Self-care Empowerment Research Articles

Care self-efficacy in adolescents with mental disorders: A qualitative study.

The promotion of health in adolescents with mental disorders depends on their levels of self-care empowerment. Self-efficacy is a significant prerequisite for successful self-management and behavior change in adolescents with mental disorders. The present study was conducted to explain the concept of care self-efficacy in adolescents with mental disorders. This qualitative study was carried out using the conventional content analysis approach. Semi-structured interviews (n = 34) were conducted with adolescents having mental disorders, their families, and healthcare providers. The participants were selected from neurology and psychiatry clinics affiliated with University of Medical Sciences using the purposeful sampling method in 2021. Data were analyzed according to Graneheim and Lundman method. According to the findings of content analysis, four main themes were derived from the data: "health information-seeking behavior," "adaptation of life to the disease and treatment conditions," "adaptive coping," and "social self-care." Based on the findings, the promotion of adaptive styles and social support is effective in acquiring social competencies. As a result, policymakers are suggested to design health-oriented educational programs based on care self-efficacy principles to promote health in adolescents with mental disorders.

Cardiovascular disease, self-care and emotional regulation processes in adult patients: balancing unmet needs and quality of life

BackgroundCardiovascular disease is a chronic non-communicable illness that causes more than half of all deaths across Europe. Unhealthy lifestyle, inadequate adherence to medical prescriptions, themselves associated with psycho-emotional disorders are considered risk factors for reduced quality of life as well physical condition.ObjectiveAim of our study was to understand predictive factors for disease management by evaluating psychological aspects, self-care processes and emotional regilati0on in CVD outpatients.MethodsAn observational study was conducted. Sixty-one patients, age 18–75 years (M 56.4 ± sd 12.0), diagnosed with CVD participated in the study. The psychological battery was administered during clinical follow-up oriented to detect emotional and psychological dimensions as well adaptive behavioral and quality of life by standardized questionnaire/scales.ResultsFinding showed that emotional dysregulation might influence QoL, particularly significant effect of awareness (β= 0.022; SE = 1.826; p < 0.002), goals (β = - 0.54; SE = 1.48; p < 0.001) and clarity (β = - 0.211; SE = 2.087; p < 0.003). The results also suggest that the mediated effect accounted for awareness index was 18.7% (R2 = 0.187) of the variance; goals index 62.8% (R2 = 0.628) of the variance and, then significant mediated effect of clarity was 58.8% (R2 = 0.588) of the variance. This evidence suggests that the relationship between triggers and QoL is mediated by emotional dysregulation indexes.ConclusionIn clinical practice psychological screening can be an effective tool for detecting predictive factors in the management of the CVD patient's health and adherence to medical treatment: the screening of predictive psychological factors for allowing a good clinical condition management and a self-care empowerment aimed at increasing psychological well-being and the Quality of Life by planning adequate integrated and multidisciplinary support.

IDF21-0231 Effect of multidisciplinary for improves diabetes outcomes: Diabetes Education, Awareness and Lifestyle modification

Background: There is a global pandemic of type2 diabetes mellitus (T2DM), mainly in Asia. Thailand has a prevalence of T2DM at 9.6%, which is higher than the world average of 8.9%. Multiple studies have shown that multidisciplinary, team-based, coordinated care has been associated with improved measures of quality care and reduced healthcare utilization. Patients with poor glycemic control and nephropathy are at the highest risk of developing cardiovascular complications and renal failure. Aim: In this study, we aimed to explore the impact of intensive multidisciplinary diabetes mellitus care with patient empowerment versus routine clinical care on the rate of progression of micro and macro vascular complications and peripheral atherosclerotic burden, as measured by change in arterial blood Index (ABI) in patients with persistently elevated HbA1c and nephropathy. Method: The study is randomized controlled trial (RCT) of intensive diabetes mellitus care with patient empowerment versus routine clinical care. Patient in the intensive arm will receive care from a multidisciplinary team consisting of an endocrinologist, diabetes nurse educator, dietitian, renal pharmacist and social worker for counseling. In addition, patients will be provided with tools for self-care empowerment such as glucometers, blood pressure monitors and calendar record to facilitate care, monitoring and education. Patients in the routine clinical care will receive standard clinical care. Follow up (FU) will be 2 years. Primary outcomes include cardiovascular events, rate of progression of nephropathy and development of end-stage renal disease. Secondary endpoints include the proportions of patients with documented improved control of cardiovascular risk factors (HbA1c, blood pressure, low density lipoprotein-(LDL-C), reduction in body weight), frequency of hypoglycemia, hospitalization days and change in ABI. We will also examine the prevalence of peripheral atherosclerosis and the predictive value and usability of lower extremity arterial ultrasound to predict cardio-cerebrovascular events, amputation and peripheral intervention. Results: The cumulative incidence of all events (DM-related complications and all-cause mortality) was 21.2% in the Trial-DM group and 40.6% in the usual care group. Trail-DM led to significantly greater reductions in cardiovascular disease (CVD) risk by 52.6% (95% CI 50.5, 54.6), micro vascular complications by 10.9% (95% CI 6.8, 14.6), mortality by 65.1% (95% CI 61.3, 62.9), specialist attendance by 31.0% (95% CI 30.6, 32.4), emergency attendance by 39.2% (95% CI 36.8, 40.5), and hospitalizations by 53.5% (95% CI 53.2, 56.7). Patients with low baseline CVD risks benefitted the most from Trail-DM, which decreased CVD and mortality risk by 58.4% (95% CI 50.8, 64.5) and 79.6% (95% CI 72.3, 81.0), respectively. Discussion: Diabetes mellitus carries significant health care cost. Patients with poorly glycemic control and nephropathy are at highest risk of developing cardiovascular complications and renal failure. Intensive diabetes mellitus care with patient empowerment may lead to sustained glycemic control, reduction of clinical complications and progression of nephropathy, and incidence of cardiovascular complications.

Effect of multidisciplinary intensive targeted care in improving diabetes mellitus\xa0outcomes: a randomized controlled pilot study \u2013 the Integrated Diabetes Education, Awareness and Lifestyle modification in Singapore (IDEALS) Program

BackgroundThere is a global pandemic of type 2 diabetes mellitus (T2DM), especially in Asia. Singapore has a prevalence of T2DM at 10.5%, which is higher than the world average of 8.8%. Multiple studies have shown that multidisciplinary, team-based, coordinated care has been associated with improved measures of quality care and reduced healthcare utilization. Patients with poor glycemic control and nephropathy are at the highest risk of developing cardiovascular complications and renal failure. In this study, we aimed to investigate the impact of intensive multidisciplinary diabetes mellitus care with patient empowerment versus routine clinical care on the rate of progression of micro and macrovascular complications and peripheral atherosclerotic burden, as measured by changes in femoral intima-media thickness (IMT) in patients with persistently elevated HbA1c and nephropathy.MethodsThe study is a single-center randomized controlled trial (RCT) with two study arms - intensive diabetes mellitus care versus routine clinical care. Patients in the intensive arm will receive care from a multidisciplinary team consisting of an endocrinologist, diabetes nurse educator, dietitian, renal pharmacist and medical social worker for counselling. In addition, patients will be provided with tools for self-care empowerment such as glucometers, blood pressure monitors and android tablets to facilitate care, monitoring and education. Patients in the routine clinical care arm will receive standard clinical care. Follow up (FU) will be for 3 years. Primary outcomes include cardiovascular events, rate of progression of nephropathy and development of end-stage renal disease. Secondary endpoints include the proportions of patients with documented improved control of cardiovascular risk factors (HbA1c, blood pressure, low density lipoprotein-C (LDL-C), reduction in body weight), frequency of hypoglycemia, hospitalization days and changes in femoral IMT. We will also examine the prevalence of peripheral atherosclerosis and the predictive value and usability of lower extremity arterial ultrasound to predict cardio-cerebrovascular events, amputation and peripheral intervention.DiscussionDiabetes mellitus carries significant healthcare costs. Patients with poor glycemic control and nephropathy are at highest risk of developing cardiovascular complications and renal failure. Intensive diabetes mellitus care with patient empowerment may lead to sustained glycemic control, reduction of clinical complications and progression of nephropathy, and incidence of cardiovascular complications.Trial registrationClinicalTrials.gov, NCT03413215. Registered on 29 January 2019.

Performance of Public Health Nurses and Coverage of the Nursing Care Program by Community Health Centers in Jember, Indonesia

ABSTRACTBackground: The coverage of the nursing care program by PHCs in the category of vulnerable families, community groups, and self-care empowerment was 48.28%, 44.87%, and 49.50%, respectively. The average coverage (low vs. high) by CHCs in the category of vulnerable families, community groups, and self-care empowerment was 50.0% versus 50.0%, 52.0% versus 48.0%, and 52.0% versus 48.0%, respectively. A significant correlation was found between the pre-defined targets and the coverage of the nursing care program by PHCs in vulnerable families (r=0.488; P<0.001), nursing care in communities’ groups (r=0.316; P=0.026), and empowerment of families’ self-care (r=0.531; P<0.001). Methods: A cross-sectional study based on secondary analysis, obtained from the Health Department of Jember District (East Java, Indonesia), was conducted in 2016. The data included quality improvement initiatives and outcomes of the nursing care program, which had been collected from 50 CHCs in Jember. The performance of PHNs and the coverage of the nursing care program by CHCs were evaluated based on three categories, namely nursing care for vulnerable families, nursing care for community groups, and family self-care empowerment. The data were analyzed using the SPSS statistical software (version 22.0).Results: The coverage of the nursing care program by PHCs in the category of vulnerable families, community groups, and self-care empowerment was 48.28%, 44.87%, and 49.50%, respectively. The average coverage (low vs. high) by CHCs in the category of vulnerable families, community groups, and self-care empowerment was 50.0% versus 50.0%, 52.0% versus 48.0%, and 52.0% versus 48.0%, respectively. A significant correlation was found between the pre-defined targets and the coverage of the nursing care program by PHCs in vulnerable families (r=0.488; P<0.001), nursing care in communities’ groups (r=0.316; P=0.026), and empowerment of families’ self-care (r=0.531; P<0.001).Conclusion: The results showed that 50% of the CHCs did not meet the required program coverage. The performance of PHN to achieve target of PHCs was correlated with the program coverage of PHCs. The competence of PHNs in providing care to the families and the community, particularly in rural areas, should be improved through an integrated training program.

Interdisciplinary care praxis in groups of people living with fibromyalgia.

to analyze the integrated community therapy model for the empowerment of people living with fibromyalgia and discuss the impact of this interdisciplinary intervention in the health-disease process and self-care. a participatory-approach qualitative study, developed in 2015 with 11 participants at the Laboratory of Physiology Applied to Physical Education of the Rio de Janeiro State University, RJ. Data production comprised World Café, participant observation and semi-structured interview. The analysis was performed according to Bardin, through data triangulation in dialogue with the relevant literature. the integrated community therapy group is a driving force in building and expanding knowledge about fibromyalgia and in self-care empowerment. this group strategy proved to be an interdisciplinary praxis tool that enables the development of solidary care networks. Thus, shared knowledge was generated, transformed into a listening and reflection environment to manage personal and family obstacles.