Mental health disorders are a major problem globally, particularly among vulnerable groups such as youth. In resource-limited settings, community health volunteers (CHVs), including youth volunteers, play a crucial role in mental health promotion, stigma reduction, early identification of distress and referral to formal services. However, evidence on training components and delivery strategies of mental health training programmes for youth CHVs remains limited. This systematic review following PRISMA guidelines aims to identify the key components, delivery strategies and reported outcomes of mental health training programmes for youth CHVs, in order to inform future module development to enhance volunteers' motivation, self-efficacy, knowledge and communication skills. English articles published between 2010 and 2024 were searched through PubMed, Scopus and Web of Science databases. Eligibility criteria included mental health training interventions for non-professional community volunteers, including youth volunteers with measurable outcomes. Data were extracted and quality assessment performed using the Mixed Methods Appraisal Tool (MMAT). Seven studies were included in this review. Training content focusing on mental health literacy, building communication and counselling skills, stigma reduction and mental health promotion demonstrated the most significant improvement in CHV's knowledge, skills, and self-efficacy. Programs adapting interactive strategies of role-playing, case studies and group discussion, combined with classroom teaching methods were significantly effective as well. Participants expressed greater confidence in handling mental health disorders within their communities. In conclusion, training programmes that prioritise mental health literacy, stigma reduction, supportive communication, self-care and help-seeking behaviour skill, implemented through interactive delivery methods are the most effective. The findings are essential for the future development of training module for youth CHVs to empower and enhance their capability to deliver effective mental health care within their community. CRD42024562221 (PROSPERO).

Psychological First Aid Self-Efficacy and Perceived Ability to Cope With Trauma Among Emergency Nurses: The Mediating Role of Mindful Self-Care Skills.

Effect of nursing interventions on self-care for ostomy patients: A systematic review and meta-analysis.

BackgroundA prevalent and serious complication of diabetes mellitus is the development of diabetic foot ulcer (DFU). There is a need for effective solutions that help prevent DFU to support our increasingly stressed health care systems. The use of mobile health (mHealth) tools has been shown to improve awareness and effective self-care management skills in people at risk of developing diabetic foot ulceration.ObjectiveIn this study, we aimed to investigate the perceived usefulness, engagement, and overall user experience of the Feetchecker app, a self-monitoring mHealth app for people at risk of DFU.MethodsA total of 24 patients (mean age 71, SD 8.6 years) with type 2 diabetes mellitus at risk of developing diabetic foot ulceration completed a 3-month evaluation period (70 recruited, 36 included, 12 dropped out) of a self-monitoring mobile app called Feetchecker app. A mixed methods approach was used to combine insights from app data with qualitative data from a pre- and postsurvey as well as interviews with patients and involved podiatrists. Data were analyzed using descriptive statistics and thematic analysis. We evaluated overall use of the app, patient engagement, and user experiences.ResultsPatients who fully completed the study conducted 393 feetchecks. In total, 7 patients sent in 9 pictures; all 7 were called for follow-up by a podiatrist. Overall, patients had a positive experience with the app and perceived the Feetchecker app as a valuable tool to monitor their feet for potential risk factors of DFU. Ease of use in performing a feetcheck and sending the podiatrist a picture was described as an important feature. Three main types of engagement with the Feetchecker app emerged: continuous, frequent, and no to little engagement. These patterns highlight enablers for self-monitoring such as ease-of-use, easy access to a podiatrist, and social support, as well as barriers such as digital skills and sustained engagement. Podiatrists highlighted the benefits of having patients report potential issues quicker and the ability to monitor their patients remotely. Challenges remain in integrating the promotion of the Feetchecker app into their consultations.ConclusionsThe Feetchecker app supported patients in self-monitoring risk factors associated with DFU through routine checks and quick contact with a health care professional in case of a potential issue. Overall, patients described a positive user experience and considered the app helpful. While mHealth tools are not for everyone, user engagement for many patients was high and shows that such apps can offer support for people able to use them. Future research should focus on improving usability and engagement with the app as well as extend the way patients can communicate with health care professionals beyond a picture.

Periodontitis is a chronic, inflammatory and multifactorial disease. It progressively destroys the tooth-supporting tissues. Most of the treatment consists of the patient acquiring self-care skills thanks to the practitioner's guidance. This study was undertaken to explore the experiences of patients suffering from periodontitis and to better understand the levers and barriers to their motivation and adherence to treatment. A qualitative study using an exhaustive sample of patients suffering from periodontitis involved in individual semi-structured interviews, was carried out. Data were collected and analysed using a thematic analysis technique until saturation point. Fourteen patients were included. Four themes were identified: medical care, empowerment, disease understanding and quality of life. Patients generally understood the disease, its peculiarities and its treatments, which helps for empowerment. Treatments for periodontitis generally improved patients' quality of life, particularly by reducing tooth mobility or halitosis. They also noted that the patient-professional relationship was a key point for treatment adherence. This study provides a better understanding of the experience of periodontitis patients across all dimensions of the disease. It also highlights the possible need for a therapeutic education program on comprehensive oral health care. Further studies could complement this research.

Aims To investigate the effectiveness of combining home-based programs with early intervention (EI) as an occupational therapy strategy for children with Down Syndrome. Methods A six-month longitudinal pilot study was conducted with 30 children with DS aged 0-3 years, recruited from an early intervention institute in Belo Horizonte, Brazil. Participants were allocated to a control group (EI only) or an experimental group (EI plus home-based programs grounded in Family-Centered Practice (FCP)). Outcomes were assessed at baseline and post-intervention using the Canadian Occupational Performance Measure (COPM), the Pediatric Evaluation of Disability Inventory (PEDI), and the Affordances in the Home Environment for Motor Development (AHEMD). Results Both groups demonstrated statistically significant improvements from pre- to post-intervention (p < 0.001). However, the experimental group showed moderate effect sizes (Hedges’ g) in occupational performance (0.61), satisfaction (0.50), and self-care (0.56), while the remaining outcomes presented small effects. No significant between-group differences were observed in environmental affordances. Conclusion The integration of home-based programs grounded in FCP into early intervention was associated with greater improvements in occupational performance, caregiver satisfaction, and self-care skills in young children with Down Syndrome. These findings support home-based programs as a feasible and effective complementary occupational therapy approach within early intervention services.

BackgroundPopulation ageing and the rise in chronic diseases are driving a shift from residential models to home care where family carers play a key role. Although education programmes have shown benefits, limited attention has been paid to how family caregivers can be effectively trained to prevent unintentional mistakes in home care and to how they should be prepared to respond to them related to the care they provide.ObjectivesThis scoping review aims to examine education programmes that enhance family caregivers’ knowledge and skills to promote safe home care, prevent unintentional mistakes and mitigate their impact on both care recipients and family caregivers.DesignThis study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) methodology for scoping reviews.Data sourcesComprehensive searches were conducted in PubMed, Scopus and Embase in April 2024.Eligibility criteriaThe review included studies on family caregivers in home-based care, focusing on education programmes promoting safe practices; quantitative, qualitative and mixed-methods designs were eligible while studies on professional care or unrelated to home safety were excluded.Data extraction and synthesisExtracted data included study characteristics, education type, target population and safety-related outcomes, which were summarised descriptively to map the available evidence.Results31 studies on home safety education programmes for family caregivers across oncological, neurological, chronic and paediatric conditions were identified, mostly from the USA and conducted in hospital, home and other health and care facilities. Randomised controlled trials predominated and were generally high quality. Education programmes targeting technical, daily living and self-care skills improved caregiver burden, knowledge, preparedness and quality of life although physical health outcomes showed limited change.ConclusionsEvidence indicates that structured education programmes enhance family caregivers’ knowledge, preparedness, competence and psychological well-being, supporting safer home care. While current education programmes are mostly short-term and caregiver-centred, this review identifies core technical, daily life and self-care competencies to guide future education programmes, highlighting the need for co-designed, rigorously evaluated education programmes that include patient safety outcomes and caregiver emotional support.

Self-care is critical for improving outcomes and quality of life in patients with chronic obstructive pulmonary disease (COPD), yet substantial barriers remain. The Middle-Range Theory of Self-Care of Chronic Illness provides a framework for systematically examining these obstacles. To explore barriers to self-care among patients with COPD. A descriptive qualitative design was employed. Semi-structured interviews were conducted with COPD patients from a rehabilitation centre in China and analysed using deductive content analysis and reported in line with COREQ guidelines. Sixteen patients (mean age 71.4 years; 75% male) participated. Across 3 dimensions of self-care, 7 categories and 21 subcategories were identified. In maintenance, patients reported difficulties with lifestyle modification, physical activity, and medication adherence. In monitoring, challenges included limited symptom recognition and lack of access to monitoring devices. In management, low confidence in autonomous care and reluctance to consult providers were major barriers. Nurses are encouraged to assess patients' existing barriers to self-care within their specific contexts and cultural backgrounds and to develop targeted, patient-centred nursing interventions aimed at strengthening self-care knowledge, motivation, and skills in clinical practice. Supportive policies are needed to promote the development of innovative self-care programmes.

Burnout and compassion fatigue are prevalent among healthcare professionals, prompting interest in well-being interventions. This study aimed to understand how staff perceive the support of Comfort Corner – a chaplain-led program - on resilience, provision of care, team engagement, and turnover, and to describe the self-care behaviors among Comfort Corner attendees. A sample of convenience included 384 completed surveys. Among the respondents, there were high levels of mental (80%), emotional (77%), and physical (82%) fatigue. Most (59%) continue to practice self-care strategies outside of hospital hours to sustain wellbeing. Nearly all agreed Comfort Corner enhanced self-care knowledge, skills, and attitudes (KSA) (90%), resilience (88%), mood (97%), clarity (90%), and energy (92%). A majority (87%) reported safer care provision and 90% cited better teamwork. Of importance, 23% identified Comfort Corner as a factor in their decision to remain in the hospital. Survey respondents value the support from Comfort Corner. Additional longitudinal studies are needed to understand Comfort Corner’s action mechanisms and its indirect effects on patient outcomes.

This study aimed to investigate the relationship between functional independence, oral hygiene habits and periodontal status in patients with Down syndrome (DS). A cross-sectional observational study was conducted with 49 patients with Down Syndrome. Sociodemographic data, oral hygiene habits and functional independence were collected. The periodontal assessment included: probing depth (PPD), Clinical Attachment Level (CAL), Gingival Bleeding Index (GBI) and Visible Plaque Index (VPI). A structural equation model was used in the statistical analysis. Regarding functional independence, higher frequencies of self-care skills were observed for eating (91.8%), using the bathroom (91.8%) and dressing (85.7%) and using the phone alone (53.1%). The experience of oral hygiene guidance contributed to an increase in the daily frequency of brushing (SRC = 0.280, SE = 0.134, p = 0.036). It was noted that the older the individual, the greater the impairment of the periodontal condition (p < 0.001). It was observed that greater functional independence was associated with less periodontal compromise. A greater functional independence is related to a better periodontal status. These study findings indicate that the development of self-care skills seems to be a positive strategy for the oral health of DS patients.

Coronary heart disease (CHD) can reduce the patient's quality of life. An important aspect in influencing the quality of life for CHD patients is self-care and family support for CHD patients, but this is often overlooked. This study aimed to determine the relationship between self-care and family support and the quality of life of patients with CHD at the Cardiac Clinic of RSUP Dr. M. Djamil Padang. A cross-sectional approach was used in this study. Totaly 303 participants were recruited in this study using purposive sampling technique. Instrument used were the MacNew Heart Disease Health-related Quality of Life Questionnaire, Self-Care of Coronary Heart Disease Inventory and family support questionnaires. The data analysis used was the Spearman rank test. The results showed that mean score of self-care was 64.95 (SD± 5.993), mean score of family support was 38.73 (SD± 2.827) and mean score of quality of life of was 143.96 (SD± 11.25). There was a relationship between self-care and quality of life (r=0.500; p= 0.001) and there was a relationship between family support and the quality of life of CHD patients (r=0.416; p=0.001). Self-care and family support were positively related to quality of life at moderate level. Patients need to improve their ability to perform self-care while family members need to provide supports to patients in order to increase patients’ quality of life. Health education about self-care needs to be provided to patients and their families to improve self-care skills and the quality of life of patients with coronary heart disease.

Venous ulcers have a prevalence of 1% in Western countries, with a tendency to become chronic and recur frequently. The lengthy periods of healing required for the treatment of these lesions result in increased costs. It is possible that patient education may enhance patients' understanding of their health condition, which could potentially lead to a reduction in recurrence rates. Nevertheless, it is uncertain whether this constitutes the optimal educational strategy. The objective of this study is to assess the superiority of an educational intervention delivered via video compared to an informative brochure in outpatient nursing clinics, focusing on patients' knowledge of venous leg ulcers and their self-care skills. A total of 144 patients with venous leg ulcers who attend the outpatient nursing clinics will be recruited to participate in this randomized controlled trial. Individuals with cognitive impairment, an ankle-brachial index of less than 0.90, arterial insufficiency, and arterial ulcers or ulcers of mixed origin will be excluded from the study. The intervention comprises 4 short educational videos specifically created for this study, in which patients will be provided with information on disease knowledge, medication management, compression therapy, and the importance of adequate nutrition and physical activity. The control group will be provided with the standard education offered at the outpatient clinics participating in the study, which will be disseminated through an information leaflet. Patient assessments will be performed with standardized, validated tools at baseline; at 1, 3, and 6 months postenrollment; and at 12 months via telephone follow-up. The primary outcomes are the patient's level of knowledge and their ability to self-care. The secondary outcomes are the patient's level of well-being, the success rate of the treatment, and the recurrence rates. A preliminary feasibility study was conducted to methodologically refine the protocol. A feasibility study was conducted to refine study procedures and data collection tools, confirming the acceptability of the questionnaires and the feasibility of digital data collection. The randomized controlled trial was funded in June 2025. It is currently pending ethics approval, and it is expected to start recruitment in spring 2026. Results from the main trial are expected to be available by the end of 2027. A video-based educational intervention may prove to be an effective, readily accessible, and replicable method of patient education. The findings of this study will inform the most effective method of patient education for this population, ensuring the delivery of high-quality care and enhancing the quality of services.

Purpose The availability of psychometrically sound patient-reported outcome measures for youth and young adults (YYA) with intellectual and developmental disabilities is an issue of justice. This study investigated the convergent and known-groups validity of the Pediatric Evaluation of Disability Inventory – Patient-Reported Outcome (PEDI-PRO) using similar measures of functional performance: the Pediatric Evaluation of Disability Inventory – Computer Adaptive Test (PEDI-CAT) and the Adaptive Behavior Assessment System (ABAS-3). Methods and materials YYA (n = 306), ages 14–22 with intellectual and developmental disabilities, were eligible for this study. Subsamples were created to optimize power for each analysis; 263 YYA had PEDI-CAT scores, 279 YYA had ABAS-3 scores, and 122 YYA had verified IQ scores. Results There were significant correlations between PEDI-PRO and PEDI-CAT domains (p < 0.001 for all): Daily activities (moderate); Social/Cognitive and Mobility (small). There were significant differences in PEDI-PRO scores for YAA with higher and lower scores on proxy-reported measures: intellectual function, self-care adaptive skills, communication and social adaptive skills, and mobility. Conclusion Results provide evidence for the PEDI-PRO’s ability to distinguish between YYA with higher and lower abilities, and provide unique yet complimentary information from that provided by parents and teachers.

Training self-care skills in children with autism is essential to help them achieve greater independence and reduce their reliance on others in daily activities. At Mutiara Hati School in Sidoarjo, several children with autism still experience difficulties in folding clothes as part of their personal care skills. Through the implementation of flip-fold media, the researcher aimed to support and enhance their ability to develop this skill more effectively. This study was designed to examine the extent to which the flip-fold media influences the improvement of clothing-folding skills among children with autism at Mutiara Hati Sidoarjo. The research employed a quantitative approach using a pre-experimental design, specifically the one-group pretest-posttest model. Data collection techniques included performance tests, direct observation, and supporting documentation. Data analysis was conducted using the non-parametric Wilcoxon signed-rank test. The results of the analysis indicated that the calculated Zvalue (Zcount = 2,74) was higher than the critical Zvalue (Ztable = 1,83) at a 10% significance level with a two-tailed test. Therefore, it can be concluded that the use of flip-fold media has a statistically significant effect on improving clothing-folding skills in children with autism at Mutiara Hati Sidoarjo.

ABSTRACT This study aims to examine the cognitive development, language development, social-emotional development, gross motor development, fine motor development and self-care skills of children aged 48–72 months in terms of their digital content preferences and tendencies toward digital play addiction. Data were collected via parent reports from 852 children aged 48–72 months across Türkiye using the Selçuk Developmental Assessment Inventory and the Digital Play Addiction Tendency Scale. Parametric techniques were used to analyze the data as they followed a normal distribution. According to the findings, the increased use in daily technology among children aged 4 to 6, greater engagement with social media platforms and a growing tendency toward digital play addiction were found to be significantly associated with developmental delays in the domains of cognitive, language, social-emotional, gross motor, fine motor and self-care skills. Importantly, merely playing digital games was not directly linked to developmental risks, indicating that usage duration and addiction tendencies are the critical factors.

While there is extensive literature about resilience among nursing students, less is understood about students' experiences of ambiguity, uncertainty, and dissonance. Theoretical linkages underpin a framework for embracing ambiguity, uncertainty, and dissonance in clinical learning environments as transformative experiences that can positively impact the transition to practice. A conceptual framework to guide students in their feelings of ambiguity, uncertainty, and dissonance as they transition to professional nursing practice is provided for nurse educators. The framework consists of four themes: capacity to persist with discomfort, composition of learning environments, dissonance as transformative, and crisis of ordinariness. Findings indicate that ambiguity, uncertainty, and dissonance can be transformative experiences. Reflective learning can enable students to embrace rather than resist these feelings. Feelings of ambiguity, uncertainty, and dissonance can be transformed into opportunities for growth to develop students' readiness, capacity, and perseverance as they transition to practice. The professional readiness of nurses is frequently tied to ameliorating issues of ambiguity by defining and preparing nurses according to professional-readiness outcomes, uncertainty through theory-to-practice instruction, and dissonance with self-care and resilience coping skills. There is little research on nursing students' capacity to embrace feelings of ambiguity, uncertainty, and dissonance despite the tendency to try to resolve these feelings as they care for patients.

Through conventional scientific research methods in the field of educational science, the study identified three core self-care skill groups and selected three groups of physical education activities with the potential for integration into self-care education. Experiments with integrating physical education activities into self-care skills education showed that the percentage of students achieving a "Good" level increased, while the percentage of those not achieving a "Not Good" level decreased. The results confirm the feasibility and effectiveness of integrating self-care skills education through physical education activities in primary schools.

Framework: This study aims to validate the IEXPAC scale for assessing patient experiences among chronic disease patients in Portugal, where over 40% of adults are affected by such conditions (OECD, 2021). Effective management of chronic illness requires understanding the experiences of patients and their caregivers to improve quality, integrated care. The IEXPAC, based on the Chronic Care Model, focuses on communication, care continuity, and emotional support. Validating the IEXPAC in Portugal addresses a gap in standardized tools for assessing patient-centered care, highlighting critical areas like digital literacy and care coordination. This tool’s insights into patient experiences support improved care practices, influencing patient well-being and adherence to treatment plans, and providing valuable guidance for healthcare policy and practice. Approach: A cross-sectional study was conducted, with data collected through online and paper questionnaire. A sample of 168 participants, aged 20-95 and predominantly female, completed the IEXPAC scale along with a subjective well-being measure. A split-sample approach with cross-validation was used to determine the scale's factor structure. Exploratory Factor Analysis (EFA) was conducted on one sub-sample, followed by Confirmatory Factor Analysis (CFA) on the second. Results : The EFA identified a two-factor structure: Integrated and Empowering Care (F1) and Digital and Social Health Empowerment (F2). The CFA confirmed this structure with good model fit and reliability. Significant positive correlations were found between the IEXPAC scale and subjective well-being, with a large correlation for the first factor and a moderate correlation for the second. This two-factor structure differs from the original three-factor model but aligns with recent studies on similar scales. Exploratory factor analysis (EFA) identified a two-factor model, which confirmatory factor analysis (CFA) validated. This two-factor structure – Integrated and Empowering Care and Digital and Social Health Empowerment – which demonstrated strong reliability, was consistent with findings from Guilabert et al. (2021) and aligns partially with the original three-factor model Mira et al. (2016). While the original factor structure identified by Mira et al. (2016) emphasizes distinct dimensions of productive interactions and patient self-management, the current study suggests a more integrated experience in chronic disease management. The sample patients seem to perceive a more holistic approach, where healthcare provider support and patient empowerment are more closely intertwined. This finding reflects evolving healthcare practices and the context of the Portuguese healthcare system, where care coordination and patient engagement might be perceived as unified elements of patient-centered care (Hickmann et al., 2022). Implications : The validation of the IEXPAC scale provides essential insights for advancing patient-centered care across healthcare settings. The factors identified – Integrated and Empowering Care and Digital and Social Health Empowerment – highlight critical elements that enhance patient well-being, including communication, coordination, and self-management. Social workers play a vital role in this process by using patient-centered approaches to support timely treatment and appropriate referrals, particularly by empowering patients through literacy and self-care skills. This study emphasizes the importance of adapting measurement tools to different contexts and integrating findings into training programs to improve patient-provider interactions.

ObjectiveTo explore the effect of meticulous nursing intervention on self-care ability of patients with acute stroke.MethodsThis randomized controlled trial included 100 stroke patients admitted to our hospital from June 2024 to December 2024. The participants were divided into a control group and a study group (50 cases in each group) using the random number table method. The control group received routine perioperative nursing, while the study group received systematic and meticulous nursing interventions on the basis of routine nursing. The primary outcome measures were the National Institutes of Health Stroke Scale (NIHSS) scores (to evaluate neurological deficits) and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) scores (to evaluate quality of life) before and after the intervention. The key secondary outcome measures included the Fugl-Meyer Assessment (FMA) scores for the lower limbs, the Functional Ambulation Category (FAC) scores, and the Exercise of Self-Care Agency (ESCA) scale scores.ResultsSignificant between-group differences were observed in primary caregivers (P=0.045), hospitalization time and hospitalization expenses (all P<0.001). After-intervention, the study group demonstrated superior outcomes compared to the control group in NIHSS scores, WHOQOL-BREF scores, FMA scores, and FAC scores (all P<0.001). Furthermore, the study group showed significantly higher scores in health knowledge level, self-concept, and self-care skills (all P<0.001).ConclusionMeticulous nursing can enhance treatment and rehabilitation compliance, promote neurological functional recovery, improve self-care capacity through multi-level nursing interventions, alleviate stroke-induced motor dysfunction in lower extremities, and consequently elevate the overall quality of life during rehabilitation.

This study aimed to develop the children with cerebral palsy (7-18 years old) self-care skills scale-parent form and assess its validity and reliability. The sample of this methodological study consisted of 317 parents of children with cerebral palsy (CP) aged 7-18 years who were trained in special education and rehabilitation centres. The data were collected using the Child-Parent Information Form and the Children with Cerebral Palsy (7-18 Years Old) Self-Care Skills Scale-Parent Form (CCPSCSS-PF). The data were analysed using descriptive statistics, Kruskal-Wallis, Cronbach's alpha, test-retest, the Kaiser-Meyer-Olkin (KMO) test, Bartlett's test, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). The Cronbach's alpha coefficients for the overall scale and its two subscales were 0.971, 0.984, and 0.913 and the test-retest reliability coefficient of the overall scale was 0.976. The KMO sample fit coefficient of the scale was 0.948, and Bartlett's test of sphericity χ2 value was 8472.344 (p < 0.001). According to the EFA results, the scale items were grouped under two factors. The factor loadings of the CCPSCSS-PF ranged from 0.767 to 0.951 for Factor 1 (self-care) and 0.811 to 0.950 for Factor 2 (ability to express self-care). The scale accounted for 83.4% of the total variance. The fit indices calculated in CFA were 1.000 for GFI, AGFI, CFI, TLI, and IFI; 0.097 for RMSEA; and 2.489 for CHISQ/Df. The CCPSCSS-PF is a valid and reliable assessment tool that can be used to evaluate the self-care skills of children with CP aged 7-18 years. The CCPSCSS-PF can be used in preventive and rehabilitative studies by professionals caring for children with CP.