Promotion Of Self-care Research Articles

Medscheme Mental Health Programme

Medscheme Mental Health Programme

Complicações do estoma intestinal em pacientes em pós- operatório de ressecção de tumores de reto

A ocorrência de complicações relacionadas ao estoma intestinal tem impacto negativo na qualidade de vida dopaciente estomizado. O presente estudo tem como objetivos: identifi car e descrever as principais complicaçõesrelacionadas ao estoma intestinal em pacientes em pós-operatório de ressecção de tumores de reto. Estudotransversal, retrospectivo e descritivo, com técnica de coleta de dados por análise do prontuário físico e avaliaçãoquantitativa dos mesmos. A coleta de dados ocorreu entre os meses de julho e novembro de 2016, e a análisequantitativa simples se deu a partir do programa Excel 2007. Nos resultados, apresentou-se a dermatite periestomalcomo a complicação mais encontrada (40,74%), seguida de prolapso de estoma (29,62%), necrose de mucosa estomal(18,51%) e hérnia paracolostômica (11,12%). Conclui-se que os resultados obtidos possibilitam o planejamentode ações direcionadas à prevenção das complicações e promoção do autocuidado do paciente estomizado. Dessaforma, faz-se necessária a reformulação do serviço de Estomaterapia, com quantitativo adequado de profi ssionaisespecializados garantindo qualidade na assistência prestada.Palavras-chave: Estomia; Neoplasias Retais; Cuidados de Enfermagem; Avaliação em Enfermagem.

Chronic leg ulcers

The most commonly encountered chronic wounds in clinical practice in the UK are venous leg ulcers (NHS Choices, 2012). Leg ulcers can be defined as loss of skin below the knee on the leg or foot, which takes more than 2 weeks to heal (National Institute for Health and Care Excellence (NICE), 2016). Leg ulcers affect 1 in 500 people in the UK and cost the NHS an estimated £400 million per year; this cost has serious consequences for an already limited NHS budget (NHS England, 2014). Therefore, promotion of self-care, an optimum healing environment and prevention of re-occurrence is a significant issue for clinicians (Wounds UK, 2016).

Interactive group therapy for the management of myofascial temporomandibular pain.

Background and aim To evaluate the outcome of a group therapy approach in the management of myofascial temporomandibular pain (TMD) through promotion of self-care.Methods A group based interactive session was introduced for those patients who, at initial consultation, were diagnosed with myalgic TMD. Feedback forms and telephone interviews were used to record patient reported outcome measures to assess patient satisfaction with the service.Results Fifty-five patients attended 17 group sessions over ten months. Feedback revealed a high level of satisfaction immediately after the session with 71% (n = 39) of patients opting for discharge, reporting confidence to self-manage in primary care. This effect appears to be sustainable up to 11 months.Conclusions This approach benefits patients with myofascial TMD through promotion of self-management while utilising health care resources efficiently.

Sizing of nursing staff associated with self-care promotion in a pediatric semi-intensive care unit.

ObjectivesTo calculate and compare the nursing staff size associated with self-care promotion at a pediatric semi-intensive care unit.MethodsThis was a prospective study in which 31 children and their caregivers participated. The nursing workload associated with each participant was evaluated at two different times (first and second hospital stays) using the Nursing Activities Score instrument. The first hospital stay corresponded to self-care promotion. Staff size was calculated according to the nursing hours recommended by the Nursing Activities Score instrument and by Conselho Federal de Enfermagem (COFEN) resolution no. 527/16, in the two hospital stays, and the results were compared.ResultsThe nursing workload in the first hospital stay (14.6 hours) was higher than the nursing workload in the second stay (9.9 hours) (p < 0.001). The Nursing Activities Score revealed that according to the nursing hours, the nursing staff size corresponded to 26 and 18 professionals in the first and second hospital stays, respectively, and to 15 professionals according to COFEN resolution no. 527/16.ConclusionThe number of personnel responsible for promoting self-care in pediatric semi-intensive care units, according to the nursing hours suggested by the Nursing Activities Score, was higher than that recommended by the existing legislation. This demonstrates the necessity of reconsidering staff size for this healthcare profile.

Relationship between Depression and Self-care in Iranian Patients with Cancer

Background:The current cross-sectional study was carried out to determine relationships between self-care and depression in patients with cancer.Materials and Methods:From October to December, 2015, 380 patients with cancer admitted to the associated university’s medical sciences hospitals (Sari, Iran), were entered into the study using non random sampling (accessible sampling). Data were collected by demographic questionnaire, Center for Epidemiological Studies Depression Scale (CES-D) and a Self-care Questionnaire.Results:Males (48.4±13±39; CI95: 46.4-50.4) were older than females (45.3±18.4; CI95:42.8-47.9). Spearman correlation analysis results showed that there was a significant negative correlation between self-care and depression (r= -0.134, P<0.05) and also a significant inverse relationship between physical (r= -0.166, P=0.001), psychological (r= -0.207, P<0.001) and emotional self-care (r= -0.179, P<0.001) with depression.Conclusions:It appears that self-care measures such as training of physical exercises, promotion of physical self-care, holding counseling sessions and psychotherapy can reduce depression levels.

The perception of users with diabetes regarding a group education strategy for the promotion of self-care

The perception of users with diabetes regarding a group education strategy for the promotion of self-care

Active Patient Programme: a local approach of integrated care in the Basque Country

Introduction : The management of chronic diseases represents a challenge for healthcare services. It is necessary to provide more efficient and coordinated care to patients with chronic conditions. As in other developed countries, the Spanish Health System is outdated, and a new organisational model is needed to provide a better care to chronic patients. A key role is given to self-management and educational programmes, implying a more active role of the patient In 2010 the Health Department of the Basque Country Government promoted a new strategy for chronic patient care based on the Chronic Care Model. Two of the cornerstones of this model are self-care promotion and community education. In this context, the “Active Patient” programme, based on the Chronic Disease Self-Management Program, has been proposed as a useful instrument. Description : The Active Patient programme is aimed at patients with a chronic condition or/and at their caregivers. It consists of 2.5 hours group sessions (8 to 15 people) once a week for 7 or 8 weeks. These sessions enable participants to acquire knowledge and skills related to the disease and its management, placing a strong emphasis on proactive tools (how to set realistic achievable targets, cope with problems related to their disease, effectively communication, share decision making…) to achieve healthier lifestyles (in terms of diet, physical exercise, management of emotions, and correct use of medication, among others). Each session is conducted by two leaders. At least one of them should be a chronic patient him/herself or caregiver. Lay leaders who are themselves chronic patients, or have close personal experience of a chronic condition, show greater empathy and tend to suggest more appropriate and realistic options than health professionals. They are volunteers. In this programme there are involved a lot of different stakeholders, among others, the public health system, citizens, patient associations, city halls, culture houses… Key findings : This programme was implanted in 2010 in 4 Osakidetza health care organisations. From 2012 has been expanded to all of them. Since November 2010 we have trained 3030 patients in two different courses. The effectiveness of the programme was evaluated by a randomized controlled clinical trial and a cualitative research. Participants satisfaction is very high 4.5/5. Nowadays we have 219 leaders, 80 are lay leaders and 139 professional leaders. During the past years the programme has been spread inside as well as outside the organisation. Focusing on the responsibility of the citizens towards their own health. Highlights : This innovative approach implies care from a holistic perspective and empowers patients through : - A better relationship between clinicians and patients - And extended knowledge of the illness and the habits recommended - Taking the drama out of the illness - Facilitating strategies to face the chronic condition and to strengthen self-esteem - Achieving a better quality of live and family relationships. - Supporting them to self-care, self-manage, engage in share decision making and co-develop and implement personalised care plans Self-efficacy significantly improved in diet, physical activity and control of the disease but no statistically significant differencies have been found in cardiovascular variables. . On the other side bringing this new approach has also found resistances among many clinicians, some agents and even some patients. We come from a traditional paternalist model and we are trying to change to a more cooperative model and so this needs some measures in order to readjust The main resistance we want to focus on is the fear and insecurity that comes up in some clinicians regarding their ability to work with and empowered patients. We must support clinicians to better support the health needs and goals of people This kind of change is progressive and need time Conclusion : It´s necessary to empower, activate and engage citizens, patients, families, carers and communities to coproduce health care service. At the same time we put in action a programme like this, we must train clinicians to encourage patients to be proactive.We must also help communication between patients and clinicians in order to make this change of philosophy possible. To involve clinicians is crucial to succeed. Even senior managers of healthcare organisations should have no doubts about the benefits of this new paradigm and should be aligned with it. The success of this innovative program will be possible when all the implicated parts are able to see the advantages that empowerment brings to all of them.

Promoting Self-Care at School for Students With Chronic Health Needs

Children with chronic health needs who have the capacity for self-care have been shown to have higher academic performance and greater social inclusion. However, self-care is rarely practiced as a focal point of health services interventions outside of clinical settings. Furthermore, little is known about how self-care develops through family, health, and educational support networks as a whole and from the point of view of teachers. This study used in-depth, semistructured interviews and a demographic questionnaire to generate teachers’ perspectives on the promotion of self-care in elementary school children with diabetes, and to represent their interactions with key supporters, including health care professionals, members of children’s families, and providers of educational services. Participants were recruited based on having at least one student with diabetes who received or was receiving care through a health services program designed to facilitate self-care in the schoolchildren. The teachers were sequentially selected from a Public School District in a midsized city in New Brunswick (Canada; N = 4) and two Boards of Education in a midsized Ontario city ( N = 4). Through a thematic analysis, teachers’ perspectives on their promotion of self-care in schoolchildren with diabetes were represented through five main interconnected themes: (a) teachers’ conceptions of self-care, (b) learning about health supports, (c) communication for self-care, (d) building inclusion, and (e) a difficult but manageable endeavor. Study limitations and future research implications are discussed.

Impact of promoting self-care in nursing workload

To assess the impact of promoting self-care in nursing workload and associate it to the variables: age, gender, socioeconomic status, education, marital status and number of children of caregivers. Prospective study with 31 children and their caregivers. Participants were assessed at two moments, 1st and 2nd hospitalization, the nursing workload was measured by the Nursing Activities Score (NAS). The mean NAS in the 1st hospitalization was 60.9% and in the 2nd hospitalization was 41.6%, that is, 14.6 and 9.9 hours of nursing, respectively. The nursing workload on the first day of hospitalization was higher compared to the last day, both for the 1st (p<0.001) and for the 2nd hospitalization (p<0.001), and higher in the first (p<0.001) and in the last day (p=0.025) in the 1st hospitalization. Comparing the 1st hospitalization to the 2nd hospitalization, the first was higher (p<0.001), and NAS items related to the training of self-care was influenced (p<0.001). The nursing workload associated to self-care promotion corresponded to 14.6 hours and was higher than determined by the existing legislation. Verificar o impacto da promoção do autocuidado na carga de trabalho de enfermagem e associá-la às variáveis: idade, gênero, classificação socioeconômica, escolaridade, estado civil e número de filhos dos cuidadores. Estudo prospectivo, onde participaram 31 crianças e seus respectivos cuidadores. Os participantes foram avaliados em dois momentos, 1ª e 2ª internação, quanto à carga de trabalho de enfermagem mensurada por meio do Nursing Activities Score (NAS). A média NAS na 1ª internação foi de 60,9%, e na 2ª internação foi de 41,6%, ou seja, 14,6 e 9,9 horas de enfermagem, respectivamente. A carga de trabalho de enfermagem no primeiro dia de internação foi maior quando comparada ao último dia, tanto na 1ª (p<0,001) como na 2ª internação (p<0,001), e maior no primeiro (p<0,001) e último dia (p=0,025) na 1ª internação. Ainda, na 1ª internação, foi maior quando comparada à 2ª internação (p<0,001), e os itens NAS referentes à capacitação do autocuidado a influenciaram (p<0,001). A carga de trabalho de enfermagem referente à promoção do autocuidado correspondeu a 14,6 horas e foi superior ao determinado pela legislação existente.

Experiences and Learning Needs of African American Family Dementia Caregivers.

Dementia family caregivers display significant rates of psychological and physical symptoms. African Americans (AAs) are disproportionately affected by dementia. African American caregivers display unique patterns of symptomology and responses to interventions designed to promote caregiver well-being. This study analyzed qualitative focus group data from 32 AA caregivers to explore how issues of race and culture may be incorporated into a culturally sensitive intervention for AA dementia family caregivers. Caregivers were asked scripted questions about their caregiving experiences and to suggest alterations to an existing psychoeducation program. Analysis revealed 4 key themes: the tradition of family care, caregiving and caregiving issues, culturally appropriate care, and navigating without a map. Suggestions for an educational program included a focus on developing caregiver skills and knowledge for caregiving, promotion of self-care, and reflection on the AA family and community as resources for care.

Nutritional self-care promotion in community-dwelling older people: a protocol of mixed method research

To describe a research protocol designed to promote nutritional self-care in older people. The aims of the research are: a) to evaluate the effectiveness of a nutritional education intervention in changing knowledge, attitudes, and behaviors; b) to describe the nutritional self-care ability and activities; c) to identify the promoting factors and barriers that influence the changes in nutritional knowledge, behaviors and attitudes in home-dwelling older people. Sequential explanatory mixed method design. The study will enroll 50 people aged 65 years and over. In the first quantitative phase, a pre-test and post-test design will be used to deliver a nutritional intervention aimed to change knowledge, behaviors and attitudes toward nutrition. Using the quantitative study results, the qualitative study phase will be conducted by interviews in sub-groups of older people. In a third phase, the quantitative and qualitative study results will be integrated. Quantitative data will be analyzed using descriptive and inferential statistics and qualitative data will be analyzed through content analysis. The study will provide new knowledge on nutritional self-care in home-dwelling older adults and the factors promoting nutritional self-care. Nutritional self-care promotion is of pivotal importance for the nursing care provided to home-dwelling older people. Educational programs aimed at the maintenance of proper nutrition in the older adults may reduce malnutrition and the related diseases. Nutrition educational programs should be based on knowledge derived from research to tailor individualized nutritional interventions and to realize effective educational programs.

Psychological determinants of self-care for health among fathers with small children

&lt;b&gt;Background&lt;/b&gt;&lt;br /&gt; Care of own health is statistically determined by many variables. The authors of the article focused exclusively on objective stable factors such as personality traits and health valuation. The conducted research study aimed at assessment of correlations between self-care for health and its psychological constituents such as personality traits, health locus of control, self-efficacy, positive and negative affect as well as health valuation examined in the population of fathers of small children.&lt;br /&gt; &lt;br /&gt; &lt;b&gt;Participants and procedure&lt;/b&gt;&lt;br /&gt; The examinations included 77 fathers aged between 30 and 40 who filled out the following questionnaires: NEO-FFI Inventory, Generalized Self-Efficacy Scale, Multidimensional Health Locus of Control Scale, Positive and Negative Affect Schedule, List of Criteria for Health, Health Value Scale and Care-for-Health Scale.&lt;br /&gt; &lt;br /&gt; &lt;b&gt;Results&lt;/b&gt;&lt;br /&gt; Positive correlations were noted between the general level of individual health self-care (including an active attitude towards own health and practices for health) and health valuation, extroversion, conscientiousness, self-efficacy, external health locus of control – influence of others (or powerful others) and positive emotionality. Negative correlations were detected between health self-care (in general and within particular health scales) and neuroticism and negative affect.&lt;br /&gt; The following factors proved statistically significant for self-care for health: health valuation, personality traits, and external health locus of control – influence of others.&lt;br /&gt; &lt;br /&gt; &lt;b&gt;Conclusions&lt;/b&gt;&lt;br /&gt; In the selected group of men the strongest correlation between health self-care and health valuation both in physical (practices for health) and psycho-social (active attitude toward own health) aspects was observed. Ascertaining health self-care predictors can be useful for constructing health self-care promotion programs to address the parents of small children.

Men's Perspective About The Care And Services Of Primary Health Care

Introduction: Men health in recent years has been excelling in the discussions about the public health policies. This fact has occurred due to increasing rates of male mortality and morbidity associated with low demand for health services, especially primary health care. Objective: To understand the perception of the man about the care and services developed within the framework of primary health care. Method: Descriptive study of qualitative approach carried out with 17 men, residents in urban area of the municipality of Sao Mateus, Ceara, Brazil and assisted by family health teams. The data were collected in October 2015 through semi-structured interviews and treated according to the technique of thematic content analysis. Results: Three themes have been identified: evaluation of care received the Perception the male population: bad, awful, restricted or non-existent and a minority considered satisfactory; Difficulties perceived about the services and facilities provided to men – assignment difficulty, use of unified health system (SUS) card, functioning hours, care discontinuity (lack of medicines, examinations) long queues and waiting time. Were facilities: Organization, customer service and timely appointments; Suggestions for improving the quality of care the health of men were: specific schedule to meet the man, performing educational actions, encourage them to look for the service, with a focus on prevention, self-care and health promotion. In addition to the need to improve the infrastructure, organization, moreover, very good breakfast choice and qualify health professionals. Final thoughts: the perception of men on primary health care predominated the negative judgment on the services and care provided concerning the restructuring needs of the services, qualification of health professionals and program availabilities/actions specific to men's health and engagement in health promotion and prevention through health education. DESCRIPTORS: Man health; Access to health services; Completeness in health; Primary health care. Introduction: Men health in recent years has been excelling in the discussions about the public health policies. This fact has occurred due to increasing rates of male mortality and morbidity associated with low demand for health services, especially primary health care. Objective: To understand the perception of the man about the care and services developed within the framework of primary health care. Method: Descriptive study of qualitative approach carried out with 17 men, residents in urban area of the municipality of Sao Mateus, Ceara, Brazil and assisted by family health teams. The data were collected in October 2015 through semi-structured interviews and treated according to the technique of thematic content analysis. Results: Three themes have been identified: evaluation of care received the Perception the male population: bad, awful, restricted or non-existent and a minority considered satisfactory; Difficulties perceived about the services and facilities provided to men – assignment difficulty, use of unified health system (SUS) card, functioning hours, care discontinuity (lack of medicines, examinations) long queues and waiting time. Were facilities: Organization, customer service and timely appointments; Suggestions for improving the quality of care the health of men were: specific schedule to meet the man, performing educational actions, encourage them to look for the service, with a focus on prevention, self-care and health promotion. In addition to the need to improve the infrastructure, organization, moreover, very good breakfast choice and qualify health professionals. Final thoughts: the perception of men on primary health care predominated the negative judgment on the services and care provided concerning the restructuring needs of the services, qualification of health professionals and program availabilities/actions specific to men's health and engagement in health promotion and prevention through health education. DESCRIPTORS: Man health; Access to health services; Completeness in health; Primary health care.

Evaluation of the telephone intervention in the promotion of diabetes self-care: a randomized clinical trial.

ABSTRACTObjective: to evaluate the effectiveness of the telephone intervention for promoting self-care related to physical activity and following a diet plan in users with diabetes, compared to conventional monitoring of users over a six-month period. Method: this was a randomized clinical trial, which included 210 users with diabetes, linked to eight Primary Health Units of Belo Horizonte, Minas Gerais. The experimental group (104 members) received six telephone interventions over the six-month monitoring; the control group (106 members) received conventional monitoring. To evaluate the self-care practices related to physical activity and following a healthy eating plan, in both groups, the self-care questionnaire was applied before the intervention and at three and six months after its start. Results: the mean effect of self-care scores in the experimental group was 1.03 to 1.78 higher than the control group, with progressive and significant improvement (p<0.001). Conclusion: the results indicate that the telephone intervention had a beneficial effect on diabetes self-care. The primary identifier of the clinical trials registry was: RBR-8wx7qb.

Nursing interventions in monitoring the adolescent with Cystic Fibrosis: a literature review.

ABSTRACTObjectives:to search for nursing interventions focused on the improvement of quality of life and promotion of self-care of adolescents suffering from the Cystic Fibrosis. Method:literature review. The inclusion criteria were: primary studies and studies with interventions developed by nurses in the adolescent population with Cystic Fibrosis, using Portuguese, Spanish, French and English with no time limit, and supported by the databases Scopus, Web of Science and CINAHL. The search expressions were: nursing AND care AND adolescent AND "Cystic Fibrosis" AND ("quality of life" OR "self-care"). Results:a total of 59 articles was retrieved; 8 matched the criteria chosen. Nursing interventions targeted at adolescents with Cystic Fibrosis and their family members were identified. These interventions were organized according to the nurses' role, namely caregiver, coordinator, counsellor, researcher, trainer and care partner. Conclusions:nursing interventions targeted at following up the adolescent during the entire therapeutic process, involving the presence of parents/significant others, since both the adolescent and family have to be responsible for self-care. Healthcare professionals should be capable of identifying the specific needs of patients with chronic disease and their family, permitting a better understanding and adaptation to the health-disease transition process.

Mobile Health: An Efficient Service to Promote Self-care among People Introducing e-selfcare

Mobile health is one of the most important electronic health services which use portable, smart devices, such as the mobile phone. With a very high rate of accessibility and a relatively low cost, this type of electronic health service can be used to offer health services to people anywhere, at any time. The main objective of the current study is to introduce the mobile health as a new service for promotion of self-care in the society. The study will continue to focus on numerous medical applications of mobile phone, particularly as an efficient and cost-effective modern device for self-care.

Keeping older people at home.

❛... older people with frailty and experiencing a crisis manage better if they are properly supported in their home environment.❜ There is consensus that health care needs to be reconfigured by reducing money spent on hospitals so that the money can be moved around the health system to release resources to support people in their own homes. Fewer and shortened hospital admissions will lessen the incidence of hospital-acquired infections and other adverse events, as well as reduce the negative consequences of a hospital admission on an older person, such as loss of independence, depletion in muscle mass, and mental deterioration. However, the realisation of a reconfigured health system is fraught with challenges arising from both healthcare staff and patients. Historically, hospital consultant ‘power’ and ‘prestige’ were related to the number of hospital beds under their control, and university and teaching hospitals cherish their patient activity for research purposes and the kudos it brings; the hospital lobby will need to engage in any reconfiguration. Primary health-care teams also need to reframe their practices so that self-care promotion is central to their endeavours alongside a willingness to support the very frail at home. Importantly, patients and the general population also need to understand that a hospital-centric health service is both unsustainable and undesirable if we are to maximise health-care resources and promote quality of life across the lifespan. Decline in function and general health is an inevitable consequence of growing older, and frailty is a state of health related to the ageing process, reflecting the gradual decline of the body systems. While about 10% of people aged over 65 years have frailty, the numbers rise significantly to 25%–50% in those aged over 85 years and are even higher in the very old (British Geriatric Society (BGS), 2014). The BGS would like all contacts with health and social care staff to include an assessment for the presence of frailty so that functional decline is monitored and reversible conditions treated promptly. The BGS recommends gait speed, the timed-up-and-go test, and the PRISMA questionnaire assessments together with regular medication reviews using the STOPP START criteria. Assessments may also enable effective interprofessional working. Poltawski et al (2011) identified three frailty scales drawn from various conceptual underpinnings that measure things in different ways. They highlighted how regular measurements identify not only the individual’s current status, but also the effectiveness of interprofessional working in the delivery of a proactive personalised care plan designed to avoid hospital usage. There is little evidence relating to the health status of the housebound older population, in part reflecting a historical trend of health research to recruit study participants through hospitals. In addition, until the present time, the lack of evidence relating to the health needs of this population was not recognised as a ‘gap’ because there was no imperative to deliver an effective service. However, this lack of evidence has also been noted in the USA with Qui et al (2010) highlighting the unmet physical and mental health needs of housebound older people. Any reconfigured health system needs to include a reliable and robust community-based response for older people with frailty. The district nursing service will be a crucial component of services. The BGS notes how older people with frailty and experiencing a crisis manage better if they are properly supported in their home environment. Perhaps, this is the opportunity for district nursing to regain its pivotal position within health service provision outside hospitals. BJCN

The Effect of Group Counseling on Physiological Aspect of Self-care and HbA1C Level of Patients with Diabetes Type II

Background: The most important underlying cause of death in diabetic patients is poor self-care. The effect of education on self-care promotion has been widely investigated; however, the advisory role and impact of the treatment team have been scarcely investigated. Aim: Determining the effect of group counseling on the psychological aspect of self-care and level of glycosylated hemoglobin in the patients with diabetes type II. Methods: In a randomized clinical trial, 73 patients with type II diabetes mellitus, who had been referred to Parsian Diabetes clinic of Mashhad in 2014, were divided into two groups of intervention and control. The group counseling program was performed in five 1.5-hour sessions with 3-day intervals, and each groups consisted of 8 to 10 people. The content of the meetings was problems in nutrition, exercise, diabetes mellitus disease, diabetes-related mental health problems, diabetes medications, and self-control of blood glucose. Researcher-made diabetes care questionnaire was filled and HbA1c test was measured before and two months after the intervention. Data were analyzed by SPSS version 11.5 using paired sample and independent t-tests. Results: In this study,27.3 percent of the subjects were male and 72.7 were female with the mean age of 49.1 ± 8.3. The scores of physiological aspect of self-care and HbA1C of the diabetic patients before the intervention was not significantly different between the groups; but in the post-intervention phase, the self-care in intervention group (49.1±5.8) significantly increased compared to the control group (31.8±12.2) (p<0.001). In the post-intervention phase, HbA1C in the intervention group significantly decreased (8.3±0.9) compared to the control group (9.1±1.4) (p<0.006). Conclusion: Group counseling might help to improve the diabetes self-care. Therefore, it can be added to the conventional training programs for better management of this chronic illness.

Interactions between the epistemological perspective of nursing educators and participants in educational programs: limits and opportunities toward the development of qualification processes for the promotion of self-care in health

Research-action aimed at exploring and transforming teaching-learning processes performed by nurses focused on the empowerment of mature adults toward self-care. An educational program was launched in two different locations, where educational sessions and post-educational reflexive meetings with nursing professionals were carried out. The selection and sampling of participants - nurses and mature adults - was intentionally pointed out. Employed methodologies were as follows: participatory observation (video recording of sessions); in-depth interviews; and reflexive sessions about educational practices. Data analysis was performed by means of the constant comparative method. Results pointed to the current coexistence of different educational interests concerning the healthcare education, the need for building dialogues between the participants' and nurses' frameworks, and the need for advancing toward more autonomous epistemological reference points that are able to forge healthcare-based dialogical learning pillars.