Self-care Program Research Articles

The Effects of Structured Self-Perineal Care Education on Episiotomy Pain Score and Wound Healing Outcome among Primigravida Mothers in Malaysia Urban Area

Background: Pain and wound dehiscence cause physical and emotional traumas, impacting the mothers' quality of life, mental health, and maternal-child bonding. Objectives: The present study aimed to examine the effect of self-perineal care (SPC) education on episiotomy pain scores and wound healing outcomes. Methods: A quasi-experimental design was used in this study. In the third trimester, 125 primigravida mothers attended the antenatal clinic and were assigned to a SPC education group (n=62) and a control group (n=63). The intervention group received two phases of SPC education apart from the study hospital’s routine care, and the mothers in the control group received only routine care. The primigravida mothers in the treatment group were provided SPC education content on their smartphones using the “SPCE” mobile application. Mothers in both groups self-reported their episiotomy pain score and wound healing outcome over 7 days post-childbirth using this mobile application. Results: The overall pain and REEDA scores (redness, oedema, ecchymosis, discharge, approximation) were significantly lower in the intervention group than in the control group for the first 7-days post-delivery with P < 0.001 except for 4 h of baseline observation. For each activity of daily living, the scores were lower in the intervention group for the 7 days post-delivery. Conclusion: Self-perineal care education positively reduced episiotomy pain scores and enhanced wound healing outcomes. This study empowered the primigravida mothers to take responsibility for their health by involving in a self-care education program.

Piloting a Faith-Based Hypertension Self-Care Program in a Church Setting.

Health promotion strategies offered in a faith-based setting can be effective in influencing positive self-care behaviors related to hypertension. Faith-based organizations are ideal places to reach vulnerable populations to improve blood pressure management and make a lasting impact. The purpose of this pilot study was to provide a 4-week management program to improve hypertension self-care among a congregation of African Americans. Results revealed improvements among participants related to self-care as well as lowered blood pressure readings.

The effect of a mobile-based self-care program on tremor of people with multiple sclerosis

Background and aims: Multiple sclerosis (MS) is one of the most common progressive neurological diseases in young people. Tremor is a common and debilitating symptom in people with MS, significantly affecting their quality of life. This study aimed to evaluate the effect of a self-care program based on a mobile application on tremors in people with MS. Methods: This semi-experimental study was conducted on 72 patients with MS in Chaharmahal and Bakhtiari province in 2019. Samples were selected by convenience sampling and randomly assigned to intervention and control groups (36 people in each group). For the intervention group, a self-care program in the form of a mobile application was installed on their mobile phones and, for two months, used by patients. The use of the program was measured using self-report checklists and telephone tracking. The control group receives routine intervention only. Data were collected before and two months after the intervention using the Fahn-Tolosa-Marin Tremor Rating Scale and analyzed using SPSS software version 21 and descriptive and inferential statistics (chi-square, independent t test, and paired t test). Results: There was no statistically significant difference between the two groups in the mean tremor score before the intervention (P=0.768). However, after the intervention, this difference was significant (P=0.022). Conclusion: According to the findings, teaching a self-care program through a mobile application effectively improves the tremor of patients with MS and can be considered an effective intervention method.

The Effect of the Teach-Back Method on Illness Perception and Self-efficacy in Patients with Coronary Artery Disease

Background: Coronary artery disease (CAD) is a chronic disease. These patients need a high level of illness perception and self-care behaviors until the end of their lives. Objectives: The present study aimed to examine the effect of the teach-back method on illness perception and self-efficacy in patients with CAD. Methods: This quasi-experimental study was conducted on 100 patients with CAD hospitalized in the coronary care units (CCUs) of Zahedan University of Medical Sciences in southeast Iran in 2021. The patients were selected through convenience sampling and divided into two intervention and control groups using simple randomization. The self-care training program was implemented individually for the patients in the intervention group in three sessions (30 - 45 minutes) on three consecutive days 24 hours after the patient’s admission to the hospital. The Brief Illness Perception Questionnaire (Brief IPQ) and Cardiovascular Management Self-efficacy Scale (CMSES) were completed by the patients in the two groups before and one month after the intervention. The collected data were analyzed in the statistical package for the social sciences (SPSS v.22) software using the independent samples t-test, paired samples t-test, chi-square test, Fisher’s exact test, regression test, and analysis of covariance (ANCOVA) at a significant level of P < 0.05. Results: In pre-test, the two groups had no significant difference in the mean score of illness perception (P = 0.49). However, the mean score of self-efficacy was significantly higher in the intervention group (P = 0.01). In the post-test, the two groups had significant differences in both illness perception (P = 0.002) and self-efficacy (P = 0.001). The results of ANCOVA showed that by controlling the effect of the pre-test, the mean scores of illness perception (P < 0.001) and self-efficacy (P = 0.007) were significantly different between the two groups after one month of the intervention. Conclusions: The teach-back method improved illness perception and self-efficacy in patients with CAD. Thus, following the insights from this study and given the vital role of nurses in patient education, nurses and medical staff can use the teach-back method to improve illness perception and self-efficacy in these patients.

Associations between compassion fatigue, burnout and secondary traumatic stress with lifestyle factors in mental health nurses: A multicenter study from Uganda

PurposeThis cross-sectional study aimed (a) to explore levels of compassion satisfaction, secondary traumatic stress, and symptoms of burnout among Ugandan mental health nurses working in regional referral hospitals in Uganda during the Covid-19 pandemic, and (b) to investigate associations between compassion satisfaction, secondary traumatic stress, and symptoms of burnout and sedentary levels, physical activity (PA) levels, sleep quality, and harmful drinking. Material and methodsIn total 108 mental health nurses from 8 regional referral hospitals across Uganda (age = 34.8 ± 10.0 years; 55.6 % female) completed the Professional Quality of Life Scale-5, (PQoLS-5), the Simple Physical Activity Questionnaire (SIMPAQ), Physical Activity Vital Sign (PAVS), Pittsburgh Sleep Quality Index (PSQI), and Alcohol Use Disorder Identification Test – Concise (AUDIT-C). Spearman Rho correlations and Mann-Whitney U tests were applied. ResultsProQOL-5 compassion satisfaction correlated significantly with SIMPAQ walking, PSQI and AUDIT-C, ProQOL-5 burnout with SIMPAQ exercise and PSQI and ProQOL-5 traumatic with SIMPAQ walking and PSQI. Mental health nurses meeting PA guidelines reported higher ProQOL-5 compassion satisfaction and lower ProQOL-5 burnout and traumatic stress than those who did not. Those who reported a poor sleep quality reported significantly less ProQOL-5 compassion satisfaction and higher ProQOL-5 burnout than those who did not. Those who reported harmful drinking patterns reported a significantly lower compassion satisfaction versus those who did not. DiscussionIn mental health nurses, a lower professional quality of life is associated with an unhealthy lifestyle. The effectiveness and efficacy of resilience and self-care programs for mental health nurses focusing on unhealthy lifestyle patterns should be explored.

Self-Care Behavior and Associated Factors in the Elderly with Hypertension

Hypertension is one of the main risk factors for life-threatening cardiovascular disease and is often called the silent killer The results of basic health research in 2018 suffered from hypertension were the most in the elderly aged 55 to 64 years (55.2%). Hypertension in the elderly is a chronic disease that requires disease care management including regular blood pressure control and self-care behavior programs to prevent further complications. This study aims to determine the factors related to self-care behavior in hypertensive elderly in the Integrated Health Care Center of elderly, Srikandi, Turi Sub District, Community Health Centers of Sukorejo, Sukorejo district, Blitar. The method used in this study was an analytical descriptive study with a cross-sectional approach conducted on 38 hypertensive elderly people. The study was conducted from January to February 2022. Analysis data using multiple linear regression analysis to ascertain the possible factors that influence self-care behavior. Based on this study, the Rank Spearman correlation test results, the factor that correlated with self-care behavior was level of education and time living with diagnosed hypertension with a Sig (2-tailed) value of 0.008; 0,000 with a correlation coefficient is positive, the value of 0.427; 0.605. so that the relationship between the two variables is unidirectional. This study recommends that community nurses must understand the factors that influence self-care behavior in hypertensive clients in the community so that they are able to provide appropriate nursing care.

Contraceptive self-injection through routine service delivery: Experiences of Ugandan women in the public health system.

Contraceptive self-injection (SI) is a new self-care practice with potential to transform women's family planning access by putting a popular method, injectable contraception, directly into the hands of users. Research shows that SI is feasible and acceptable; evidence regarding how to design and implement SI programs under real-world conditions is still needed. This evaluation examined women's experiences when self-injection of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) was introduced in Uganda alongside other contraceptive options in the context of informed choice. We conducted structured survey interviews with 958 randomly selected SI clients trained in three districts in 2019. SI clients demonstrated their injection technique on a model to permit an assessment of injection proficiency. A randomly selected subset of 200 were re-interviewed 10–17 months post-training to understand resupply experiences, waste disposal practices and continuation. Finally, we conducted survey interviews with a random sample of 200 clients who participated in training but declined to self-inject. Data were analyzed using Stata IC/14.2. Differences between groups were measured using chi square and t-tests. Multivariate analyses predicting injection proficiency and SI adoption employed mixed effects logistic regression. Nearly three quarters of SI clients (73%) were able to demonstrate injection proficiency without additional instruction from a provider. Years of education, having received a complete training, practicing, and taking home a job aid were associated with higher odds of proficiency. Self-reported satisfaction and continuation were high, with 93% reinjecting independently 3 months post-training. However, a substantial share of those trained opted not to self-inject. Being single, having a partner supportive of family planning use, training with a job aid, practicing, witnessing a demonstration and exposure to a full training were associated with higher odds of becoming an SI client; conversely, those trained in a group had reduced odds of becoming an SI client. The self-care program was successful for the majority of women who became self-injectors, enabling most women to demonstrate SI proficiency. Nearly all those who opted to self-inject reinjected independently, and the majority continued self-injecting for at least 1 year. Additional research should identify strategies to facilitate adoption by women who wish to self-inject but face challenges.

Planning and developing a web-based intervention for active surveillance in prostate cancer: an integrated self-care programme for managing psychological distress

ObjectivesTo outline the planning, development and optimisation of a psycho-educational behavioural intervention for patients on active surveillance for prostate cancer. The intervention aimed to support men manage active surveillance-related psychological distress.MethodsThe person-based approach (PBA) was used as the overarching guiding methodological framework for intervention development. Evidence-based methods were incorporated to improve robustness. The process commenced with data gathering activities comprising the following four components:• A systematic review and meta-analysis of depression and anxiety in prostate cancer• A cross-sectional survey on depression and anxiety in active surveillance• A review of existing interventions in the field• A qualitative study with the target audienceThe purpose of this paper is to bring these components together and describe how they facilitated the establishment of key guiding principles and a logic model, which underpinned the first draft of the intervention.ResultsThe prototype intervention, named PROACTIVE, consists of six Internet-based sessions run concurrently with three group support sessions. The sessions cover the following topics: lifestyle (diet and exercise), relaxation and resilience techniques, talking to friends and family, thoughts and feelings, daily life (money and work) and information about prostate cancer and active surveillance. The resulting intervention has been trialled in a feasibility study, the results of which are published elsewhere.ConclusionsThe planning and development process is key to successful delivery of an appropriate, accessible and acceptable intervention. The PBA strengthened the intervention by drawing on target-user experiences to maximise acceptability and user engagement. This meticulous description in a clinical setting using this rigorous but flexible method is a useful demonstration for others developing similar interventions.Trial registration and Ethical ApprovalISRCTN registered: ISRCTN38893965. NRES Committee South Central – Oxford A. REC reference: 11/SC/0355

Decreasing 30-Day Readmission Rates in Patients With Heart Failure.

Heart failure affects approximately 6.2 million adults in the United States and has an estimated national cost of $30.7 billion annually. Despite advances in treatment, heart failure is a leading cause of hospital readmissions. Nonadherence to treatment plans, lack of education, and lack of access to care contribute to poorer outcomes. For patients with heart failure, the mean readmission rate is 21% nationally and 23% in New York State. Before the pilot heart failure program began, the 30-day readmission rate in the study institution was 28.6%. A multidisciplinary team created a heart failure self-care pilot program that was implemented on a hospital telemetry unit with 47 patients. Patients received education on their disease process, medications, diet, exercise, and early symptom recognition. Patients received a follow-up telephone call 48 to 72 hours after discharge and were seen by a cardiologist within a week of discharge. The 30-day readmission rate for heart failure decreased by 16.6% after implementation of the pilot program, which improved patient adherence to their medication and treatment plan and resulted in a reduction of readmissions. Patients in the pilot program represented diverse backgrounds. Socioeconomic factors such as the lack of affordable, healthy food choices and easy access to resources were associated with worse outcomes. The evidence-based heart failure program improved knowledge, early symptom recognition, lifestyle modification, and adherence to medication, treatment plan, and follow-up appointments. The multidisciplinary team approach to the heart failure program reduced gaps in care and improved coordination and transition of care.

Policies on mental health in the workplace during the COVID-19 pandemic: A scoping review.

The COVID-19 pandemic has had a profound impact on both mental health and working conditions. Workplaces are conducive spaces for implementing strategies and interventions to promote mental health. In addition to this, they are preventing, identifying, and managing mental disorders effectively. Although international agencies have identified some guidelines for the management of mental health in the workplace in the context of the COVID-19 pandemic, a more precise characterization of both the components of the policies, their implementation, and evidence of the outcome is required to provide useful information for decision-makers. This study aims to synthesize scientific information regarding national and local policies focusing on preventing or improving, directly or indirectly, mental health problems in the workplace during COVID-19 pandemic. Our study is a scoping review. The Scopus, Web of Science, and Embase databases and PubMed search engine were used. Original and reviewed articles published from January 1, 2020 to October 14, 2021 were included in the research. Articles with abstract or full text in English, Spanish, German and Portuguese were also included. Our strategy is based on identifying policies (intervention) which focuses on directly or indirectly preventing or ameliorating mental health problems in the workplace during COVID-19 pandemic (participants). A total of 6,522 records were identified, and only four studies were included in the scoping review, which were of low quality. That is, we found limited evidence evaluating mental health policies using primary or secondary data (empirical evaluation). Among the policies that have been identified are the increase of mental health resources, the promotion of mental health and self-care support programs, and the reduction of barriers to access to mental health treatment. Our research finds that there is limited evidence available to evaluate national and local policies aimed at directly or indirectly preventing or ameliorating mental health problems at work during COVID-19 pandemic. This forces decision-makers to use different criteria to guide the allocation of resources and budgets. Therefore, there is a need for health intelligence teams in health systems to be able to assess the impact of policies as an important input for decision-makers.

Design, implementation, and evaluation of self-care program in the prevention of breast cancer among women in Isfahan: a community-based participatory action research protocol

IntroductionBreast cancer is one of the most prevalent cancers among women in Isfahan, Iran; however, its prevention is not desirable in this city. This disease poses several health, social and economic challenges for women. To promote women's self-care in breast cancer prevention, this study aims to design, implement and evaluate a self-care program among women in Isfahan through using a community-based participatory action research method.MethodsThe present study is based on a community-based participatory action research approach. In this study, the participatory action research includes four general phases of organizing, action planning, action, and rethinking. These phases are summarized as follows: In the organizing phase, the needs of the participants and the action research settings are examined. This means that the current situation is identified and the views of the process owners are assessed. In the action planning phase, using the results of the first phase, some strategies are designed to promote self-care behaviors in the prevention of breast cancer among women in Isfahan. In the implementation phase, the selected strategies are implemented with the help of the process owners. Finally, in the rethinking phase, the results of the implementation of the strategies are monitored and evaluated. This cycle continues until the intended results are achieved.DiscussionChanging the role of individuals from a passive status to an aware and active status in the care process requires motivation, responsibility, and active participation of individuals in the disease control process. Moreover, many cultural and social factors affect the active participation of Iranian women. Therefore, individuals can be involved in promoting their health using a community-based participatory action research approach.

Health education of patients with cardiovascular disease for effective self-care

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cardiovascular Disease leads to physical and psychosocial problems and worsens the quality of life of patients. Cardiovascular Disease Management is focused not only on reducing morbidity and mortality, but also on opportunities to improve daily life and overcome risk factors. Nurses play a key role in patient health education and their contributions have expanded in recent decades in Bulgaria. Purpose The aim of this study was to explore the possibilities for nurses' active participation in the health education of patients with Cardiovascular Disease. Methods The study included 146 patients with Cardiovascular Disease and a control group. The mean age of the respondents is 61.15 ± 2.35. The practical part of the study included 52 patients. The toolkit contains questionnaires for assessing stress and coping with everyday life, behavioral risk factors, a health education program and self-care. All participants have signed an informed consent, in accordance with the ethical principles of the Declaration of Helsinki. Results The results of physical activity, routine activities, self-care and anxiety show some disorders in the patient group. Patients with anxiety were 49.3%, individuals in the control group were 21.9%, (χ2 = 23.89, p <0.001). There was a statistically significant difference in anxiety level between patients and the control group (t = 4.07, p <0.001). There was a statistically significant difference in the relative shares of the two groups in terms of anxiety and physical activity (Z = 7.09, p = 0.000). Patients with self-care difficulties and anxiety are 24.0%. A relationship between anxiety and self-care options was found in patients (Z = 6.29; p = 0.000). A structured interview was conducted to identify lifestyle risk factors. The results show that 55.8% of patients are overweight. The relationship between waist circumference and BMI is straight moderate (r = 0.397, p = 0.004). The predominant number of men who smoke is 60.7%. A relationship was established between smoking and the gender of the respondents (χ2 = 18.21, df = 2, p = 0.000). The nurse conducted an individual interview with each patient to improve diet, daily routine, control blood pressure, blood sugar and more. A pedagogical model for health education was applied, based on goal setting, motivation, and self-care to achieve long-term results in terms of risk factor management. Positive changes were reported after 3 months in terms of hygiene and diet, physical activity, regular monitoring of blood pressure and medication. Conclusion Patient education is one of the most important aspects of nurses' work. Primary care nurses are a key factor in improving the quality of life of patients by implementing self-care education programs, reducing risk factors and monitoring the condition.

Effectiveness of nurse-led self-care interventions on self-care behaviours, self-efficacy, depression, and illness perceptions in people with heart failure: a meta-analysis

Abstract Funding Acknowledgements Type of funding sources: None. Background Insufficient self-care behaviours, low self-efficacy, depression, and poor illness perceptions are obstacles to the management of people with heart failure, leading to adverse patient outcomes. Self-care interventions are strategies used to support individuals in self-care. Currently, evidence on the effects of nurse-led self-care interventions on self-care behaviours and the correlates (self-efficacy, depression, and illness perceptions) in people with heart failure is scarce. Objectives This meta-analysis aims to systematically synthesize current evidence to determine the effectiveness of nurse-led self-care interventions on self-care behaviours, self-efficacy, depression, and illness perceptions among people with heart failure and identify the characteristics of effective nurse-led heart failure self-care programs. Methods MEDLINE, Embase, Web of Science, CENTRAL, CINAHL, and PsycINFO were electrically searched for relevant articles from the inception to December 2021. Randomised controlled trials examining the effects of nurse-led self-care interventions on self-care behaviours, self-efficacy, depression, and illness perceptions among people with heart failure published in the English language were included. The quality appraisal of included studies was performed using the revised Cochrane tool for assessment of the risk of bias in randomised controlled trials (RoB 2.0). The meta-analysis was conducted using Review Manager 5.4 and Stata SE 16.0. The certainty of the evidence was rated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results Twenty-four studies with 2488 participants were identified in this review. The results of our study revealed that nurse-led self-care interventions significantly improved self-care maintenance (MD: 9.93, 95% CI: 5.24 to 14.61, P<0.001, low certainty of evidence), self-care management (MD: 13.54, 95% CI: 6.84 to 20.23, P<0.001, moderate certainty of evidence), self-efficacy (SMD: 0.90, 95% CI: 0.58 to 1.22, P<0.001, low certainty of evidence), depression (SMD: -0.51, 95% CI: -0.66 to -0.35, P<0.001, high certainty of evidence), and illness perceptions (SMD: 1.99, 95% CI: 1.57 to 2.42, P<0.001, moderate certainty of evidence) among people with heart failure. Moreover, subgroup analyses indicated that the ideal duration of intervention for enhancing self-care behaviours, self-efficacy, and reducing depression in people with heart failure was 1 to 3 months. Conclusions This review provides low to high certainties of evidence supporting the beneficial effects of the nurse-led self-care interventions on self-care behaviours, self-efficacy, depression, and illness perceptions among people with heart failure. The duration of the intervention is one of the factors that may affect the intervention effects. Further well-designed randomised controlled trials are recommended to strengthen the current evidence.

Effect of a Self-care Training Program Based on Temperament Modification on the Quality of Life of Patients with Type 2 Diabetes

Objective: Considering the high prevalence of diabetes mellitus and its effect on the quality of life (QoL) of patients which can lead to low self-care and increased risk of disease complications, this study aims to assess the effect of a self-care training program based on temperament modification on the QoL of patients with type 2 diabetes (T2D). Methods: In this quasi-experimental study, 110 patients with T2D were selected by a convenience sampling method and were randomly divided into two groups of intervention and control using the random number table. After obtaining informed consent from them, they completed a demographic from and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire, and their temperament was diagnosed by a doctor expert in Iranian traditional medicine. The intervention group received four sessions of self-care training based on temperament modification each for 45 minutes. The control group received routine treatment without any intervention. Then, they completed the WHOQOL-BREF questionnaire again three months after the intervention. Data were analyzed in SPSS software, version 22 using chi-square test, paired t-test, and independent t-test. The significant level was set at 0.05. Results: Before the intervention, there was no significant difference in the quality of life score between the intervention (83.2±11.9) and control (85±9.4) groups (P= 0.194). After the intervention, the difference was significant between the intervention (87.7±11.3) and control (85.1±9.5) groups (P=0.044). There was no significant difference in the quality of life score in control group before and after the intervention (P=0.244). Conclusion: The self-care program training based on temperament modification can improve the quality of life of patients with T2D.

Promoting Health Literacy and Perceived Self-Efficacy in People with Chronic Obstructive Pulmonary Disease.

Background:Chronic Obstructive Pulmonary Disease (COPD) is an irreversible condition and it is of great importance for the patients to practice self-care. Given the impact of inadequate health literacy on people's self-efficacy in a self-care program, the aim of this study was to improve health literacy and self-efficacy in people with COPD.Materials and Methods:The present quasi-experimental study was conducted on 70 patients with COPD admitted to Shahrekord educational hospitals in 2019. Using random allocation software, the samples were randomly divided into intervention and control groups. Data collection tools included three questionnaires including demographic, health literacy, and perceived self-efficacy questionnaires. A training program, with three weekly sessions of theoretical and practical trainings, was conducted for the intervention group in classes in the hospital. The time of each session was 40 min. Data were collected three times i.e., before, immediately after, and three months after the trainings. Data were analyzed by means of SPSS 21 statistical software using descriptive and inferential statistics.Results:Before the intervention, the mean scores of perceived self-efficacy and health literacy did not differ significantly between the two groups, but after the intervention, the scores of the members in the intervention group increased significantly (f = 62.15, p < 0.05).Conclusions:The results of the study indicated an increase in the scores of perceived self-efficacy and health literacy in people with COPD. The use of targeted educational interventions can have a positive effect on the treatment and control of the disease.

Mental Health and Wellbeing of Secondary School Teachers in Malaysia

The teaching profession has been consistently ranked as the most stressful job in the world today. Teachers who experience prolonged exposure to high levels of work-related stress can find there to be a detrimental effect on their physical health, mental health, social life, and work performance. This study aims to characterise the mental health and wellbeing of secondary school teachers in Malaysia according to gender and age group. We examined burnout levels among 776 secondary school teachers who were measured across three dimensions (i.e., depersonalisation, emotional exhaustion, and personal accomplishment), as well as their sources of stress, manifestations of stress, and psychological symptoms. The quantitative data analysis revealed that most of the teachers had experienced burnout in terms of their personal accomplishments, work-related stressors, and time management, and that it mostly manifested as fatigue. Overall, the sample of secondary school teachers in Malaysia indicates a risk of poor mental health. Further psychological interventions and self-care programs are suggested to help secondary school teachers cope with the early signs of burnout.

신체활동, 우울, 스트레스가 만성신장병 동반 고혈압 성인의 삶의 질에 미치는 영향

This study is a descriptive research study using data from the 1st and 3rd years of the 7th National Health and Nutrition Examination Survey (2016, 2018) to identify the health-related quality of life characteristics and influencing factors of hypertensive adults according to the presence or absence of chronic kidney disease. The subjects of the study were 2,476 hypertensive adults and 308 hypertensive adults with chronic kidney disease. The complex sample Rao-Scott chi-square test, general linear model test, and ordinal regression analysis were used. Hypertensive adults with chronic kidney disease had significantly lower health-related quality of life than hypertensive adults (p&lt;.001). The risk of quality of life deterioration factors in hypertensive adults was 1.69 times higher when not performing aerobic physical activity, 7.34 times higher in depression, and 1.93 times higher in stress. Hypertensive adults with chronic kidney disease were 1.48 times higher in depression and 4.02 times higher in stress. Since the quality of life is significantly lowered by multiple morbidities than single morbidity, a strategy to delay the onset of multiple morbidity and disease progression by applying a self-care program that includes physical activity and depression and stress management from the single morbidity stage is required. Depression and stress management programs are provided for people with multiple morbidities.

Validity and reliability of the Arabic version of the Self-Efficacy for Managing Chronic Disease scale in rheumatoid arthritis patients

Background and objectivesRheumatoid arthritis (RA) is an autoimmune inflammatory condition that causing disability and affection of patient’s quality of life (QoL). Self-efficacy investigation helps us to detect the requirements of chronically affected patients and evaluation of self-care management programs. The aim of our study was to test validity and reliability of Self-Efficacy for Managing Chronic Disease (SEMCD-Arabic) in RA patients.MethodThis study included 248 RA patients, carried out at Rheumatology and Rehabilitation Department. The SEMCD-Arabic Validity was assessed by correlating the SEMCD-Arabic scale with the validated Arabic version of the modified Health Assessment Questionnaire HAQ (MHAQ), the Arabic version of the Multidimensional Assessment of Fatigue (MAF) scale, and the Arabic version of Short Form 36 version 2 for quality of life (SF QoL). Internal consistency, test–retest reliability was assessed.ResultsConvergent validity was confirmed by a positive correlation between (physical, mental) component of SF QoL and SEMCD-Arabic (r = 0.918, r = 0.925) respectively, and negative correlation between MAF and SEMCD-Arabic (r = − 0.657) and MHAQ with SEMCD-Arabic (r = − 0.595). Discriminant validity confirmed by a significant negative correlation between visual analogue scale (VAS) for pain, disease activity scale (DAS28), Morning stiffness, patient health, physician health, age, duration, and SEMCD-Arabic (r = − 0.1–0.7) (P < 0.001). Test–retest reliability was estimated which revealed a high interclass correlation coefficient (ICC = 0.87–0.997) indicating excellent agreement and internal consistency is acceptable as the Cronbach’s alpha value (0.660 to 0.78).ConclusionThe SEMCD-Arabic questionnaire can be used as a valid and reliable measure for assessment of patient’s self-efficacy in RA.Key Points• The SEMCD-Arabic questionnaire has a statistically significant validity in correlation with different clinical manifestations MHAQ, SF QoL, and MAF.• The Arabic SEMCD is highly reliable with a Cronbach’s alpha of 0.660 to 0.78.

Effects of self-care programs on the incidence of diabetes among adults with prediabetes: A systematic review and meta-analysis of randomised controlled trials.

To verify the effects of self-care programs among adults with prediabetes, to identify the preferable structure components and to summarise the core content components of self-care programs. A systematic review and meta-analysis of randomised controlled trials. PubMed, Embase, Cochrane, CINAHL, PsycINFO, Wanfang, CNKI, Chinese Biomedical Database and Open Grey were searched for studies published from January 2002 to December, 2021. Meta-analysis was conducted to verify the effects of self-care programs on diabetes incidence. Subgroup analyses based on structure components were performed to contrast the effects. We made a critical analysis to generalise the core elements of content components. The study was reported according to PRISMA statement. Totally, 15 studies were included in systematic review, of which 14 studies were eligible for meta-analysis. The results of meta-analysis showed the incidence of diabetes for prediabetic adults receiving self-care programs was significantly lower than those who received usual care (OR 0.58; 95% CI 0.46 to 0.73). The results of subgroup analyses based on delivery mode, intervention implementer, health education brochures provided, and follow-up duration showed statistically significant reduction in incidence compared with control group (p < .05). However, the differences of these pair-wise comparisons (face-to-face or remote, individual or interdisciplinary team, with or without brochures provided, ≤1year or >1year) were not statistically significant (p > .05). Three core content elements were generalised: cognitive education, behaviour guidance and psychological support. Self-care programs can effectively delay the progression of prediabetes to diabetes. Regardless of the diversified structure components, self-care programs can achieve better effects on the diabetes incidence than usual care, while the optimal structure components still remain unknown. Cognitive education, behaviour guidance and psychological support are core elements for these programs. More clinical trials with rigorous study design are needed to provide further evidence.

Self-care for head and neck cancer survivors with lymphedema and fibrosis: A pilot randomized clinical trial.

6094 Background: Lymphedema and fibrosis (LEF) are debilitating late effects in head and neck cancer survivors (HNCS). Initial therapy is usually directed by therapists following which patients undertake a LEF self-care program (SCP). No evidence based LEF-SCP are available. We report on the feasibility and preliminary efficacy data of a multifaceted LEF-SCP. Methods: 59 HNCS with LEF were randomized to: Usual care (n = 20), usual care + LEF-SCP (n = 20), and usual care + LEF-SCP + routine follow-up with a lymphedema therapist (n = 19). Assessments were conducted at baseline, 3-, 6-, 9-, and 12-months. Outcome measures include feasibility and preliminary efficacy (LEF progression, symptom burden, and jaw range of motion [ROM]). Multivariate covariance pattern model analysis was used to test for difference between arms. Results: 1) Feasibility: LEF-SCP training sessions - 80% completion rate; 90% satisfaction with the LEF-SCP; self-care adherence was similar between arms; no adverse event. 2) Preliminary Efficacy: Compared to usual care, participants randomized to LEF-SCP (+/- follow-up) showed a decrease in LEF severity (p &lt; 0.05), reduction in symptom burden (p &lt; 0.05), without significant improvement in jaw ROM. No significant differences were noted between the patients +/- follow-up with a lymphedema therapist. There was a trend to improved self-efficacy in patients participating in the LEF-SCP. Conclusions: The LEF-SCP is feasible and potentially efficacious for HNCS. Further testing is warranted. Clinical trial information: NCT03030859.