Self-care Measures Research Articles

Role of Inpatient Rehabilitation Facility Quality Measures to Predict Community Discharge After Stroke

<h3>Research Objectives</h3> Main objective: Examine the association between National Institutes of Health Stroke Scale (NIHSS) scores measured during the acute care stay and inpatient rehabilitation facility (IRF) admission functional status, measured by the IRF-Patient Assessment Instrument (IRF-PAI) self-care and mobility quality measures, to deduce if quality measures can serve as a proxy for stroke severity. The self-care and mobility quality measures are indicators of physical function. Secondary objective: Investigate the predictive power of the NIHSS and IRF-PAI admission physical function quality measures to predict community discharge from IRF after stroke. <h3>Design</h3> Retrospective cohort study using electronic health records and Uniform Data System Medical Record file data from January 1, 2018 to December 30, 2019. <h3>Setting</h3> Academic hospital-based IRF. <h3>Participants</h3> 544 patients transferred from acute care hospital to IRF after an ischemic or hemorrhagic stroke. Exclusion criteria: transient ischemic attack, discharged against medical advice, died during IRF stay, or re-admitted to acute care within 48 hours of IRF admission. Cases with incomplete data (missing IRF-PAI, NIHSS scores) were excluded from analyses. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Community discharge status from IRF. <h3>Results</h3> Of 544 patients, 76.6% had community discharge; the median age was 64.7 years. NIHSS scores were available for 434 patients, with the majority of patients classified as minor to moderate stroke (n=294). NIHSS scores were significantly associated with IRF-PAI admission self-care scores across each NIHSS stroke category (n=433). There was no association between NIHSS and IRF-PAI admission mobility score. IRF admission self-care and mobility scores were each a significant predictor of successful discharge to the community (n=430; OR=1.09, 95% CI: 1.03 – 1.17, OR=1.1, CI: 1.03 – 1.18, respectively). NIHSS scores from acute care were not a significant predictor of community discharge (OR = 0.70 CI 0.47-1.04) from IRF. <h3>Conclusions</h3> IRF-PAI self-care quality measure is associated with the NIHSS and can serve as a proxy for stroke severity. IRF-PAI self-care and mobility measures each predict community discharge status. <h3>Author(s) Disclosures</h3> No disclosures or conflicts of interest.

Efectividad de la fisioterapia multimodal acuática mediante ejercicio terapéutico, autodrenaje manual y medidas de autocuidado en el linfedema de miembro superior en mujeres supervivientes de cáncer de mama. Ensayo clínico aleatorizado

IntroductionLymphedema secondary to breast cancer is a chronic pathology. Complex decongestive physiotherapy is the conservative treatment of choice, it consists of an intensive phase to minimize the volume of the limb, and a maintenance phase to promote self-control of the pathology. The objective is to evaluate if aquatic multimodal physiotherapy (AMP) composed of therapeutic exercise, manual self-drainage and upper limb self-care measures maintains or reduces the volume of lymphedema in the maintenance phase and if it is more effective than upper limb multimodal physiotherapy in-room. MethodologyA randomized clinical trial has been carried out comparing two groups, experimental N:43 that performed a pattern of exercises in an aquatic environment and control N:47 that performed the same pattern of exercises in-room. Both groups carried out 20 sessions of 45min, 2 or 3 days per week. The main variables were the changes in the volume of the lymphedema, by means of circometry, and the quality of life of the participants, by means of the FACT-B + 4 scale. ResultsNo statistically significant differences were found between the interventions carried out, both improve the volume at 20 sessions (p = 0.7855), the interaction between the frequency of treatment and the time after intervention was (p-value: < 0.01). Improvements were found in quality of life variables; «general physical state of the patient», «family and social environment», «emotional state», «personal functioning capacity» and «patient concerns» (p-value: < 0.01). ConclusionUpper limb AMP seems to improve the quality of life of surviving women with upper limb lymphedema in the maintenance phase. AMP does not show an added benefit to room multimodal physiotherapy.

Knowledge and practices about COVID-19 among diabetic population in a rural set up: A cross-sectional study

With the emergence of a novel human corona virus, it is believed that persons with underlying health conditions or co-morbidities like diabetes mellitus, have an increasingly rapid and severe progression, often leading to death. India as a country has demonstrated an escalating prevalence of diabetes not only in urban populations, but also in rural populations as a result of the urbanization of lifestyle parameters. A cross-sectional questionnaire-based survey was conducted among 250 diagnosed diabetic patients of age group 18-60 years attending outpatient department of Rural Health Training Centre affiliated to the tertiary care hospital. The responses were tabulated and analyzed for frequencies and percentage. We observed that 70% of diabetic patients of rural population were aware about the high risk of Covid-19 infection in diabetics. Half of the diabetic patients in our study were aware of the technique of hand washing and importance of wearing mask as a precautionary measure in this COVID era. Prevention is of utmost importance, but for the millions of diabetics managing their disease must remain the priority. Sensitization of population with co-morbidities regarding self-care and precautionary measures must be implemented at root level.

Home care nursing practice for older persons with heart failure living at home.

To enhance knowledge of how older people with heart failure, living at home, manage their illness with the support of their family caregivers and home care nursing services. Heart failure monitoring and self-care have been important means of reducing the serious impact of heart failure. Drawing on theories of practice as enacted and conceptualising service users and their family caregivers as active, the idea of attunement was used to explore how home care nurses work in supporting them. Ethnographic case study. Data collection involved home visits and interviews (10 home care users, 10 caregivers, five home care team leaders). Data were field-notes and transcribed interviews. Themes were deductively developed from the findings, informed by the theoretical background, using content analysis. The COREQ checklist was used. Three themes were developed from the data: (1) Practices of attunement in relations, (2) Becoming among difficulties and (3) Off track-difficult to attune around self-care. The findings reflect the complexity of heart failure monitoring at home, showing how, in addition to self-care measures, users are supported by an array of informal and formal care. The caregiving situation is shaped by relations among participants and involves making oneself available to the situation. We suggest a stance of attunement for home care nurses, which demands tact and calls for interest, engagement and openness. Study findings caution against limiting heart failure monitoring to circumscribed tasks, instead calling for a holistic understanding of what may be helpful for users. Home care nurses need time to attune with users living with heart failure and their caregivers to prevent exacerbations and promote well-being. Although patients were not formally involved in study design ethnography favours their voice.

Is self-reported adherence a valid measure of glycaemic control among people living with diabetes in rural India? A cross-sectional analysis

BackgroundVisual analogue scale (VAS) is one of the simplest to measure medication adherence. It has neither been widely used for Non communicable diseases (NCD) nor validated for in the Indian setting. We examined the validity of self-reported medication adherence measures in relation to HbA1C in a rural population with diabetes mellitus (DM). MethodsParticipants with DM was administered VAS, Diabetes Self-Management Questionnaire (DMSQ) and assessed for missed pills. Descriptive statistics and logistic regression analysis were done. ResultsWe recruited 1347 participants and 84% of them reported being 100% adherent as per VAS and 83.8% stated that they did not miss any pills. However, 58.2% of participants who reported having 100% adherence had poor glycaemic control, as did 58.1% of those who did not miss any pills. None of the diabetic self-care measures was significantly associated with glycaemic control. ConclusionWe found a lack of association between self-reported adherence measures and glycaemic control in participants with DM suggesting that self-reported adherence scales may not be valid in this population.

Experiences of living with symptomatic atrial fibrillation.

To explore the experiences of living with symptomatic atrial fibrillation. This study, with a descriptive qualitative design, was performed using semi-structured individual interviews. Six women and nine men with symptomatic atrial fibrillation were included. The transcribed interviews were analysed using qualitative content analysis. The COREQ checklist was followed. The analysis resulted in a main theme, namely balancing life and included the themes striving for illness control, becoming a receiver or an active partner in care and dealing with changed self-image. The participants strived to understand their illness, prevent attacks and manage anxiety. Some of the participants were not involved in decision-making, were uninformed about self-care measures, reported a lack of continuity in care and felt that the doctors focused on information about the medical part of care.

Self-Care and Preventive Measures of Coronavirus: Evidence from India

Introduction: Coronavirus cases increased across countries so quickly, and in response, no country was ready to handle it. India is the most populous country; inadequate healthcare infrastructure and lack of insurance coverage were the main concerns. Here, self-care and preventive measure is the only option to deal with the pandemic and such virus. Objective: To analyze the awareness about the self-care and preventive measures for Coronavirus in India. Methods: This study analyses the self-care and preventive measures taken against the Coronavirus by the people in India. The study collected the data of 517 Indian respondents through the questionnaire (i.e., based on a convenience sampling technique). The statistical tools used frequency, percentage, and correlation. Results: Most respondents reported the Coronavirus infection causes symptoms like cough, fever, shortness of breath, stomachache, sore throat, and cold (i.e., 86.3, 87.8, 81.4, 88.4, 77.4, and 72.0 percent of respondents, respectively). Most of the respondents agreed that wearing masks (77.2 percent), gloves (66.9 percent), and hand hygiene (88.8 percent) could prevent the spreading of the virus. Conclusion: The findings concluded that most people were aware of self-care and preventive measures and Coronavirus symptoms. Social media acted as the fastest route to make people more aware of information dissemination which prevented pandemics’ outbursts.

Maintenance of Self-Care Activities During COVID-19 Lockdown in Patients with Type 2 Diabetes That Received a Comprehensive Care Program Training.

IntroductionIn 2020, several countries established a global emergency state. Lockdowns restricted people’s lifestyles and daily activities to prevent coronavirus spread. These measures hindered diabetes mellitus control and lifestyle changes. This study aims to evaluate if attending a multidisciplinary program before the pandemic helped maintain a good metabolic state, lifestyle modifications, and mental health in patients with diabetes mellitus during the COVID-19 lockdown.MethodsPatients included in this study attended a multidisciplinary program, with <5 years of diagnosis of type 2 diabetes, without disabling complications, between 18–70 years old. The complete lockdown occurred from February 27, 2020, to May 31, 2020. The first patient (non-COVID) to return to the center for face-to-face consultation was in March 2021. Consultations in 2019 were face-to-face and changed to a virtual modality during 2020. We analyzed metabolic, lifestyle, mental health, and diabetes education parameters.ResultsA total of 133 patients with type 2 diabetes mellitus were included with complete information in visits before and during the lockdown. Metabolic parameters and self-care measures (nutrition plan, foot evaluation, and self-glucose monitoring) evaluated on our patients had no change during the lockdown. We found a significant increase in the time patients spent sitting during the day (p<0.05). Barriers to exercise increased during lockdown, being joint pain (3.8% to 12.0%, p<0.01) and lack of time to exercise (4.5% to 7.5%, p=0.33) being the most common. There was no significant difference in symptoms of anxiety and depression, quality of life, and empowerment.ConclusionA multidisciplinary diabetes mellitus program, including diabetes education for self-care activities, positively impacts patients, maintaining good outcomes despite lockdown difficulties.

The Impact of eHealth Interventions on the Improvement of Self-Care in Chronic Patients: An Overview of Systematic Reviews.

Promoting self-care is one of the most promising strategies for managing chronic conditions. This overview aimed to investigate the effectiveness of eHealth interventions at improving self-care in patients with type-2 diabetes mellitus, cardiovascular disease, and chronic obstructive pulmonary disease when compared to standard care. We carried out a review of systematic reviews on PubMed, Scopus, Cochrane, PsychInfo, and CINAHL. AMSTAR-2 was used for quality appraisal. Eight systematic reviews (six with meta-analysis) were included, involving a total of 41,579 participants. eHealth interventions were categorized into three subgroups: (i) reminders via messaging apps, emails, and apps; (ii) telemonitoring and online operator support; (iii) internet and web-based educational programs. Six systematic reviews showed an improvement in self-care measurements through eHealth interventions, which also led to a better quality of life and clinical outcomes (HbA1C, blood pressure, hospitalization, cholesterol, body weight). This overview provided some implications for practice and research: eHealth is effective in increasing self-care in chronic patients; however, it is required to designate the type of eHealth intervention based on the needed outcome (e.g., implementing telemonitoring to increase self-monitoring of blood pressure). In addition, there is a need to standardize self-care measures through increased use of validated assessment tools.

Global Perspectives on Violence Against Women: A Study of a Social Work Elective During COVID-19

ABSTRACT The purpose of this study was to glean understanding of student learning, global perspectives, and self-care in an elective that explored violence against women in diverse contexts. The study consisted of a survey with quantitative measures of global perspectives and self-care, and discussion groups conducted at four time-points. Results from the quantitative analysis showed significant increases for two global perspectives subscales and a slight (nonsignificant) increase in self-care frequency. Thematic analysis of qualitative data generated three themes: (a) forging connections, (b) learning in a global pandemic, and (c) grappling with preconceptions. The findings highlight the dramatic impact of the COVID-19 pandemic, opportunities for integrating critical global perspectives, and need for an explicit decolonizing framework to guide instructors and students.

Relationships among adverse childhood experiences, delay discounting, impulsivity, and diabetes self-management.

Adverse childhood experiences (ACEs) have been linked to risky health behaviors, as well as the development of chronic health conditions such as both type 1 and type 2 diabetes mellitus. A connection between ACEs and diabetes self-management has not yet been established. The current study aims to investigate the relationships among ACEs, delay discounting, impulsivity, and diabetes self-management. A total of 227 adults aged 18 to 77 with type 1 diabetes, type 2 diabetes, and prediabetes were recruited to complete an online survey via Amazon's mechanical Turk. Participants completed validated measures of diabetes self-care, delay discounting, and impulsivity, as well as questions regarding diabetes history and financial strain. In the overall sample and controlling for financial strain, increased number of ACEs was significantly associated with poorer diabetes management (r = -.15, p < .05). Higher delay discounting was associated with fewer ACEs (r = -.31, p < .05) and better diabetes care (r = .42, p < .01), as well as increased number of diabetes-related complications (r = .33, p < .01), controlling for financial strain. Participants who use insulin to manage their diabetes had significantly better diabetes self-care scores (t(225) = 8.19, p < .01), higher levels of delay discounting (t(101) = 3.15, p < .01), and fewer reported ACEs (t(224) = -2.19, p < .05). ACEs are associated with poorer diabetes self-management later in life. This may be an important consideration for clinicians treating patients with diabetes and prediabetes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

THE EFFECT OF MASSAGE EFFLEURAGE WITH LAVENDER AROMATHERAPY ON THE INTENSITY OF DYMENORORE PAIN IN ADOLESCENT WOMEN IN THE PABELAN HEALTH CENTER

ABSTRACT&#x0D; &#x0D; The incidence of dysmenorrhea in the world is very large, at least 45-90% of women experience dysmenorrhea during the reproductive years. Several self-care measures can be taken for the management of menstrual pain. One of the non-pharmacological methods to reduce pain intensity can be done by using effleurage massage and lavender aromatherapy.&#x0D; This study aims to find out the effect of massage effleurage combination of lavender aromatherapy on the intensity of dysmenorrhea pain in adolescent women in the working area of Pabelan Health Center.&#x0D; The research method used is quantitative using a quasi-experimental approach. The sampling technique used non-probability sampling/non-random, the number of samples was 28 people according to the specified criteria. Massage effleurage combined with lavender aromatherapy for 10 minutes. The act of giving 3 drops of lavender aromatherapy into 40 ml of water through a diffuser that will be turned on during massage effleurage therapy&#x0D; The result of this study was that there was a difference in disminore pain in adolescent women before and after the intervention of Massage Effleurage therapy combined with lavender aromatherapy in the working area of Pabelan Health Center of Semarang Regency (P-value = 0.000).&#x0D; &#x0D; Keywords: Dysmenorrhea, Lavender Aromatherapy, Massage Effleurage,

COVID-19 Infection in Heart Transplant Recipients: Results of a Six-Month Prospective Survey-Based Study

Solid-organ transplantation recipients were assumed highly vulnerable to coronavirus disease 2019 (COVID-19). However, the results of previous studies in patients with orthotopic heart transplantation (OHT) under immunosuppressive therapy are contradictory. Therefore, we aimed to assess the prevalence of COVID-19 infection and associated risk factors, along with the six-month outcomes in COVID-19 positive OHT patients. This single-center telephone-based survey was conducted on OHT patients. Using a detailed questionnaire, exposure to COVID-19, related symptoms, and preventive self-care measures were collected. Outcomes of COVID-19-positive patients were reassessed using another survey six months later. 118 OHT patients (male: n=87, 73.7%) were included with a mean age of 45.3±13.1 years. Sixteen patients (13.5%) reported one or more symptoms compatible with COVID-19, of whom 12 (10.2%) tested positive. Our results indicated no statistically significant association between COVID-19 and comorbidities. Poor adherence to self-care measures and contact with positive index cases were both significantly associated with COVID-19 infection (P&lt;0.001). A later six months follow-up showed that two out of 12 (16.6%) COVID-19 positive OHT patients died. There was no statistically significant difference between the prevalence of COVID-19 in our patients compared to Iran’s general population (P=0.152). Non-compliance with personal protective protocols and a history of contact with COVID-19 cases were the most risk factors for COVID-19 infection in OHT patients.

Occupational Therapy Using Ayres Sensory Integration®: A Randomized Controlled Trial in Brazil.

Research conducted in the United States has found that occupational therapy using Ayres Sensory Integration® is an effective evidence-based intervention for children with autism spectrum disorder (ASD). Replication of this research in other cultures is needed. To evaluate the outcomes of occupational therapy using Ayres Sensory Integration in a sample of Brazilian children with ASD. Prospective randomized controlled trial. Occupational therapy clinic. Seventeen children with ASD ages 5-8 yr (n = 9 in the intervention group, n = 8 in the usual-care control group) recruited from a local hospital via flyers and word-of-mouth. Completed pretreatment characterization and baseline measurement. The intervention group received occupational therapy using Ayres Sensory Integration, and the control group received usual therapeutic and educational services only. We conducted a pre-post assessment of self-care and socialization using the Pediatric Evaluation of Disability Inventory and individualized goal ratings. Participants in the intervention group scored significantly higher on outcome measures of self-care (p = .046, rb = .57), social function (p = .036, rb = .61), and parent-identified goal attainment (p < .001, rb = .94) compared with the control group. Occupational therapy using Ayres Sensory Integration was effective in enhancing self-care, socialization, and goal attainment for children with ASD in a Brazilian cohort. What This Article Adds: This study contributes further support from outside the United States that occupational therapy using Ayres Sensory Integration is an effective evidence-based intervention to improve self-care, socialization, and parent-identified goal attainment in children with ASD.

Assessment Knowledge of Parents Regarding Health Preventive Measures and Self-Care of Hemophilia Children

Background: Together hemophilia A and B are categorized through spontaneous indoors bleeding and excessive bleeding later on accidents or surgery. The biggest common places for bleeding are into joints and much less commonly in muscle tissues and organs such as the talent or kidneys. Objective(s): The aim of the study is to assess knowledge of parents regarding health preventive measures and self-care of hemophilia children. Method: a descriptive design is carried out through the use of questionnaire format for non –probability (purposive) sample of (40) patients who their children have hemophilia and treat in Blood Disease center in - AL_ Nasiriya City. Results: the study result showed that the highest rate of parents who participate in the study were father in age 38 years and more, who graduated from institute and their social status was married. The study show that the majority of participants have low information about self-care and health preventive measures for their children with hemophilia. Conclusion: The study participants have a low knowledge level about health preventive measures and self-care and health preventive measures of hemophilia children. Recommendations: Preparing lectures and providing simple manual booklet prepared and presented to health care providers and parents with hemophilia to enhancing their homecare (illness, diet, fluid, medication exercise and treatment) of patients. Keywords: Assessment, Parents, Health Preventive Measures, Self-Care, Hemophilia Children.

Validity and Reliability of the Korean Version of the Revised Self-Care of Heart Failure Index v7.2.

The psychometric properties of the Korean version of the revised Self-Care of Heart Failure Index (SCHFI) remain undetermined; therefore, we aimed to evaluate the construct and convergent validity and reliability of the Korean version of the SCHFI in Korean patients with heart failure (HF). Using a cross-sectional design, 207 patients with HF provided data on self-care and self-efficacy in self-care for this psychometric testing. The confirmatory factor analysis supported the construct validity of the Korean version with a three-factor structure: Self-Care Maintenance, Symptom Perception, and Self-Care Management. Convergent validity was supported by the significant relationships between self-efficacy and each scale of the Korean version of the SCHFI (r = .425-.549, p < .001). The reliability estimates were marginally adequate, with a Cronbach's alpha of .655 to .776, McDonald's omega of .710 to .836, and composite reliability coefficients of .704 to .834. The SCHFI was supported as a valid and reliable measure of self-care for Koreans with HF. However, the marginal levels of the Cronbach's alpha coefficients still require validation in a larger sample.

Social Determinants in Self-Protective Behavior Related to COVID-19: Association Rule-Mining Study.

BackgroundHuman behavior is crucial in health outcomes. Particularly, individual behavior is a determinant of the success of measures to overcome critical conditions, such as a pandemic. In addition to intrinsic public health challenges associated with COVID-19, in many countries, some individuals decided not to get vaccinated, streets were crowded, parties were happening, and businesses struggling to survive were partially open, despite lockdown or stay-at-home instructions. These behaviors contrast with the instructions for potential benefits associated with social distancing, use of masks, and vaccination to manage collective and individual risks.ObjectiveConsidering that human behavior is a result of individuals' social and economic conditions, we investigated the social and working characteristics associated with reports of appropriate protective behavior in Brazil.MethodsWe analyzed data from a large web survey of individuals reporting their behavior during the pandemic. We selected 3 common self-care measures: use of protective masks, distancing by at least 1 m when out of the house, and handwashing or use of alcohol, combined with assessment of the social context of respondents. We measured the frequency of the use of these self-protective measures. Using a frequent pattern–mining perspective, we generated association rules from a set of answers to questions that co-occur with at least a given frequency, identifying the pattern of characteristics of the groups divided according to protective behavior reports.ResultsThe rationale was to identify a pool of working and social characteristics that might have better adhesion to behaviors and self-care measures, showing these are more socially determined than previously thought. We identified common patterns of socioeconomic and working determinants of compliance with protective self-care measures. Data mining showed that social determinants might be important to shape behavior in different stages of the pandemic.ConclusionsIdentification of context determinants might be helpful to identify unexpected facilitators and constraints to fully follow public policies. The context of diseases contributes to psychological and physical health outcomes, and context understanding might change the approach to a disease. Hidden social determinants might change protective behavior, and social determinants of protective behavior related to COVID-19 are related to work and economic conditions.Trial RegistrationNot applicable.

Real-world Benefits of Diabetes Management App Use and Self-monitoring of Blood Glucose on Glycemic Control: Retrospective Analyses.

BackgroundAmong self-care measures, the self-monitoring of blood glucose (SMBG) is a critical component for checking blood glucose levels. In addition, there is growing evidence suggesting that digital technologies are being adopted as an additional method for health care systems to increase patient contact. However, for patients with non–insulin-treated diabetes mellitus type 2 (DMT2), the value of SMBG was inconsistent among studies, and the evidence for digital technologies from real-world clinical practice is still limited.ObjectiveOur study aimed to assess patients with non–insulin-treated DMT2 who were receiving care from a single clinic and analyze whether the use of a diabetes management app and SMBG behavior would affect glycemic control in a real-world clinical setting.MethodsWe collaborated with a large clinic focused on diabetes care in Taiwan that had been using the Health2Sync mobile app and web-based Patient Management Platform to collect the data. The patients were divided into 2 groups (app-engaged-user group and only-data-uploader group) according to different activities in the app, and blood glucose was recorded every month from 1 to 6 months after registration in the app. A sample of 420 patients was included in the analysis, and a linear mixed model was built to investigate which factors affected the patients’ blood glucose percentage change.ResultsUsing the mixed model coefficient estimates, we found that the percentage change was significantly negative when the only-data-uploader group was set as the baseline (t=–3.873, df=1.81 × 104; P<.001 for the patients of the app-engaged-user group). We found that for patients with shorter diabetes duration, their blood glucose decreased more than patients with longer diabetes duration (t=2.823, df=1.71 × 104; P=.005 for the number of years of diabetes duration). In addition, we found that for younger patients, their blood glucose decreased more than older patients (t=2.652, df=1.71 × 104; P=.008 for the age of the patients). Furthermore, the patients with an education level of junior high school or lower saw a significantly greater decrease in blood glucose percentage change than the patients with an education level of senior high school or higher (t=4.996, df=1.72 × 104; P<.001 for the patients with an education level of senior high school or higher). We also found that the count of blood glucose measured enlarged the decrease along the interaction months (t=–8.266, df=1.97 × 104; P<.001 for the nth month × the count of blood glucose in the nth month). Lastly, the gender of the patients did not significantly affect the percentage change (t=0.534, df=1.74 × 104; P=.59 for female patients).ConclusionsOur analysis showed the following: the blood glucose percentage change of the patients in the app-engaged-user group dropped more than that in the only-data-uploader group; shorter diabetes duration is associated with a steeper decrease in the patients’ blood glucose percentage change; the percentage decrease in blood glucose change in younger patients is greater than older patients; the blood glucose percentage change of the patients with an education level of junior high school or lower dropped more than those with an education level of senior high school or higher; and the more frequently the patients test SMBG each month, the greater the decrease in the patients’ blood glucose percentage. Further studies can be performed to consider the differences in daily behaviors such as exercise and diet across the patients and whether these factors could have vital effects on glycemic control.

Motivations for the Practice of Self-Care Measures Applicable to Mitigate COVID-19 Pandemic

Objective: To identify relevant factors influencing the practice of self-care measures for prevention of the ongoing COVID-19 preventions based on prior evidence-based experiences. Method: We conducted a literature review of empirical studies conducted between the years 2000 and 2020 focusing on self-care measures in a pandemic situation. Result: Of the 250 studies identified, 19 studies met inclusion criteria. Sixty-three percent of the eligible studies reported handwashing, 21% reported social distancing, facemask wearing, 11% reported social avoidance and information-seeking behaviour. The identified factors motivating these practices include risk perception, health education and social trust. Conclusion: We found that public health agencies commonly recommend self-care measures during pandemics. The adherence to them depends on individuals' perception of risk, knowledge about the situation, trust in the government agencies providing the recommendations and empathy that can motivate adherence. Practice Implication: The public, researchers, and policymakers could learn from the past and present situation to understand what measures are proven relevant and what factors could motivate adherence. More emphasis could be placed on the role of individuals in health promotion and disease prevention as they have been proven to be helpful.

We Are Not Heroes; Elevating the Discourse of Burnout in Hospice and Palliative Care Nurses (HPCNs) in the Pre/Post COVID Era: A Scoping Review (S504)

Outcomes1. Describe results from a scoping review related to personal factors, organizational and workplace factors, and nursing professional development factors related to hospice and palliative care nurses2. Recognize characteristics of hospice and palliative care nurses (HPCNs) that are associated with burnout and strategies to mitigate burnoutBackground and ObjectiveBurnout among HPCNs has been rising throughout the COVID-19 pandemic and threatens patient safety and quality of care. The extant literature provides insight into burnout within the interdisciplinary hospice and palliative care team, but little attention has been given among HPCNs specifically. We conducted a scoping review to examine burnout among HPCNs and unify disparate findings.Study IdentificationUsing the Arksey and O'Malley framework, we systematically searched 8 major databases from 2015 to 2020. Studies were included if they focused on HPCN experiences of burnout, were published in English within the last 5 years with the exception of seminal works, and were discoverable in electronic databases. Exclusion factors included articles that were not focused solely on hospice and palliative nursing, specifically focused on burnout (ie, depression, compassion fatigue, workplace environment), or research articles.Data Extraction and SynthesisTwo authors extracted data from the full-text inclusion studies. Results were presented in tabular summary and descriptive summary of quantitative findings.ResultsAmong 1,893 studies, 8 met inclusion criteria. All studies were quantitative, classified as level IV within the rating system for hierarchy of evidence for literature, and spanned across 6 countries. HPCNs working across settings such as inpatient, outpatient, community, and inpatient hospice were represented. Results of studies were coalesced into 3 overarching categories: personal factors, organizational or workplace factors, and nursing professional development factors. Each of these categories was then divided into three cross-cutting subcategories: contributory and noncontributory factors, mitigating factors, and workplace issues.Conclusions and Implications for Practice, Policy, and ResearchBurnout among HPCNs may not be entirely preventable, but the recognition of contributory and mitigating factors should be taken into consideration by professional nurses and organizations. Additional research is needed to test workplace interventions suggested in the literature, including whether resilience or self-care measures affect burnout in HPCNs. Qualitative research is needed to capture HPCN experiences of burnout, especially in a post-COVID-19 era.