Self-care Behaviors In Patients Research Articles

The role of nurse-patient mutuality on self-care behaviours in patients with chronic illness.

To examine the role of nurse-patient mutuality on three self-care behaviours in chronic illness patients. A cross-sectional multi-centre study was conducted. Mutuality was measured with the Nurse-Patient Mutuality in Chronic Illness scale which has the dimensions of developing and going beyond, being a point of reference and deciding and sharing care, and self-care was measured with the Self-care of Chronic Illness Inventory (SC-CII). Multivariable linear regression analyses were used to assess the contribution of three dimensions of mutuality on self-care maintenance, monitoring and management behaviours controlling for patient gender, age, education, number of medications, and presence of a family caregiver. The sample included 465 inpatients and outpatients with at least one chronic illness. The three dimensions of mutuality had different roles in their influence on the three dimensions of self-care. Developing and going beyond was significantly associated with self-care maintenance and self-care monitoring behaviours. Point of reference was significantly associated with self-care maintenance behaviour. Deciding and sharing care was significantly associated with self-care monitoring and self-care management behaviours. The mutuality between nurse and patient may be a novel area of research to support and improve patient self-care behaviours with implications for clinical practice and education. Mutuality between nurse and patient increases patient engagement, symptom recognition, decision-making process and patient-centred approach favouring the development of self-care behaviours. Mutuality between nurse and patient is a new concept and its association with the patient outcomes could bring relevance to the nursing profession. Self-care behaviours are important in the management of chronic diseases, but are difficult to perform. Mutuality between nurse and patient influences the three different behaviours of self-care in chronic illness, for this reason it is important to increase the level of mutuality in this dyad. STROBE checklist for cross-sectional studies was followed in this study. Patients were involved in the sample of the study.

Status and Influencing Factors of Foot Care Behavior for Patients with Diabetic Foot Amputation: Across-Sectional Study.

This study aimed to investigate the contemporary status and influencing factors of foot self-care behavior in diabetic foot amputation patients. A total of 250 patients with diabetic foot amputation were included. The general information questionnaire, Chinese Version of the Nottingham Assessment of Function Footcare (CNAFF), Knowledge of Diabetic Foot Questionnaire, and The Third Version of the Diabetes Attitude Scale were used to investigate the status and influencing factors of foot self-care behavior in patients with diabetic foot amputation. From our sample, the Chinese version of Nottingham foot care behavior score was 68.32 ± 10.35 points, which showed that the foot self-care behavior of patients with diabetic foot amputation is at a medium level. Multiple linear regression analysis showed that education level, the knowledge of how to choose shoes and socks, the knowledge of self-care for feet, the need for special training in education, and the patient's autonomy in diabetes care were the main factors influencing foot self-care behavior of patients with diabetic foot amputation (P < 0.05). The total variation of CNAFF score was 49%. The results of this study show that the level of foot care of diabetic amputees must be improved, and medical staffs need to take targeted intervention measures to help patients improve their self-care behavior after amputation, thereby reducing the recurrence rate of diabetic feet and improving their quality of life.

The relationship between caregiver contribution to self-care and patient quality of life in heart failure: A longitudinal mediation analysis.

Patients with heart failure may experience poor quality of life due to a variety of physical and psychological symptoms. Quality of life can improve if patients adhere to consistent self-care behaviors. Patient outcomes (i.e., quality of life) are thought to improve as a result of caregiver contribution to self-care. However, uncertainty exists on whether these outcomes improve as a direct result of caregiver contribution to self-care or whether this improvement occurs indirectly through the improvement of patient heart failure self-care behaviors. To investigate the influence of caregiver contribution to self-care on quality of life of heart failure people and explore whether patient self-care behaviors mediate such a relationship. This is a secondary analysis of the MOTIVATE-HF randomized controlled trial (Clinicaltrials.gov registration number: NCT02894502). Data were collected at baseline and 3 months. An autoregressive longitudinal path analysis model was conducted to test our hypotheses. We enrolled a sample of 510 caregivers [mean age = 54 (±15.44), 24% males)] and 510 patients [mean age = 72.4 (±12.28), 58% males)]. Patient self-care had a significant and direct effect on quality of life at three months (β = 0.20, p < .01). Caregiver contribution to self-care showed a significant direct effect on patient self-care (β = 0.32, p < .01), and an indirect effect on patient quality of life through the mediation of patient self-care (β = 0.07, p < .001). Patient quality of life is influenced by self-care both directly and indirectly, through the mediation of caregiver contribution to self-care. These findings improve our understanding on how caregiver contribution to self-care improves patient outcomes.

Effect of psychosocial factors on autonomic nervous system activity in patients with heart failure.

Autonomic imbalance predicts worse clinical outcomes in patients with heart failure (HF). Managing the variables affecting heart rate variability (HRV) might improve the clinical outcomes of patients with HF. This study aimed to investigate variables affecting HRV. We assessed autonomic nervous system activity (low-frequency [Lf], high-frequency [Hf], and Lf/Hf ratio) in 60 patients with HF, employing standard measures to capture short-term HRV. To estimate the independent effects of variables such as well-known cardiac risk factors and psychosocial conditions on HRV, multivariate analyses were conducted. For psychosocial variables, we assessed depression and quality of life in patients and their family caregivers. We also assessed the self-care behavior of patients and their caregivers' burden. Depression in family caregivers and self-care behavior of patients were independently associated with a decreased Hf (β-coefficient = 0.309, P = .039 and β-coefficient = -0.029, P = .047, respectively). Depression of family caregivers and self-care behavior of patients may affect HRV in patients with HF.

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.

Validity and reliability of the English version of the Diabetic Foot Self-Care Questionnaire: a cross-cultural adaptation.

The objective of this study was to carry out the cross-cultural adaptation and validation of the Diabetic Foot Self-Care Questionnaire into the English language, broadening the applicability of this patient-reported outcome measure and improving the monitoring of patients with diabetic foot disease. The validation study into English was conducted in two phases: cross-cultural adaptation and psychometric validation study. Short Form-12 Version 2, EuroQoL-5D and Foot Function Index were used to analyze the criterion validity. Item response, internal consistency, standard error of measurement, minimal detectable change and construct validity were calculated in the validation phase. An English version of the questionnaire (DFSQ-UMA-En) was successfully obtained. A total of n = 193 participants were tested to confirm the validity and reliability of the questionnaire. Internal consistency values ranged from very good to excellent (Cronbach's α =0.889-0.981), and reliability was excellent (ICC = 0.854-0.959). Standard error measurement value was =2.543. Criterion validity ranged from r = 0.429 to r = 0.844. For construct validity, Kaiser-Meyer-Olkin test was =0.752. DFSQ-UMA-En is a valid and reliable tool with good readability and comprehension features. This questionnaire addresses foot self-care behaviors in patients with diabetic foot disease, standing out as essential for early diagnosis and prevention strategies in clinical and research settings.

Description of self-care behaviours in patients with non-valvular atrial fibrillation on oral anticoagulant therapy: A scoping review.

The primary aim of this scoping review was to explore and categorise the medication-related self-care behaviours exhibited by patients with non-valvular atrial fibrillation (NVAF) who are on oral anticoagulant (OAC) therapy. A scoping review was performed, and the systematic search of the literature yielded an initial 887 records. After deduplication and screening, 61 studies were included in the analysis, ranging from 2003 to 2023. The studies represented a wide geographical distribution and diverse methodologies. The results identified 16 self-care behaviours: a higher focus of the included literature on self-care monitoring (60.65% of studies), followed by self-care management and self-care maintenance (each 16.39%). These behaviours ranged from regular blood testing to consulting healthcare providers and lifestyle changes. The results also highlighted the relationship between treatment satisfaction, self-efficacy, and adherence. Several studies emphasised the critical role of healthcare providers in influencing medication adherence. Furthermore, patient knowledge, quality of life, and psychological factors were identified as key elements affecting self-care behaviours. The review provides a comprehensive landscape of medication-related self-care behaviors among NVAF patients on OAC therapy. It underscores the predominance of self-care monitoring behaviours and the critical roles of healthcare providers, psychological factors, and patient knowledge in influencing these behaviours. The findings also highlight the necessity for an integrated, patient-centred approach to improving self-care and self-management in OAC treatment. Future research should focus on addressing the identified gaps, including the relative lack of studies on lifestyle modification, emotional well-being, and technology-assisted interventions. This review is part of a broader project and is documented at ClinicalTrials.gov (NCT05820854).

Prevalence and predictors of poor self-care behaviors in patients with chronic heart failure

Despite the indispensable role of self-care behavior in managing heart failure, the practice of self-care behavior remains poor, especially in developing countries. There is a scarcity of research focusing on poor self-care behavior and its determinants within our specific context. Therefore, the objective of this study was to investigate the prevalence and predictors of poor self-care behavior among ambulatory heart failure patients. A facility-based cross-sectional study was conducted at a tertiary care hospital in Ethiopia, involving patients with heart failure. We utilized the European Heart Failure Self-Care Behavior Scale (EHFScBS-9) to evaluate adherence to self-care behaviors. Data were gathered through patient interviews and a review of medical records. A binary logistic regression analysis was performed to identify predictors of poor self-care behavior in heart failure patients. We included a total of 343 participants in the final analysis of this study. The findings revealed that a majority of the patients (73.8%) demonstrated poor overall self-care behavior. Specifically, the majority of patients did not engage in regular exercise (76.1%), failed to consult doctors in case of rapid weight gain (75.6%), did not monitor weight daily (71.5%), did not restrict fluid intake (69.9%), and did not contact doctors in case of experiencing fatigue (68.6%). Additionally, 32.4% of patients did not reach out to doctors when experiencing shortness of breath, 30% did not restrict salt intake, 29% did not adhere to prescribed medication, and only 7% did not consult doctors if edema occurred. Our findings indicated that rural residence (AOR: 5.76, 95% CI: 2.47–13.43), illiteracy (AOR: 2.64, 95% CI: 1.52–6.31), prior hospitalization (AOR: 2.09, 95% CI: 1.21–3.61), and taking five or more medications (AOR: 1.83, 1.01–3.33) were significant predictors of poor self-care behavior. In conclusion, a majority of the participants in our study demonstrated poor self-care behavior. Risk factors for this behavior included rural residence, illiteracy, prior hospitalization, and taking five or more medications. Therefore, it is crucial to prioritize these high-risk patients and implement interventional programs aimed at improving self-care behaviors and overall treatment outcomes in heart failure patients.

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.

Design and validation of a Questionnaire on the factors influencing self-care behaviors in patients with Multiple sclerosis (QFASMS)

BackgroundMultiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system (CNS). Since MS does not have a definitive cure, individuals affected by it need to adapt and coordinate with their chronic illness in order to fulfill their duties and responsibilities. The first step in helping patients to better care for and manage their illness is to engage in self-care behaviors. This study was conducted with the aim of design and validation of a questionnaire on the factors influencing self-care behaviors in patients with Multiple sclerosis.MethodsThis cross-sectional study was conducted on Multiple sclerosis patients in Iran in 2023. The age range of patients varied between 22 and 52 years. Having MS disease, passing one year of the disease duration, living in Mashhad city, having informed consent to participate in the study and not completing the questionnaire were the entry and exit criteria of the study.ResultsThis study was conducted on 500 patients with multiple sclerosis. Based on the results of psychometrics (face, content and construct validity), the number of questions was reduced from 120 to 47 questions and 73 questions were eliminated. Finally, the questionnaire was approved with 47 questions and 4 subscales of understanding the symptoms of the disease (9 questions), tendency to conscious and targeted care (21 questions), laziness in care (8 questions) and tendency to receive therapy services (9 questions). Cronbach's alpha and McDonald's omega index for all questionnaire questions were 0.877 and 0.881, respectively.ConclusionsBased on the results of this questionnaire, 47 questions and 4 subscales can be used to measure the factors influencing the adoption of self-care behaviour’s in patients with multiple sclerosis.

The Influence of Social Support on Self-Care Behavior among T2DM Patients.

T2DM is a chronic health condition that requires routine self-care. Despite T2DM patients being able to manage self-care behaviors, psychosocial factors, including social support, have been considered effective in improving diabetic self-care behaviors. This study aimed at examining the influence of social support on self-care behavior among T2DM patients in Dr. Soliaman Fakeeh Hospital. This was a cross-sectional study. The study was carried out at Dr. Soliaman Fakeeh Hospital using a sample size of 192 T2DM patients. Data were collected using a self-administered questionnaire comprised of a demographic section, the Scale of Perceived Social Support (MSPSS) section, and the Diabetes Self-Care Activities Questionnaire (DSCAQ) section. The data were analyzed using descriptive statistics and inferential statistics. The study analyzed data from 192 complete responses (91.86%) out of 209 respondents. Regarding gender, most of the respondents were female T2DM patients (n = 103, 53.6%), while males (n = 89, 46.4%) The highest level of social support was from the family (mean of 5.49). The highest performing self-care activity performed by the respondents was blood glucose monitoring (mean of 6.01). Analysis of the correlation between the Scale of Perceived Social Support (MSPSS) and the DSCAQ revealed positive and significant correlations (r = 0.370, p = 0.001). This study showed that social support influenced self-care behaviors in patients with T2DM. Therefore, interventions should be developed focused on enhancing the levels of social support and self-care behaviors.

Effectiveness of Acceptance and Commitment Based Group Therapy with the Islamic Approach on Diabetes Control and Increasing Self-Care Behaviors in Patients with Type II Diabetes in Yazd province.

Objective: The purpose of this study was to investigate the effectiveness of acceptance and commitment based group therapy (ACT) with the Islamic approach to diabetes control, increasing self-care behaviors in patients with type II diabetes mellitus (T2DM) referent to the Yazd Diabetes Research Center.&#x0D; Materials and Methods: The study method was semi experimental with control group. For this purpose, 40 diabetic patients were randomly divided into two experimental and control groups. The study was in Yazd diabetes research center. The purposeful sampling method was done. So, all of the patients did the A1C hemoglobin test, and completed the self-care questionnaire for diabetic patients (SDSCA). Then, the experimental group received ACT with an Islamic approach during 16 weeks. The population of both groups performed the A1C Hemoglobin test and completed the self-care questionnaire again after performing the instructional plan. In this research, the covariance analysis test was done to analyze the results.&#x0D; Results: The findings of the research showed that ACT group therapy with an Islamic approach effects on HbA1c decreasing (P: 0.001) and self-care behaviors improvement (P: 0.001) in T2DM patients.&#x0D; Conclusion: This study showed that the treatment group based on commitment resulted in a significant reduction of HbA1 and a significant increase in self-care activities in patients with T2DM.

Effectiveness of Nurse-led Educational Interventions on Glycemic Control and Self-care Behaviors of Type 2 Diabetics: A Systematic Review

Background: Blood glucose control is challenging for patients with diabetes and is often associated with self-care behaviors. The effectiveness of nurse-led educational interventions for glycemic control and self-care behaviors in patients with type 2 diabetes is unclear.Objective: To determine effectiveness of nurse-led educational intervention on glycemic control and self-care behaviors in patients with type 2 diabetes.Design: Mixed methods systematic review.Data Sources: A comprehensive search in Medline, CINAHL and Scopus was conducted in February 2023 to identify peer-reviewed papers published between 2003 and 2023.Review Methods: The review was guided by the Joanna Briggs Institute systematic review manual. Data were extracted and assessed by two evaluators using a standardized checklist. Due to the high level of heterogeneity between studies, the data were analyzed using Popay et al.'s (2006) conduct of narrative synthesis in systematic reviews.Results: Ten randomized controlled trials met the inclusion criteria. Studies described nurse-led educational interventions delivered either face-to-face or online. The outcomes of the educational interventions and the measurement tools used were diverse, with many studies reporting attrition. Most studies reported that nurse-led educational interventions improved outcomes for patients with type 2 diabetes.Conclusions: The evidence identifies that nurse-led educational interventions are effective for glycemic control and self-care behaviors in patients with type 2 diabetes. This review demonstrates evidence of approaches that could inform future practice and research to support all adult populations of patients with type 2 diabetes to improve glucose control and self-care behaviors. Future research would benefit from well-designed clinical trials that use common outcome measures to provide more information about the effectiveness as well as the sustainability of such interventions.

Self-care Behavior Based on Integrated Behavioral Model in Patients With Atrial Fibrillation: A Structural Equation Modeling Approach.

There is limited research exploring the behavioral intentions, beliefs, and application of theoretical models in relation to self-care in patients with atrial fibrillation (AF). This study aimed to identify the factors that influence self-care behavior in patients with AF. The study used an integrated behavioral model and collected data from 216 patients diagnosed with AF. Data were analyzed using SPSS 24.0 and AMOS/WIN 24.0 to verify the fit of the hypothesis model, confirm factor analysis, and the validity of the hypothesis itself. Self-care behavioral intention (β = 0.433, p < .001) and habit (β = 0.395, p = .005) had a significant direct effect, while instrumental attitude (β = 0.077, p = .045), injunctive norm (β = 0.084, p = .037), and self-efficacy (β = 0.249, p = .011) had a significant indirect effect on self-care behavior, explaining 64.4% of the variance. The final model validated the factors that impact self-care behavior in patients with AF, highlighting the importance of fostering positive recognition of instrumental attitude, bolstering social influence and self-efficacy through significant individuals to improve self-care behavior. It is recommended to create an intervention program that encourages intentions and motivations for self-care behavior and incorporates tactics to make self-care behavior a habit. The study's path diagram can serve as a conceptual framework for designing strategies to enhance self-care behavior in patients with AF.

Mediators of the Association Between Cognitive Function and Self-care Behaviors in Patients Hospitalized With an Exacerbation of Heart Failure

Background Patients with heart failure (HF) must engage in self-care, yet their self-care is often poor. Cognitive function commonly is impaired in HF and is associated with poor self-care. Heart failure knowledge and self-care confidence also are needed to preform self-care. Few investigators have examined mediators of the association of cognitive function with self-care. Objectives The aim of this study was to determine whether HF knowledge and self-care confidence mediated the association of cognitive function with self-care maintenance and management among patients with HF. Methods This was a cross-sectional observational study of 164 patients with HF. Cognitive function was assessed using the Montreal Cognitive Assessment. Self-care maintenance and self-care management behaviors and self-care confidence were measured using the Self-care of Heart Failure Index. Heart failure knowledge was measured using the Dutch Heart Failure Knowledge Scale. We conducted 2 parallel mediation analyses using the PROCESS macro in SPSS, one for self-care maintenance and one for self-care management. Results Cognitive function was indirectly associated with self-care maintenance through HF knowledge (indirect effect, 0.54; 95% confidence interval, 0.10–1.02) and self-care confidence (indirect effect, 0.26; 95% confidence interval, 0.04–0.54). Those with better cognitive function had more HF knowledge and self-care confidence. Better cognitive function was not directly associated with self-care management but indirectly associated with better self-care management through higher self-care confidence (indirect effect, 0.50; 95% confidence interval, 0.04–1.05). Conclusions Both HF knowledge and self-care confidence mediated the association of cognitive function with self-care maintenance, and only self-care confidence mediated the association between cognitive function and self-care management. Interventions targeting HF knowledge and self-care confidence may improve self-care even for those with lower cognitive function and need to be developed and tested.

Analysis of self-care behaviors in patients with arteriovenous fistula

Analysis of self-care behaviors in patients with arteriovenous fistula

Effect of telemedicine on self-care in heart failure patients: insights from the iCOR randomised controlled trial

Abstract Background/introduction Poor self-care in heart failure (HF) patients is well recognised to lead to a worse prognosis, through an increased risk of readmissions and mortality. In this regard, the integration of eHealth-based telemonitoring and tele-intervention tools into integrated HF-care programmes could help to improve the self-care of these patients. Nevertheless, the current evidence regarding the impact of eHealth solutions on the self-care of HF patients is scarce. Purpose To evaluate the effect of telemedicine (TM) on self-care behaviour in patients with HF after hospital admission compared to usual care (UC). Methods We designed a post-hoc analysis of the "Insuficiència Cardíaca Optimització Remota" (iCOR) study focussing on self-care. iCOR was a randomised, controlled, single-centre proof-of-concept clinical trial, designed to evaluate the efficacy to adding a eHealth-solution to an existing specialised, comprehensive, multidisciplinary, nurse-based, hospital/primary care integrated HF management programme. Participants were randomised to TM or UC after hospital discharge ("vulnerable-phase") and were followed for 6 months. The primary study endpoint of the current analysis was the delta change of self-care after 6 months of follow-up, assessed using European Heart Failure Self-care Behaviour Scale-12 item (EHFScBS-12 item, lower scores meaning better self-care). To assess the change in self-care between the 2 groups, a repeated-measures ANOVA analysis was performed, adjusted for baseline self-care. Results 178 patients were analysed (81 TM vs 97 UC). The median age of the patients was 74±11 years, 41% were female and the median ejection fraction was 47±17%. Self-care at baseline had a median score of 21.6±10.5 points. As shown in Figure 1, there were no differences in baseline values of self-care between the two comparison groups (21.9±11 TM vs 21.5±11 UC, p-value &amp;gt; 0.05). Both groups experienced an improvement in self-care over time (p-value 0.002 for time effect). However, patients in the TM group experienced greater improvement (from 21.9±11 to 14±0.7 mean Delta change = -7.9±11) than in the UC (21.3±10.5 to 19±0.7, mean delta change = -2.2±10.4, p-value &amp;lt;0.001 in inter-groups comparison) (Figure 1). We designed several multivariate linear regression models exploring the determinants of self-care at baseline and the determinants of change in self-care over time. As shown in Table 1, baseline self-care and randomisation arm were the only independent predictors of improvement of self-care over time. Conclusions Integration of TM into HF care programs can contribute to further improve self-care and thus empowerment in the HF-management.Self-care status changeDeterminants of self-care

Development of the ‘ACT now & check-it-out’ intervention to support patient-initiated follow up for Head and Neck cancer patients

ObjectiveCurrent Head and Neck cancer (HNC) follow-up models are considered sub-optimal at detecting recurrences. We describe the development of a patient-initiated follow up (PIFU) trial intervention support package, to support HNC patients to engage in PIFU self-care behaviors. MethodsAn intervention mapping approach, informed by evidence synthesis, theory and stakeholder consultation, guided intervention development. Data sources included a patient survey (n = 144), patient interviews (n = 30), 7 workshops with patients (n = 25) and caregivers (n = 3) and 5 workshops with health professionals (n = 21). ResultsThe intervention (‘ACT now & check-it-out’) comprises an education and support session with a health professional and an app and/or a booklet for patients. The main targets for change in patient self-care behaviors were: assessing what is normal for them; regularly checking for symptom changes; prompt help-seeking for persistent/new symptoms; self-management of fear of recurrence; engaging with the intervention over time. ConclusionsWe have developed an evidence, person and theory-based intervention to support PIFU self-care behaviors in HNC patients. Practice implicationsA trial is underway to assess the effectiveness and cost-effectiveness of the intervention. If successful, this intervention could be adapted for patients with other cancers or diseases, which is important given the recent shift towards PIFU pathways.

Improving medication adherence of patients with heart failure using tele-motivational interviewing.

The patient's self-care behavior encompasses various aspects, including medication adherence, which has been identified as a significant concern in the context of heart failure. To encourage patients in their medication, tele-motivational interviewing can be used. The main aim of this research is to examine the effects of tele-motivational interviewing on medication adherence in individuals who have been diagnosed with heart failure. In this research, an experimental pretest-posttest design with a control group was chosen. The study involved the implementation of tele-motivational interviewing, which spanned a duration of two months, with interventions taking place on a weekly basis. To measure medication adherence, the Morisky Medication Adherence Scale (MMAS-8) was employed. In a randomly selected sample of 176 respondents, half were assigned to the experimental group (n=88), and the other half were assigned to the control group (n=88). Pre-test medication adherence levels for the experimental group indicate that 68 respondents (77.2%) fall into the low category (score >2), whereas post-test medication adherence levels for the same group indicate that 55 respondents (62.5%) fall into the highest category (score 0). The Wilcoxon Signed Rank Test demonstrates the p-value to be less than 0.001. Tele-motivational interviewing as a skill in education that supports the patients directly and continuously by monitoring during treatment by telephone, gradually changes and affects the patients' behavior. Hence, the utilization of tele-motivational interviewing presents a viable approach for enhancing medication adherence in individuals diagnosed with heart failure.

Cross-Cultural Adaptation and Validation of the Revised Brief Diabetes Knowledge Test (DKT2) in Individuals With Type 2 Diabetes Mellitus and Their Caregivers.

The purpose of the study was to develop an Italian version of the Revised Brief Diabetes Knowledge Test (DKT2), providing a cultural and linguistic validation supported by psychometrics and hypotheses testing. This multimethods study was divided into 4 phases: (a) cultural-linguistic validation, with a translation and back-translation process; (b) confirmatory factor analysis (CFA) considering the original scale's structure (knowledge and insulin-specific knowledge); (c) criterion validity via hypotheses testing; and (d) cross-group measurement invariance. The internal consistency reliability was assessed by the Kuder-Richardson Formula 20 (KR-20) of the overall scale. A total of 251 patients and 251 caregivers were enrolled. The CFA showed good goodness of fit for both patients and caregivers. The tested hypotheses supported criterion validity in both groups. Reliability was adequate: All KR-20 values in both groups and domains were higher than 0.60. The mean percentage of knowledge score on DKT2 was lower for patients than caregivers. The DKT2 is a valid and reliable scale to assess overall knowledge of diabetes, considering its role in promoting appropriate self-care behaviors in patients with type 2 diabetes mellitus. The Italian version of DKT2 demonstrated reliability and validity, and it can be used by researchers and diabetes care and education specialists to assess a patient's or population's overall knowledge of diabetes.