Motivation For Self-care Research Articles

Self-management app usage and expectations by patients with heart failure: results of a qualitative study

Abstract Background Effective self-care in heart failure (HF) is essential to prevent acute deterioration and improve treatment adherence and quality of life. The supportive role of eHealth is becoming increasingly important to alert HF patients to changes in symptoms and take greater responsibility for maintaining or improving their state of health. Integrating the expectations, perceptions, and impression of HF patients into the design, customization, and utilization of self-care apps is crucial to ensure sustainable and beneficial implementation of such solutions. Purpose To explore patients' with HF expectations, their usage, and first impressions towards a self-care app. Methods The self-care app developed could monitor HF symptoms, provide education via e-learning modules, and telemedical services including regular checkups, recommendations, and feedback from healthcare professionals (HCP). Patients from four clinical sites in Europe, Germany (DE), United Kingdom (UK), Ireland (IRL), Netherlands (NL), who had used this app were invited to participate in a semi-structured interview. These were recorded, transcribed, and analysed by two researchers based on qualitative content analysis according to Mayring. Results In total 32 male and 6 female HF patients aged between 32 and 84 years (66±13) were interviewed (see figure 1). Average duration was 34 minutes. Most patients had used the app for 1-2 weeks at time of the interview. Most patients planned to use the app 2-3 times a week and integrate it into their daily routines. Patients expressed a preference for sessions (regular checkups, e-learnings) not to exceed 10 minutes. Patients believed features like reminders, gamification, and direct feedback from the app could positively influence their behaviour. Conversely, technical issues, too frequent data entry or repetitive questioning were perceived as negative. In case the app could give medical advice, some patients (n=12) indicated that they would only follow the app's recommendations after consulting an HCP. Overall, patients expected the app to provide continuous monitoring and an early warning system to detect and counteract deterioration at an early stage. They deemed the combination of telemedical services and patient records to be particularly valuable. Moreover, patients expected the app to serve as an information source on HF and believed it could increase their motivation and self-discipline for better self-care and therapy adherence (see figure 2). Conclusion The results show that HF patients consider eHealth apps to be valuable tools for autonomously monitoring and improving their health. However, behaviour and acceptance can be encouraged or inhibited depending on the functionalities and design of the app. The findings underline the increasing relevance of eHealth solutions, such as a self-care app in healthcare and emphasize the necessity of considering patients' needs and preferences during the development.Functions with the greatest benefit

Factors Influencing The Usage of Stress Relief Applications: From The Psychological Perspective

Stress remains one of the most difficult challenges in responding to various situations. It elicits negative thoughts and feelings in the person. Counseling, training, exercise, and other methods effectively reduce stress. However, with the advancement of technology, different approaches to dealing with it have emerged. One of the types of digital health applications was stress relief applications. This application was starting to become famous as an alternative to help individuals manage their stress levels. Numerous stress-management or stress-relief applications are available for smartphones and tablets. These applications include a variety of stress-reduction techniques, including meditation, mindfulness breathing, cognitive behavioral therapy, and relaxation techniques. This review paper explores the psychological factors influencing the usage of stress relief applications. In this review paper, researchers focused on perceived stress, motivation for self-care, and cognitive engagement. Understanding these psychological factors can help the individual experiencing high stress levels to utilize the stress relief application. Besides, for the application developers, it gives the idea to create compelling digital tools that cater to users' specific needs and preferences, ultimately promoting better stress management and overall well-being.

Integrating the Sufficiency Economy Royal Philosophy and Participatory Action Research Approach to Promote Self-Care for Stroke Prevention in Selected Communities of Southern Thailand.

(1) Introduction: Effective control of stroke risk factors can reduce stroke incidence. Motivation for participatory action of community dwellers to practice self-care to modify stroke risk after providing them with knowledge of stroke risk factors is considered useful under a situation of limited healthcare resources. This study aimed to evaluate the outcomes of integrating the sufficiency economy philosophy (SEP), a royal economic philosophy in Thailand, and the participatory action research (PAR) approach on stroke risk factors control among selected communities. (2) Methods: Villagers who had medium to high stroke risk from two provinces with leading stroke incidences in southern Thailand were invited to participate in an eight-month SEP-PAR program conducted in 2019. Group meetings among the study participants, local healthcare providers, the researchers, and relevant stakeholders in the communities were held to co-design a health behaviors program targeting lower waist circumference (WC), body weight (BW), blood pressure (BP), fasting blood sugar, blood lipids, and smoking and alcohol consumption rates. Follow-up physical measurements and blood tests were compared with the baseline results for significant differences by descriptive statistics (p < 0.05) using the R program. (3) Results: Of 126 participants, 75.4% were female. Moderate and high stroke risk levels were found in 58.2% and 19.8%, respectively. Elevated baseline WC, BW, BP, and blood test results were found in 50-80% of the participants. The co-designed health behaviors in this study were dietary control, regular exercise, relieving psychological stress, and stopping smoking and alcohol consumption. Overall, the participants had significant adherence to the co-designed health behaviors. At the end of the program, the follow-up tests showed significant reductions in BW, BP, fasting blood sugar, and lipids, but not in WC. (4) Conclusions: A combined SEP and PAR approach was effective for stroke risk factors control among the community dwellers. Motivation for self-care is a significant strategic outcome expected of this approach. Longer follow-up studies in larger populations are needed.

Self-care challenges of patients with heart failure from the perspectives of patients and caregivers: A qualitative study

Objective: self-care is critically important for the long-term management of heart failure (HF) patients, with caregivers playing an important role in promoting self-care. However, adherence to self-care is typically low among HF patients worldwide.Methods: In-depth qualitative interviews were conducted with individuals diagnosed with HF. To structure the interview guide and underpin the analysis, two established behavioral science frameworks, the Behavior Change Wheel (BCW) and the Theoretical Domains Framework (TDF), were used in this study.Results: A total of 32 participants were included (n = 16 patients, n = 16 caregivers), with themes involving: barriers included: "Self-care with Limited Capability," "Insufficient External Support," "Lack of Motivation for Self-Care." Facilitators included: "Striving to Adapt to Disease Demands," "Adequate External Support," "Positive Health Behaviors and Experiences."Conclusions: Providing positive support to heart failure patients and their caregivers, along with cultivating intrinsic motivation for behavioral change, can enhance self-care ability.

A narrative of recovery in forensic hospitals

AimConcerns about the applicability of recovery orientation to forensic care have surfaced due to the traditionally restrictive practices associated with forensic institutions. We interviewed 19 experts-by-experience and 18 professionals working with them across five Finnish forensic hospitals and one out-patient clinic to describe how they define recovery in forensic. MethodsWe utilized semi-structured, one-on-one interviews and then analyzed the collected data using structural narrative analysis. Our points of interest were the plots of the recovery stories and the ways in which various factors affected recovery. We also investigated whether staff and experts-by-experience had different perceptions of recovery in forensic psychiatry, and whether recovery-oriented practices were present in these accounts. ResultsA wider mutual narrative with a chronological plot was identified, and recovery-oriented practices and goals were found with a special emphasis on offending. Insight into mental illness, motivation for self-care, trust in therapeutic relationships, and gaining possibilities to proceed in care were found to promote recovery, whereas insufficient understanding of the illness, a closed environment, lack of trust, and substance abuse hindered the recovery process. Both the professionals and experts felt that the most prominent goal of recovery is integration into society. Conclusions and implications for practiceThe views of the interviewed experts-by-experience and professionals regarding recovery were rather univocal. Forensic psychiatric services in Finland were found to demonstrate recovery-oriented features, which can be promoted further by involving experts-by-experience in different assignments. The results also highlight that the families of patients should become more active partners in care. Impact and implications statementRecovery in forensic psychiatric hospitals can be perceived as a process towards a new role in society. To reach this goal the forensic patients need support from staff, peers, and family. We found numerous factors which enable and hinder the recovery process, and which should be considered during forensic care.

Exploring T2DM Patients’ Motivation in Diabetic Self-care: a Qualitative Study

Motivation refers to the larger mental processes that guide individual behaviours. Self-care behaviours are crucial in aiding disease adaptation by improving treatment adherence, disease control, quality of life, and self-perceived health status. Diabetic patients have been shown to have fewer concerns about their health. Thus, this study aimed to explore the motivating factors of diabetes self-care (DSC) among people with Type 2 Diabetes Mellitus (T2DM). A qualitative approach was adopted to explore and better understand the motivation behind self-care among diabetic patients. In-depth interviews (IDI) were conducted with 21 patients from two government healthcare facilities in Selangor, namely Hospital Tengku Ampuan Rahimah, Klang and the Meru Health Clinic from November to December 2019. All the qualitative data were managed using the NVivo software and thematically analysed. In general, this study identified two major types of motivation: self-motivation and social- motivation. Under self-motivation, there were six significant sub-themes, i.e. perceived better health condition having received DM exposure, perceived importance of diet and medication, self or personal experience, fear of diabetes complications, perceived importance of lifestyle modification, and positive thinking. In addition, the results revealed five significant sub-themes in terms of social-motivation: family support, community support, others’ experiences, financial support, and employer support. Our findings demonstrated the importance of various motivating factors in providing self-care support to diabetic patients. A well-planned diabetes management programme should incorporate motivational support to encourage patients to better manage their conditions.

Exploring the Level of Self-Care Behavior, Motivation, and Self-Efficacy among Individuals With Hypertension: A Cross-Sectional Study.

Hypertension is a serious public health issue. It is a significant but controllable factor in the emergence of cardiovascular disease. Controlling hypertension is a main target for individuals to prevent further illness. This study aims to explore the level of self-care behaviors, motivation, and self-efficacy among individuals with hypertension. A cross-sectional, descriptive, correlational design was used to recruit (n = 121) participants utilizing the Hypertension Self-Care Profile (HTN-SCP) questionnaire. The analysis revealed that the mean score of self-care behavior was 49.7 (SD = 10.0) out of 20-80, which indicates that they are likely to have good self-care behavior. The mean score of motivation for self-care was 59.7 (SD = 11.8) out of 20-80, reflecting that individuals with hypertension have a good level of motivation for self-care, and the mean score of self-efficacy was 70.0 (SD = 9.8) out of 20-80, which means that individuals with hypertension have a high level of self-efficacy. Also, there was a significant positive correlation between self-care behavior and motivation for self-care (r = .527, p < .001), between motivation for self-care and self-efficacy (r = .554, p < .001), and between self-efficacy and self-care behavior (r = .572, p < .001). The study revealed that Jordanian patients with hypertension have good self-care practices, motivation, and high self-efficacy. Patients should therefore be strongly recommended to be compliant with self-care practices. The government should prioritize hypertensive patients by making it easier for them to receive information about self-management practices to improve their quality of care.

Diabetes-related distress and its associated factors among people with type 2 diabetes in Southeast Ethiopia: a cross-sectional study

BackgroundDiabetes-related distress lowers the motivation for self-care, often leading to lowered physical and emotional well-being, poor diabetes control, poor medication adherence and increased mortality among individuals with diabetes.ObjectiveTo assess factors...

Adults living with type 2 diabetes experiences of a randomised adapted diabetes nutrition education programme: a qualitative process evaluation

Aim: The purpose of this study was to investigate how a randomised controlled trial (RCT) of an adapted diabetes nutrition education programme (NEP) was received by adults with sub-optimally controlled (HbA1c of ≥ 8%) type 2 diabetes in a tertiary setting. This could aid in understanding the small effect of NEP on HbA1c and other outcomes and the high attrition rate. Methods: This qualitative study was done alongside the year-long RCT. In the RCT, intervention participants received four NEP components, and both intervention and control group participants received education materials (fridge/wall poster). Five focus-group discussions were held with the intervention group participants at two time periods: after they completed the NEP curriculum (7th month) (n = 26; 67% of randomised participants [RP]( and at the end of the study (12 months) [n = 24; 61.5% RP). Nineteen (50% RP) control group participants were individually interviewed at the end of the study. Data were analysed using a thematic framework. Results: All participants (control and intervention) reported high satisfaction with the NEP. Participants emphasised the value of the fridge/wall poster for themselves and their families. Participants (control and intervention) reported various benefits of the NEP: improved diabetes knowledge, skills in dietary self-care, family support for self-care, better health and motivation for appropriate self-care. Some participants also reported positive changes to their diet and physical activity behaviours. The perceived benefits were the main reason for completing the study. Conclusions: Irrespective of the arm of participation, the NEP was well received, and perceived benefits inspired participation. The limited NEP impact and the sub-optimal programme participation do not appear to be related to participants’ perceptions of the adapted NEP.

Structured educational app in improving self-care management in diabetes mellitus patients: systematic review

Self-care management is a process that does not only develop over time but evolves along with the experience of the type of illness. Successful self-management of diabetes mellitus depends on self-care motivation and self-awareness, specifically designed to control symptoms and avoid complications. This systematic review uses telehealth intervention and smartphone-based applications for diabetes mellitus patients with randomized control trial, qualitative, and cross-sectional studies obtained from six databases. This review included inclusion and exclusion criteria established using population, intervention, comparison, outcomes and study (PICOS) framework, and then data were extracted, reviewed, and assessed using the Joanna Briggs Institute (JBI) tool. Seventeen selected articles that met the inclusion and exclusion criteria passed the selection through the selection process shown in the flow chart, which all research results show an impact on self-care management. The use of technology especially the applications, is very influential and effective in increasing knowledge and self-care management of diabetes mellitus patients. Besides that, it can also save operational costs in providing interventions for people with diabetes mellitus, but further research is needed to look at the sustainability of structured educational applications on health outcomes.

Perceptions and self-care motivation among people with hypertension in Belu, East Nusa Tenggara

Purpose: to identify patients’ perceptions of hypertension and motivation for self-care related to hypertension. Design: a qualitative descriptive study. Method: Semi-structured interviews were conducted with 16 hypertensive patients in Belu Regency, East Nusa Tenggara. The data was collected by using a tape recorder and transcribed verbatim. The data analysis used the NVIVO 12 Plus software. Main Findings: Two important themes were identified, including perceptions related to hypertension and self-care motivation. The perceptions of the disease consisted of 1) perceptions of the causal factors (the presence of chemicals in food, blood sugar and cholesterol factors, fatigue, pregnancy, stress due to death of a family member, lack of rest, consumption of food high in salt, and the presence of uterine tumor), 2) individual perceptions (the myth that people whose blood pressure is measured will always become hypertensive patients), and 3) the impact of hypertension (stroke and heart problems). Meanwhile, motivation includes internal and external aspects. Conclusions and recommendations: This study promotes an understanding of patients’ perceptions of hypertension and their motivation for self-care in Belu, East Nusa Tenggara. Successful implementation depends heavily on how to overcome false perceptions and low self-care motivation which results in poor adherence to maintenance. Further research is suggested to explore self-care management to control blood pressure among people with hypertension in Belu, East Nusa Tenggara.

1398-P: Lactobacillus rhamnosus Attenuates Depressive-Like Behavior in High-Fat Diet Fed Mice and Regulates Tyrosine Hydroxylase

Prevalence of depression is higher in diabetic patients compared to healthy humans due to a shared pathogenesis including insulin resistance and inflammation. These factors are also linked to intestinal dysbiosis. Interestingly, preventive intake of probiotic lactobacilli has been shown to improve dysbiosis along with mood and metabolism. Yet, a potential therapeutic role and underlying mechanism of Lactobacillus rhamnosus GG (LGG, ATCC 53103) to improve emotional behavior in diet-induced obesity is unknown. Male C57BL/6N mice were fed a low-fat diet (LFD, 10% kcal from fat) or high-fat diet (HFD, 45% kcal from fat) for 6 weeks and followed by daily oral gavage of vehicle or 1x108 CFU of LGG. Dark-Light Box Test was used to evaluate anxiety, Mousetail Suspension Test (MST) and Splash Test were used to assess depressive-like behavior and motivation for self-care. Cecal microbiome composition was analyzed using 16S rRNA Sequencing. Plasma and CSF were collected for metabolomic analysis, and gene expression was analyzed using qPCR. We observed that 12 weeks of HFD feeding increased anxiety and depressive-like behavior. Strikingly, LGG decreased specifically depressive-like behavior in the MST which was confirmed by the Splash Test. Metagenomics analysis revealed that HFD but not LGG alters cecal microbiome composition, indicating a transient effect. Moreover, HFD feeding significantly altered plasma lipid metabolism whereas LGG decreased branched chain amino acids which associated with improved emotional behavior. In dopaminergic brain regions, LGG restored the HFD-induced decrease of tyrosine hydroxylase, the rate-limiting enzyme in dopamine synthesis, while not altering enzymes responsible for dopamine degradation. Our data indicate that LGG attenuates specifically depressive-like behavior in HFD-fed mice with a molecular signature of restored dopamine synthesis. Disclosure M.Schell: Other Relationship; Novozymes A/S, Denmark. K.Wardelmann: None. R.Hauffe: None. M.Rath: None. S.Chopra: None. A.Kleinridders: Other Relationship; Novozymes. Funding German Ministry of Education and Research (BMBF) and the State of Brandenburg (DZD grant 82DZD00302 and BMBF grant 031B0569) .

Ninjin'yoeito, a traditional Japanese medicine, attenuates age-related deficits of muscle performance, self-care motivation, and body temperature in C57BL/6 mice.

As both physiological and psychological factors influence age-associated declines in older people, the development of drug therapy with multifaceted effects is required. To investigate the utility of ninjin'yoeito (NYT) against geriatric syndromes, we evaluated the effects of NYT on age-related declines in old C57BL/6 mice (88-week-old) as a preclinical model of frailty progression. Here, we showed that NYT reversed the decline of rectal temperature in old mice and also improved forelimb grip strength compared with that in the old control group without affecting skeletal muscle loss. Moreover, NYT significantly increased the duration of grooming after a sucrose solution was sprayed, which reflected self-care motivation. Finally, we revealed the antioxidant effects of NYT using a cell-free assay. These results suggest that NYT can improve both physiological and psychological declines associated with aging, and the mechanism may include antioxidant effects. NYT may have potential utility for maintaining the health of older people.

Self-Care Experiences of Empty-Nest Elderly Living With Type 2 Diabetes Mellitus: A Qualitative Study From China.

BackgroundThe number of type 2 diabetes mellitus (T2DM) cases among empty-nest elderly increases with increasing aging in China. Self-care plays an important role in preventing and reducing adverse outcomes of diabetes; however, few studies focus on self-care experiences of empty-nest elderly with T2DM.ObjectiveTo explore self-care experiences for a chronic disease among empty-nest elderly patients with T2DM in mainland China.MethodsA descriptive phenomenological design was used in this study. Semi-structured interviews were conducted for 15 empty-nesters with T2DM. Interviews were implemented in department of endocrinology at a tertiary teaching hospital located in Shandong province, east of China.ResultsThe participants were poorly adept with monitoring their blood glucose and lacked the ability to deal with abnormal blood glucose levels. Most participants had a good relationship with medication and physical activity. Living without children was perceived as a benefit that improved dietary management and is a disadvantage in terms of economic and emotional support and access to medical resources. Elderly empty-nesters also lacked knowledge about diabetes and paid little attention to potential complications.ConclusionEmpty-nest elderly patients with T2DM value medication compliance and lifestyle modification more than blood glucose monitoring, complication prevention, and coping with negative emotions. Friends and spouses play indispensable roles in patients’ self-care motivation and maintenance. Diabetes education on self-care, access to medical resources, and social support is needed for better diabetes management.

O manejo odontológico do paciente bipolar em litioterapia, com ênfase para a cárie dentária, no método clínico de intervenção : estudo de casos

The present work is a case study of 8 bipolar patients under lithium therapy, being all of them members of the lithium group of the Hospital de Clínicas de Porto Alegre. It describes the dental management of bipolar patients under lithium therapy, emphasizing dental caries and the clinical method of intervention. The work was divided into three phases, existing a ninety-day interval between each ofthem. In the first part ofthe research, dental examinations were carried out and the patients were interviewed with the special purpose of describing each one of them regarding his buccal health. They were also inquired about their experience in living with the bipolar disease, about the medication taken and its side effects. The patients received dental treatment according to the clinical method as they also attended health educational sessions destined to increase their autonomy up to the dental dismissal. In the second and third phases, the exams that had been carried out in the first phase were repeated in order to analyze the commitment of each bipolar patient to the proposed dental treatment. The questions about the relationship between the bipolar patient and the treatment of this disease were also repeated. It was concluded that the results of the dental exams were related to the degree of stabilization of the bipolar disease; the patients detaining the best results in the dental treatment were those who had the bipolar disease stabilized. It was concluded that, having in mind the occurrence frequency of bipolar disease, it would be plausible that a denfist who works in the Public Service sooner or later would attend bipolar patients; bipolar patients are a peculiar population group that need a specific dental program; the planning and scheduling of these specific odontological programs for bipolars should take into account the disruptions in the dental therapy, caused by the disease and it is also necessary to renegotiate with the bipolar, his responsibilities and his motivation for buccal self-care, which will result in more frequent dental visits.

School Readiness Beliefs of Dominican and Salvadoran Immigrant Parents

ABSTRACT Parents are children’s first teachers, and it is critical that they understand what children need to be successful in school. This study examined the school readiness beliefs of 43 Latinx immigrant parents from the Dominican Republic and El Salvador. Parents participated in semi-structured interviews regarding which skills their children should have before starting kindergarten, how they perceived their role in helping children acquire these skills, and how they learned which skills were necessary for success. Research Findings: Social and language skills were the most commonly identified school readiness skills. Approximately half of the parents mentioned math and general knowledge. Less than a third of the parents named self-care skills, motor development, and interest or motivation. Almost all parents in this study described taking an active role in fostering their children’s school readiness skills. Parents typically described getting information through informal channels: either from friends and family or through experiences with older children. Only a few parents mentioned getting information from schools regarding the skills needed for kindergarten. Practice/Policy: Schools and policymakers should explore ways to provide parents with information about school readiness before children reach the age of five.

Self-care perception and behaviour in patients with heart failure: A qualitative and quantitative study.

Background and objectiveSelf‐care strategies in heart failure (HF) are effective for disease management, yet adherence in many patients is inadequate. Reasons are presumably multifactorial but remain insufficiently investigated; thus, we aimed to analyse self‐care adherence and associated factors in outpatients with HF.Methods and resultsTo measure self‐care levels and explore barriers and facilitators to self‐care adherence in patients with HF, quantitative study using the European Self‐Care Behaviour Scale (EHFScBS‐9) (n = 80; NYHA II–III, mean age 72 ± 10 years, 58% male) and qualitative study using semi‐structured interviews (n = 32; NYHA II–III, mean age 73 ± 11, 63% male) were conducted. We detected lowest adherence to regular exercise (39%) and contacts with healthcare provider in case of worsening symptoms (47%), whereas adherence was highest for regular medication taking (94%). Using the EHFScBS‐9 standardized cut‐off score ≤ 70, 51% of patients reported inadequate self‐care. Binary logistic regression analysis showed significant influence of education (OR = 0.314, 95% CI: 0.103–0.959) and perceived control (OR = 1.236, 95% CI: 1.043–1.465) on self‐care adequacy. According to the situation‐specific theory of HF self‐care, most commonly reported factors affecting the process of self‐care were knowledge about HF self‐care behaviours (84%), experience with healthcare professionals (84%), beliefs about their expertise (69%) and habits related to medication taking (72%). Among values, working responsibilities (53%) and maintenance of traditions (31%) appeared as the most prevalent socially based values affecting motivation for self‐care. Situational characteristics related to the person (self‐confidence, 53%; adaptive coping strategies, 88%), problem (burdensome breathing difficulties, 56%; co‐morbidities, 81%) and environment (practical support from family/caregivers, 59%; financial difficulties, 50%) were also commonly reported.ConclusionsVarious factors, including health‐related beliefs, habits and socially based values, need to be taken into account when planning self‐care interventions in patients with HF. A patient tailored approach should be based on adequate patient evaluation, taking into consideration the particular personal and social context.

Toward a Conversational Agent to Support the Self-Management of Adults and Young Adults With Sickle Cell Disease: Usability and Usefulness Study.

Sickle cell disease (SCD) is the most common genetic blood disorder in the world and affects millions of people. With aging, patients encounter an increasing number of comorbidities that can be acute, chronic, and potentially lethal (e.g., pain, multiple organ damages, lung disease). Comprehensive and preventive care for adults with SCD faces disparities (e.g., shortage of well-trained providers). Consequently, many patients do not receive adequate treatment, as outlined by evidence-based guidelines, and suffer from mistrust, stigmatization or neglect. Thus, adult patients often avoid necessary care, seek treatment only as a last resort, and rely on self-management to maintain control over the course of the disease. Hopefully, self-management positively impacts health outcomes. However, few patients possess the required skills (e.g., disease-specific knowledge, self-efficacy), and many lack motivation for effective self-care. Health coaching has emerged as a new approach to enhance patients' self-management and support health behavior changes. Recent studies have demonstrated that conversational agents (chatbots) could effectively support chronic patients' self-management needs, improve self-efficacy, encourage behavior changes, and reduce disease-severity. To date, the use of chatbots to support SCD self-management remains largely under-researched. Consequently, we developed a high-fidelity prototype of a fully automated health coaching chatbot, following patient-important requirements and preferences collected during our previous work. We recruited a small convenience sample of adults with SCD to examine the usability and perceived usefulness of the system. Participants completed a post-test survey using the System Usability Scale and the Usefulness Scale for Patient Information Material questionnaire. Thirty-three patients participated. The majority (64%) was affected by the most clinically severe SCD genotypes (Hb SS, HbSβ0). Most participants (94%) rated the chatbots as easy and fun to use, while 88% perceived it as useful support for patient empowerment. In the qualitative phase, 72% of participants expressed their enthusiasm using the chatbot, and 82% emphasized its ability to improve their knowledge about self-management. Findings suggest that chatbots could be used to promote the acquisition of recommended health behaviors and self-care practices related to the prevention of the main symptoms of SCD. Further work is needed to refine the system, and to assess clinical validity.

Usage motivation of a new health application in the elderly and the general public through family institution and social media channels

The purpose of this study was to explore usage motivation and satisfaction of a new health application among the elderly in the Bangkok Metropolitan Region. The sampled population included elderly individuals living in the region, and the data were collected using a questionnaire. The resulting data were then analyzed statistically using frequency, percentage, mean, standard deviation, and multiple regression analysis. The results of the study revealed that the motivation for using the new health application was overall at a very good level. When considered in different aspects, motivation for application usage and self-care were found at a very good level, while the motivation from the application’s benefits and in recommendation or referral were found at a good level. As for usage behavior, users of the new health application were found to use it approximately 4 times per day. The outcomes of the hypothesis tests also revealed that the motivation from the application’s benefits and application usage were found to positively affect the usage satisfaction in terms of the decision to use with statistical significance level of .01. Motivation from the application’s benefits and self-care were also found to positively affect usage satisfaction in terms of usage frequency (times/day) with statistical significance level of .01.

Motivational Interviewing and Self-Care in Type 1 Diabetes: A Randomized Controlled Clinical Trial Study Protocol.

BackgroundType 1 diabetes is a disease with complex therapeutic recommendations that require day-to-day lifestyle changes. Motivational Interviewing is a communication tool that has proved effective in changing behaviors in people with addictions, obesity and type 2 diabetes. Our objective is to evaluate the effects of a Motivational Interviewing intervention in people with type 1 diabetes.MethodsSixty-six patients with type 1 diabetes and hemoglobin A1c >= 8% have been included and randomly assigned (computer-generated sequence, sealed envelopes, ratio 1:1) either to the intervention or to the control group. In the intervention group, appointments every 4 months with the endocrinologist include Motivational Interviewing; in the control group, the appointments proceed as usual. Patients will be followed for 16 months. The primary outcome will be self-care behaviors, assessed by a validated questionnaire, the Diabetes Self-Care Inventory-Revised Version. Secondary outcomes include: HbA1c, motivation for self-care, self-efficacy, health-related quality of life, satisfaction with professional-patient relationship, and fulfillment of patients’ own objectives. The practitioners receive training in Motivational Interviewing in order to help them promote adherence to self-care, encourage patient motivation and improve the doctor-patient relationship. The Motivational Interviewing intervention will be evaluated by two psychologists, blinded to the assigned treatment, through video recordings of the sessions and the administration of a purpose-built questionnaire, the EVEM 2.0 scale.DiscussionThere is evidence that MI can improve self-care in type 2 diabetes. In this study, we aim to evaluate the effect of MI on self-care and HbA1c in people with type 1 diabetes.Clinical Trial Registration https://clinicaltrials.gov/ct2/show/NCT03906786, identifier NCT03906786.