Self-care Management Program Research Articles

Effect of Self-Care Management Program on Knowledge, Health Behaviors, and Self-Efficacy of Type 2 Diabetic Patients

Effect of Self-Care Management Program on Knowledge, Health Behaviors, and Self-Efficacy of Type 2 Diabetic Patients

Impact of Incorporating a Self-care Management Program with Telephone Follow-up on Geriatric Patients’ Self-care Compliance and Coping Post Cataract Surgery

Impact of Incorporating a Self-care Management Program with Telephone Follow-up on Geriatric Patients’ Self-care Compliance and Coping Post Cataract Surgery

Effectiveness of a Digital Application-Based Self-Care Management Program in Patients with Type 2 Diabetes in Thai Nguyen Province, Vietnam

Purpose: To evaluate the effectiveness of educational communication intervention using SMDia software in improving knowledge, self-care activities, quality of life and glycemic control in patients with type 2 diabetes in Thai Nguyen province, Vietnam.
 Methodology: It was an intervention study with control group. Intervention study was conducted from March 2021 to May 2022 on 240 patient’s type 2 diabetes who was randomly assigned to the control group and intervention group, each group had 120 people. It was to evaluate the effectiveness of educational communication intervention using SMDia software for self-care knowledge, self-care activities, and quality of life, using the DSCKQ-30, SDSCA, and V.SF-36v2 toolkits for glycemic control by fasting blood sugar levels, HbA1c at times before and after intervention.
 Findings: After intervention, there was a clear improvement over time and level in the intervention group compared to the control group after 24 weeks. The self-care knowledge score in the intervention group’s 26.60 ± 2.96 points; the self-care activity score in the intervention group's 69.40 ± 9.31 points; the quality of life score for physical health in the intervention group's 73.25 ± 9.34 points; the mental health quality of life score in the intervention group's 72.74 ± 7.0 points. The intervention effect on change in self-care activities, quality of life and self-care knowledge were 167.8%, 163.6%, and 64.0%, respectively. After 24 weeks, the rates of patients with poor blood sugar control and poor HbA1c in the intervention group was 36.7% and 7.5%. The rate of blood sugar control achieved the target increased by 15.8%, HbA1c reached the target increased by 31.7%. Intervention effectiveness reached 8.2% for blood sugar control and 41.8% for HbA1c control.
 Unique contribution to theory, practice and policy: Educational communication intervention using SMDia software has shown to significantly improve self-care knowledge, self-care activities, quality of life and glycemic control for patients with type 2 diabetes.

IDF21-0259 Development of a self-care program for older people with type 2 diabetes attending community health centers

Background: Diabetes is a growing problem globally, with the major impact being experienced in low and middle-income countries. In South Africa, diabetes is a major cause of morbidity and mortality and a burden to the overstretched health services, community, family, and people with the disease. Self-care management is a cornerstone of diabetes care. Aim: To inform the development of a self-care management program for older people attending public sector primary health care services in Cape Town, South Africa by using the PRECEDE planning model. Method: (1) This research study is based on the theoretical framework of the PRECEDE-PROCEED model (PPM). (2) In the PPM, a complete needs assessment involving phases should be made before planning a health promotion intervention. Results: This research study incorporates five interlinked studies, The first was a systematic review of studies that assessed the prevalence of type 2 diabetes mellitus among older people in African countries conducted between 2000 and 2015 with the objective of providing data for the monitoring of future trends. the overall prevalence of diabetes was 13.7% (95% CI 11·3–16·3) and was twofold higher in studies based on the oral glucose tolerance test than in those using fasting plasma blood glucose. The second is a secondary analysis of the Study on global AGEing and adult health (SAGE) South Africa Wave 1 data that examined the prevalence of self-reported diabetes and the association between diabetes and each health-related quality of life and disability amongst South Africa’s older adults. The results were that diabetes was associated with lower quality of life and greater disability. The third, a cross-sectional survey, examines the knowledge of older people with diabetes attending primary care clinics. Its major finding is that there was a lack of knowledge about the complications of diabetes, suggesting that the available diabetes educational opportunities have not been effective. Importantly, however, social support was positively associated with both knowledge and a number of self-care aspects. The fourth is a qualitative study consisting of a documentary review. This found that generally older persons face numerous barriers in managing their condition. Further, there are multiple efforts to re-orientate the healthcare system to focus more effectively on non-communicable diseases for the population which would benefit older patients with diabetes. Finally, the study includes a systematic review of peer and non-professional health worker-led diabetes self-management programmes (COMP-DSMP) in low and middle-income country primary health care settings, and also examines the implementation strategies and associated diabetes-related health outcomes This found equivocal evidence supporting the use of COMP-DSMP for people with diabetes in these countries and suggested that the models of a peer/CHW-led programme need to be further explored, especially given the inevitability of a professional healthcare workforce shortage in LMICs Discussion: This research alerts policymakers and clinicians to some of the specific issues considered to be pertinent and important in the care and management of older persons with diabetes. Many of these would also be applicable to older individuals with other chronic conditions.

Cost-effectiveness of a preventive self-care health management program for community-dwelling older adults: a randomised controlled trial.

To examine the cost-effectiveness of a preventive self-care health management program for community-dwelling older adults as compared to usual care. A cost-effectiveness analysis was executed alongside a randomised controlled trial. Nurse case managers provided interventions, including holistic assessment, empowerment of self-care, preventive health behaviours and self-efficacy with co-produced care planning, supported by nursing students. The control group received social control calls. Community-dwelling older adults were randomly assigned to the intervention (n = 271) or control (n = 269) group. The intervention was conducted in collaboration with 11 community centres under four non-government organisations in various districts of Hong Kong. Cost and quality-adjusted life years (QALYs) were collected pre (baseline, 0months) and post intervention (3months) and 3months after completion of the program (6months). Incremental cost-effectiveness ratios between the groups were calculated, dividing the difference in cost by the difference in QALYs. Analysis showed that the net incremental QALY gain was 0.0014 (3months) and 0.0033 (6months) when the intervention group was compared to the control group. The probability of being cost-effective at 6months was 53.2% and 53.4%, based on the cost-effectiveness thresholds recommended by both the National Institute for Health and Clinical Excellence ($200,000/QALYs) and the World Health Organization (Hong Kong gross domestic product/capita, HK$381,780). The results provide some evidence to suggest that the addition of a home-based, preventive self-care health management program may have effects on cost outcomes for community-dwelling older adults in Hong Kong.

Abstract P480: The Distinct Role of Occupational Therapy in Addressing the Self-care Management Needs of Patients With Heart Failure

Introduction: Hospitalizations for heart failure (HF) are the highest single Medicare expenditure. This cost primarily results from readmissions linked to failed self-care. Evidence suggests that effective self-care routines are equivalent to medication in preventing HF exacerbation and hospitalization. Occupational therapists (OT) are well suited to address HF self-care needs by facilitating self-efficacy and adapting patients’ routines, roles and habits. A recent study determined that OT is the only hospital spending category associated with lower HF readmission rates. Hypothesis: Occupational therapy has a significant role in addressing the self-care management needs of patients with HF throughout the continuum of care. Methods: The OT department launched a HF self-care management program as part of process improvement initiatives at an AHA-recognized teaching hospital. An assessment battery was developed which included the following: The Self-Care of Heart Failure Index (SCHFI) v.6.2, Minnesota Living With Heart Failure Questionnaire, Patient Health Questionnaire-9, and the Montreal Cognitive Assessment. Administration of the OT HF assessment battery to a pilot group of 12 inpatients revealed factors that affect patient adoption and adherence to beneficial self-care management routines. Based on assessment battery data, an outpatient OT program was established. Eleven outpatients were enrolled and completed 3-6 hours of OT treatment. The SCHFI was administered at program evaluation and completion to measure self-care maintenance and confidence. To expand service access, a telehealth self-care program was introduced and a single patient case study was assessed to determine the feasibility and effectiveness of the virtual format. Results: Assessment battery data enabled the development of outpatient treatment modules focusing on symptom monitoring, medication management, low sodium diet, activity tolerance and psychosocial strategies. All outpatients who completed the modules demonstrated improved self-care maintenance (ranging from 16-53 points) and half demonstrated improved self-care confidence (ranging from 6-39 points). The patient assessed after completing the telehealth program demonstrated improved self-care maintenance (70 points) and self-care confidence (28 points). Conclusions: In conclusion, OT has a significant role in addressing the self-care management needs of patients with HF throughout the continuum of care. The utilization of a standardized OT HF assessment battery is effective in determining the needs of this population and for guiding the implementation of targeted individualized treatment. Outpatient and telehealth delivery of OT programming is effective in improving self-care for people with HF.

Web-based self-care management program of patients with type 2 diabetes mellitus

Background: The purpose of the study is to determine the effectiveness of web-based self-care management program for type 2 diabetes mellitus through sharing evidenced-based information about Diabetes through the use of a web-based module.
 Materials and methods: The study used the quasi-experimental pre and posttest design to determine the effectiveness of a web-based self-care management program in the management of patients with type 2 Diabetes mellitus (DM). The study was conducted in three phases and acquired 30 purposively selected type 2 DM adult patients. The study used a web-based self-care management program that included basic information about Type 2 Diabetes mellitus using three designed modules specifically for diet, exercise and drug management.
 Results: The patient status during the pre and post-intervention phase is an FBS reading of 152 mg/dl or diabetes stage to pre-diabetes stage (119 mg/dl), normal BMI (22), low risk for obesity WHR and barely satisfactory to satisfactory level of knowledge to diabetes and DM management. There is very significant difference (p=<000) in the pre and post FBS reading of patients and the level of knowledge to diabetes and DM management after the web based DSME while there is no significant difference in the BMI and WHR. There is very significant difference (p=<000) in the RBS readings of the patients during the 1st, 2nd and 3rd phases of the intervention of .web based DSME (p=<000) post hoc analysis with Wilcoxon Signed Rank Test revealed that there is very significant difference (p=<000) between groups.
 Conclusion: The use of web-based self-care management program is effective in improving FBS/RBS and level of knowledge to diabetes and DM management of patients with type 2 diabetes mellitus but needed longer intervention to improve BMI and WHR .Nurses as part of the DSME group and as health educator may use technology in giving health education to patients to improve patients self-management to diabetes.

Effect of educational programs on knowledge and self-management of patients with chronic obstructive pulmonary disease

Background Patient education has a vital role in caring for patients with chronic obstructive pulmonary disease (COPD), and a corner stone of self-management in chronic illnesses.Aim of the study This study aimed to evaluate the effect of educational programs on the knowledge and self-management of patients with COPD.Methods This study was carried out on 40 COPD patients at outpatient follow-up Medical Clinics at Tanta University Hospital. The researchers interviewed them using an interview schedule to assess the sociodemographic characteristics, patients’ medical history, physical examination, and knowledge regarding COPD and an observational checklist to assess self-care practice of the patient.Results The results have shown significant differences in relation to decrease in the signs of cough, sputum, and shortness of breath immediately and after 2 months of implementing the self-care management program, but there were no significant differences in relation to other signs of the disease. The majority of patients (95%) had poor knowledge, and all of them had unsatisfied practice regarding self-management skills for COPD before implementation. Immediately postimplementation of the educational program, the study showed highly statistically significant improvement in total score of knowledge, where the majority of them had a fair knowledge and good practice regarding COPD; these scores decreased in post-test 2.Conclusion This study concluded that the education of patients regarding knowledge for COPD and healthcare practice is very effective in improving their self-management skills, but they need reinforcement follow-up. Therefore, this study recommended that the healthcare personnel should provide health education for COPD patients on self-care to their improve knowledge which helps prevent complications and maintain their life.

Integrative Review of Guidelines Related Symptom Management and Physical Activity for Developing of Self-Care Management Program for Cancer Survivors

Integrative Review of Guidelines Related Symptom Management and Physical Activity for Developing of Self-Care Management Program for Cancer Survivors

Home Self-Care Management Program for Patients with Open Heart Surgery in Kalyubia Governorate

Abstract: The purpose of this study was to evaluate home self -care management program for studied patients with open heart surgery in Kalyubia Governorate. Design: A Quasi experimental design was utilized for this study. Setting: The study was conducted at Chest &Heart Surgical Outpatient Clinic in Benha University Hospital to collect the sample and followed by home visits. The sample study involved 70 patients who had open heart surgeries. Two instruments were used in the study: A structured questionnaire was used by the researcher to collect data above. These studies recommended that home self-care program should be designed to support and provide follow up care for open heart patients in outpatient clinics by a specialized team in order to prevent complication, improve knowledge & practices.

Improving Patient Self-Care and Reducing Readmissions Through an Outpatient Heart Failure Case Management Program.

The purpose of this evidence-based practice project was to incorporate a heart failure (HF) self-care case management program in an outpatient cardiology clinic to improve self-care behaviors and reduce hospital readmissions with HF patients recently discharged from the hospital. Using Riegel's

The impact of a multidisciplinary self-care management program on quality of life, self-care, adherence to anti-hypertensive therapy, glycemic control, and renal function in diabetic kidney disease: A Cross-over Study Protocol.

BackgroundDiabetic kidney disease, a global health issue, remains associated with high morbidity and mortality. Previous research has shown that multidisciplinary management of chronic disease can improve patient outcomes. The effect of multidisciplinary self-care management on quality of life and renal function of patients with diabetic kidney disease has not yet been well established.Method/DesignThe aim of this study is to evaluate the impact of a multidisciplinary self-care management program on quality of life, self-care behavior, adherence to anti-hypertensive treatment, glycemic control, and renal function of adults with diabetic kidney disease. A uniform balanced cross-over design is used, with the objective to recruit 40 adult participants with diabetic kidney disease, from public and private out-patient settings in French speaking Switzerland. Participants are randomized in equal number into four study arms. Each participant receives usual care alternating with the multidisciplinary self- care management program. Each treatment period lasts three months and is repeated twice at different time intervals over 12 months depending on the cross-over arm. The multidisciplinary self-care management program is led by an advanced practice nurse and adds nursing and dietary consultations and follow-ups, to the habitual management provided by the general practitioner, the nephrologist and the diabetologist. Data is collected every three months for 12 months. Quality of life is measured using the Audit of Diabetes-Dependent Quality of Life scale, patient self-care behavior is assessed using the Revised Summary of Diabetes Self-Care Activities, and adherence to anti-hypertensive therapy is evaluated using the Medication Events Monitoring System. Blood glucose control is measured by the glycated hemoglobin levels and renal function by serum creatinine, estimated glomerular filtration rate and urinary albumin/creatinine ratio. Data will be analyzed using STATA version 14.DiscussionThe cross-over design will elucidate the responses of individual participant to each treatment, and will allow us to better evaluate the use of such a design in clinical settings and behavioral studies. This study also explores the impact of a theory-based nursing practice and its implementation into a multidisciplinary context.Trial registrationClinicalTrials.gov identifier: NCT01967901, registered on the 18th of October 2013.Electronic supplementary materialThe online version of this article (doi:10.1186/s12882-016-0279-6) contains supplementary material, which is available to authorized users.

The Impact of Historical and Current Loss on Chronic Illness: Perceptions of Crow (Apsáalooke) People.

The purpose of this research was to gain a better understanding of perceptions about the impact of historical and current loss on Apsáalooke (Crow) people acquiring and coping with chronic illness. This study took a qualitative phenomenological approach by interviewing community members with chronic illness in order to gain insight into their perceptions and experiences. Participants emphasized 10 areas of impact of historical and current loss: the link between mental health and physical health/health behaviors; resiliency and strengths; connection and isolation; importance of language and language loss; changes in cultural knowledge and practices; diet; grieving; racism and discrimination; changes in land use and ownership; and boarding schools. The findings from this research are being used to develop a chronic illness self-care management program for Crow people.

당뇨병성 족부 궤양을 가진 환자의 자가 관리 프로그램 적용 효과

Purpose: Diabetic foot ulcers are significant problems in diabetes mellitus and often result in lower extremity amputation. This study was conducted to evaluate the effects of a self-care management program on Korean patient’s self-efficacy, self-care behavior, size of the wound, and wound related pain. Methods: This study was a quasi-experimental study of pre-test and post-test design in a nonequivalent control group. The intervention strategies of the self-care management program consisted of individual intervention (education, practice and demonstration), computer animation, and face-to-face counseling. There were thirty seven patients, and 20 were assigned to the experimental group while the other 17 were assigned to the control group. The experimental group was given a self-care management program. The control group received information on diabetic mellitus care by means of a leaflet. The data was analyzed using descriptive statistics, a chi-square test, an independent t-test, and a Mann-Whitney test. Results: There were significant differences in self-care behavior and wound related pain. Conclusion: A Self-care program is an effective way to increase patient’s self-care ability. This program is highly applicable to diabetic foot ulcer patients in various settings.

Type 2 diabetes-related foot care knowledge and foot self-care practice interventions in the United States: a systematic review of the literature.

IntroductionThe purpose of this systematic literature review is to review published studies on foot care knowledge and foot care practice interventions as part of diabetic foot care self-management interventions.MethodsMedline, CINAHL, CENTRAL, and Cochrane Central Register of Controlled Trials databases were searched. References from the included studies were reviewed to identify any missing studies that could be included. Only foot care knowledge and foot care practice intervention studies that focused on the person living with type 2 diabetes were included in this review. Author, study design, sample, intervention, and results were extracted.ResultsThirty studies met the inclusion criteria and were classified according to randomized controlled trial (n=9), survey design (n=13), cohort studies (n=4), cross-sectional studies (n=2), qualitative studies (n=2), and case series (n=1). Improving lower extremity complications associated with type 2 diabetes can be done through effective foot care interventions that include foot care knowledge and foot care practices.ConclusionPreventing these complications, understanding the risk factors, and having the ability to manage complications outside of the clinical encounter is an important part of a diabetes foot self-care management program. Interventions and research studies that aim to reduce lower extremity complications are still lacking. Further research is needed to test foot care interventions across multiple populations and geographic locations.

Effect of Self Care Management Program regarding Fatigue among Adolescents' Cancer Patients

Fatigue is a common and complex, subjective symptom with physical, emotional and cognitive dimensions. The aim of the study is to evaluate the effect of self-care management program regarding fatigue among adolescents' cancer patients. Research design Quasi-experimental design was used to complete this study. Setting: The study was conducted at the Outpatient Unit at Specialized Children Hospital in Kalyobia Governorate, and Cancer Institute in Cairo City. Sample: Simple random sample of forty six adolescents' patients with cancer who were newly or old diagnosed with cancer. Tools: Two tools were used to collect the study data: I): An interviewing Questionnaire which includes five parts: a): A study subjects' characteristics. b): Burden of the disease on patients. c): Present medical history of the study subject. d): Adolescents' patients' knowledge regarding fatigue. e): Self-care practices as reported regarding fatigue. II): Multidimensional assessment of fatigue (MAF) scale which includes 12 questions -after modifying- ranged from no fatigue to sever felling with fatigue. Results: 65.2% aged less than14 years as the same percentage were female while 63.0% engaged in secondary education and 54.3 living in urban areas. 43.5% of study subjects had dependent on other persons for daily living activities, 69.6% having no any sports. Overall the results have statistically significant differences before and after implementing the program regarding (MAF) scale. Conclusion: the study concluded that the adolescent patient with cancer had inadequate knowledge regarding fatigue, and the health educational program was succeed to increasing their knowledge, and improving health practices to deal with fatigue, their overall activities were improved after implementation the program regarding MAF scale. Recommendations: The study recommended that the importance of health educational program for patients and families regarding self care management of fatigue related cancer should be provided.

An Innovative Worksite Self-Care Management Program to Improve the Outcomes of Adults With or At Risk for Chronic Diseases

An Innovative Worksite Self-Care Management Program to Improve the Outcomes of Adults With or At Risk for Chronic Diseases