Health Self-management Research Articles

Cost of “Ideal Minimum Integrated Care” for Type 2 Diabetes and Hypertension Patients in Cambodia Context: Provider Perspective

Introduction: As in other countries worldwide, Diabetes mellitus type 2 (T2D) and hypertension (HTN) prevalence is increasing in Cambodia. The country is examining models to scale-up integrated T2D and HTN care. However, costs of integrated care in this setting are not yet well-understood. Thus, we modelled the cost of an “Ideal Minimum Integrated Care” (IMIC) package (detection, diagnosis, treatment + health education, self-management and follow-up) for T2D and HTN in Cambodia. Description: We visualised a package – IMIC – of effective interventions for T2D and HTN inspired by SCUBY-ICP and PEN. WHO NCD and HEART Costing Tools were adapted to estimate annual total IMIC intervention cost per health centre, cost per case and cost per capita. Discussion: Cost of the IMIC provides information on costs to aid decision-making on implementation. The Excel-based costing tool is easy to accomplish and can be replicated to provide more accurate results by using more precise actual input data, once these are available in the country. Conclusion: The projected costs of IMIC for T2D and HTN in Cambodia provides evidence to informed decision-making of relevant actors in implementing scale-up of IMIC for T2D and HTN. The model can be used in countries with similar context to calculate costs of integrated care.

The Complexity of Health Self-Management Behavior. Beliefs and Attitudes of Individuals Living With Spinal Cord Injury in Switzerland.

Within the objective of defining targets for interventions to support self-management behaviors among people living with spinal cord injury, this study aims to describe self-management attitudes and beliefs in community-dwelling people living with spinal cord injury in Switzerland and to identify their correlates in terms of personal characteristics and outcomes, such as secondary health conditions and quality of life. This is a cross-sectional, observational study using data from the third community survey of the Swiss Spinal Cord Injury Cohort Study. Out of 1158 individuals, the data revealed high endorsement in areas of prevention importance, perceived knowledge, adherence to recommendations, and proactive problem-solving. Personal and lesion characteristics were significantly associated with differing self-management beliefs and attitudes. Overall, a more positive and proactive stance toward self-management correlated with enhanced outcomes. However, readiness to renounce activities to adhere to self-management recommendations was associated with lower quality of life. The findings confirm the complex nature of self-management among individuals with spinal cord injury, advocating for a tailored, person-centered approach in designing interventions. Highlighting a potential trade-off between strict self-management adherence and quality of life outcomes posits an avenue for balanced, individualized self-management strategies to ameliorate health outcomes and life quality for individuals with spinal cord injury.

Development of the iManage SCD mobile health application for transition

ObjectiveThis paper outlines the design and implementation of iManage SCD, a self-management mobile health application for adolescents and young adults (AYA) with sickle cell disease (SCD) during transition from pediatric to adult health care. MethodsThe Integrate, Design, Assess, Share (IDEAS) framework, emphasizing user insights, iterative design, rigorous assessment, and knowledge sharing, guided the development process. The design team consisted of researchers, psychologists, physicians, social workers, AYA with SCD, and parents of AYA with SCD (n = 16) across three states. Qualitative focus groups and interviews were conducted and analyzed using thematic analysis across the integrate and design phases. Point of use feedback from AYA with SCD was used to assess feasibility and acceptability. ResultsThe development process was centered around tenants of the Social-ecological Model of Adolescent and Young Adult Readiness to Transition. Development integrated multidisciplinary perspectives, fostering a person-centered approach. The iterative design process involved collaboration with a digital health firm, Agency39A. Health equity and implementation considerations were addressed at individual, community, and healthcare system levels. Themes that emerged from focus groups with AYA, clinicians, and researchers in the integrate and design phases of development included recommendations for content and user experience features. ConclusionsiManage SCD emerges as a comprehensive, user-friendly mobile health application, incorporating theoretical principles and direct user input. The development process demonstrated feasibility and acceptability, and the paper discusses dissemination strategies for the Community Health Workers and Mobile Health Programs to Help Young Adults with SCD Transition to Using Adult Healthcare Services (COMETS) study.

Prediction of mental health risk in adolescents via a smartphone app: a feasibility pilot study

Abstract Background The prevalence of mental health problems in adolescents is a global public health concern. Machine learning (ML) can analyse multidimensional data collected by phone sensors (passive tracking) and symptom self-reporting (active tracking) to model and predict mental health states. However, research in adolescents is lacking. This study investigated the feasibility of using ML to predict mental health in a non-clinical population of adolescents from active and passive data collected through the Mindcraft mobile app. Methods We recruited 103 secondary students (aged 14-18) who first completed the Strengths and Difficulties Questionnaire (SDQ) and then used the Mindcraft app for two weeks. The app integrates sensor data (location, steps, noise, light, battery, app usage) and self-reports. We extracted 85 sensor-based features and 19 from questionnaires to develop a gradient-boosted ensemble ML model. This model identifies students with abnormal SDQ scores and was evaluated using leave-one-out cross-validation. Results All students completed the active questionnaires; 67 also provided passive sensor data. 31 had abnormal SDQ scores. Using passive data, the ML model reached a balanced accuracy of 0.64 and an AUC score of 0.57. Incorporating both data types improved accuracy to 0.67 and AUC to 0.70. Feature importance scores showed step count and questionnaire on racing thoughts and hopefulness as most significant. Conclusions Our findings affirm the potential of integrating passive and active data collection to monitor mental health in real-world settings. Our ML model demonstrated moderate accuracy in predicting adolescents’ mental health risk measured with a behavioural screening questionnaire. This study will guide the development of a ML-driven, personalised mobile intervention for early symptom detection and mental health self-management, which might constitute an innovative and scalable tool for mental health prevention and intervention in adolescents. Key messages • This study shows the feasibility of using active and passive data to predict mental health risk in adolescents. • This study informs the development of a personalised machine learning-driven mobile intervention.

Empowering health literacy: Turkiye’s Health Literacy Action Plan 2022-2026

Abstract Issue/Problem The ‘Health Literacy Action Plan 2022-2026’ of the Turkish Ministry of Health addresses the critical public health issue of limited health literacy, leading to increased hospital admissions, inappropriate emergency department use, and poor health outcomes. This underscores a significant challenge in individual health self-management and higher healthcare expenditure within the country. Description of the Problem The Health Literacy Action Plan aims to tackle disparities in health literacy levels among people. It employs customized teaching schemes, digital communication, and inclusive healthcare practices to reach every demographic group. The plan seeks to enhance health knowledge and empowerment among Turkish people by increasing access to medical information, simplifying clinician instructions, and promoting closer communication between patients and healthcare professionals. Results Comparative evaluation of nationwide surveys conducted in 2017 and 2023 with 15,000 participants shows remarkable improvements. Despite delays due to the pandemic, the action plan led to a notable increase in adequate health literacy levels from 31.9% in 2017 to 46.1% in 2023. Additionally, significant improvements were observed in ailment prevention and health promotion, with health literacy levels in disease prevention increasing from 28.4% to 45.7%. Lessons The Health Literacy Action Plan plays a crucial role in developing and implementing multifaceted public health strategies based on data and stakeholder participation. These interventions, requiring continuous monitoring and adjustment, are essential steps toward achieving high-level health literacy. Key messages • Strategic health literacy interventions are essential for improving health outcomes and optimizing the use of public resources. • Evidence-based interventions and ongoing evaluation are key to promoting health literacy.

Pathway analysis of the impact of health literacy, social support, and self-management on frailty in patients with chronic heart failure: A cross-sectional study.

Chronic heart failure (CHF) is a significant global health challenge, and frailty is common among CHF patients. Although abundant evidence has revealed significant intercorrelations among health literacy, social support, self-management, and frailty, no study has explored their associations into 1 model based on a theoretical framework. The study aimed to test the Information-Motivation-Behavioral Skills Model in a sample of Chinese CHF patients and explore the potential relationships among social support, health literacy, self-management, and frailty. A cross-sectional study was conducted on CHF patients (n = 219) at a tertiary hospital in China. The Tilburg Frailty Indicator, Heart Failure Specific Health Literacy Scale, Social Support Rating Scale, and Self-management Scale of Heart Failure Patients were used to assess frailty, health literacy, social support, and self-management, respectively. Structural equation modeling with the bootstrapping method was used to test the hypothesized relationships among the variables. The results showed that 47.9% of the CHF patients suffered from frailty. Frailty was negatively correlated with health literacy (r = -0.268, P < .01) with a moderate effect size, social support (r = -0.537, P < .01) with a large effect size, and self-management (r = -0.416, P < .01) with a moderate effect size. The structural equation modeling model showed that social support was positively associated with health literacy (β = 0.419, P < .01) and self-management (β = 0.167, P < .01) while negatively associated with frailty (β = -0.494, P < .01). Health literacy was positively associated with self-management (β = 0.565, P < .01), and self-management was negatively associated with frailty (β = -0.272, P < .01). Our study suggests the potential positive impacts of health literacy, social support, and self-management on improving frailty in CHF patients. Healthcare providers should strengthen patient health education, improve their health literacy, enhance their social support, and promote their self-management so as to reverse frailty and reduce the risk of adverse outcomes.

Impact of Digital Innovations on Health Literacy Applied to Patients with Special Needs: A Systematic Review

MHealth strategies have been used in various health areas, and mobile apps have been used in the context of health self-management. They can be considered an adjuvant intervention in oral health literacy, mainly for people with special health needs. Thus, the aim of this study was to identify the improvement of oral health literacy in patients with special needs when using digital platforms. A systematic literature review, based on the Joanna Briggs Institute (JBI) guidelines, was the main research method employed in this study. A search was undertaken in PubMed/MEDLINE and Cochrane Central Register of Controlled Trials (CENTRAL) databases, according to the relevant Mesh descriptors, their synonyms, and free terms (Entry Terms). Studies published between the years 2012 and 2023 were included. Two researchers independently assessed the quality of the included studies by completing the Newcastle–Ottawa Quality Assessment Scale questionnaire. The analysis corpus comprised 5 articles among the 402 articles selected after applying the inclusion/exclusion criteria (k = 0.97). The evidence from the considered articles is consensual regarding the effectiveness of using new technologies and innovations in promoting oral health literacy in patients with special health needs. The interventions were based on using the Illustration Reinforcement Communication System, inspired by the Picture Exchange Communication System, Nintendo® Wii™ TV, virtual reality, smartphones, with software applications to read messages sent, Audio Tactile Performance technique, and Art package. One study had a low-quality assessment, and four had a high quality. The evidence from the articles included in this systematic review is consistent regarding the effectiveness of using new technologies and innovations in promoting oral health literacy in patients with special health needs.

Effectiveness of Mobile Application Disease Self-Management Programme on Mental Health and Self-Management of Patients With Hypertension: A Randomised Controlled Trial.

Hypertension is a chronic disease that consumes considerable medical resources. The aim of this study is to evaluate a model able to develop and assess the effectiveness of a mobile application disease self-management programme regarding mental health and self-management for patients with hypertension. A randomised controlled trial and single-blind random assignment was employed to group the participants. A total of 100 patients were collected from the cardiology clinic of a teaching hospital in Taiwan. There were 50 participants in each group: the mobile application group (experimental group) and the routine care (control group). The primary outcome measures were mental health and self-management. This study discovered that the intervention improved the mental health and self-management of the experimental group. The results for the experimental group revealed significantly improved effects and outcomes superior to those of the control group. The study results verified that a mobile application disease self-management programme could improve the mental health and disease self-management of patients with hypertension.

Nurse-Led Physical Screening of Patients With Substance Use Disorders: A Cross-Sectional Study.

Somatic comorbidity is the main cause of reduced life expectancy in patients with substance use disorders (SUDs). This study aims to investigate somatic health challenges in patients with SUDs using the USS. Patient self-management of somatic health and quality of life were also assessed. In our study, a stratified random sample of 136 clients who received treatment at a specialist addiction facility was drawn to investigate their physical health and lifestyle behaviours using the Utrecht Somatic Screening 2.0 (USS 2.0). The sample included three subgroups, that is, patients receiving outpatient treatment through Flexible Assertive Community Treatment (FACT), Heroin-Assisted Treatment (HAT) and Opioid Replacement Therapy (ORT). Pain, self-management and quality of life were also measured. Descriptive statistics were used to analyse the data. The findings indicate that many patients experience a large number of somatic health problems, including pain and exhaustion. The most prevalent conditions in this study are cardiovascular disease (25%) and COPD (20%), underweight and poor oral health. Tobacco smoking is prevalent among 88% of patients. Fifty percent of the patients expressed a need for support in managing their physical health. Somatic health care and lifestyle promotion should be tailored to the specific characteristics of patients. Patients with SUDs suffer from poor physical health and show unhealthy lifestyle behaviours, which demand the promotion of tailored somatic health.

Organizational health literacy in German hospitals: a cross-sectional survey among hospital managers

BackgroundOrganizational health literacy (OHL) describes conditions and measures in healthcare institutions to enable patients to make good health-related decisions. By providing easy access to and appropriate communication of understandable information to use and navigate the facility, healthcare organizations can contribute to strengthening patients’ health literacy and self-management. The extent of OHL implementation in German hospitals remains largely unknown. This study aims to fill this gap in our knowledge by investigating OHL-related activities reported by hospital managers.MethodsBetween November and December 2022, we conducted a national online survey among medical, nursing and administrative hospital managers with hospitals that operate more than 50 beds. The data were collected via the health literate health care organization ten item questionnaire (HLHO-10) and supplemented by sociodemographic questions and an open-ended question. We applied variance and correlation analyses to investigate the data.ResultsOf 3,301 invited hospital managers, 371 participated in the survey (response rate 11%). The overall mean score for HLHO-10 was 4.6 (SD = 1.1) on a 7-point Likert scale, indicating a moderate level of OHL implementation. Hospital managers stated that hospitals concentrate on helping patients find their way around and communicating the costs of treatment transparently and clearly; conversely, that active patient participation in the design and evaluation of health information is rare in care settings, and that health information is seldom provided to patients through a range of media. For the practical implementation of the OHL, most hospital managers mentioned activities regarding communication standards, such as providing information materials.ConclusionsGiven their unique position as hubs of human interaction, hospitals provide an ideal opportunity to promote the adoption of OHL. By actively involving patients, hospitals can better tailor their approaches to meet patient needs and preferences. Compared to studies from oncology centres in Germany and 20 Italian hospitals, the average HLHO-10 score of this study is lower. While some aspects of OHL are already embedded in inpatient care, it is imperative that OHL is thoroughly embedded in the hospitals’ organizational culture and plays a fundamental role in the daily operations of the institution. This could be done, for instance, by more explicitly addressing the topic of health literacy in staff communication training.

Generative AI-based knowledge graphs for the illustration and development of mHealth self-management content.

Digital therapeutics (DTx) in the form of mobile health (mHealth) self-management programs have demonstrated effectiveness in reducing disease activity across various diseases, including fibromyalgia and arthritis. However, the content of online self-management programs varies widely, making them difficult to compare. This study aims to employ generative artificial intelligence (AI)-based knowledge graphs and network analysis to categorize and structure mHealth content at the example of a fibromyalgia self-management program. A multimodal mHealth online self-management program targeting fibromyalgia and post-viral fibromyalgia-like syndromes was developed. In addition to general content, the program was customized to address specific features and digital personas identified through hierarchical agglomerative clustering applied to a cohort of 202 patients with chronic musculoskeletal pain syndromes undergoing multimodal assessment. Text files consisting of 22,150 words divided into 24 modules were used as the input data. Two generative AI web applications, ChatGPT-4 (OpenAI) and Infranodus (Nodus Labs), were used to create knowledge graphs and perform text network analysis, including 3D visualization. A sentiment analysis of 129 patient feedback entries was performed. The ChatGPT-generated knowledge graph model provided a simple visual overview with five primary edges: "Mental health challenges", "Stress and its impact", "Immune system function", "Long COVID and fibromyalgia" and "Pain management and therapeutic approaches". The 3D visualization provided a more complex knowledge graph, with the term "pain" appearing as the central edge, closely connecting with "sleep", "body", and "stress". Topical cluster analysis identified categories such as "chronic pain management", "sleep hygiene", "immune system function", "cognitive therapy", "healthy eating", "emotional development", "fibromyalgia causes", and "deep relaxation". Gap analysis highlighted missing links, such as between "negative behavior" and "systemic inflammation". Retro-engineering of the self-management program showed significant conceptual similarities between the knowledge graph and the original text analysis. Sentiment analysis of free text patient comments revealed that most relevant topics were addressed by the online program, with the exception of social contacts. Generative AI tools for text network analysis can effectively structure and illustrate DTx content. Knowledge graphs are valuable for increasing the transparency of self-management programs, developing new conceptual frameworks, and incorporating feedback loops.

Supporting Self-Management of Kidney Health in Diabetic Patients via a Novel Digital Health Intervention: Protocol for a Prospective Interventional Study

Supporting Self-Management of Kidney Health in Diabetic Patients via a Novel Digital Health Intervention: Protocol for a Prospective Interventional Study

User Engagement With mHealth Interventions to Promote Treatment Adherence and Self-Management in People With Chronic Health Conditions: Systematic Review.

There are numerous mobile health (mHealth) interventions for treatment adherence and self-management; yet, little is known about user engagement or interaction with these technologies. This systematic review aimed to answer the following questions: (1) How is user engagement defined and measured in studies of mHealth interventions to promote adherence to prescribed medical or health regimens or self-management among people living with a health condition? (2) To what degree are patients engaging with these mHealth interventions? (3) What is the association between user engagement with mHealth interventions and adherence or self-management outcomes? (4) How often is user engagement a research end point? Scientific database (Ovid MEDLINE, Embase, Web of Science, PsycINFO, and CINAHL) search results (2016-2021) were screened for inclusion and exclusion criteria. Data were extracted in a standardized electronic form. No risk-of-bias assessment was conducted because this review aimed to characterize user engagement measurement rather than certainty in primary study results. The results were synthesized descriptively and thematically. A total of 292 studies were included for data extraction. The median number of participants per study was 77 (IQR 34-164). Most of the mHealth interventions were evaluated in nonrandomized studies (157/292, 53.8%), involved people with diabetes (51/292, 17.5%), targeted medication adherence (98/292, 33.6%), and comprised apps (220/292, 75.3%). The principal findings were as follows: (1) >60 unique terms were used to define user engagement; "use" (102/292, 34.9%) and "engagement" (94/292, 32.2%) were the most common; (2) a total of 11 distinct user engagement measurement approaches were identified; the use of objective user log-in data from an app or web portal (160/292, 54.8%) was the most common; (3) although engagement was inconsistently evaluated, most of the studies (99/195, 50.8%) reported >1 level of engagement due to the use of multiple measurement methods or analyses, decreased engagement across time (76/99, 77%), and results and conclusions suggesting that higher engagement was associated with positive adherence or self-management (60/103, 58.3%); and (4) user engagement was a research end point in only 19.2% (56/292) of the studies. The results revealed major limitations in the literature reviewed, including significant variability in how user engagement is defined, a tendency to rely on user log-in data over other measurements, and critical gaps in how user engagement is evaluated (infrequently evaluated over time or in relation to adherence or self-management outcomes and rarely considered a research end point). Recommendations are outlined in response to our findings with the goal of improving research rigor in this area. PROSPERO International Prospective Register of Systematic Reviews CRD42022289693; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022289693.

Impact of Community Proactive Health Management Application on Electronic Health Literacy and Self-Management of Hypertensive Patients.

Investigating the impact of the Community Proactive Health Management Application on electronic health literacy, self-management level, and blood pressure in hypertensive patients within the community. Between September and November 2020, two communities in Hengyang City, Hunan Province, China were selected as the intervention and control groups using convenience sampling. Subsequently, 30 hypertensive patients from each of the two communities were randomly selected to participate as study subjects. The control group patients received foundational hypertension management, whereas the intervention group received additional care through the Community Proactive Health Management Application. Following a 3-month period, the intervention group exhibited significantly higher total scores (t=2.193, p=0.032) and application dimension scores (t=2.605, p=0.012) for electronic health literacy compared to the control group. The total scores of electronic health literacy scale for both the intervention (t=-5.671, p<0.001) and control (t=-3.613, p=0.001) groups were higher after the intervention compared to before. The total score of the self-management scale (t=3.872, p<0.001), as well as the scores for the treatment management (t=6.580, p<0.001) and habit management dimensions (t=2.315, p=0.024) of hypertensive patients in the intervention group, were significantly higher than those in the control group. The self-management scores of both groups of hypertensive patients showed a significant increase compared to preintervention levels (intervention group t=-14.391, p<0.001; control group t=-6.584, p<0.001). The intervention group exhibited a statistically significant decrease in systolic blood pressure compared to the control group (Z=-2.036, p=0.042). Following the intervention, both groups exhibited a significant reduction in systolic and diastolic blood pressure levels compared to preintervention levels (all p<0.001). The Community Proactive Health Management Application has the potential to enhance the electronic health literacy and self-management capabilities of hypertensive patients, enabling them to engage in better health management, reduce hypertension levels, and elevate their overall quality of life.

Influencing factors of self-management ability among dry eye patients in west China.

To investigate the current situation and influencing factors of self-management ability in dry eye patients in west China. A total of 265 patients clinically diagnosed with dry eye received a convenience survey questionnaire at West China Hospital of Sichuan University. All participants completed the rating scale of health self-management skill for adults (AHSMSRS), Huaxi Emotional-Distress Index (HEI), e-health literacy scale (e-HEALS) and Brief Illness Perception Questionnaire (Brief-IPQ). A generalized linear model was employed to establish a multivariate linear model with demographic data, psychological state, e-HEALS, and illness perception as independent variables and health self-management skill score as the dependent variable. The mean score for health self-management skill was 165.58±15.79. Multivariate analysis revealed that advanced age, better illness perception and improved psychological state were associated with better health self-management ability among dry eye patients. Furthermore, the health self-management ability of patients with a disease duration less than 1y was found to be higher compared to those with a disease duration exceeding 1y. The health self-management ability of dry eye patients in west China is relatively high. Age, duration of disease, illness perception and psychological state are the influencing factors on the health self-management ability of dry eye patients.

Qualitative study on health self-management of patients with metabolic syndrome among bereaved population after earthquake

The study explore the influencing factors and healthy self-management of MS patients with bereaved relatives after Wenchuan and Yushu Earthquake of their real life; explore difficulties and challenges in the process of self-management; and supply information that could not be sought in quantitative studies. Purposive sampling was used to recruit 36 MS patients who are bereavement population in two earthquakes, and those patients met the inclusion criteria for semi-structured focus group interview. The Nvivo11 software was used to collate and analyze the transcribed data. The main influencing factors of health self-management behavior for MS patients are as follows: the degree of understanding of disease prevention knowledge, emotion management induced by earthquake trauma, the source of disease-related information, access and identification are very limited; ethnic traditional culture, religious beliefs, and production activities and routines before and after the earthquake is an important factor in their healthy self-management behavior. The lack of health beliefs and self-efficacy of MS patients among bereaved families after Wenchuan and Yushu earthquake are key obstacle in their self-management. The overall level of the knowledge of patients’ MS prevention, self-efficacy and self-management behaviors are still low. Some positive factors that can be changed including MS prevention knowledge, self-efficacy, social support, and family function. Some negative factors which can be improved afterwards, including negative coping style, traumatic life experiences from earthquake and smoking.

Exploring Demographic and Cognitive Predictors of Self-Management in Quasi-Randomized Fall Prevention Intervention for Older Adults With and Without Traumatic Brain Injury.

Changes in health behavior are key to maintaining health, safety, and independence of older adults. The purpose of this study was to explore factors impacting training in self-management and behavior change in older adults with and without traumatic brain injury (TBI), informing efforts to improve safety and independent function. Forty-one older adults, 19 with TBI, completed a self-regulation intervention (mental contrasting with implementation intentions; MCII) to promote fall prevention behavior change. Participant outcomes were related to single and recurring behavior changes; implementation outcomes were measured as modifications to treatment. Although participants with TBI performed more poorly on tests of neurocognitive function, there were no differences in behavior change rates following MCII, suggesting the treatment worked similarly for participants with and without TBI. Across both groups, those with higher executive function scores were more likely to complete recurring behavior changes. Participants with higher stress, higher Fall Risk Scores, or history of TBI were more likely to need modifications to treatment. This quasi-experimental pilot study describes cognitive and psychosocial predictors that may be critical for participation and success in health behavior change and self-management of fall prevention for older adults with and without TBI.

Spiritual Diabetes Self-Management Health Coaching Against Psychological Well-Being and Self-Management Compliance in Diabetes Mellitus Patients

Introduction: For patients with diabetes to keep being consistent with self-management, they should build their psychological well-being and feeling of direction in life through a progression of intricate and tedious errands. Aim: This examination looked to inspect the impacts of Spiritual Diabetes Self-Management Health Coaching on psychological health and self-management conduct. Methode: The study utilized a quasi-trial research design, using a basic irregular sampling method to decide the sample based on inclusion and exclusion rules. A sum of 126 respondents were remembered for the sample, with 63 respondents each in the intervention and control groups. Ryff's Psychological Well-Being (RPWB) and a Questionnaire on Compliance with Diabetes Self-Management (QCDSM) were the instruments utilized in this study. A t-test with p&lt;0.5 was used in the statistical analysis. Results: The findings demonstrated that the normal psychological well-being in the intervention bunch was 174.22 both when the intervention, and the typical compliance with self-management was 47.56. Pre-and post-intervention averages for psychological well-being and self-management compliance in the control bunch were 144.62 and 19.32, respectively. A p-worth of 0.000 between spiritual diabetes self-management compliance and psychological well-being is uncovered by information analysis. Conclusion: Spiritual Guidelines for Overseeing Diabetes Patients with diabetes mellitus can profit from long-term health coaching to upgrade their psychological health and compliance with self-management.

A Study on AIDS Self-Management Status and Its Influencing Factors.

To investigate and analyse the status quo of the self-management of patients living with HIV/AIDS (PLWHA) and its influencing factors and to provide the basis for formulating intervention strategies. In this cross-sectional study, 300 PLWHA who visited the Infection Center of Beijing Youan Hospital, Capital Medical University between September 2021 and December 2021 were enrolled using the convenience sampling method. Demographic characteristics and disease-related data were collected for each participant. The HIV/AIDS Self-Management Scale was used to evaluate the self-management ability of PLWHA. A total of 251 male and 49 female PLWHA were included in this study, with an average age of 39.08 ± 12.09 years and an average disease duration of 9.61 ± 37.04 months. Univariate analysis showed that the PLWHA's place of residence, educational level, physical condition, family relations, duration of HIV disease, receipt or not of antiviral therapy and knowledge of disease had an influence on the scores of the HIV Self-Management Scale (all p < 0.05). The results of the self-management scores indicated that the total score for self-management was 41.5 ± 6.4 points, with a scoring rate of 69.6%, which was at a medium level. Long-term self-management had the highest scoring rate (12.2 ± 2.5 points), followed by daily health management (22.3 ± 4.3 points), and social support for self-management had the lowest scoring (5.1 ± 0.9 points). Multivariable analysis showed that the self-management ability of PLWHA was related to educational level, duration of disease and family relations (R2 = 0.67, F = 121.7, p < 0.05). The self-management level of patients with AIDS, especially the social support of daily health management and self-management, needs to be further improved. Educational level, duration of disease and family relations are important factors influencing the self-management of PLWHA.

Patient and Caregiver Perspectives on Gender Disparity in Chronic Kidney Disease: Questionnaire Survey, Based on an Interview Study

Introduction: Chronic kidney disease (CKD) in stages 3–5 without albuminuria occurs more often in women than in men; however, most patients initiating and receiving kidney replacement therapy are men. Sex-determined biological factors and gender-related aspects both likely account for this discrepancy. Patient opinions on gender-related discrepancies in kidney care have not been investigated. Methods: Building upon the findings of semi-structured interviews previously conducted with CKD patients and their caregivers, two questionnaires were developed to investigate patient behavior and opinions relating to gender and CKD. These questionnaires containing 39 items were distributed to eight outpatient clinics in Austria. Responses were descriptively analyzed and compared between genders, as well as between age-groups and CKD stages. Results: Questionnaires from 783 patients and 98 caregivers were included in the analysis and covered health awareness and self-management of disease, the impact of gender roles and gender equality, and patient autonomy and trust in the health-care system. A total of 56.1% of men patients and 63.1% of women patients found that women were better at looking after their health compared to men (41.1%/34.3% no difference, 2.8%/2.6% men better). A total of 95.4% of men patients, 95.0% of women patients, 100% of men caregivers, and 95.5% of women caregivers stated that all patients with kidney disease were treated completely equally, irrespective of gender. Conclusion: Neither the patients nor the caregivers stated gender-determined treatment decisions in CKD care. Both men and women however agreed that women are better at maintaining their own health and excel in disease self-management.