Patient Self-care Research Articles

The Effect of Distance Education on Self-care in Patients With Heart Failure in the Chronic or Stable Phase: A Systematic Review and Meta-analysis.

Health education is important for self-care in patients with heart failure. However, the evidence for the effect of distance education as an intervention to deliver instruction for patients after discharge through digital devices on self-care is limited. In this study, our aim was to explore the effect of distance education on self-care in patients with heart failure. We searched 11 electronic databases and 3 trial registries for randomized controlled trials with low risk of bias and high-quality evidence to compare the effect of usual and distance education on self-care. Quality appraisal was performed using the Cochrane Risk of Bias Tool. Using the Review Manager 5.4 tool, a meta-analysis was conducted. Certainty of the evidence was rated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Fifteen articles were eligible for this study. Compared with usual education, distance education improved self-care maintenance (mean difference [MD], 6.62; 95% confidence interval [CI], 3.93-9.31; GRADE, moderate quality), self-care management (MD, 5.10; 95% CI, 3.25-6.95; GRADE, high quality), self-care confidence (MD, 6.66; 95% CI, 4.82-8.49; GRADE, high quality), heart failure knowledge (MD, 0.78; 95% CI, 0.01-1.56; GRADE, moderate quality), and quality of life (MD, -5.35; 95% CI, -8.73 to -1.97; GRADE, moderate quality). Subgroup analysis revealed distance education was more effective than usual education in self-care when the intervention was conducted for 1 to 6 months, more than 3 times per month, and a single intervention lasting more than 30 minutes. This review shows the benefits of distance education on self-care, heart failure knowledge, and quality of life of patients with heart failure. The intervention duration, frequency, and duration of a single intervention could have affected the intervention effect.

Telemedicine in the management of temporomandibular disorders: A literature review

Background: Temporomandibular disorders are clinical disorders involving the muscles of mastication, temporomandibular joints, and related structures. There are several treatments, such as self-help exercises, that can be done at home using remote care, often called telemedicine, after the patient has been directed to do so by a practitioner and evaluated during regular visits. Along with advancement of the times and technology, as well as with the prevention of COVID-19, telemedicine may currently be the main means of self-care for patients at home without losing the supervision of a doctor. Purpose: The purpose of this study is to determine the effect of using telemedicine in the management of temporomandibular disorders. Methods: A systematic literature review was undertaken using literature search methods in electronic databases: PubMed, ProQuest, and Google Scholar. The keywords were “(Telemedicine OR Teledentistry) AND (Temporomandibular disorder) AND (Effect).” The inclusion criteria for selection of the scientific articles were publication from 2012 to 2022, publication in English, and the full paper being available. Results: Seven articles have been included in this review. Based on the results of this systematic study, using telemedicine is considered able to assist the management of temporomandibular disorders by conducting consultation, follow-up, and treatment remotely via telephone, smartphone application, or internet-based or website-based applications. Conclusion: Telemedicine makes it easier for patients who do not have access to a health center to receive consultations and treatments from home, minimizing time and costs.

Advancing Virtual at-Home Care for Community Health Center Patients Using Patient Self-Care Tools, Technology, and Education [Letter

Advancing Virtual at-Home Care for Community Health Center Patients Using Patient Self-Care Tools, Technology, and Education [Letter

Advancing Virtual at-Home Care for Community Health Center Patients Using Patient Self-Care Tools, Technology, and Education.

Health centers are community-based, patient directed primary care providers that offer accessible, high-quality primary care within medically underserved communities. Screening for cancer and managing complex chronic conditions such as diabetes, hypertension, obesity, and depression are vital services for the vulnerable populations seen by community health centers. Delivering care for complex chronic conditions and preventive services using virtual models that integrate self-care tools and technology is an important approach to increasing access for hard-to-reach patients served by health centers. This study aimed to explore the use of a virtual care model, applied using a systems approach and patient-driven tools and technology, on the performance of clinical and patient experience measures. A virtual care model, applied using a systems approach offered by the Value Transformation Framework (VTF), was combined with self-care tools and technology in twenty health centers across 17 states to drive improvement efforts. Changes in clinical measures and patient experience were compared. A total of 385 patients were enrolled and 270 (70.1%) completed a baseline visit and at least four virtual visits during the six-month intervention period. Statistically significant improvements were seen in measures for HbA1c, systolic and diastolic blood pressure, and bodyweight. Among the 270 who completed the baseline and at least 4 virtual visits, the percentage up-to-date for colorectal cancer screening increased from 113/270 (41.9%) to 169/270 (62.6%) after six months, p<0.001, a 20.7% increase. Patients completing the baseline visit and at least 4 virtual visits reported a 10.7% decrease in depression and increased satisfaction with virtual care visits compared to in-person visits (p<0.001). Health centers applying the Value Transformation Framework's organizing framework to the use of virtual care models together with patient self-care tools, technology, and education, had improvements in measures for chronic and preventive conditions and patient experience.

Self-care in patients with type 2 diabetes mellitus, in primary health care to avoid diabetic foot

Introduction: Type 2 Diabetes mellitus is a chronic, multifactorial disease, characterized by an alteration in carbohydrate metabolism. Objective: Determine self-care in patients with Type II Diabetes Mellitus to prevent complications such as diabetic foot. Methodology: Quantitative, descriptive quasi-experimental study that includes a total of 20 adults from the Guaytacama parish of the city of Latacunga-Cotopaxi-Ecuador, for data collection a survey validated by experts in the area and with a reliability index was used. Cronbach's Alpha 0.9, inclusion and exclusion criteria were applied and data tabulation was carried out using the SPSS statistical tool. Results: At the beginning of the survey, it was determined that the patients had deficient knowledge about their disease and the care that it entails; after the intervention of the health personnel, the patients have clear information about self-care. Conclusion: Diabetes mellitus is a disease that in the long term can cause disability, which is why the role of health personnel is fundamental in addressing education, since this helps to promote self-care, in order to avoid complications that can cause disability, and consequently psychological problems that worsen the quality of life of patients.

Interplay of self-care, self-efficacy, and health deviation self-care requisites: a study on type 2 diabetes patients through the lens of Orem’s self-care theory

BackgroundThis study aimed to examine the relationship between Self-Care, Self-Efficacy, and Health Deviation Self-Care Requisites in patients with type 2 diabetes based on Orem’s Self-Care Theory.MethodsThe research involved 341 patients with type 2 diabetes in Rasht, Iran, using a descriptive-analytical cross-sectional design. The data collection included questionnaires assessing Self-Care Behaviors, Self-Efficacy, and Health Deviation Self-Care Requisites based on Orem’s model.ResultsDemographic factors such as gender, marital status, employment, education, age, duration of disease, and oral treatment and insulin had no consistent effect on self-care behaviors. Self-efficacy was a key factor influencing Self-Care Behaviors in diabetic patients. There was a strong and direct correlation between Self-Care Behaviors and Self-Efficacy, indicating the role of individuals’ confidence in managing diabetes. Health Deviation Self-Care Requisites had both positive and negative correlations with different domains of Self-Care Behaviors.The physical exercise construct of self-efficacy was the most significant predictor of Self-Care Behaviors.ConclusionsThis study provides valuable insights into the complex relationship between Self-Care, Self-Efficacy, and Health Deviation Self-Care Requisites in patients with type 2 diabetes. The findings underscore the importance of addressing Self-Efficacy and specific self-care domains, such as physical activity and foot care, in diabetes management strategies. This research contributes to the existing knowledge base and may inform healthcare professionals and policymakers in developing targeted interventions to improve self-care practices in diabetic patients.

Analysis of the Role of Cognitive Behavioral Therapy on Self-Care in Thyroid Cancer Patients

Objective: To explore the effect of cognitive behavioral therapy on self-care in thyroid cancer patients. Methods: A total of 144 thyroid cancer patients treated at the Affiliated Hospital of Hebei University from January 2022 to August 2023 were selected as research subjects. Using the random number table method, they were divided into a control group and an experimental group, each consisting of 72 cases. The control group received routine nursing intervention, while the experimental group received cognitive behavioral therapy based on standard nursing practices. The self-care ability (self-concept, self-efficacy, self-care skills, health knowledge level), coping style (confrontation, avoidance, and surrender), and quality of life (psychological function, social function, material life, physical function) of both groups before and after the intervention were compared. Results: In comparison to the pre-intervention period, the experimental group exhibited significantly higher self-care ability, quality of life, and confrontation scores after the intervention, as opposed to the control group. Additionally, the avoidance and surrender scores were lower in the experimental group than in the control group, with these differences proving to be statistically significant (P &lt; 0.01). Conclusion: The application of cognitive behavioral therapy can enhance the self-care ability of thyroid cancer patients, aid in better disease coping, and improve their overall quality of life. This approach is deserving of further promotion.

N06 Self-care in patients affected by inflammatory bowel disease: SELF-IBD observational study in a single center

Abstract Background Self-care is an active process to maintain and promote health in chronic disease situations, and is effective in the results of many chronic diseases. So far, few studies have been conducted on the self-care of IBD. The study of self-care in IBD is also motivate, by the increase in prevalence in the coming years and the impact on health resources it could have. In addition, the study of self-care in relation to socio-sanitary features and habits within the population affected by IBD may be the beginning to identify areas for educational interventions by health care personnel. The primary objective of this study is to describe the levels of self-care maintenance, monitoring and management in patients with IBD. Methods Cross-sectional observational study to evaluate self-care in IBD patient. The questionnaire used was the Self-Care of Chronic Disease Index (SCCII). The SCCII investigates three aspects of self-care, maintenance, monitoring and management and the self-efficacy. The sociodemographic characteristics and some patient habits such as smoking habit, fatigue, exercise, sleep, nutrition and supplement use, were investigated. Ethics Committee approved Results We enrolled 85 patients with an average age of 44.8±16.8, of which 51.8% (female) and 50.6% (CD), 48.4% (UC). The level of self-care (SCCII) areas investigated ranged from score levels of 71.30 (Self-maintenance), 79.52 (self-monitoring), 68.94 (self-management) and 75.70 (self-efficacy). In the area of self-care maintenance the aspects that seem least considered by patients (never or rarely) are stress management (44.1%) and exercise (40%). Only 57.6% of patients often or always get enough sleep and only 22.3% of patients follow a healthy diet. The presence of fatigue seems to affect 68% of patients in the self-monitoring phase. In the area of self-management, only 41.2% of patients (often or always) try to rest during the day and only 52% of the sample succeeds continuously with the appearance of symptoms. In self-efficacy, it seems that 85.8% of the patients interviewed persist in following the treatment even when it is difficult. It seems that men have more significant levels of self-maintenance score 74. vs 68.8 (p&amp;gt;0.01) than women. Table 1 shows the average self-care scores in relation to the habits investigated. Conclusion From the results of our study it seems that patients with IBD have adequate levels of self-care (score ≥70), although sleep/rest, diet and exercise seem not to be highly considered by patients. Future studies may investigate which specific sociodemographic and clinical characteristics can be identified as predictors of maintaining self-care, self-care management and self-confidence, to improve areas of nurse educational intervention.

N42 New tool for IBD nurses to support IBD patients

Abstract Background There are about 58000 Inflammatory Bowel Disease (IBD) patients in Finland. The number has doubled in ten years. Over 5500 IBD patients live in the Pirkanmaa region. Patients are treated in three different hospitals and there are eight trained IBD nurses in adult services. Patients can contact a call back-system at any hour of the day. With growing number of patient contacts there is a need for additional contact channels and ways of support for patients care. Methods TaysPolku is an app developed by Buddy HealthCare where IBD patients can see their appointments, upcoming procedures, information packages, medication instructions, videos and questionnaires related to their treatment all in one place. TaysPolku provides automatic reminders and enables them to contact their own care unit directly via message. IBD nurses has been part of creating material for TaysPolku. IBD nurse explains the app and creates TaysPolku for the patient after providing the necessary information. The app is downloaded from app stores, verified by strong authentication. The app works with any face ID or pin number chosen by the patient. Results TaysPolku was introduced in June 2021 and the first users were patients receiving intravenous biologicals. IBD nurses informed about the new service during the infusion visits and provided written material. In the next phase, TaysPolku was set up for biological self-injecting patients. Currently, TaysPolku have been created 299 patients at Tampere University Hospital Tays. The utilization rate of the created TaysPolku is high. Messages on TaysPolku has been send/received 3896 times. The messages feature enables the care unit to reach everyone using TaysPolku simultaneously. It is used in all three hospitals and every IBD nurses take care of it. Satisfaction with TaysPolku has been good for both patients and IBD nurses. Patient questionnaire highlighted the benefits, and the answers highlighted the ease of use of the service. "A well-functioning system " "Reminds me very much of the lab, questions and treatment days. Easy to useand connect. There could also be a connection to other departments when care is taken in other departments as well" Conclusion Different forms of service are needed with the growing number of patients, and a digital app that supports the patient's self-care has been proven to work. Further development is underway to offer a similar service to all IBD patients in the region.

Mapping the Cardiometabolic Patient Experience and Self-Care Behaviors to Inform Design, Implementation, and Persistent Use of Digital Health Care Solutions: Mixed Methods Study.

Cardiometabolic conditions including acute coronary syndrome (ACS) and type 2 diabetes (T2D) require comprehensive care and patient engagement in self-care behaviors, and the drivers of those behaviors at the individual and health system level are still poorly understood. We aim to gain insights into self-care behaviors of individuals with cardiometabolic conditions. A convenience sample of 98 adult patients with ACS and T2D was recruited in the United States, Germany, and Taiwan to participate in a mixed methods study using ethnographic methods. All participants completed 7-day web-based diaries tracking their level of engagement, and 48 completed 90-minute web-based semistructured interviews between February 4, 2021, and March 27, 2021, focusing on themes including moments of engagement. Qualitative analysis identified factors influencing self-care practices and a Patient Mind States Model prototype. Patient reports indicate that many patients feel social pressure to adhere to treatment. Patients' experience can be understood within 5 categories defined in terms of their degree of engagement and adherence ("ignoring," "struggling," "juggling," "controlling," and "reframing"). For people living with ACS and T2D, the self-care journey is defined by patterns of patient experiences, which can identify areas that tailored digital health care interventions may play a meaningful role.

Self Efficacy On Self Care In Coronary Heart Patients

Non-communicable diseases are the leading cause of death in the world, one of the non-communicable diseases is coronary heart disease. Self-efficancy in people with heart disease is defined as confidence in the patient's ability to perform physical activity that can be affected by symptoms or complications of cardiovascular disease. Rehospitalization is not only due to the progression of the disease, but can also be caused by indifference to medication and poor self-care. Self-care is the process of maintaining health through practices that promote health, and manage diseases and symptoms. The study aims to improve the relationship between self-efficiency and self-care in coronary heart patients. The research method used in this study includes quantitative research with a sectional coss study design using a chi-square test with a sample of 70 patients suffering from coronary heart disease in the Hospital Cinere Diagram. Based on the results of the chi-square test that has been carried out obtain a p value of 0.007 or &amp; &lt; 0.05 where this indicates that there is a relationship between self-efficiency and self-care. The conclusion is that self-efficancy has a significant relationship with self-care in patients with coronary heart in Hospital Diagram Cinere

Care models for patients with heart failure at home: A systematic review.

The aim of this study is to evaluate the relative merits of various heart failure models of care with regard to a variety of outcomes. Systematic review. Five databases including PubMed, Web of Science, Medline, Embase and Science Direct were searched from the inception date of databases to August 20, 2022. This review used the Cochrane Collaboration's 'Risk of Bias' tool to assess quality. Only randomised controlled trails were included in this review that assessed all care models in the management of adults with heart failure. A categorical summary of the pattern of the papers was found, followed by extraction of outcome indicators. Twenty articles (19 studies) were included. Seven examined nurse-led care, two examined multidisciplinary specialist care, nine (10 articles) examined patient self-management, and one examined nurse and physiotherapist co-led care. Regarding outcomes, this review examined how well the four models performed with regard to quality of life, health services use, HF self-care, and anxiety and depression for heart failure patients. The model of patient self-management showed more beneficial results than nurse-led care, multidisciplinary specialist care, and nurse and physiotherapist co-led care in reducing hospital days, improving symptoms, promoting self-care behaviours of HF patients, enhancing the quality of life, and strengthening self-care ability. This systematic review synthesises the different care models and their relative effectiveness. Four different models of care were summarised. Of these models, the self-management model demonstrated better outcomes. The self-management model is more effective in increasing self-management behaviours and self-management abilities, lowering the risk of hospitalisation and death, improving quality of life, and relieving anxiety and depression than other models. There was no funding to remunerate a patient/member of the public for this review.

Effectiveness of nursing intervention in short-term hospitalization for patients suffered from borderline personality disorder and self-harm. A narrative literature review

Introduction: Personality disorder sufferers with severe self-harm and experience long psychiatric hospitalizations have complex mental health conditions and are at risk of suicide. When the symptoms of emotional instability are combined with self-harm, the resulting crisis often becomes difficult for patients and caregivers to manage. To improve care during these crises, the Dutch Multidisciplinary Guideline for Personality Disorders designates “brief admission” (BA) hospitalizations as an ameliorative intervention. Objective: To describe the effectiveness of short hospitalization nursing care for people with borderline personality disorder and who practice self-harm, compared to ordinary hospitalization. Methods: A narrative review was conducted through the Embase and CINAHL databases, the selected articles had to answer the following research questions: “what are the observable benefits of short-term hospitalization on patients with borderline personality disorder?”; and “what are the benefits compared to short hospitalization operators?”. Results: Seven studies were selected. The results show that BA was perceived as an effective nursing intervention, which promoted the patient’s self-determination and self-care. This helped increase confidence in daily life and allowed people to maintain their daily routines, work, and relationships by decreasing long hospitalizations and increasing patient compliance. There has also been benefit from the staff, who report an improvement in work quality. Conclusions: This type of hospitalization has developed in Northern European states. BA has never been tested in the Italian healthcare sector. It would be appropriate and desirable, given the results obtained, to experiment with this procedure also in Italy to obtain specific feedback regarding the relationship of short-term hospitalization with our National Health Service. It is hoped that this research can be a stimulus in this sense.

The long-term effect of an m-health tool on self-care in patients with heart failure: a pre-post interventional study with a mixed-method analysis.

The aims of this study were (i) to evaluate the effects of using an m-health tool on self-care behaviour at 3 and 12 months and (ii) to explore the experiences and perceptions of heart failure (HF) patients about the m-health tool. In this pre-post interventional study with a mixed-method analysis, 71 patients diagnosed with HF [49% female, mean age 76.7 years, New York Heart Association (NYHA) II 31%, NYHA III 69%] were enrolled and had the m-health tool installed in their home for 1 year. The tool consisted of a pre-programmed tablet including a weighing scale and interactive education about HF self-care. At baseline, and at 3 and 12 months, self-care was assessed using the European Heart Failure Self-care Behaviour (EHFScB-9) Scale, an eight-item self-administered questionnaire assessing the experiences of the m-health tool. The mean EHFScB-9 at baseline was 63.8 ± 2.8 and it improved to 67.6 ± 7.6 after 3 months (P < 0.05). After 1 year, the score had decreased to 63.2 ± 7.1 (P = 0.68). Most patients rated the tool as 'good', both at 3 months (92%) and after 12 months (93%). Some found the system to be unnecessary to some degree, and this number increased between 3 and 12 months (P < 0.001). Most patients felt that m-health increased their feelings of security, and 85% responded that the system increased their family members' sense of security. The m-health tool significantly improved patients' self-care behaviour after 3 months, but this effect did not persist after 1 year. For achieving long-term effects and outcomes, additional and regularly updated self-care support may be needed. ClinicalTrials.gov: NCT04955600.

Effectiveness of Lifestyle Modification Training on Psychological Symptoms and Self-Care in Patients with Type 2 Diabetes

Objective: Diabetes is a disease that endangers the health of many individuals in society. The aim of this study was to evaluate the effectiveness of lifestyle modification training on psychological symptoms and self-care in patients with type 2 diabetes. Methods and Materials: The study employed a pre-test post-test design with experimental and control groups. The research population consisted of all patients with type 2 diabetes from the Diabetes Association and hospitals in Gilangharb province, in 2020. A total of 45 individuals (divided into a lifestyle modification intervention group and a control group) were selected using a convenience sampling method. Data were collected using the SCL-90-R and the Toobert and Glasgow Self-Care Questionnaires. Data were analyzed using multivariate and univariate analysis of covariance tests, as well as the LSD post hoc test, utilizing the SPSS software. Findings: The results of the multivariate analysis of covariance indicated that after controlling for pre-test effects, F was significant at the 0.05 level for "psychological symptoms" components. In other words, there were significant differences in the post-test scores of these variables between the "experimental group" and the "control group". The results also showed differences between the two intervention groups and the control group in the self-care variable. Furthermore, the lifestyle modification training intervention was effective in components of psychological symptoms, including somatization, obsessive-compulsive, anxiety, aggression, phobia, paranoid ideation, and psychoticism dimensions. Conclusion: It can be concluded that lifestyle modification training was effective in improving psychological symptoms and self-care in patients with type 2 diabetes, and this psychological approach can be used to improve the condition of patients with type 2 diabetes.

Use of Telenursing in the conservative treatment of patients with chronic renal insufficiency: scoping review.

to map the evidence of the use of telenursing in adherence to treatment and promotion of self-care in patients with chronic renal insufficiency undergoing conservative treatment. scoping review study, with selection of documents indexed in eight databases and two catalogs of theses and dissertations. Additionally, the reference lists of selected studies were consulted. Selection and analysis of studies were carried out using Rayyan software through double, independent and blind investigation. 56 eligible publications were found and ten were selected to compose the study. The following stand out among telenursing interventions: cell phone applications, websites, digital platform, telephone support and teleconferencing. it was evident that the use of Telehealth by Nursing is relevant to the health sector, but still little explored in national and international literature, representing a gap in knowledge to be filled in future research. Studies have shown that its implementation helps and supports healthcare professionals, providing inferences and guidance for quick, safe and effective assistance, even remotely. Telenursing presents itself as a strategy capable of promoting adherence to treatment and self-care in patients with chronic renal insufficiency undergoing conservative treatment. (1) Develops health innovation strategies in remote treatment. (2) Provides support to professionals with preventive measures, minimizing costs. (3) Encourages the practice of self-management of care. (4) Provides inferences and guidance for quick and safe assistance. (5) Contributes to the advancement of public policies in the area of noncommunicable diseases.

Effectiveness of Planned Teaching Program on Self-care for Patients with Diabetes Mellitus in a Selected Community at Tumkur

Aim: The aim of this study is to find the Effectiveness of planned teaching program (PTP) on self-care for patients with diabetes mellitus in a selected community at Tumkur.Materials and Methods: The investigation was quantitative. This study used a non-equivalent control group quasi-experimental design. The study took place at Kaivara. This study includes all Kaivara diabetics. Data were collected from 30 diabetics. This study used purposive sampling methods. Data analysis makes use of both inferential (paired and unpaired “t” tests) and descriptive (mean, standard deviation, frequency, and percentage) statistics.Result: Group I patients had pre- and post-test knowledge scores of 18–60 and 84–101. For Group I, the mean knowledge score after the test (93.67) was higher than the mean score before the test (33.8). The “t” value for Group I (“t” = 22.10) demonstrated a notable change, demonstrating PTP increased diabetic patients’ understanding. Group I patients’ self-care practice scores also changed significantly. Group I patients’ pre-test and post-test self-care practice scores were 22–56 and 63–75. Mean post-test score for self-care (70.53) was greater than pre-test. The Group I “t” value (16.19) demonstrated a significant difference, demonstrating that PTP increases diabetes mellitus patients’ self-care practices. The mean post-test knowledge score on frequent check-ups, exercise, and food (97, 98.92, and 98.38) was significantly greater than the score on the pre-test following PTP. The mean percentage of self-care practice score for medications (96.67) and skin care (99.13) increased significantly for Group I.Conclusion: The experimental and control groups had substantial differences in post-test self-care and knowledge scores, proving that individual-planned teaching program work

Comparing the Effectiveness of Acceptance and Commitment Therapy (ACT) and Dialectical Behavior Therapy Skills Training (DBT-ST) on Self-Care and Psychological Well-being in Patients with Type 2 Diabetes

Objective: Diabetes is a chronic, multifaceted, threatening disease with significant psychological consequences. The present study aimed to compare the effectiveness of Acceptance and Commitment Therapy (ACT) and Dialectical Behavior Therapy Skills Training (DBT-ST) on self-care and psychological well-being in patients with Type 2 diabetes. Methods and Materials: The present study was a quasi-experimental, pre-test-post-test with a control group design. The population included all patients with Type 2 diabetes visiting a medical clinic in the city of Sari, among whom 45 were conveniently selected and randomly assigned into two experimental groups (Acceptance and Commitment Therapy and Dialectical Behavior Therapy Skills Training) and one control group. Data were collected using the Self-Care Questionnaire (Toobert et al., 2000), and the Psychological Well-being Scale (Ryff &amp; Keyes, 1995) at three stages: pre-test, post-test, and follow-up, and were analyzed using analysis of variance with repeated measures. Findings: The results showed that both Dialectical Behavior Therapy Skills Training and Acceptance and Commitment Therapy were effective on the scores of self-care and psychological well-being. However, the effect of Acceptance and Commitment Therapy was greater than that of Dialectical Behavior Therapy Skills Training on the scores of self-care and psychological well-being. Conclusion: Based on the results of this study, it can be stated that Acceptance and Commitment Therapy and Dialectical Behavior Therapy Skills Training, through cognitive coping strategies, can lead to the improvement of psychological indicators and enhance the mental and physical health of patients with Type 2 diabetes.

The Effect of a Training Program Based on the Theory of Planned Behavior on the Self-Care of Patients with Cerebrovascular Accident: A Randomized Controlled Trial.

Cerebrovascular accident dramatically impacts patients' lives. However, this chronic disease could be managed by boosting self-care and following healthy behaviors. Accordingly, this trial sought to specify the impact of a training program established on the theory of planned behavior on the self-care of clients with this condition. This trial was performed on 80 clients, who were selected using a random numbers table and divided into two equal groups to receive either usual care alone or usual care plus a training program based on the theory of planned behavior (five in-hospital individual sessions for 5 weeks and weekly phone follow-ups for 2 months after discharge). Self-care and the dimensions of the theory of planned behavior were investigated at baseline and 2 months after the last in-hospital session using the standardized Shah version of the modified Barthel index and a researcher-made questionnaire, respectively. The mean score of self-care was significantly higher in the experimental arm at the posttest (Mann-Whitney = 506.00, p = 0.005). Also, the increase in mean change of self-care from baseline to posttest was significantly more in the experimental arm (t78= -6.6, p < 0.001). Such findings were also found for all dimensions of the theory of planned behavior. Based on results, nurses and health policymakers can incorporate training based on the theory of planned behavior into routine care programs for patients with cerebrovascular accident to boost their self-care. The implemented intervention also could be reproduced in other contexts. Hence, further trials are requested to specify the sustainability of the findings.

Design and development of a self-care application for patients with liver cirrhosis.

Due to the capabilities of the mobile application in the self-care of patients, the present study was conducted to design and evaluate a mobile-based self-care application for patients with liver cirrhosis. Liver cirrhosis is a progressive and chronic disease that, if left untreated, leads to liver cancer and, finally, the death of the patient. This study was conducted in six phases, including determining and confirming the validity of the minimum data set and capabilities for the application, designing a conceptual and logical model and determining the technical capabilities, designing the application, evaluating the prototype usability in a laboratory environment by technical experts, evaluation of the application usability in a real environment by 30 patients with QUIS (Questionnaire of User Interface Satisfaction) questionnaire. The designed application has capabilities such as calculating the patient's MELD score (Model for End-Stage Liver Disease), medication reminder, location in emergency, and conversation with the physician. The results showed that the patients evaluated the application with a score of 7.94 (out of 9 points) at a good level. The self-care application can help patients with liver cirrhosis and their families access the necessary information related to the special care of the patient at any time and place; it also helps better manage the patient's life, improve the quality of life, and monitor the patient. These applications can effectively manage chronic diseases by reducing the burden of referrals and costs.