Self-care Behaviors Research Articles

The Effect of Family-Centered Empowerment Program on Husbands' Understanding of Illness, Perceived Stress and Self-care Behaviors of Type 2 Diabetes Patients

Background: Comprehensive support from individuals with whom one has a deep emotional connection can significantly improve the management of life's stresses. Objectives: This study aims to investigate the impact of a family-oriented empowerment program for husbands on the illness understanding, perceived stress, and self-care behaviors of patients with type 2 diabetes. Methods: In this semi-experimental study, 72 spouses of diabetic patients who met the inclusion criteria were randomly selected and divided into intervention and control groups. The intervention group received an educational program based on the family-centered empowerment model, which consisted of six 60-minute training sessions over six consecutive weeks. The control group received usual care. Data were collected using questionnaires on self-care behaviors, disease understanding, and perceived stress, administered before, immediately after, and three months after the intervention. Data were analyzed using independent t-tests, paired t-tests, and repeated measures ANOVA. Results: There were no significant differences between the intervention and control groups in terms of demographic characteristics and baseline variables (P = 0.11). The Mann-Whitney test revealed significant differences between the two groups in terms of disease understanding, perceived stress, and self-care behaviors after the intervention (P < 0.001). The independent t-test confirmed significant changes in the mean scores for disease perception, perceived stress, and self-care behaviors between the two groups (P < 0.001). Conclusions: The results indicate that a family-centered empowerment program can enhance illness understanding, reduce perceived stress, and improve self-care behaviors among the spouses of diabetic patients. Given the increasing prevalence of diabetes, incorporating such programs into nursing care plans is recommended.

Assessing the Status of Self-care Behavior in Patients with Type 2 Diabetes in Binzhou City: A Cross-sectional Study

Worldwide, diabetes is a silent epidemic that claims 4.2 million lives worldwide each year. Experts predict that by 2045, one in 10 people will be affected by the disease. In China, with the change of lifestyle in recent years, the number of obese and overweight people is increasing, and the incidence of diabetes is also rising year by year, which makes the health education of diabetic patients particularly important. The purpose of this study was to assess self-care behavior and its influencing factors. This study is an analytical cross-sectional study. Data will be collected through questionnaires. Participants will be divided into two groups based on the questionnaire results: high adherence and low adherence. In this group of questionnaires, the Chinese version of the Diabetes Self-care Questionnaire (DSMQ) (r>0.60, Cronbach’s alpha=0.764) will be used, and another questionnaire which will determine the influencing factors will be designed by the author . The convenience sampling method will be used to select the survey objects. The minimum sample size for this study will be 384. Of the 377 participants,171 (45.36%) were female and 296 (54.64%) were male. The mean HbA1C was 8.807%±3.975%. The average BMI was 22.198±2.940kg. The self-care behavior score of the subjects was 4.368±2.388, which was in the sub-optimal nursing level.

Addressing emotional distress to improve outcomes in adults with type 1 diabetes: Protocol for ACT1VATE randomized controlled trial

BackgroundDiabetes distress (DD) is a prevalent concern among people with type 1 diabetes (T1D) and is linked to poor clinical outcomes. Instead of targeting the elimination of DD, we propose a novel approach that empowers individuals with strategies to manage their diabetes effectively in the context of DD: Acceptance and Commitment Therapy (ACT). The purpose of this in-progress trial is to compare an ACT group intervention (ACT1VATE) with usual care in improving HbA1c, DD, quality of life, and cost-effectiveness in adults with T1D. MethodsThis is a two-arm, parallel group, randomized controlled superiority trial enrolling N = 250 adults with T1D, elevated HbA1c, and significant DD in a real-world community-based health system. Participants are randomized to receive ACT1VATE (a five-week ACT group telehealth intervention) or diabetes self-management education and support (usual care as the first-line recommended intervention for DD). The trial will examine comparative effectiveness in improving HbA1c, DD, quality of life, and cost-effectiveness over 12 months. DiscussionWe predict that ACT1VATE will be superior given its (1) specific focus on DD, without any expectation that difficult diabetes-related thoughts and emotions must (or can) be completely eliminated; and (2) purposeful linkage of diabetes self-care behaviors to an individual’s deeply held values, thus eliciting intrinsic, patient-centric motivation for meaningful and lasting health behavior changes. This trial will provide a valuable test of real-world effectiveness, drive sustainability and scalability, and inform the future of chronic disease care.Trial registration: NCT04933851 (https://clinicaltrials.gov/ct2/show/NCT04933851).Clinical Trial: Clinicaltrials.govNCT04933851https://clinicaltrials.gov/study/NCT04933851

Development and psychometric evaluation of the self-care of informal caregivers inventory

BackgroundIn recent years, a growing body of literature on informal caregivers’ health and well-being has emerged, highlighting the need for a tool to measure their self-care practices. ObjectiveThe aim of the study was to develop a theory-based instrument measuring the self-care behaviors of informal caregivers and test its psychometric properties. DesignThe initial phase of instrument development entailed a detailed, six-step process (conceptualization, theoretical adaptation, back-translation and cultural adaptation, cognitive interviewing, item enhancement, and content validity), followed by formal psychometric testing (participant engagement, validity, internal consistency reliability, test-retest reliability). SettingStudy conducted at a hospital located in Tehran, Iran. ParticipantsA sample of 234 informal caregivers of cancer outpatients receiving treatment in oncology wards was enrolled. Caregivers had to be 18 years or older, recognized as the primary caregiver by the patient, and willing to provide informed consent. MethodsThe Self-Care of Informal Caregivers Inventory items comprise three dimensions: self-care maintenance (11 items), self-care monitoring (7 items), and self-care management (9 items), which achieved a content validity index rating of 100 % in a panel of experts. Data were collected from caregivers during routine clinic visits. Construct validity was verified through exploratory structural equation modelling and reliability was verified using Cronbach's α and multidimensional model-based reliability. Test-retest reliability was evaluated using the Intraclass Correlation Coefficient. ResultsAll three dimensions showed good model fit indices (self-care maintenance: Comparative Fit Index = 1.00, Tucker-Lewis Index = 0.99, Root Mean Square Error of Approximation = 0.044; self-care monitoring: Comparative Fit Index = 1.00, Tucker-Lewis Index = 1.00, Root Mean Square Error of Approximation = 0.027; self-care management: Comparative Fit Index = 0.99, Tucker-Lewis Index = 0.99, Root Mean Square Error of Approximation = 0.048) and Cronbach's α of 0.88, 0.88, and 0.91, respectively. The overall multidimensional model-based reliability was 0.93. The Intraclass Correlation Coefficient values for the three dimensions were 0.94, 0.60, and 0.51, respectively. ConclusionPreliminary testing provides support for use of the Self-Care of Informal Caregivers Inventory in research. Using this theory-based instrument to assess the self-care practices of informal caregivers can assist in identifying topics to discuss and opportunities for guidance. Tweetable AbstractThe Self-Care of Informal Caregivers Inventory: A validated tool for informal caregivers is useful for research. #Informalcaregivers #SelfCare

Transcultural adaptation and theoretical models validation of the Spanish version of the Self-Care of Diabetes Inventory.

For patients with diabetes mellitus, self-care is crucial because it prevents complications and helps preserve quality of life. Clinicians and researchers require effective tools for assessing self-care behaviors across various dimensions to identify individual needs and maximize resource allocation. The aim of this study was to evaluate the validity and reliability of the Spanish version of the Self-Care of Diabetes Inventory (SCODI). Two hundred eighteen participants with DMT1 and DMT2 who were recruited through convenience sampling from a university hospital participated in our cross-sectional study. After translation and cultural adaptation, the enrolled patients answered the questions. We performed an exploratory factor analysis (EFA) on each of the SCODI scales and Confirmatory factor analysis (CFA) was performed using our models which appropriate fit indices. The original structure of the four-dimensions tool was confirmed. The overall consistency across the four scales was assessed by Cronbach's alpha: self-care maintenance (0.766), self-care monitoring (0.790), self-care management (0.771), and self-care confidence (0.936). The model fit yielded a chi-square index of 1.028 with 773 degrees of freedom. Confirmatory factor analysis showed a good fit, thereby affirming the reliability of the model. The internal consistency and reliability of the SCODI Spanish version are deemed adequate. This tool is appropriate when it is desired to evaluate the self-care practices of Spanish persons suffering from diabetes due to its good psychometric qualities.

Factors influencing preventive self-care behaviors to avert Diabetes Mellitus among Thai Buddhist Monks, Thailand: A Cross-sectional Study

A cross-sectional study was conducted to investigate factors related to self-care behavior for diabetes mellitus prevention among 393 Thai Buddhist monks in the upper northeastern region of Thailand. Data were collected using questionnaires and analyzed using descriptive statistics, including percentages, means, minimums, maximums, and standard deviations. Relationships between factors related to self-care behaviors among Buddhist monks were analyzed using bivariate analysis (chi-square test) and multivariate analysis (binary logistic regression). The findings demonstrated that significant factors included age under 35 years (AOR=5.34, 95% CI=2.02-14.14), eating two meals per day (AOR=2.99, 95% CI=1.33-6.76), self-management (AOR=6.51, 95% CI=3.52-12.02), access to health information and health services (AOR=0.26, 95% CI=0.15-0.47), and making correct health decisions (AOR=1.98, 95% CI=1.04-3.78). These factors were significantly related to self-care behaviors among Buddhist monks (p < 0.05). The study concludes that improving health literacy among Thai Buddhist monks, particularly those under 35 years of age, is crucial for effective T2DM prevention. Targeted health education programs can significantly enhance their self-management skills, enable them to make informed health decisions, and encourage the adoption of better self-care and consumption behaviors.

Self-Care Activities Among Diabetic Patients in an Urban Health Centre in Thirumazhisai, Tamil Nadu: A Cross-Sectional Study.

Background Diabetes is a long-term medical condition characterized by consistently high blood glucose levels, which can be attributed to both genetic and environmental factors. Global diabetes prevalence is predicted to reach 10.4% by 2040, impacting over 642 million people. Diabetes is becoming more common in India; by 2030, an estimated 87 million individuals are predicted to have the disease. Self-care activities are essential for managing diabetes, yet adherence to these practices is often low in developing countries like India due to socioeconomic, cultural, and healthcare barriers. Objective In this study, the self-care practices of diabetic patients who visited an Urban Health Center in Thirumazhisai, Tamil Nadu, were assessed, along with the factors influencing these practices. Methods A three-month cross-sectional study was conducted in a facility with 200 type 2 diabetic patients who had been unwell, for a minimum of a year. The participants were selected via purposeful sampling, and interviews were conducted using the most recent version of the Summary Diabetes Self-Care Activities (SDSCA) questionnaire. The data was analyzed using SPSS version 26 (IBM Corp., Armonk, NY, USA) to discover connections between the duration of diabetes and self-care practices using descriptive statistics and chi-square tests. Results The study found that 136 (68%) of participants tested their blood sugar levels at least once in the preceding three months, 104 (52%) exercised for at least 30 minutes each day, and 96 (48%) of individuals maintained a balanced diet. On the other hand, adherence to insulin injections and oral hypoglycemic medications was lower, at 98 (49%) and 79 (39.5%), respectively. Foot hygiene was also not at its best; only 85 (42.5%) people washed their feet daily. Considerable correlations have been shown between the length of diabetes and particular self-care behaviors, including eating patterns, exercise routines, and foot hygiene. Conclusion The results emphasize the necessity of focused interventions, especially in developing nations, to enhance diabetic patients' self-care behaviors.Tailored, patient-centered strategies are essential to address the complex factors influencing diabetes management, ultimately improving glycemic control and patient outcomes.

Negative Self-Care Behaviours Among Diabetic Patients Bukittinggi, Indonesia

Diabetes mellitus is a chronic multifactorial endocrine disorder that affects approximately 5-10% of adults worldwide. In Indonesia, approximately 10.8 million people, which accounts for 10% of the population, suffer from diabetes. The current treatment considered suitable for diabetes management involves self-care management. Self-management plays a crucial role in achieving blood sugar control, reducing complications, improving quality of life, and lowering hospitalization rates. Negative self-care behaviors frequently observed among diabetes patients include consuming high-fat foods, sugary snacks, non-adherence to diabetes diet protocols. These unhealthy habits make it more difficult to regulate one's own health, which increases the risk of morbidity and death, uncontrolled blood sugar levels, and a decline in quality of life. The purpose of this study is to identify poor self-care practices among type 2 diabetes patients in the Bukittinggi health facilities' service region. Using a deliberate sample technique, a qualitative descriptive study was carried out in seven operational regions of the community health clinics in Bukittinggi, Indonesia. Participants were interviewed in semi-structured interviews, and a chollezi was used to analyze the data. There were 15 people in all, ages 30 to 69, who participated in this study. The participants had been diagnosed with diabetes for a duration of 2 to 21 years. The study identified four themes: unhealthy dietary behaviors, poor medication adherence, preference of unstandardized based herbal medicine, and surrender to Diabetic. Future research should focus on developing appropriate interventions and health promotion strategies

Effect of the Theory-driven Educational Intervention on Self-Care Behavior and Glycosylated Hemoglobin Level in Patients with Type 2 Diabetes.

The diabetics' lack of knowledge about self-care and incorrect beliefs in this care are the reasons for their admission to hospitals. The present study aimed to examine the impact of education based on the theory of planned behavior (TPB) on intention, self-care behavior, and glycosylated hemoglobin (HbA1c) levels in patients with Type 2 Diabetes. The present study was conducted on 60 diabetic patients who were randomly classified into intervention and control groups. In the intervention group, self-care education based on TPB was held, but the control group only received routine care. The data were collected using a fourpart questionnaire including characteristics, items of patients' knowledge, items of TPB constructs, and items of diabetes self-care. Data were analyzed in SPSS software. In intervention group, mean score of self-care behavior and its domains significantly changed from (total: 52.26±14.75, diabetic diet: 22.20±6.05, exercise: 5.17±4.04, blood sugar testing: 5.03 ± 4.15, medication: 5.40±2.28, foot care: 13.47±8.42) into 76.66±8.87, 29.43±5.48, 7.60±2.60, 8.73±2.31, 6.48±1.09, 23.53±3.09, respectively three months after intervention (p<0.01). In this case, these changes were not seen in the control group. The mean level of HbA1c in the intervention group (6.38±0.16) was significantly lower than before the intervention (7.56±1.08) and the control group (8.02±0.25) three months after intervention (p<0.01). Education based on the TPB was effective in improving the patients' self-care behavior and HbA1c index. Therefore, we suggest all medical centers to use the TPB as an effective and low-cost educational approach to improve diabetics' self-care behavior and health.

Effect of patient-centered self-management intervention on glycemic control, self-efficacy, and self-care behaviors in South Asian adults with type 2 diabetes mellitus: A multicenter randomized controlled trial.

This study aimed to test the efficacy of patient-centered self-management intervention (PACE-SMI) to improve HbA1c, self-efficacy, and self-care behaviors in adults with type 2 diabetes mellitus (T2DM). In this multicenter, parallel two-arm randomized controlled trial, 612 adults with T2DM and HbA1c ≥ 7% were enrolled and assigned to the control group (n = 310) and the intervention group (n = 302) using stratified permuted block randomization. The control group received usual care, whereas the intervention group received usual care plus nurse-led, theory-driven, culturally tailored PACE-SMI, comprising eight weekly sessions of individualized education, counseling, behavioral training, and home visit. Outcomes were assessed at baseline, postintervention, and 3 months follow-up. Data at 3 months were provided by 583 participants (control: n = 295, intervention: n = 288). Per-protocol analysis showed that the intervention group had a lower mean HbA1c (8.49% [standard deviation (SD), 1.58]) than the control group (8.74% [SD, 1.62]), with small yet statistically significant mean difference of 0.25% (95% confidence interval [CI], -0.01 to 0.51; Cohen's d = 0.16; p = 0.03). Self-efficacy and self-care behaviors significantly improved in the intervention group (116.89 [SD, 25.50] and 70.01 [SD, 17.97]) compared to the control group (75.43 [SD, 18.99] and 51.54 [SD, 12.04]), with mean differences of 41.48 (95% CI, 37.83-45.13; Cohen's d = 1.84; p < 0.0001) and 18.56 (95% CI, 16.08-21.04; Cohen's d = 1.22; p < 0.0001), respectively. Linear regression analysis indicated the effect of PACE-SMI on HbA1c was significantly mediated by improvements in self-efficacy and self-care behaviors (R2 = 0.232, p < 0.001). PACE-SMI led to modest but significant improvement in HbA1c and substantial enhancements in self-efficacy and self-care behaviors in adults with T2DM.

CN29 Short term effects of self-care behaviours on quality of life for patients on oral anticancer agents

CN29 Short term effects of self-care behaviours on quality of life for patients on oral anticancer agents

Interprofessional heart failure education for self-care knowledge and medication adherence in cardiac rehabilitation patients: A short report

Heart failure (HF), a costly and often deadly syndrome, is associated with hindered cardiac functioning. Suboptimal HF disease knowledge and related poor self-care practices result in worsening heart failure, increased rehospitalizations, decreased quality of life, and potential death. Provision of interprofessional education is essential to encourage disease understanding and reliable adoption of appropriate self-care behaviors. This short report describes the timely implementation of an evidence-based practice educational project (EBP) designed to augment heart failure knowledge and vital self-care management strategies, among phase II cardiac rehabilitation (CR) patients. Individual sessions led by interprofessionals included nursing, advanced nursing, nutrition, information technology, and exercise physiology clinicians. Post-intervention results suggest collaborative interprofessional patient education effectively enhanced knowledge (19.1 % increase) about overall heart failure and specifically improved medication adherence rates (5.4 % increase). Efficient and effective interprofessional self-care-focused education should become routine practice in phase II CR patients to address complex care challenges, decrease costs and improve overall outcomes.

Causal Relationship Model of Health Literacy, Self-Efficacy Perception, Self-Care Behaviors on Blood Sugar Levels Among Elderly People with Type-2 Diabetes

Objective: To develop a causal relationship model of health literacy, self-efficacy perception, and Self-Care Behaviors on Blood Sugar Levels of Type 2 Diabetes on Elderly and check for the developed model's consistency with empirical data. Method: The sample consisted of 455 elderly people with type-2 diabetes who could not control their glycemic control using stratified sampling. The tool used to collect data was a questionnaire. The confidence value was 0.804-0.964. The LISREL program analyzed structural equation model data. Results: The developed causal relationship model consisted of self-care behaviors as direct negative causes of blood sugar levels. Health literacy and self-efficacy were negative indirect causes of blood sugar levels with self-care behavior as a carrier. The developed model was consistent with the empirical data with Chi-Square = 62.20, df= 54, relative Chi-Square = 1.15, p = 0.20733, RMSEA = 0.0183, RMR= 0.00895, SRMR = 0.0186, GFI = 0.983, AGFI = 0.962, CFI = 0.999, NFI = 0.989 and all variables contributed to the percentage variance in blood glucose level. at 97.8 %. Conclusion: The findings revealed that in caring for the elderly with type 2 diabetes, health literacy development must be considered, self-efficacy perception and better self-care behavior in order to help reduce blood sugar levels in this group of elderly people in the end.

Comparison of Self-Care Behavior through Diabetes Self-Care Management Education in Type 2 DM Patients in Urban And Rural

Comparison of Self-Care Behavior through Diabetes Self-Care Management Education in Type 2 DM Patients in Urban And Rural

Self-care: An effective strategy to manage chronic diseases.

The increase in life expectancy and an aging demographic have led to a surge in chronic diseases, presenting substantial challenges to healthcare systems worldwide. Chronic conditions are characterized by their long-term nature, recurrence and incurability, necessitating effective management strategies. This paper aims to explore the concept of self-care as a pivotal element in chronic disease management, examining its evolution, components and the role of caregivers in facilitating self-care practices. It also seeks to review the development of instruments for measuring self-care and discuss recent experimental research on self-care interventions. Self-care is an essential strategy for managing chronic diseases, involving maintenance, monitoring and management practices influenced by various personal and environmental factors. Caregivers play a vital role in supporting self-care, especially within certain cultural contexts. The development of reliable and valid instruments to measure self-care is crucial for assessing the effectiveness of the interventions. Recent trials, such as those focusing on motivational interviewing and virtual reality, show promise in improving self-care behaviors and patient outcomes. This paper advocates for the design of tailored, evidence-based interventions and highlights the potential of artificial intelligence in advancing self-care research. Future studies should continue to explore the dyadic dynamics between patients and caregivers and include economic evaluations to inform clinical decision-making.

Walking away from depression: the mediating role of walking activity in depression impacting blood glucose levels of people with diabetes or prediabetes.

Depression can exacerbate diabetes by impairing self-care behaviors and increasing the risk of complication; however, the underlying mechanism is still unclear. Given the suggested associations between walking activity, depression status, and blood glucose levels this study explores the intricate relationship between depression and blood glucose (BG) control, with a focus on walking activity as a behavioral mediator. The purpose of this study is to examine walking activity's mediating role in depression's impact on BG levels, investigating and validating the non-linear association between BG levels and walking activity. This retrospective real-world study demonstrates the potential of regular walking activity as a simple and accessible intervention to mitigate the negative effects of depression on BG levels in T2D and prediabetes. A cohort of 989 users with T2D and prediabetes, who regularly tracked their steps levels and BG levels for 12 months using the Dario digital health platform was evaluated. The mediating role of the monthly average number of steps on the relationship between the self-reported depression status and lagged monthly average BG was assessed. Additionally, the association between monthly walking activity and monthly average BG was tested using a piecewise linear mixed effects model. Users with self-reported depression demonstrated increased BG levels compared to users without depression (B=8.00, P=.01). The association between depression and monthly average number of steps was significant (B=-.27, P<.005) and monthly average number of steps significantly predicted the following months' average BG (B=-.81, P=.001), adjusting for depression. The monthly average number of steps significantly mediated the effect of self-reported depression on the following month's average BG (M=.22, P<.005). Further sensitivity analysis demonstrated model robustness over various periods. Finally, non-linear dynamics of walking activity over time was validated using unseen data showing a decrease in monthly average BG for users with over an average of 400 steps per day (B=-1.87, P<.01). This study shows how regular walking may reduce the negative impact of depression on BG levels in people with T2D. Our findings advocate for the integration of walking activity into treatment protocols as a cost-effective, accessible intervention strategy to improve glycemic management and depressive symptoms in this population.

Knowledge and Self-care Behaviors During Menstruation Among Adolescent Females

Background: Menstruation is a significant milestone in adolescent development, often accompanied by stress, tension, and embarrassment. Proper knowledge about menstruation and hygienic menstrual practices are crucial for the health and well-being of adolescent females. Objectives: The present study aimed to identify the knowledge of adolescent females about menstruation and their self-care behaviors during menstruation in Al Karak Governorate, Jordan. Methods: This descriptive cross-sectional study was conducted among 100 school-aged adolescent females at three government girls’ schools in Al-Karak. Data were collected through a self-administered questionnaire and analyzed using SPSS 26 software, employing an independent t-test and analysis of variance (ANOVA). Results: In this study, a total of 100 school-aged adolescent female students from three government girls’ schools in Al-Karak governorate participated, with a mean age of 15.83 ± 1.43, ranging from 11 to 17 years old. The vast majority of the sample knew that menstruation occurs due to hormonal changes (76%) and that it lasts for 2 - 7 days (77%). Additionally, 94% of participants correctly identified the true meaning of hygiene during menstruation. Nearly all participants (98.5%) washed their genitals during their period. Conclusions: Adolescent schoolgirls in Al Karak City, Jordan, have a good level of knowledge about menstruation and menstrual hygiene management and demonstrate satisfactory to fair levels of hygienic practices during menstruation.

The health behaviors differences among male and female school-age adolescents in the Middle East and North Africa region countries: a meta-analysis of the Global School-based Student Health Survey data.

Understanding gender disparities in adolescent health behaviors is crucial for developing targeted health promotion strategies. This study uses data from the Global School-based Student Health Survey (GSHS) across 17 MENA countries to analyze gender differences in adolescent health behaviors, aiming to provide a comprehensive overview for both boys and girls. This meta-analysis incorporates data from recent years of the GSHS, covering 17 MENA countries. The objective was to assess and compare health behaviors between adolescent girls and boys. A random-effects model was employed to calculate odds ratios for gender comparisons in these behaviors. Statistical analyses and modeling were performed using JAMOVI software. In most MENA countries, boys consumed more vegetables compared to girls. Girls were less likely to frequent fast food establishments (OR = 0.82, 95% CI: 0.69-0.98) and generally exhibited better self-care behaviors. Boys reported a higher prevalence of physical altercations (OR = 2.18, 95% CI: 1.88-2.51) and were more involved in fights (OR = 3.00, 95% CI: 2.46-3.67). Girls were more likely to miss school without permission and were consistently described as kinder and more helpful across various income levels. However, in some countries such as Oman and Tunisia, boys missed school more frequently. There were no significant gender differences in parental oversight of homework or knowledge of students' activities, but girls were reported to have stronger parental relationships and better parental understanding of their problems and free time, with exceptions in Morocco and the Palestinian Territory-Gaza. Boys were more likely to engage in smoking (OR = 3.57, 95% CI: 2.69-4.76) and other substance use. Conversely, girls reported higher levels of physical inactivity and loneliness, but also demonstrated greater kindness and helpfulness in school settings and stronger parental relationships. Policymakers in the MENA region should develop and implement gender-specific interventions targeting key areas such as hygiene practices, physical activity, and substance use. By focusing on these targeted strategies, they can address the distinct health behaviors and needs of both boys and girls. Effective interventions in these areas are crucial for improving overall health outcomes and promoting healthier lifestyles, thereby enhancing adolescent health and well-being across the region.

Effectiveness of Guided E-Booklet-Based Education on Self Care Behavior and Blood Sugar in Hospital X Bandung

Diabetes mellitus is a metabolic disorder requiring patients to manage and stabilize their condition to prevent complications. Education using e-booklets can facilitate information access and blood sugar control. This study aimed to eval_uate the effectiveness of e-booklet-based education on self-care behavior and blood sugar levels in diabetes mellitus patients. Conducted from June to August 2023 at X Hospital's internist clinic in Bandung, the research employed a quasi-experimental pre-test and post-test design with a control group. The study involved 126 respondents, with 63 in the intervention group and 63 in the control group, selected through purposive sampling. The intervention lasted 4 weeks, covering 8 materials with ongoing monitoring and active participation. Self-care behavior and random blood sugar levels were measured at the beginning and end of the study using the Summary Diabetes Self-Care Activity (SDSCA) questionnaire and blood glucose tests. The Wilcoxon test revealed significant differences in self-care behavior and blood sugar levels before and after the intervention (p &lt; 0.05). The Mann-Whitney test showed significant differences between the intervention and control groups (p &lt; 0.05). Multivariate analysis indicated that age, gender, education, disease duration, and e-booklet-based education accounted for 22.2% of the variance in self-care behavior and 30.6% in blood sugar levels. E-booklet-based education effectively improves self-care behavior and blood sugar control. The study recommends ongoing development and supervision to establish healthy habits and prevent complications.

The association between dietary habits and self-care behavior of pregnant women with pregnancy complications

Pregnancy as a sensitive period has a critical effect on the mother and infant's life. It is well understood that dietary habits and mother awareness can improve health status and prevent pregnancy complications such as gestational diabetes, pre-eclampsia, and nausea and vomiting. The current study was conducted to investigate the association between dietary habits and self-care behaviors with pregnancy complications. This cross-sectional study was conducted across 300 pregnant women in their third trimester referred to healthcare centers and Yas hospital in Tehran, Iran. Dietary habits and self-care behaviors were assessed by valid and reliable questionnaires. Dietary intake and physical activity were evaluated using valid and reliable Food Frequency Questionnaires and Pregnancy Physical Activity questionnaires, respectively. Women with self-care behaviors had a lower rate of pre-eclampsia (P = 0.9). Regarding food habits, pregnant women who ate their meals faster had a non-significantly higher rate of gestational diabetes and pre-eclampsia. Pregnant women who consumed red meat on a daily frequency had a significantly higher rate of nausea and vomiting (OR 1.85; 95% CI 1.05–3.28, P = 0.03). Also, there was a significant positive association between the mother's pre-pregnancy BMI and gestational diabetes and pre-eclampsia [(OR 2.03; 95% CI 1.03–3.98, P = 0.03) and (OR 4.23; 95% CI 1.12–16.0, P = 0.03) respectively]. There was no significant association between pregnant women's dietary habits and GDM and pre-eclampsia. However, pregnant women with pre-pregnancy overweight and obesity had increased odds of gestational diabetes and pre-eclampsia significantly.