Self-care Educational Intervention Research Articles

Improving foot self-care in people with diabetes in Ghana: A development and feasibility randomised trial of a context appropriate, family-orientated diabetic footcare intervention.

Africa presents a higher diabetic foot ulcer prevalence estimate of 7.2% against global figures of 6.3%. Engaging family members in self-care education interventions has been shown to be effective at preventing diabetes-related foot ulcers. This study culturally adapted and tested the feasibility and acceptability of an evidence-based footcare family intervention in Ghana. The initial phase of the study involved stakeholder engagement, comprising Patient Public Involvement activities and interviews with key informant nurses and people with diabetes (N = 15). In the second phase, adults at risk of diabetes-related foot ulcers and nominated caregivers (N = 50 dyads) participated in an individually randomised feasibility trial of the adapted intervention (N = 25) compared to usual care (N = 25). The study aimed to assess feasibility outcomes and to identify efficacy signals on clinical outcomes at 12 weeks post randomisation. Patient reported outcomes were foot care behaviour, foot self-care efficacy, diabetes knowledge and caregiver diabetes distress. Adjustments were made to the evidence-based intervention to reflect the literacy, information needs and preferences of stakeholders and to develop a context appropriate diabetic foot self-care intervention. A feasibility trial was then conducted which met all recruitment, retention, data quality and randomisation progression criteria. At 12 weeks post randomisation, efficacy signals favoured the intervention group on improved footcare behaviour, foot self-care efficacy, diabetes knowledge and reduced diabetes distress. Future implementation issues to consider include the staff resources needed to deliver the intervention, family members availability to attend in-person sessions and consideration of remote intervention delivery. A contextual family-oriented foot self-care education intervention is feasible, acceptable, and may improve knowledge and self-care with the potential to decrease diabetes-related complications. The education intervention is a strategic approach to improving diabetes care and prevention of foot disease, especially in settings with limited diabetes care resources. Future research will investigate the possibility of remote delivery to better meet patient and staff needs. Pan African Clinical Trials Registry (PACTR) - PACTR202201708421484: https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=19363 or pactr.samrc.ac.za/Search.aspx.

The impact of hypertension education on self-care management in hypertensive patients in Senderak village health centre.

To determine the effect of hypertension education on self-care management in hypertensive patients in a rural setting. The quasi-experimental study was conducted in January and February 2022 at the Senderak Village Health Centre, Bengkalis, Indonesia, and comprised hypertension patients without any complications referred to the community health centre between August 2021 and January 2022. The subjects underwent self-care education intervention. The knowledge level was assessed at baseline and post-intervention using the Hypertension Self-Management Behaviour Questionnaire. Data was analysed using IBM SPSS Statistic v23 software. All the 30(100%) patients were females, 12(40%) were aged 46-55 years, 20(66.7%) had received elementary school education and 25(83.3%) were housewives. There were 21(70%) respondents with stage II hypertension having systolic blood pressure ≥160mmHg. The mean level of knowledge about self-care management of hypertension increased significantly post-intervention (p<0.0001). Health education could improve knowledge on self-care management of hypertension in hypertensive patients.

Self-Care Education on the Pain, Quality of Life, and Consequences of Disease in Patients with Knee Osteoarthritis.

Knee osteoarthritis (KOA) is one of the most common and prevalent debilitating chronic diseases across the world with various adverse effects such as pain and movement limitations which impact the health status and quality of life of the patients in the long run. This study aimed to investigate the effects of self-care education on pain, quality of life, and consequences of disease in patients with KOA in Southern Iran. This is a randomized controlled clinical trial using a pretest-posttest design. Eighty patients with KOA were enrolled in this study and randomly allocated to a control and an intervention group. The data collection instruments included VAS: Visual Analog Scale, the SF-36 quality of life scale, and the Knee Injury and Osteoarthritis Outcome Score. The collected data were analyzed through SPSS v. 22, using descriptive tests, paired t-tests, independent t-tests, Chi-square, and ANOVA. A P level of <.05 was considered as the significant level. Before the self-care educational intervention, no statistically significant difference was found between the control and intervention groups in pain intensity, quality of life, and consequences of osteoarthritis. After the self-care educational intervention, the findings revealed a significant difference between the intervention group's mean ± standard deviation for pain intensity (41.25 ± 21.74), quality of life (49.87 ± 14.74), and consequences of KOA (39.06 ± 12.15), respectively (P < .05). However, in the control group, there was no significant difference. Based on the results of this study, the positive effect of self-care education on patients with osteoarthritis was shown as to their pain intensity, quality of their lives, and reduction of the disease consequences. Thus, healthcare managers are recommended to apply this type of intervention for patients with osteoarthritis.

A Pre-Post, Mixed-Methods Study to Pilot Test a Gamified Heart Failure Self-Care Education Intervention.

Objective: Self-care is essential to improving heart failure patient outcomes. However, the knowledge and behaviours necessary for self-care decision making, such as symptom perception and management, are complex and require patient education. The objective of this study was to test the feasibility, acceptability, and potential effectiveness of a web-based, gamified heart failure patient education solution, Heart Self-Care Patient Education (HeartSCaPE), that used narrative and virtual reward gamification techniques. Materials and Methods: This mixed-methods study used a pre-post-test design with an embedded explanatory qualitative phase. Patients completed the Self-Care of Heart Failure Index, that measured self-care behaviour change and the Dutch Heart Failure Knowledge Scale, used to measure heart failure knowledge. Usability measures of HeartSCaPE were tracked using Google Analytics and the System Usability Scale. Results: Nineteen patients completed the study, with a subset of six participating in semi-structured interviews. We found increases in HF knowledge despite high baseline knowledge scores. Post-intervention self-reported HF self-care behaviours (maintenance, management and confidence), as measured by the Self-Care of Heart Failure Index, were also improved. Knowledge and self-care scores were not correlated. Participants also scored HeartSCaPE as highly usable. In interviews, participants described valuing the opportunity to practice self-care decision-making. There were mixed opinions regarding the use of virtual rewards. Conclusion: We found that a gamified web-based solution that uses narrative and reward-based gamification techniques has the potential to improve HF patient knowledge and self-care. Further research is needed to confirm the study's clinical benefits and address technology literacy inequities.

Effects of Self-Care Education Intervention Program (SCEIP) on Activation Level, Psychological Distress, and Treatment-Related Information.

Self-care education can direct patients to manage their side effects during treatment, reduce psychological distress, and improve self-care information. In this study, the effectiveness of the Self-Care Education Intervention Program (SCEIP) on patient activation levels, psychological distress, and treatment-related concerns in women with breast cancer was assessed by adopting a longitudinal quasi-experimental pre-test and post-test design. The data for 246 women with breast cancer undergoing adjuvant chemotherapy were collected. Pre- and post-interventional assessments were conducted at baseline (T1) and the second (T2), fourth (T3), and sixth (T4) cycles using the 13-item Patient Activation Measure, 14-item Hospital Anxiety and Depression Scale, and 25-item Cancer Treatment Survey. It was found that the SCEIP significantly improved the activation level (p ≤ 0.001), psychological distress (anxiety level (p ≤ 0.001), the depression level (p ≤ 0.001)), and treatment-related concerns (sensory/psychological concerns (p = 0.05); procedural concerns (p ≤ 0.001)). Therefore, the SCEIP could potentially improve patients’ activation level, psychological distress, and treatment-related concerns regarding symptom management during chemotherapy, specifically for Malaysian women with breast cancer.

Effect of a self-care educational intervention to improve self-care adherence among patients with chronic heart failure: a clustered randomized controlled trial in Northwest Ethiopia

BackgroundAs the burden of cardiovascular disease increases in sub-Saharan Africa, there is a growing need for low-cost interventions to mitigate its impact. Providing self-care health education to patients with chronic heart failure (CHF) is recommended as an intervention to prevent complications, improve quality of life, and reduce financial burdens on fragile health systems. However, little is known about health education’s effectiveness at improving CHF self-management adherence in sub-Saharan Africa. Therefore the present study aimed to assess the effectiveness of an educational intervention to improve self-care adherence among patients with CHF at Debre Markos and Felege Hiwot Referral Hospitals in Northwest Ethiopia.MethodsTo address this gap, we adapted a health education intervention based on social cognitive theory comprising of intensive four-day training and, one-day follow-up sessions offered every four months. Patients also received illustrated educational leaflets. We then conducted a clustered randomized control trial of the intervention with 186 randomly-selected patients at Debre Markos and Felege Hiwot referral hospitals. We collected self-reported data on self-care behavior before each educational session. We analyzed these data using a generalized estimating equations model to identify health education's effect on a validated 8-item self-care adherence scale.ResultsSelf-care adherence scores were balanced at baseline. After the intervention, patients in the intervention group (n = 88) had higher adherence scores than those in the control group (n = 98). This difference was statistically significant (β = 4.15, p < 0.05) and increased with each round of education. Other factors significantly associated with adherence scores were being single (β = − 0.25, p < 0.05), taking aspirin (β = 0.76, p < 0.05), and having a history of hospitalization (β = 0.91, p < 0.05).ConclusionsWe find that self-care education significantly improved self-care adherence scores among CHF patients. This suggests that policymakers should consider incorporating self-care education into CHF management.Trial registration number: PACTR201908812642231

The effect of nursing self-care educational intervention on depression in women with breast cancer undergoing post-mastectomy chemotherapy: A quasi-experimental study

Background and objectiveDepression is one of the most common psychological reactions that patients show during diagnosis and treatment. This study aimed to determine the effectiveness of nursing self-care educational intervention on reducing depression in women with breast cancer undergoing post-mastectomy chemotherapy. MethodsThis quasi-experimental study (pre-test-post-test) was performed on 90 women with breast cancer undergoing post-mastectomy chemotherapy referred to two teaching hospitals in southeastern Iran from September 1, 2019, to December 1, 2020. Patients were selected using the convenience sampling method and randomly assigned into intervention (nursing self-care educational intervention) and control (routine care) groups. The standard BDI-13 instrument was used to assess depression. ResultsIn this study, the mean age of patients in the intervention and control groups was 46.20 and 44.64, respectively. The results showed that the nursing self-care educational intervention in the intervention group compared to the control group significantly reduced depression in patients with breast cancer undergoing chemotherapy after mastectomy (p = 0.001). ConclusionAccording to the results of the present study, nursing self-care educational intervention can be used as an effective and cost-effective adjunctive therapy along with common treatments to reduce depression in women with breast cancer undergoing chemotherapy after mastectomy.

Survey on the effect of two education methods (face to face and distance) on the self-care skill of Behvarz

Background: With increase in the number of patients with chronic illnesses, long-term health care systems are experiencing significant problems in providing these services. Therefore, in order to organize these patients and facilitate the work, it is suggested that some care be provided by the individuals themselves. The present study aimed to investigate the effect of face to face and distance education on self-care.Methods: Data were collected through a researcher-made questionnaire. The statistical population of the study consisted of Bahvarzes of two cities: Khaf and Sarakhs. According to population size and based on Cochran formula, 45 Bahvarzes were randomly selected from khaf and Sarakh health centers as the statistical sample. The intervention of face-to-face training in Sarakhs health center and intervention of distance education in Khaf Health Center were used. Data was analyzed through SPSS 24 software.Results: Based on the results of paired t-test, it was found that face to face training intervention was effective on self-care of non-communicable diseases in Behvarz of Sarakhs city (p-value = 0.001). But self-care distance education intervention has not been effective on self-care of non-communicable diseases in Behvarz of khaf city (p-value=0.1). Also the results of comparing the mean of two methods of face to face and distance training showed that there was a significant difference between the scores mean of Behvarz in the two methods (p-value = 0.001) and the face to face training intervention was more effective than distance training intervention.Conclusion: Self-care face to face training of non-communicable diseases in Behvarz is more effective than distance training.

Effectiveness Diabetes Self Care Management Education (DSME) intervention with Short Message Service (SMS) or Mobile Application in Glycemic Control: A Systematic Review

Introduction: Glycemic control in DM is responsive to the condition of patients who have hemoglobin A1c (HbA1c) levels of 5-6%. However, most patients find it difficult to achieve the target of glycemic control. Diabetes Self-Management Education (DSME), which integrates the five pillars of DM management, emphasizes intervention behavior independently. The purpose of this systematic review is to analyze the effectiveness of diabetes self-management education intervention with short message service (SMS) or mobile application on glycemic control.Methods: This systematic review was conducted by searching five electronic databases, such as Scopus, PubMed, Science Direct, Springer Link and ProQuest over five years or more with full text in the English language. The search keywords were adjusted according to the medical subject headings and Boolean operators. This study used the PRISMA flow chart to select articles. Fifteen studies were included if they reported on diabetes self-care management education intervention with short message service or mobile application interventions in patients with diabetes. Reviews and editorials were excluded.Results: DSME interventions with SMS and with mobile application have effectiveness to manage and decrease glycemic control (HbA1c and blood glucose level) by health education, diet monitoring, and self-monitoring of blood glucose levels.Conclusion: This systematic review has shown that DSME intervention with SMS and mobile application significantly improves glycemic control despite the heterogeneity across the studies. The recommendation for further research is to analyze the comparison of the effectiveness of online and direct DSME intervention, which can improve glycemic control.

The effects of add-on self-care education on quality of life and fatigue in gastrointestinal cancer patients undergoing chemotherapy

BackgroundGastrointestinal cancer is one of the most common malignancies and imposes heavy burdens on both individual health and social economy. We sought to survey the effect of a self-care education program on quality of life and fatigue in gastrointestinal cancer patients who received chemotherapy.MethodsNinety-one eligible gastrointestinal cancer patients were enrolled in this study and 86 valid samples were analyzed. Data were acquired with a demographics questionnaire, endpoint multidimensional questionnaire and the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire QLQ-C30. The collected data were analyzed using SPSS software.ResultsThe self-care education intervention significantly improved the quality of life with respect to emotional function (p = 0.018), role function (p = 0.041), cognitive function (p = 0.038) and alleviated side effects such as nausea/vomiting (p = 0.028) and fatigue (p = 0.029). Further analysis demonstrated that the self-care education benefited total fatigue, affective fatigue and cognitive fatigue in gastrointestinal cancer patients regardless of baseline depression.ConclusionOur results suggested the beneficial effects of the self-care education in both quality of life and anti-fatigue in gastrointestinal cancer patients under chemotherapy. The self-care education could be considered as a complementary approach during combination chemotherapy in gastrointestinal cancer patients.

Effectiveness of a theory of planned behavior-based intervention for promoting periodontal preventive behaviors among medical students in Taiwan

Objective To evaluate the effectiveness of an oral self-care education intervention based on the Theory of Planned Behavior in Taiwanese undergraduates. Participants We recruited 63 and 90 students in the experimental group (EG) and comparison group (CG), respectively, from a medical university. Methods A quasi-experimental design was employed. The EG received health education and a brief action and coping planning intervention. Results The EG was significantly more likely to brush for more than 3 minutes (adjusted odds ratio [aOR] = 2.52), use the modified Bass brushing technique (aOR = 7.81), and floss (aOR = 21.21) at the 2-week follow-up than was the CG. At the 6-week follow-up, the combined effect of high action and coping planning with high perceived power for predicting floss use was observed in the EG (p < 0.05). Conclusions Intervention may promote periodontal-disease-preventing behaviors in undergraduates, particularly for achieving adherence to daily flossing.

An educational intervention on foot self-care behaviour among diabetic retinopathy patients with visual disability and their primary caregivers.

To assess the effectiveness of a 12-week educational intervention on foot self-care behaviour among diabetic retinopathy patients with visual disability and their primary caregivers in China. Diabetes with the coexistence of diabetic retinopathy and foot problems complicating diabetes not only represents a personal disaster, but also becomes a serious burden to public health in China. A foot self-care educational intervention is both cost-effective and feasible even in a health resource-limited setting, which should be developed and evaluated. Quasi-experimental. From July-September 2017, we enrolled 80 eligible hospitalised diabetic retinopathy patients and their primary caregivers by convenient sampling method in a first-class comprehensive hospital in Nantong, in China. Before and after the educational intervention that is in accordance with the TREND statement (for details, see the "Supplementary File 1"), researchers and subjects filled out the self-designed questionnaire on foot problems complicating diabetes and the Diabetic Foot Self-care Behavior Scale, respectively. Scores of foot self-care behaviour among the subjects significantly improved from 54.19±8.01-75.85±5.04. The number of patients with fasting blood glucoses <7.0mmol/L improved from 43 (53.75%)-80 (100%). The results of incidence of foot problems complicating diabetes were not statistically significant. The complete execution of each item in Diabetic Foot Self-care Behavior Scale of subjects was apparently higher. This educational intervention can facilitate positive foot self-care behaviours among the diabetic retinopathy patients with visual disability and their primary caregivers in China. This study adds to the evidence of the effectiveness of an educational intervention to foster positive foot self-care behaviours. This educational intervention appears to be prospective in promoting diabetic home-based self-management in China, and the delivery method of the intervention may be applied to other chronic diseases.

A systematic review of the effectiveness of clinical nurse specialist interventions in patients with chronic obstructive pulmonary disease (COPD)

Abstract Objective This review aimed to examine the effectiveness of clinical nurse specialist (CNS) interventions in patients with chronic obstructive pulmonary disease (COPD). COPD significantly affects people’s health worldwide. With the development in nursing, CNSs are playing increasingly important roles in different departments. However, the studies on the effectiveness of CNSs in COPD are not as well organized as the studies on the effectiveness of CNSs in bronchiectasis and asthma. Therefore, this review aims to find some updated evidence on the CNS interventions for patients with COPD and on whether these interventions are effective. Methods A narrative analysis of the data was performed for the eligible studies. Four databases were chosen: CINAHL, MEDLINE, British Nursing Index, and Cochrane Library. Other websites such as the National Institute for Health and Clinical Excellence, National Health Service Evidence, Association of Respiratory Nurse Specialists, and National Association of Clinical Nurse Specialist were searched as well. Two reviewers performed study identification independently, and all the retrieved articles were stored using the EndNote X7 software. The risk of bias in the included studies was assessed using the Cochrane Collaboration’s risk of bias tool. Results A total of nine studies were included in this review. There were five current interventions by CNSs for patients with COPD. These interventions were home nursing support, CNS’s supported discharge, multidisciplinary cooperation programs, nurse-led care programs, and self-care management education. The effectiveness of these five interventions was evaluated individually. There is low- to moderate-quality evidence indicating that home nursing support interventions may have a positive effect on mortality and quality of life. No significant difference in quality of life has been found between the CNS-supported discharge intervention and the usual service. The multidisciplinary cooperation program probably had a positive effect on quality of life in patients with COPD. Both nurse-led care and self-care management education intervention had a positive effect on mortality of patients with COPD. Conclusions The findings of this review provide updated evidence on the effectiveness of CNS interventions for patients with COPD. Although nine trials were included and five types of interventions were identified, there is still lack of high-quality evidence.

The efficacy of social cognitive theory-based self-care intervention for rational antibiotic use: a randomized trial.

Misuse of antibiotics can be described as a failure to complete treatment, skipping of the doses and reuse of leftover medicines and overuse of antibiotics. Health education interventions are expected to enhance awareness and general belief on rational antibiotics use. Therefore, the study aimed to determine the efficacy of social cognitive theory (SCT)-based self-care intervention for rational antibiotic use. This randomized trial was conducted in a sample of 260 adults. The study participants were randomly assigned as the intervention (n=130) and a control (n=130) groups. The intervention group received self-care educational intervention of four sessions lasting 45-60 min augmented with the text messages and the control groups attended usual education program in health centers. The study participants were invited to complete questionnaires at the baseline and end of the intervention. The data were analyzed using SPSS version 23.0. Chi-square (X2), independent t-test and covariance analysis were used for data analysis. P<0.05 was considered statistically significant. After the intervention, all SCT constructs revealed significant differences in the intervention group compared with control groups (P<0.001). Awareness and general beliefs of rational antibiotic use showed a significant difference in intervention group before and after six months (P<0.001) whereas in control group no significant differences (P>0.05). The study suggested that tailored appropriate educational programs based on SCT constructs can reflect a positive impact on appropriate antibiotics use. Therefore, a tailored health promotion intervention should be provided to enhance the awareness and general beliefs of the target groups.

Self-care educational intervention to reduce hospitalisations in heart failure: A randomised controlled trial

A variety of educational interventions have been implemented to assist patients with heart failure to maintain their own health, develop self-care behaviours and decrease readmissions. The purpose of this study was to determine the effectiveness of a multimedia educational intervention for patients with heart failure in reducing unplanned hospital readmissions. The study, a randomised controlled trial in a large tertiary referral hospital in Australia, recruited 200 patients. Patients diagnosed with heart failure were randomly allocated 1:1 to usual education or a multimedia educational intervention. The multimedia approach began with an individual needs assessment to develop an educational plan. The educational intervention included viewing a DVD, and verbal discussion supported by a written manual with a teach-back evaluation strategy. The primary outcome was all-cause unplanned hospital readmission at 28 days, three months and 12 months post-recruitment. The secondary outcomes were changes in knowledge and self-care behaviours at three months and 12 months post-recruitment. At 12 months, data on 171 participants were analysed. There were 24 participants who had an unplanned hospital readmission in the intervention group compared to 44 participants in the control group ( p=0.005). The self-care educational intervention reduced the risk of readmission at 12 months by 30% (relative risk: 0.703; 95% confidence interval: 0.548-0.903). A targeted multimedia educational intervention can be effective in reducing all-cause unplanned readmissions for people with heart failure.

An evaluation of involving family caregivers in the self-care of heart failure patients on hospital readmission: Randomised controlled trial (the FAMILY study)

BackgroundThe prevalence of heart failure is increasing in Lebanon but to date there is no systematic evaluation of a disease management intervention. ObjectiveThe aim of this study was to evaluate the effect of involving family caregivers in the self-care of patients with heart failure on the risk of hospital readmission. DesignA multi-site, block randomised controlled trial. SettingsThe study was conducted over a 13-month period in three tertiary medical centres in Beirut and Mount Lebanon, Lebanon. ParticipantsAdult patients presenting for an exacerbation of heart failure to one of the study centres were included. Patients with limited life expectancy or physical functionality, planned cardiac bypass or valve replacement surgery, living alone or in nursing homes, or aged less than 18 years were excluded. MethodsPatients allocated to the intervention group and their family caregivers were provided with a comprehensive, culturally appropriate, educational session on self-care maintenance and symptom management along with self-care resources. The usual care group received the self-care resources only. Follow-up phone calls were conducted 30days following discharge by a research assistant blinded to treatment assignment. The primary outcome was hospital readmission and the secondary outcomes were self-care, quality of life, major vascular events and healthcare utilization. ResultsThe final sample included 256 patients hospitalized for heart failure randomised into control (130 patients) and intervention (126 patients) groups. The mean age was 67 (SD=8)years, and the majority (55%) were male. Readmission at 30days was significantly lower in the intervention group compared to the control group (n=10, 9% vs. n=20, 19% respectively, OR=0.40, 95% CI=0.02, 0.10, p=0.02). Self-care scores improved in both groups at 30days, with a significantly larger improvement in the intervention group than the control group in the maintenance and confidence sub-scales, but not in the self-care management sub-scale. No differences were seen in quality of life scores or emergency department presentations between the groups. More patients in the control group than in the intervention group visited health care facilities (n=24, 23% vs. n=12, 11% respectively, OR=0.39, 95% CI=0.18, 0.83, p=0.01). ConclusionThe trial results confirmed the potential of the family-centred self-care educational intervention under evaluation to reduce the risk of readmission in Lebanese patients suffering from exacerbated heart failure. Further research is needed to validate these findings with longer periods of follow-up and to identify the intervention components and intensity required to induce sustained benefits on patients' self-care management and quality of life.

The Self-care Educational Intervention for Patients With Heart Failure: A Study Protocol.

A variety of educational interventions have been implemented to assist patients with heart failure (HF) to maintain their own health, develop self-care behaviors, and decrease readmissions. The most effective approach to education has yet to be established. The aim of this study is to determine the effectiveness of a multimedia educational intervention for patients with HF in reducing hospital readmissions. Secondary outcomes include changes in knowledge and self-care behaviors. A randomized controlled trial in a large tertiary referral hospital in Australia has recruited 200 patients and will follow them for 12 months. Patients diagnosed with HF have been randomly allocated 1:1 to either usual education or a multimedia educational intervention. Framed by the principles of adult learning, this individualized intervention was delivered face to face by a specialized HF nurse, with a targeted educational assessment and subsequent development of an educational plan. The multimedia approach combined viewing a DVD and verbal discussion supported by a written manual. The teach-back strategy at the conclusion of the intervention evaluated the patient's learning through 5 key questions about self-management of HF. Readmissions are assessed at 28 days, 3 months, and 12 months. Knowledge and self-care behavior are assessed at baseline, 3 months, and 12 months. This study evaluates the effectiveness of a targeted multimedia educational intervention. Study results may inform the design of in-hospital education for HF patients.

The Effect of the Supportive Educative Nursing Program on Glycemic Control in Vietnamese Patients with Uncontrolled Type 2 Diabetes Mellitus: a Randomized Controlled Trial

Background: The prevalence of uncontrolled diabetes has dramatically increased. Nursing interventions in this area are limited. This study was a randomized controlled trial design that aimed to test the effect of the supportive educative nursing program on glycemic control in Vietnamese patients with uncontrolled type 2 diabetes mellitus. Methods: Eighty-four participants were randomly assigned to an experimental (n=41) and a control group (n=43). Participants in the experimental group received the supportive educative nursing program while the control group received routine care. The glycated hemoglobin (Hb A1C ) level was measured as an indication of glycemic control on day one, before implementation of the program, and at 3 months after, following program implementation. Descriptive statistics, the Chi-square test and the Fisher exact test were used to analyze the data. Results: After 3 months of program implementation, the mean score of Hb A1C level in the experimental group (Mean = 8.47%, SD = 1.27) was lower than that in the control group (Mean = 9.4%, SD = 1.36). Moreover, the proportion of glycemic control in the experimental group was significant higher than that in the control group (p<.02). Conclusions: This finding suggests that a self-care education intervention can improve glycemic control level of Vietnamese patients with uncontrolled type 2 diabetes mellitus which leads to better quality of patients’ life.

The Self-Care Educational Intervention study: study protocol of a randomised controlled trial

Background: A variety of educational interventions have been implemented to assist patients with heart failure maintain their own health, develop self-care behaviours and decrease readmissions. The most effective approach to education has yet to be established. Aim: To determine the effectiveness of a multimedia educational intervention for patients with heart failure in reducing hospital readmissions. Secondary outcomes will include changes in knowledge and self-care behaviours. Design: A randomised controlled trail in a large tertiary referral hospital will recruit 200 patients with 12 month follow-up. Patients diagnosed with heart failure and being managed by a heart failure service will be randomly allocated 1:1 to either usual education or a multimedia educational intervention. The intervention, based on the principles of adult learning is delivered face to face by a specialised heart failure nurse and is individualised. It includes a targeted educational assessment and subsequent development of an educational plan. A multimedia approach is utilised including verbal discussion, viewing of a DVD and provision of a written manual. The teach-back strategy at the conclusion of the intervention evaluates the patient's learning through 5 key questions about self management of heart failure. Readmissions are assessed at 28 days, 3 months and 12 months. Knowledge and self-care behaviour are assessed at recruitment, 3 months and 12 months. Discussion: This study evaluates the effectiveness of a targeted multimedia educational intervention. Study results will contribute to a better understanding of the impact of an individualised needs assessment, education plan and teach-back evaluation strategy on patient outcomes.

Effects of A Foot Self-Care Educational Intervention on Improving Footwear in Patients with Type 2 Diabetes at Low Risk for Foot Ulceration

s / Can J Diabetes 38 (2014) S29eS74 S31 France; FSD in Japan). Upon adjusting for demographic/clinical practice variables, regression models showed a negative relationship between physician empathy and perceived challenges for total score (all 12 items) as well as DPD and FSD (all p<0.0001). Thus many physicians, especially those scoring lower on empathy, report significant challenges and frustrations with diagnosis conversations. 92% wanted tools to help pts sustain behavioural change. Supporting use of empathy-related skills may contribute to better pt outcomes.