Self-care Outcomes Research Articles

Psychometric properties of the caregiver contribution to self-care of oral anticancer agents index: Longitudinal study.

The use of oral anticancer agents (OAAs) has increased in recent decades. Despite the advantages of OAAs, people with cancer face challenges such as adherence, prevention, recognition, and management of OAA side effects. Informal caregivers can help their patients who take OAAs by facing the above challenges with the implementation of behaviours to maintain stability (Caregiver contribution to self-care maintenance), monitoring (Caregiver contribution to self-care monitoring) and managing (Caregiver contribution to self-care management) the conditions of their patients. To develop and test the psychometric properties of the Caregiver Contribution to self-care in the Oral Anticancer Agents Index (CC-SCOAAI). A longitudinal study was conducted. Factorial validity was tested using Confirmatory Factor Analysis (CFA). Furthermore, we also tested the internal consistency and validity of the CC-SCOAAI construct. The Mann-Whitney U test was used to demonstrate associations between CC-SCOAAI scores and patient's re-hospitalizations, emergency-room attendances, and mortality. We enrolled 318 caregivers, mostly female (63.52%), with an age of <44 (39.94%) and spouse of the patient (54.66%). The CFA demonstrated the factorial validity of the CC-SCOAAI. Caregivers of patients with more re-hospitalizations had a lower contribution to self-care maintenance (U=2933.500; p=.04), while caregivers of patients with more emergency room admissions (U=1392.500; p<.001) and re-hospitalizations (U=2385.500; p<.001) had a lower contribution to self-care management. Caregivers of patients with emergency-room admissions (U=1392.500; p=.005), re-hospitalisations (U=2322.500; p<.001) and mortality (U=515.500; p=.001) had lower contribution to self-care monitoring. CC-SCOAAI is a valid and reliable tool. Given that caregivers are crucial in supporting these patients, the CC-SCOAAI may help clinicians improve caregiver efficacy and researchers using CC-SCOAAI to determine better self-care outcomes in patients with OAA.

Impact of stress coping style on self-care behaviors and prognosis in patients with heart failure: A prospective longitudinal observational study

BackgroundHeart failure (HF) requires effective management and self-care education to improve outcomes. However, daily self-care routines necessary for managing HF can lead to psychological issues, including stress, potentially exacerbating the condition. Patient stress-coping behaviors may significantly impact prognosis. ObjectiveWe aimed to identify stress coping styles in patients with HF and examine their impact on self-care behavior and prognosis. s. MethodsThis study utilized a longitudinal prospective observational design. Patients were categorized into task-oriented (task), emotion-oriented (emotion), and avoidance (avoidance) coping groups using the Coping Inventory for Stress Situations. Stress levels and self-care behaviors were evaluated during hospitalization and 1 and 3 months after discharge. The primary outcome was a composite of HF readmission and all-cause mortality during the 180-day post-discharge period. Longitudinal changes in self-care behaviors were assessed according to stress intensity. ResultsWe included 151 patients (age, 74 [60–80] years; female, 37.1 %) hospitalized for HF exacerbation between August 2021 and August 2023. The task group comprised 45 patients (29.8 %); emotion group, 47 (31.1 %); and avoidance group, 59 (39.1 %). The avoidance group had a higher risk of adverse events during follow-up (task, emotion, and avoidance: 8.9 % vs. 14.9 % vs. 32.2 %, p = 0.004). The avoidance-coping style was the only independent predictor of the primary outcome (hazard ratio: 3.84, 95 % confidence interval: 1.40–10.53, p = 0.009). Self-care behaviors were notably poorer in the avoidance group, particularly under conditions of high stress. ConclusionsStress-coping strategies impact both prognosis and self-care outcomes in patients with HF, and education programs should consider incorporating these strategies.

Core Outcomes of Self-Care Behaviours in Patients with Breast Cancer Treated with Oral Anticancer Agents: A Systematic Review.

The use of oral anticancer agents (OAA) dates to the late 20th century in cancer treatment. It is crucial that patients implement self-care behaviours to keep their disease stable and manage their OAA treatment. The three dimensions of self-care according to Riegel et al., self-care maintenance, self-care monitoring, and self-care management, may be implemented to avoid negative outcomes. This paper seeks to identify outcomes associated with self-care in breast cancer patients during treatment with OAA and to compare which of these outcomes fall into the core outcome categorizations in oncology (minimal set of outcomes that research on a given health issue should measure). A systematic review with narrative synthesis was conducted. This study included patients with breast cancer taking any kind of OAA and described outcomes of self-care. The search was performed on MEDLINE, Web of Science and CINAHL/PsycINFO; Results: Of 4173 records, eight studies were selected and reviewed. The core outcomes mainly considered were mortality, survival, disease recurrence and quality of life. All studies focused only on pharmacological adherence outcome; none of them focused on other dimensions of self-care. This systematic review highlighted that there is a great lack of research on outcomes related to self-care in patients with breast cancer taking OOA. Even though pharmacological adherence to OAA is important, other behaviours are also important to improve patients' outcomes, but they have not been studied. Further research is needed to study how self-care behaviours can impact patients' outcomes.

Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients

Background/Aim: Acute Coronary Syndrome (ACS) remains a significant cause of morbidity and mortality worldwide. Cardiovascular disease (CVD) prevention remains crucial despite advancements in clinical outcomes. Empowering patients with self-care skills is essential for managing ACS, and digital tools can enhance these practices. This study qualitatively evaluates patients' experiences with post-ACS digital tools to improve self-care. Material and methods: A qualitative phenomenological approach was employed, utilizing in-depth interviews with patients diagnosed with ACS enrolled in a telephonic follow-up program. Sampling continued until saturation was reached. Data collection included patients' perceptions of the accessibility and utility of digital tools in enhancing self-care knowledge. A descriptive analysis of age and gender was conducted to analyze potential demographic influences. Results: Ninety patients participated, with males predominating (70%) and a mean age of 69.2 years. Patients reported positive engagement with both educational videos and health blogs. Preferences varied, with 54% favoring videos and 36% preferring blogs. Difficulties in accessing digital tools were observed, especially among elderly patients. However, patients emphasized the instrumental role of these tools in complementing knowledge and facilitating self-care, while recognizing the irreplaceable value of direct interaction with healthcare professionals. Conclusions: Future interventions should focus on improving digital tools accessibility and effectively integrating them into patient care pathways to optimize self-care outcomes.

Refugee school consultation effects on teacher self-efficacy, self-care, and peer consultation skills.

Guided by a participatory culture-specific consultation model, this study contributes to an understanding of the effectiveness of school consultation with teachers of refugee students. The goal of the present study was to determine the impact of an individual consultation intervention with refugee teachers on their self-efficacy and self-care, in addition to their peer consultation skills. The participants were 109 teachers at refugee schools in Malaysia, most of whom were refugees (91% refugees; 73% female). Of the 109 participants, 84 teachers were coconsultants with psychology graduate students; all 109 were individual consultees. The study used a two-timepoint design with the outcomes of self-reported teacher self-care; teacher self-efficacy in the management of refugee student emotion regulation and emotional engagement; and consultation skills. Additionally, consultee-reported goal attainment, consultation effectiveness, and satisfaction were collected. The findings suggested significant latent growth from baseline to post-intervention in refugee teacher self-care and self-efficacy in the management of student emotion regulation and emotional engagement in addition to the growth of their consultation skills. The effect sizes were large for latent growth of teacher self-efficacy in promoting student emotion regulation, behavior, and emotional engagement (d = 1.19, 1.01, 1.02); the effect size for self-care was medium (d = .62). Growth was not dependent on dosage, age, gender, or consultee education, with the exception of teacher self-efficacy in management of emotional engagement which was dependent on dosage. After the intervention, the consultees reported that they completed their consultation goals at a higher level than expected, were satisfied with the consultation, and found the consultants to be helpful. The discussion situates the findings in relevant theory, research, and the culture-specific context. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Mindfulness-Based Social Work and Self-Care with Social Work Professionals: Replication and Expansion of a Randomised Controlled Trial

Abstract Social workers are at high risk of work stress and burnout, with the Covid-19 reported to have amplified this risk. The Mindfulness-based Social Work and Self-Care programme (MBSWSC) has been found to support cognitive and emotion regulation of social workers, leading to improved stress, burnout, mental health, and well-being. This randomised controlled trial (RCT) aimed to replicate and expand the findings of an earlier RCT of MBSWSC, with a wider group of social work professionals (including managers), by evaluating the effects of MBSWSC (n = 29) versus an active control (n = 31). Replication of RCTs acts as an important means by which findings can be confirmed, results replicated, generalisability assessed and processes and applicability improved. When compared to an online active control group, MBSWSC (which was also delivered online) was found to improve stress, emotional exhaustion, depersonalisation of service users, anxiety, depression, well-being, along with a range of mindfulness mechanisms of action which support cognitive and emotion self-regulation. The results from this study evidence the acceptability, effectiveness and durability of MBSWSC, and provide clear guidance that if MBSWSC is implemented across social work services, social workers are likely to experience improvements in these critical social work practice and self-care outcomes.

Voices of Wisdom: Geriatric Interviews on Self-Management of Type 2 Diabetes in the United States-A Systematic Review and Metasynthesis.

This review is aimed at unraveling the intricacies of diabetic self-management among geriatric people, drawing on current insights and understanding the complex paths geriatric people navigate. A wide search was conducted in health-oriented databases, including CINAHL, Embase, PsycINFO, MEDLINE, PubMed, Web of Science, and Cochrane Library, while gray literature was excluded. The search combined keywords and subject headings, focusing on the geriatric population, diabetes, self-management, and qualitative research. A three-tiered screening process was employed, with titles and then abstracts initially reviewed. Full-text analysis followed, with disagreements resolved among reviewers. In total, there were 248 participants included across these eight studies. Positive attitudes and perceptions were found to play a significant role in optimizing diabetes self-care outcomes. Support from family and friends was identified as crucial for self-care, while healthcare professionals often lacked adequate support and encouragement. Participants emphasized the importance of listening to their bodies and acknowledging hidden issues. These themes collectively highlight the multifaceted aspects of diabetes self-care and the impact of various factors on the self-management experiences of geriatric individuals with diabetes. The goal of this review is not to objectify self-management as a treatment strategy but to emphasize the importance of cultivating positive attitudes, respecting individual values, and addressing cultural and ethnic differences in healthcare practices to enhance self-management in this population. By embracing cultural diversity, understanding barriers, and respecting individual values, healthcare professionals and policymakers can improve the quality of life for the geriatric population living with diabetes.

HYPERTENSION SELF-CARE AMONG MEDICARE BENEFICIARIES WITH SELF-REPORTED HEARING TROUBLE

Abstract Hearing loss is common in older adults and frequently comorbid with chronic illnesses like hypertension, which requires self-care practices learned through patient-provider health communication. However, hearing loss is a barrier to communication. This cross-sectional analysis used the 2020 Medicare Current Beneficiary Survey of (N=11,587; weighted estimate, 51.8 million) to characterize hypertension self-care outcomes (measuring blood pressure, taking blood pressure medications, reducing alcohol, and confidence in blood pressure control) by hearing status among Medicare beneficiaries ages &amp;gt;65. In the sample, 39% reported a little and 6% reported a lot of trouble hearing while 66% reported having received a hypertension diagnosis. In models adjusted for sociodemographic and health variables, Medicare beneficiaries with a little trouble hearing (OR=0.84 95% CI=0.72-0.97; P=0.02) and a lot of trouble hearing (OR=0.74; CI 0.57-0.95; P=0.02) had 16% and 26% reduced odds of reporting confidence in hypertension control compared to beneficiaries with no hearing trouble. Similar results were found when excluding hearing aid users (a little trouble hearing OR=0.85; CI=0.72-1.01; P=0.06; a lot of trouble hearing OR=0.69; 95% CI=0.52-0.91; P=0.01). No significant difference was found for other self-care outcomes. To the authors’ knowledge, this is the first characterization of hearing difficulty and hypertension self-care and findings align with previous work suggesting hearing loss may be a barrier to vital health communication. Future work should focus on examining self-care activities across chronic illnesses, temporal relationships, and designing population-appropriate interventions to improve self-care understanding among adults with hearing loss.

Mobility and self-care outcomes in patients with a bariatric comorbidity during inpatient rehabilitation.

First, we describe the characteristics and functional outcomes of obese and bariatric patients in an inpatient rehabilitation facility (IRF). Second, we assessed differences in functional outcomes for bariatric, obese, and standard weight body mass index (BMI) groups. Third, we explored whether these characteristics differ between time periods and diagnostic groups. A retrospective study comparing electronic medical record data collected in 2016 and 2018, using a repeated cross-sectional cohort design. IRF. Individuals ≥18 years of age diagnosed with brain injury, medical complexity, general neurology, orthopedic, spinal cord injury (SCI), and stroke. Participants grouped as standard (BMI <30 kg/m2), obese (BMI 30-39 kg/m2), and bariatric (BMI ≥40 kg/m2) weights. (N = 2015 in 2016, N = 2768 in 2018.) INTERVENTIONS: Patients received standard inpatient rehabilitation. In 2018, clinicians had access to new weight-appropriate equipment. Discharge destination; length of stay (LOS) by BMI group and medical diagnoses; item-specific functional independence measure (FIM) change scores. Sixty-four percent to 67% of all BMI groups achieved a home discharge. The bariatric BMI group had a longer LOS (21 days) than the standard or obese groups. There was a significant interaction in a linear regression analysis between diagnosis and LOS, where LOS was longer in medically complex patients with bariatric BMI (19.3 days compared to 16.1 days) but shorter in bariatric patients with SCI (20.6 days) compared to standard weight patients (26.2 days). In 2018, the bariatric BMI group had greater average FIM change scores for bathing, lower body dressing, toilet transfers, and bed transfers. Patient BMI is associated with LOS in the IRF, although affected by diagnosis. Patients with higher BMIs can make changes in specific individual motor FIM items. For patients with bariatric BMIs, FIM change scores were higher in 2018, possibly due to the use of equipment and facilities designed for higher weight capacities.

A Nurse-Led Model of Care with Telemonitoring to Manage Patients with Heart Failure in Primary Health Care: A Mixed-Method Feasibility Study.

To determine whether a nurse-led care model with telemonitoring in primary care for patients with stable heart failure and their caregivers is feasible and acceptable. A mixed-methods feasibility study was conducted. Patients with stable heart failure and their caregivers were consecutively enrolled from March 2021 to April 2022. Participants were managed by nurses in a community health center through education and monitoring with a mobile app. The outcomes were feasibility outcomes, self-care outcomes, and qualitative acceptability and satisfaction. Quantitative and qualitative outcomes were linked to understanding how the model of care might benefit patients. Twenty-six patients and nine of their caregivers were enrolled. Ten participants used the mobile app. Nineteen patients and eight caregivers were interviewed. Participants who improved their self-care appreciated the help in finding coping strategies, being close to the clinic, and feeling cared for. Participants with fewer improvements in self-care perceived the model of care as useless and were far from the centre. Participants decided to use the app mainly for usefulness prevision, and most of them were satisfied. The model of care was not successful in recruiting patients, and adjustments are needed to improve the recruitment strategy and to engage people who perceive the model of care as not useful or unable to use the app.

Self-care practices for common acute conditions in the Philippines: a scoping review

PurposeThis review aimed to identify and map published studies on self-care practices to manage common acute health conditions in the Philippines.Design/methodology/approachThe authors conducted a scoping review in PubMed, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), ProQuest Central, Journal Storage (JSTOR) and the Philippine Council for Health Research and Development – Health Research and Development Information Network (HERDIN). The authors included all studies on self-care practices to manage common acute conditions, namely low back pain, allergic rhinitis, general acute pain, cough, cold, diarrhea, constipation and stress, published up to 2021 in the Philippines. Information on the article type, aim of the study, study design and setting, population characteristics and size, and self-practices employed for the conditions were extracted and synthesized.FindingsThe authors identified various self-care practices for acute conditions among the general population and indigenous peoples in the Philippines from 26 studies included in the review: the use of medicines with and without a prescription, appropriate and inappropriate antibiotic use, use of medicinal plants and other traditional and alternative therapies and products, recreational activities and healthy habits and behaviors, and self-management or seeking care from traditional healers (albularyo or manggagamot) or health professionals. A number of considerations influenced their decision on how to manage symptoms, including perceived severity of the condition, availability and perceived effectiveness of treatment, cost, and advice from trusted sources of health information.Research limitations/implicationsThe authors searched five major databases and a local research database, but some studies may still have been missed in the review. The review also excluded intervention studies on the outcomes of self-care, which limits the authors' ability to make conclusions on the effectiveness of the different modalities of self-care.Social implicationsFilipinos engage in a variety of “safe” (or evidence-informed) and “unsafe” (or harmful) self-care practices. While the term “self-care” is not routinely used by the general population and health providers, it is widely enculturated and practiced in the Philippines. Self-care benefits individuals and the health system, but there are also practices that increase risk of adverse outcomes and death including inappropriate antibiotic use, prescription sharing and reuse, and delays in seeking adequate treatment from a health professional. To leverage on self-care in advancing Universal Health Coverage (UHC) goals, the authors recommend a national strategy that provides guidance on how to practice responsible self-care, further research on the effectiveness and safety of alternative medicine and other priority areas, and better integration of self-care in the formal education and health systems. The authors also propose that the research agenda on self-care include acute health conditions, given their impact and burden on health and the economy.Originality/valueThis is the first published review of self-care practices for managing common acute health conditions, which captured practices of various groups and populations including indigenous peoples.

Outcomes of a tailored self-care intervention for patients with heart failure and major depression: A secondary analysis of a randomized controlled trial

BackgroundDepression is a recognized barrier to heart failure self-care, but there has been little research on interventions to improve heart failure self-care in depressed patients. ObjectivesTo investigate the outcomes of an individually tailored self-care intervention for patients with heart failure and major depression, and to determine whether the adequacy of self-care at baseline, the severity of depression or anxiety, or other factors affect the outcomes of this intervention. DesignSecondary analysis of data from a pre-registered randomized controlled trial (NCT02997865). MethodsOutpatients with heart failure and comorbid major depression (n = 139) were randomly assigned to cognitive behavior therapy or usual care for depression. In addition, an experienced cardiac nurse provided the tailored self-care intervention to all patients in both arms of the trial starting eight weeks after randomization. Weekly self-care intervention sessions were held between Weeks 8 and 16; the frequency was tapered to biweekly or monthly between Weeks 17 and 32. The Self-Care of Heart Failure Index (v6.2) was used to assess self-care outcomes, with scores ≥70 on each of its three scales (Maintenance, Management, and Confidence) being consistent with adequate self-care. The Week 16 Maintenance scale score was the primary outcome for this analysis. ResultsAt baseline, 107 (77%) of the patients scored in the inadequate self-care range on the Maintenance scale. Between Weeks 8 and 16, Maintenance scores improved more in patients with initially inadequate than initially adequate self-care (11.9 vs. 3.2 points, p = .003). Sixty-six (48%) of the patients with initially inadequate Maintenance scores achieved scores in the adequate range by Week 32 (p < .0001). Covariate-adjusted predictors of better Maintenance outcomes included adequate Maintenance at baseline (p < .0001), higher anxiety at baseline (p < .05), and higher dosages of the self-care intervention (p < .0001). Neither treatment with cognitive behavior therapy nor less severe major depression predicted better self-care outcomes. ConclusionsDepressed patients with inadequate heart failure self-care are able to achieve clinically significant improvements in self-care with the help of an individually tailored self-care intervention. Further refinement and testing are needed to increase the intervention's potential for clinical implementation.

Comparison of Functional Outcomes After Acute Inpatient Rehabilitation After Acquired Brain Injury Before and During the COVID-19 Pandemic.

The objective of this study was to characterize and compare functional outcomes of acquired brain injury patients in an inpatient rehabilitation facility in the year before (April 2019-March 2020) and during the first year (April 2020-March 2021) of the COVID-19 pandemic, when the most drastic changes in the delivery of health care occurred. In this retrospective single-center chart review study, functional outcomes, based on the Center for Medicare and Medicaid Services Inpatient Rehabilitation Facility-Patient Assessment Instrument, were obtained and analyzed for patients in acute inpatient rehabilitation with acquired brain injury. Data from 1330 patients were included for analysis. Functional outcomes of average self-care, bed mobility, and transfer scores were statistically, but not clinically, different between groups. More patients in the pandemic group were discharged home (prepandemic n = 454 [65.4%]; pandemic n = 461 [72.6%]; P = 0.011), although they had significantly longer lengths of stay (prepandemic median = 14.0 [interquartile range = 9.0-23.0]; pandemic = 16.0 [10.0-23.0]; P = 0.037). Despite the impact of hospital policies due to the COVID-19 pandemic, similar functional outcomes were obtained for those with acquired brain injury after inpatient rehabilitation.

Self-care in coronary heart disease patient and caregiver dyads (HEARTS-IN-DYADS)-Protocol of a multicenter longitudinal study.

Self-care performed by patients and the caregiver contribution to this self-care are essential for improving cardiovascular outcomes; however, so far, no studies have sufficiently investigated this field in Italy. This paper describes a research protocol of a multi-center longitudinal study designed to investigate the self-care of patients affected by coronary heart disease (CHD), the caregiver's contribution to this self-care, the predictors of patient and caregiver self-care, the mediating role of self-efficacy, and the self-care outcomes. Data collection will be performed across seven Italian inpatient settings at baseline and 3 and 6 months from enrollment. Multilevel modeling and actor partner interdependence models will be implemented on a sample of 330 patient-caregiver dyads to adjust for the interdependence of measurements. The study received approval from an ethics committee in Italy and was financed in January 2021 by a grant from the Solidal Foundation in Alessandria. This research will advance the knowledge about the self-care process in CHD. The results will guide research and clinical practice by identifying variables sensitive to educational interventions.

Mirror therapy effect on shoulder pain and disability and quality of life of mastectomy women: a randomized clinical trial

PurposeTo investigate mirror therapy (MT) influence on shoulder pain/disability and quality of life in mastectomy women.Materials and methodsSixty unilateral mastectomy women were recruited and randomly assigned to an MT group (N = 30) or a sham therapy (ST) (N = 30). Women in the MT and ST group attended a nurse-led, unsupervised, 30 min a day, five days a week, and at home training program for three weeks with and without a mirror, respectively. Shoulder pain and disability scale and QOL outcomes were assessed at baseline and 3 months after intervention.ResultsShoulder pain and disability were significantly improved in the MT group but there was not meaningful difference between groups in the EORTC-QOL scales except for some functional scores of QLQ-BR23 scale in the MT group after 3 months follow-up.ConclusionsNurses should instruct MT as a rehabilitation program to mastectomy patients during or after hospitalization to reduce their post-op shoulder pain and disability. This intervention may have also positive impact on their self-care outcomes. It is recommended that further studies should be performed with nurse-supervised exercises, a validated tool for measuring QOL for a long period after surgery, and a longer follow-up period at least for 6 months.Implication for rehabilitationThis study aimed to investigate whether an unsupervised, nurse-led mirror therapy (MT) can alleviate shoulder pain and disability of mastectomy patients and improve their quality of life.Our findings indicated that nurse-led MT as a novel rehabilitation option for mastectomy patients, may reduce shoulder pain and disability even after long period after the surgery.Rehabilitation centers can equip rooms for MT so breast cancer women can use it immediately after mastectomy.Mirror therapy can be used as a rehabilitation method for mastectomy patients because it is easy-to-use, inexpensive, and without the need to attend a rehabilitation center.Rehabilitation centers can provide mirrors along with nursing instructions to women who want to use this method at home.

The effectiveness of patient-centered care vs. usual care in type 2 diabetes self-management: A systematic review and meta-analysis.

Patient-centered care in diabetes self-management might be a significant factor in improving health outcomes of adults with type 2 diabetes, yet the supporting evidence is inadequate. This review aimed at assessing the effectiveness of patient-centered self-management care interventions on glycemic control (HbA1c) and self-care behaviors compared with usual care. CINAHL, PubMed, Cochrane Library, Google Scholar, and the HEC Digital Library were searched for studies in English language that assessed patient-centered self-management educational and/or behavioral interventions in adults aged 18 years or older with type 2 diabetes from 2005 to 2020. Interventional studies with at least 3 months of follow-up and reporting on self-care outcomes such as glycemic control (HbA1c) and self-care behaviors including diet control, physical activity, foot care, and medication adherence were included. Of 168 identified records, 24 were found eligible comprising 20 RCTs and four QESs with total 4,083 participants. The meta-analysis involved 19 RCTs that provided enough information for a pooled estimate of HbA1c. Compared with the control group, patient-centered self-management interventions significantly lowered HbA1c, -0.56 (95% CI -0.79, -0.32). Stratified analysis for HbA1c with respect to various aspects of intervention showed larger effects in interventions employing both educational and behavioral components, -0.66 (95% CI -0.97, -0.34); spanned over shorter (<03 months) duration, -0.85 (95% CI -1.28, -0.43); administered by nurses, -0.80 (95% CI -1.44, -0.16); and delivered in community settings -0.70 (95% CI -1.14, -0.26). This systematic review provided evidence supporting the effectiveness of patient-centered self-management care interventions in improving glycemic control and self-care behaviors in adults with type 2 diabetes and identified key features of intervention contributing toward success.

Efficacy of Early Inpatient Rehabilitation of Post-COVID-19 Survivors: Single-Center Retrospective Analysis.

The aim of this study was to understand the demographic, clinical characteristics, and effectiveness of early inpatient rehabilitation of post-COVID survivors. A single-center retrospective chart review analysis of 100 patients admitted to a newly created acute COVID rehabilitation unit (CORE+) from April to December 2020 was conducted. The demographic and clinical characteristics and complications of 100 post-COVID patients were reviewed. Functional outcomes of GG Self-care and Mobility Activities Items (Section GG0130 and GG0170) of the Centers for Medicare & Medicaid Services of the Inpatient Rehabilitation Facility Patient Assessment Instrument (Version 3.0) at admission and discharge, prevalence of oxygen requirement, the need for cognitive and neuropsychology support by discharge, and dispositions after completion of inpatient rehabilitation facility stay were analyzed. The functional outcomes of 59 primary pulmonary manifestations of COVID patients were further analyzed based on the presence of intensive care unit stay before transfer to the COVID rehabilitation unit. Most patients demonstrated significant functional gains after completion of inpatient rehabilitation facility stay; however, a considerable number of patients continued to require cognitive support by discharge. The data suggested the benefit of early rehabilitation for hospitalized post-COVID patients. Services need to be geared to include patients' cognitive deficits.

Self-care and quality of life among men with chronic heart failure.

IntroductionChronic Heart Failure (CHF) involves a complex regimen of daily self-care behaviors: pharmacological therapy, symptom monitoring and lifestyle modifications. Patients with CHF may have a reduced health related quality of life (HRQoL) due to various physical and emotional symptoms. HRQoL may be improved through the use of self-care interventions.PurposeTo assess the level of self-care and quality of life among men with chronic heart failure.MethodsThe study was conducted among 80 men diagnosed with CHF (mean age 58 years). The study was cross-sectional. A self-administered questionnaire and analysis of medical records were used to collect baseline sociodemographic and clinical data. Self-care was assessed using the standardized European Heart Failure Self-care Behavior Scale- EHFScBS-9 and quality of life was assessed using the World Health Organization Quality of Life Bref.ResultsThe Patients in NYHA class II constituted the vast majority (71.25%), mean LVEF in the study group was 43.5%, and mean disease duration was 3 years. The most common comorbidities were ischemic heart disease (72.5%), hypertension (70%) and diabetes mellitus (60%). The most commonly reported non-pharmacological treatments for NS were fluid restriction (45%), moderate physical activity (42.50%) and daily weight control (41.25%). The EHFSc-9 questionnaire score averaged 50.31 points out of 100 possible (SD = 26.52). The mean score regarding perception of QoL was 2.78 points (SD = 0.91), and 40% of patients indicating poor perception of QoL. The mean score for self-rated Analysis of the results of the individual domains of the WHOQoL BREF questionnaire showed that patients rated their QoL best in the environmental domain (M = 13.28; SD = 3.11), then in the social domain (M = 12.81; SD = 2.71), and in the psychological domain (M = 12.8; SD = 3.2). In contrast, QoL in the physical domain was rated the lowest (M = 10.44; SD = 2.85). There was no significant correlation between quality of life and self-care (p > 0.05).ConclusionsMen with CHF have unsatisfactory self-care outcomes and low quality of life scores and are dissatisfied with their health. Strategies to improve selfcare and quality of life in this group are indicated.

329-OR: Videoconferencing for Diabetes Self-Management Support—A Viable Option for Meeting the Needs of High-Risk Patients in Rural Areas?

Ongoing support is critical for effective diabetes (DM) self-management, but difficult to deliver, particularly in areas with limited resources. The purpose of the study was to assess the impact of a virtual support model on DM outcomes for high-risk patients in rural underserved communities. Methods: Patients with HbA1c&amp;gt;9% receiving care in federally qualified centers were referred to the Telemedicine for Reach, Education, Access, Treatment and Ongoing Support (TREAT-ON) program, where a Diabetes Care and Education Specialist (DCES) provided in person diabetes self-management education and ongoing support through videoconferencing. Participant demographics, BMI and HbA1c were collected from patient records. Participants completed the DM Summary of Self-Care Activities, Distress and Empowerment Scales and Morisky Medication Adherence Measure at baseline and 6 months, and the Telehealth Usability Questionnaire at study completion. Pre/post values were compared for HbA1c, self-care, psychosocial and process outcomes. Results: Participants (n=37) were 84% white, mean age 46.1 years with mean BMI 37.5. Glycemia improved with a mean reduction in HbA1c from 11.2% at baseline to 9.1% at follow-up (p&amp;lt;.001) . There was significant improvement in self-care behaviors of general diet (p=.001) and foot care (p=.041) . DM distress was reduced significantly (p&amp;lt;.001) , attributed to less emotional and regimen distress. Participants also reported a high level of satisfaction with TREAT-ON and interest in future use (4.6/5 points) . Conclusions: Findings offer evidence of significant benefits and acceptability of a video-conferencing delivery model for DM self-management support. Future research should explore additional ways to empower individuals to continue and sustain improvements. Disclosure R.Hammoudeh: None. J.S.Krall: Research Support; Becton, Dickinson and Company, Sanofi. P.A.Johnson: None. S.L.Reynolds: None. K.Ruppert: None. J.Ng: Research Support; Sanofi. L.M.Siminerio: Advisory Panel; Abbott, Bayer AG, Research Support; Becton, Dickinson and Company, Sanofi. Funding National Institute of Diabetes Digestive and Kidney Diseases of the National Institutes of Health (R34DK123370) .

620-P: Dietary Patterns in Diverse Adults with Type 2 Diabetes (T2D) : Self-Efficacy and Personal Control

Objectives: Diabetes self-efficacy (confidence in ability to perform diabetes self-care) and personal control (perceived ability to influence diabetes outcomes) have been associated with better T2D self-care and health outcomes. Social cognitive theory posits that both beliefs are necessary for optimal initiation and maintenance of behavior change. However, their independent effects are unclear in T2D, especially in relation to dietary behaviors. We examined the independent associations of self-efficacy and personal control with junk food dietary patterns (JFDP) among predominantly Latino and disadvantaged adults with T2D and explored potential mediating effects. Methods: Adults with T2D (N = 812; Age = 59.2 (10.8) ; F = 57%; A1C = 9.3 (1.8) ; Latino = 86%; Spanish-speakers = 78.0%) enrolled in a trial of telephonic self-management support, completed self-report measures of diet (Starting the Conversation-STC) , diabetes self-efficacy, and diabetes personal control at baseline. A 5-item JFDP sub-scale of the 8-item STC was supported by factor analysis. Results: Unlike personal control (r = 0.10, 95% CI = -0.06, 0.08) , self-efficacy was inversely correlated with JFDP (r = -0.16, 95% CI = -0.23, -0.10) . In multivariable analysis, higher self-efficacy had a small independent association with less JFDP (b = -0.02, SE = 0.003, 95% CI = -0.02, -0.01) but perceived control did not (b = -0.04, SE = 0.15, 95% CI = -0.35, 0.29) . Mediation analyses showed no evidence for personal control as a mediator of the relationship between self-efficacy and JFDP. Conclusion: Among a predominantly Latino, disadvantaged adults with sub-optimally controlled T2D, diabetes self-efficacy was associated with lower reported consumption of junk foods, whereas no effect was observed for personal control. If these associations reflect causal relationships, interventions aiming to reduce junk food consumption in this vulnerable population may have more of an impact by targeting self-efficacy beliefs. Disclosure H.Mendez-rodriguez: None. V.H.Jonas: None. L.D.Pappalardo: None. R.Fang: None. C.Schechter: None. E.A.Walker: None. C.J.Hoogendoorn: None. J.S.Gonzalez: Consultant; Virta Health Corp. Funding National Institute of Health's National Institute of Diabetes Digestive and Kidney Diseases (1R18DK098742-01A1)