Self-care Function Research Articles

Effects of Shared Decision-Making, Health Literacy, and Self-Care Knowledge on Self-Care Behavior Among Hemodialysis Patients in Korea: A Cross-Sectional Survey.

Patients undergoing hemodialysis for chronic kidney failure experience various complications and physical and emotional difficulties, leading to decreased quality of life. Self-care behaviors are essential for preventing complications and reducing mortality rates. Effective self-care behaviors significantly depend on shared decision-making, health literacy, and self-care knowledge, each critical in patient self-care performance and disease management. This study aimed to determine the importance and relevance of shared decision-making, health literacy, and self-care knowledge. In particular, it enhances self-care behaviors among hemodialysis patients. Participants were 108 adult hemodialysis patients from the hemodialysis centers of three medical institutions in Cheongju City, Korea. Moreover, the study utilized a descriptive survey research design. Data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, Pearson's correlation coefficients, and multiple linear regression analyses. The average score for self-care behaviors was 125.28 out of 175 points, with high scores for medication and vascular management. Furthermore, there were low scores for social activities and dietary management. Factors influencing self-care behaviors in hemodialysis patients were identified as sex, age, economic status, health literacy, and self-care knowledge. These factors explained 45.2% of the variance in self-care behaviors. To promote self-care behaviors in hemodialysis patients, it is essential to improve health literacy and self-care knowledge, strengthen tailored educational programs, and promote the explanatory role of nurses and shared decision-making. Additionally, comprehensive interventions, including economic support, are necessary.

Predictors of self-care performance in patients with unruptured intracranial aneurysms

In South Korea, there has been an increasing number of patients diagnosed with unruptured intracranial aneurysms (UIAs), requiring rigorous self-care to prevent rupture. This study aimed to identify predictors of self-care performance in patients with UIAs, focusing on illness perception and social support. A cross-sectional correlation design was employed. Data from 150 participants was analyzed. The Brief Illness Perception Questionnaire (B-IPQ), the Multidimensional Scale of Perceived Social Support (MSPSS), and a Self-Care Performance Tool were used for measurement. Pearson correlation was used to analyze the correlation among the participants’ perceived illness perception, social support, and self-care performance. Differences in the level of self-care performance according to sociodemographic and clinical characteristics and correlations among continuous variables were identified using univariate statistics. Hierarchical multiple regression was used to identify predictors of self-care performance. The results showed that the self-care performance score was positively correlated with illness perception and social support. Regression analysis showed that being a non-smoker, not consuming alcohol, receiving social support from family, receiving social support from medical personnel, and strong illness perception positively affected the self-care performance score. Our findings should be considered when developing education and intervention programs to enhance self-care performance among patients with UIAs.

Prevalence of urinary incontinence and its associated predictor and Self-care behavior among the elderly females in Chaiyaphum Province, Thailand: Cross-sectional study.

Urinary incontinence (UI) has been overlooked by elderly females because it is considered an embarrassment and physical dysfunction that occurs naturally in older women. However, UI is problematic if symptoms are ignored, and the condition becomes chronic. This cross-sectional descriptive research was conducted in a community context using semi-structured interviews as data collection methods. The interviews involved 1475 elderly females who live in Muang district, Chaiyaphum province and were analyzed by Chi-square, Pearson Product Moment Correlation Coefficient, Stepwise multiple regression, Bivariate and Multivariate at 0.05 statistical significance. The study found a 30.37% prevalence of UI. Nine factors are related to the cause: Pelvic muscle exercise, water intake, caffeine and alcohol intake, diabetes, environmental obstacles, activities, constipation, urination frequency, and exercise. Elderly females who had their highest education at primary school to high school also had the possibility to experience 64% and a diploma had the possibility to experience 68% less UI than illiterate ones. The elderly females who had more than 23 kilograms per square meter (kg/m2) for body mass index (BMI) tend to have 2.64 times more than those who had 18.5-22.9 kg/m2 at 0.05 statistical significance. UI self-care behavior on overall prediction was moderate, whereas behavioral change and self-care performance were high. Nine factors are related to this cause. The possibility is also related to educational level and BMI. The overall UI self-care behavior showed a moderate level of prediction, but a high level of behavioral change and self-care performance.

Changes in cognitive functional performance and basic activities of daily living in patients with traumatic brain injury after two methods of cognitive retraining

Introduction: Evidence supports a bottom-up approach to assist in addressing functional cognitive deficits in patients with traumatic brain injury (TBI). There is however, little evidence supporting the use of online programmes for this purpose. The aim of this research was to describe the outcomes for cognitive functional performance and basic activities of daily living (bADL) or self-care functioning after cognitive retraining using an online programme versus task-oriented intervention for patients with acute mild and moderate traumatic brain injury (TBIs). Methods: A quantitative, quasi experimental, longitudinal research design was used for determining within-group and between-groups changes for cognitive functional performance and bADL functioning in two sample groups with mild to moderate TBI. Intervention using an online programme (n=7) or task-oriented activities (n=15) was evaluated at three assessment intervals: on recruitment into the study (Assessment 1), on completion of inpatient hospital intervention (Assessment 2) and after four weeks of home programme intervention and fortnightly outpatient intervention (Assessment 3). Results: Results for both groups showed a statistically significant change for cognitive functional performance assessed on the Bay Area Functional Performance Evaluation (BaFPE) while the task-oriented cognitive training group also achieved a statistically significant change in bADL scores during the first inpatient assessment period. Only the online programme group had statistically significant improvement during the home programme in the third assessment period. Conclusion: Cognitive retraining using an online programme or task-oriented activities resulted in positive change in a therapist directed inpatient programme but a structured, graded, online programme was more effective in supporting significant improvement in cognitive functional performance when used with an outpatient home programme. Implications for practice Cognitive retraining using an online programme or task orientated activities have a positive outcome for cognitive functional performance in patients with mild or moderate TBI in a therapist directed inpatient intervention. A task orientated approach for cognitive retraining appears to have positive effect on bADL outcomes. Cognitive retraining using an online programme intervention should be considered as a home programme to improve cognitive functional performance in patients with mild or moderate TBI.

Post-Discharge Self-Care Confidence and Performance Levels in Hospitalized Heart Failure Patients

BackgroundMultidisciplinary self-care education plays a critical role in ensuring the high-quality transitional care of hospitalized heart failure (HF) patients. However, whether confidence on self-care during their index hospitalization would influence their post-discharge self-care performance and long-term outcomes remains uncertain. MethodsWe conducted an assessment of 100 consecutive HF patients who completed self-care questionnaires both during their hospitalization and one year after discharge. Within these hospitalized HF patients, self-care confidence was assessed immediately after completing their pre-discharge educational program. One year after the index hospitalization, we evaluated self-care performance using European Heart Failure Self-care Behavior Scale. Logistic regression analysis was employed to identify determinants of poor self-care behavior 1-year after the hospitalization. Additionally, the Cox proportional hazards model with adjustment for Seattle Heart Failure Model was applied to assess their association with 2-year mortality and readmission risk. ResultsThe enrolled patients predominantly had HF with reduced ejection fraction (43.0%), and approximately half of the patients had experienced a previous HF hospitalization (47.0%). The three worst-performing aspects of post-discharge self-care behavior (among the 12 items) were appropriate consultation for fatigue (40.0%), weight gain (52.0%), and application of regular exercise (57.0%). After adjustment, low self-care confidence during the index hospitalization were associated with poor post-discharge self-care performance (OR: 1.11, CI: 1.00–1.21). Poor post-discharge self-care behavior was not associated with a worse prognosis over a 2-year follow-up (hazard ratio [HR]: 1.82, CI: 0.85–3.86); however, the association was significant in patients with reduced ejection fraction (HR: 4.04, CI: 1.17–13.89) and previous HF hospitalization (HR: 3.66, CI: 1.46–9.13). ConclusionsPost-discharge self-care performance was associated with self-care confidence during the index HF hospitalization. Effective measures that improve pre-discharge confidence levels in self-care should be considered to enhance the quality of transitional care.

Empowering Post-Stroke Patients to Improve Self-Care and Prevent Recurrent Stroke Using Stroke Empowerment Education

Aims: Stroke can lead to varying outcomes, ranging from recovery with disability, death, to surviving with recurrent strokes. Post-stroke patients require special attention to improve self-care behaviors. Stroke empowerment education is an educational approach given to stroke patients with an empowerment-focused approach centered on the patient. This study aimed to determine the effect of stroke empowerment education on the self-care of post-stroke patients as an effort to prevent recurrent strokes at RSUD Gambiran Kota Kediri. Methods: The research design used was a Quasi-Experiment with a pre-post test design with a control group. Sampling was done using accidental sampling technique, resulting in 98 respondents. Data collection on self-care was conducted using the modified version of The Subjective Self-Care Performance Scale questionnaire. Results: The results of the Wilcoxon Signed Ranks Test showed significant improvement (p = 0.000) in self-care among post-stroke patients after Stroke Empowerment Education. Conclusion: This study concluded that there was an effect of stroke empowerment education on improving self-care among post-stroke patients as an effort to prevent recurrent strokes at RSUD Gambiran Kota Kediri. As a recommendation, the results of this study can be continued as an intervention in hospitals to enhance services for post-stroke patients to improve self-care as an effort to prevent recurrent strokes.

Improving the Accuracy of Patient Self-Care After Joint Replacement Surgery

Joint replacement wound stitches are typically not removed until two weeks after the operation. Therefore, patients with joint replacement must be able to execute proper wound care after discharge from the hospital to reduce the risk of wound infection. Prior data from Chang Gung Memorial Hospital's orthopedics ward indicate only 69% of joint-replacement patients are able to perform wound care properly at home. Potential causes for this noted by patients include age-related forgetfulness, being unable to discern redness or swelling in the wound, and language comprehension difficulties (i.e., Taiwanese vs. Mandarin). Poor rates of wound care may also be attributable to incomplete wound care education by nursing staff and wound care education being provided without adequate practice on the day of patient discharge. This project was implemented to improve the accuracy of wound self-care performed by patients after joint replacement surgery and to enhance their related knowledge and wound-care technical correctness. A wound care education checklist, wound care cue cards, wound care video clips, wound condition red flag cue cards, and customized wound care pack were proposed and implemented. The rate of accuracy of wound self-care performance increased from 69% pretest to 98% posttest, showing the intervention to have effectively improved post-discharge wound care quality. To effectively improve the post-discharge accuracy of wound self-care in patients with joint replacement, the consistency of post-surgery wound care education given by nursing staff to patients should be improved, patients should be reminded of wound assessment and care steps, and patients should be aware that wound abnormalities require an immediate return to the hospital for follow-up treatment.

Association of Rate of Functional Recovery With Therapy Time and Content Among Adults With Acquired Brain Injuries in Inpatient Rehabilitation

ObjectiveTo examine associations among the time and content of rehabilitation treatment with self-care and mobility functional gain rate for adults with acquired brain injury. DesignRetrospective cohort study using electronic health record and administrative billing data. SettingInpatient rehabilitation unit at a large, academic medical center. ParticipantsAdults with primary diagnosis of stroke, traumatic brain injury, or nontraumatic brain injury admitted to the inpatient rehabilitation unit between 2012 and 2017 (N=799). InterventionsNot applicable. Main Outcome MeasuresGain rate in self-care and mobility function, using the Functional Independence Measure. Hierarchical regression models were used to identify the contributions of baseline characteristics, units, and content of occupational therapy, physical therapy, and speech-language pathology treatment to functional gain rates. ResultsMedian length of rehabilitation stay was 10 days (interquartile range, 8-13d). Patients received an mean of 10.62 units of therapy (SD, 2.05) daily. For self-care care gain rate, the best-fitting model accounted for 32% of the variance. Occupational therapy activities of daily living units were positively associated with gain rate. For mobility gain rate, the best-fitting model accounted for 37% of the variance. Higher amounts of physical therapy bed mobility training were inversely associated with mobility gain rate. ConclusionsMore activities of daily living in occupational therapy is associated with faster improvement on self-care function for adults with acquired brain injury, whereas more bed mobility in physical therapy was associated with slower improvement. A potential challenge with value-based payments is the alignment between clinically appropriate therapy activities and the metrics by which patient improvement are evaluated. There is a risk that therapists and facilities will prioritize activities that drive improvement on metrics and deemphasize other patient-centered goals.

Design and Psychometrics of the Awareness and Self-Care Performance Questionnaire of Diabetic Patients in the Coronavirus Disease 2019 Pandemic

Background: The sudden emergence of the coronavirus disease 2019 (COVID-19) epidemic worldwide has led to numerous problems for patients with chronic diseases, such as diabetics, due to the lack of required information to deal with the disease. The present research aims to investigate the design and psychometrics of the Awareness and Self-Care Performance Questionnaire of diabetic patients during the COVID-19 pandemic. Methods: The present methodological study aimed to investigate the design and psychometrics of the Awareness and Self-Care Performance Questionnaire. The face and content validity were assessed through both quantitative and qualitative studies. For the quantitative study, 100 diabetic patients were randomly selected during the COVID-19 pandemic. The reliability of the questionnaire was assessed using the internal consistency method by Cronbach’s alpha coefficient. Results: The original version of the questionnaire was designed with 82 items and the final version with 56 items (awareness [32 items] and self-care performance [24 items]) with seven areas, including disease characteristics, prevention ways, ways of disease transmission, disease symptoms, disease risk factors, diet, and care methods. The content validity index (CVI) was 0.97, the content validity ratio (CVR) was 0.93, and the internal consistency of the questionnaire was calculated to be 0.80 using Cronbach’s alpha coefficient, showing the appropriate validity and reliability of this questionnaire. Conclusion: The Awareness and Self-Care Performance Questionnaire of diabetic patients in the COVID-19 pandemic possesses the required validity and reliability to evaluate the knowledge level of diabetic patients in infectious pandemics, such as COVID-19, and it has the applicability to be used in similar conditions. It is suggested that the questionnaire’s construct validity be measured to enhance the content validity.

Person and Environment Factors Supporting Self-Care Performance and Social Participation After Mild Stroke.

Mild stroke survivors seldom receive occupational therapy services as their deficits are assumed to be minor enough to not affect their daily occupations. Yet many mild stroke survivors report deficits in self-care performance and social participation. This study investigates person and environment factors influencing self-care performance and social participation among mild stroke survivors, using the Person-Environment-Occupation-Performance (PEOP) model. A retrospective cohort analysis of 736 mild stroke survivors was conducted using electronic health records. Person factors included demographic characteristics and clinical characteristics, and environment factors included the Social Vulnerability Index. The analysis included logistic regression. Approximately, 10% of patients reported deficits in self-care or social participation. Disability level was the only person factor associated with self-care performance. Person factors affecting social participation included mobility and unemployment. Socioeconomic status was associated with both occupation measures. Occupational therapy practitioners must address the person and environment factors affecting mild stroke survivors' self-care performance and social participation.

Design and evaluation of mobile application for adolescents’ self-care: protocol for a randomized controlled field trial

BackgroundAdolescence is a critical stage for the development of self-care. Many adolescents use mobile apps to monitor and improve their health. Health information technology plays a significant role in the field of self-care. This article provides a protocol for a study to design and evaluate mobile applications for adolescent self-care.MethodsThe present research is a combination of applied development study, methodological, and intervention experimental. This study will be done in three stages: The first stage is the design and evaluation of a mobile application for adolescent self-care. The second stage is, designing and evaluating the psychometric properties of the “Questionnaire for Measuring Adolescent Self-Care Performance.” This questionnaire will be used before and after using the application in the third stage. The third stage is determining the effectiveness of self-care interventions based on mobile applications among adolescents. The target group will be adolescents aged 10–19 from the schools of Amol City. In the first stage, the opinions of 30 people adolescents, parents, and experts will be used. In the second stage, the number of samples will be 10 times the number of items in the questionnaire. In the third stage, 50 people will be in the intervention group and 50 people will be in the control group. Descriptive statistics will be used for data analysis. Between-group and intra-group comparisons will be calculated about quantitative variables, independent t-test and paired t-test, and analysis of variance. The chi-square test and Fisher’s exact test will be used in SPSS 16 software to test the homogeneity of qualitative variables between the two groups.DiscussionIn the first stage, based on the opinions received from the target group, a user-centered educational application for self-care of adolescents will be designed. In the second stage, after determining the validity and reliability, a questionnaire will be designed to measure the self-care performance of adolescents. In the third stage, using an intervention study for 3 months, the effectiveness of the training will be determined through the designed application. Our findings are scheduled for a full analysis, with expectations that analyses will be completed by September 2023.

Factors Associated With Diabetes Self-Care Performance in Indonesians With Type 2 Diabetes: A Cross-Sectional Study.

In Indonesia, the number of Type 2 diabetes cases is increasing rapidly, making it the third leading cause of death and among the leading noncommunicable disease healthcare expenditures in the country. Thus, there is a critical need for Indonesians with Type 2 diabetes to perform better self-care to optimize their health and prevent the onset of comorbidities. This study was designed to investigate the influence of knowledge, depression, and perceived barriers on Type 2 diabetes self-care performance in Indonesia. A cross-sectional study was conducted on 185 patients with Type 2 diabetes, with demographic, diabetes history, obesity status, diabetes knowledge, depression, perceived barriers, and self-care performance data collected. The Indonesian version of the Revised Diabetes Knowledge Test, Depression Anxiety Stress Scale, Perceived Barrier Questionnaire and Self-Care Inventory-Revised were used. Descriptive, bivariate, and multiple linear regression analyses were performed. Study participants were found to have moderate diabetes self-care performance scores. Annual eye checks, blood glucose self-monitoring, healthy diet selection, and regular exercise were the least common self-management techniques performed and were consistent with the perceived difficulties of the participants. Being illiterate or having an elementary school education (β = 4.59, p = .002), having a junior or senior high school education (β = 3.01, p = .006), having moderate depression (β = -0.92, p = .04), diabetes knowledge (β = 0.09, p = .006), and perceived barriers (β = 0.31, p < .001) were found to explain 40% of the variance in self-care performance. Educational level, depression, and perceived barriers were the strongest factors that impacted Type 2 diabetes self-care performance in this study. Nurses should not only provide diabetes education but also identify barriers to diabetes self-care early, screen for the signs and symptoms of depression, and target patients with lower levels of education.

Teaching self-care: understanding the learned and lived self-care experiences of social work students

ABSTRACT Professional self-care in social work is regarded as paramount to ethical and competent practice. However, the absence of an agreed upon operationalization of self-care leaves social work educators directionless on the teaching and modeling of self-care. This study investigated the learned and lived self-care experiences of BSW and MSW students (n = 80) in their final field education experience. Data collection included an anonymous online survey, focus groups, and a follow-up online survey. Broadly, students were asked to consider three aspects of self-care: 1) their understanding of self-care, including the sources of that understanding; 2) their experienced internal and external barriers to self-care; and 3) the interface between self and systems when practicing self-care. Utilizing a general inductive approach to data analysis, several evocative themes emerged suggesting gaps between the learned experience and the lived experience of self-care including the conflict between familial or cultural values and formal self-care education, a divide between their positive experiences with self-care and their actual performance of self-care, and inhibitory components of professional systems to the personal practice of self-care. Students exhorted their social work educators to model self-care, teach it explicitly, provide in-vivo practice opportunities, and to understand the student experience.

Development and psychometric evaluation of an expanded urinary catheter self-management scale: A cross-sectional study.

To develop and test the psychometric properties of an expanded catheter self-management scale for patients with in-dwelling urinary catheters. A cross-sectional validation study. Despite the utility of the original 13-item catheter self-management scale, this instrument did not include bowel management, general hygiene and drainage bag care, which are fundamental skills in urinary catheter self-management to prevent common problems resulting in unnecessary hospital presentations. The expanded catheter self-management scale was developed with 10 additional items to comprehensively assess all five essential aspects of urinary catheter self-management. A total of 101 adult community-dwelling patients living with indwelling urinary catheters were recruited from Western Sydney, Australia. Using exploratory factor analysis with Varimax rotation, the number of factors to be extracted from the expanded 23-item expanded catheter self-management scale was determined using a scree plot. The reliability of the overall scale and subscales was measured using Cronbach's alpha. Convergent validity was assessed using Spearman's correlations between clinical characteristics, overall scale and subscales. The 23-item expanded catheter self-management scale yielded a 5-factor solution, labelled as: (i) self-monitoring of catheter function, (ii) proactive, help-seeking behaviour function, (iii) bowel self-care function, (iv) hygiene-related catheter site function and (v) drainage bag care function. Cronbach's alpha of the expanded catheter self-management scale indicating all 23 items contributed to the overall alpha value. Convergent validity results showed a negative correlation between the overall expanded catheter self-management scale and catheter-related problems. The 5-factor structure provided a comprehensive assessment of key aspects of urinary catheter self-management essential to reduce the likelihood of catheter-related hospital presentations. The expanded catheter self-management scale can be used to assess and monitor effective patient-centred interventions for optimal self-management to prevent catheter-related problems and improve the quality of life of patients. Many patients start their journey of living with a urinary catheter unexpectedly and are not supported with quality information to care for their catheter. The findings of this study show the correlation between catheter self-management skills and catheter-related problems. The expanded catheter self-management scale (E-CSM) assists with analysing the self-management skills of patients living with a catheter and developing tailored interventions to prevent problems and improve their quality of life. In addition, this screening tool can be included in policies, guidelines, and care plans as a standard for improving catheter management and developing educational resources for patients. STROBE checklist was used to report all aspects of this study comprehensively and accurately. Patients living with indwelling urinary catheter and their carers have participated in surveys, interviews and co-designing interventions. This paper reports the psychometric analysis of the expanded catheter self-management scale (E-CSM) used in the patient survey as part of the main study 'Improving Quality of Life of Patients Living with Indwelling Urinary Catheters: IQ-IDC Study' (Alex etal. in Collegian, 29:405-413, 2021). We greatly value our consumers' contributions and continue to communicate the progress of the study to them. Their contributions will be acknowledged in all publications and presentations. In addition, all participants will be provided the option of receiving the interventions and publications generated from this study.

Psychometric Analysis of the Health Self-Care Neglect Scale.

The Health Self-Care Neglect (HSCN) scale is a measure of self-care neglect developed for use in informal caregivers, where self-care is defined as behaviors undertaken to maintain health. There was no formal psychometric analysis of the scale, so we tested a 9-item, dichotomous-response version of the HSCN scale in a sample of 250 informal caregivers of adults with chronic heart failure. As the indicators of self-care neglect were considered formative (influencing the latent variable directly) rather than reflective (influenced by the latent variable), we used a procedure for the specification of formative measurement models. First, maximally correlated composites of indicators were identified for the latent variable, and optimal scoring weights were developed. Then, the reflective factor was tested with confirmatory factor analysis, and longitudinal invariance of the factorial structure was tested by introducing model constraints. Reliability was assessed with composite reliability model-based estimates. Concurrent validity was assessed by correlating the HSCN scale total score with the maintenance scale score of the Self-Care Inventory. Strict invariance, the highest level possible, was achieved. Reliability was 0.81 at baseline. Concurrent validity was demonstrated ( r = -0.475, P < .0001). The results of this analysis indicate that the HSCN scale is reliable, stable, and valid as a measure of health self-care neglect when tested in a sample of caregivers. The HSCN scale measures the successful performance of self-care, whereas existing measures of self-care reflect intention. Understanding both intention and behavior is useful, so we recommend using the HSCN scale in addition to existing measures of self-care.

Evaluation of the functional status of the “unaffected” hand in hemiplegic patients

Objectives: To evaluate the functional status of the unaffected hand in hemiplegic patients and its relationships with activities of daily living. Methods: This cross-sectional study included 30 right, 30 left hemiplegic patients with ischemic cerebrovascular accident history in last year, and 30 healthy volunteers. All participants were right-hand dominant. Data on age, gender, height, weight, comorbidities, duration of stroke, Brunnstrom recovery stages were recorded. Handgrip strength (with Jamar-type dynamometer), pinch strengths (with pinch-meter), and hand dexterity [with Nine Hole Peg Test (NHPT)] were evaluated in unaffected hand in patient groups and in both hands in control group. Lawton Instrumental Activities of Daily Living Scale (Lawton-IADL) and Functional Independence Measure (FIM) were applied to patient groups. Results: Hand grip and pinch strengths were lower, NHPT duration was longer in right (p=0.004, p=0.03, p&lt;0.001) and left (p=0.03, p=0.02, p=0.002) hemiplegia groups compared to control group. Hand grip and pinch strengths were positively, NHPT duration was negatively correlated with FIM self-care performance (r:0.47 p&lt;0.00, r:0.38 p=0.003, r:-0.40 p=0.002), and Lawton-IADL scores (r:0.48 p&lt;0.001, r:0.42 p=0.001, r:-0.56 p&lt;0.001). Conclusion: Ipsilesional hand, which is considered unaffected, functions are impaired in hemiplegic patients. This functional impairment is associated with greater dependence on activities of daily living.

Factors associated with capability and performance in children with neurodevelopmental disorders: an exploratory cross-sectional study

Background Children with neurodevelopmental disorders (NDD) have a lower level of independence and major need of assistance to perform daily living skills is one the main concerns of caregivers and therapists of children, adolescents and adults with these disabilities. Aim To identify factors associated with capability and performance in self-care, mobility and social activities in children with NDD. Method A cross-sectional study was performed with 96 children with NDD, most were male (69.8%), with a mean age of 8.53 (± 1.83) years. The Pediatric Evaluation of Disability Inventory was used to evaluate capability and performance outcomes. The explanatory variables were intellectual function, motor skills, economic level, and maternal education. Stepwise multiple linear regression models were used. Results The motor skills were the main factor that explained self-care, mobility and social function capability outcomes and, self-care and mobility performance outcomes (p < 0.05). The intellectual function explained only the social function performance outcome (p < 0.05). Moreover, highest economic extracts increased the explanation of outcomes. Conclusion The findings are relevant to understanding the factors associated with performance and capability and performance in self-care, mobility and social activities to help clinicians to make an informed decision based on the best practice evidence for these children. An expanded assessment of functioning and of the environmental factors is necessary to help the planning interventions to improve capability and performance of the children with NDD.

Development and Psychometric Properties of the Caring Behaviors of Operating Room Nurses Questionnaire during the COVID-19 Pandemic: A Mixed-Method Study.

Considering the threats in the operating room during the COVID-19 pandemic, the optimal care and safety of the operating room nurses should be maintained when performing surgery on an acute respiratory patient. It seems necessary to design a tool to measure the caring behaviors of operating room nurses. Therefore, the present study was conducted with the aim to design a valid and reliable tool for measuring the caring behavior of operating room nurses during the COVID-19 pandemic. In this sequential, exploratory, mixed-method study, the designing and psychometric evaluation of the caring behaviors of operating room nurses questionnaire during the COVID-19 pandemic were performed in qualitative and quantitative phases from August 2021 to July 2022 in Aja University of Medical Sciences, Iran. In the qualitative phase, the concept of caring behaviors of operating room nurses was explored through interviews and a literature review based on online searches. In the quantitative phase, validity (face, content, and construct), and reliability of the questionnaire were evaluated. The findings supported 21 items in the 5 factors of caring behaviors related to attitude toward patients, knowledge of surgical care, virus prevention principles, self-care knowledge, and self-care performance, which explained 35.92 of the total variance. Scale-Content Validity Index/Average and Cronbach's alpha were calculated to be 0.93 and 0.89, respectively. Given its desirable reliability and validity, simple scoring, and ease of use by operating room nurses, the Caring Behaviors of Operating Room Nurses Questionnaire is applicable and its use is recommended.

Self-care and Quality of Life in Patients with Chronic Renal Failure Undergoing Hemodialysis at Sulaimaniyah Province, Kurdistan Region of Iraq

Background: Chronic renal failure (CRF) is a significant and growing public health issue globally with a negative impact on self-care and quality of life (QoL). Self-care and QoL are essential aspects of controlling the adverse effects of the illness.&#x0D; &#x0D; Objectives: To assess self-care and QoL of patients with CRF who undergo hemodialysis (HD).&#x0D; &#x0D; Patients and Methods: A descriptive-analytical design was carried out in Sulaimani Province Hemodialysis Centers/Unit from March to September 2022. About 150 patients with CRF undergoing hemodialysis consented to participate in the study. Non-probability convince sample technique was used to select the participants. The data were collected through a questionnaire by direct interview.&#x0D; &#x0D; Results: Most patients were ≥60 years, males, married, illiterate, lived in an urban area and had barely sufficient economic status with 4-6 family members. The study's findings revealed inadequate self-care in &gt;50% of patients. A significant correlation between self-care and QoL in limitation of activities was found for CRF patients who underwent Hemodialysis with no correlation for general health, physical and emotional, and energy and emotion. Also, there was a significant difference between QoL and age (for the general health domain), gender, and level of education (for the limitations of the activities domain). Mean self-care measurement was significantly associated between previous occupation and duration of Hemodialysis.&#x0D; &#x0D; Conclusions: Most patients had inadequate self-care and poor QoL, which means that higher self-care performance was associated with better QoL in the limitation of activities only and no other QoL domains.

Validity of Self-reported Self-Care Assessment and Determinants of Self-Care Practices in Older Patients with Heart Failure

Background: Self-care as a disease management strategy in heart failure (HF) is important for the prevention of rehospitalisation, but it is difficult to assess and does not always reflect actual self-care practices. This study aimed to compare self-reported self-care assessments and actual self-care practices in older patients with HF and examine factors influencing self-care performance. Methods: We included 64 patients with HF aged ≥65 years who had been hospitalised and prescribed rehabilitation with stable symptoms between April 2019 and September 2020. We assessed the B-type natriuretic peptide levels and New York Heart Association (NYHA) classification, Short Physical Performance Battery (SPPB), grip strength, and the Japanese version of the Montreal Cognitive Assessment (MoCA-J). We used the European Heart Failure Self-care Behaviour Scale (EHFScBS) to assess self-care behaviour in patients with HF. The patients filled in a self-assessment chart during their stay, which was used to work out the self-care implementation rate. Results: No significant correlation between the self-care implementation rate and the EHFScBS was identified (r= −0.160, p=0.207). Multiple regression analysis of factors associated with the rate of self-care and EHFScBS revealed that age, NYHA classification, SPPB and MoCA-J scores were significantly associated with the rate of self-care; however, no factors were associated with EHFScBS. The results were similar irrespective of the presence or absence of cognitive decline. Conclusion: In older patients with HF, the self-reported assessment of self-care did not reflect actual self-care performance. A reliable self-care behaviour scale needs to be developed.