Self-care Practices Research Articles

“If it has happened once, it can happen again”. The impact of previous pregnancy loss on anxious women's ongoing pregnancies: A qualitative study from Pakistan

BackgroundPregnancy loss that includes both miscarriage and stillbirth cause significant psychological distress for women including anxiety, depression, and grief that persist long after physical recovery. This study focuses on the experiences of women in Pakistan, where pregnancy loss rates are high. ObjectiveTo explore how pregnant women with anxiety symptoms and a history of pregnancy loss perceive their past experiences with the loss and how it affects overall well-being in their current pregnancy. DesignQualitative methods were used to explore the impact of previous pregnancy loss on the well-being of pregnant women. SettingThis qualitative research was embedded within a randomized control trial conducted in a tertiary care facility in Rawalpindi, Pakistan. ParticipantsData were collected through in-depth interviews with 18 pregnant women who had experienced pregnancy loss. Data was analyzed using Framework Analysis. FindingsThe findings revealed several factors influencing participants' well-being during pregnancies that resulted in a loss, such as unsupportive and abusive environments, unintended pregnancies, certain superstitious beliefs, poor health, and lack of access to quality healthcare. The study also highlighted the adverse impact of previous pregnancy loss on the ongoing pregnancy, including deterioration of physical and mental health and aversion of healthcare services. However, some participants reported positive changes in medical and self-care practices and an enhanced faith and reliance on destiny in their subsequent pregnancies. ConclusionOur study highlights the lasting impact of past pregnancy loss on subsequent pregnancies, affecting overall wellbeing and leading to healthcare avoidance. We identified persistent anxiety along with positive outcomes like enhanced medical practices and strengthened faith. Results suggest the need for culturally responsive interventions to support the overall well-being of anxious pregnant women with a history of pregnancy loss in resource-constrained settings.

Increasing the Efficiency of Lifestyle Medicine Counseling: A Visual Approach.

Description Too much to counsel on, too little time? We would like to present a unique and innovative perspective on lifestyle medicine counseling through the lens of a homemade flyer, designed to bridge the gap between conventional health care practices and personalized, holistic well-being. In the promising field of health care humanities, the homemade lifestyle medicine flyer serves as a tangible manifestation of individual agency in promoting health and vitality. The flyer encapsulates a diverse range of self-care practices, dietary insights, and mindfulness techniques, emphasizing the inherent connection between mind, body, and spirit in one's health journey. This double-sided document highlights the significance of empowering individuals to take an active role in their own health journey. Included are a broad range of tips for building a solid health and well-being foundation, as well as a QR code with resources to make those changes happen. Patients may understand that they need to eat healthy foods and spend time outdoors but may not know how best to implement those changes in their area. Although there is limited time for the average office visit, something as simple as a visual aid can go quite far in creating ripples of change beyond the clinic. As a take-home document, it can become an opportunity to share and empower others in the patient's own sphere of influence as well. The flyer acts as a tangible artifact, becoming a conduit for fostering a sense of community engagement, encouraging dialogue, and promoting shared experiences in the pursuit of well-being.

Development and Psychometric Testing of Scales of Knowledge, Attitude, and Practice of Self-Care for Patients With Arteriovenous Fistula.

Background and Purpose: To validate the scales of knowledge, attitude, and practice of self-care for arteriovenous fistulas in renal patients on hemodialysis. Methods: A methodological study verified the evidence of validity based on the content, response processes, and internal structure of the scales. The content was evaluated by six judges, and the response processes were verified with six patients. In the evaluation of the internal structure, the scales were applied to 220 patients for exploratory factor analysis with evaluation of McDonald's omega adjustment and calculation indexes. Results: The scales explained variance and McDonald's omega values of 40.4%/0.896, 60.7%/0.843, and 36.9%/0.702 for the knowledge (19 items), attitude (4 items), and practice (8 items), respectively. Conclusions: The scale of attitude was valid after the analysis of the content evidence, response processes, and internal structure. The arteriovenous fistula self-care knowledge and practice scales explained less than 50% of the constructs. Therefore, it is recommended that new studies be conducted to validate scales of knowledge and practice of fistula self-care.

Development and validation of a video-based intervention on self-care practices for patients with hypertension in Malaysian primary care settings.

Self-care practices among patients with hypertension have been shown to improve blood pressure control. Video-based interventions (VBIs) are helpful in enhancing patients' selfcare practices. However, validated VBIs in the Malay language for patients in primary care settings are scarce. This study aimed to develop and validate a VBI series in the Malay language to educate patients with hypertension on self-care practices in primary care settings. This study was conducted in three phases: (1) pre-production, (2) production and (3) post-production. The pre-production phase involved designing the storyboard and scripts, which underwent content validation by content experts and subsequently by patients with hypertension. Once the storyboards and scripts achieved acceptable consensus, the videos were recorded (production phase). The post-production phase included video editing and face validation among patients with hypertension. Statistical analysis included the calculation of the item-level content validation index (I-CVI) and item-level face validation index (I-FVI) during content and face validation, respectively. The storyboards and scripts for five videos were developed. The I-CVI of all videos was 1.0 after two rounds of content validation among six content experts. The I-CVI of all videos was 1.0 among five patients with hypertension. Five videos were recorded and edited, achieving an I-FVI of 1.0 during face validation among 10 patients. A VBI series consisting of five videos was developed and validated for use among patients with hypertension in primary care settings to improve their knowledge of self-care practices.

Self-Care Practices and Pregnancy Outcomes among Women undergoing Cervical Cerclage

Self-Care Practices and Pregnancy Outcomes among Women undergoing Cervical Cerclage

Prevalence and Associated Factors of Chronic Respiratory Symptoms among Street Sweepers in Bangkok, Thailand: A Cross-sectional Study.

Chronic respiratory diseases are becoming a more prominent cause of morbidity and mortality worldwide. Street sweepers are commonly found in low- and middle-income countries. This job involves outdoor work that exposes workers to various health hazards and air pollution, particularly affecting respiratory health. There is still limited research focusing specifically on street sweepers. The study aims to examine the prevalence of chronic respiratory symptoms and the associated factors in street sweepers in Bangkok, Thailand. We undertook a cross-sectional survey between February and April 2023. A multi-stage sampling technique was employed, stratifying the sample according to district locations within Bangkok, Thailand. Data were collected through a questionnaire assessing demographic characteristics, occupational and environmental factors, and respiratory symptoms using a modified version of the Medical Research Council questionnaire. Data analysis included bivariate analysis and multiple logistic regression. The response rate was 98.0% (n = 341). The prevalence of chronic respiratory symptoms among street sweepers in Bangkok, Thailand, with at least one respiratory symptom was reported by 33.7% of the participants, specifically cough (22%), phlegm (20.2%), dyspnea (17.6%), and wheeze (7.0%). The average age of the sample group was 43.2 years, with a majority being female (85.9%). Among the participants, 88.3% were non-smokers, while 37.2% reported exposure to secondhand smoke. All participants reported the use of respiratory protective equipment, with face masks used at 78.9%. 7.3% of the participants lived near sources of pollution, and 12.0% were involved in household pollution activities. An average annual air quality index in the workplace area was categorized as 'good' at 57.8%. Multiple logistic regression analysis revealed significant associations of chronic respiratory symptoms with the following factors: exposure to secondhand smoke [odds ratio (OR) =2.3, 95% confidence interval (CI) 1.3-4.2] and household activities (OR = 3.0, 95% CI 1.3-6.6). Exposure to secondhand smoke and indoor air pollutants in household environments are significant factors associated with the symptoms. Raising awareness about secondhand smoke hazards in household and environmental settings and promoting self-care practices related to various activities with potential exposure to indoor air pollution is crucial.

The Grieving Process for Nurses: A Concept Analysis

Background: This study delved into the nuanced experience of grieving among nurses, shedding light on an essential yet often overlooked aspect of their professional and personal lives. Grief among nurses is a significant issue due to the frequent exposure to patient deaths and personal losses, which can profoundly impact their emotional and psychological well-being. Objective: The objective of this study was to employ a structured approach to conceptualize and elucidate the multifaceted nature of nurses' grief. The study aimed to identify defining attributes, antecedents, consequences, and empirical referents of nurses' grieving process, providing a comprehensive understanding to inform targeted interventions. Methods: This concept analysis used Walker and Avant's methodological framework, which includes eight steps: topic selection, establishing analysis goals, recognizing all possible uses of the concept, defining attributes, presenting a model case, identifying additional cases (e.g., borderline, contrary), determining antecedents and consequences, and describing empirical referents. A comprehensive literature review was conducted using databases such as PubMed, CINAHL, and PsycINFO. Data collection involved reviewing existing literature on the grieving process, emotional distress, burnout, self-care, and supportive interventions for nurses. The ethical principles outlined in the Declaration of Helsinki were followed, ensuring confidentiality and anonymity of all data sources. Results: The defining attributes of the grieving process for nurses included intense emotions (sadness, anger, guilt, depression), physical and emotional pain, and the unique demands of the nursing profession. Antecedents identified were personal loss and exposure to patient deaths, while consequences included emotional distress, impaired work performance, and increased stress. Empirical referents were measurable indicators such as the frequency of crying episodes, reports of physical symptoms, changes in work performance, and use of coping strategies. The analysis found that 85% of nurses experienced significant emotional distress, 70% reported impaired work performance, and 60% utilized some form of support or coping strategy. Conclusion: Understanding the grieving process among nurses is crucial for developing effective interventions and support systems. This study's findings underscore the importance of education, supportive interventions, self-care practices, and teamwork in promoting nurses' well-being and enhancing patient care outcomes. By providing a comprehensive understanding of nurses' grief, the study contributes valuable insights to nursing knowledge and practice, highlighting the need for targeted interventions to support nurses in coping with the emotional challenges of their profession.

Pre-post-evaluation of a dementia-specific advance care planning toolkit for Japanese primary care clinicians.

The population of people living with dementia (PLwD) continues to grow in Japan where advance care planning (ACP) for PLwD is relatively new. Our aim was to evaluate the feasibility and cultural acceptability of a dementia-specific ACP communication skills toolkit for Japanese primary care clinicians. We delivered 13 training sessions in primary care clinics across central Japan and conducted a post-training survey to assess whether the toolkit increased confidence in dementia-specific ACP communication skills and the acceptability of the toolkit with the following four statements: (1) The language in the sessions was clear, (2) The sessions took an appropriate amount of time to complete, (3) The design of the sessions was an effective educational method, and (4) The sessions were culturally appropriate for communication with Japanese patients with dementia and their family members. We asked participants to respond using a 5-point Likert scale from strongly agree to strongly disagree. All participants were Japanese and included 80 physicians (mean age 39.8 years), 33 nurses (mean age 45.7 years), and 58 other participants (mean age 42.9 years), who were 30.0%, 87.9%, and 55.2% female, respectively. Most participants practiced in rural settings. In pre- post-comparisons, participant confidence increased in determining capacity, understanding dementia prognosis, goals of care, eliciting surrogates, recommending self-care practices to families, and leading family meetings (all p < 0.001). Most participants strongly agreed or agreed that the toolkit was an effective method (96.9%), took an appropriate amount of time (94.5%), contained clear language (89.8%), and was culturally appropriate (73.6%). Dementia-specific ACP communication skills toolkit can be delivered in Japan. Japanese primary care clinicians generally felt the dementia-specific ACP toolkit increased their confidence in ACP communication skills and was acceptable. The language, time, and design were well received, though further work is needed to improve the cultural appropriateness of the toolkit.

The Care of the Self and the Meaningful Four-Day Workweek

Those who find their work meaningful often need to be more committed. Over-commitment, in turn, frequently results in stress, personal conflicts, and burnout. Such over-commitment, in other words, leads to employees needing to take more care of themselves. This paper considers the prospects for meaningful self-care in the context of working time reduction. For this, we consider the case of the four-day workweek, asking employees of such organizations to explain how they make meaning out of their newly found time off. Conceptually, we rely upon the work of Michel Foucault, particularly his analysis of the care of the self. On its basis, we coded five self-care practices: (1) rest and recuperation, (2) professional and personal development, (3) domestic work, (4) balancing work, and (5) additional work. We conclude by highlighting the theoretical and practical implications of work reduction for the analytical, ethical, and practical pursuit of meaningful work.

The feasibility of a social media-based foot self-management education and support program for adults with diabetes: A partially randomized preference trial

AimTo assess the feasibility of Diabetic Foot Care Group (DFCG), a social media-based self-management education and support intervention, for people with diabetes (PWD) empowerment in diabetes-related foot ulceration prevention. MethodsA partially randomized preference trial was conducted among 32 PWD. DFCG was implemented through Facebook. Participants in the intervention group joined the DFCG in addition to their usual care, while the control group received usual care. Data were collected online using questionnaires on participants' DFCG acceptance, engagement and preliminary efficacy on nine diabetes foot care-related outcomes at baseline, one, and three months post-intervention. ResultsThe participants' study intervention acceptability and engagement rates were 84.2% and 55.2%, respectively. DFCG efficacy rate compared to usual care was 88.9% to 22.2%. Three diabetes foot care-related outcomes increased significantly in the intervention group three-month post-intervention: foot self-care adherence (p = 0.001, ηp2 = 0.35), preventive foot self-care practice (p = 0.002, ηp2 = 0.33), and physical health status (p < 0.02, ηp2 = 0.23). ConclusionDFCG is feasible and could effectively improve diabetes foot care-related outcomes. InnovationSocial media is an innovative approach healthcare professionals could utilize to virtually support PWD in ongoing learning and engagement in optimal foot self-care activities. Trial registrationClinicalTrials.gov, Identifier: NCT04395521

Warao Self-care practices in Coping with the COVID-19 Pandemic in Manaus (Amazonas, Brazil)

This article put together information about the formation of the warao self-care practices, exposing the centrality of shamanism in the processes of health and illness. The reflection is built from the context of coping with the COVID-19 pandemic in indigenous shelters in Manaus (Amazonas), between March and December of 2020. These actions not only systematically disregarded shamanism and native theories, but also produced strong control over the presence of these indigenous people in the city. Through a critical analysis of the situation in the Amazonian capital, it reflects on the need for adaptation in health care for the Warao in Brazil and, by extension, for other indigenous people, especially those residing in urban contexts. The data presented were obtained through fieldwork with an ethnographic perspective, in addition to documentary and bibliographical research.

Predictive Ability of Self-Care and Psychological Flow in Occupational Stress Among Nurses

Background The nursing workforce is crucial in healthcare systems worldwide and contributes to community well-being. also, Nurses experience numerous psychological, social, emotional, and behavioral shocks and challenges in their work. In Jordan, 43% of doctors and nurses suffer from high levels of burnout, around 55% experience high levels of emotional exhaustion, and 33% of doctors and nurses suffer from high levels of psychological pressure and job stress. Others found that 70% of nurses experience stress. these issues can be reduced by practicing self-care and psychological flow which impact in work-related tasks which are important in effectively addressing occupational stress healthily and soundly. This study aims to determine predictive ability of self-care and psychological flow in occupational stress among nurses Methods This study follows the quantitative technique. sample consisting of 476 nurses in Amman Jordan was chosen. Three scales were developed to meet the study objectives: Occupational stress scale, Self-care scale, and psychological flow scale. Results The study results indicate that self-care and psychological flow levels were low, while the occupational stress level was high. Also, there are a predictive ability of self-care and psychological flow in occupational stress among nurses. Conclusions This study shows that of self-care and psychological flow predict occupational stress among nurses, which helps us to manage the occupational stress among them by giving them self-care and psychological flow practices and healing time.

Perspectives on Medical Education in Paraguay: Time Management, Mental Health, and Self-Awareness Strategies for Brazilian Students

Medical training is a demanding process that challenges students both academically and personally. This article explores some of these challenges based on an interview conducted during the "Brazilians Beyond Borders: The Journey of Medical Training in Paraguay" Congress in 2024. Eduardo Paglioni interviewed clinical psychoanalyst and medical student Kelton Oliveira, who shared his perspectives on crucial topics such as time management, mental health, resilience, and self-awareness.The study identifies and analyzes the main challenges faced by Brazilian students who choose to study medicine abroad, particularly in Paraguay, highlighting the importance of an integrated approach that encompasses both technical competence and emotional and psychological well-being. Kelton Oliveira emphasizes the need for effective time management strategies to avoid burnout, self-care practices to maintain balanced mental health, and the promotion of self-awareness to cope with the pressures of medical training.The methodology employed included the transcription and detailed qualitative analysis of the interview, contextualizing the challenges faced and extracting practical strategies to overcome them. To reinforce the importance of this topic, we also conducted a review of scientific publications that highlight the necessity and relevance of these issues for medical students.Although the analysis is based on a single interview, integrating information provided by other researchers in available scientific publications allows for correlating these contributions to obtain a broader and more comprehensive perspective. This provides a better understanding of the challenges faced by medical students in Paraguay and in other international contexts.This article aims to provide an in-depth analysis of the challenges faced by these students and present practical suggestions that can be applied to improve their academic performance and promote a healthy balance between their academic, personal, and professional lives.

Effectiveness of discharge teaching regarding post-mastectomy care on self-care practice and arm lymphedema among patients with breast cancer.

Effectiveness of discharge teaching regarding post-mastectomy care on self-care practice and arm lymphedema among patients with breast cancer.

Uncertainty affects cancer-related fatigue among breast cancer women undergoing peripherally inserted central catheter chemotherapy: the chain mediating role of psychological resilience and self-care

BackgroundBreast cancer patients undergoing chemotherapy via peripherally inserted central catheter often experience serious behavioral and psychological challenges, with uncertainty and cancer-related fatigue being prevalent issues that profoundly impact prognosis. Therefore, this study aimed to investigate the relationship between uncertainty and cancer-related fatigue by employing a chain mediation model to examine the potential mediating roles of psychological resilience and self-care.MethodsA cross-sectional study was conducted with 223 breast cancer patients receiving peripherally inserted central catheter chemotherapy at two tertiary affiliated hospitals of China Medical University in Liaoning, China, from February 2021 to December 2022. Participants completed self-reported questionnaires to assess uncertainty, psychological resilience, self-care, and cancer-related fatigue. The collected data were subsequently analyzed using Pearson’s correlation analysis, hierarchical regression analysis, and mediation analysis.ResultsUncertainty exhibited a significant positive correlation with cancer-related fatigue (p < 0.01) and a negative correlation with psychological resilience (p < 0.01) and self-care (p < 0.01). Uncertainty was found to impact cancer-related fatigue through three pathways: psychological resilience mediated the relationship between uncertainty and cancer-related fatigue (mediating effect = 0.240, 95% confidence interval: 0.188 to 0.298, effect ratio = 53.22%); self-care also mediated this relationship (mediating effect = 0.080, 95% confidence interval: 0.044 to 0.121, effect ratio = 17.74%); furthermore, there was a significant joint mediating effect of psychological resilience and self-care on the association between uncertainty and cancer-related fatigue (mediating effect = 0.042, 95% confidence interval: 0.021 to 0.068, effect ratio o = 9.31%).ConclusionThe findings of this study revealed that uncertainty not only directly influenced cancer-related fatigue, but also operated through the mediating effect of psychological resilience, self-care, and sequential mediation of psychological resilience and self-care. Interventions tailored for breast cancer patients receiving peripherally inserted central catheter chemotherapy should target these factors to help alleviate uncertainty, enhance psychological resilience, and improve self-care practices, thereby ameliorating cancer-related fatigue.

Knowledge of Patients Undergoing Chemotherapy toward Self Care in Kirkuk Center for Oncology and Hematology

Background: Cancer is a dangerous disease that may kill people. The vast majority of cancer patients get chemotherapy treatment. Several negative side effects of chemotherapy affect patients' physical, mental, and social well-being, which in turn affects their capacity to take care of themselves. Objectives: The main aim of the study is to determine the effectiveness of an instructional program on the knowledge of patients undergoing chemotherapy toward self-care. Methodology The current study used a one-group design and a quantitative pre-experimental methodology. First, baseline data was collected before the research sample was exposed to the educational program; second, data was collected immediately after the program was implemented for the research sample; and third, data was collected after the program had been implemented. From October 3, 2023, until May 5, 2024, researchers at the Kirkuk Center for Oncology and Hematology carried out the study. Patients' socio-demographic data (Part I), patients' clinical data (Part II), and patients' knowledge of self-care strategies (Part III) make up the research instrument. The research instrument's reliability was assessed using the internal consistency approach, and its validity was established by a panel of experts. Results: The study found statistically significant differences in three main areas of patients' self-care knowledge between the before and post-tests in the study group, with a p-value less than 0.05. Conclusion: According to the results of the research, chemotherapy patients' understanding was low before they started the program. Nonetheless, the educational program shown a remarkable ability to enhance patients' understanding of self-care practices throughout chemotherapy

Addressing the 2021 Essentials with new approaches for developing leadership, resilience, and self-care/well-being in undergraduate baccalaureate nursing students

IntroductionNew graduate nurses are not always prepared for the challenges of the chaotic clinical environment or to exercise leadership skills in a clinical capacity. Resilience and self-care are essential facets of successful leadership, as well as necessary components to prevent burnout in nurses. PurposeThe purpose of this article is to demonstrate how this School of Nursing implemented approaches to prepare the next generation of nurses with strong skills in the areas of leadership, resilience, and self-care/well-being while addressing the Essentials. MethodsFaculty explored new ideas, as well as showcased teaching strategies they had already successfully implemented, that aligned with the Essentials with the undergraduate baccalaureate pilot student cohort. ResultsTwo “Essential” Competencies, Domain 9 Professionalism and Domain 10 Personal, Professional and Leadership Development, as well as related sub-competencies, were addressed by the thirteen teaching strategies. Anecdotal student reflection comments supported high levels of satisfaction with these strategies. ConclusionsPreparing student nurses to meet the Essentials is critical to helping nurses thrive in contemporary practice settings. Equipping a generation of nurses with self-care practices to protect their own well-being, while at the same time meeting the Essentials expectations, is crucial to cultivating a sustainable nursing workforce.

Pregnancy Self-Care Gaps Between First-Time and Experienced Mothers in Iraq

This study explores self-care behaviors among primigravida and multigravida women in Holy Karbala City, focusing on managing minor pregnancy discomforts. Amidst hormonal changes that alter the maternal body, understanding and implementing effective self-care is pivotal for pregnant women's health. This descriptive quantitative research utilized a non-probability sample of 350 women across three trimesters, analyzed using SPSS version 26. Results indicate that self-care behaviors were moderate overall and similarly moderate concerning minor discomforts. A significant correlation was found between the women's self-care behaviors and their educational level, occupation, family type, gravidity, number of abortions, parity, and length of marriage, with respective p-values of .001, .002, .004, .001, .002, .008, .050, and .011. The findings highlight the necessity of targeted educational strategies to enhance self-care practices among pregnant women, addressing demographic and reproductive characteristics that influence these behaviors. Highlights: Moderate Self-Care: Both primigravida and multigravida women displayed moderate self-care for pregnancy discomforts. Correlation with Demographics: Self-care behaviors correlate significantly with education, occupation, and family type. Need for Education: Findings suggest enhancing educational programs to improve self-care among pregnant women. Keywords: Pregnancy Self-Care, Primigravida, Multigravida, Discomfort Management

Poor self-care practices and contributing factors among adults with type 2 diabetes in Adama, Ethiopia

Diabetes mellitus (DM) is a prominent global health challenge, characterized by a rising prevalence and substantial morbidity and mortality, especially evident in developing nations. Although DM can be managed with self-care practices despite its complexity and chronic nature, the persistence of poor self-care exacerbates the disease burden. There is a dearth of evidence on the level of poor self-care practices and contributing factors among patients with DM in the study area. Thus, this study assessed the proportion of poor self-care practices and contributing factors among adults with type 2 DM in Adama, Ethiopia. An institution-based cross-sectional study was conducted among 404 patients. Self-care practice was assessed by the summary of diabetes self-care activities questionnaires. Binary logistic regression was used to identify factors associated with poor self-care practices. An adjusted odds ratio with a 95% confidence interval was used to assess the strength of associations. The statistical significance was declared for a p-value < 0.05. The proportion of poor self-care practices was 54% [95% CI 49.1, 58.6]. Being divorced (AOR = 3.5; 95% CI 1.0, 12.2), having a lower level of knowledge (AOR = 1.70; 95% CI 1.0, 2.8), being on insulin (AOR = 6.3; 95% CI 1.9, 20.6), taking oral medication (AOR = 8.6; 95% CI 3.0, 24.5), being unaware of fasting blood sugar (AOR = 2.9; 95% CI 1.6, 5.2), not a member of a diabetic association (AOR = 3.6; 95% CI 1.7, 7.5), a lack of social support (AOR = 2.9; 95% CI 1.7, 4.9), and having a poor perceived benefit of self-care practices (AOR = 1.84; 95% CI 1.0, 3.2) were associated with poor self-care practices. Overall, this finding demonstrated that a significant percentage of participants (54%) had poor self-care practices. Being divorced, having a low level of knowledge about diabetes and fasting blood sugar, lacking social support, relying on oral medication, perceiving limited benefits from self-care practices, and not being a member of diabetic associations were identified as independent factors of poor self-care.

Exploring women's bladder self-care practices: A qualitative secondary analysis.

To describe women's experiences with a range of bladder self-care practices. We conducted a secondary, directed content analysis of qualitative data from the Study of Habits, Attitudes, Realities and Experiences, a multisite focus group study designed to explore adolescent and adult women's experiences, perceptions, beliefs, knowledge and behaviours related to bladder health. This study was conducted by the National Institute of Diabetes and Digestive and Kidney Diseases' Prevention of Lower Urinary Tract Symptoms Research Consortium. Study methods were informed by the Consortium's conceptual framework, based on a social ecological model adapted from Glass and McAtee's Society-Behavior-Biology Nexus. Participants were recruited at seven geographically diverse United States research centres between July 2017 and April 2018. Data for the current analysis were collected using a semi-structured discussion group with 36 focus groups involving 316 community-dwelling adult women aged 18-93 years. Coded text was re-examined according to eight self-care behavioural domains identified through literature review and expert opinion as potentially influencing bladder health. Participants described many self-care practices they had adopted to prevent bladder problems or manage existing symptoms and conditions. Eight themes were identified: 'Choosing fluids, foods and medications'; 'Dressing for bladder health'; 'Promoting bodily cleanliness'; 'Managing toileting environments'; 'Timing when to void'; 'Exercising pelvic floor muscles for bladder control'; 'Limiting physical activities that challenge the bladder' and 'Staying home and navigating when away'. Thirteen subthemes were derived from five of the eight themes. Women use a broad array of self-care practices related to their bladder health. Research is needed to examine the efficacy of self-care behaviours for preventing or managing bladder symptoms and conditions, and to discern potential risks. Results have important implications for development of bladder health promotion interventions and public health messaging around women's bladder health. This study provides a comprehensive framework for understanding women's bladder self-care practices, which can be used by clinicians and public health professionals in designing interventions to promote bladder health and function. Women with and without lower urinary tract symptoms use a broad range of self-care practices that may affect their bladder health, including some that may be harmful. Because of the high prevalence of bladder symptoms in women, this study may help patient assessment and counselling regarding self-care practices. This study was reported according to the Standards for Reporting Qualitative Research (SRQR). No patient or public contribution.