Independence In Self-care Research Articles

Improvements in upper extremity isometric muscle strength, dexterity, and self-care independence during the sub-acute phase of stroke recovery: an observational study on the effects of intensive comprehensive rehabilitation.

Stroke often impairs upper extremity motor function, with recovery in the sub-acute phase being crucial for regaining independence. This study examines changes in isometric muscle strength, dexterity, and self-care independence during this period, and evaluates the effects of a comprehensive intensive rehabilitation (COMIRESTROKE). Individuals in sub-acute stroke recovery and age- and sex-matched controls were assessed for pre- and post-rehabilitation differences in primary outcomes (grip/pinch strength, Nine Hole Peg Test [NHPT], Action Research Arm Test [ARAT]). COMIRESTROKE's effects on primary and secondary outcomes (National Institute of Health Stroke Scale [NIHSS], Modified Rankin Scale [MRS], Functional Independence Measure [FIM]) were evaluated. Outcomes were analyzed for dominant and non-dominant limbs, both regardless of impairment and with a focus on impaired limbs. Fifty-two individuals with stroke (NIHSS 7.51 ± 5.71, age 70.25 ± 12.66 years, 21.36 ± 12.06 days post-stroke) and forty-six controls participated. At baseline, individuals with stroke showed significantly lower strength (dominant grip, key pinch, tip-tip pinch, p adj < 0.05), higher NHPT scores (p adj < 0.05), and lower ARAT scores (p adj < 0.001). COMIRESTROKE led to improvements in dominant key pinch, non-dominant tip-tip pinch, NHPT, and both dominant and non-dominant ARAT (p adj < 0.05). Notably, non-dominant key pinch improved significantly when considering only impaired hands. Pre- and post-test differences between groups were significant only for ARAT (both limbs), even after adjustment (p adj < 0.05). All secondary outcomes (NIHSS, MRS, FIM) showed significant improvement post-COMIRESTROKE (p adj < 0.001). Individuals with stroke exhibit reduced muscle strength and dexterity, impairing independence. However, comprehensive intensive rehabilitation significantly improves these functions. Data are available from the corresponding author upon request and are part of a sub-study of NCT05323916.

Анализ доступной школьной формы для детей с особенностями развития

This article examines the importance of designing and developing adaptive clothing for girls with autism spectrum disorder (ASD). Creating comfortable, safe, and functional school uniforms for such children is an increasingly relevant issue, as standard clothing models often fail to meet their unique needs. The study highlights the significance of adapting clothing elements—such as materials, fastenings, and construction—to reduce sensory discomfort, heightened tactile sensitivity, and challenges with independent dressing. Key attention is given to principles of inclusivity and ergonomics, ensuring freedom of movement and comfort. The article analyzes factors affecting fabric and design choices that contribute to improving the quality of life for children with ASD. The findings of this study can assist designers and manufacturers in creating inclusive clothing that fosters children’s social adaptation and independence in self-care.

Building independence in self-care and household tasks: a qualitative study with adolescents with cerebral palsy and their caregivers

Purpose Adolescents with cerebral palsy (CP) may experience limitations in self-care and household tasks. The aim of the study was to understand the process of building independence in self-care and household tasks from the perspective of adolescents and their caregivers. Materials and methods We conducted a qualitative study with a phenomenological approach with 10 adolescents (15–17 years old) and 11 caregivers from a transition service in Brazil. Semistructured, remote interviews were conducted with each participant. The interviews were recorded for transcription and content analysis. Results Two thematic categories emerged: (1) “Thinking about independence” and (2) “Possible ways to foster independence.” The first category was divided into three subcategories: “Expectations and the desire to be independent,” “Obstacles to independence,” “Concerns about the future.” The second category was divided into four subcategories: “People and places,” “Opportunities for practice,” “Personal attitude” and “Adaptations that facilitate.” Conclusion Adolescents’ independence in several everyday activities involves physical, socioemotional and environmental aspects. Enabling opportunities for practice, an adapted environment, support from rehabilitation services and developing collaborative relationships with caregivers are elements that may favor the independence of adolescents with CP.

Characteristics and outcomes of reversible platypnoea-orthodeoxia syndrome in COVID-19 pneumonia.

Platypnoea-orthodeoxia syndrome (POS) is an uncommon clinical entity characterised by dyspnoea and platypnoea (oxygen desaturation that follows the assumption of an upright position from recumbency). Since the coronavirus disease 2019 (COVID-19) outbreak, increasing reports of COVID-19-related POS and its associated morbidity have been reported around the world. We aimed to study the characteristics of COVID-19-related POS and orthodeoxia (including associations leading to a more prolonged orthodeoxia), and the postdischarge functional outcomes of patients with COVID-19-related POS. An observational cohort study was conducted in a tertiary hospital that managed post-COVID-19 patients. Twenty-four participants with severe-to-critical COVID-19 disease/pneumonia and POS, who received inpatient pulmonary rehabilitation, were enrolled. Descriptive analysis of the data was performed to describe POS/orthodeoxia characteristics and functional outcomes in these participants. Correlation analyses were carried out to identify significant factors associated with a prolonged orthodeoxia. The mean duration of POS and orthodeoxia was 12.9 ± 8.3 days and 28.5 ± 14.6 days, respectively. All participants demonstrated resolution of POS and orthodeoxia by hospital discharge. On multivariable analysis, intensive care unit admission and maximal level of respiratory support were significantly associated with a prolonged duration of orthodeoxia. One participant was lost to follow-up. The remaining 23 participants achieved independence in self-care. With the exception of one patient, who was recovering from a hip fracture, the rest achieved independence in ambulation and independent community access. Resolution of orthodeoxia was observed in all our participants with COVID-19-related POS. Good functional outcome can be attained with timely and effective rehabilitation interventions.

Developmental milestones and daily living skills in individuals with Angelman syndrome

BackgroundAngelman syndrome (AS) is a neurodevelopmental disorder associated with severe global developmental delay. However, the ages at which different developmental skills are achieved in these individuals remain unclear. We seek to determine the probability and the age of acquisition of specific developmental milestones and daily living skills in individuals with AS across the different molecular subtypes, viz. class I deletion, class II deletion, uniparental disomy, imprinting defect, and UBE3A variants.MethodsCaregivers participating in a longitudinal multicenter Angelman Syndrome Natural History Study completed a questionnaire regarding the age at which their children achieved specific developmental milestones and daily living skills. The Cox Proportional Hazard model was applied to analyze differences in the probability of achievement of skills at various ages among five molecular subtypes of AS.ResultsAlmost all individuals, regardless of molecular subtype, were able to walk with support by five years of age. By age 15, those with a deletion had at least a 50% probability of acquiring 17 out of 30 skills compared to 25 out of 30 skills among those without a deletion. Overall, fine and gross motor skills such as holding and reaching for small objects, sitting, and walking with support were achieved within a fairly narrow range of ages, while toileting, feeding, and hygiene skills tend to have greater variability in the ages at which these skills were achieved. Those without a deletion had a higher probability (25–92%) of achieving daily living skills such as independently toileting and dressing compared to those with a deletion (0–13%). Across all molecular subtypes, there was a low probability of achieving independence in bathing and brushing teeth.ConclusionIndividuals with AS without a deletion are more likely to achieve developmental milestones and daily living skills at an earlier age than those with a deletion. Many individuals with AS are unable to achieve daily living skills necessary for independent self-care.

Lower Independent Self-Care Readiness Persists over Time in Teens with Type 1 Diabetes and Executive Function Challenges.

Management of type 1 diabetes is complex and benefits from adequate executive function (EF) (planning, organization, problem-solving). Teens with diabetes and executive dysfunction may have challenges with acquisition of self-care skills. Over 18 months, parents of teens with type 1 diabetes aged 13-17 completed the Diabetes Family Responsibility Questionnaire (DFRQ) and Readiness for Independent Self-Care Questionnaire (RISQ) every 6 months. Parents assessed teen EF, completing the Behavior Rating Inventory of Executive Function (BRIEF). T-score ≥60 defined EF challenges. EF, demographic, and diabetes treatment variables predicted RISQ score over time using longitudinal mixed modeling with false discovery rate adjustment. There were 169 teen participants (54% male) aged 15.9±1.3 years, diabetes duration 8.4±3.7 years, and A1c 8.6±1.2%. About a third (31.4%) of teens had parent-reported BRIEF Global Executive Composite (GEC) scores ≥60. After adjusting for age, gender, and DFRQ, those with GEC <60 had RISQ score 4.1 points higher than those with GEC ≥60, p=0.016. Behavioral regulation index (BRI; adjusted for age, CGM use, DFRQ, and A1c) did not predict RISQ while metacognition index (MI; adjusted for age, gender, and DFRQ) did; those with MI <60 had RISQ score 5.3 points higher than those with MI ≥60, p<0.001. In all models, older teen age (p<0.05) and less parental involvement (p<0.001) predicted higher RISQ score. EF skills, especially metacognition, appear important for acquisition of self-care behaviors in teens with type 1 diabetes. Evaluating EF during adolescence may identify teens needing extra support during the transition process.

Participation and autonomy, independence in activities of daily living and upper extremity functioning in individuals with spinal cord injury

Improvements in care and rehabilitation have resulted in a higher proportion of people living with spinal cord injury (SCI), which calls for an increased focus on participation and autonomy. This observational cross-sectional study investigated the impact of SCI on autonomy and how it correlates to activity performance and upper extremity functioning. A total of 25 adults (mean age 58 years) with chronic cervical or thoracic SCI were included. Self-perceived autonomy was measured with Impact on Participation and Autonomy questionnaire, independence in activities of daily living (ADL) with Spinal Cord Independence Measure, upper extremity functioning with Action Research Arm Test (ARAT) and kinematic measures of the drinking task. The results showed that most participants perceived injury-related restrictions in outdoor autonomy (80%), family role (76%), and in indoor autonomy (72%). Independence in self-care (r = 0.72), mobility (r = 0.59) and upper extremity kinematics of movement time (r = 0.63) and smoothness (r = 0.49) were correlated to indoors autonomy. Social life autonomy was correlated to self-care (r = 0.50) and ARAT (r = 0.41). In conclusion, autonomy was perceived restricted after SCI in several major life areas and correlated with independence in ADL and upper extremity functioning. The aspects of autonomy should be considered more in goal setting and clinical decision-making.

Distinct experiences and care needs of advanced cancer patients with good ECOG performance status: a qualitative phenomenological study.

Advanced cancer patients with good Eastern Cooperative Oncology Group (ECOG) performance status (score 0-1) are underrepresented in current qualitative reports compared with their dying counterparts. To explore the experiences and care needs of advanced cancer patients with good ECOG. A qualitative phenomenological approach using semi-structured interview was employed. Data was analyzed using the Colaizzi's method. Purposive sample of terminal solid cancer patients on palliative care aged 18-70 years with a 0-1 ECOG score were recruited from a tertiary general hospital. Sixteen participants were interviewed. Seven themes were generated from the transcripts, including experiencing no or mild symptoms; independence in self-care, decision-making, and financial capacity; prioritization of cancer growth suppression over symptom management; financial concerns; hope for prognosis and life; reluctance to discuss death and after-death arrangements; and use of complementary and alternative medicine (CAM) and religious coping. Advanced cancer patients with good ECOG have distinct experiences and care needs from their dying counterparts. They tend to experience no or mild symptoms, demonstrate a strong sense of independence, and prioritize cancer suppression over symptom management. Financial concerns were common and impact their care-related decision-making. Though being hopeful for their prognosis and life, many are reluctant to discuss death and after-death arrangements. Many Chinese patients use herbal medicine as a CAM modality but need improved awareness of and accessibility to treatment options. Healthcare professionals and policy-makers should recognize their unique experiences and needs when tailoring care strategies and policies.

Nursing interventions to promote dyspnea self-management of complex chronic patients: An integrated review

ObjectivesChronic dyspnea, a distressing symptom in patients with complex chronic conditions, is linked to higher risks of mortality. This study aimed to identify nursing interventions that could improve self-management for complex chronic patients, thereby enhancing control over chronic dyspnea. The findings intend to guide nursing care strategies that promote self-management among this population. MethodsWe searched the databases Medline, Scopus, Web of Science, CINAHL, Cochrane Database of Systematic Reviews (CDSR), and Joanna Briggs Institute (JBI) databases were searched in December 2023. We included adult patients with complex chronic conditions with chronic dyspnoea. The team screened articles collaboratively, using Rayyan software. A qualitative appraisal was performed according to JBI Critical Appraisal Checklist tools. The review protocol is registered under the number CRD42023456021. ResultsOur review included 18 studies that explored a variety of interventions for chronic dyspnea. We identified pharmacological interventions (such as oxygen therapy and inhalation treatments) and non-pharmacological approaches (including educational programs, breathing exercises, fluid intake management, body awareness techniques, peer support, emotional intelligence training, and the use of web applications). Those interventions empower patients, improve their ability to fulfill life roles, mitigate emotional distress, and improve overall quality of life. Nursing care can be crucial in enabling individuals to achieve independence and autonomy in self-care. ConclusionsPromoting self-management for chronic dyspnea in complex chronic patients requires a holistic approach, encompassing multidisciplinary interventions, individualized self-care education, peer engagement, and technological support. Current research on self-management inadequately addresses interventions targeting patient behaviour change. It highlights the need to delve deeper into the self-management process. Further research is needed to expand the evidence base and refine these interventions.

Personal hygiene pada odgj dengan defisit perawatan diri di kelurahan Padang harapan kecamatan Gading Cempaka kota Bengkulu, 38225

Personal hygiene is an independent self-care activity, including maintaining the cleanliness of body parts consisting of hair, clean eyes, nose, mouth, teeth and skin. Self-care deficit is a situation where a person experiences a lack of technological level to carry out individual personal hygiene activities including bathing, hygiene and defecation (Abdul, 2015). According to Orem, lack of self-care is an individual's inability to carry out personal hygiene adequately, so several systems are needed that can help clients meet their self-care needs (Erlando, 2019).

Predicting Complete versus Incomplete Long-Term Functional Independence after Acute AIS Grade D Spinal Cord Injury: A Prospective Cohort Study.

The proportion of patients with American Spinal Injury Association Impairment Scale (AIS) grade D traumatic spinal cord injuries (tSCI) is increasing. Although initial motor deficits can be relatively mild, some individuals fail to recover functional independence. This study aims to identify factors associated with failure to reach complete functional independence after AIS grade D tSCI. An observational prospective cohort study was conducted at a level 1 trauma center specialized in SCI care. A prospective cohort of 121 individuals with an AIS-D tSCI was considered. The baseline characteristics, length of acute stay, need for inpatient rehabilitation, and 12-month functional status were assessed. Univariate and classification and regression tree (CART) analyses were performed to identify factors associated with reaching complete versus incomplete functional independence (defined as perfect total SCIM III score at 12-month follow-up). There were 69.3%, 83.3%, and 61.4% individuals reaching complete independence in self-care, respiration/sphincter management, and mobility, respectively. A total of 64 individuals (52%) reached complete functional independence in all three domains. In the CART analysis, we found that patients are more likely to achieve complete functional independence when they have a baseline motor score ≥83 (65% individuals) and if they present fewer medical comorbidities (70% individuals if Charlson Comorbidity Index [CCI] ≤4). About half of individuals with AIS grade D tSCI can expect complete long-term functional independence. It is important to recognize early during acute care individuals with baseline motor score <83 or a high burden of comorbidities (CCI ≥5) to optimize their rehabilitation plan.

Quality of life in dysphagia and functional performance of cancer patients in palliative care.

To correlate the functional performance and impact of dysphagia on the quality of life of cancer patients in palliative care. This cross-sectional, quantitative study was conducted at the outpatient clinic and oncology ward of a university hospital. Inclusion criteria required patients to respond positively to the question: "Do you have difficulty or problems swallowing?". Patients were excluded if they had been diagnosed with head and neck cancer, were unable to answer questionnaires due to actively dying status, were in a state of drowsiness, experienced extreme pain and systemic instability, or if data collection instruments were incomplete. Two instruments were used in their Brazilian Portuguese versions: the Palliative Performance Scale (PPS) and the M. D. Anderson Dysphagia Inventory (MDADI). The variables were analyzed using descriptive and inferential statistics, with Pearson's correlation used at a 5% significance level. The sample consisted of 39 participants, with an average age of 65.3 years, of whom 24 (61.5%) were women. The most frequent neoplasm sites were the pancreas and stomach. The results of the PPS indicated that the average patient had reduced ambulation and inability to work, but maintained independence in self-care, with a complete level of swallowing and consciousness. The MDADI showed an average degree of limitation. Outpatients exhibited a moderate correlation between the MDADI result and the level of functionality according to the PPS. Cancer patients at the palliative care outpatient clinic demonstrated a correlation between functional performance and the impact of dysphagia on quality of life.

Qualidade de vida em disfagia e performance funcional de pacientes oncológicos em cuidados paliativos

ABSTRACT Purpose To correlate the functional performance and impact of dysphagia on the quality of life of cancer patients in palliative care. Methods This cross-sectional, quantitative study was conducted at the outpatient clinic and oncology ward of a university hospital. Inclusion criteria required patients to respond positively to the question: “Do you have difficulty or problems swallowing?”. Patients were excluded if they had been diagnosed with head and neck cancer, were unable to answer questionnaires due to actively dying status, were in a state of drowsiness, experienced extreme pain and systemic instability, or if data collection instruments were incomplete. Two instruments were used in their Brazilian Portuguese versions: the Palliative Performance Scale (PPS) and the M. D. Anderson Dysphagia Inventory (MDADI). The variables were analyzed using descriptive and inferential statistics, with Pearson's correlation used at a 5% significance level. Results The sample consisted of 39 participants, with an average age of 65.3 years, of whom 24 (61.5%) were women. The most frequent neoplasm sites were the pancreas and stomach. The results of the PPS indicated that the average patient had reduced ambulation and inability to work, but maintained independence in self-care, with a complete level of swallowing and consciousness. The MDADI showed an average degree of limitation. Outpatients exhibited a moderate correlation between the MDADI result and the level of functionality according to the PPS. Conclusion Cancer patients at the palliative care outpatient clinic demonstrated a correlation between functional performance and the impact of dysphagia on quality of life.

Exploring the Health Behaviors of Young Adults Who Are Blind in South Korea

Introduction: Compared to sighted people, not only do people who are blind have multiple comorbidities and exhibit early mortality, but they also display high-risk health behaviors. To prevent problematic health behaviors affecting health-related quality of life and well-being, understanding the shared patterns of health behaviors among individuals with visual impairments, including blindness, is essential. Methods: This qualitative study explored the hidden constructs and patterns of health behaviors among employed young adults who are blind using a multiple case study analysis. Eight participants with self-reported total blindness were recruited via convenience sampling and recruitment postings. Results: The mean age was 27.43 ± 6.32 years with a range of 20–39 years. Seven males and one female completed the one-on-one telephone interviews. The study discovered eight patterns of health behaviors of young adults who are blind: (a) leading a sedentary lifestyle with physical inactivity, (b) eating irregularly and not cooking, (c) avoiding uncertainty and illness, (d) facing disability stigma in health care services, (e) seeking online information related to medical care, (f) sharing health-related information within the blind community, (g) receiving unreadable formats of health-related information, and (h) aiming for independence and autonomy in self-care. The following categorized health behavior constructs were extracted: perceived health problems, experiential attitude toward health care systems, health beliefs, perceived facilitators, and barriers. Discussion: The findings indicate that young adults who are blind prefer independent health-related activities. The identified problematic health behaviors were correlated to inaccessible healthcare resources. Implications for Practitioners: More accessible health resources enhancing the independence of young adults who are blind are needed to promote their health behaviors. For instance, more accessible fitness facilities and personalized exercise programs in workplaces and communities can motivate the physical activity of young adults who are blind.

Post-COVID-19 Intensive Care Unit-Acquired Weakness Compromises Long-Term Functional Status.

The objective of this study was to evaluate the impact of intensive care unit (ICU)-acquired weakness (ICUAW) on the functional independence of patients hospitalized for coronavirus disease 2019 (COVID-19) over 6months after ICU discharge. This was a prospective cohort study that included patients who were admitted to the ICU because of COVID-19 and who were monitored for 6months after discharge from the ICU via telephone. Patients were evaluated at 3 times (30days, 3months, and 6months after discharge from the ICU) for functional independence for personal care and mobility activities (Barthel Scale), independence for self-care (Katz Index), impact of COVID-19 on functional status (post-COVID-19 Functional Status Scale [PCFS]), and mobility level (ICU Mobility Scale). The existence of some degree of dependence was considered when the Barthel Scale score was <100 points, the Katz Index was ≥1, and the PCFS score was ≥1. A PCFS score of ≥3 indicated moderate or severe dependence. Patients with a Medical Research Council score of <48 at discharge from the ICU were diagnosed with ICUAW. Sixty-eight patients were included, with a mean age of 51 (SD = 13) years. The ICUAW rate at ICU discharge was 35%. In the evaluation with the PCFS, the values for the presence of any functional limitation at 30days, 3months, and 6months after ICU discharge were 89.7%, 57.4%, and 38.2%, respectively. The rate of persistence of functional limitations after 6months was higher in patients with ICUAW than in those without ICUAW (66.7% vs 22.8%; P = .000); the same was true for moderate or severe limitations (20.8% vs 4.5%; P = .035). Likewise, functional independence for personal care, mobility, and self-care activities was poorer in patients with ICUAW. In patients surviving an ICU stay due to COVID-19, decreased functional independence persists even 6months after discharge, and patients with ICUAW have worse outcomes. Patients who survive ICU stays due to COVID-19 continue to have greater functional dependence even 6months after ICU discharge.

SPCR-07 REDEFINING BOUNDARIES: STEREOTACTIC RADIOSURGERY FOR ENHANCED QUALITY OF LIFE AND SURVIVAL IN PATIENTS WITH 5-20 BRAIN METASTASES

Abstract INTRODUCTION Brain metastases (BMs) occur in 10-30% of adult patients with cancer. The therapeutic approach for BMs depends on several factors including lesion number, location and size, primary cancer type, and the patient’s overall health. ASCO-SNO-ASTRO guidelines conditionally recommend stereotactic radiosurgery (SRS) for 1-10 BMs. The aim of this study was to investigate the outcomes of radiotherapy in patients with 5 or more BMs using SRS. METHODS We implemented the prospective Cohort for patient-reported Outcomes, Imaging and trial inclusion in Metastatic BRAin disease (COIMBRA) to examine all patients with BM(s) who underwent radiotherapy. In this sub-study we investigated overall survival (OS) and health related quality of life (HRQoL) for 47 patients with 5 to 20 BMs. We evaluated patients’ HRQoL using the EQ5D-VAS, at baseline and at 3 monthly intervals after radiotherapy. RESULTS Median OS was 21.3 months for patients with 5-10 BMs (n=38) and 12.5 months for patients with &amp;gt;10 BMs (n=9). Questionnaires at both baseline and 6 months after radiotherapy showed stability or improvement on the EQ5D-VAS after radiotherapy in 58.1%. Additionally, independence in self-care was not limited before or after SRS. Also, the proportion of patients (66.7%) reporting no limitation on their ability to do daily activities remained stable after radiotherapy. Fewer patients reported pain or other discomfort after SRS compared to before (25% vs 40%). CONCLUSION Our findings suggest that radiotherapy may improve QoL in patients with 5-20 BMs. Furthermore, compared to the literature, we observed a prolonged OS in this prospective cohort, suggesting that SRS should be considered as the treatment option for these patients. These results highlight the need for further investigation of the role of SRS instead of Whole Brain Radiotherapy (WBRT) in the management of patients with multiple BMs.

Physiotherapy Rehabilitation in Bilateral Lower Limbs Amputations Following Dry Gangrene: A Case Report

Background: Bilateral lower limb amputation is becoming more frequent in recent years. This case report will outline the pre-operative and post-operative physiotherapy protocol for bilateral lower limb amputations following dry gangrene. Additionally, this case was evaluated to see if postoperative physiotherapy treatment consisting of prevention of complications, patient education, independent self-care, and functional mobility improved outcome. Case: A 76-year-old man came to the hospital with clinical features of dry gangrene of both feet. Preoperatively he was given education on care for his limbs along with the therapy plan following surgery. Pain on VAS scales were taken prior to surgery and postoperatively as well. Results: Preoperative education helped the patient improve his pain status, which is an important aspect for postoperative rehabilitation. Decreasing pain on VAS facilitated early rehabilitation which further helped lessening the chances of postoperative complications. Conclusion: Pre- and early post-operation rehabilitation improve patient outcomes such as improved pain levels, range of motion and prevention of complication related to bilateral lower limb amputation.

The Relationship between Family Support and Self-Care Behavior on Diabetes Mellitus Patients

Diabetes Mellitus is a non-communicable disease which is a global health problem with a control strategy that requires patient independence in self-care. This study aims to determine the relationship between family support and self-care behavior in Diabetes Mellitus patients in the Working Area of ​​UPT Puskesmas Tubaan. This research is a type of correlational quantitative research with a cross sectional design. There is a significant relationship between family support and self-care behavior in Diabetes Mellitus patients in the Working Area of ​​UPT Puskesmas Tubaan (p-value = 0.006). So it can be concluded that family support with low Diabetes Mellitus patients is 2 times more likely to result in low self-care behavior. It is necessary to take a family approach so that the patient is able to get family support to achieve better self-care behavior.

Home rehabilitation using android-based system as booster on the independences of stroke patients in local government hospital in Aceh, Indonesia.

The independence of stroke patients played the main role in not only preventing the asymptomatic attacks which delayed assistance but also enhancing their quality of life by reducing their dependence on family members or caregivers. However, the inaccessibility and expense of treatment prevented stroke patients from continuing their rehabilitation and exercise after returning home. Thus, the purpose of this study was to provide an efficient system for alternative home rehabilitation to boost the self-care Independence of stroke patients by designing Android-based home rehabilitation. The quantitative research was conducted using a non-randomized trial where the patients were purposively sampled. 70 participants were joined and divided into two groups: the control and intervention groups. The intervention group will have SIMTROKE application on their smartphone as the home rehabilitation process where control group would not have SIMTROKE installed. The effect of home rehabilitation was assessed by univariate, bivariate analysis and the correlation matrix to analyze home rehabilitation effect to the participants' self independences. The result showed that the independent intervention in post-stroke patients has a significant effect on increasing the independence of stroke patients to improve their quality of life of stroke patients. The highest improvements were found in urination and toileting followed by defecation, dressing, active and phase motion range, self-care, stepping to stairs, mobilization, showering, and eating abilities. The result proved that home rehabilitation utilizing an Android-based system could be employed as an alternate method to assist stroke patients in improving their independence and quality of life. (www.actabiomedica.it).

Peningkatan Kapasitas Keluarga Dalam Pemenuhan Self Care Pasien Tuberkulosis di Kelurahan Balocci Baru

Tuberculosis is still one of the deadliest infectious diseases and has claimed millions of lives over the years. Several factors such as treatment adherence including length of treatment, drug side effects and access to health services are factors in increasing TB mortality rates. Some people who have family members with a history of tuberculosis do not understand how to care for and increase the independence of TB patients, plus the lack of internet access which makes people less exposed to health information, this is a partner problem so it is important to hold counseling on how to care for family members with TB, as well as assistance in increasing the self-care independence of TB patients. The service method is lecture/counseling, accompanied by simulations and questions and answers. This community service is held in January-February in Balocci Baru Village, Kec. Balocci to be exact in the courtyard area of the Balocci Baru village office. The results of the service are in accordance with the plan where participants are able to understand increasing the independence of self-care for TB patients and are enthusiastic during the counseling and mentoring process.