Self-management Of Individuals Research Articles

Discordant Medication Beliefs in Black Individuals With Mild Cognitive Impairment and Diabetes.

To investigate the effects of discordant medication beliefs on diabetes self-management and glycemic control in older Black individuals with diabetes and Mild Cognitive Impairment (MCI). Cross-sectional analysis of baseline data from two clinical trials testing behavioral interventions to improve glycemic control in older Black primary care patients with diabetes and MCI. The mean number of discordant medication beliefs was 6 (SD = 3; range 0 to 16). Sixty-seven of 246 (27%) participants held ≥ 9 discordant beliefs (i.e., one SD above the mean), and these participants had worse diabetes self-management and glycemic control than participants with fewer beliefs. Discordant medication beliefs, low adherence to diabetes self-management, poor glycemic control, and impaired cognition may exist in a causal relationship. Modifying discordant medication beliefs may eliminate the first step of this pathogenic sequence and reduce risk of cognitive decline in a high-risk population of older Black individuals with diabetes.

The Influence of Electronic Health Education Media on Enhancing Self-Management Among Individuals Afflicted with Gout Arthritis: A Comprehensive Scoping Review

Monosodium urate crystals accumulate in Gout Arthritis, resulting in joint inflammation, significant pain, and potential joint damage, which can impair mobility and lead to disability. Additionally, uncontrolled hyperuricemia may result in the formation of kidney stones and diminished kidney function. Therefore, implementing effective management and treatment strategies is crucial for enhancing self-management in individuals diagnosed with Gout Arthritis. This scoping review seeks to provide an overview of the effectiveness of various electronic health education media in improving the self-management of individuals suffering from Gout Arthritis. The study followed the PRISMA guidelines for scoping reviews and involved a comprehensive literature search across ProQuest, Science Direct, Wiley, and Google Scholar, focusing on publications from 2016 to 2022. Ten articles that met the predetermined inclusion criteria were synthesized for this review. The findings suggest that using electronic health education media can significantly enhance self-management practices and medication adherence among Gout Arthritis patients and facilitate favourable changes in uric acid levels. These insights may serve as valuable contributions to managing Gout Arthritis cases

The effect of information, motivation and behavioural skills model-based Diabetes Education and Motivational Interview Program on health outcomes in middle-aged adults with type 2 diabetes: a randomised controlled study.

Many models and theories are used to increase the self-management of individuals with type 2 diabetes. This study aims to examine the effect of information, motivation, behavioural skills (IMB) model-based diabetes education and motivational interviewing program on health belief, self-efficacy, self-management, and metabolic control in adults with type 2 diabetes. The study is a single-blind, randomised controlled trial. The study was conducted between 2021 and 2022 with intervention (n = 30) and control groups (n = 30). The intervention group applied the diabetes education and motivational interviews program for 12 weeks that was created based on the IMB model. The study data were collected with a socio-demographic questionnaire, Diabetes Knowledge Scale, Health Belief Scale, Self-Efficacy Scale, and Self-Management Scale. In the post-test and follow-up measurements, the mean scores of the intervention group on the knowledge, health belief, self-efficacy, and self-management scale were significantly higher than those of the control group, while the HbA1c% and body mass index (BMI) values of the intervention group showed a significant decrease over time. However, there was no difference between the groups in the post-test BMI and HbA1c% values. The nurse-led intervention was found to be effective in increasing information, health belief, self-efficacy, self-management, and decreasing HbA1c%, BMI in adults with type 2 diabetes. The study was registered in ClinicalTrials NCT05030844.

Using technology to support diabetes care in hospital: Guidelines from the Joint British Diabetes Societiesfor Inpatient Care (JBDS-IP) group and Diabetes Technology Network (DTN) UK.

This article summarises the Joint British Diabetes Societies for Inpatient Care (JBDS-IP) Group guidelines on the use of technology to support diabetes care in hospital. The guideline incorporates two main areas: (i) use of wearable technology devices to improve diabetes management in hospital (including continuous glucose monitoring and insulin pump therapy) and (ii) information technology. Although it is reasonable to extrapolate from the evidence available, that devices developed to enhance diabetes care outside hospital will show similar benefits, there are challenges posed within the inpatient setting in hospital. This guidance provides a pragmatic approach to supporting self-management in individuals using wearable technology admitted to hospital. Furthermore, it also aims to provide a best practice guide for using information technology to monitor diabetes care and communicate between health professionals.

Pain Self-Management in Individuals With Chronic Musculoskeletal Pain During Lebanon's Overlapping Crises

ObjectivesWith Lebanon facing multiple crises simultaneously, it is important to understand how Lebanese adults with chronic musculoskeletal pain (CMP) are self-managing their pain amidst challenging circumstances. This study aimed to describe the pain self-management strategies Lebanese adults with CMP are using, as measured by the Arthritis Pain Self-Management Inventory (APSI), and to determine how helpful they perceive these strategies to be for pain relief. A secondary aim was to translate, culturally adapt, and validate the APSI in Lebanese adults with CMP. MethodsA descriptive design was used and a convenience sample of 154 Lebanese adults with CMP completed the Arabic version of the APSI and self-report measures of pain intensity and sociodemographic and clinical characteristics. ResultsThe APSI demonstrated acceptable content and cultural validity in Lebanese adults with CMP. Self-directed arthritis education was the strategy used by the largest number of participants, although it was perceived as the second least helpful for pain relief. The second and third most common strategies used were rest/relaxation, warm baths, and maintaining a healthy weight. The most helpful strategy was maintaining a healthy weight, followed by watching religious television, music therapy, and the use of braces or splints. ConclusionsLebanese adults with CMP should actively participate in their pain management plan and be educated on the various strategies they could use to effectively self-manage their pain.

A mobile app for chronic disease self-management for individuals with low health literacy: A multisite randomized controlled clinical trial.

The purpose of this study was to evaluate the effects of a mobile app designed to improve chronic disease self-management in patients 40 years and older with low health literacy and who had at least one chronic health condition, and to assess the impact of delivering information at different levels of reading difficulty. A randomized controlled trial was completed at two sites. Individuals aged 40 years and older screened for low health literacy who had at least one chronic health condition were randomly assigned to a tailored information multimedia app with text at one of three grade levels. Four primary outcomes were assessed: patient activation, chronic disease self-efficacy, health-related quality of life, and medication adherence. All groups showed overall increases in activation, self-efficacy, and health-related quality of life, but no change in medication adherence. No between-group differences were observed. The mobile app may have been effective in increasing participants' levels of several psychosocial variables, but this interpretation can only be advanced tentatively in light of lack of control-experimental group differences. Reading difficulty level was not significantly related to outcomes.

Managing Multiple Chronic Conditions during COVID-19 Among Patients with Social Health Risks.

Optimal care for persons with multiple chronic conditions (MCC) requires primary and specialty care continuity, access to multiple providers, social risk assessment, and self-management support. The COVID-19 pandemic abruptly changed primary care delivery to increase reliance on telehealth and virtual care. We report on the experiences of individuals with MCC and their family caregivers on managing their health and receiving health care during the initial pandemic. Semistructured qualitative interviews with 30 patients (19 English speaking, 11 Spanish speaking) plus 9 accompanying care partners, who had 2+ primary care encounters between March 1, 2020, and November 30, 2020, 2+ chronic conditions, and 1 or more self-reported social risks. Questions focused on access to and experiences with care, roles for care partners, and self-management during the first 6 months of the pandemic. Participants experienced substantial changes in care delivery. The most commonly reported changes were a shift to more virtual relative to in-person care and shifting roles for care partners. Changes fostered new perspectives on self-management and an appreciation of personal resilience and self-reliance. Virtual care was an acceptable complement to in-person care, though not a substitute for periodic in-person visits. It was more acceptable for English speakers and with a usual provider. New models of care delivery that recognize patient and family resilience and resourcefulness, emphasize provider continuity, and combine virtual and in-person care may support self-management for individuals with MCC and social needs.

Enhancing Diabetes Care through a Mobile Application: A Randomized Clinical Trial on Integrating Physical and Mental Health among Disadvantaged Individuals.

This study examines integrating physical and mental healthcare for disadvantaged persons with type 2 diabetes mellitus and mild-to-moderate depression in the community, using a mobile application within a public-private-academic partnership. The Korean Diabetes Association has developed a mobile application combining behavioral activation for psychological well-being and diabetes self-management, with conventional medical therapy. Participants were randomly assigned to receive the application with usual care or only usual care. Primary outcomes measured changes in psychological status and diabetes selfmanagement through questionnaires at week 12 from the baseline. Secondary outcomes assessed glycemic and lipid control, with psychological assessments at week 16. Thirty-nine of 73 participants completed the study (20 and 19 in the intervention and control groups, respectively) and were included in the analysis. At week 12, the intervention group showed significant reductions in depression severity and perceived stress compared to the control group. Additionally, they reported increased perceived social support and demonstrated improved diabetes self-care behavior. These positive effects persisted through week 16, with the added benefit of reduced anxiety. While fasting glucose levels in the intervention group tended to improve, no other significant differences were observed in laboratory assessments between the groups. This study provides compelling evidence for the potential efficacy of a mobile application that integrates physical and mental health components to address depressive symptoms and enhance diabetes self-management in disadvantaged individuals with type 2 diabetes mellitus and depression. Further research involving larger and more diverse populations is warranted to validate these findings and solidify their implications.

Silent struggles to self-manage high blood pressure among deaf sign language users: a qualitative study.

Tailored self-management support of hypertension, considering language and communication, is important for minorities, specifically in the deaf community. However, little is known about the experiences of hypertension self-management in deaf individuals who use sign language. This study aimed to explore the factors and processes of self-management in deaf sign language users with hypertension. Ten men and women who used sign language participated in this study. Data were collected using in-depth personal interviews conducted in the presence of a sign language interpreter between November 2022 and February 2023. All interviews were recorded and transcribed for conventional content analysis. Qualitative analyses identified four categories related to the self-management of hypertension among participants: personal factors (chronic hand pain, unique language and communication, and efforts to turn crisis into opportunities), family and socioeconomic factors (family support and financial burden of living), challenges (limited health literacy and alienation from health education), and desire for health education considering the deaf community. The results of this study suggest that family support, socioeconomic status, hand pain, and health literacy should be considered for the planning and development of health education on self-management of hypertension in deaf individuals. In addition, this health education requires cooperation with qualified sign language interpreters in healthcare settings.

The use of mobile health applications in empowering self-management of type 2 diabetes: a literature review

The use of mobile health applications is vital for achieving glycemic control, promoting lifestyle changes, and empowering self-management in individuals with type 2 diabetes. This literature review aims to assess the effectiveness of mobile health applications in empowering self-management among type 2 diabetes patients. A thorough search was conducted in databases like PubMed, CINAHL, Web of Science, Cochrane Library, Scopus, ULAKBIM National Database, and Medline between January 2020 and March 2023, using keywords such as "mobile health, mobile applications, type 2 diabetes, diabetes self-management, nursing." The search yielded 525 articles, out of which 34 studies in Turkish or English that evaluated the effectiveness of mobile health applications in individuals aged 18 years and above with type 2 diabetes were included in the review. Recent studies demonstrate a growing utilization of mobile health applications for the management of treatment and care in individuals with type 2 diabetes. These applications have been shown to empower self-management by promoting dietary adherence, regular blood sugar monitoring, regular physical activity, reduced medication requirements, and decreased HbA1c levels. Additionally, mobile health applications have been found to reduce face-to-face counseling time and healthcare costs. In conclusion, mobile health applications offer promising solutions for improving self-management and healthcare outcomes for individuals with type 2 diabetes. Further research and continued integration of these applications into clinical practice are essential to optimize their benefits and address the challenges faced by diabetes patients worldwide.

Evaluation of Patient-facing Health Application Features to Support Self-management of People Living with Prediabetes or Type 2 Diabetes Mellitus – A Health-care Professional Perspective

Abstract Background: Diabetes mellitus (DM) remains a significant chronic disease worldwide. Effective self-management is essential for optimal glycemic control and preventing long-term complications in people with DM (PWD). In recent years, e-health applications have emerged to support the self-management of individuals with type 2 DM (T2DM) in particular regarding the evaluation of blood glucose (BG) levels. However, numerous challenges still exist. Aims and Objectives: This questionnaire-based study aimed to understand the knowledge, attitude, and practice regarding a novel e-health application to monitor BG levels using a smartphone camera that is designed for individuals with prediabetes or T2DM in low- and middle-income countries. Materials and Methods: An open-ended questionnaire guide was used to investigate the PWD’s needs from a health-care professional’s (HCP) perspective and the challenges that could be addressed by new features of the health application. Responses were graded on a 5-point ordinal scale and evaluated to identify advantages, disadvantages, and suggestions to improve the proposed features. Results: The HCPs highlighted the application’s simplicity and convenience of use, the mobile device-based measurement of BG ranges, the step-by-step guided features, and lifestyle advice. They suggested improvements such as a one-step handling approach and quantitative versus qualitative BG level assessment. Conclusion: It is expected that younger and technologically proficient individuals with T2DM will benefit the most from this application. However, further research is necessary to assess how the proposed features affect individuals’ empowerment in managing diabetes and the distress associated with the burden of self-management.

The Relationship Between Medication Self-Efficacy and Self-Management in Individuals with Type 2 Diabetes and the Role of Type D Personality

Aim: To determine the relationship between medication self-efficacy and self-management in individuals with type 2 diabetes mellitus
 (T2DM), and the role of type D personality in this relationship.
 Material and Methods: The study was conducted with 329 individuals with T2DM between May and July 2023. The data of the study
 were collected using the Introductory Information Form, Diabetes Medication Self-Efficacy Scale (DMSS), Diabetes Self-Management
 Questionnaire (DSMQ), and Type D Personality Scale (TDPS). The data were evaluated using the Pearson Correlation and the Maximum
 Likelihood method, which was a structural equation modeling.
 Results: It was determined that 64.4% of individuals with T2DM had type D personalities. The relationship between the DMSS and
 the DSMQ was negative and weak, the relationship between the TDPS and the DSMQ was negative and weak, and no correlation was
 found between TDPS and DMSS. According to the results, it was determined that diabetes self-management had an effect on diabetes
 medication self-efficacy (β= -0.163, p=0.019), and diabetes self-management had an effect on TDPS (β= -0.185, p=0.013). According
 to the results of the structural equation modeling, it was determined that Diabetes Self-Management was associated with Diabetes
 Medication Self-Efficacy, but D-type personality had no mediating effect.
 Conclusion: According to the scale evaluation scores, it was concluded that the individuals had good medication self-efficacy, their
 self-management was average, and more than half had D-type personalities. In addition, it was determined that type D personality
 had no mediating role in the relationship between medication self-efficacy and diabetes self-management in individuals with type D
 personalities.

Relationships Among Demographic Factors, Stigma, Social Support, and Self-Management in Individuals With Bipolar Disorder in Remission.

The current cross-sectional study aimed to investigate the extent to which demographic characteristics, stigma, and social support impact the self-management abilities of individuals with bipolar disorder in remission. Participants (N = 114) completed a demographic questionnaire, Self-Stigma Scale-Short Form, Social Support Rating Scale, and Self-Management Scale for Patients With Bipolar Disorder. Mean scores were 60.65 (SD = 10.42) for self-management, 35.76 (SD = 7.14) for social support, and 21.38 (SD = 5.06) for stigma. In the univariate analysis, age, educational level, method of payment for care, illness duration, and number of hospitalizations demonstrated significant associations with self-management (p < 0.05). Correlation analysis revealed a positive correlation between self-management and social support (r = 0.574, p < 0.01) and negative correlations between self-management and stigma (r = -0.489, p < 0.01) and stigma and social support (r = -0.476, p < 0.01). Multiple linear regression analysis included number of hospitalizations (β = -3.818), social support (β = 0.436), literacy (β = 2.132), and stigma (β = -0.397). Individuals in remission from bipolar disorder exhibit moderate levels of self-management. Follow-up interventions should prioritize enhancing social support and addressing stigma to promote improved self-management and overall well-being. [Journal of Psychosocial Nursing and Mental Health Services, 62(7), 26-35.].

Home-based self-management for sedentary individuals with mild walking disability after stroke: protocol for a randomised pilot study

BackgroundA Phase I study showed that it is feasible to implement a home-based self-management program aimed at increasing physical activity in individuals after stroke with mild walking disability in Brazil. The next step is to test this program against a control group in order to provide a power analysis for a fully-powered Phase III clinical trial.MethodsA Phase II pilot randomised clinical trial with concealed allocation, blinded measurement, and intention-to-treat analyses will be carried out. The inclusion criteria will be individuals diagnosed with stroke, in the acute or subacute phase, with mild walking disability, sedentary, and no significant language impairment. The participants will be randomly allocated to the experimental or control group. The experimental group will receive six sessions of a home-based self-management program based on behaviour change techniques through the Social-Cognitive Theory and Control Theory over 11 weeks. The control group will receive one session of education about stroke (regarding the importance of practising physical activity after a stroke) and usual care. A total of 24 participants will be recruited. The primary outcome will be physical activity, measured through steps taken per day by an activity monitor (Actigraph wGT3X-BT, Pensacola, FL, USA). The mean of daily steps will be analysed to compare groups after intervention. Secondary outcomes will be cardiovascular risk (body mass index, waist circumference, and blood pressure), depressive symptoms (Geriatric Depression Scale), walking ability (6-Minute Walk Test and 10-Meter Walk Test), exercise self-efficacy (Self-Efficacy for Exercise scale), social participation (Stroke Impact Scale) and quality of life (EuroQual-5D). Two-way analyses of variance will be implemented for all parametric outcomes, and the Kruskal–Wallis test for non-parametric outcomes will be used to determine the statistical significance of the between-group differences and reported as mean differences between groups (95% CI). All analyses will be conducted intention-to-treat. All outcomes will be measured at baseline (Week 0), post-intervention (Week 12), and follow-up (Week 24). This pilot clinical trial was registered online at Clinical Trials under number NCT05461976 on 4th April 2022.DiscussionIf beneficial, this Phase II pilot randomised trial will provide data to plan a fully powered future Phase III clinical trial aimed at verifying the efficacy of this program to promote physical activity after stroke.Trial registrationClinical Trials NCT05461976 on 4th April 2022.

Call for Cultural and Language-Concordant Diabetes Care, Nutrition Education, and Self-Management for South Asian Individuals Living in the US

Ethnic South Asian Americans have the highest relative risk of type 2 diabetes mellitus in the US. Culturally tailored and language-concordant diabetes care and nutrition interventions can potentially promote South Asian diabetes management and disease progression. From our perspective, the extent of their use and evaluation in the US settings remains limited. This Perspective characterizes and evaluates the necessity and outcomes of culturally and linguistically adapted lifestyle interventions targeted toward type 2 diabetes mellitus indicators among South Asian individuals in the US. Suggestions for how this education could be modified include emphasizing the cultural and linguistic knowledge and self-awareness of diabetes educators and the sociological and historical factors that influence the cultural and linguistic orientation of diabetes care professionals and their clients. Such strategies could ensure better diabetes education and self-management among South Asian individuals.

Telehealth Walking Self-Management for Individuals With Amputation: A Qualitative Study of Therapist Perspectives on Adoption.

The aim of this study was to understand therapist-identified factors influencing clinical adoption of a telehealth walking self-management intervention for individuals with lower limb amputation. Semi-structured focus groups were completed with actively practicing physical and occupational therapists treating populations that are medically complex. A qualitative explorative design was employed with conventional content analysis and iterative independent parallel coding using 2 analysts. Themes and subthemes were generated with a consensus building process identifying patterns and collapsing codes to represent participant perspectives. Thematic saturation was met after 5 focus groups (24 therapists). Therapists were on average 34years old and predominantly female (n = 19; 79%) physical therapists (n = 17; 71%). Three primary facilitator and barrier themes were identified for intervention adoption: system, therapist, and person. System considerations included telehealth support and interprofessional care coordination. Therapist facilitators included self-management programming that overlapped with standard of care and personalization methods. However, limited behavioral theory training was a therapist level barrier. Finally, person factors such as patient activation could influence both positively and negatively. Person facilitators included social support and barriers included the complex health condition. System, therapist, and person facilitators and barriers must be considered to maximize the adoption of similar telehealth walking self-management interventions and prior to larger scale implementation of the current intervention for individuals with lower limb amputation. A telehealth walking self-management intervention has potential impact for individuals with lower limb amputation and must be considered in terms of optimizing system, therapist, and person level facilitators and barriers to implementation.

An investigation of stigma and self-management in individuals diagnosed with epilepsy

AimThe complex nature of epilepsy disease confronts individuals with difficulties such as stigma. Stigma has a negative impact, particularly on individuals' coping with the disease. It is important for individuals diagnosed with epilepsy to adopt many self-management behaviors so that they can control these situations. This study aims to measure the stigma and self-management levels of individuals diagnosed with epilepsy and determine the relationship between stigma and self-management. MethodsThis descriptive and associational study was conducted in the Neurology Outpatient Clinic of a Training and Research Hospital and 295 patients were included in the sample based on various inclusion criteria such as having a diagnosis of epilepsy for at least six months and not having any psychiatric disorder that would prevent reading and comprehension. Data were collected through the Descriptive Information Form, the Stigma Scale of Epilepsy, and the Epilepsy Self-Management Scale. Data analysis was performed using IBM SPSS Statistics Standard Concurrent User V 26 statistical package program. FindingsThe Stigma Scale of Epilepsy total mean score was found 60.62 ± 15.40 in individuals diagnosed with epilepsy. The mean scores for the sub-scales were found 7.08 ± 2.20 for the false beliefs sub-scale, 18.86 ± 4.97 for the discrimination sub-scale, 21.64 ± 7.07 for the social isolation sub-scale, 8.46 ± 3.18 for the inadequacy sub-scale, and 5.45 ± 1.41 for the stigma resistance sub-scale. The ESMS total mean score of individuals diagnosed with epilepsy was found to be 140.54 ± 15.33. The mean scores for the ESMS sub-scales were 44.76 ± 4.29 for the medicine management sub-scale, 20.29 ± 5.98 for the information management sub-scale, 30.49 ± 4.80 for the safety management sub-scale, 23.95 ± 4.34 for the seizure management sub-scale, and 21.02 ± 4.65 for lifestyle management sub-scale. A significant and negative relationship was found between the Epilepsy Self-Management Scale (ESMS) and the Stigma Scale of Epilepsy. ConclusionThis study found that individuals experienced a moderate level of stigma and had high levels of self-management. Stigma was found to decrease with the increase in the self-management level. In this regard, it is recommended to conduct intervention studies to increase self-management levels and reduce stigma for individuals diagnosed with epilepsy.

Self-management interventions for people with pulmonary fibrosis: a scoping review.

The most effective method for encouraging self-management in individuals with pulmonary fibrosis (PF) is unclear. This review aimed to identify common self-management components, the outcome measures used and the impact of these components in PF. A scoping review was conducted according to the Joanna Briggs Institute Manual for Evidence Synthesis using Medline, Embase, PsychInfo, CINAHL and the Cochrane Central Register of Controlled Trials. Eligible studies included those with educational, behavioural or support components aimed at facilitating self-management among adults with PF and employed quantitative and/or qualitative methods. 87 studies were included. Common self-management components included education (78%), managing physical symptoms (66%) and enhancing psychosocial wellbeing (54%). Components were predominantly delivered in a pulmonary rehabilitation setting (71%). No studies tested a PF-specific self-management package. Common outcome measures were 6-min walk distance (60%), St George's Respiratory Questionnaire (37%) and the Medical Research Council Dyspnoea scale (34%). Clinically significant improvements in these outcomes were seen in ≥50% of randomised controlled trials. Qualitative data highlighted the importance of healthcare professional and peer support and increased confidence in managing PF. Self-management components are commonly incorporated into pulmonary rehabilitation programmes rather than being offered as standalone packages. Future research should focus on testing PF-specific self-management packages and employ standardised outcome assessments that include self-efficacy and health-related behaviours.

Exploring diabetes status and social determinants of health influencing diabetes-related complications in a Northwestern community, Ontario, Canada: A mixed method study protocol.

Diabetes is a common chronic condition affecting the many spheres of individuals' lives. It can also lead to severe complications without continuous management. Accordingly, this paper describes a study protocol aimed at 1) determining the status and prevalence of diabetes complications in a Northwestern Ontario community; 2) exploring the internal (e.g., demographic and clinical variables) and external factors (e.g., access to services and resources) affecting diabetes outcomes (e.g., complications, emergency room visits, hospitalizations); 3) critically exploring how the social determinants of health affect self-management for individuals living with diabetes; and 4) identifying individuals' needs, concerns, and challenges to monitor and regulate diabetes. The study uses a cross-sectional design and a social constructivist approach based on qualitative data collection. The proposed study will include patients with type 1 and type 2 diabetes with or without diabetes complications who have been attending the Centre for Complex Diabetes Care (CCDC) in Thunder Bay, Ontario, Canada, since January 2019. Quantitative data related to diabetes complications and other outcomes, diabetes management, and demographic and clinical status will be retrieved from patients' charts using a data extraction form. Analyses of the quantitative data will include the prevalence of diabetes complications, rate of hospitalizations, and their associations with diabetes management, access to services, and social determinants of health. Additionally, interviews will occur with at least 10 participants with or without diabetes complications to understand their needs, concerns, and struggle to self-manage diabetes daily. The results of this study will generate evidence to support future research and policy on the development and implementation of an educational program to improve self-care management and outcomes for individuals living with diabetes and its complications in Northwestern Ontario.

Sociocultural and patient-health care professional related factors influencing self-management of multiethnic patients with multimorbidities: A thematic synthesis.

Self-management is critical for the general well-being and disease management of individuals with multimorbidities. A better understanding of sociocultural and patient-professional level factors affecting self-management can be valuable for designing individual and community-based strategies to promote optimal self-management. The purpose of this review was to explore sociocultural and patient-health care professional related factors affecting self-management among patients with multimorbidities. A metasynthesis was conducted. Literature was searched in PubMed, CINAHL, Scopus, Web of Science, and OVID databases. In total, 21 qualitative studies published from January 2010-March 2023 were critically appraised and reviewed. Thematic synthesis was used for analysis and eight descriptive and three analytical themes were generated. The analytical themes illustrated that personal and structural vulnerabilities, social and family struggles, and fragmented interpersonal relationships with health care professionals affect health care access, navigation, and self-management of individuals with multimorbidities. Engagement in self-management for individuals with multiple chronic conditions is hampered by under-resourced community and health care environments, structural vulnerabilities, familial and interpersonal conflicts, and disjointed relationships. There is a dire need to ensure optimal community resources to support individuals to address and navigate complexities associated with accessing care and effectively managing their illnesses.