Self-care Behaviors In Patients Research Articles

Self-care behaviours in patients with restless legs syndrome (RLS): development and psychometric testing of the RLS-Self-care Behaviour questionnaire.

Restless legs syndrome (RLS) is a highly prevalent condition that significantly disrupts sleep and causes reduced quality of life. While previous RLS research has mainly focused on the pharmacological treatment, this study presents the first instrument to measure self-care, the RLS-Self-care Behaviour questionnaire (RLS-ScBq). Self-care, defined as an active decision-making process, can empower patients to effectively participate in their own healthcare through awareness, self-control, and self-reliance to cope with their disease. Self-care can in a RLS context include actions such as physical exercise, meditation, and massage. Hence, the aim of this study is to explore the psychometric properties of the RLS-ScBq in patients with RLS. A cross-sectional design, including 788 patients with RLS (65% women, mean age 70.8 years, [standard deviation (SD) =11.4]) was used. Sociodemographics, comorbidities, and RLS-related treatment data, including insomnia symptoms (i.e., Insomnia Severity Index), daytime sleepiness (i.e., Epworth Sleepiness Scale) and RLS symptoms (i.e., RLS-6 scale) were collected. The validity and reliability of the RLS-ScBq were investigated using exploratory factor analysis and Rasch models. The two-factor solution (i.e., physical, and mental actions) showed an explained variance of 32.33% for The Self-care Behaviour Frequency part and 36.28% for The Benefit of Self-care Behaviour part. The internal consistency measured by Cronbach's α was 0.57 and 0.60, and McDonald's ω was 0.60 and 0.67, respectively. No differential item functioning was identified for gender, age, insomnia, daytime sleepiness, or RLS severity. The eight-item RLS-ScBq can serve as a tool enabling healthcare personnel to explore use and benefit of self-care activities in patients with RLS.

Comparison of the effect of SMS-based education and face-to-face teaching on self-care behavior of type 2 diabetic patients in Khorramabad city

IntroductionConsidering that the adoption of self-care behaviors in patients with type 2 diabetes can reduce the complications caused by this disease, aim of the present study was compared the effect of SMS-based teaching and face-to-face teaching on self-care behavior of type 2 diabetic patients in Khorramabad city.MethodsThis was a pre- and post-test semi-experimental study. The research sample size was composed of 135 diabetic patients referred to the Khorramabad diabetes clinic who were selected using random sampling method and were randomly divided into face-to-face teaching group (n = 45), SMS-based teaching group (n = 45), and control (n = 45). Data collection tools were demographic information questionnaire, Tubert self-care behaviours questionnaire, and self-efficacy questionnaire. The educational intervention in the face-to-face training group included four face-to-face training sessions and in the SMS-based training group included three to four daily training SMS and without training intervention in the control group. For all analysis, SPSS software version 24 was done and at a significance level of 0.05.ResultsAt the baseline, average score of self-efficacy and self-care, and blood sugar were not significant between the face-to-face teaching, SMS-based and control groups. However, at the end of intervention, the mean score of these variables were significantly more in the face-to-face teaching and SMS-based groups compared to the control group (p-value < 0.001).DiscussionConsidering the positive effect of educational intervention in promoting self-care in patients with type 2 diabetic, it is suggested to use empowerment programs with self-care approach to improve the health of diabetic patients.

Predictors of self-care behaviors in hypertensive patients based on the protection motivation theory

IntroductionGlobally, hypertension is a significant public health concern and a leading cause of premature death. Since this disease is incurable, it is necessary to promote patients’ self-care behaviors to control it. The goal of this research was to identify the elements that influence self-care actions in individuals with hypertension, utilizing the Protection Motivation Theory (PMT) framework.MethodsA study was carried out in Omidiyeh, located in southern Iran, using a cross-sectional design, involving 397 adults with hypertension (198 females and 199 males) who were selected from comprehensive health centers using a stratified random sampling technique. Data was gathered through a demographic data collection form and a questionnaire created by the researcher, which was based on the PMT. Data were assessed utilizing SPSS 25 and AMOS 24 software, and various statistical tests including one-way ANOVA, Pearson correlation, multiple regression, independent t-test, and structural equation modeling were conducted.FindingsThe variables of intrinsic reward (r = 0.182), extrinsic reward (r = 0.288), and response cost (r = 0.126) showed a significant negative correlation with self-care behaviors. On the other hand, perceived susceptibility (r = 0.212), perceived severity (r = 0.110), self-efficacy (r = 0.555), and response efficacy (r = 0.424) demonstrated a significant positive correlation with self-care behaviors. Specifically, self-efficacy and response efficacy were the most powerful predictors of self-care behaviors, respectively.ConclusionThe results showed that several factors can forecast self-care behaviors in patients with hypertension. Researchers are recommended to incorporate PMT in educational interventions and concentrate on self-efficacy and response efficacy constructs.

Association between self-care behaviour and multiple frailty domains in older patients with heart failure

Abstract Background/Introduction Heart failure (HF) self-care is important for the effective management of HF, reducing clinical events such as all-cause mortality and hospitalizations. HF self-care behaviours encompass comply with a regimen involving medication, diet, and exercise, symptom monitoring, and seeking assistance when symptoms occur. Frailty, prevalent among older patients with HF, involves physical, social, and cognitive domains. Identified factors influencing self-care behaviours in patients with HF include age, social support, and knowledge of the condition. Despite research on the association between self-care behaviours and frailty, there is a notable gap in studies that explore the relationship between self-care behaviour and multiple domains of frailty, particularly with adjustments for clinical characteristics. Purpose The aim of this study was to assess the association between self-care behaviour and multiple domains of frailty in older patients with HF. Methods The study included 182 patients with HF who were aged 65 years or older. Self-care behaviour was assessed 5 months after their discharge using the European Heart Failure Self-Care Behaviour Scale (EHFScBS), a self-report questionnaire. Frailty was assessed using the revised Japanese version of the Cardiovascular Health Study criteria (J-CHS) for physical frailty, and using Makizako’s five items for social frailty, and using Mini-Cog for cognitive decline. We used multiple regression analysis to assess the association between self-care score and multiple frailty domains and the number of frailty domains. The adjusted model was constructed based on age, gender, body mass index, New York Heart Association Classification, left ventricular ejection fraction, log-transformed B-type natriuretic peptide, estimated glomerular filtration rate and history of HF. In addition, we used multiple regression analysis to assess the association between the EHFScBS subitems score complying with regimen, asking for help, and adapting activities and multiple frailty domains and the number of frailty domains. Results According to the results of a multiple regression analysis, poor self-care behaviour was significantly associated with physical and social frailty and the number of frailty domains (all p &amp;lt; 0.05), even after adjusting for clinical characteristics. Poor complying with regimen was also significantly associated with physical and social frailty and the number of frailty domains (all p &amp;lt; 0.05). Poor asking for help was significantly associated with social frailty and the number of frailty domains (all p &amp;lt; 0.05). Conclusion The study indicates that poor self-care behaviour is linked to physical and social frailty, in addition to the cumulative number of frailty domains in older patients with HF, even when clinical characteristics are taken into consideration. This underscores the importance of factoring in the frailty status when guiding patients with HF in disease management.

Self-Care of Older Patients Affected by at Least Two Chronic Conditions Between Heart Failure, Diabetes Mellitus and Chronic Obstructive Pulmonary Disease: A Comparative Study.

This study aims to describe disease-specific self-care behaviours in patients with heart failure (HF), diabetes mellitus (DM) and chronic obstructive pulmonary disease (COPD) in various combinations; to compare these self-care behaviours within patient groups; and to evaluate differences across these groups. Cross-sectional study. A total sample of 1079 older patients was recruited from outpatient clinics and home settings. Eligible patients were aged ≥ 65 years and had a diagnosis of HF and/or DM, and/or COPD, along with at least one additional chronic condition. Data were collected using validated tools: the Self-Care of Heart Failure Index, Self-Care of Diabetes Inventory and Self-Care of Chronic Obstructive Pulmonary Disease Inventory. Descriptive statistics were used to analyse disease-specific self-care behaviours. Group comparisons were performed using Student's t-test and univariate, followed by multivariate analyses of variance. The analysis focused on a subset of 223 patients who had a combination of at least two chronic conditions between HF, DM and/or COPD. The mean age of participants was 77.3 (SD 7.5) years, with a majority being female (53.4%). Self-care maintenance, monitoring and management for HF and COPD were found to be inadequate across all patient groups. Adequate self-care was only observed in DM management among those with HF and DM and in DM maintenance for those with DM and COPD treated with insulin. Significant differences in all self-care dimensions were observed across groups, particularly in patients managing all three conditions (HF, DM and COPD). The findings provide valuable insights into the complexities of self-care in patients with multiple chronic conditions, underscoring the need for tailored, integrated and patient-centred interventions. Healthcare strategies should focus on enhancing patient education and developing personalised approaches to improve health outcomes and quality of life in this population. All the authors have adhered to the EQUATOR guidelines STROBE Statement. A convenience sample of patients was recruited in outpatient clinics and their homes. Data were collected between March 2017 and August 2022, by face-to-face during routine outpatient visits or directly at the patient's home.

Knowledge and self-care behavior among heart failure patients in South India

BACKGROUND: Heart failure (HF) is a chronic condition with significant public health concerns. HF necessitates adequate knowledge and adherence to self-care for enhanced quality of life and decreased rehospitalization. This study aimed to explore knowledge and self-care behavior in patients with HF. MATERIAL AND METHODS: The study was conducted in cardiology wards of a tertiary care hospital and the design was a randomized controlled trial. The baseline data (before the intervention) from 160 HF patients enrolled in a randomized controlled trial were analyzed. Knowledge and self-care behavior were measured using the Dutch HF Knowledge Questionnaire (score ranging from 0 to 15) and European HF Self-care Behavior Scale-9 (score ranging from 0 to 100). Higher scores indicated better self-care behavior and knowledge. Descriptive statistics such as frequency, percentage, mean, and standard deviation and inferential statistics such as independent sample t-test and ANOVA were performed. RESULTS: The majority (75.0%) were men with a mean age of 56.1 ± 7.9 years. A significant proportion had hypertension (65%), diabetes (58.7%), or both comorbidities (40.6%). Most exhibited a left ventricular ejection fraction &lt;30% (60.6%) and New York Heart Association class II (43.1%). The mean knowledge and self-care behavior scores were 7.1 ± 2.0 and 45.0 ± 12.4, respectively. Over half of the participants had inadequate self-care behavior (51.2%), and 88.3% lacked sufficient knowledge about HF. Medication adherence was high (87.0%) among the participants, while only 3.1% reported regular weight monitoring and 32.3% exercised regularly. CONCLUSIONS: There was a lack of HF-related knowledge and inadequate self-care behavior for HF management. Effective interventions to improve disease-related knowledge may lead to better self-care behavior and improve clinical outcomes.

The Impact of Health Belief Model-Based Education on Self-Care Behaviors of Hypertensive Patients

The Impact of Health Belief Model-Based Education on Self-Care Behaviors of Hypertensive Patients

Factors Affecting Glycemic Control in Patients with Type 2 Diabetes in Kalasin Province, Thailand: An Analytical Cross-Sectional Study

Background: Optimal glycemic management is critical since it can predict all associated essential causes of death, even after accounting for other risk factors. Objectives: This study investigated the factors associated with glycemic control in patients with type 2 diabetes mellitus (T2DM), particularly self-care behaviors. Methods: An analytical cross-sectional study examined 385 patients with T2DM in 1 general and 17 community hospitals in Kalasin Province. The samples were collected using mixed-method sampling. Data were collected using a validated questionnaire with six parts and laboratory examination records between September 2021 and December 2022. Descriptive statistics (e.g., percentages and means ± SD) were used to analyze the data. The relationship between relevant factors and lack of glycemic control was analyzed by multivariate logistic regression using SPSS version 25. Results: Results showed that most patients were female (78.18%), and the mean age was 59.84 ± 9.05 years. Additionally, a significant proportion of the patients (79.74%) had poor glycemic control. Several factors are significantly associated with poor glycemic control in patients with T2DM. These factors included subjects under the age of 60 years (OR = 2.95, 95% CI: 1.57 to 5.54; p-value &lt; 0.001), a diabetes duration of over 10 years (OR = 3.95, 95% CI: 1.90 to 8.22; p-value &lt; 0.001), poor knowledge about diabetes (OR = 3.92, 95% CI: 1.59 to 9.67; p-value &lt; 0.003), and inadequate self-care behaviors (OR = 6.12, 95% CI: 3.20 to 11.68; p-value &lt; 0.001). Conclusions: In conclusion, proper interventions for controlling glycemic level behaviors are necessary to improve proper self-care behaviors in patients who have a low knowledge level of T2DM, have had diabetes for over ten years, and are aged &lt; 60 years. This approach can reduce the likelihood of experiencing disabilities and economic hardship.

Impact of Mobile Health Literacy, Stroke-Related Health Knowledge, Health Beliefs, and Self-Efficacy on the Self-Care Behavior of Patients with Stroke

Background: The recent substantial increase in the incidence of stroke cases has resulted in high medical expenses. Stroke necessitates ongoing care, emphasizing the importance of consistent self-management. The occurrence of stroke impacts healthcare costs and has far-reaching effects on social services, encompassing disability, unemployment, and other related concerns beyond individuals and families. This study aimed to assess the impact of mobile health literacy, stroke-related health knowledge, health beliefs, and self-efficacy on self-care behaviors of patients with stroke to plan tailored self-care interventions for this patient population. Methods: This descriptive survey included 99 stroke patients from three hospitals, which provided treatment equivalent to or better than general hospitals, in City C and was conducted between 7 July 2023 and 30 May 2024. The data collected from hospitalized stroke patients were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, and multiple linear regression. Results: The self-care behavior of patients with stroke who participated in the study was 73.01 ± 12.24 points. Stroke self-efficacy was identified as a significant factor influencing stroke self-care behaviors and eating habits. Mobile health literacy and stroke self-efficacy also influenced medication and self-care behavior, whereas hypertension and stroke self-efficacy affected lifestyle self-care behaviors. Conclusions: Strengthening stroke self-efficacy, improving mobile health literacy, and addressing comorbidities such as hypertension are important for promoting self-care behavior in stroke patients.

Predictors of self-care in patients with cancer treated with oral anticancer agents: A systematic review.

In the last two decades, the use of oral anticancer agents (OAAs) has increased in cancer patients. Despite this, patients and their caregivers face some challenging issues (side effects, drug-to-drug interactions, etc.) related to OAA administration. The three dimensions of self-care by Riegel et al., self-care maintenance (i.e., stability of patient condition), self-care monitoring (i.e., detection of side effects), and self-care management (i.e., management of side effects), may be implemented to avoid negative outcomes. However, knowledge of self-care determinants is necessary to recognise people at risk of poor self-care behaviours. Determine which are the predictors of self-care maintenance, self-care monitoring and self-care management in patients with cancer taking OAA. A systematic review with narrative synthesis was conducted. We included studies on adult patients with cancer using any kind of oral anticancer agent and describing a predictor of self-care. The search was performed on PubMed, CINAHL/PsycINFO, and Web of Science. Of 3,061 records, 45 studies were included in this review. Forty-six predictors organised into 14 categories were identified. In general, all studies focused only on adherence, considered as a self-care maintenance component, and none of them focused on other dimensions of self-care. The predictors of OAA adherence most reported were age, side effects, and socioeconomic factors (e.g., insurance status, and annual income). This systematic review highlighted the literature gap on the analysis of determinants of self-care behaviours in patients taking OAAs. This element could be a starting point for future research that can provide elements to support the oncology nursing research agenda, aimed at recognising patients at risk of poor self-care.

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&gt;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.

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 &lt; 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 &lt; 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.

The effect of education through a mobile application on self-care behavior in patients undergoing percutaneous coronary: A randomized clinical trial

Background &amp; Aim: Patients who receive percutaneous coronary interventions often display inadequate levels of self-care actions, which could create difficulties in managing the disease and achieving favorable treatment results. This study investigates the impact of using an educational mobile application on self-care behaviors in patients undergoing percutaneous coronary intervention. Methods &amp; Materials: A randomized clinical trial was conducted with 110 patients undergoing percutaneous coronary interventions at Shahid Rajaei Hospital in Karaj, Iran, in 2023. The study enrolled and assigned them to either the intervention group (n=55) or the control group (n=55) by block randomization. In addition to training upon discharge, the experimental group received educational resources via a mobile phone application. The data collection instruments included MSCBS. Patients completed the MSCBS before the intervention and 4 weeks later. The data were analyzed with SPSS 21. The study's level of significance was set to P&lt;0.05. Results: Before the intervention, there was no significant difference in the self-care scores and the subscales between the two groups (P&lt;0.05). Nonetheless, After the intervention, a significant difference was observed in the self-care scores and the subscales between the control and intervention groups, (p=0.001), and the difference in scores between the control and intervention groups increased significantly after the intervention and the scores of the intervention group had a significant increase compared to the scores of the control group. Conclusion: The study showed that the mobile phone educational application could improve self-care behaviors in patients undergoing percutaneous coronary interventions. Therefore, it can be recommended that nurses working in medical centers use this educational application to enhance self-care in these patients.

Comparing the effectiveness of acceptance-based emotion regulation therapy and acceptance and commitment therapy on hemoglobin glycosylated and self-care in patients with type II diabetes: A randomized controlled trial.

Type 2 diabetes (T2D) is a chronic metabolic disorder characterized by impaired glucose regulation. This study aimed to compare the effectiveness of Acceptance-Based Emotion Regulation Therapy (ABERT) and Acceptance and Commitment Therapy (ACT) on HbA1c levels and self-care behaviors in patients living with T2D. Participants were randomly assigned to ABERT (n = 16), ACT (n = 17), and control (n = 17) groups. The treatment groups received therapy based on treatment manuals, while the control group received treatment as usual (i.e., standard medical treatment). Assessments were conducted pre- and post-treatment, with a six-month follow-up, measuring HbA1c levels and self-care behaviors. Results from repeated-measures ANOVAs and post-hoc analysis demonstrated that both ABERT and ACT led to significant improvements compared to the control group. However, ABERT was more effective than ACT in reducing HbA1c levels and enhancing self-care behaviors, with sustained benefits observed in the long term. At the individual level, a higher percentage of participants in the ACT and ABERT groups experienced a global improvement in HbA1c compared to the control group during the post-test assessment. Furthermore, a higher percentage of participants in the ABERT group showed global improvement compared to both the ACT and control groups in the post-test to follow-up period. No statistically significant differences in self-care behaviors were observed between the groups at the individual level. These findings suggest that the ABERT may be a valuable intervention for individuals living with T2D, though more studies are needed to examine this subject.

Cognitive Behavioral Therapy: A Quasi-Experimental Study of Self Care Activity with Type 2 Diabetes Mellitus Patients

Individuals diagnosed with diabetes mellitus require a multi-faceted approach to treatment. Key aspects of self-care for these patients include maintaining a proper diet, engaging in regular physical activity, adhering to prescribed medications, consistently monitoring blood glucose levels, caring for the legs, and managing smoking habits. Among the therapeutic interventions used in nursing, Cognitive Behavioral Therapy (CBT) is noteworthy. The purpose of this study was to examine the impact of CBT on self-care behaviors in patients with Type 2 diabetes mellitus. Utilizing a quasi-experimental design, this study implemented a pre and post-test control group methodology. A total of 32 participants were selected based on specific criteria and probability sampling methods were employed to determine the sample. Data was gathered using the Summary of Self-Care Diabetic Activity questionnaire. Findings from the study indicate that CBT significantly enhanced dietary compliance (p-value = 0.02), increased physical activity (p-value = 0.001), and improved independent blood glucose monitoring (p-value = 0.003). Additionally, CBT enhanced adherence to medication (p-value = 0.004), leg care (p-value = 0.004), and reduced smoking behaviors (p-value = 0.021). CBT effective in enhancing various self-care activities among diabetic patients by fostering changes in mindset and encouraging positive behavioral shifts

Study protocol: Collaboration Oriented Approach to Controlling High blood pressure (COACH) in adults – a randomised controlled trial

IntroductionHypertension, the clinical condition of persistent high blood pressure (BP), is preventable yet remains a significant contributor to poor cardiovascular outcomes. Digital self-management support tools can increase patient self-care behaviours...

The effectiveness of social media-based microlearning in improving knowledge, self-efficacy, and self-care behaviors among adult patients with type 2 diabetes: an educational intervention

BackgroundThe purpose of this study is to investigate the impact of social media-based microlearning (SMBM) on enhancing the knowledge, self-care, and self-efficacy behaviors of patients with type 2 diabetes (T2D) receiving care at a hospital-based diabetes clinic in Zahedan, Iran.MethodsThis intervention study was conducted from September 2021 to the end of 2022, with an intervention group (SMBM) and a control group (conventional-based training) consisting of patients with T2D. A total of 80 eligible patients were selected using a convenience sampling method and randomly assigned to either the intervention group (n = 40) or the control group (n = 40). The knowledge level, self-care, and self-efficacy of the samples were assessed before and two weeks after the educational intervention. Data analysis was conducted using SPSS version 24, and independent and paired T-tests were used for analysis.ResultsThe results of the study revealed that after the intervention, the levels of knowledge, self-care, and self-efficacy in the intervention group were significantly higher than those in the control group (p-value < 0.001).ConclusionIn conclusion, the SMBM appears to be an effective tool for improving self-efficacy, self-care, and knowledge among patients with type 2 diabetes.

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.