Self-care Skills Training Research Articles

Self-Care Skills to Prevent Burnout: A Pilot Study Embedding Mindfulness in an Undergraduate Nursing Course.

Background Burnout negatively affects nurses and increases nursing turnover. Many student nurses experience burnout throughout their academic program, negatively affecting student success and patient care. Objectives To explore effects of mindfulness education / self-care skills training in undergraduate nursing students on stress and self-care. Design A four-week pilot with four-week follow-up. Setting In-person mindfulness sessions were offered to first-year nursing students. Participants 67 students enrolled in a nursing skills course. Methods Four in-person mindfulness educational sessions were provided with a 4-week follow-up. Outcomes were stress and self-care, measured by the Perceived Stress Scale and Mindful Self-Care Scale at pre-, post-, and follow-up. Results 58 (86.6%) completed pilot; mean age = 22.8 (5.75), majority females (84%) and Caucasian (79%). Students practicing one or more mindfulness techniques at least 8 times outside class increased self-care 9.5% pre- to post-intervention (p = .01), although not sustained at follow-up. Stress did not change significantly in either direction (p = .94), potentially mediating the stress of starting clinical immediately following the intervention. Conclusions Mindfulness education increased self-care in first-year nursing students who practiced mindfulness outside class. Recommendations include further research and integration of mindfulness into courses to assess benefits and coping skills for future nurses.

Теоретичне обґрунтування комплексного застосування вакуумної терапії та кінезіотерапії при хронічному рановому процесі

The purpose of the study was to substantiate theoretically the possibility of complex application of vacuum therapy and kinesiotherapy in elderly people with chronic wound healing. Materials and methods. The methodological approach was used in the study: an analysis of literary sources and Internet resources; analysis of advanced foreign and domestic experience, system analysis method, comparison method, organizational analysis. Results and discussion. Vacuum therapy of wounds is considered as an additional method of treatment in patients with chronic wounds and wounds that heal for a long time, which is especially important for the elderly people because of the slowed metabolism and reduced immunological resistance of the body. Vacuum therapy stimulates wound healing by using localized negative pressure on the surface of the wound, and helps to remove excess of exudate around and within the wound. Another method of physical therapy which has a positive effect on the processes of recovery or recuperation of motor function, reducing the risk of complications (thromboembolism, respiratory diseases, pressure ulcers, contractures) and maintaining the patient's overall physical ability is kinesiotherapy. Kinesiotherapy, the main meaning of which is physical exercise, is aimed at improving aerobic performance, muscle performance of strength and endurance, stretching and lengthening of muscles, mechanisms of neuro-muscular control of inhibition and excitation. Any exercise activates not only the musculoskeletal system, but also all body systems, including nervous, hormonal, immune, which significantly accelerates the healing process. The main meaning of physical exercise, along with the use of vacuum therapy, is the dosed performance of physical activity with a healthy limb or a segment of the body to improve trophicity in tissues to achieve a general tonic and trophic effect caused by physical exercise for a faster resorption of inflammation products, preventing the appearance of hyperproliferative processes in wounds. Conclusion. It was theoretically substantiated that the combined use of negative pressure therapy and kinesiotherapy can lead to a reduction in the time of complete wound healing and a decrease in the time of temporary disability / inability to self-care, as well as contribute to an earlier restoration of daily activity. Exercise for the elderly may include: aerobic exercise to improve endurance and recovery; body mechanics training; breathing exercises for the prevention of congestion in the lungs; exercises to develop coordination of movements; self-care skills training; ideomotor exercises; perception training; exercises for the amplitude of movements and stretching of soft tissues; relaxation exercises; exercises for general strengthening, strength and endurance

Social support to improve the self-care ability of people with mental disabilities: a qualitative study in the “Kampung Tunagrahita”

The objectives of this research are to describe and explain types of social support provided by families and residents of surrounding communities to individuals with mental disabilities in the “kampung tunagrahita” of mentally disabled people in Ponorogo Regency. This research used a qualitative descriptive approach along with its case study design. The data collection was undertaken through in-depth interviews, documentation, and passive observation. The sources of data were derived from main informants, events or activities that provided the social support to improve the ability of people with mental disabilities, and documents in the form of background data on the people with mental disabilities and other pertinent documents. The research subjects were dietermined using a purposive sampling technique, and the data analysis used an interactive analysis model. The results show that families, normal citizens, and village government in Jambon district, Ponorogo Regency provide the social support to people with mental disabilities through the provision of self-care skills training, information and assistance in taking care of family members with mental disabilities. Likewise, the much-needed skills training is set to produce works worth considering.

Professional training in mental health self-care for nurses starting work in hospital departments.

Nurses working in hospitals can suffer from occupational stress due to high workloads and low job and/or personal resources. This can lead to work-related stress, exhaustion, health problems, and low quality of care. The aim of the study was to evaluate the effectiveness of work-related self-care skill training for nurses. A pilot study was conducted with 94 nurses in hospital departments in Germany. Nurses were either assigned to the intervention group that received competence training or to a waitlist control group. The intervention took place in groups over a period of 12 weeks. Training content included i.e. work-related stress management training, problem-solving techniques, and solution-focused counselling. The outcomes studied were changes in work-related stress, emotional exhaustion, emotion regulation, and job satisfaction. Three follow-up assessments were arranged. Nurses in the IG achieved a decrease in perceived job stress and emotional exhaustion as well as improvements with regard to enhanced emotion regulation skills. The intervention was evaluated with high satisfaction scores. This study showed first indications that training of mental health self-care skills for junior nurses could be a supportive approach for nurses starting work in hospital departments. However, replication studies are needed to verify the results.

Evaluation of self-care skills training and solution-focused counselling for health professionals in psychiatric medicine: a pilot study

Objective: The purpose of this pilot study was to implement and to evaluate a self-care skills training with solution-focused counselling to support psychiatrists in handling their daily work challenges.Methods: A total of 72 psychiatrists working in a psychiatric clinic were randomised in a single-blind trial to either an intervention group or a control group. Outcomes were measured at baseline and at the end of the training (follow-up 1: after 3 months; follow-up 2: after 6 months). A validated questionnaire including the Perceived Stress Questionnaire, the Copenhagen Psychosocial Questionnaire, Brief Resilient Coping Scale, Self-Efficacy Scale and the Quality of Relationship Inventory was used.Results: Psychiatrists in the intervention group reached a significant reduction in perceived job stress (p = 0.01, d = 0.05), improvements in job satisfaction (p = 0.02, d = 0.04), resilience (p = 0.02, d = 0.04) and self-efficacy (p = 0.04, d = 0.02) from baseline to all follow-ups with no comparable results seen in the control group. Psychiatrists stated an improved quality of physician–patient relationship (e.g. support, conflict management; p < 0.05).Conclusions: A self-care skills training, including solution-focused counselling, for psychiatrists was associated with significant improvements in perceived stress, job satisfaction, individual protective skills and quality of relationship to patients. This training is suitable to implement as a group training program for psychiatrists.

The effectiveness of individual self-control and self-care skills training programs in chronic heart failure patients

The effectiveness of individual self-control and self-care skills training programs in chronic heart failure patients

The self-care for people initiative: the outcome evaluation

To determine the effects of a community-based training programme in self-care on the lay population. Self Care is recognised as being a cornerstone of the populations health, but to date there have been few large-scale studies of its effectiveness on the general public. This paper reports on an evaluation of a self-care skills training course delivered in small group sessions within workplace and parent and toddler group settings to a lay population. A quasi-experimental longitudinal study of 12-month duration was conducted in three intervention primary care trusts (PCTs) and two similar comparison PCTs in England. The sample comprised 1568 self-selecting participants: 868 received the intervention and 700 did not. No changes were seen in usage of General Practitioner services, the primary outcome, however, statistical analysis suggested that being in the intervention group may be associated with increased use of out-of-hours and secondary care services. At six months' follow-up small but statistically significant positive effects of being in the intervention group were seen on self-esteem, well-being and anxiety scores. At 12 months' follow-up small but statistically significant positive effects of being in the intervention group were also seen on recovery locus of control, health literacy and self-esteem scores, and on knowledge of adult cough. The clinical significance of these very small changes is unclear. The training programme had a small but positive effect, which was still evident at 12 months, on individuals' knowledge and confidence levels with regard to managing their own health, but did not lead to reductions in health service use.

Are some more equal than others? Social comparison in self-management skills training for long-term conditions

Social comparisons influence self-evaluation and social and psychological adjustment to illness but are under-explored in relation to self-skills training group situations. A longitudinal qualitative study embedded within an RCT of a national programme of lay led self-care support in England (Department of Health, 2001). In-depth interviews were undertaken with a purposeful maximum variation sample of recruits. Data were analysed thematically. Three key themes emerged highlighting (1) the experience of group participation and interaction, (2) the process and (3) function of social comparison. Data highlight the salience of social comparison as an underlying feature of the group dynamics of self-care skills training. The nature, dimensions and scope of social comparisons extend beyond the cognitive states and dimensions traditionally forming the focus of social-psychological approaches to social comparison to include wider dimensions including entitlement to resources. The results confirm the tendency to make positive comparisons that result in beneficial self-evaluations. However, positive comparisons allow respondents to present themselves as socially and morally worthy, which may act to mask the identification of appropriate need and inequalities. Social comparisons function both as an accurate representation of internal cognitive states but also constitutes identity work involving competing values and moral requirements. We show that even those who report significant needs will sometimes portray themselves in a way that suggests positive social comparisons, which fit with a rationed and morally prescriptive and acceptable view of entitlement to NHS services. Such insights suggest that social comparisons in initiatives such as the EPP may be beneficial for some but exacerbate rather than alleviate health inequalities in long-term condition management for others.

Joining Up Self-Care: evaluation of a PCT-wide programme of support for self-care

Background and AimAlthough there is existing activity within the NHS and local communities to support self-care there has been no previous attempt at integration across a Primary Care Trust (PCT). The Joining Up Self-Care (JUSC) study aimed to implement and evaluate such a programme.MethodsThree self-care support modules for members of the public, together with a training course for primary care teams, were developed with, and implemented in, one PCT. The modules related to disease prevention (community-based coronary heart disease (CHD) prevention), care of people with long-term conditions (a disease-specific self-care skills training course for asthma) and the management of minor ailments aimed at mothers of children aged 3 months to 12 years (the ‘Pharmacy First’ service plus information booklets and campaigns). Postal questionnaires were completed by participants in CHD prevention (178), management of asthma (76) and minor ailments management (92), and by controls. A general population survey (n = 540) provided a comparison group for the CHD module and assessed general awareness of local self-care support. Four focus groups were held with mothers of young children. An audit of general practitioner (GP) records was conducted for consultations for minor ailments. Structured telephone interviews were conducted with 51 local health professionals and nine members of staff from the PCT.ResultsParticipants in the CHD module reported significantly more risk-reducing behaviours. Participants in a disease-specific Expert Patient Programme (EPP) for people with asthma rated the course positively, were subsequently more confident about discussing asthma with their doctor and had fewer concerns about their asthma medicines. Most users of the ‘Pharmacy First’ minor ailments scheme reported positive feedback and an intent to use the service again in the future. There were no significant differences in numbers of GP consultations for minor ailments between intervention and control groups. Health professionals were generally positive about encouraging self-care. Many felt they were already doing this but had insufficient time to implement it. A Local Enhanced Service (LES) was successful in engaging local general practices with self-care. Some organizational development relating to self-care occurred within the PCT but integration across different directorates was not achieved.ConclusionsThe JUSC programme was associated with changes in self-reported CHD risk reduction behaviours, in confidence to manage asthma and fewer concerns about medication, and with more positive attitudes towards consulting a pharmacist for minor ailments. Key principles for future PCT self-care strategies were identified. Further work is needed to embed support for self-care across the PCT as an organization.

Motivating patients with shoulder and back pain to self-care: can a videotape of exercise support physiotherapy?

Objectives The National Health Service is developing an ethos of self-care. Patients are being encouraged to become proficient in helping themselves. This has long been a philosophy of the physiotherapy profession, where self-care between consultations has been an integral part of the treatment process through encouraging the uptake of self-care skills training. This study explored how patients with shoulder and back pain perceived videotaped exercises and instructions to support their routine physiotherapy, and how the videotape was used. Design A videotape, developed by physiotherapists for patients with musculoskeletal problems, of exercises to view at home was given to patients by their physiotherapists to support their routine physiotherapy consultations. A qualitative methodology was used to examine how patients responded to being given a videotape of exercises and instructions between consultations. Data were collected through semi-structured interviews. Setting The study was based in 26 general practices that had access to practice-based physiotherapists in two primary care trusts in the north-west of England. Participants Thirty-three patients with shoulder and back pain who received a videotape of exercises and advice were interviewed. Results Three themes emerged from the data: finding space for exercise; remembering and doing exercises; and supporting the physiotherapy–patient relationship. Patients discussed aspects of motivation, and described how a videotape of exercises might support or inhibit the performance of exercises prescribed by physiotherapists. Patients identified a range of different ways in which they derived support from the videotape. Conclusions The videotape supported patients with a variety of different needs as it enhanced their ability to complete exercises correctly. Videotapes (or DVDs) are useful for patients and could be adopted as a tool to support treatment.

Recruitment to a trial of self-care skills training in long-term health conditions: Analysis of the impact of patient attitudes and preferences

The rise of evidence-based practice has highlighted the importance of effective recruitment to randomised controlled trials if studies are to be adequately powered and valid. However, there are also increasing concerns about patient preferences and choice within trials. The current authors are involved in a trial of a programme to provide self-care skills training for people with long-term health conditions (the ‘Expert Patients Programme’), and during the design stage there were significant concerns about the impact of patient preferences on the feasibility and validity of the study, because recruitment required that patients risk randomisation to a waiting list control group. This paper first details the issues raised in this trial, and the methods used to attempt to overcome them. Data on recruitment rates, loss to follow up and patient decision making about participation are presented, which suggested that initial assumptions about the impact of patient preferences were incorrect. Key lessons concerning preferences in this patient population and related issues in trial administration are then discussed.

Teaching Self-Care Skills to Latchkey Children: A Review of Research

Growing concerns about the welfare of latchkey children have led educators to develop programs that prepare children for the demands and responsibilities of spending time without adult supervision. These programs attempt to teach basic safety, time management, and other self-reliance skills to school-age children. This article reviews research examining the effects of self-care skills training on children's knowledge, behaviors, and emotional well-being. The article also suggests ways in which the findings can be used to improve the quality of self-care instruction and presents directions for future research.

Treatment patterns for schizophrenia in psychiatric hospitals

This paper analyzes the patterns of clinial treatments prescribed to patients diagnosed with schizophrenia who were admitted to state and county mental hospitals, private for-profit psychiatric hospitals, and private nonprofit psychiatric hospitals in July 1980. Treatment patterns were specified by examining the distribution of treatment types provided to patients over a 3-month period through standard tabular arrays and matrix analysis that holds constant the number of treatment types received by the patients. Data for this study are based on nationwide patient sample surveys and facility enumerations conducted in 1980 by the Survey and Reports Branch, National Institute of Mental Health. Clear differences and similarities emerged among the three types of hospitals in terms of the number and type of treatments provided to patients with schizophrenia. In general, patients with schizophrenia admitted to private psychiatric hospitals received a more comprehensive care regimen (generally inclusive of individual therapy) than similarly diagnosed patients admitted to state and county mental hospitals; private nonprofit psychiatric hospitals had marginally discernible treatment patterns from private for-profit psychiatric hospitals, especially with respect to assignment of group and self-care skill training.