quasi-experimental study, 89 health workers from comprehensive urban health service centers in Rudbar city, Gilan, participated. The participants were randomly assigned into control and intervention groups. An educational intervention, consisting of five 60 - 75 minute sessions based on the HBM, was designed and implemented for the intervention group. Outcome data were collected before and three months after the educational intervention using a questionnaire that measured HBM constructs and health-promoting self-care behaviors. Data analysis was performed using the chi-square test and Mann-Whitney U test. Results: The age range of most participants (43%) was 30 - 39 years, and 86% of participants were female. Both experimental and control groups were comparable in demographic characteristics, HBM constructs, and health-promoting self-care behavior at pretest. The educational intervention based on the HBM improved the mean scores of the HBM constructs (except for perceived benefits) and dimensions of self-care behavior (P < 0.05 for all). The average score of self-care behavior in the intervention group increased from 128.4 before the intervention to 148.37 after the intervention. Conclusions: According to the results, using the HBM, with its suitable methods and structure for engaging employees actively, was effective for designing educational interventions to promote self-care behaviors in health workers. Therefore, it can be used as a suitable framework for planning educational interventions to enhance self-care behaviors among health workers.

The effect of social network based motivational interviewing on health behaviors among infertile women with polycystic ovary syndrome: A randomized controlled trial.

Polycystic ovary syndrome is one of the commonest and complex endocrine disorders in females of reproductive age. Attention to self-care behaviors such as health-promoting behaviors can improve physiological and psychological conditions in women with PCOS. This study aimed to determine the efficacy of Social Network-Based Motivational Interviewing on health-promoting behaviors and quality of life of infertile women with polycystic ovary syndrome. In this randomized controlled trial, 60 infertile women with polycystic ovary syndrome were randomly selected and assigned to the interventio (n = 30) or a control group (n = 30). Participants in the control group received routine care. Those in the intervention group received five motivational group sessions in WhatsApp, which were conducted in five groups of six participants each. The data related to health-promoting behaviors and quality of life were collected through an online questionnaire. Both groups were followed up immediately and 2 months after the intervention. Data collected in the two stages were analyzed using the paired-samples t-test, Chi-square, and repeated measures analysis. No significant difference was observed between the two groups before the intervention means health-promoting behaviors and quality of life scores (p>0.05). Immediately and two months after the intervention, the mean scores of health-promoting behaviors and their domains increased in the intervention group. This increase is statistically compared to the first test, and the scores obtained by the control group in the second (p< 0.001, ES = 1.5) and the third test (p< 0.001, ES= 1.3) were significant. The score of the quality of life variable increase was not statistically significant compared to the first test and also to the scores obtained by the control group. However According to the Generalized estimating equations (GEE) test, the changes in quality of life score between the two groups in the three stages of measurement are statistically significant. WhatsApp support increases the health-promoting self-care behaviors rate and has favorable effects on follow-up.Trial registration: Iranian Registry for Clinical Trial (the link to trial: https://www.irct.ir/trial/48089 ). Registered August 11 2020.

Development and Psychometric Properties of a health-promoting self-care behavior scale (HPSCB-S) in recovered patients from Drug Addiction

Background and objectivesDrug addiction is a chronic and relapsing brain disease. Practicing self-care is one of the rules offered by therapists to improve the withdrawal process and prevent relapse. Based on the evidence, health beliefs, including Pender’s proposed model, are significantly effective in adopting self-care behaviors in patients. On the other hand, in order to evaluate preventive interventions regarding drug use and relapse of drug use; Having a good and appropriate tool is a special priority. Therefore, the present study aims to design and determine the psychometric characteristics of the questionnaire for measuring health-promoting self-care behaviors in patients recovered from drug addiction has been carried out in the west of Mazandaran province.MethodsThe current study is a cross-sectional descriptive methodological research. In the first stage, the items and primary classes of the new tool were extracted based on the review of studies consistent with Pender’s self-care promotion and a questionnaire was designed. In the second stage, the psychometric characteristics of the designed questionnaire were examined using face validity, content validity, construct validity and reliability. In the construct validity, the number of participants was 245 for exploratory factor analysis and 203 for confirmatory factor analysis. In the reliability test, 25 people participated to check internal consistency and test-retest. Random sampling was done from 12 drug addiction treatment clinics in two cities of Tonkabon and Ramsar in the west of Mazandaran province during 2021–2022. Data were analyzed using SPSS and AMOS software version 23.ResultsThe exploratory factor analysis revealed 7 factors containing 29 item explained more than 61% of the total observed variance. The results of confirmatory factor analysis showed that the data fit the model. In the reliability test, Cronbach’s alpha coefficient indicated the appropriate internal consistency of the tool and retesting the tool with an interval of 2 weeks showed acceptable stability of the tool.ConclusionThe present study showed that the researcher-made questionnaire has good validity and reliability and can be used to measure self-care behaviors of patients who have recovered from addiction in order to provide appropriate solutions to prevent the relapse of drug use.

Fit and fun: Content analysis investigating positive body image dimensions of adolescents’ Facebook images

Body-positive content on social media offers a promising approach to promote positive body image (PBI). However, we need further research in order to better characterize and understand its nature. This study provides a content analysis of adolescents’ image-based posts on Facebook. We aimed to determine whether the theoretical six-facet conceptualization of PBI was reflected in adolescents’ posts, and whether there were different trends according to gender and time, over a 3-year period. A set of 6,503 images posted by 66 adolescents (51.5% male), were coded for PBI attributes. The results indicate that inner positivity and appreciation of body functionality through involvement in sports and fun activities were the most represented PBI facets. Conversely, imagery representing taking care of the body via healthy food/beverage choices, embracing body diversity, and filtering information in a body-preserving manner, was rarely used to project self-image on Facebook. Gender differences were only found in the appreciation of body functionality via sports activities (more prevalent in boys) and investment in appearance using benign methods, such as the use of cosmetics (more prevalent in girls). Posts addressing appearance and health-promoting self-care behaviors tended to increase in mid-adolescence. We conclude that the adolescents’ posts on Facebook reflected several PBI characteristics, with a particular focus on those that enhance a functional view of the body. Future social media and school-level initiatives should prioritize the development of attuned self-care as well as mechanisms to filter messages that could endanger PBI, while also increasing the visibility of the diverse bodies that exist in the world.

Fit and fun: Content analysis investigating positive body image dimensions of adolescents’ Facebook images

Body-positive content on social media offers a promising approach to promote positive body image (PBI). However, we need further research in order to better characterize and understand its nature. This study provides a content analysis of adolescents’ image-based posts on Facebook. We aimed to determine whether the theoretical six-facet conceptualization of PBI was reflected in adolescents’ posts, and whether there were different trends according to gender and time, over a 3-year period. A set of 6,503 images posted by 66 adolescents (51.5% male), were coded for PBI attributes. The results indicate that inner positivity and appreciation of body functionality through involvement in sports and fun activities were the most represented PBI facets. Conversely, imagery representing taking care of the body via healthy food/beverage choices, embracing body diversity, and filtering information in a body-preserving manner, was rarely used to project self-image on Facebook. Gender differences were only found in the appreciation of body functionality via sports activities (more prevalent in boys) and investment in appearance using benign methods, such as the use of cosmetics (more prevalent in girls). Posts addressing appearance and health-promoting self-care behaviors tended to increase in mid-adolescence. We conclude that the adolescents’ posts on Facebook reflected several PBI characteristics, with a particular focus on those that enhance a functional view of the body. Future social media and school-level initiatives should prioritize the development of attuned self-care as well as mechanisms to filter messages that could endanger PBI, while also increasing the visibility of the diverse bodies that exist in the world.

Evaluation of health-promoting self-care behaviors in hypertensive patients with concomitant chronic kidney disease in primary care

This study was to investigate the relationships among health behaviors and quality of life (QOL) and to test a proposed model among people with hypertension and concomitant chronic kidney disease (CKD) in primary care. In addition, the mediation effect of modifiable risk factors between self-care health behaviors and QOL was examined. This study was prospective, conducted in the centers of primary medical care in the period from January 2018 to January 2020. In total, 170 patients diagnosed with hypertension and CKD at least 12 months previously were included in this study. The following parameters were measured: self-efficacy, self-care health behaviors with the subscales of health responsibility, exercise, consumption of a healthy diet, stress management, and smoking cessation; modifiable risk score; and QOL (assessed using the 36-item Short-Form Health Survey instrument). Self-efficacy had a significantly positive direct effect on self-care health behaviors, with a standardized regression coefficient of 0.87 (P = 0.007), a negative indirect effect on risk factors, with a standardized regression coefficient of 0.11 (P = 0.006), and a positive indirect effect on QOL, with a standardized regression coefficient of 0.62 (P = 0.008). Self-care health behaviors had a significantly positive direct effect on QOL, with a standardized regression coefficient of 0.72 (P = 0.012); there was also an indirect effect of 0.053 (P = 0.004). The direct effect of risk factors on QOL was significant, with a standardized regression coefficient of 0.44 (P = 0.018). The direct effect of self-care health behaviors on QOL was 0.77 (P = 0.008), which has been reduced to 0.72 (P = 0.012). The reduced effect of 0.05 was significant (P = 0.004), confirming the mediating role of modified risk factors. This study indicates health-promoting behaviors in hypertensive patients with CKD have a potential impact on their QOL in primary care. Primary care physicians should focus on motivation strategies to encourage individuals to perform self-care health-promoting behaviors associated with the improved QOL, in order to achieve better outcomes in risk factor management.

Assessment of Health-Promoting Self-Care Behaviors in Hypertensive Patients with Concomitant Type 2 Diabetes Mellitus in Primary Care

Assessment of Health-Promoting Self-Care Behaviors in Hypertensive Patients with Concomitant Type 2 Diabetes Mellitus in Primary Care

Effect of Educational Intervention Based on Health-Promoting Self-Care Behaviors Model on Quality of Life, Resilience, and Sense of Coherence in Patients with Multiple Sclerosis: A Randomized Controlled Trial

Background: Multiple sclerosis (MS) is a progressive central nervous system disease that has an enormous effect on a patient’s quality of life due to physical complications and psychological problems. Objectives: The purpose of this study is to investigate the effect of self-care education program based on Health-Promoting Self-Care Behaviors System Model on quality of life, resilience, and sense of coherence in patients with MS. Methods: In this randomized controlled clinical trial, 80 patients with MS referred to hospitals for special diseases in Kerman were enrolled using systematic sampling method and then randomly assigned to the intervention and control groups. The main research instruments, including demographic information checklist, Multiple Sclerosis Quality of Life (MSQOL-54), Connor-Davidson scale, Resilience Scale and Sense of Coherence Scale were completed by subjects in both intervention and control groups. The intervention group participated in 18 training sessions that addressed the needs of patients. The two groups completed the questionnaires one week and two months after intervention again. Generalized Estimating Equations (GEE) (GEE) test was used for data analysis. Results: Pre-intervention results revealed that intervention and control groups were not significantly different in the mean scores of most dimensions of quality of life and sense of coherence (P > 0.05). However, intervention and control groups were significantly different in mean scores of all dimensions of quality of life, resilience and sense of coherence one week and (P 0.05). Conclusions: Teaching health-promoting self-care behaviors system model improves the quality of life, resilience, and sense of coherence in patients with MS. Therefore, it is recommended to plan and implement self-care training interventions in accordance with this model for all patients with MS.

Health Promoting Self-care Behaviors in Patients With Multiple Sclerosis in the Southeast of Iran: Developing a Model for Practice.

Introduction:Promoting self-care practice, as a critical strategy for enhancing the quality of life in patients with Multiple Sclerosis (MS) is a challenging issue. This study aimed to propose a model of health-promoting self-care behaviors in MS patients.Methods:In this cross-sectional study, 200 patients with MS, who had referred to the Hospital for Special Diseases in Kerman City, Iran, were chosen. The main data collection instruments were the multiple sclerosis knowledge questionnaire, the Rosenberg self-esteem scale, multiple sclerosis self-efficacy scale, questionnaire of perceived barriers and benefits of self-care behaviors, social support, the health promotion lifestyle profile II, and resilience and sense of coherence scale. Data analysis was conducted in SPSS V. 22 and AMOS18 software. The Structural Equation Modeling (SEM) was also used for further analysis of dataResults:The model explained 82% of variance in Health-Promoting self-care Behavior (HPB). The results of the final model obtained from the SEM showed that self-efficacy (β=0.53, SE=0.04, P= 0.007), self-esteem (β=0.39, SE=0.04, P=0.005), social support (β=0.36, SE=0.04, P=0.009), sense of coherence (β=0.34, SE=0.07, P=0.006), resilience (β=0.33, SE=0.07, P=0.018), and perceived benefits (β=0.25, SE=0.05, P=0.009) had a positive and significant relationship with HPB.Conclusion:The self-care empowerment model in patients with MS presented in this study can be used as a framework for designing health promotion interventions to improve the quality of life of patients with MS.

Health-Promoting Self-Care in Family Caregivers of People With Dementia: The Views of Multiple Stakeholders.

Family carers often experience difficulties managing their own needs, which can lead to ill health. This study aimed to explore the views of carers and other stakeholders about the factors related to health-promoting self-care behavior in family carers of people with dementia. This multimethod qualitative study involved three consultation events with multiple stakeholders (n = 46) and four focus groups with carers (n = 27). Anonymous notes were collected from the consultation events. Focus group discussions were tape recorded and transcribed verbatim. Inductive thematic analysis was used to analyze the data. Two overarching themes were identified and labeled "Services" and "Individual factors." Poor service organization and coordination, lack of respite breaks, lack of continuity of care, poor staff attitudes, as well as difficulty to prioritize own needs, health impact, financial impact, and relationships and feelings were related poorer carer health-promoting self-care behavior. Limited health-promoting self-care often led to situations of crisis, which were related to carers' health issues, need for emergency services, and unanticipated care home placement. Carers require high-quality respite to have more time to themselves, support from better coordinated and compassionate services, and more education and awareness about their own needs. There are several factors that may limit carers' involvement with health-promoting self-care activities, which may affect their own health, on the care provided to their relatives and on service use. Future research and policy need to consider how to better support cares to manage their own health issues.

Improving health-promoting self-care in family carers of people with dementia: a review of interventions.

BackgroundProviding care for a family member with dementia can leave little time for carers to look after their own health needs, which makes them more susceptible to mental and physical health problems. This scoping review aimed to explore potential health benefits of interventions aimed at improving health-promoting self-care in family carers of people with dementia.MethodsA scoping review was carried out using Arksey and O’Malley’s methodological framework. EMBASE, MEDLINE, PsycINFO and Google Scholar were consulted. Original and peer-reviewed research published in English up to April 2017 were included. Publications were selected by two reviewers independently. Eight experts from several countries provided extra relevant information, which was triangulated with the review results. A narrative approach was used to describe and discuss the review findings.ResultsSeven interventions were identified. These were highly heterogeneous in content, method of delivery, and outcome measures. None was specifically focused on improving and evaluating health-promoting self-care, instead they often focused on health promotion and healthy lifestyle (eg, physical activity). Some of the multi-component interventions included “self-care” as a domain, but none used a specific measure of health-promoting self-care, so we were unable to affirm that the improvements found in the interventions were due to an improvement in this area. Interventions helped reduce carer depression and burden and increased quality of life, positive affect, and physical activity. The expert panel recommended to consider carers’ preparedness and capacity to adhere to self-care practices, as well as carers’ age and culture. Future interventions should be context specific, flexible, and person-centered.ConclusionPsychosocial interventions may improve health-promoting self-care behavior, but more research is needed to establish efficacy. Interventions should be flexible, use a person-centered approach, be implemented with fidelity and use the right dosage.

Health-promoting Lifestyles and Related Factors in Pregnant Women

Introduction: Health-promoting behavior increases the self-care of the individuals and improves the health. It reduces the chance of maternal and fetal harm during pregnancy. The objective of this study was to determine the sociodemographic factors related to health-promoting self-care behavior in Iranian pregnant women categorized by domains.Materials and Methods: A cross-sectional study design with convenience sampling was used to recruit 384 pregnant Iranian women that were referred to the health center in Sari in 2014-2015. Self-reporting questionnaires included sociodemographic characteristics and health-promoting lifestyle profile-II questionnaires. Data were analyzed with using the statistical package for the social sciences software (version 19). One-way ANOVA and chi-square tests were used to determine the relationship between the sociodemographic characteristics and health-promoting behaviors.Results: The mean age of pregnant women was 27.65±4.753 years. Most of the participants were in the second trimester of pregnancy. The mean of the total score for health-promoting behaviors was 142.96±17.947. Among the six dimensions of health-promoting behaviors, the interpersonal relations scored maximal, and the physical activity scored the lowest. Significant correlations existed between spirituality and the wife’s education, the wife’s job, and the family income. In addition, a significant correlation was established between stress management and the wife’s education, also between the aspect of relationships and the husband’s education, the wife’s education, the family income, and the decision maker (all P&lt;0.005).Conclusion: The findings of the present study confirmed that the sociodemographic factors were vital in health-promoting behaviors in pregnant women.

Illness perception, risk perception and health promotion self-care behaviors among Chinese patient with type 2 diabetes: A cross-sectional survey

AimTo explore illness perception and perceived risk of developing diabetes complications in relation to health-promoting self-care behaviors among Chinese patients with type 2 diabetes. BackgroundIllness and risk perceptions are important determinants of various health behaviors. However, few studies have simultaneously examined the impacts of these two constructs on self-care among diabetic patients. MethodsData were collected on participants' characteristics, illness perception, risk perception, and health-promoting self-care behaviors over 6months among 304 subjects from three general hospitals. ResultsSignificant associations between illness perception and risk perception were observed. Illness perception and/or risk perception explained an independent, small but significant proportion of the variance in each health-promoting self-care behavior. ConclusionOne's perceptions of illness and future risk might be influential in understanding health-promoting self-care among diabetic patients. It may be useful to improve self-management by tailoring intervention content to individuals' illness-related perceptions.

The Effect of Intervention Based on Pender’s Model of Health-Promoting Self-Care Behaviors in Women who are the Head of their Household

Background: A number of studies have reported that women as the head of the household suffer from poor physical health. Yet, a few studies are available on the effects of health-promoting interventions for this vulnerable group. Objectives: The present study was conducted to determine the effect of an intervention based on Pender’s model on health-promoting behaviors in women who were the head of their household. Methods: A quasi-experimental study was conducted on 66 women, who were the heads of households with inappropriate physical health-promoting behaviors, selected by the consensus method and allocated to intervention and control groups using the randomized permuted block method. The intervention group received supportive-educational intervention according to Pender’s model. Posttest was carried out for both intervention and control groups two months after the end of the intervention. Data were analyzed using descriptive statistics and inferential tests, including independent samples t, paired t, Chi-square, Mantel-Haenszel tests and logistic regression analysis. Results: The subjects’ mean age was 39.58 ± 6.69 years, of whom, 47% were widowed; they were mostly housewives with a mean schooling of 7.97 ± 4.31 years, and 74.2% had insufficient income. Prior to the intervention, women who were the head of the household and had poor level of health-promoting behaviors were selected. There was no significant difference between the two groups in mean score of the components of the health-promoting model (P < 0.05). The intervention group had significantly better performance in physical health-promoting behaviors, two months after the intervention (P < 0.001). Conclusions: The supportive-educational intervention was effective on the physical health-promoting behaviors of women who were the head of the household. Thus, this model can be used as a framework for planning interventions to promote the physical health of such women.

Predicting health-promoting self-care behaviors in people with pre-diabetes by applying Bandura social learning theory

AimsThe aim of this study was to apply Bandura social learning theory in a model for identifying personal and environmental factors that predict health-promoting self-care behaviors in people with pre-diabetes. BackgroundThe theoretical basis of health-promoting self-care behaviors must be examined to obtain evidence-based knowledge that can help improve the effectiveness of pre-diabetes care. However, such behaviors are rarely studied in people with pre-diabetes. MethodsThis quantitative, cross-sectional survey study was performed in a convenience sample of two hospitals in southern Taiwan. Two hundred people diagnosed with pre-diabetes at a single health examination center were recruited. A questionnaire survey was performed to collect data regarding personal factors (i.e., participant characteristics, pre-diabetes knowledge, and self-efficacy) and data regarding environmental factors (i.e., social support and perceptions of empowerment process) that may have associations with health-promoting self-care behaviors in people with pre-diabetes. ResultsMultiple linear regression showed that the factors that had the largest influence on the practice of health-promoting self-care behaviors were self-efficacy, diabetes history, perceptions of empowerment process, and pre-diabetes knowledge. These factors explained 59.3% of the variance in health-promoting self-care behaviors. ConclusionsTo prevent the development of diabetes in people with pre-diabetes, healthcare professionals should consider both the personal and the environmental factors identified in this study when assessing health promoting self-care behaviors in patients with pre-diabetes and when selecting the appropriate interventions.

Health Promoting Self-Care Behaviors and Its Related Factors in Elderly: Application of Health Belief Model

Health Promoting Self-Care Behaviors and Its Related Factors in Elderly: Application of Health Belief Model

Self-Care for Caring Practice: Student Nurses’ Perspectives

This study took place in Western Canada; it examined undergraduate nursing students’ self-care behaviors. The researchers developed a 27-item questionnaire asking students about sleep, exercise, diet, fluid intake, weight, checkups, relaxation, complementary therapy use, alcohol intake, health goals, and smoking habits. Of 330 degree, diploma, and post-diploma nursing students, 211 students responded to the questionnaire. The majority of students reported that they engaged in health-promoting selfcare behaviors. However, it seems that busy schedules often prevented students from having enough sleep, fluid, exercise, and self-care activities. The majority of the students reported that they used complementary therapies.

The Relationship Between Perceived Stress and Health-Promoting Behaviors in High-Risk Pregnancy

The purpose of this study was to examine the relationship between maternal perceived stress and health-promoting self-care behaviors in women experiencing high-risk pregnancies. Descriptive correlational. Women (N=69) who had a complication in pregnancy that required referral to a perinatologist at a tertiary care center and ere in the third trimester of pregnancy. The Perceived Stress Scale is a 14-item scale measuring the extent to which one appraises life situations as stressful. Health-Promoting Lifestyle Profile II is a 52-item scale from which scores for an overall health promotion scale and 6 subscales (health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, and stress management) are calculated. There was a significant and negative relationship between perceived stress and health-promoting lifestyle. The relationships between perceived stress and spiritual growth, interpersonal relations, and stress management were significant and negative. During a high-risk pregnancy, women who engage in more health-promoting behaviors may experience less stress; however, the causal relationship between stress and health promotion is not known. Nurses can offer stress management techniques and health-promoting self-care during this stressful time to encourage health in mother and neonate.

The Influence of Growth on Spiritual Self-Care Agency in an Older Adult Population

This study investigated the relationships among health-promoting self-care behaviors, self-care self-efficacy, and self-care agency in an older adult population. The purpose of this study was to identify the relationships among these concepts as well as the specific influence of spiritual growth, a component of health-promoting self-care behaviors, on self-care agency. The instruments used in this study included the Health-Promoting Lifestyle Profile II, Self-Rated Abilities for Health Practices Scale, and Exercise of Self-Care Agency Scale. A canonical correlation identified a significant variate having a correlation of .74 (p = .000) that accounted for 55% of the variance explained. The loading variables included spiritual growth, self-concept, initiative, and responsibility. The conclusion was made that spiritual growth influences older adults' self-care agency to a greater extent than self-care self-efficacy.

The Influence of Basic Conditioning Factors on Healthy Behaviors, Self-Efficacy, and Self-Care in Adults

This article presents secondary statistical analyses of data from a 2003 study by the author investigating the relationships among health-promoting self-care behaviors, self-care self-efficacy, and self-care agency in an adult population. The purpose of this article is to identify the influences of selected basic conditioning factors on the practice of healthy behaviors, self-efficacy beliefs, and ability for self-care. The sample consisted of 379 adult participants who completed four research instruments: Health-Promoting Lifestyle Profile II Scale, Self-Rated Abilities for Health Practices Scale, Exercise of Self-Care Agency Scale, and a demographic questionnaire assessing basic conditioning factors. Statistically significant relationships were found between the following basic conditioning factors and the study variables: age, gender, income, marital status, education, race, and routine practice of religion. These results give direction for nursing interventions that promote self-care and holistic health in an adult population.