Self-care Support Research Articles

To monitor or not after detected AF, this is a question: report from the consumer-led screening programme of long-term extension mAFA cohort

Abstract Background The consumer-led screening for atrial fibrillation (AF) is evolving with the widespread availability of wearables. Nonetheless, what the long-term impact on the individual's behavior of rhythm monitoring after detected AF is unclear. Objective To investigate the long-term impact on health behavior for the individuals using wearables for cardiac rhythm. Methods In the mobile technology supported screening and integrated care in atrial fibrillation (mobile atrial fibrillation application, mAFA programme), the general population freely decided to enter the screening programm with wristbands or watches across China. At least 14-day monitoring was proposed, the individuals with detected AF can consider to receive the mAFA App for AF care. The adherence of rhythm monitoring after detected AF with wearables was calculated, while the multinomial logistics regression model was utilised to analyze the independent factors associated with the adherence. Results There were 4337172 individuals entered into AF screening programme using wearables between Oct, 2018 and Feb 14, 2024. Among them, 22224 individuals (0.5%, 22224/4337172, mean age, SD, 55, 16 years old, male 82.4%) were monitored with AF episodes. There were 21223 individuals remaining the wearables use for rhythm monitoring after first AF identification. The time (days, median, interquartile ) using wearables for monitoring the pulse rhythm were 465 (130, 889) days. The time to first identified AF (days, median, interquartile) were 16 (1, 176) days. The continuing monitoring time since first identified AF (days, median, interquartile) were 290 (54, 668) days. The adherence of cardiac rhythm monitoring after detected AF with wearables (Figure): 96.0% individuals continued the rhythm monitoring using wearables during 30 days, 58.8% in 2 years, and 35.7% in 3 years and over. In the adjusted multinomial logistics regression model, the palpitation, hypertension, obstructive sleep apnea, heart failure, age and mAFA use were independently associated with the adherence for the individuals remaining the wearables use for rhythm monitoring after detected AF (all p<0.05). Conclusions The general population at risk were likely to receive long-term rhythm monitoring after detected AF, and the mAFA use, with the self-care support, was an independent factor for the continuing monitoring.

Trend of body mass index and its impact on glycemic control in Finnish patients with type 2 diabetes

Abstract Background Obesity prevalence has increased in Finland and is prevalent in patients with type 2 diabetes (T2D). Understanding the trend in body mass index (BMI) and its impact on glycemic control helps in the assessment of treatment strategies for T2D. We aimed to investigate the current trend in BMI among Finnish patients with T2D and the glycated hemoglobin (HbA1c) control across different BMI categories. Methods Regional data on electronic health records (EHRs) covering all public health care in North Karelia, Finland, were used. Patients with T2D (ICD-10 code E11) in 2012-2022 were identified from EHRs. In each study year, patients with ≥1 measurement of BMI and HbA1c were included in data analysis. Generalized estimating equations regression analyses were performed to evaluate the trends. Results The annual number of patients in the analyses ranged from 5149 to 10216 in 2012-2022. The unadjusted mean BMI remained stable. However, an increasing trend in BMI was observed in the age-adjusted model and remained unchanged with further adjustment for sex, duration of diabetes, and antidiabetic medication use, reflecting the aging of the patient population and lower BMI in aged patients. Patients with higher BMI had higher HbA1c levels in 2012-2022. The increasing trends in HbA1c over time were observed across different BMI categories (except for the obsess class III) accounting for age, sex, and duration of diabetes. However, a decreasing trend in HbA1c was found in the obese class III category with further adjustment for antidiabetic medication use, along with the highest usage rates of the new antidiabetic medications during the follow-up. Conclusions Our findings suggest that weight management requires increased attention in Finnish patients with T2D and is also important for better glycemic control. Multimodal treatment, including effective lifestyle counseling, self-care support, and medication management, is needed. Key messages • More attention and resources are needed to achieve optimal weight control. • Weight management could aid in better glycemic control.

Profiles of knowledge, self-efficacy, psychological and physical health in type 2 diabetes and its association with outcomes

BackgroundSelf-management is impacted by knowledge, self-efficacy, psychological health (general mental health and diabetes-related distress) and physical health (KSPP), and variations in KSPP contribute to heterogeneity in diabetes self-management education (DSME) program outcomes. This study aimed to identify unique KSPP profiles, and their associations with self-management behaviors. MethodsA cross-sectional survey was conducted in 518 participants with type 2 diabetes. Diabetes knowledge, self-efficacy, diabetes-related distress, mental and physical health, self-care, medication adherence and social support were assessed. A mixed-model latent profile analysis was conducted on eight KSPP variables, and sociodemographic, self-care (diet, physical activity, and medication adherence), and glycemic levels were compared across profiles. ResultsFour unique KSPP profiles were identified: profile 1 (untroubled), profile 2 (distressed: diabetes-specific), profile 3 (distressed: global) and profile 4 (activated). Profile 3 was associated with the lowest self-care, highest glycemic and lowest social support levels. Profile 4 was associated with the highest self-care, lowest glycemic and highest social support levels. ConclusionsOur study identified novel KSPP profiles, which were associated with differential self-management behaviors and metabolic profiles. Practice ImplicationsIdentifying KSPP profiles might improve self-management support through identifying clustering of care needs, and support more targeted DSME development.

Multisite Randomized Controlled Trial of CareSTEPS: A Supportive Care Intervention for the Family Caregivers of Patients With Advanced Lung Cancer

ObjectivesPatients with advanced lung cancer (LC) face significant physical, psychological, and functional challenges, increasing their reliance on caregivers. This study evaluates the efficacy of CareSTEPS (Self-Care, Stress management, Symptom management, Effective communication, Problem-solving, and Social support), a 6-week telephone-delivered intervention designed to improve psychological functioning (depression and anxiety symptoms) and reduce caregiver burden among family caregivers of patients with advanced LC. MethodsIn this multisite, open-label, parallel-group randomized controlled trial, 174 caregivers (74.1% female individuals, 40.2% from a racial or ethnic minority group) of patients with stage IIIB or IV NSCLC or extensive-stage SCLC completed baseline surveys and were randomly assigned to CareSTEPS (n = 87) or usual care (n = 87) using stratified block randomization. Caregivers in the CareSTEPS arm received a manual with information on self-care, stress management, symptom management, effective communication, problem-solving, and social support. They also participated in six weekly telephone sessions with Masters-level trained interventionists with a mental health background, who provided psychoeducation, skills training, and support. Eight weeks after baseline, caregivers completed a follow-up survey. ResultsUsing an intent-to-treat framework, analyses of covariance were conducted to assess the efficacy of CareSTEPS, with p values lower than 0.05 indicating significant differences. Caregivers who received CareSTEPS reported improved psychological functioning and lower burden compared with those who received usual care, with effect sizes ranging from small to large (depression d = −0.55, anxiety d = −0.81, burden d = −0.37). ConclusionsThe CareSTEPS intervention reports great promise in meeting the critical support needs of the family caregivers of patients with advanced LC, significantly improving caregivers' psychological functioning and reducing their burden. Overall, the findings emphasize the importance of incorporating caregiver support into the comprehensive management of advanced LC. Clinical Trial RegistrationClinicalTrials.gov NCT02414672.

A qualitative study exploring the acceptability of a telehealth intervention for family members of people experiencing a first episode psychosis: PERCEPTION.

Family members of people experiencing a first-episode psychosis (FEP) can experience high levels of carer burden, stigma, emotional challenges, and uncertainty. This indicates the need for support and psychoeducation. To address these needs during the COVID-19 pandemic, we developed a multidisciplinary, blended, telehealth intervention, incorporating psychoeducation and peer support, for family members of FEP service users: PERCEPTION (PsychoEducation for Relatives of people Currently Experiencing Psychosis using Telehealth, an In-person meeting, and ONline peer support). The aim of the study was to explore the acceptability of PERCEPTION for family members of people who have experienced an FEP. Ten semi-structured interviews were conducted online via Zoom and audio recorded. Maximum variation sampling was used to recruit a sample balanced across age, gender, relatives' prior mental health service use experience, and participants' relationship with the family member experiencing psychosis. Data were analysed by hand using reflexive thematic analysis. Four themes were produced: 'Developing confidence in understanding and responding to psychosis'; 'Navigating the small challenges of a broadly acceptable and desirable intervention'; 'Timely support enriches the intervention's meaning'; and 'Dealing with the realities of carer burden'. Broadly speaking, PERCEPTION was experienced as acceptable, with the convenient, safe, and supportive environment, and challenges in engagement being highlighted by participants. Data point to a gap in service provision for long-term self-care support for relatives to reduce carer burden. Providing both in-person and online interventions, depending on individuals' preference and needs, may help remove barriers for family members accessing help.

Heart of Care: Embracing Grief and Growth in Oncology and Palliative Medicine

Introduction The emotional impact of patient loss in oncology and palliative care profoundly affects healthcare professionals. This study explores clinicians’ experiences, emotional reactions, and coping mechanisms in these fields, focusing on their professional and personal growth. It aims to provide a comprehensive understanding of how healthcare professionals from different regions and with varying years of experience deal with patient loss, emphasizing cultural, social, and institutional influences on their coping strategies. Methods A mixed-methods approach combined qualitative and quantitative elements. Data were collected using a Microsoft® Forms© survey targeting oncology and palliative care healthcare professionals. The survey included questions on experiences with patient loss, coping strategies, personal and professional growth, and beliefs. Statistical methods and thematic analysis were used to analyse quantitative and qualitative data. Ethical approval was obtained, and the survey ensured participant anonymity and confidentiality. Results The survey received 125 responses from nineteen countries. Emotional reactions to patient loss were significant, with various coping strategies reported, including spiritual practices, self-care, and professional support groups. Personal and professional growth were key outcomes of dealing with patient loss. Themes like Emotional Impact, Coping Mechanisms, and Reflections on Death and Dying were prevalent. Analysis revealed no significant correlation between the time taken by the participants to complete the survey and years of healthcare experience. Conclusion Healthcare professionals in oncology and palliative care face significant emotional challenges due to patient loss. The study emphasizes the importance of diverse and effective coping mechanisms, the supportive role of personal beliefs and workplace environments, and the journey of personal and professional growth amidst these challenges. It highlights the resilience of healthcare workers and underscores the need for supportive systems in managing the emotional aspects of patient care.

Second Victims in Industries beyond Healthcare: A Scoping Review.

The second victim phenomenon (SVP) refers to workers negatively impacted by involvement in unanticipated adverse events or errors. While this phenomenon has been extensively studied in healthcare since its acknowledgment over 20 years ago, its presence and management in other high-risk industries have remained unclear. We conducted a scoping review aiming to map the SVP in non-healthcare industries, as well as to explore the available interventions or support programs addressed to help second victims (SVs). A total of 5818 unique records were identified and, after the screening process, 18 studies from eight sectors were included. All industries acknowledged the existence of the SVP, though many did not use a specific term for defining the SV. Similarities in psychological and emotional consequences were found across sectors. Support strategies varied, with the aviation sector implementing the most comprehensive programs. Self-care and peer support were the most reported interventions, while structured clinical support was not mentioned in any industry. Our review highlighted a lack of standardized terminology and industry-specific, evidence-based support interventions for the SVP outside of healthcare. Healthcare appears to be at the forefront of formally recognizing and addressing the SVP, despite traditionally learning from other high-reliability industries in safety practices. This presents opportunities for reciprocal learning and knowledge transfer between healthcare and other high-risk sectors.

Integrated Psycho-Socio-Educational Programmes for Women Victims of Gender-Based Violence.

Although women victims of gender-based violence suffer health and self-care issues, there is still a lack of coordinated integrated support programmes aimed at mitigating the socio-health impact of gender-based violence on women that are suitably adapted to new social contexts. Given the importance of analysing the effectiveness of integrated psycho-socio-educational interventions and self-care programmes, this study reviews the interventions and programmes implemented in Spain, focusing specifically on their implementation and impact in the autonomous region of Navarra. The data reviewed were extracted from official publications and websites pertaining to the 17 Spanish autonomous regions and the corresponding Spanish government ministries. Additionally, 18 reports on psycho-socio-educational interventions (n = 63) for the whole of Spain centring on integrated support for self-care were analysed. In the case of the autonomous region of Navarra, four psycho-socio-educational intervention programmes (n = 4) involving self-care were analysed. The analysis found that there are a number of diverse integrated psycho-socio-educational programmes focusing on self-care that provide support and interventions. The results indicate that the women who benefit from the services, especially those relating to self-care (self-esteem, healthcare, personal image, and health), report improvements in their general wellbeing.

Between principles and pragmatism – primary healthcare and social services professionals’ experiences and perceptions of self-care for older adults with home care: a qualitative study

Objective To explore the experiences of healthcare and social services professionals and their perceptions of using Certificate for self-care with support (CSS) for preventive self-care for older adults with home care, including the CSS process and collaborations between primary healthcare and social services. Design An inductive qualitative study including seven focus group interviews analyzed with reflexive thematic analysis. Setting and subjects The study was conducted in the Stockholm Region 2022/23. In total, 23 informants were recruited from four key partners involved in the CSS process: professionals from primary care rehabilitation and primary healthcare, social services officers, and home care staff. Result The analyses resulted in five interconnected themes: ‘Guidelines with scope for interpretation,’ ‘Support for self-care is needed, but complicated in practice,’ ‘To trust the other professions’ competence,’ ‘There is a transfer of responsibility,’ and ‘Communication is key.’ The overarching theme ‘Principles or pragmatism for safe person-centered care,’ anchoring the other themes, revealed a common goal of achieving safe and individualized care within available resources, but from two conflicting perspectives: the importance of following the process according to the guidelines or taking a more pragmatic approach. Conclusion This study highlights the need to establish structures facilitating safe self-care among frail groups, such as older persons dependent on home care. Our findings emphasize that the demarcation between, and responsibilities of, organizations need to be discussed and clarified to offer person-centered support. Comprehensible guidelines and functioning communication channels must be established so that all important perspectives can be heard, not least the patient’s.

Psychological stress of general practitioners in the care of patients with palliative care needs: an exploratory study

BackgroundIn Germany, general practitioners play a pivotal role in palliative care provision. Caring for patients with palliative care needs can be a burden for general practitioners, highlighting the importance of self-care and mental health support. This study aimed to explore the role of palliative care in general practitioners’ daily work, the stressors they experience, their coping mechanisms, and the potential benefits of Advance Care Planning in this context.MethodsAn exploratory approach was employed, combining a short quantitative survey with qualitative interviews. The analysis was based on a structuring qualitative content analysis, following a deductive-inductive procedure and integrating the Stress-Strain Model and Lazarus’ Transactional Model of Stress and Coping. We recruited eleven general practitioners to take part in the study.ResultsGeneral practitioners viewed palliative care as integral to their practice but faced challenges such as time constraints and perceived expertise gaps. Societal taboos often hindered conversations on the topic of death. Most general practitioners waited for their patients to initiate the topic. Some general practitioners viewed aspects of palliative care as potentially distressing. They used problem-focused (avoiding negative stressors, structuring their daily schedules) and emotion-focused (discussions with colleagues) coping strategies. Still, general practitioners indicated a desire for specific psychological support options. Advance Care Planning, though relatively unfamiliar, was acknowledged as valuable for end-of-life conversations.ConclusionsPalliative care can be associated with negative psychological stress for general practitioners, often coming from external factors. Despite individual coping strategies in place, it is advisable to explore concepts for professional psychological relief.Trial registrationNot registered.

Relationships among perceived social support, mindful self-care, and resilience among a sample of nurses in three provinces in China: a cross-sectional study.

In this study, we aimed to determine the relationships among perceived social support, mindful self-care, and resilience in a sample of nurses in three provinces of China. A cross-sectional study was conducted in seven hospitals in Guangdong, Guizhou, and Henan provinces between August and October, 2023; the provinces are located in south, southwest, and central China. A total of 389 nurses were surveyed using a self-designed sociodemographic characteristics questionnaire and the Chinese versions of Multidimensional Scale of the Perceived Social Support, Brief-Mindful Self-Care Scale and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). Of the 389 nurses, the majority were women (n = 365; 93.8%), aged 26-35 years (n = 244; 62.7%) and had bachelor's degrees (n = 337; 86.6%), had worked for 10-20 years (n = 136; 35%), with junior professional titles (n = 331; 85.1%), and had a monthly income in the range 3,001-6,000 yuan in CNY (n = 239; 61.4%). Nurses' resilience was measured using the CD-RISC-10, which ranges from 10 to 40 points. And average score of nurses' resilience was (23.94 ± 6.95). Multiple linear regression showed that scores for resilience were higher among nurses who had higher educational attainment (95% confidence interval: 0.568-3.024, p < 0.01), professional titles (95% confidence interval: 0.009-1.693, p < 0.05), scores of mindful self-care (95% confidence interval: 0.086-0.155, p < 0.01), and scores of perceived social support (95% confidence interval: 0.242-0.328, p < 0.01). Nurses with higher educational attainment and professional titles exhibited higher levels of resilience. Perceived social support and mindfulness self-care are significantly positively correlated with resilience of nurses. The findings of this study are beneficial to further our understanding of nurses' resilience. The identification of associated factors is conducive to providing more support for nurses who tend to have lower resilience earlier, and can provide useful information for research targeted intervention and support plans aimed at improving nurses' resilience in the future.

Improving patient-centered mental health promotion in primary care in vulnerable communities through mindfulness training in Rio de Janeiro, Brazil.

Brazilian Primary Health Care (PHC) is responsible for all-sanitary actions for a community-based population, including health promotion and mental health care. Mindfulness Based Health Promotion (MBHP) is an intervention that can promote self-care and psychosocial support in PHC. To discuss the effects of mindfulness based psychosocial group interventions for health promotion in primary care units in Rio de Janeiro, Brazil. The intervention was based on the MBHP model adapted for SUS. Nine groups were held in Rio de Janeiro. A quali-quanti research was held with two parts: (a) quantitative study, pre and after the 8 weeks intervention, evaluating the effect on mindfulness and self-compassion and their association with levels of anxiety, depression, and quality of life. (b) Qualitative research using Focus Groups with the participants to investigate their experience at the end of the mindfulness groups. Sixty-two participants finished the 9 groups where 86% were women, mostly between 30 and 59 years of age and low income, and around 80% under regular medical care in PHC in SUS. In the studied sample 80% had at least one chronic health condition under treatment, including 42% with anxiety and 35% with depression. The effects included significant improvement in Anxiety and Depression and in Quality of Life, mainly in the psychological but also in the physical and interrelation domains. The qualitative study showed that most patients joined the group on the recommendation of health professionals for managing physical and mental health symptoms. Patients reported being able to use the practices taught in the sessions to manage symptoms such as insomnia and emotionally distressing situations in their daily lives. Including family members in mindfulness practices was a strategy to negotiate not only a space at home to meditate, but also to obtain a different approach to health problems. Participants pointed to mindfulness as a complementary therapeutic option to medication and psychotherapy. Mindfulness-Based Intervention have shown to be a feasible, well-accepted and efficacious method of offering psychosocial support and promoting well-being for low-income patients in primary care in LAMIC.

Longitudinal look at individual resident preferences to prevent burnout: Which matter the most?

ABSTRACT A longitudinal look at individual resident preferences to prevent burnout: Which matter the most? Background and Objectives Burnout among residents-in-training is being reported more frequently. Previous studies have shown that lower measures of emotional intelligence, mindfulness, emotional regulation, and gratitude earlier in residency were associated with higher burnout scores later. Many studies have reported interventions intended to lessen burnout but not chosen by the residents with variable results on subsequent burnout measures. This paper reports an individually paired longitudinal analysis of strategies ranked by the resident as important with a subsequent burnout measure. Methods From 2017 through 2021, 32 residents completed a survey ranking their preference of ten approaches to preventing burnout at the beginning of the academic year. Then they later completed a burnout survey at the end of each year. Results With a usable response rate of 94% and calculating Spearman’s Correlation, residents completing their first year of training after medical school (PG-1) who gave a higher rank to a workplace supporting their personal values (p=.016), self-care (p=.031), and administrative support (p=.046) showed less burnout at the end of the year. PG-3s (those completing their third year of training after medical school) who gave a higher rank to spending time with family and friends (p=.002) showed less burnout. For all three years, the most powerful correlation was with adopting a healthy philosophical outlook (p=.014, .008, &lt;.001). Conclusions In this group of residents, the correlations of preferred strategies for lessening burnout differed by training level. Rather than faculty choosing an intervention, we propose these ten strategies as a potential menu, allowing the individual resident to focus on their preferences working with a mentor. Group discussion of methods used by individual residents to adopt a healthy philosophical outlook would also be helpful.

Supporting contraceptive self-care and reproductive empowerment with a digital health game in Barbados: Development and Pre-implementation study for What’s My Method?

Effective contraceptive education is essential to reducing unwanted pregnancy, increasing uptake of modern contraceptive methods, and thoughtfully planning desired births. New WHO and family planning organization guidelines recommend situating contraceptive education and counseling within a broader context of self-care that emphasizes individual agency and reproductive empowerment. Digital health interventions, and games for health specifically, have been validated as effective and scalable tools for self-guided and interactive health education, especially among younger tech-savvy individuals. Barbados currently supplements provider-based contraceptive counseling with analog materials (pamphlets and posters) and informational videos that play on a screen in the waiting room. This study seeks to conduct a formative evaluation of the What’s My Method? (WMM) game intervention as a tool to support contraceptive counseling and increase reproductive empowerment among childbearing persons in Barbados. We test-deployed the WMM game in Bridgetown, Barbados, conducting focus groups and sample deployments with prototypes of the WMM game among three groups of stakeholders (youth contraception ambassadors: n=8; healthcare providers: n=7; and nursing students: n=27) to determine acceptability of the intervention, efficacy of the game as a learning tool, and willingness to adopt the tool in their healthcare context. Feedback on acceptability of the game was largely positive. Constructive feedback informed modifications and improvements to the game. Assessment of contraceptive knowledge gain was complicated by several factors and resulted in modifications of the questionnaire and methodology for measurement of efficacy. Results indicate that the WMM game is well-reviewed and accepted by the target audience of childbearing people and healthcare professionals who would be deploying it. The questionnaire did not perform as intended for our target audience. This pilot testing has informed the design and outcome selection for the upcoming RCT with the final version of the game.

Person and Environment Factors Supporting Self-Care Performance and Social Participation After Mild Stroke.

Mild stroke survivors seldom receive occupational therapy services as their deficits are assumed to be minor enough to not affect their daily occupations. Yet many mild stroke survivors report deficits in self-care performance and social participation. This study investigates person and environment factors influencing self-care performance and social participation among mild stroke survivors, using the Person-Environment-Occupation-Performance (PEOP) model. A retrospective cohort analysis of 736 mild stroke survivors was conducted using electronic health records. Person factors included demographic characteristics and clinical characteristics, and environment factors included the Social Vulnerability Index. The analysis included logistic regression. Approximately, 10% of patients reported deficits in self-care or social participation. Disability level was the only person factor associated with self-care performance. Person factors affecting social participation included mobility and unemployment. Socioeconomic status was associated with both occupation measures. Occupational therapy practitioners must address the person and environment factors affecting mild stroke survivors' self-care performance and social participation.

Automated Personalized Self-care Program for Patients With Type 2 Diabetes Mellitus: A Pilot Trial

PurposeProviding continuous self-care support to the growing diabetes population is challenging. Strategies are needed to enhance engagement in self-care, utilizing innovative technologies for personalized feedback. This study aimed to assess the feasibility of the Automated Personalized Self-Care program among type 2 diabetes patients and evaluate its preliminary effectiveness. MethodsA parallel randomized pilot trial with qualitative interviews occurred from May 3, 2022, to September 27, 2022. Participants aged 40–69 years with type 2 diabetes and HbA1c ≥ 7.0% were recruited. The three-month program involved automated personalized goal setting, education, monitoring, and feedback. Feasibility was measured by participants’ engagement and intervention usability. Preliminary effectiveness was examined through self-care self-efficacy, self-care behaviors, and health outcomes. Qualitative interviews were conducted with the intervention group. ResultsA total of 404 patients were screened. Out of the 61 eligible patients, 32 were enrolled, resulting in a recruitment rate of 52.5%. Retention rates at three months were 84.2% and 84.6% in the intervention and control groups, respectively. Among the intervention group, 81.3% satisfied adherence criteria. Mobile application’s usability scored 66.25, and participants’ satisfaction was 8.06. Intention-to-treat analysis showed improvements in self-measured blood glucose testing, grain intake, and HbA1c in the intervention group. Qualitative content analysis identified nine themes. ConclusionsFeasibility of the program was verified. A larger randomized controlled trial is needed to determine its effectiveness in self-care self-efficacy, self-care behaviors, and health outcomes among type 2 diabetes patients. This study offers insights for optimizing future trials assessing clinical effectiveness. Trial registrationClinical Research Information Service, KCT0008202 (registration date: 17 February 2023).

Cancer Survivors’ and Care Partners’ Audio Diaries on Stress and Social Support Resources During the COVID-19 Pandemic

ObjectivesTo describe cancer survivors’ and care partners’ perceived stress and social support during the COVID-19 pandemic and assess the feasibility of audio diaries for assessing role-related needs and resources. MethodsParticipants (N = 51; n = 28 survivors, n = 23 care partners) recorded three monthly audio diaries reporting stress and support experiences. Diaries were transcribed and content-analyzed using a hybrid approach. Stress-related content was inductively coded, and social support content was deductively coded by type (instrumental, information, emotional, companionship, appraisal; κ = 0.75) then inductively coded. Descriptive statistics summarized sociodemographic data and compared coding frequencies by role. We developed narrative summaries of stress and support categories and selected quotes for contextual detail. ResultsCancer-related stressors were most prevalent (28.8%), followed by work (26.8%), family (23.1%), social isolation (13.4%), and finances (8.0%). While no significant difference in reporting frequency was observed between roles, cancer-related stress was more prevalent for survivors while work-related stress was mentioned more by care partners. Emotional support was the most prevalent support type (32.1%), followed by companionship (25.3%), appraisal (17.9%), instrumental (16.67%), and informational support (8%). Survivors reported more appraisal support than care partners (χ2 = 6.48, df = 1, P = .011) and more support for self-care, while care partners expressed more other-oriented concerns and focused more on managing responsibilities and interactions outside the household. ConclusionsThe pandemic complicated and intensified role-based stressors already present in the survivorship context. Our findings highlight the importance of informal social support networks, particularly when access to formal services is limited, and suggest that audio diaries can be an effective tool for assessing support needs and resources. Implications for Nursing PracticeNurses and healthcare providers should tailor social support assessments to address the distinct support needs and individual resources of cancer survivors and their care partners. This is especially critical in contexts that limit access to care and formal services.

The Relationship Between Family Support and Self Care in Hypertension Clients

Many hypertensive clients get less support from family members. This results in a decrease in the spirit of hypertensive clients in carrying out self-care well, so hypertensive clients are unable to manage signs and symptoms of hypertension and minimize disruption in body function, and complications of hypertension. The purpose of this research is to know the correlation between family support and self-care in hypertension clients in Sumberjo Village Kademangan. The research design used was correlational, with independent variables of family support and dependent variable self-care on hypertensive clients. The data collection techniques used family support questionnaires and self-care questionnaires. The location of the research was conducted in Sumberjo Village Kademangan from 30 June until 03 July 2017. The population was 30 people by using total sampling. The results of family support showed 60% good, 20% enough, and 20% less and self-care showed 73% total self care, 27% partial self care. Using the Spearman test shows the value of ? = 0,000 where &lt; 0,05 meaning there was a correlation between family support with self self-care hypertension clients in Sumberjo Village Kademangan. The correlation coefficient rs = 0.834, which means the correlation of family support with self-care on hypertension clients in Sumberjo Village Kademangan has a direct correlation. From the results of this study is expected, that health workers to increase cooperation with village officials in providing health services such as counseling. To increase public knowledge about the importance of self-care for hypertension

Exploring the potential extended role of community pharmacy in the management of osteoarthritis: A multi-methods study with pharmacy staff and other healthcare professionals.

Osteoarthritis is the commonest form of chronic joint pain, which patients often self-manage before seeking healthcare advice. Patients frequently seek advice from community pharmacies, and a recent policy has recommended integrating community pharmacies into long-term condition pathways. This study explored community pharmacy teams' (CPs) and other healthcare professionals' (HCPs) views on community pharmacies providing an extended role for osteoarthritis management, identifying potential barriers and facilitators to this. A multi-methods study comprising surveys of CPs and other HCPs, followed by qualitative interviews. Descriptive statistics were used in an exploratory analysis of the survey data. Qualitative data were analysed using reflexive thematic analysis and the identified barriers and facilitators were mapped to the Theoretical Domains Framework. CPs and other HCPs in the surveys and interviews reported that an extended role for osteoarthritis management could include: a subjective assessment, explaining the joint problem and its treatment, medication management and support for self-care. There was less consensus on diagnosing the problem as OA and completing an objective assessment. A key facilitator was training to deliver the role, whilst barriers were high workload and lack of access to General Practitioner medical records. Acceptable elements of an extended community pharmacy role for osteoarthritis centre around the provision of information, advice on medication and supported self-management. CPs are well placed to contribute towards evidenced-based osteoarthritis management. Feasibility testing of delivering the extended role is needed and future implementation requires training for CPs and raising public awareness of the extended role.

Sense of coherence moderates job demand-resources and impact on burnout among nurses and midwives in the context of the COVID-19 pandemic: A cross-sectional survey.

This study aimed to test the propositions using the job demands-resources (JD-R) model for main/moderation/mediation effects of a sense of coherence and practice environment support on mental well-being (anxiety, depression and burnout) outcomes in nurses and midwives in Australia during the COVID-19 pandemic. Cross-sectional quantitative survey. The study was a cross-sectional design using self-report questionnaires reported as per the Reporting of Observational Studies in Epidemiology Guidelines. Following human research ethics approval (2020.ETH.00121) participants were recruited to take part in an online anonymous survey using self-report instruments to test the JD-R model in Australia. 156 participant nurses and midwives experienced anxiety, depression and emotional burnout during COVID-19. While a considerable proportion of participants indicated high levels of emotional exhaustion, their responses showed low levels of depersonalization (detached response to other people) and high levels of personal accomplishment (high levels of work performance and competence). A sense of coherence was a significant protective factor for mental health well-being for the participants, which is to say, high levels of sense of coherence were predictive of lower levels of anxiety, depression and burnout in this study sample. It is evident that both nursing and midwifery professions require psychosocial support to preserve their health both in the short and long term. Ensuring individualized tailored support will require a layered response within organizations aimed at individual self-care and collegial peer support. There was no patient or public contribution in this study, as the focus was on nurses and midwives.