Lack Of Self-management Research Articles

NURSE AND PATIENT PERCEPTION IN SELF-MONITORING OF DAWN EFFECT TO ENHANCE SELF-MANAGEMENT IN DIABETES MELLITUS PATIENT’S: A QUALITATIVE CASE STUDY

Background: A phenomenon in diabetes mellitus patients is called dawn effect, the condition of hyperglycemia suddenly increasing insulin requirement in the morning caused by nonattendance of nighttime hypoglycemia. Self-monitoring can be minimizing the impacts of dawn effect. Self-management can be actualized to oversee the blood glucose levels fluctuation in diabetes mellitus patients. Objective: to gain self-monitoring influencing factors of dawn effect phenomenon, and increase self-management in diabetic patient and nurse knowledge in Temanggung, Central Java Methods: A qualitative study design was used in this research with semi-structured interviews and open-ended questions. Participants were selected using purposive sampling technique from primary healthcare and secondary healthcare of both nurse and patient. Twelve participants consisted of senior nurse (n=5), patients with type 2 diabetes mellitus (n=7). Information of psychometric diabetes self-management scale and blood glucose monitoring were day by day collected within the morning. Result: Nurses' perception of the dawn effect is still relatively low due to a lack of knowledge and competence in self-management of diabetes patients. They followed the doctor's advice. In addition, the patient's perspective of blood glucose monitoring was taken into account, despite the fact that they did not have a glucometer from a mobile device (lack of self-management and dawn effect). Furthermore, all participants (n=7) increase in blood glucose level in the morning. Invasive glucometer has a high accuracy, but inducing finger discomfort, uncomfortable, and increase risk of infection when it checked daily. Conclusion: Perceptions of nurse and patient about self-monitoring can improve patient self-management and prevent the occurrence of dawn effects.

Current topics of frailty in association with hypertension and other medical conditions.

Frailty is a state of increased vulnerability to stress resulting from physiological decline associated with aging. Topics of hypertension management and its association with frailty and cognitive function, recent studies of coronavirus disease 2019 infection (COVID-19) in elderly is discussed in this narrative review. While various guidelines for hypertension recommend that frailty is taken into account in treatment decisions, specific assessment tools and clinical decision criteria have not been explicitly established. Hypertension is prevalent in frail individuals, although a direct association has not been reported. Therefore, optimal blood pressure (BP) control is critical for managing cardiovascular risk reduction and preserving quality of life in frail hypertensive patients. BP typically decreases in later life or situations in which patients are dependent on nursing care. Mortality is reported to be high among frail patients with lower BP, raising questions about appropriate BP targets for frail patients. Cognitive decline is one of the domains of frailty, and is associated with a loss of autonomy, lack of self-management, and compromised quality of life. It remains to be clarified whether antihypertensive treatment is beneficial for cognitive function especially in older individuals. Increased severity and mortality of COVID-19 infection has been reported in older people. Clinical manifestations and biomarkers particular to older patients, and lifestyle changes including social isolation during the COVID-19 pandemic is reported. From the knowledge from recent literatures, future perspectives for holistic approach and management of frail older people is addressed.

The Relationship Between Patient Characteristics Diabetes Self-Care Management with Diabetic Peripheral Neuropathy in Type 2 DM Patients in Regional General Hospital in Indonesia

One of the microvascular complications is loss of sensation in the leg area (peripheral neuropathy) which causesfoot ulcers and the risk of amputation. The purpose of this study was to determine the relationship betweenpatient characteristics and Diabetes Self-Care Management (DSCM) with Diabetic Peripheral Neuropathy (DPN)in type 2 diabetes mellitus patients in a regional public hospital in one of the provinces in Indonesia. This studyused a correlative design with a cross-sectional approach to 154 patients with type 2 diabetes mellitus who wereselected using a proportionate stratified random sampling technique. The data were obtained using a Summaryof Diabetes Self-Care Activities and the Michigan Diabetic Neuropathy Score and analyzed using the Chi-squaretest and logistic regression. The results showed that age and duration of diabetes were the sub-variables ofpatient characteristics that were most associated with neuropathy in diabetic patients. Patients are expectedto be able to do diabetes management regularly so that no more diabetes patients are injured due to a lack ofself-management. Hospitals are expected to routinely carry out training and counseling for diabetic patients toprevent serious complications caused by peripheral neuropathy.

Developing literacy and providing health information to reduce inequality of health in adults in the southern part of India

The poor health literacy choice is associated with poor health, riskier behavior, more hospitalization and lack of self-management. Developing literacy and providing health information to reduce inequality of health in adults in the southern part of India. To study a case pattern of adults concerning the conditions of health information and to assess the impact in the condition of health literacy score with understanding a short educational presentation. The current study was carried out at one of the Multi speciality Hospital, Nellore, Andhra Pradesh from January 2017 to March 2017. Assessment tool of health literacy validated and utilized in this study with the inspection of health information questionnaire elicited both data on the participants and demographic data related to health information. Association of inspection between patterns and variables of the sample population used related health information. Potential sources regarding health information, general practitioner rank was highest, and their first preference would be 70%. Their second and third preference 50% ranking followed by the clinical pharmacist. All 100 % of participants' health information themselves sought ongoing medical conditions and also seeking about themselves to 85% new medical conditions. The mean newest vital sign baseline scores for the sample of 4.4 (Std. deviation = 2.912) with inline the health literacy survey results for India which means 2.526 for all ages and 2.643 over 56 years. The study confirmed that considerable methods of the cohort study of older Indian people have substantial problems with health literacy and also warrants additional attention.

Ignorance or motivated beliefs: the role of motivated beliefs in self-management of diabetes

Exercise, dieting and adherence to medicines are effective measures to reduce long-term consequences of diabetes; however, patients throughout the world fail to manage their condition. We propose the existence of motivated beliefs as an explanation for this paradox. We empirically test the economic model of motivated beliefs using data from 100 patients with diabetes. We operationalized beliefs by comparing real BMI to an individual’s BMI reference point where she is motivated to believe that she should start preventive effort. We measure an individual reference point to start prevention by using previously validated pictorial BMI-based body size guide. Most respondent’s report a reference BMI to initiate preventive effort larger than their real BMI; interestingly this reference BMI is uncorrelated with real BMI. The distortions between real and reference body image to start prevention are higher among males and among younger individuals. Those with a larger negative distance from the reference point are 0.64 points less likely to engage in self-management, which is 23% of the average behavior. These results open the possibility that personalized medicine should incorporate information about an individual’s beliefs to improve the efficacy of treatment. Our results have implications to explain the lack of self-management in other chronic conditions.

Persons' Experiences of Suffering from Nephrotic Syndrome.

SUMMARYBackgroundLittle is known about health and wellbeing among patients with nephrotic syndrome (NS), despite it being a serious condition in patients with renal failure. In order to promote health, it is important that both healthcare professionals and patients are aware of the signs and symptoms of the disease.ObjectivesThe aim was to explore patients’ experience of suffering from nephrotic syndrome.DesignAn inductive, qualitative method.ParticipantsTen adult patients with either newly diagnosed or a relapse of NS treated in a University hospital, south of Sweden from February 2016 to February 2019.MeasurementsData were collected using open‐ended interviews and analysed by means of Lindseth and Norberg's phenomenological‐hermeneutical method.ResultsSuffering from NS meant being a stranger in an unfamiliar world of symptoms, signs and medical treatment without professional guidance or piloting, illustrated by four themes: Feeling ill and well at the same time, Being passively adherent, Being in uncertainty, and Trying to comprehend and cope.Implications for practiceThe result provides an in‐depth understanding of the illness experience among patients with NS and constitutes a foundation for clinical guidelines on treatment, follow‐up and health promotion.ConclusionPatients with NS end up in a state of ambiguity due to a profound knowledge deficit that causes uncertainty and a lack of self‐management. The experienced lack of professional self‐management support is partly compensated for by social support from relatives, enabling those with NS to manage everyday life in a reasonable way.

PILOT STUDI: MANAJEMEN DIRI PASIEN DIABETES MELITUS DI RUMAH SAKIT HL. MANAMBAI ABDULKADIR

Background: The population of people with diabetes mellitus is increasing every year, furthermore included into number three of deadliest disease in Indonesia. The total number of patients with diabetes mellitus currently are 10.3 million, predicted in 2045, the population will increase to 16.7 million. The main cause population of people with diabetes mellitus are increasing due to public awareness regarding self-management is still less. No researcher has been conducted research about diabetes self-management in HL. Manambai Abdulkadir hospitals. Objectives of the Pilot Study: the main objective in this pilot study was to understand the self-management of people with diabetes mellitus in HL Manambai Abdulkadir hospitals. Methodology: The participants in this pilot study were people diabetes mellitus type 2 in HL Manambai Abdulkadir hospitals using cross sectional design by diabetes self-management, self-efficacy, diabetes self-management knowledge and diabetes distress scale questionnaire. Results: 60% of patients in HL Manambai Abdulkadir hospitals had lack of self-management. The result from measuring of distress scale, knowledge and self-efficacy of patients are related to self-management of patients with diabetes mellitus with P Value <0.05. Conclusion: further research is needed with additional interventions to overcome the lack of self-management to people who suffer diabetes mellitus in HL Manambai Abdulkadir Hospital.

Factors Associated with Achievement of Glycemic Goal in Africa—Results from the International Diabetes Management Practices Study (IDMPS)

The IDMPS is a global observational survey on the management and patterns of care of people with type 1 (T1D) and type 2 (T2D) diabetes in the developing world. Due to regional heterogeneity, a logistic regression model per region was performed entering factors significant at the 10% level from the univariate analysis. Odds ratios with 95% CI were estimated for each significant predictor. A backward selection procedure identified predictive factors that were significant at the 5% level. Here we report the cross-sectional results observed using data collected in 2015-16 from 12 African countries (Algeria, Cameroon, Côte d’Ivoire, Democratic Republic of the Congo, Egypt, Kenya, Madagascar, Morocco, Nigeria, Senegal, South Africa, Tunisia). An unhealthy diet and lack of exercise increased the risk of not reaching glycemic target by 7 and 4.5 times in people with T1D (n=781) and T2D (n=2403), respectively (Figure). Lack of self-management (self-monitoring of blood glucose and self-adjustment of insulin) was also a significant predictor in both populations. A negative impact of poor diabetes education and longer duration was only observed for people with T1D. Hospitalizations in the past 12 months seem to be a significant marker of poor glycemic control. All these predictors call for improved patient education regarding the management and use of insulin. Disclosure J. Mbanya: Advisory Panel; Self; GlaxoSmithKline plc.. Speaker's Bureau; Self; Novo Nordisk A/S, Sanofi, Servier. P. Aschner: Other Relationship; Self; Sanofi. J.J. Gagliardino: Other Relationship; Self; Sanofi. H.M. Ilkova: Advisory Panel; Self; Abbott, Eli Lilly and Company, Novartis AG, Novo Nordisk A/S, Boehringer Ingelheim GmbH, Servier, Merck Sharp & Dohme Corp.. Speaker's Bureau; Self; AstraZeneca. Advisory Panel; Self; Medtronic, Roche Diabetes Care Health and Digital Solutions, Bilim İlac. F.J. Lavalle-Gonzalez: Advisory Panel; Self; Sanofi. Speaker's Bureau; Self; Sanofi. Research Support; Self; Janssen Pharmaceuticals, Inc.. Advisory Panel; Self; Janssen Pharmaceuticals, Inc.. Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc.. Consultant; Self; Novo Nordisk Inc.. Advisory Panel; Self; AstraZeneca. Speaker's Bureau; Self; AstraZeneca. Research Support; Self; AstraZeneca. Advisory Panel; Self; Merck Sharp & Dohme Corp.. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Speaker's Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Advisory Panel; Self; Eli Lilly and Company. Speaker's Bureau; Self; Eli Lilly and Company. Advisory Panel; Self; Abbott. Speaker's Bureau; Self; Abbott. A. Ramachandran: None. G. Kaddaha: Other Relationship; Self; Sanofi. M.V. Shestakova: None. J. Chantelot: Employee; Self; Sanofi. Stock/Shareholder; Self; Sanofi. J.C. Chan: Consultant; Self; Bayer AG. Other Relationship; Self; Bayer AG. Consultant; Self; Sanofi. Other Relationship; Self; Sanofi, Eli Lilly and Company, Amgen Inc.. Consultant; Self; AstraZeneca, Merck & Co., Inc., Pfizer Inc.. Other Relationship; Self; Pfizer Inc.. Board Member; Self; Asia Diabetes Foundation. Stock/Shareholder; Self; GemVCare. Other Relationship; Self; Merck Sharp & Dohme Corp.. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Novartis AG, Eli Lilly and Company.

Investigating on taste changes and self care in cancer patients undergoing chemotherapy

Objective To investigate the status of taste changes and self care in cancer patients during chemotherapy in order to provide evidence for nurses to help patients taking self care effectively.Methods A questionnaire regarding self-care strategies to cope with taste changes was given to a total of 118 inpatients after two cycle of chemotherapy for collecting information.Results One hundred and twenty questionnaires were released and 118 were retrieved with a effective response rate of 98％.Among 118 patients,the incidence of taste changes was 79.7％,but 54.2％ of them had not taken any methods to cope with it.Conclusions Taste changes were commonly symptoms and had obvious negative effects to patients in chemotherapy,while the patients are lack of self-management of taste changes.Nurses may take interventions to minimize the negative effects and promote patients to perform self-care actions to improve their quality of life. Key words: Chemotherapy; Cancer; Taste changes; Self care

Primary care provider concerns about management of chronic pain in community clinic populations.

Chronic pain is a common patient complaint in primary care, yet providers and patients are often dissatisfied with treatment processes and outcomes. To assess provider satisfaction with their training for and current management of chronic pain in community clinic settings. To identify perceived problems with delivering chronic pain treatment and issues with opioid prescribing for chronic pain. Mailed survey to primary care providers (PCPs) at 8 community clinics. Respondents (N=111) included attendings, residents, and nurse practioners (NPs)/physician assistants (PAs). They reported 37.5% of adult appointments in a typical week involved patients with chronic pain complaints. They attributed problems with pain care and opioid prescribing more often to patient-related factors such as lack of self-management, and potential for abuse of medication than to provider or practice system factors. Nevertheless, respondents reported inadequate training for, and low satisfaction with, delivering chronic pain treatment. A substantial proportion of adult primary care appointments involve patients with chronic pain complains. Dissatisfaction with training and substantial concerns about patient self-management and about opioid prescribing suggest areas for improving medical education and postgraduate training. Emphasis on patient-centered approaches to chronic pain management, including skills for assessing risk of opioid abuse and addiction, is required.