Self-Management Scale Research Articles

Application of Comprehensive Nursing Program Based on Evidence-Based Concept in Patients with HIV-Related Lymphoma

Objective: To explore the application and effect of comprehensive nursing program based on evidence-based concept in patients with HIV-related lymphoma. Methods: 148 patients with HIV-related lymphoma were randomly divided into control group and observation group, with 74 cases in each group （Table 1). The control group was given routine nursing, while the observation group was given comprehensive nursing on the basis of routine nursing. The HIV Self-management Scale, Herth Hope Index and WHO Quality of Life Questionnaire for HIV Brief Version were used to evaluate the score of self-management, hope and quality of life of patients in the two groups before and after intervention. The level of chemotherapy compliance and the incidence of complications were also compared between the two groups. Results: Compared with the control group, the scores of self-management, hope and quality of life in the observation group were significantly higher (P<0.05) , the compliance of chemotherapy and the incidence of complications in the observation group were significantly lower than those in the control group (P <0.05) (Table 2). Conclusion: The comprehensive nursing program based on evidence-based concept can effectively improve the self-management ability, the level of hope and quality of life of the patients with HIV-related lymphoma after chemotherapy, it is worth popularizing in clinic to improve the compliance of patients and reduce the incidence of complications.

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.

Current status and influencing factors of self-management in knee joint discomfort among middle-aged and elderly people: a cross-sectional study

BackgroundThis study aims to identify the current status and factors influencing self-management of knee discomfort in middle-aged and elderly people in China.MethodsA stratified multistage cluster sampling method was used to select participants from communities in China from January 15 to May 31, 2020. A cross-sectional survey was conducted using the general information questionnaire and the Knee Joint Discomfort Self-management Scale. Univariate analysis and a generalized linear model were used to analyze the factors influencing self-management.ResultsThe prevalence of knee discomfort was 77%. Moderate to severe discomfort accounted for 30.5%. The average item score of self-management in 9640 participants was 1.98 ± 0.76. The highest and lowest levels were: ‘daily life management’ and ‘information management’. Gender, ethnicity, education level, economic source, chronic disease, knee pain in the past month, and the degree of self-reported knee discomfort were significant predictors of self-management.ConclusionThe self-management of knee discomfort in middle-aged and elderly people is poor, and the degree of discomfort is a significant predictor. Healthcare providers should consider socioeconomic demographic and clinical characteristics to help these individuals improve their self-management skills. Attention should also be given to improving their ability to access health information and making them aware of disease risks.

Rasch 모형을 이용한 뷰티전문가의 자기관리 측정도구 타당화

The purpose of this study was to validate the self-management measurement tool's validity for beauty professionals using the Rasch model. Data was collected from 679 participants who were beauty professionals working in the metropolitan area. Kim Hyun-jeong's (2021) self-management scale was used as the measurement tool. Data analysis methods included testing for normality, exploratory factor analysis, and confirmatory factor analysis. In the Rasch model analysis, the validation of the data included testing for unidimensionality, item fit and difficulty, and the validity of response category thresholds.
 The results obtained from the research are as follows. First, the normality testing of the self-management measurement tool's sub-factors for beauty professionals confirmed that the data showed no skewness and was within the normal distribution range. Second, both the exploratory factor analysis and confirmatory factor analysis of the self-management measurement tool for beauty professionals confirmed that all items were appropriate, thus validating its construct validity. Third, the analysis of item fit using the Rasch model confirmed that the self-management measurement tool for beauty professionals established validity in terms of unidimensionality, item fit and difficulty, and the appropriateness of item category thresholds.
 In summary, based on the comprehensive findings of this study, Kim Hyun-jeong's (2021) self-management measurement tool for beauty professionals was found to be highly valid.

Reciprocal associations between beliefs about medicines, health locus of control and adherence to immunosuppressive medication in allogeneic hematopoietic cell transplant patients: Findings from the ADE-TRAM study

PurposePatients undergoing allogenic hematopoietic stem cell transplantation (allo-HSCT) are required to strictly adhere to immunosuppressive medications to avoid rejection and infective complications. Since medication adherence is among the most important modifiable behaviors to achieve better outcomes, the aims of this study were to measure the baseline and longitudinal trends of medication adherence and investigate the psychological factors associated with medication adherence in allo-HSCT patients. MethodsThis was a single-center, longitudinal study of patients who underwent allo-HSCT to treat hematological malignancies at the University hospital of Florence (Italy). Adherence was measured with the Immunosuppressive Medication Self-Management Scale; psychological factors (i.e., beliefs about medicines and health locus of control) were measured with the Beliefs About Medicines Questionnaire and Multidimensional Health locus of Control Scale. Data were collected 1, 3, 6 and 12 months after discharge. A mixed effects model was performed after adjusting for demographic characteristics. Results50 adult patients were included in this study. Adherence to immunosuppressant was optimal and increased significantly 3 months after bone marrow transplantation (B = 0.23, p = 0.041). Patients with lower concerns about immunosuppressive medications were more likely to be adherent (B = 0.02, p = 0.040), while those having beliefs that their disease was due to external factors were less likely to be adherent (B = −0.02, p = 0.026) than their counterparts. ConclusionsThese results underline the importance of psychological factors in affecting adherence to immunosuppressants of allo-HSCT patients. Healthcare providers and researchers should target medication beliefs and reorient locus of control with appropriate interventions, in order to improve adherence.

An Online Structured Diabetes Self-Management Education and Support Programme Improves Glycaemic Control in Young Adults with Type 1 Diabetes.

We explore the effect of a structured online DSMES program on glycaemic control and the self-management behaviour of adolescents and young adults with T1DM. We used a pre-post uncontrolled intervention design over a period of 6 months. A total of 37 youths with T1DM aged 10-45 years were enrolled. The intervention comprised 11 structured online DSMES course sessions; these were video-based and delivered by a diabetes specialist, nurses and a dietitian. The primary outcome was a change in (glycated hemoglobin) HbA1c. The secondary outcomes were changes in hypoglycaemia frequency, time in target range (TIR) among patients using a continuous glucose monitoring (CGM) system and self-management behaviour; the latter was measured using a T1DM self-management scale for Chinese adults (SMOD-CA) and the Chinese version of the diabetic behaviour rating scale in adolescents with T1DM (DBRS). Twenty-three (85.2%) participants attended ≥8 of the online sessions. There was a significant reduction in HbA1c (from 6.92% to 6.47%, P = 0.002), hypoglycaemic episodes (from 6.0 to 4.0 during the preceding month, P = 0.026) and a significant increase in TIR (from 74.0% to 80.5%, P = 0.027) and an increase in the SMOD-CA score (from 79.6 to 84.6, P = 0.026) in young adults. No significant change in glucose control, hypoglycaemic events or DBRS score were found among children and adolescents. The score of the 12-item version of the Barrett-Lennard Relationship Inventory (B-L RI:mini) indicated that more than half of the participants experienced congruence, positive regard, and an empathic understanding in this programme. The online structured DSMES programme was effective in improving the glycaemic control and self-management behaviour of young adults with T1DM; however, integrating offline visits or appointments with online consultations may be necessary for youth patients.

Development and initial validation of the Career Self-Management scale for Chinese coaches.

The purpose of the study was to develop and initially validate a context-specific scale assessing Career Self-Management for Chinese coaches (Career Self-Management Scale-CC; CSMS-CC). Firstly, qualitative data obtained from in-depth interview with coaches were contently analyzed to generate potential CSMS-CC items. The content validity of the items was evaluated by a panel of experts. Secondly, the factor structure and item performance of the CSMS-CC were examined using exploratory factor analysis (EFA) and internal consistency reliability of its subscales were evaluated in sample 1 (n = 229, 24.01% females). Thirdly, factor structure of the CSMS-CC was further examined using confirmatory factor analysis (CFA) in sample 2 (n = 295, 32.54% females). Internal consistency reliability was evaluated using Cronbach' alpha coefficient and composite reliability. Nomological validity was examined using Pearson correlation and structural equation modeling (SEM) by investigating the correlations between CSMS-CC subscales with career success. Finally, measurement invariance and latent mean difference of the CSMS-CC was examined across gender, professional title and coaching class using multiple-group CFA (MGCFA). Based on the results of the content analysis and content validity evaluation, 18 CSMS-CC items were retained for further analysis. Results of EFA in sample 1 revealed that eight items were problematic and removed. The second round of EFA revealed that three components were retained and labelled as Networking Behavior (4 items), Training Exploration (3 items), and Guanxi Development (3 items). Results of CFA in sample 2 suggested that the 10-item three-correlated-factors model of CSMS-CC demonstrated acceptable model fit to the data, χ2 = 135.01, df = 32, p < 0.01, CFI = 0.91, TLI = 0.90, SRMR = 0.05, RMSEA = 0.092 (90% CI = 0.076-0.108). Composite reliability (ranging from 0.84 to 0.88) and Cronbach's alpha coefficients (ranging from 0.78 to 0.81) of three subscales were found satisfactory. Nomological validity was supported by the results that total score and subscale scores of the CSMS-CC were significantly associated with internal marketability and external marketability. It was found that the CSMS-CC measurement model was strict invariant across gender, professional title and coaching class. Significant differences on all three subscales across professional title and on Guanxi development across coaching class were revealed. Results of this study provided initial support for the psychometric properties of the 10-item CSMS-CC, which suggested that the CSMS-CC could be used for measuring the career self-management of Chinese coaches.

Psychosocial health and activities during the COVID-19 pandemic.

The COVID-19 pandemic has become a major cause of stress at work. To examine the effect of self-management and self-control skills on perceived stress of employees in the COVID-19 period. The study's self-administered survey included demographics and the Perceived Stress Scale (PSS) and Self-Control and Self-Management Scale (SCMS). Associations with PSS were determined using a multiple variable linear regression analysis. Scores for stress (28.45±7.82) and self-management (55.73±12.15) were moderate for employees. Of the 181 employees, 41.43% had a mild, 52.48% had moderate, and 6.07% had severe stress levels. Stress was significantly associated with lower self-management level. A negative relation was found between SCMS and PSS (p = 0.000, r = -0.320). Employees with high self-management skills had low stress levels. Employees also reported negative changes to physical activity, income and sleep. Gender, occupation, income category, compliance with COVID-related rules and self-management were associated with levels of stress (p < 0.05). The regression model explained 24.8% of the variance in stress perception (R2=0.248, F = 11.452, p = 0.000). Multiple linear regression analysis showed gender (β=5.089, 95% CI: 2.820 to 7.358, p = 0.000) compliance with COVID-related rules (β=2.274, CI: 0.066 to 4.483, p = 0.044), a decrease in income (β=2.051, CI: -0.64 to 4.166, p = 0.057) and self-management (β=-0.173, CI: -0.258 to -0.087, p = 0.000) were significantly associated with lower scores in the stress perception. Self-control and self-management were associated with a decline in mental health. Health-promotion strategies directed at adopting or maintaining positive self-control and self-management-related behaviors should be utilized to address increases in psychological distress during the COVID-19 pandemic.

Mediating role of learned helplessness’ components in the association between health literacy/social support and self-management among maintenance haemodialysis patients in Changsha, China: a cross-sectional study

ObjectivesTo explore the multiple mediating roles of the learned helplessness’s core system in the relationship between health literacy/social support and self-management.DesignCross-sectional survey design.SettingChangsha, China.Participants239 Chinese maintenance haemodialysis (MHD) patients.MethodsTwo multiple...

Relationship Between Symptom Burden and Self-Management Among Patients with Chronic Heart Failure: A Cross-Sectional Study.

Chronic heart failure (CHF) is a cardiovascular disease that seriously jeopardizes global human health. Studies indicate that good self-management can be effective in controlling disease symptoms. However, there is still insufficient evidence on the association between self-management and symptom burden among CHF patients. This study aimed to observe and assess the correlation of the self-management with the symptom burden and each dimension status in patients with CHF. This was a cross-sectional study. Data were collected in-hospital using convenience sampling, and 128 patients with CHF were included. A general data questionnaire was used to collect demographic and disease-related data. The Memorial Symptom Assessment Scale-Heart Failure was used to measure patients' symptom burdens. The Heart Failure Self-Management Scale was used to measure the self-management level of patients. The correlation between self-management and symptom burden was analyzed using the Spearman correlation. The total scores for symptom burden and self-management were 1.26 ± 0.49 and 49.97 ± 7.14, respectively. The total score of self-management was negatively correlated with that of symptom burden. The univariate linear regression analysis indicated that age, place of residence, smoking, residence status, New York Heart Association grade of cardiac function, and attitude toward the disease were risk factors for symptom burden. The multiple linear regression analysis indicated that the regression model with symptom burden as a dependent variable included three variables: drug management, symptom management, and attitude toward the disease. Hospitalized patients with CHF had heavy overall symptom burdens, and their self-management levels were moderate to low. There was a negative correlation between the total self-management score and each dimension of symptom burden.

171-LB: The Online Structured DSMES Program Improved Glycemic Control in Young Adults but Not in Children and Adolescence with T1DM

Background: The COVID-19 pandemic has forced rapid reconsideration of the way in which health care is delivered in patients with T1DM. We explored the effect of an online structured DSMES program on glycemic control and self-management behavior in patients with T1DM. Methods: The intervention included 2 modules: (1) series of online DSMES sessions based video courses and personalized discussion on diabetes management; (2) continuous interactions and support based Wechat platform through text, audio or video. Results: A total of 36 subjects were enrolled into the final analysis, of them, 26 (72.2%) were young adults above 18 years and 10 (27.8%) were children and adolescence below 18. There were significant changes in HbA1c, TIR and hypoglycemic event in young adults; however, no significant difference were found in children and adolescence. There were significant behavior change measured using self-management scale of T1DM for Chinese adults (SMOD-CA) in participants aged ≥18, mainly in the domains of daily performance, coping with disease-related problems and goals of disease management; however, no significant behavior change were found in adolescence with T1DM (DBRS). (Table 1) Conclusions: The online structured DSMES program improved glycemic control, self-management behavior and reduced hypoglycemic event in young adults but not in children and adolescence with T1DM. Disclosure L. An: None. L. Ji: Other Relationship; Eli Lilly and Company, Novo Nordisk, Merck &amp; Co., Inc., Bayer Inc., Sanofi-Aventis U. S., Roche Pharmaceuticals, MSD Life Science Foundation, AstraZeneca, Boehringer Ingelheim Inc., Abbott, Metronics.

The analysis of the adherence of liver transplant recipients to immunosuppressant treatment, their self-control, and self-management in the post-transplantation period

In our study, it was aimed to investigate the adherence of liver transplant recipients to immunosuppressant therapy, their self-control, and their self-management in the post-transplantation period. The sample of this descriptive and cross-sectional study was composed of liver transplant recipients. The personal information form, Immunosuppressant Therapy Adherence Scale, and the Liver Self-Control and Self-Management Scale were used to collect data, and descriptive statistical methods, independent samples t-test and one-way analysis of variance analysis was used to analyze the collected data. In light of the data collected in this study, it was identified that, of all recipients, 73.6% were 45–64 years old, 72.5% were male, 25.2% were workers, and 44.6% had equivalent income and expenses. It was observed that the recipients did not fully adhere to the immunosuppressant therapy regimen, and their self-control and self-management levels were below the medium level. The social support system of liver transplant recipients is very important. Recipients with a good social support system can receive caregiver support from their relatives, thereby supporting their self-control and self-management. Both liver transplant patients and the people providing care to them should be simultaneously provided with training programs and given information, and both groups should be supported in treatment and care processes.

The Relationship Between Chronic Disease Self-Management and Well-Being in Hemodialysis Patients / Hemodiyaliz Hastalarında Kronik Hastalık Öz Yönetimi ve İyilik Hali Arasındaki İlişki

Aims: To appraise the relation between self-management and well-being and related sociodemographic and clinical features in patients receiving hemodialysis treatment. Methods: The study was carried out with 261 patients who were treated at three hemodialysis centers in Izmir between September and December 2022 and who met the criteria for inclusion. The data of the research; “Sociodemographic Data Form”, “PERMA Scale” and “Chronic Illness SelfManagement Scale” were collected through face-to-face interviews. Ethics committee approval was obtained to conduct the study. Number, percent, mean, standard deviation, Mann Whitney U/Kruskal Wallis H tests and Spearman correlation analysis were used in the statistical analysis of the data. Results: The PERMA Scale mean score was 7.21±1.31 and the self management scale mean score was 3.31±0.35. Patients who have a high perception of psychological well-being, who have no problems with diet and who can cope with physical problems completely have higher levels of both self-management and well-being (p&lt;0.05).There is a positive relationship between self-management and well-being (r: 0.385, p&lt;0.01). Conclusion: Results supported that hemodialysis patients were found to have moderate disease self-management and high wellbeing. In addition, it was determined that as the disease selfmanagement increased, the well-being of the patients increased.

Character Strengths Use in Diabetes Self-management Scale: Development and psychometric testing.

To develop and psychometrically test Character Strengths Use in Diabetes Self-management Scale in people with type 2 diabetes. Cross-sectional design. Based on literature reviews and examination by experts, a 20-item scale was developed and administered to 350 participants with type 2 diabetes who were enrolled from two endocrine clinics by convenience sampling in Taiwan. Item analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), concurrent and predictive validity as well as reliability were used to examine the psychometric characteristics of the scale. Data were collected from November 2021 to March 2022. EFA and CFA supported a 12-item scale with three factors, namely learning proactively, taking on challenges and thinking positively, fit the data well. The total score of the 12-item scale significantly and positively correlated with diabetes-specific quality of life, and significantly and negatively correlated with baseline and 9-month haemoglobin A1c levels. Cronbach's α for overall scale and subscales ranged between .78 and .91. The 12-item Character Strengths Use in Diabetes Self-management Scale demonstrated satisfactory validity and reliability in people with type 2 diabetes. Nurses could apply this new scale to identify the degree of using character strengths in self-management in people with type 2 diabetes; accordingly, character strength-based interventions could be provided to improve self-management in such patients with diabetes. Furthermore, the 12-item Character Strengths Use in Diabetes Self-management Scale has the potential to be used to measure the effectiveness of strength-based interventions in people with Type 2 diabetes. Five patients with type 2 diabetes were invited to take the original 20-item scale to evaluate the clarity, readability and comprehensiveness of the 20 items.

Self-Management and Its Predictors in adult Patients with Epilepsy: A Cross-Sectional Study.

Appropriate self-management (SM) is crucial in controlling epilepsy and improving self-efficacy, medication adherence and avoidance of seizure triggers in patients with epilepsy (PWE. The aim of this study was to evaluate SM and its predictors among adult PWE in Iran. This cross-sectional study was conducted in 2021. The participants were 335 adult PWEs that were selected from healthcare settings in Hamadan, Iran. Epilepsy Self-Management Scale (ESMS) was used to measure patients' self-management behaviors. Data were analyzed using the independent samples t-test, Pearson's and Spearman's correlation analyses and multiple linear regression analysis. The mean score of SM was 114.37±11, indicating moderate level of SM, and the mean scores of SM in the medication management, seizure management, and safety management subscales were significantly more than the mean scores of the other subscales (P < 0.05). Age, place of residence, marital status, seizure type, seizure frequency, and epilepsy duration significantly predicted 53% of the variance of SM (adjusted R square = 0.532). PWEs have moderate SM and need SM-related education, particularly about lifestyle management and information management. Predictors of SM should be considered to boost SM practice.

The development of a self-management evaluation scale for elderly adults with hypertension based on the capability, opportunity, and motivation-behaviour (COM-B) model

BackgroundUsing accurate assessment tools to assess patients in clinical practice is important to mining influencing factors and implementing interventions. However, most evaluation tools for the self-management of elderly patients with hypertension lack a theoretical basis and wide applicability, which makes the intervention effect insignificant.MethodsBased on the Capability, Opportunity, and Motivation-Behaviour (COM-B) model, combined with literature review and qualitative research, a questionnaire item pool was initially formulated; then the initial items were screened and adjusted through expert consultation and pre-testing to form an initial scale. A field survey of 450 elderly hypertensive patients was then performed using the initial scale to test the reliability and validity of the scale. Cronbach’s alpha, test–retest reliability and composite reliability were used to test the reliability of the scale, and the validity of the scale was evaluated from two aspects: content validity and construct validity. The evaluation results of the content validity of the scale by experts were used as the content validity index; the results of exploratory factor analysis and confirmatory factor analysis were used as the structural validity index to further verify the model structure of the scale and develop a formal scale.ResultsThe final self-management scale included 4 dimensions and 33 items. The Scale-Content Validity Index was 0.920. Exploratory factor analysis extracted four factors that explained 71.3% of the total variance. Cronbach’s alpha of the formal scale was 0.867, test–retest reliability was 0.894, and composite reliability of the 4 dimensions were within 0.943 ~ 0.973. Confirmatory factor analysis showed the scale had good construct validity.ConclusionsThe Self-management Capability, Support and Motivation-Behaviour scale for elderly hypertensive patients has good reliability and validity, providing a tool for medical staff to evaluate the self-management level of elderly hypertensive patients.

Development and validation of the Chinese version of the self-management support scale for kidney transplant recipients

BackgroundProviding self-management support to kidney transplant recipients is essential. However, a scale to identify the self-management support they have received is lacking. The purpose of this study is to develop a Self-management Support Scale for Kidney Transplant Recipients (SMSSKTR) and test its psychometric properties.MethodsThis is an instrument development and validation study, which has a three-stage cross-sectional design. In Stage 1, a preliminary item pool was formed using a literature review, semi-structured interviews, and the Delphi method. In Stage 2, six experts were invited to assess content validity. A convenience sample of 313 participants was used to explore the factor structure by using exploratory factor analysis. The test-retest reliability was assessed using the intra-class correlation coefficient (ICC). In Stage 3, two hundred and sixty-five participants were recruited to validate the factor structure by using confirmatory factor analysis. Convergent validity was examined using Spearman’s correlation coefficient. Cronbach’s alpha coefficient and corrected item-total correlation coefficient were used to test the reliability of the entire scale and its dimensions. The study was reported according to the STARD and GRRAS checklists.ResultsAn initial 40-item scale was developed in Stage 1. In Stage 2, three factors with 22 items emerged from the exploratory factor analysis: instrumental support, psychosocial support, and relational support. The content validity index of the scale was 0.97. The intra-class correlation coefficient for the entire scale and the subscales were 0.915, 0.771, 0.896, and 0.832, respectively. In Stage 3, the confirmatory factor analysis indicated that the three-factor model had a good fit. The score of the scale was positively associated with that of the Self-Management Scale of Renal Transplant Recipients (r = 0.532). Cronbach’s alpha was 0.959 for the entire scale and 0.956–0.958 for the three subscales. The corrected item-total correlation coefficient ranged from 0.62 to 0.82.ConclusionThe 22-item SMSSKTR has sufficient psychometric properties to assess the self-management support they have received, which has not been measured before.

NURSE AND PATIENT PERCEPTION IN SELF-MONITORING OF DAWN EFFECT TO ENHANCE SELF-MANAGEMENT IN DIABETES MELLITUS PATIENT’S: A QUALITATIVE CASE STUDY

Background: A phenomenon in diabetes mellitus patients is called dawn effect, the condition of hyperglycemia suddenly increasing insulin requirement in the morning caused by nonattendance of nighttime hypoglycemia. Self-monitoring can be minimizing the impacts of dawn effect. Self-management can be actualized to oversee the blood glucose levels fluctuation in diabetes mellitus patients. Objective: to gain self-monitoring influencing factors of dawn effect phenomenon, and increase self-management in diabetic patient and nurse knowledge in Temanggung, Central Java Methods: A qualitative study design was used in this research with semi-structured interviews and open-ended questions. Participants were selected using purposive sampling technique from primary healthcare and secondary healthcare of both nurse and patient. Twelve participants consisted of senior nurse (n=5), patients with type 2 diabetes mellitus (n=7). Information of psychometric diabetes self-management scale and blood glucose monitoring were day by day collected within the morning. Result: Nurses' perception of the dawn effect is still relatively low due to a lack of knowledge and competence in self-management of diabetes patients. They followed the doctor's advice. In addition, the patient's perspective of blood glucose monitoring was taken into account, despite the fact that they did not have a glucometer from a mobile device (lack of self-management and dawn effect). Furthermore, all participants (n=7) increase in blood glucose level in the morning. Invasive glucometer has a high accuracy, but inducing finger discomfort, uncomfortable, and increase risk of infection when it checked daily. Conclusion: Perceptions of nurse and patient about self-monitoring can improve patient self-management and prevent the occurrence of dawn effects.

The Risk Factors of Self-Management Behavior among Chinese Stroke Patients.

Stroke is associated with a high number of disability-adjusted life years globally, so long-term care is necessary and important for those survivors, so self-management is becoming a more significant concept in stroke rehabilitation. Ischemic stroke patients (n = 354) were enrolled from the outpatient department of Neurology in West China Hospital from September 2018 to December 2019. The general demographic and disease-related data of stroke patients were collected. The stroke self-efficacy questionnaire (SSEQ), the brief cognition questionnaire (BIPQ), and the stroke self-management scale (SSMS) were used to collect data on self-efficacy, disease cognition, and self-management behavior separately. The chi-square test, Fisher exact test, independent sample t-test, and Mann-Whitney U test were used for comparison among groups. The logistic regression analysis was used to explore the independent risk factors of the different levels of self-management behavior in stroke patients. The score of self-management among Chinese stroke patients was 151.07 ± 18.53. Multivariate analysis showed that the way of paying medical expenses (OR = 3.215, 95% CI (1.130, 7.769)), self-management efficacy (OR = 2.467, 95% CI (1.534, 3.968)), health education before discharge (OR = 2.354, 95% CI (1.457, 3.802)), age (elder) (OR = 2.060, 95% CI (1.265, 3.355)), educational level (OR = 1.869, 95% CI (1.169, 2.988)), and mRS score (OR = 1.850, 95% CI (1.129, 3.031)) were statistically significant (P < 0.05). The self-management behavior of Chinese stroke patients was at the middle level. Patients with medical insurance, high self-efficiency of management, and better limb function may have better self-management behavior. Besides, patients with a high educational level who accept health education before discharge may also have better self-management behavior. For patients, it is important to know this disease in the right way and set up the faith to take care of themselves independently gradually. For medical staff, it is necessary and important to give all patients health education about self-management before discharge. It is urgent to call for attention to this disease, and the government and all of society should give more support to stroke patients.

Translation and Psychometric Evaluation of the Partners in Health Scale Among Iranian Adults With Chronic Diseases

Objectives: Characterizing the psychometric attributes of the Persian variant of partners in health (PIH) in multiple sclerosis (MS), Diabetes, and Low Back Pain (LBP) patients. Methods: In this cross-sectional study, 183 MS, diabetes, and LBP patients (70 male, 113 female) were treated with PIH post-forward-backward translation. Confirmatory factor analysis was used for studying the factor structure. Cronbach’s α and McDonald’s Ω coefficients were used to analyze PIH internal consistency. We used an interclass correlation coefficient to evaluate test-retest reliability. Criterion validity was determined by studying the correlation of PIH and Short Form (36) Health Survey (SF-36), Diabetes Self-Management Scale (DSMS), and Self-Efficacy in Chronic Disease Self-Management (SES6G). Results: The median age of the participants was 49.73±15.16 years, 113 (61.75%) of them were female, 64 (35.0%) had MS, 66 (36.1%) had diabetes, and 53 (29.0%) had LBP. Content validity was determined across all areas (clarity, relevancy, simplicity) by a content validity index ≥0.82. Additionally, all items were confirmed via a content validity ratio ≥0.78. The outcome of CFA depicts that the statistics presented as model fit were as follows: CFI= 0.938, NFI= 0.899, and RMSEA= 0.085. All PIH items exhibited valid internal consistency (0.886-0.893). The PIH showed sufficient test-retest reliability regarding its corresponding subscales (0.554-0.679). The construct validity was confirmed by the total scores of PIH correlated with the total score of SF-36, SES6G, and DSMS. Discussion: The Persian variant of the PIH showed sufficient validity and reliability as a measure to assess self-management in patients suffering from chronic disease (MS, diabetes, and LBP).