Self-Care Inventory Research Articles

Sustainability of health outcomes of patients with type-2 diabetes mellitus after completing 6 months of remote tele-monitoring: Two-year results from a randomised controlled trial (OPTIMUM).

Meta-analysis shows that home tele-monitoring (HTM) improves glycaemic control in patients with type-2 diabetes mellitus (T2DM) up to 12 months, but their health outcomes after HTM cessation remains unclear. This study aimed to determine the health outcomes of these patients 18 months after completing 6 months of HTM, compared to standard care. Patients with T2DM were enrolled in an open-labelled randomised controlled trial, aged 26 to 65 years, and suboptimal glycaemic control (HbA1c = 7.5%-10%). Patients in the intervention group (n = 165) undertook HTM using the OPTIMUM (Optimising care of Patients via Telemedicine In Monitoring and aUgmenting their control of diabetes Mellitus) HTM system for 6 months followed by usual care for another 18 months, while control group (n = 165) had usual care for 24 months. The OPTIMUM HTM system includes in-app video-based tele-education, tele-monitoring of the blood pressure (BP), capillary glucose and weight via Bluetooth devices and mobile applications, followed by algorithm-based telecare by the investigators. They were assessed using the Self-Care Inventory Scale (SCIR) and medication adherence (Medication Adherence Report Scale 5) at baseline, 6-month and 24-month time-points. The data from 146 (intervention) and 152 (control) patients, with comparable baseline demographic profiles were eventually analysed. The decrease in HbA1c over 24 months was comparable between intervention and control group. Those in the intervention group were more likely to maintain their glycemic control (HbA1c ≤ 8%) (adjusted odds ratio (AOR) = 1.9, 95%confidence interval (CI) = 1.1-3.2; p = 0.028), had higher SCIR score (p = 0.004), and less likely to "never forget" (p = 0.022), or "stop medications" (p = 0.048), at 24-month time-point as compared to subjects in the control group. The glycaemic control of patients with T2DM continued to be maintained for another 18 months after 6 months of HTM, which were attributed to sustained self-care behaviour and medication adherence.

Measuring Self-Care: A Description of the Family of Disease-Specific and Generic Instruments Based on the Theory of Self-Care of Chronic Illness.

In recent years, there has been an exponential increase in attention paid to the patient-reported outcome of self-care. Many investigators have used one of the families of self-care instruments freely available on the website www.self-care-measures.com. These self-care measures have been translated into many languages, which are also available on the website. The measures include both disease-specific and generic instruments, which are based on a common theoretical framework, the Middle Range Theory of Self-Care of Chronic Illness. The purpose of this article is to illustrate similarities among the instruments and to standardize their scoring, analysis, and use. We describe the Self-Care of Heart Failure Index, the Self-Care of Coronary Heart Disease Inventory, the Self-Care of Hypertension Inventory, the Self-Care of Diabetes Inventory, the Self-Care of Chronic Obstructive Pulmonary Disease Inventory, the Self-Care of Chronic Illness Inventory, and the Self-Care Inventory. Detailed guidance on scoring, translation, and analysis is provided. Complementary measures of self-care self-efficacy and those used to measure caregiver contributions to patient self-care are briefly described. Many of the common questions of instrument users are answered in this article. Following this guidance will facilitate consistent use of the instruments, which will enable users to compare their results to those of others worldwide and facilitate future reviews and meta-analyses.Clinical ImplicationsThis review, emphasizing standard scoring and interpretation, is useful for clinicians and researchers across various populations and settings.

Correlation of Diabetes self-care adherence with glycemic measures: a cross-sectional health facility-based study in Kathmandu, Nepal

Self-care plays a key role in prevention of complications, and improvement of the quality of life of persons with diabetes (PWDs). This study has assessed adherence to self-care behavior and its correlation with glycemic measures among PWDs attending private health care facilities in Kathmandu, Nepal. A cross-sectional study was carried out using a semi-structured questionnaire. Socio-demographic information and recent fasting (FBG) and 2-hr post-prandial blood glucose (2-hr PBG) levels were recorded. Self-care inventory (SCI) 12-item version was used to assess adherence to diabetes self-care over the preceding four weeks. Self-care practice was measured in five domains: glucose monitoring; diabetes medication; diet; exercise; and preventative care. The overall adherence score was obtained by computing the average of seven items (items 1, 2, 4, 5, 6, 7, 14). Scores more than or equal to median score were considered as higher levels of self-care efficacy. Univariate linear regression analysis of the subscale scores and individual item-wise score with age, duration of diabetes (years), FBG and PPBG levels was carried out. Pearson’s coefficient (r) was reported for normally distributed variables. Among 385 PWDs, mean FBG was 146 mg/dl (±54.7), 2-hr PBG was 210 mg/dl (±82). Median score for overall adherence to diabetes self-care was 25 (IQR:21 to 29). Higher self-care efficacy was seen among 55% (n=212). Overall adherence to self-care was significantly and negatively correlated with age and glycemic measures. Self-care efficacy was mainly driven by adherence to diabetes medication. Adherence to preventative care, exercise and home monitoring of blood glucose was low. FBG was significantly and negatively correlated with glucose regulation (r=-0.16, P=0.001), diabetes medication and food regulation (r=-0.11, P=0.03), preventative care (-0.14, P=0.03) and overall adherence to treatment (-0.15, P=0.004). 2-hr PBG was significantly and negatively associated with all domains of self-care (r -0.14, P=0.04 to -0.21, P<0.0001). Elderly persons, may face difficulty with regular physical exercise, dietary recommendations and overall adherence to self-care. Continuing diabetes education is imperative to motivate PWDs and caregivers regarding importance of self-care efficacy in glycemic regulation and diabetes care.

Psychosocial consequences of the COVID-19 pandemic and its effects on professional resilience and self-care on nurses: an example of Ankara

ABSTRACT The COVID-19 pandemic has significantly impacted nurses, who are frontline care providers, with high infection risk, disease transmission to relatives, and adverse psychosocial effects. This descriptive and correlational study examines the psychosocial impact of COVID-19 on 224 nurses, focusing on their professional resilience and self-care during active care of COVID-19 patients from December 2022 to August 2023. Data was collected through demographic information forms, questionnaires, and scales. Structural equation modeling was used for the relational dimension of the study. The mean score of the nurses’ COVID-19 Pandemic Psychosocial Impact Scale was 85.43 (SD = 22.08), while the Skovholt Practitioner Professional Resiliency and Self-Care Inventory had a mean score of 135.64 (SD = 19.73). A statistically significant low-level negative relationship between the scale scores (r = -0.220). The COVID-19 pandemic’s psychosocial impact scores significantly impact personal vitality and stress, indicating a direct negative effect on these factors, according to structural equation modeling results.

The Relationship Between Self-care Ability and Health-Promoting Behaviors of Patients with Multiple Sclerosis

Background: Multiple sclerosis (MS) is a chronic disease. Familiarity and awareness of self-care conditions and health-promoting behaviors contribute to patients’ self-efficacy. Objectives: This study examines the relationship between self-care ability and health-promoting behaviors in patients with Multiple Sclerosis. Methods: This descriptive-analytical study involved 112 MS patients from the MS Society of Khuzestan province, selected through convenience sampling. Data were collected using a demographic form, Weaver’s Self-Care Inventory (SCI), and Walker’s Health-Promoting Lifestyle Profile (HPLP), then analyzed with SPSS software at a significance level of 0.05. Results: The mean self-care ability score was 104.49 ± 12.72 (range 40 - 240), and the mean health-promoting behavior score was 132.52 ± 12.72 (range 50 - 208), indicating overall poor health-promoting behaviors. Self-care ability was significantly related to health-promoting behaviors in MS patients (P < 0.01). Age (P = 0.001), education (P = 0.002), and job type (P = 0.017) showed significant relationships with self-care ability. However, there was no significant relationship between demographic variables and health-promoting behaviors (P < 0.05). Conclusions: Multiple sclerosis patients exhibit poor health-promoting behaviors and self-care ability. Improving self-care ability and health-promoting behaviors requires ongoing education and culturalization. The MS Society can design and implement structured training programs by understanding the self-efficacy needs and abilities of patients and collaborating with other therapy group members.

Öz Bakım Envanteri’nin Türkçe Geçerliği ve Güvenirliği

Amaç: Öz bakım, bireylerin sağlığını geliştirme, hastalıklarını önleme, sağlıklarını koruma ve hastalık ve sakatlıkla başa çıkma yeteneğidir. Öz bakım üç boyuttan oluşur; sağlığı geliştirme ve tedaviye uyum (öz bakımı sürdürme), vücudu anlama ve semptom tanıma (öz bakım izleme) ve semptomları kontrol altına almak için harekete geçme (öz bakım yönetimi). Bu çalışmada genel yetişkin popülasyonunda öz bakımı ölçmek için Michela Luciani ve arkadaşları tarafından geliştirilen Öz Bakım Envanteri’nin Türkçe geçerlik ve güvenirlik çalışmasını yapmak amaçlanmıştır. Gereç ve Yöntem: Araştırma metodolojik tiptedir. Araştırma verileri Şanlıurfa’daki Zeliha Öncel Aile Sağlığı Merkezi’nde Eylül-Ekim 2022 tarihleri arasında toplandı. Çalışma 18 yaş ve üzeri 311 kişiyle tamamlandı. Veriler SPSS 26.0 ve AMOS programı kullanılarak analiz edildi. Faktör yapısı incelenirken; Bartlett ve Kaiser-Meyer-Olkin testi yapıldı. Maddelerin faktör yapılarına uygunluğunu ve bu faktörler ile yapının yeterince temsil gücünü test etmek için ise, Doğrulayıcı Faktör Analizi (DFA) yapıldı. Envanterin güvenirliği için; madde toplam puan analizi, iç tutarlılığını belirlemek için Cronbach Alfa katsayısı, toplanabilir özelliği olup olmadığını değerlendirmede Tukey Toplanabilirlik Analizi, tepki yanlılığını belirlemede Hotelling T Kare testi kullanıldı. Bulgular: Cronbach alfa iç tutarlık katsayısı 0.86 olarak bulundu. Split half testi sonucunda envanterin ilk yarısının cronbach alfa değeri 0.75, ikinci yarısının cronbach alfa değeri 0.77 olarak bulundu. Envanterin, Tukey Toplanamazlık testi sonucuna göre toplanamazlık değeri P<0.001 olarak bulundu. Maddeler arası F değeri 59.301, P<0.001 olarak bulundu. Hotelling’s T testi P<0.001 olarak bulundu. Kaiser-Meyer Olkin (KMO) değeri 0.90, Bartlett’in küresellik testi sonucu P<0.001 olarak bulundu. DFA sonucunda tespit edilen uyum iyiliği değerleri şu şekildedir: CMIN/df: 1.47; GFI: 0.93; CFI: 0.95; RMSEA: 0.04; AGFI: 0.91 ve IFI: 0.95. Envanter toplam puanı kadınlarda, yükseköğrenim düzeyinde, gelir düzeyi iyi olanlarda ve çocuğu olmayanlarda istatistiksel olarak anlamlı düzeyde yüksek bulundu (P<0.05). Sonuç: Envanter 3 boyut ve 20 sorudan oluşan haliyle Türkçe konuşan toplumda kullanmak için uygun bulundu. Yapılan faktör analizleri sonrası envanterin geçerlik ve güvenirliği belirlendi.

Involvement in self-care of a patient with type 2 diabetes aged 60-80

Introduction: Self-care is an indispensable element of the treatment of type 2 diabetes, it involves the independent implementation of multidimensional activities that allow you to maintain proper glucose levels and reduce the risk of complications.
 Materials and methods: The study was conducted on a group of 100 patients (including 56 women and 44 men) at the Health Clinic in Zembrzyce in the period from August 10, 2019 to October 30, 2019. The study was conducted using the diagnostic survey method. The research tools included: a self-report questionnaire consisting of a sociodemographic and clinical part and the Self-Care Inventory in Diabetes (SCODI).
 Results: It was shown that greater independence in self-care regarding health behaviors, health control, glucose control and self-confidence were significantly higher in patients without addictions.
 Conclusions: Involvement in self-care in the study population was higher among patients with secondary and higher education, and in patients without addictions, with normal body weight and underweight and treated with diet, tablets and insulin.

An analysis of digital stories of self-care practices among first- year students at a university of technology in South Africa

This article reports on a qualitative study that explored self-care practices among first-year studentsin managing stressors related to the first-year experience in the context of the COVID-19 pandemic.Qualitative data were collected using a purposive sample between March and June 2022. A total of 26first-year students registered at a university of technology in South Africa participated in the study byproducing digital stories sharing how they practised self-care. The domains of self-care were adoptedas a framework and data were analysed using thematic analysis. Six domains of self-care practicesemerged from the data and were categorised as physical, emotional, spiritual, relational, professional,and psychological. The findings show that first-year students engaged in a range of self-care practicesacross the domains of self-care including exercising, listening to music, performing ancestral rituals,donating blood, following successful people on social media, and learning new skills. Further,
 relational self-care was the most fundamental domain that underpinned first-year students’ well-being. In contrast, oversleeping or sleep deprivation, reckless spending, and eating unhealthy food
 to cope with stressors related to the first-year experience pointed to unhealthy self-care practicesin managing the stressors. Unhealthy self-care practices can threaten first-year students’ well-beingand possibly academic success. Student affairs and services need to design self-care programmes andcurricula to prevent harm and support adequate self-care. In designing self-care programmes, socialinvolvement and engagement are fundamental principles that should be emphasised. Future studiescan develop a self-care inventory to identify students at risk of poor self-care and design targetedinterventions to promote self-care.

Psychometric Analysis of the Health Self-Care Neglect Scale.

The Health Self-Care Neglect (HSCN) scale is a measure of self-care neglect developed for use in informal caregivers, where self-care is defined as behaviors undertaken to maintain health. There was no formal psychometric analysis of the scale, so we tested a 9-item, dichotomous-response version of the HSCN scale in a sample of 250 informal caregivers of adults with chronic heart failure. As the indicators of self-care neglect were considered formative (influencing the latent variable directly) rather than reflective (influenced by the latent variable), we used a procedure for the specification of formative measurement models. First, maximally correlated composites of indicators were identified for the latent variable, and optimal scoring weights were developed. Then, the reflective factor was tested with confirmatory factor analysis, and longitudinal invariance of the factorial structure was tested by introducing model constraints. Reliability was assessed with composite reliability model-based estimates. Concurrent validity was assessed by correlating the HSCN scale total score with the maintenance scale score of the Self-Care Inventory. Strict invariance, the highest level possible, was achieved. Reliability was 0.81 at baseline. Concurrent validity was demonstrated ( r = -0.475, P < .0001). The results of this analysis indicate that the HSCN scale is reliable, stable, and valid as a measure of health self-care neglect when tested in a sample of caregivers. The HSCN scale measures the successful performance of self-care, whereas existing measures of self-care reflect intention. Understanding both intention and behavior is useful, so we recommend using the HSCN scale in addition to existing measures of self-care.

Psychometric properties and measurement invariance of the Arabic Self-Care Inventory.

Self-care is a fundamental aspect of health and well-being for healthy individuals and those with chronic illnesses. However, the available self-care measurement instruments have limited support regarding their psychometric properties. Research about the validation of comprehensive, theory-based self-care tools in the Arabic language and culture is also limited. In addition, many self-care measurement tools are available only for people with chronic illnesses. To examine the psychometric properties of the Arabic version of the Self-care Inventory (SCI) in the general adult population in Jordan. This study was conducted using a cross-sectional design. Data collection was performed using a demographics questionnaire, and Arabic versions of the SCI, Self-care Self-Efficacy, and the Center for Epidemiologic Studies Depression Scale-revised. SPSS and AMOS were used to analyze the data. Data analysis was conducted by performing confirmatory factor analysis, measurement invariance, internal consistency, and bivariate correlations. The results revealed that the SCI comprises three scales: self-care maintenance, self-care monitoring, and self-care management. The goodness of mode fit indices showed that the models of these scales fit the data well by meeting the following set a priori criteria: (RMSEA < .07, CFI > .95, and X2/df < 5). The factor loadings of the individual items of the SCI provided further evidence about the factor structure of the three scales. Regarding measurement invariance, the results indicated that partial invariance across participants' sex is assumed. The values of both Cronbach's α and composite reliability showed that the internal consistency of the SCI is supported. Cronbach's α of the self-care maintenance, self-care monitoring, and self-care management were .82, .86, and .83, respectively. The psychometric properties of the Arabic version of the SCI demonstrate its validity and reliability as a robust assessment tool for measuring self-care in the general adult population.

Mealtime Insulin BOLUS Score More Strongly Predicts HbA1c Than the Self-Care Inventory in Youth With Type 1 Diabetes.

To meet their glycated hemoglobin (HbA1c) goals, youth with type 1 diabetes (T1D) need to engage with their daily T1D treatment. The mealtime insulin Bolus score (BOLUS) is an objective measure of youth's T1D engagement which we have previously shown to be superior to other objective engagement measures in predicting youth's HbA1c. Here, to further assess the BOLUS score's validity, we compared the strengths of the associations between youth's HbA1c with their mean insulin BOLUS score and a valid, self-report measure of T1D engagement, the Self-Care Inventory (SCI). One-hundred and five youth with T1D self-reported their T1D engagement using the SCI. We also collected two weeks of insulin pump data and a concurrent HbA1c level. We scored youth's SCI and calculated their mean insulin BOLUS score using standardized methods. For the analyses, we performed simple correlations, partial correlations, and multiple regression models. Youth had a mean age of 15.03 ± 1.97 years, mean time since diagnosis of 8.11 ± 3.26 years, and a mean HbA1c of 8.78 ± 1.49%. The sample included n = 58 boys (55%) and n = 96 families (91%) self-identified as white. Simple correlations between youth's age, HbA1c, SCI total score, and BOLUS score were all significant. Partial correlation and regression models revealed that youth's insulin BOLUS score was more strongly associated with HbA1c than the SCI. Youths' BOLUS score has better concurrent validity with HbA1c than the SCI. We should consider reporting the BOLUS score as an outcome metric in insulin pump data reports.

Knowledge about diabetes and its association with adherence to self-care and glycemic control in patients with type 1 diabetes in Southern Brazil.

To evaluate the association between knowledge about the disease, adherence to self-care, and glycemic control in people diagnosed with type 1 diabetes mellitus. A cross-sectional study of patients aged over 18 years diagnosed with type 1 diabetes mellitus, treated at an outpatient clinic of a Brazilian university hospital. Participants with other types of diabetes, cognitive impairment, pregnancy, and outpatient discharge were excluded. Data were collected from January to March 2021 (by telephone call), with questions about the participants' profile, diabetes knowledge questionnaire (DKN-A), and self-care inventory revised (SCI-R) translated into and adapted for Brazilian Portuguese. Data analysis involved chi-square associations, Mann-Whitney U tests, and Poisson regression. Among 198 adult participants, the mean age was 42 ± 12 years, 53.5% were women, the mean glycated hemoglobin was 8.6 ± 1.6%, 140 (70.8%) had satisfactory knowledge about diabetes, 65 (32.8%) had adherence to self-care, and 46 (23.2%) had adequate glycemic control. We found an association between knowledge and adherence to self-care (p < 0.001). Knowledge was not associated with glycemic control (p = 0.705). Knowledge about diabetes was associated with greater adherence to self-care in people with type 1 diabetes mellitus, but it did not reflect in better glycemic control.

ICare4Me for FTD: A pilot randomized study to improve self-care in caregivers of persons with frontotemporal degeneration.

A tremendous burden is placed on frontotemporal degeneration (FTD) caregivers who sacrifice their own self-care to manage the functional impairments of their loved one, contributing to high levels of stress and depression. Health coaching provides support for coping with stress while fostering self-care behaviors. We report on preliminary evidence for efficacy of a virtual health coach intervention aimed at increasing self-care. Thirty-one caregivers of persons with behavioral variant FTD (bvFTD) were assigned randomly to an intervention group, which included 10 coaching sessions over 6 months plus targeted health information or the control group receiving standard care augmented with the health information. Caregiver self-care (primary outcome), stress, depression, coping, and patient behavioral symptoms were collected at enrollment and 3 and 6 months. Change over time was evaluated between the intervention and control groups using linear mixed-effects models. There was a significant group-by-time interaction for self-care monitoring (t58 = 2.37, p = 0.02 and self-care confidence (t58 = 2.32, p = 0.02) on the Self-Care Inventory, demonstrating that caregivers who received the intervention improved their self-care over time. Behavioral symptoms were reduced in bvFTD patients whose caregivers received the intervention (t54 = -2.15, p = 0.03). This randomized controlled trial (RCT) shows promise for health coaching as a way to increase support that is urgently needed to reduce poor outcomes in FTD caregivers.

Measuring self-care in the general adult population: development and psychometric testing of the Self-Care Inventory

BackgroundSelf-care is important at all stages of life and health status to promote well-being, prevent disease, and improve health outcomes. Currently, there is a need to better conceptualize self-care in the general adult population and provide an instrument to measure self-care in this group. Therefore, the aim of this study was to develop and evaluate the Self-Care Inventory (SCI), a theory-based instrument to measure self-care in the general adult population.MethodsBased on the Middle Range Theory of Self-Care, the 20-item SCI was developed with three scales: Self-Care Maintenance (8 items), Self-Care Monitoring (6 items), and Self-Care Management (6 items). A cross sectional study with a US-based sample (n = 294) was conducted to test the SCI. Internal validity was assessed with Confirmatory Factor Analysis. Internal consistency reliability was assessed with Cronbach alpha for unidimensional scales or composite reliability and the global reliability index for multidimensional scales. Construct validity was investigated with Pearson correlation to test the relationship between general self-efficacy, positivity, stress, and self-care scores.ResultsThe Self-Care Maintenance and Management scales were multidimensional and the Self-Care Monitoring scale was unidimensional. The global reliability index for multidimensional scales was 0.85 (self-care maintenance) and 0.88 (self-care management). Cronbach alpha coefficient of the self-care monitoring scale was 0.88. Test-retest reliability was 0.81 (self-care maintenance), 0.91 (self-care monitoring), and 0.76 (self-care management). The General Self-Efficacy Scale was positively related to all three self-care scale scores: self-care maintenance r = 0.46, p < 0. 001, self-care monitoring r = 0.31, p < 0. 001, and self-care management r = 0.32, p < 0. 001. The positivity score was positively related to self-care maintenance (r = 0.42, p < 0. 001), self-care monitoring (r = 0.29, p < 0. 001), and self-care management (r = 0.34, p < 0. 001) scores. The perceived stress was positively related to the self-care management (r = 0.20, p < 0. 001) score.ConclusionsThe SCI is a theoretically based instrument designed to measure self-care in the general adult population. Preliminary evidence of validity and reliability supports its use in the general adult population.

Diabetes knowledge and self-care practices among people living with type 2 diabetes mellitus in a diabetes clinic in Southwestern Nigeria

Objective: The objective of this study is to assess the knowledge and self-care practices of people living with type 2 diabetes mellitus (T2DM).Materials and Methods: The study was conducted in a clinic in Southwestern Nigeria. It adopted a cross-sectional design. The sample consists of 107 people living with T2DM. Data were collected using Diabetes Knowledge Questionnaire and Revised Self-care Inventory Scale.Results: The mean diabetes knowledge of the participants was 16.2 ± 3.0 and 70.1% had inadequate knowledge of T2DM. The mean diabetes self-care practice score among the participants was 49.9 ± 4.9, and 89.7% reported poor diabetes self-care practice. There is no significant difference in the knowledge of diabetes between male (16.42 ± 3.42) and female (16.12 ± 2.8) participants (t = 0.45; P = 0.65), and no significant difference in self-care practice of male (49.23 ± 4.51) and female (50.06 ± 5.07) participants (t = 0.75, P = 0.46). In addition, there is no correlation between age and knowledge of diabetes (r = -0.18, P = 0.07) and self-care practices (r = 0.08, P = 0.38) of participants. No significant relationship was found between knowledge of diabetes and diabetes selfcare practices (χ2 = 1.605, P = 0.448)Conclusion: Knowledge of diabetes and self-care practices of people living with T2DM in this study were poor. Effort should be directed at improving their diabetes knowledge and self-care practices.

Abstract 10070: All Caregivers Are Not Alike: Stress, Caregiving Effort, and Self-Care in Heart Failure and Dementia Caregivers

Introduction: Caregiving for someone with a chronic condition is stressful. Deferring self-care is common among caregivers but little is known about differences among various caregiver groups. The aim of this study was to compare stress, self-care, and self-care confidence in two groups of caregivers. Methods: We compared baseline data from two groups of caregivers (HF and frontotemporal dementia [FTD]) enrolled in an on-going study of an intervention designed to decrease stress and improve self-care. Eligible participants had to report caregiving ≥8 hours/week and neglect of ≥2 self-care behaviors (e.g., adequate sleep). Stress was measured with the Perceived Stress Scale (14 items, 5-point scale, higher score means higher stress). Self-care was measured with the Self-Care Inventory with embedded scales measuring self-care maintenance, monitoring, management, and confidence (30 items, 5-point scale, higher scores mean better self-care). Each self-care scale is standardized 0-100; ≥70 reflects adequate self-care. Baseline data prior to the intervention were compared. Results: Compared to HF caregivers, the FTD caregivers were significantly more likely to be Caucasian (87.1% vs. 60.9%), male (25.8% vs. 14.3%), married to the patient (98.8% vs. 72.5%), and older (64.8±10.1 vs. 54.4±15.1) years. The FTD caregivers had been caregiving for fewer years (5.1±3.7 vs. 7.3±8.6) but their daily caregiving effort was higher (Table). Stress levels did not differ significantly and self-care was poor in both groups. Self-care confidence was higher in HF than FTD caregivers. Conclusions: Although caregiving effort was higher in FTD caregivers, stress levels were comparable and self-care was poor in both HF and FTD groups. Understanding the source of the stress, barriers to self-care, and the factors that promote self-care confidence are important for developing and testing tailored interventions to promote self-care of caregivers.

56-LB: The Mediating Role of Shared Responsibility in the Relationship of Trait Mindfulness and Diabetes-Related Outcomes

In youth with T1D, mindfulness and parental involvement (i.e., shared responsibility) of diabetes self-management (DSM) behaviors are associated with positive diabetes-related outcomes. This study explored the mediating role of shared responsibility in the relationship of mindfulness with DSM and A1c. A cross-sectional study was conducted among 129 adolescents aged 12-18 years with T1D at a tertiary medical center. Adolescents completed a survey on mindfulness (Child Acceptance &amp; Mindfulness Measure), shared responsibility (Diabetes Family Responsibility Questionnaire-Short) and DSM (Self-care Inventory). A1c was obtained from medical records. The PROCESS SPSS macro by Hayes (v3.5) was used to assess mediation. Unstandardized and standardized path coefficients (β), SE, p-value, and 10,000 bias-corrected bootstraps 95% CI reported. Results: Mindfulness had positive significant association with shared responsibility (a-path=0.974, SE=.045, β=.189, R2=.036, p=.032). Shared responsibility had significant association with DSM (b-path=0.055, SE=.017, β=.275, p=.0015). The direct (c’) and total (c) relationships between mindfulness and DSM were significant (c’=0.198, SE=.087, β=.193, p=.024; c=.251, SE=.088, β=.245, R2=.06, p=.005). The relationship between mindfulness and DSM was partially mediated by shared responsibility (ab=0.053, SE=0.031 bias-corrected bootstrapped 95% CI = [0.0059, 0.0119]). For the second mediational model, neither mindfulness nor shared responsibility was associated with A1c (p&amp;gt;.05). Mindfulness and shared responsibility had positive association with DSM but not A1c. Shared responsibility partially mediated the relationship between mindfulness and DSM, whereby youth with higher levels of trait mindfulness had greater shared responsibility and better DSM. Temporal inferences should be interpreted with caution. Interventions targeting both mindfulness and shared responsibility should be explored. Disclosure H. Abujaradeh: None. P. Viswanathan: None. S. M. Sereika: None. M. M. DiNardo: None. C. A. Feeley: None. D. Charron-Prochownik: None. Funding National Association of Pediatric Nurse Practitioners; Eta Chapter-Sigma Research Award; Swigart/Gold Doctoral Student Award; J. Wiggins Scholarship

4-OR: Racial/Ethnic Disparities in Diabetes Self-Care in Young Adults (YA) with Type 1 Diabetes (T1D)

Background: Racial/ethnic disparities in diabetes self-care among YA with T1D may contribute to worse outcomes. We conducted a secondary data analysis of the Young Adult Racial Disparities in Type 1 Diabetes (YARDD) study to determine racial-ethnic differences in self-care and contributory factors. Methods: The YARDD study recruited a diverse cohort of YA with T1D aged 18-28 years from six diabetes centers across the U.S. and collected cross-sectional information on sociodemographics, social determinants of health, clinical factors, psychosocial variables, and diabetes self-care. We performed multivariable linear regression to examine the association of race/ethnicity with a measure of diabetes self-care (Self-Care Inventory Revised (SCI-R)), and related factors. Results: We included 299 YA with T1D: median age 20 years (IQR 19-22); 55% female (n=162); 33% each non-Hispanic White, non-Hispanic Black, and Hispanic. Compared with White YA, Black YA reported slightly lower SCI scores (B= -6.81/100, P=0.006), while Hispanic YA reported similar scores (B=-1.33/100, P=0.58). In multivariate analyses, race/ethnicity accounted for little variability in SCI score (adjusted R-squared=0.02), while age, sex and diabetes distress explained significant variability (adjusted R-squared=0.24). Diabetes distress scores on the Diabetes Distress Scale were slightly higher in Black YA than Hispanic or White YA (B= 0.38/6.0, P=0.01). Discussion: In this large national study of YA with T1D, race/ethnicity was not independently associated with differences in diabetes self-care after accounting for demographic, social determinant, psychosocial, and clinical factors. However, diabetes distress was slightly higher among Black YA with T1D and had a strong association with diabetes self-care, providing a potential race-specific target for intervention. Disclosure R. Sadiq: None. M. Fazzari: None. S. Nahvi: Research Support; Self; Pfizer Inc. C. Cunningham: Employee; Spouse/Partner; GE Healthcare, Stock/Shareholder; Spouse/Partner; GE Healthcare. S. Agarwal: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (K23DK115869); National Center for Advancing Translational Science (UL1TR002556)

Factors associated with self-management practices and self-efficacy among adults with cancer under treatment in Saudi Arabia.

To discover the current state of self-management practices and levels of self-efficacy among adults with cancer under treatment in Jeddah City, Saudi Arabia, and to identify their associated factors. The prevalence of cancer and cancer treatment-related problems is increasing in Saudi Arabia. However, effective cancer care programmes are not provided in this country. Cross-sectional correlational study. This study was conducted with a convenience sample of 130 adults with cancer under treatment from May 2020-August 2020 at the largest tertiary care hospital providing cancer care in the western region, Saudi Arabia. The study methods were compliant with the STROBE checklist. Data were collected by Self-Care Inventory, Strategies Used by People to Promote Health, and sociodemographic and clinical surveys. Descriptive statistics and stepwise linear regression analysis were performed. The total score for self-management practices was 84.38 (SD=13.66) and self-efficacy, as a strong associated factor of self-management, earned a total score of 104.24 (SD=15.87). Stepwise regression analysis identified self-efficacy, age and education level as important associated variables, explaining 57.6% of the total variance in self-management practices. Significant effects of age, gender, marital status and duration of cancer on patients' self-efficacy were also found. The levels of self-management practices and self-efficacy to manage cancer treatment-related problems demonstrated by patients with cancer in this study were rated as a medium. Self-efficacy, age and education level were the significant factors associated with self-management practices of patients in Saudi Arabia. Age, gender, marital status and duration of cancer were identified as associated factors of self-efficacy. Enhancing patient's adherence to self-management practices and increase patient's self-efficacy through adopting educational intervention programmes, considering patient's sociodemographic and disease-related characteristics, and continuous patient education must be taken into consideration in the cancer management plan.

Psychometric Properties of the Self-Care Inventory for Children with Cerebral Palsy in a Resource-Constrained Urban South African Context

ABSTRACT INTRODUCTION: For children with cerebral palsy (CP), conducting self-care tasks may be difficult due to physical and cognitive problems. Accurate assessment of children with CP is needed for realistic intervention. The Self-Care Inventory for Children with Cerebral Palsy (SCICP) was developed by Julia Burg in 2016. The SCICP is a caregiver reported questionnaire that aims to assess the extent to which a CP child can conduct their self-care tasks independently. Burg created the SCICP due to the lack of a valid assessment tool for the South African population to assess CP children's self-care abilities. The aim of the study was to investigate selected psychometric properties of the SCICP in terms of known-group validity, concurrent validity with the gross motor function, and manual abilities of the children with CP as well as the tool's diagnostic accuracy METHOD: A quantitative cross-sectional, non-experimental study design with the caregivers of 50 children with CP (0 to 8-years-old), and 50 typically developing children (0 to 6-years-old) was conducted. Data were collected at two hospitals in the Ekurhuleni district in Gauteng, South Africa. The caregivers completed a demographic questionnaire and the SCICP assessment tool for each child. Descriptive statistics and non-parametric statistics including the Mann- Whitney U test as well as Spearman's correlation co-efficient were used to analyse the data, since data were ordinal. Sensitivity and specificity and internal consistency were also established RESULTS: The SCICP differentiates between children who are typically developing and children with CP who present with developmental delay on the overall score. For some components of self-care activities for the 0 to 1-year-old children, the difference in scores is not significant since typically developing children of this age may be dependent in many self-care tasks CONCLUSION: The SCICP shows promising results for use in the clinical setting to identify deficits in CP children's ability to perform their self-care tasks and provide guidance for intervention for self-care for children with CP Keywords: Cerebral palsy; resource-constrained environment; self-care; participation; evaluation; known-group validity; functional mobility; low socio-economic status.