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Role of self-care in management of diabetes mellitus.  


Diabetes mellitus (DM) is a chronic progressive metabolic disorder characterized by hyperglycemia mainly due to absolute (Type 1 DM) or relative (Type 2 DM) deficiency of insulin hormone. World Health Organization estimates that more than 346 million people worldwide have DM. This number is likely to more than double by 2030 without any intervention. The needs of diabetic patients are not only limited to adequate glycemic control but also correspond with preventing complications; disability limitation and rehabilitation. There are seven essential self-care behaviors in people with diabetes which predict good outcomes namely healthy eating, being physically active, monitoring of blood sugar, compliant with medications, good problem-solving skills, healthy coping skills and risk-reduction behaviors. All these seven behaviors have been found to be positively correlated with good glycemic control, reduction of complications and improvement in quality of life. Individuals with diabetes have been shown to make a dramatic impact on the progression and development of their disease by participating in their own care. Despite this fact, compliance or adherence to these activities has been found to be low, especially when looking at long-term changes. Though multiple demographic, socio-economic and social support factors can be considered as positive contributors in facilitating self-care activities in diabetic patients, role of clinicians in promoting self-care is vital and has to be emphasized. Realizing the multi-faceted nature of the problem, a systematic, multi-pronged and an integrated approach is required for promoting self-care practices among diabetic patients to avert any long-term complications. PMID:23497559

Shrivastava, Saurabh Rambiharilal; Shrivastava, Prateek Saurabh; Ramasamy, Jegadeesh



The effectiveness of a self-care intervention for the management of postpartum fatigue  

Microsoft Academic Search

The purpose of this study was to test the effectiveness of the Tiredness Management Guide (TMG) as a self-care intervention for the management of postpartum fatigue from the second to the sixth week postpartum. An experimental repeated measures analysis of variance design was used with a sample of 68 primiparous mothers. Interaction effects between group membership and time in the

Nancy Wieland Troy; Peggy Dalgas-Pelish



SMS reminders- future in self-care management of diabetes mellitus?  


Application of SMS in reminders of medical appointments and delivering medical tests is not new, however its focus on clinical interventions has just begun. Usage of tailored SMS reminders to increase adherence in treatment programs among sick individuals has allowed an interventional role in self-care management of Diabetes Mellitus (DM). PMID:22762775

Riaz, Talha; Riaz, Haris; Hussain, Syed A; Kherani, Danish



Promoting Self-Care Management among Persons with Serious Mental Illness and HIV  

PubMed Central

People with a serious mental illness (SMI) along with HIV have complex health conditions. This population also has high rates of poverty, difficulty in sustaining regular housing, and limited supportive networks. Typically, the combination of psychotropic and HIV medication regimens is complicated, changes frequently, and requires coordination among multiple providers. Furthermore, fragmented and divided primary health care and mental health care systems present substantial barriers for these individuals and for the public health nurses who care for them. In this paper, we present “real world” case studies of individuals with SMI and HIV and the self-care management strategies used by nurses to address medication and treatment management, build interpersonal skills, and develop sustainable health networks. The case studies can be used for quality improvement discussions among practicing public health nurses and for instructing nursing students in a self-care management approach.

Hanrahan, Nancy P.; Rolin-Kenny, Donna; Roman, June; Kumar, Aparna; Aiken, Linda; Blank, Michael



Diabetes Management and Self-Care Education for Hospitalized Patients With Cancer  

PubMed Central

Managing diabetes can be a daunting task for patients with cancer. Empowerment-based diabetes education and motivational interviewing are complementary approaches. Oncology nurses may feel unprepared to teach patients and their families about self-care for diabetes, but they provide individualized information on symptom management of cancer throughout hospitalization and at discharge. The essential self-care issues include food, exercise, medication, blood glucose monitoring, prevention, recognition and treatment of hypoglycemia and hyperglycemia, and when and how to get additional medical and educational support. This patient-centered model of diabetes education differs from the older “compliance” model that covers many universal rules for all patients, which are predetermined by the nurse. Informing nurses about their role in care of patients with cancer and diabetes is critical.

Leak, Ashley; Davis, Ellen D.; Houchin, Laura B.; Mabrey, Melanie



[Waste management as part of self-care: an in-hospital training?].  


As a health care professional, I feel concerned by the gap existing between urban and hospital practice concerning the management of waste, even when it is the same objects which are disposed. In the daily practice of the hospital care givers, the patients' education is mainly focused on the prevention measures or the care techniques to be adopted. The waste dumping modes are very seldom taken in consideration, despite the fact that everybody is afraid at the discovery of care material abandoned in a public place. That is why the following hypothesis was formulated: "The better the patient is educated, the better he will manage his self-care waste." The methods used for this diploma work are the documentary research and the investigation interviews with all the actors in and out of the hospital concerned by the patients' education and/or the management of care waste. The pilot study was conducted by means of enquiry questionnaires. It was focused on the hospital care givers and on the insulin-dependent diabetic patients who practice their self-care, through the enquiry technique "before-after" The aims of this research were to assess the quality of the education given by the hospital care giving staff on the management of self-care waste and the impact of this training on the patients. The drawing up of a system of reference (at the end of this research investigation work) should enable the improvement of the present situation. The small size of the sample used for the pilot study did not enable us to invalidate or confirm our working hypotheses. But the results obtained during out pilot study showed the bad quality of the training given by the hospital care givers and the inadequacy of the patients' procedure. That is why our professional project is based on an updating of the knowledge of the hospital care givers for the management of the self-care material in order to improve the quality of the care given by a hospital team and its adequation to the needs of the population at which it is aimed. PMID:10897743

Delpech, A



Older Adults' Self-Management of Daily Symptoms: Complementary Therapies, Self-Care, and Medical Care  

PubMed Central

Objectives To describe older adults' use of complementary therapies, self-care practices, and medical care to treat daily symptoms and to delineate gender, ethnic, age, and education differences. Method A total of 200 African American and White participants (age 65+) selected using a site-based procedure complete a baseline interview and up to six sets of three daily follow-up interviews at monthly intervals. The percent of older adults using a therapy and the frequency with which therapies are used are considered. Results The use of complementary therapies to treat daily symptoms, though important, is substantially less than the use of self-care practices and medical care. Participants differed by age, ethnicity, and education in the use of therapies. Discussion In considering the percentage of individuals who use a therapy and the frequency with which therapies are used, this analysis adds a new dimension to understanding how older adults manage daily symptoms. Older adults are selective in their use of health self-management.

Arcury, Thomas A.; Grzywacz, Joseph G.; Neiberg, Rebecca H.; Lang, Wei; Nguyen, Ha; Altizer, Kathryn; Stoller, Eleanor P.; Bell, Ronny A.; Quandt, Sara A.



Self-management intervention to improve self-care and quality of life in heart failure patients.  


Self-management intervention is a good method to improve self-care ability, as such, to promote quality of life. However, the research focused on self-management intervention in heart failure patients in Taiwan is very limited. Therefore, the purposes of this study were to test the effectiveness of self-management intervention in patients with heart failure in Taiwan and examine the relationship between self-care ability and quality of life. A quasi-experimental design was used in this study with convenience sampling. Of the 82 subjects participating in this study, 40 of them chose to join the experimental (self-management intervention plus usual care) and 42 of them chose to join control (usual care) group. Three questionnaires were used to collect the data, which were the demographic questionnaire, the self-care questionnaire (Self-Care of HF Index V 6), and the quality of life questionnaire (Minnesota Living with Heart Failure Questionnaire). To examine the effectiveness of the intervention, self-care ability and quality of life were measured, using a pretest, 1- and 2-month follow-up assessment. Generalized estimation equations (GEE) were used to compare changes over time among groups for outcomes to ensure the effectiveness of the intervention. This study confirmed the effectiveness of the self-management intervention. The clinical provider should increase the awareness of the importance of self-management skills and self-care ability especially for heart failure patients. The designated disease-specific self-management patient book and individualize intervention should be dispensing and implementing. PMID:23279120

Tung, Heng-Hsin; Lin, Chun-Yu; Chen, Kuei-Ying; Chang, Chien-Jung; Lin, Yu-Ping; Chou, Cheng-Hui



Managing Mental Health Problems in Everyday Life: Drug Treatment Clients’ Self-Care Strategies  

Microsoft Academic Search

Little is understood about the self-care activities undertaken by drug treatment clients. Using data from a qualitative study\\u000a of drug treatment and mental health we identify the self-care practices of drug treatment clients diagnosed with anxiety and\\u000a depression. Seventy-seven participants were interviewed in four sites across Australia. Participants described a range of\\u000a self-care practices for mental health including: self-medication, seeking

Martin Holt; Carla Treloar



Managing Mental Health Problems in Everyday Life: Drug Treatment Client's Self-Care Strategies  

ERIC Educational Resources Information Center

|Little is understood about the self-care activities undertaken by drug treatment clients. Using data from a qualitative study of drug treatment and mental health we identify the self-care practices of drug treatment clients diagnosed with anxiety and depression. Seventy-seven participants were interviewed in four sites across Australia.…

Holt, Martin; Treloar, Carla



Managing Mental Health Problems in Everyday Life: Drug Treatment Client's Self-Care Strategies  

ERIC Educational Resources Information Center

Little is understood about the self-care activities undertaken by drug treatment clients. Using data from a qualitative study of drug treatment and mental health we identify the self-care practices of drug treatment clients diagnosed with anxiety and depression. Seventy-seven participants were interviewed in four sites across Australia.…

Holt, Martin; Treloar, Carla



Symptom management and self-care for peripheral neuropathy in HIV\\/AIDS  

Microsoft Academic Search

Peripheral neuropathy is the most common neurological complication in HIV and is often associated with antiretroviral therapy. As part of a larger study on self-care for symptoms in HIV disease, this study analyzed the prevalence and characteristics of peripheral neuropathy in HIV disease, sociodemographic and disease-related correlates and self-care strategies. A convenience sample of 1,217 respondents was recruited from data

P. K. Nicholas; J. K. Kemppainen; G. E. Canaval; I. B. Corless; E. F. Sefcik; K. M. Nokes; C. A. Bain; K. M. Kirksey; L. Sanzero Eller; P. J. Dole; M. J. Hamilton; C. L. Coleman; W. L. Holzemer; N. R. Reynolds; C. J. Portillo; E. H. Bunch; D. J. Wantland; J. Voss; R. Phillips; Y.-F. Tsai; M. Rivero Mendez; T. G. Lindgren; S. M. Davis; D. M. Gallagher



Self-care management practices for the home health nurse: staying hale and hearty through enhanced self-care and ergonomics--with a case study.  


Ergonomics provides a broad framework for home healthcare nurses to improve their individual physical, psychological, cognitive, and spiritual well-being through application of models for self-care planning. As the individual becomes stronger, more resilient and work hardy, the benefits to the individual, along with the work organization and ultimately the clients, grow exponentially. This article seeks to explore the relevant ergonomic domains and assist home healthcare nurses to develop self-care planning practices that lead to healthy lifestyles and improved quality of life. PMID:22565351

Hitt, Jennifer M; Tatum, Eva; McNair, Mary; Harrington, Marilyn; Stanton, Sandra D; Askew, Rebecca; Lofton, Susan; Walker, Jean T; Robertson, Amy



Psychosocial factors associated with poor diabetes self-care management in a specialized Center in Mexico City  

Microsoft Academic Search

To examine the relationship between demographic, clinical and psychosocial variables and diabetes self-care management in Mexican type 2 diabetic patients. Cross-sectional study of 176 consecutive patients with type 2 diabetes aged 30–75 years, attending a tertiary health-care center in Mexico City. A brief medical history and previously validated questionnaires were completed. The study group consisted of 64 males\\/112 females, aged 55

Israel Lerman; Liliana Lozano; Sergio Hernández-Jiménez; Katie Weinger; Carlos Aguilar Salinas; Maria Luisa Velasco; Francisco Javier Gómez-Pérez



Transforming hypertension management using mobile health technology for telemonitoring and self-care support.  


Achieving and sustaining good blood pressure control continues to be a challenge for many reasons including nonadherence with prescribed treatment and lifestyle measures, shortage of primary care physicians especially in less populated areas, and variations in physicians' practice behaviour. Many strategies have been advocated to improve outcomes with the greatest success being achieved using nurse or pharmacist-led interventions in which they were given the authority to prescribe or alter antihypertensive treatment. However, this treatment approach, which historically involved 1-on-1 visits to a doctor's office or pharmacy, proved costly, was not scalable, and did not actively engage patients in treatment decision-making. Several electronic health interventions have been designed to overcome these limitations. Though more patient-centred and often effective, they required wired connections and a personal computer, and logging on for Internet access and navigating computer screens greatly reduced access for many older patients. Furthermore, it is unclear whether the benefits were related to better case management or technological advances. Mobile health (mHealth) technology circumvents the technical challenges of electronic health systems and provides a more flexible platform to enhance patient self-care. mHealth applications are particularly appropriate for interventions that depend on patients' sustained adherence to monitoring schedules and prescribed treatments. Studies from our group in hypertension and other chronic conditions have shown improved health outcomes using mHealth applications that have undergone rigourous usability testing. Nonetheless, the inability of most electronic medical record systems to receive and process information from mobile devices continues to be a major impediment in realizing the full potential of mHealth technology. PMID:23618506

Logan, Alexander G



Cognitive impairment and self-care in heart failure  

PubMed Central

Background Heart failure (HF) is a prevalent chronic disease in older adults that requires extensive self-care to prevent decompensation and hospitalization. Cognitive impairment may impact the ability to perform HF self-care activities. We examined the association between cognitive impairment and adherence to self-care in patients hospitalized for acute HF. Design Prospective cohort study. Setting and participants A total of 577 patients (mean age = 71 years, 44% female) hospitalized for HF at five medical centers in the United States and Canada. Measurements and methods Participants were interviewed for information on self-reported adherence to self-care using the European Heart Failure Self-care Behaviour Scale. We assessed cognitive impairment in three domains (memory, processing speed, and executive function) using standardized measures. Patients’ demographic and clinical characteristics were obtained through medical record review. Multivariable linear regression was used to examine the association between cognitive impairment and self-care practices adjusting for demographic and clinical factors. Results A total of 453 patients (79%) were impaired in at least one cognitive domain. Average adherence to self-care activities among patients with global cognitive impairment did not differ significantly from those without cognitive impairment (30.5 versus 29.6; 45-point scale). However, impaired memory was associated with lower self-care scores (P = 0.006) in multivariable models. Conclusion Cognitive impairment is highly prevalent among older patients hospitalized for HF. Memory impairment is associated with poorer adherence to self-care practices. Screening for memory impairment in patients with HF may help to identify patients at risk for poor self-care who may benefit from tailored disease management programs.

Hajduk, Alexandra M; Lemon, Stephenie C; McManus, David D; Lessard, Darleen M; Gurwitz, Jerry H; Spencer, Frederick A; Goldberg, Robert J; Saczynski, Jane S



Adults with sickle cell disease: an interdisciplinary approach to home care and self-care management with a case study.  


The complexity of caring for adults with sickle cell disease (SCD) strains the confines of a care-segregated medical system. As treatment protocols have dramatically improved since 1990, many patients with SCD are now living well beyond their 6th decade of life. This improved survival rate presents opportunities and challenges for the home healthcare nurse in the management of adult patients with SCD. The home healthcare nurse is essential in the coordination of interdisciplinary health team members to reduce pain episodes and the potentially catastrophic complications of renal failure, pulmonary disease, and cardiovascular events. In addition, the home healthcare nurse serves as patient advocate for the transition from acute care to home, as well as advocate for healthcare maintenance of vision, musculoskeletal involvement, and social and psychological support. This article seeks to provide a viable network for home healthcare nurses to establish self-care management and support of the adult patient with SCD. PMID:22391660

Lee, Lishia; Askew, Rebecca; Walker, Jean; Stephen, Jennifer; Robertson-Artwork, Amy



Averaging of nonlinearity-managed pulses  

SciTech Connect

We consider the nonlinear Schroedinger equation with the nonlinearity management which describes Bose-Einstein condensates under Feshbach resonance. By using an averaging theory, we derive the Hamiltonian averaged equation and compare it with other averaging methods developed for this problem. The averaged equation is used for analytical approximations of nonlinearity-managed solitons.

Zharnitsky, Vadim; Pelinovsky, Dmitry [Department of Mathematics, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801 (United States); Department of Mathematics, McMaster University, Hamilton, Ontario L8S 4K1 (Canada)



Creating 'good' self-managers?: Facilitating and governing an online self care skills training course  

Microsoft Academic Search

BACKGROUND: In chronic disease management, patients are increasingly called upon to undertake a new role as lay tutors within self-management training programmes. The internet constitutes an increasingly significant healthcare setting and a key arena for self-management support and communication. This study evaluates how a new quasi-professional health workforce – volunteer tutors – engage, guide and attempt to manage people with

Anne Kennedy; Anne Rogers; Caroline Sanders; Claire Gately; Victoria Lee



Self care in patients with chronic heart failure. Pilot study - self care includes problems.  


AIM: The goal of this pilot study was to define the scope of therapeutic self-care demand in heart failure (HF) patients according to the concepts of self-care postulated by D.E. Orem and to determine the level of problems experienced and self-care in these patients. METHODS: A questionnaire consisting of 7 areas with closed format questions was developed according to the definition. The level of patient problems and level of self-care actions were mapped in each area. The questionnaire was distributed at the hospital outpatient clinic. The study group consisted of 47 heart failure patients (14 women) with following characteristics: average age 68 years, average BMI 29.4, resynchronization therapy 21%, hypertension 69.8%, diabetes mellitus 25.6%, coronary artery disease 46.5%, dilated cardiomyopathy 46.5%, obesity 46.5%, smoking history 39.5% (present and past smoking together), other cardiac disease 16.28%, condition after myocardial infarction 27.8% (NYHA II 41%, NYHA III 56.8%, NYHA IV 2.2%). RESULTS: The greatest problems were in the area of physical activity, sleep and fatigue, the least were in the area of chest pain and blood circulation. The greatest self-care agency was shown in the area of managing problems with physical activities and sleep, the lowest in the area of liquid intake and output. In the patients' subjective opinion, fatigue and sleep problems had the greatest impact on the quality of life. There were no substantial differences in either area based on gender. CONCLUSIONS: The data can serve as a foundation for modifying the extent and structure of patient education for more comprehensive and more effective out?patient treatment of HF. PMID:23765097

Halmo, Renata; Galuszka, Jan; Langova, Katerina; Galuszkova, Dana



Telehealth for Persons with Severe Functional Disabilities and their Caregivers: Facilitating Self-care Management in the Home Setting  

PubMed Central

Persons with severe functional disabilities are the highest users of health care services. Caring for the needs of this population represents a significant percentage of our national health care costs. A growing body of research has demonstrated the efficacy of self-management strategies and caregiver engagement for effective long-term care for individuals with chronic medical conditions. Economic forces over the past decade have led to new challenges and resulted in major changes in health care delivery resulting in shortened length of inpatient stays and greater limits on the length of outpatient treatment. Telehealth is an innovative method for health care delivery and a means of meeting this new challenge. This paper highlights the findings of three pilot studies on the use of telecommunications technologies in promoting self-care management and enhancing health care outcomes in persons with severe disabilities and their family caregivers. The importance of matching technology to the needs of this population, lessons learned from these investigations, and future directions for research are addressed.

Forducey, Pamela G.; Glueckauf, Robert L.; Bergquist, Thomas; Maheu, Marlene M.; Yutsis, Maya



Creating 'good' self-managers?: Facilitating and governing an online self care skills training course  

PubMed Central

Background In chronic disease management, patients are increasingly called upon to undertake a new role as lay tutors within self-management training programmes. The internet constitutes an increasingly significant healthcare setting and a key arena for self-management support and communication. This study evaluates how a new quasi-professional health workforce – volunteer tutors – engage, guide and attempt to manage people with long-term conditions in the ways of 'good' self-management within the context of an online self-management course. Methods A qualitative analysis of postings to the discussion centre of 11 online classes (purposively selected from 27) run as part of the Expert Patients Programme. Facilitators (term for tutors online) and participants posted questions, comments and solutions related to self-management of long-term conditions; these were subjected to a textual and discursive analysis to explore: a) how facilitators, through the internet, engaged participants in issues related to self-management; b) how participants responded to and interacted with facilitators. Results Emergent themes included: techniques and mechanisms used to engage people with self-management; the process facilitators followed – 'sharing', 'modelling' and 'confirming'; and the emergence of a policing role regarding online disclosure. Whilst exchanging medical advice was discouraged, facilitators often professed to understand and give advice on psychological aspects of behaviour. Conclusion The study gave an insight into the roles tutors adopt – one being their ability to 'police' subjective management of long-term conditions and another being to attempt to enhance the psychological capabilities of participants.

Kennedy, Anne; Rogers, Anne; Sanders, Caroline; Gately, Claire; Lee, Victoria



From Cues to Action: Information Seeking and Exercise Self-Care among Older Adults Managing Chronic Illness  

Microsoft Academic Search

Drawing from the health belief model, cues to action have been theorized to influence health behaviours; however, few studies have examined these constructs explicitly. This study investigated the relationship between information cues to action and exercise self-care. It was hypothesized that reading about illness information, knowing about services, and consulting with others about one’s illness triggers exercise self-care. The sample

Pak Hei Benedito Chou; Andrew V. Wister



Testing a Model of Diabetes Self-Care Management: A Causal Model Analysis with LISREL.  

ERIC Educational Resources Information Center

|A diabetes-management model is presented, which includes an attitudinal element and depicts relationships among causal elements. LISREL-VI was used to analyze data from 115 Type-I and 105 Type-II patients. The data did not closely fit the model. Results support the importance of the personal meaning of diabetes. (TJH)|

Nowacek, George A.; And Others



Self-Care and Health Outcomes of Diabetes Mellitus  

Microsoft Academic Search

Studies show that self-care improves diabetes mellitus (DM) outcomes; however, previous studies have focused on self-care maintenance, and little is known about self-care management. The objective of this study is to examine the influence of DM self-care maintenance and management on number of hospitalizations and hospitalization days. A cohort design with secondary analysis of data from the Health and Retirement

MinKyoung Song; Sarah J. Ratcliffe; Nancy C. Tkacs; Barbara Riegel



Social networks, work and network-based resources for the management of long-term conditions: a framework and study protocol for developing self-care support  

Microsoft Academic Search

Background  Increasing the effective targeting and promotion of self-care support for long-term conditions requires more of a focus on\\u000a patient contexts and networks. The aim of this paper is to describe how within a programme of research and implementation,\\u000a social networks are viewed as being centrally involved in the mobilisation and deployment of resources in the management of\\u000a a chronic condition.

Anne Rogers; Ivaylo Vassilev; Caroline Sanders; Susan Kirk; Carolyn Chew-Graham; Anne Kennedy; Joanne Protheroe; Peter Bower; Christian Blickem; David Reeves; Dharmi Kapadia; Helen Brooks; Catherine Fullwood; Gerry Richardson



Self care in patients with chronic heart failure  

Microsoft Academic Search

'Heart failure self care' refers to the practices in which patients engage to maintain their own health, and to the decisions that they make about managing signs or symptoms. In this article, we base our discussion of self care in chronic heart failure on the classification of patients as being 'expert', inconsistent', or 'novice' in heart failure self-care behaviors. The

Christopher S. Lee; Victoria Vaughan Dickson; Barbara Riegel



Breastfeeding - self-care  


Nursing mothers - self-care ... be safe, but you should consult your health care provider about the possible risks. If you are ... these medications are safe. Check with your health care provider before taking any medications. Do NOT stop ...


Perspectives on Self-Care  

ERIC Educational Resources Information Center

|Self-care for clinicians is much needed. To discover ways to implement self-care into our lives, we (four therapists) tried different self-care methods over a span of one to two weeks. After using practices that explored self-care through mindfulness meditation, autohypnosis, music, and spirituality, we wrote about the outcome of these…

Williams, Isha D.; Richardson, Tenille A.; Moore, Darren D.; Gambrel, Laura Eubanks; Keeling, Margaret L.



Structural role of perceived benefits and barriers to self-care in patients with diabetes  

PubMed Central

Introduction and Goal: In diseases and disorders such as diabetes, treatment and disease management depends mostly on patient's performance. So, self-care is very important in these patients and they can affect their own welfare, functional capabilities, and disease processes by achieving self-care skills. Nowadays, we know that self care follows individual, psychological and social factors which its recognition can assist health care providing systems to carry out educational programs. This study aimed to investigate the role of perceived benefits and barriers in doing self-care behaviors among diabetic patients. Materials and Methods: This study is a narrative review and articles with sectional, cohort, and interventional, clinical trial, qualitative and narrative designs were chosen using databases and academic search engines such as PubMed, SCOPUS, ProQuest, Elsevier and key words like self-care diabetes, perceived benefits and barriers. Persian articles were also selected using databases like IRANMEDEX, MEDLIB, as well as searching the articles in sites of domestic scientific magazines. Results: Reviewed articles’ findings show the average situation of perceived benefits and barriers in diabetic patients regarding self-care. Qualified blood sugar (glucose) control, weight control, happiness feeling and expenses reduction are the most important perceived benefits. The most significant perceived barriers in self-care consist of lack of family support, shame feeling, forgetfulness and not being able to ignore foods’ flavor. Conclusion: Perceived benefits and barriers, as central constructs in some patterns and theories of behavior change, were related to self-care, so that it was directly related to perceived benefits and reversely related to perceived barriers. Therefore, these two constructs can be considered as strategies for promoting self-care behaviors in diabetic patients.

Mohebi, Siamak; Azadbakht, Leila; Feizi, Avat; Sharifirad, Gholamreza; Kargar, Mehdi



Health-seeking behaviors and self-care practices of Dominican women with lymphoedema of the leg: implications for lymphoedema management programs  

PubMed Central

Background In the Dominican Republic, a Latin American country with filariasis-endemic areas, more than 63,000 people have lymphatic filariasis and more than 400,000 people are at risk of future infection. In this paper, we explore the health beliefs, health-seeking behaviors and self-care practices of women with lymphoedema in filariasis-endemic areas to better understand the needs of women when developing lymphoedema morbidity control programs. Methods Qualitative data were collected through semi-structured interviews of 28 women, 3 focus group discussions with 28 women, field notes and photographs. Results Women described exhaustive and expensive attempts at seeking a cure for their lymphoedema. Family members were influential in providing women with initial care seeking referrals to indigenous healers credited with influence over physical, mental, spiritual and supernatural properties of illness. When indigenous treatments proved to be ineffectual, the women sought care from trained healthcare providers. Most healthcare providers incorrectly diagnosed the edema, failed to adequately treat and meet the needs of women and were viewed as expensive. Most women resorted to self-prescribing injectable, oral, or topical antibiotics along with oral analgesics as a standard practice of self-care. Conclusion Healthcare providers must understand a woman's cultural perspectives of illness, her natural networks of support and referral, her behavioural practices of care-seeking and self-care and the financial burden of seeking care. In the culture of the Dominican Republic family members and traditional healthcare providers are influential advisors on initial health-seeking behaviors and self-care practices. For this reason family-oriented interventions, support groups for women and their families, community education and training on simple, low cost lymphoedema management techniques for indigenous healers are viable ways to influence the early detection, diagnosis and treatment of women with lymphoedema. The extensive use of injectable, oral and topical antibiotics by indigenous healers and women without medical supervision suggests a need for health education messages related to the risks of such practices.

Person, Bobbie; Addiss, David G; Bartholomew, L Kay; Meijer, Cecilia; Pou, Victor; van den Borne, Bart



Effects of COPD self-care management education at a nurse-led primary health care clinic.  


Chronic obstructive pulmonary disease (COPD) is disabling, with symptoms such as chronic cough, phlegm, wheezing, shortness of breath and increased infections of the respiratory passage. The aim was to examine the effects of a structured educational intervention programme at a nurse-led primary health care clinic (PHCC) on quality of life (QoL), knowledge about COPD and smoking cessation in patients with COPD. This study had an experimental design in which 52 patients with COPD from a Swedish primary care setting were randomized into two groups (intervention or control). Both groups received standard care but patients in the intervention group were also offered two visits to a nurse specialized in COPD care. The purpose of the visits was to increase the patients' self-care ability and their knowledge about COPD. The study was approved by the local Research Ethics Committee. Data were collected using two questionnaires, one pertaining to knowledge about COPD and smoking habits and St. George's Respiratory Questionnaire, addressing how QoL was affected by the patients' respiratory symptoms. The intervention and control groups answered both questionnaires on their first and last visits to the PHCC. A statistically significant increase was noted in the intervention group on QoL, the number of patients who stopped smoking and patients' knowledge about COPD at the follow-up, 3-5 months after intervention. However, a confounding factor may have been that one of the researchers (Eva Osterlund Efraimsson), as a nurse in the PHCC, performed the intervention. This implies that patients were in a dependent relationship which may have affected the responses in a favourable direction. Our findings show that conventional care alone did not have an effect on patients' QoL and smoking habits. Instead, the evidence suggests that a structured programme with self-care education is needed to motivate patients for life-style changes. PMID:18489687

Efraimsson, Eva Osterlund; Hillervik, Charlotte; Ehrenberg, Anna



Self-Care Behaviors and Adherence in Diabetes Mellitus.  


Self-care behaviors are essential in managing diabetes. The Diabetes Control and Complications Trial (DCCT) showed that intensive self-care regimens can slow the progression of microangiopathy and delay onset of long-term complications. Increased attention to adherence with specific components of personal regimens is needed to help diabetics achieve maximal benefits. Self-management in terms of medication-taking, self-monitoring, diet, and excercise is inconsistent. Factors contributing to self-care and non-compliance are discussed. Recommendations for enhancing self-care and adherence research are offered. PMID:10320442

Robiner; Keel



Patient self care in acute asthma  

Microsoft Academic Search

Psychosocial and other factors that may affect patient self care in acute asthma were investigated in 210 asthmatic adults recruited from general practice and hospital clinics. Interviews and self complete questionnaires were used to assess patients' management of a hypothetical slow onset and rapid onset attack of asthma, attitudes to asthma, family support, psychiatric morbidity, recent asthma morbidity, and knowledge

B Sibbald



Measures of Diabetic Patient Knowledge, Attitudes and Behavior Regarding Self-Care: Summary Report.  

National Technical Information Service (NTIS)

The report presents research undertaken to identify or develop reliable, valid measures of diabetic patient self-care in the areas of management tasks, patient knowledge of drug self-administration, and patient attitudes about compliance. Self-care topics...

K. H. Marquis J. E. Ware D. A. Relles



Self-Care Communication during Medical Encounters: Implications for Future Electronic Medical Records  

PubMed Central

Objective The growing importance of electronic medical records (EMRs) to healthcare systems is evident, yet the debate concerning their impact on patient-provider communication during encounters remains unresolved. For this study, we hypothesize that providers' use of the EMR will improve patientprovider communication concerning self-care during the medical encounter. Design Cross-sectional, observational study. Setting A primary-care outpatient clinic of the South Texas Veterans Health Care System in San Antonio, TX, USA. Methods A convenience sample of 50 patient/physician encounters was videotaped, transcribed verbatim, and analyzed to determine the time that the physician spent using the EMR and self-care topics discussed. Self-care topics included medication use, recognition of disease symptoms, diet, exercise, management of physical and emotional distress, self-monitoring activities, cigarette smoking, alcohol consumption, and family support/community resources. Two observers independently coded for the kind of self-care topics (kappa = 0.91) using the Atlas.ti software package. Results Encounters averaged 22.6 minutes (range: 5–47, SD = 8.9). We identified two encounter types based on EMR usage: low use (n = 13), with EMR use of two minutes or less, and moderate to high EMR use (n = 37), with EMR use of five minutes or more. Average time for encounters was 25 minutes for moderate to high EMR use encounters and 16 minutes for low EMR use encounters (t test, p < 0.001). Issues pertaining to facets of self-care management were discussed in every physician-patient interaction (100 percent). The most frequently discussed self-care topics were medication use (100 percent), physical distress (76 percent), and disease symptoms (76 percent). Self-monitoring activities, exercise, and diet were discussed in 62 percent, 60 percent, and 46 percent of the 50 encounters respectively. Emotional distress (26 percent), smoking (30 percent), family support/community resources (26 percent), and alcohol consumption (20 percent) were the least discussed issues. Encounters were similar with respect to the kinds of self-care elements discussed. However, EMR use encounters were more likely to include a higher number of self-care topics raised by physicians than low EMR use encounters, particularly on disease symptoms (odds ratio = 4.4, p = 0.05), and physical distress (odds ratio = 7.4, p = 0.006). A significant correlation was observed between the number of self-care elements discussed and time spent on the EMR (r = 0.6, p < 0.05), but no correlation was observed between the length of the encounter and self-care discussion (r = 0.009, p = 0.90). Conclusions The use of an EMR during encounters is associated with an increase in the number of self-care topics raised by physicians. EMRs offer the opportunity to involve patients and physicians in discussion of self-care during patients' visits. Given the current emphasis on the widespread implementation of EMRs, future EMRs should be designed to systematically facilitate the integration of EMRs into clinical exchanges about self-care.

Arar, Nedal H; Wang, Chen-Pin; Pugh, Jacqueline A



Self-care practices of Chinese individuals with diabetes  

PubMed Central

The aim of this study was to investigate the self-care practices of Chinese individuals with diabetes. Data were collected from 163 Chinese individuals with diabetes using a one-to-one interview approach. The Chinese version of the Summary of Diabetes Self-Care Activities (SDSCA) was used to assess diabetes-related knowledge and self-care practices. The majority of participants were aware of the importance of self-care in managing diabetes. However, only 70 participants (43%) scored >50% in the diabetes-related questionnaires. Mean fasting blood glucose (FBG) levels were higher (P<0.04) for participants who had extra meals per day (46%). The majority of participants took oral hypoglycemic agents (OHAs; 60.1%) and some were also treated with OHA-insulin combination therapy (17.8%). Participants with medication adherence (52%) tended to have lower FBG levels. Only 13% of participants practiced self-monitoring of blood glucose (SMBG). The predictors of a knowledge deficit or poor self-care were a low level of education (P<0.01) or old age (older than 53 years old; P=0.002). Deficits in diabetes-related knowledge and self-care practices existed among the majority of patients with suboptimal blood glucose control. The understanding of the importance of self-care practices requires improvement in individuals with diabetes. The development of effective education strategies to improve the awareness of self-care practices by Chinese individuals with diabetes is necessary.




Exploring the contribution of general self-efficacy to the use of self-care symptom management strategies by people living with HIV infection.  


General self-efficacy (GSE), the expectation that one is able to perform a behavior successfully, may differentiate those who are able to successfully utilize self-care symptom management strategies (SCSMS). This subanalysis (n=569) of an international 12 site longitudinal randomized controlled trial (RCT) (n=775), investigated GSE as an important factor determining symptom burden, SCSMS, engagement with the provider, and medication adherence over time, and identified differences in those with high and low GSE ratings concerning these variables. Parametric and nonparametric repeated-measures tests were employed to assess GSE and the perceived effectiveness of SCSMS for anxiety, depression, diarrhea, fatigue, nausea, and neuropathy. Symptom burden, engagement with the provider, and antiretroviral adherence were analyzed with regard to GSE. Our data indicated that there were differences in the perceived symptom burden over time of HIV infected individuals by GSE. Those individuals with higher GSE had fewer symptoms and these symptoms were perceived to be less intense than those experienced by the low GSE group. There were few meaningful differences in the SCSMS used by those with high versus low GSE other than the use of illicit substances in the low GSE group. The low GSE group was also significantly (p=

Corless, Inge B; Wantland, Dean; Kirksey, Kenn M; Nicholas, Patrice K; Human, Sarie; Arudo, John; Rosa, Maria; Cuca, Yvette; Willard, Sue; Hamilton, Mary Jane; Portillo, Carmen; Sefcik, Elizabeth; Robinson, Linda; Bain, Cathy; Moezzi, Shanaz; Maryland, Mary; Huang, Emily; Holzemer, William L



Self-care: a foundational science.  


Further development of conceptual elements of the theory of self-care, one of the three constituent theories of Orem's self-care deficit theory of nursing, is reported. Five content areas of a practical science of self-care are identified; one content area, self-care requisites, is refined and developed. The nature of self-care requisites is reformulated; guides and standards for the expression of self-care requisites, examples of expressed self-care requisites, and a self-care practice guide are described. These developments are illustrated using the example of the requisite to maintain an adequate fluid intake. PMID:11873354

Denyes, M J; Orem, D E; Bekel, G; SozWiss



Randomised controlled trial to determine the benefit of daily home-based exercise in addition to self-care in the management of breast cancer-related lymphoedema: a feasibility study.  


Exercise is considered to be a key aspect of lymphoedema treatment, although there is little evidence for the therapeutic effect of exercise in managing breast cancer-related lymphoedema (BCRL). This small randomised controlled trial (RCT) was designed to determine the feasibility, prior to undertaking a larger RCT, of researching a daily home-based exercise programme to treat stable BCRL. An experimental design compared the exercise intervention combined with standard lymphoedema self-care to self-care alone over a 6-month period. Twenty-three women with stable unilateral BCRL of ?10 % excess limb volume (ELV) were randomly allocated to a daily home-based exercise programme and self-care (n?=?11) or self-care measures alone (n?=?12). The primary objective was to determine difference in limb volume reduction for the two groups. Secondary objectives were to monitor change in other areas that impact BCRL: quality of life, arm function and range of shoulder movement. All 23 women completed the trial, providing full data for each time point. The intervention group showed a clinically and statistically significant improvement in relative ELV at week 26 (95 % confidence interval (CI) -26.57 to -5.12), whereas the control group improvement crossed the line of no effect (95 %CI -17.71 to 1.1). This study demonstrated the feasibility of conducting a RCT of exercise as a therapeutic intervention in the management of BCRL. Although the sample was small, the results support the findings of other exercise studies which have shown trends towards improvement. PMID:23073712

Jeffs, Eunice; Wiseman, Theresa



Self-Care Among Chronically Ill African Americans: Culture, Health Disparities, and Health Insurance Status  

PubMed Central

Little is known about the self-care practices of chronically ill African Americans or how lack of access to health care affects self-care. Results from a qualitative interview study of 167 African Americans who had one or more chronic illnesses found that self-care practices were culturally based, and the insured reported more extensive programs of self-care. Those who had some form of health insurance much more frequently reported the influence of physicians and health education programs in self-care regimens than did those who were uninsured. It is concluded that the cultural components of self-care have been underemphasized, and further, that the potential to maximize chronic illness management through self-care strategies is not realized for those who lack access to health care.

Becker, Gay; Gates, Rahima Jan; Newsom, Edwina



The effect of low literacy on the self-care behaviors of men receiving radiation therapy.  


Using Orem's theory as the framework, two purposes guided the study: (a) to test the effectiveness of an audio-visual education program and behavioral contracting to promote self-care behaviors in managing radiation side effects and (b) to determine the extent to which low literacy affects self-care abilities. Seventy men diagnosed with prostate cancer participated in this experimental study. The nursing interventions of education and behavioral contracting significantly increased the self-care behaviors of men in managing radiation side effects. An increase in self-care behaviors was especially shown in men with low-literacy skills. PMID:20871005

Wilson, Feleta L; Mood, Darlene; Nordstrom, Cheryl K; Risk, Joanne



Self-care in people with long term health problems: a community based survey  

Microsoft Academic Search

Background  Self-care is a key component of current policies to manage long term conditions. Although most people with long-term health\\u000a problems care for themselves within lay networks, consultation rates for long-term undifferentiated illness remain high. Promotion\\u000a of self-care in these individuals requires an understanding of their own self-care practices and needs to be understood in\\u000a the context of health care pluralism.

Fiona MacKichan; Charlotte Paterson; William E Henley; Nicky Britten



Varicose and other vein problems - self-care  


Venous insufficiency- self-care; Venous stasis ulcers - self-care; Lipodermatosclerosis - self-care ... These problems usually get worse over time. Learn self-care that you can do at home to: Slow ...


Health Literacy and Self-Care of Patients with Heart Failure  

PubMed Central

Background and Research Objective Today’s complex health care system relies heavily on sophisticated self-care regimens. To navigate the system and follow self-care protocols, patients must be able to understand and use health information, which requires health literacy. However, nearly 90 million Americans lack the necessary health literacy skills to adequately care for themselves in the face of a complex healthcare system and self-care regimens. Understanding how to effectively care for one’s self is thought to improve heart failure symptoms and patient outcomes, but little is actually known about how health literacy influences self-care in patients with heart failure. The purpose of this pilot study was to examine the relationship between health literacy and self-care of patients with heart failure. Subjects and Methods Patients with a diagnosis of heart failure were recruited from a variety of community settings. Participants completed the Short-Form Test of Functional Health Literacy (measured health literacy), the Self-Care Index of Heart Failure (measured self-care maintenance, management, and confidence), and a demographic questionnaire. Spearman’s Rho correlations were used to assess the strength of the relationship between health literacy level and self-care scores. Results and Conclusions Among the 49 participants recruited, health literacy was positively related to self-care maintenance (Rs=0.357, p=0.006). Health literacy had a negative relationship with self-care management (Rs=?0.573, p=0.001). There was no association between health literacy and self-care confidence (Rs=0.201, p=0.083). This project provides preliminary data regarding the association between health literacy and self-care in heart failure, showing support for higher health literate patients performing more self-care maintenance, which has been shown to improve patient outcomes in heart failure. Patients with higher health literacy trended toward having greater self-care confidence, which can increase the likelihood of performing self-care, but this finding was not significant. It was unexpected to find that lower health literate patients performed more self-care management.

Chen, Aleda M. H.; Yehle, Karen S.; Plake, Kimberly S.; Murawski, Matthew M.; Mason, Holly L.



[Hospital discharge preparation: enhancing self-care competence of patients after minimally invasive hip arthroplasty].  


Increasing numbers of hip replacement implant surgeries in Switzerland today are minimally invasive. Patients undergoing such procedures become mobile faster and are discharged from hospital to home within an average of four days. Using a qualitative descriptive design, this study examined how post-operative self-care is taught to patients in the orthopaedic department of a rehabilitation hospital after a minimally invasive hip arthroplasty and explored ways to optimise such teaching methods. Data were collected by conducting three focus groups with nine nursing professionals and expert interviews with the chief surgeon and the assigned physiotherapist. Data were analysed by using qualitative content analysis procedures. Results showed that teaching to enhance self-care competence of patients was not carried out systematically. Instead, the primary focus was to inform and prescribe rather than empower patients. Empowerment, however, would be necessary to assure adherence to the treatment regime. Hospital discharge often takes place surprisingly early and prevents assessment-based counselling of patients. The researchers concluded that the introduction of the minimally invasive surgical technique requires that the multidisciplinary rehabilitation team adapts its teaching methods. Self-care confidence in patients should be enhanced by following participatory clinical pathways. This demands modification in discharge and rehabilitation teaching plans to make them patient-oriented, and the plans should be supported by the entire team and the management. PMID:24088649

Schärli, Marianne; Hantikainen, Virpi; Bischofberger, Iren



Preparing Kids for Self-Care. Strong Families: Competent Kids. Family Workshop Leader's Guide.  

ERIC Educational Resources Information Center

|A program called Strong Families: Competent Kids was developed in response to the growing number of latchkey kids. The goals of the program are to help parents determine when their children are ready for self-care and to provide children with skills to manage self-care safely and confidently. It does not advocate that children should be left in…

Prince William Cooperative Extension Service, Manassas, VA.


Marijuana Effectiveness as an HIV Self-Care Strategy  

Microsoft Academic Search

Persons living with HIV\\/AIDS use self-care for symptom management. This study assesses the use of marijuana as a symptom management approach for six common symptoms for persons living with HIV\\/AIDS--anxiety, depression, fatigue, diarrhea, nausea, and peripheral neuropathy. This sub-analysis of the efficacy of a symptom management manual encompasses the experiences of participants from sites in the U.S., Africa, and Puerto

Inge B. Corless; Teri Lindgren; William Holzemer; Linda Robinson; Shahnaz Moezzi; Kenn Kirksey; Christopher Coleman; Yun-Fang Tsai; Lucille Sanzero Eller; Mary Jane Hamilton; Elizabeth F. Sefcik; Gladys E. Canaval; Marta Rivero Mendez; Jeanne K. Kemppainen; Eli H. Bunch; Patrice K. Nicholas; Kathleen M. Nokes; Pamela Dole; Nancy Reynolds



Dorthea Orem's self care theory as related to nursing practice in hemodialysis.  


Dorthea Orem believed that people have a natural ability for self care, and nursing should focus on affecting that ability. Using a literature search of studies involving adults receiving hemodialysis for end stage renal disease (ESRD) in an outpatient dialysis setting and self-care/management publications in peer-reviewed journals and dissertations, this article explores the implementation of Dorthea Orem's Self Care Theory in the hemodialysis setting, considering the ways it relates to a population in which self-management is critical for patients' positive quality of life, nurses' ability to promote self care for this population, and potential health outcomes. In order to maximize the health of patients with ESRD, considerable lifestyle changes must be made. As healthcare professionals who provide direct care, nurses can assist with these changes by providing educational opportunities and strategies that increase self-care agency, thus making a positive impact on patient quality of life. PMID:19715109

Simmons, Laurie


Spirituality and self care: Expanding self-care deficit nursing theory  

Microsoft Academic Search

The purpose of this study was to extend the theory of self-care deficit nursing by including specific constructs of religion, spirituality, and spiritual self-care practices within the structure suggested by Orem's self-care deficit nursing theory. Based on an extensive literature review, practice experience, and a discovery theory-building approach, a new mid-range theory called White's theory of spirituality and spiritual self-care

Mary Louise White



Spirituality And Spiritual Self-Care: Expanding Self-Care Deficit Nursing Theory  

Microsoft Academic Search

The purpose of this study was to extend the theory of self-care deficit nursing by including specific constructs of religion, spirituality, and spiritual self-care practices within the structure suggested by Orem's self-care deficit nursing theory. Based on an extensive literature review, practice experience, and a discovery theory-building approach, a new mid-range theory called White's theory of spirituality and spiritual self-care

Mary Louise White



Self-care coping strategies in people with diabetes: a qualitative exploratory study  

PubMed Central

Background The management of diabetes self-care is largely the responsibility of the patient. With more emphasis on the prevention of complications, adherence to diabetes self-care regimens can be difficult. Diabetes self-care requires the patient to make many dietary and lifestyle changes. This study will explore patient perceptions of diabetes self-care, with particular reference to the burden of self-care and coping strategies among patients. Methods A maximum variation sample of 17 patients was selected from GP practices and diabetes clinics in Ireland to include patients with types 1 and 2 diabetes, various self-care regimens, and a range of diabetes complications. Data were collected by in-depth interviews; which were tape-recorded and transcribed. The transcripts were analysed using open and axial coding procedures to identify main categories, and were reviewed by an independent corroborator. Discussion of the results is made in the theoretical context of the health belief, health value, self-efficacy, and locus of control frameworks. Results Patients' perceptions of their self-care varied on a spectrum, displaying differences in self-care responsibilities such as competence with dietary planning, testing blood sugar and regular exercise. Three patient types could be distinguished, which were labeled: "proactive manager," a patient who independently monitors blood glucose and adjusts his/her self-care regime to maintain metabolic control; "passive follower," a patient who follows his/her prescribed self-care regime, but does not react autonomously to changes in metabolic control; and "nonconformist," a patient who does not follow most of his/her prescribed self-care regimen. Conclusion Patients have different diabetes self-care coping strategies which are influenced by their self-care health value and consequently may affect their diet and exercise choices, frequency of blood glucose monitoring, and compliance with prescribed medication regimens. Particular attention should be paid to the patient's self-care coping strategy, and self-care protocols should be tailored to complement the different patient types.

Collins, Margaret M; Bradley, Colin P; O'Sullivan, Tony; Perry, Ivan J



The Association Between Self-Efficacy and Hypertension Self-Care Activities Among African American Adults  

PubMed Central

Chronic disease management requires the individual to perform varying forms of self-care behaviors. Self-efficacy, a widely used psychosocial concept, is associated with the ability to manage chronic disease. In this study, we examine the association between self-efficacy to manage hypertension and six clinically prescribed hypertension self-care behaviors. We interviewed 190 African Americans with hypertension who resided in the greater metropolitan Charlotte area about their self-efficacy and their hypertension self-care activities. Logistic regression for correlated observations was used to model the relationship between self-efficacy and adherence to hypertension self-care behaviors. Since the hypertension self-care behavior outcomes were not rare occurrences, an odds ratio correction method was used to provide a more reliable measure of the prevalence ratio (PR). Over half (59%) of participants reported having good self-efficacy to manage their hypertension. Good self-efficacy was statistically significantly associated with increased prevalence of adherence to medication (PR = 1.23, 95% CI: 1.08, 1.32), eating a low-salt diet (PR = 1.64, 95% CI: 1.07–2.20), engaging in physical activity (PR = 1.27, 95% CI: 1.08–1.39), not smoking (PR = 1.10, 95% CI: 1.01–1.15), and practicing weight management techniques (PR = 1.63, 95% CI: 1.30–1.87). Hypertension self-efficacy is strongly associated with adherence to five of six prescribed self-care activities among African Americans with hypertension. Ensuring that African Americans feel confident that hypertension is a manageable condition and that they are knowledgeable about appropriate self-care behaviors are important factors in improving hypertension self-care and blood pressure control. Health practitioners should assess individuals’ self-care activities and direct them toward practical techniques to help boost their confidence in managing their blood pressure.

Seymour, Rachel B.; Brunner Huber, Larissa R.



The association between self-efficacy and hypertension self-care activities among African American adults.  


Chronic disease management requires the individual to perform varying forms of self-care behaviors. Self-efficacy, a widely used psychosocial concept, is associated with the ability to manage chronic disease. In this study, we examine the association between self-efficacy to manage hypertension and six clinically prescribed hypertension self-care behaviors. We interviewed 190 African Americans with hypertension who resided in the greater metropolitan Charlotte area about their self-efficacy and their hypertension self-care activities. Logistic regression for correlated observations was used to model the relationship between self-efficacy and adherence to hypertension self-care behaviors. Since the hypertension self-care behavior outcomes were not rare occurrences, an odds ratio correction method was used to provide a more reliable measure of the prevalence ratio (PR). Over half (59%) of participants reported having good self-efficacy to manage their hypertension. Good self-efficacy was statistically significantly associated with increased prevalence of adherence to medication (PR = 1.23, 95% CI: 1.08, 1.32), eating a low-salt diet (PR = 1.64, 95% CI: 1.07-2.20), engaging in physical activity (PR = 1.27, 95% CI: 1.08-1.39), not smoking (PR = 1.10, 95% CI: 1.01-1.15), and practicing weight management techniques (PR = 1.63, 95% CI: 1.30-1.87). Hypertension self-efficacy is strongly associated with adherence to five of six prescribed self-care activities among African Americans with hypertension. Ensuring that African Americans feel confident that hypertension is a manageable condition and that they are knowledgeable about appropriate self-care behaviors are important factors in improving hypertension self-care and blood pressure control. Health practitioners should assess individuals' self-care activities and direct them toward practical techniques to help boost their confidence in managing their blood pressure. PMID:21547409

Warren-Findlow, Jan; Seymour, Rachel B; Brunner Huber, Larissa R



The Association Between Self-Efficacy and Hypertension Self-Care Activities Among African American Adults  

Microsoft Academic Search

Chronic disease management requires the individual to perform varying forms of self-care behaviors. Self-efficacy, a widely\\u000a used psychosocial concept, is associated with the ability to manage chronic disease. In this study, we examine the association\\u000a between self-efficacy to manage hypertension and six clinically prescribed hypertension self-care behaviors. We interviewed\\u000a 190 African Americans with hypertension who resided in the greater metropolitan

Jan Warren-FindlowRachel; Rachel B. Seymour; Larissa R. Brunner Huber


Self-Care and Professionally Guided Care in Osteoarthritis  

PubMed Central

Objective The aim of this study was to examine the prevalence of self-management practices among older White and African American persons with osteoarthritis. Self-management was defined broadly to include all behaviors adopted to reduce morbidity, whether recommended by physicians or not. Methods A population-based sample of Medicare beneficiaries (n = 551) was recruited. An expanded set of self-management behaviors using structured and open-ended inquiry, along with use of arthritis-specific medications was elicited. Results Few differences in self-care behaviors between race groups were found. However, older African American persons were significantly less likely to have prescriptions for nonsteroidal anti-inflammatory agents (NSAIDs) and more likely to use over-the-counter nonprescription analgesics. Discussion Older White and African American persons made similar use of self-care strategies to reduce disease morbidity. African Americans without access to prescription pain relievers substituted nonprescription analgesics. A broader view of self-management is valuable for assessing the ways people may move between professionally guided care and self-care.

Albert, Steven M.; Musa, Donald; Kwoh, C. K.; Hanlon, Joseph T.; Silverman, Myrna



Relationship between quality of life and self-care ability in patients receiving hemodialysis  

PubMed Central

BACKGROUND: Although hemodialysis has a therapeutic effect on end stage renal disease (ESRD), these patients encounter many physical, psychological, and social stressful factors that lead to a decrease in their quality of life (QOL). One of the factors that are effective on increasing the QOL is the self-care ability. Review of literature demonstrated a few studies done on different aspects of QOL in ESRD patients under hemodialysis and their relationships with self-care ability in Iran. So, in this research besides determining the quality of life and its dimensions and self-care ability of hemodialysis patients, we evaluated their relationships with each other. METHODS: For this purpose, all hemodialysis patients who had inclusion criteria and were hospitalized in hemodialysis wards of Bonab, Maragheh, and Miandoab hospitals were selected and data were collected by interview using a questionnaire that included three parts, demographic factors, quality of life, and self-care ability. RESULTS: The results indicated that quality of life in 34%, and self-care ability in 78.3% of hemodialysis patients were desirable, and there was a direct and significant relationship between these two variables (p < 0.001, r = 0.4), as self-care ability explained 29% of variance of QOL. In quality of life subsectors, social dimension in 98.3% of patients was desirable, while physical dimension (80%) and psychological dimension (63.5%) in most patients were undesirable. Physical dimension was the most impressible dimension of quality of life in self-care ability whereas self-care ability explained 27% of total variance of physical dimension of QOL. CONCLUSIONS: Nearly two thirds of mentioned patients had no desirable QOL and regarding the positive relationship between QOL and self-care ability, it is suggested that health care planner and managers prepare the condition that through educating and reinforcing self-care ability in these patients improve the QOL in hemodialysis patients.

Heidarzadeh, Mehdi; Atashpeikar, Solmaz; Jalilazar, Tahereh



Psychometric testing of the self-care of heart failure index version 6.2.  


The Self-Care of Heart Failure Index Version 6.2 (SCHFI v.6.2) is widely used, but its psychometric profile is still questioned. In a sample of 659 heart failure patients from Italy, we performed confirmatory factor analysis (CFA) to test the original construct of the SCHFI v.6.2 scales (Self-Care Maintenance, Self-Care Management, and Self-Care Confidence), with limited success. We then used exploratory factor analysis to determine the presence of separate scale dimensions, followed by CFA in a separate sub-sample. Construct validity of individual scales showed excellent fit indices: CFI?=?.92, RMSEA?=?.05 for the Self-Care Maintenance Scale; CFI?=?.95, RMSEA?=?.07 for the Self-Care Management Scale; CFI?=?.99, RMSEA?=?.02 for the Self-Care Confidence scale. Contrasting groups validity, internal consistency, and test-retest reliability were supported as well. This evidence provides a new understanding of the structure of the SCHFI v.6.2 and supports its use in clinical practice and research. © 2013 Wiley Periodicals, Inc. Res Nurs Health 36: 500-511, 2013. PMID:23832431

Vellone, Ercole; Riegel, Barbara; Cocchieri, Antonello; Barbaranelli, Claudio; D'Agostino, Fabio; Antonetti, Giovanni; Glaser, Dale; Alvaro, Rosaria



A Concept Analysis: Assuming Responsibility for Self-Care among Adolescents with Type 1 Diabetes  

PubMed Central

Purpose This concept analysis clarifies “assuming responsibility for self-care” by adolescents with type 1 diabetes. Methods Walker and Avant’s (2005) methodology guided the analysis. Results Assuming responsibility for self-care was defined as a process specific to diabetes within the context of development. It is daily, gradual, individualized to person, and unique to task. The goal is ownership that involves autonomy in behaviors and decision-making. Practice Implications Adolescents with type 1 diabetes need to be assessed for assuming responsibility for self-care. This achievement has implications for adolescents’ diabetes management, short- and long-term health, and psychosocial quality of life.

Hanna, Kathleen M.; Decker, Carol L.



Knowledge on diabetes mellitus in the self care process.  


This descriptive study in the interior of São Paulo aimed to verify diabetes mellitus patients' knowledge about the disease, causes and complications, highlighting its importance in self care. Data were collected through interviews with 84 persons and analyzed through descriptive statistics. Average age was 53.3 +/- 13 years, time of disease 12.9 +/- 9 years and 58% of the participants did not finish basic education. Only 28.6% of the participants gave correct answers to "what is diabetes" and "what are its causes"; 71% were diagnosed without presenting classic symptoms and 64% had already been hospitalized due to an acute or chronic complication. We indicated aspects that turn the learning process more difficult; little knowledge about the disease, its causes and symptoms, thus affecting the prevention and early diagnosis and entailing predisposition towards complications. Furthermore, the interference of biopsychosocial factors in the self care process is highlighted. PMID:17117257

Pace, Ana Emilia; Ochoa-Vigo, Kattia; Caliri, Maria Helena Larcher; Fernandes, Ana Paula Morais


Developing a nurse-led education program to enhance self-care agency in leg ulcer patients.  


Patients with leg ulceration face changing self-care demands associated with the consequences of the disease and treatment. Often patients can manage their self-care for some time, but new therapeutic self-care demands may emerge that require more complex self-care actions. The purpose of this article is to describe the development of a nurse-led education program in North-Rhine Westphalia, Germany, that aims to help patients with leg ulcers to meet their therapeutic self-care demands. Orem's self-care deficit nursing theory is used as a framework to provide the conceptual context for this supportive-educative nursing system that is being tested in a multi-site clinical trial. PMID:18378825

Herber, Oliver R; Schnepp, Wilfried; Rieger, Monika A



Self-Care Recommendations of Middle-Aged and Older Adults with Sickle Cell Disease  

PubMed Central

Self-care management is an important part of living with a chronic illness. Sickle cell disease (SCD) is a chronic disease with acute, painful exacerbations that often results in a shortened life expectancy. Some middle-aged and older adults with SCD lived with the disease prior to having a diagnosis and without modern advances. The purpose of this study is to share the self-care recommendations of middle-aged and older adults with SCD. Using descriptive qualitative methods, data were gathered through semistructured interviews from 11 individuals living with SCD, including 6 women and 5 men. Self-care recommendations themes included physiological, psychological, and provider-related. The self-care recommendations may be seen as an additional resource or “words of wisdom” for younger adults with SCD who can use the recommendations to better manage their own disease. Additionally, providers may be able to use these recommendations to inform their practice.

Jenerette, Coretta M.; Brewer, Cheryl; Leak, Ashley N.



Constructing the moral body: self-care among older adults with multiple chronic conditions.  


Older adults are increasingly living with and managing multiple chronic conditions. The self-management of illness occurs in a social and political context in which the responsibility for health has shifted from the State to the individual, who is expected to be an active consumer of health care. Although there has been extensive investigation of the management of single chronic conditions, the realities of living with multiple morbidities have largely been ignored, particularly among older adults. Addressing this gap, our study entailed in-depth interviews with 35 older Canadian adults, aged 73 to 91, who had between three and 14 chronic conditions. Self-care emerged as a primary means by which our participants managed their illnesses. Specifically, all of our participants were engaged in some form of self-care in order to cope with often debilitating physical symptoms and functional losses. They also utilized self-care because they had reached the limits of available medical treatment options. Finally, our participants argued that self-care was a moral responsibility that was underscored by gendered motivations. Whereas the men tended to emphasize the importance of self-care for the achievement of masculine ideals of control and invulnerability, the women suggested that self-care allowed them to maintain feminine norms of selflessness and sensitivity to the needs of others. In this way, self-care enabled the men and women to reframe their aging, chronically ill bodies as moral, socially valued bodies. We discuss our findings in relation to the extant research and theorizing pertaining to self-care, gender, and healthism. PMID:22773552

Clarke, Laura Hurd; Bennett, Erica V



The influence of basic conditioning factors on menopausal self-care agency and menopausal self-care in midlife women  

Microsoft Academic Search

The purpose of this study was to test a mid-range theory of menopausal self-care deduced from Orem's Theory of Self-Care Deficit and Theory of Self-Care that was both theoretically and clinically relevant to nursing. Theoretically, this inquiry tested the relationship between basic conditioning factors and menopausal self-care agency and menopausal self-care. Selected basic conditioning factors included age, developmental state, sociocultural\\/economic

Norma Rose Zehnder



Self-care is a lifelong journey.  


As the most influential catalysts for health care reform in America, the time for nurses to emulate wellness and prevention has never been more critical. By creating healthy habits for ourselves, we flourish as ambassadors of self-care for our patients, families, colleagues, and communities. By taking care of ourselves first, we bring positive energy and vitality to work that positively affects others and influences the overall landscape. In essence, the practice of self-care should be expected as part of the professional role of nursing. PMID:24069721

Richards, Kim


Chakra Self-Care: A Heuristic Exploration  

Microsoft Academic Search

Therapists are vulnerable to a number of stressors that may affect them professionally and personally. It is critical that they engage in appropriate self-care activities and develop selfawareness to not only avoid boredom and burnout, but to maintain motivation and creativity in their work. The purpose of this study was to explore the use of the chakra system as a

Alexandra L. Starrett



African American hypertensives: Cognition and self care  

Microsoft Academic Search

Problem. While evidence is present supporting aging and hypertension's association with cognitive decline, few, if any, studies have related cognition, self-care, and blood pressure outcomes in African American elders with hypertension. Purpose. The purposes of this study were to: (a) describe types of cognitive functions in elder hypertensive African Americans, (b) test relationships among concepts in a mid-range theory derived

Kay Louise Klymko



College Student Self-Care Diary.  

ERIC Educational Resources Information Center

|The purpose of this docoment is to help college students maintain health by keeping a weekly diary of health related behaviors including diet, exercise, and stress levels. In addition each weekly entry presents a self-care tip for health improvement. Discussions of the college student and health, health and lifestyle, instructions on use of the…

Greenberg, Jerrold S.; Dintiman, George B.


Helping Your Child Learn Self-Care.  

ERIC Educational Resources Information Center

|Practical advice for parents of handicapped children is the focus of this issue on self-care skills including self-feeding, dressing, and personal hygiene. Ten initial tips for teaching skills to children include constant repetition, modeling, and keeping verbal instruction to a minimum. The section on self-feeding addresses the topics of…

Murphy, Linda; Corte, Suzanne Della



Experiences of Burnout, Self-Care, and Recovery of Female University Counsellors in Taiwan  

ERIC Educational Resources Information Center

|The purpose of this study was to describe the burnout, self-care, and recovery experiences of female university counsellors working at a university counselling centre in Taiwan. The 9 participants had an average age of 42.44 years and had worked at the centre for an average of 11.3 years. A qualitative method of phenomenology with in-depth…

Lin, Yii-Nii



Predictors of self-care in adolescents with cystic fibrosis: a test of Orem's theories of self-care and self-care deficit.  


Pediatric nurses often struggle to find ways to encourage adolescents with cystic fibrosis (CF) to engage in self-care that is essential to their health and life. A study of predictors of self-care was conducted to provide a stronger evidence base for nursing practice with these youth. Orem's theories of self-care and self-care deficit were tested to explain and predict the universal and health deviation self-care of 123 adolescents with CF. Four dimensions of self-care agency emerged as predictors of universal self-care, two of which were also predictive of health deviation self-care. Seventy percent of the variance or change in universal self-care scores and 40% of health deviation self-care variance were explained. Clarification and extension of Orem's theories were also an important outcome. Development of nursing interventions designed to strengthen predictors of universal and health deviation-specific self-care identified in this research holds the potential to improve length and quality of life for adolescents with CF. PMID:18207046

Baker, Lois K; Denyes, Mary J



Self-Care Strategies to Cope With Taste Changes After Chemotherapy  

PubMed Central

Purpose/Objectives To describe factors related to taste changes, to examine patients’ use of a self-care suggestion sheet to manage taste changes associated with chemotherapy, and to identify potentially useful strategies for managing specific taste changes after chemotherapy. Design Quasi-experimental, pre/post design. Setting Four outpatient urban and suburban oncology centers in Illinois. Sample 42 patients who had received at least two cycles of chemotherapy previously identified to be associated with taste changes. Methods Pre- and postintervention survey of taste changes; patient education regarding self-care for taste changes. Main Research Variables Taste changes, taste change strategies, and self-care. Findings Most patients that reported taste changes had affected their ability to eat. Taste changes and strategies varied somewhat according to chemotherapy regimen. Avoiding strong-smelling or -tasting foods, eating blander foods, drinking more water with foods, oral care before eating, and eating smaller, more frequent meals were reported to help. Conclusions Taste changes are common in patients receiving cisplatin, carboplatin, or cyclophosphamide. At-risk patients may benefit from prechemotherapy teaching regarding specific taste change management suggestions. Use of a taste change suggestion sheet encouraged self-care, and counseling patients regarding strategies to deal with taste changes may help them during chemotherapy. Implications for Nursing Nurses should incorporate patient education tools that promote self-care regarding the management of taste changes in patients with known factors that could affect taste early in their chemotherapy.

Rehwaldt, Maureen; Wickham, Rita; Purl, Sandy; Tariman, Joseph; Blendowski, Carol; Shott, Susan; Lappe, Mary



Teaching Counselors Self-Care through Mindfulness Practices  

ERIC Educational Resources Information Center

|Few counseling programs directly address the importance of self-care in reducing stress and burnout in their curricula. A course entitled Mind/Body Medicine and the Art of Self-Care was created to address personal and professional growth opportunities through self-care and mindfulness practices (meditation, yoga, gong, and conscious relaxation…

Newsome, Sandy; Christopher, John Chambers; Dahlen, Penny; Christopher, Suzanne



Self-Caring IT Systems: A Proof-of-Concept Implementation in Virtualized Environments  

Microsoft Academic Search

In self-caring IT systems, faults are handled proactively, e.g. by slowing down the deterioration of system health thereby effectively avoiding or delaying system failures. This requires health management which entails health monitoring, diagnosis, prognosis, planning of recovery and remediation actions. A brief overview of our prior work, which proposes a general methodology to capture system properties and incorporate health management

Selvi Kadirvel; José A. B. Fortes



Self-care in health promotion  

Microsoft Academic Search

About 10 years ago academics discovered the fact that people actually take care of themselves. This was a process rather reminiscent of the academic discovery of poverty in the sixties [1. Poverty Studies in the Sixties. A Selected and Annotated Bibliography. U.S. Department of Health, Education and Welfare, Washington, D.C., 1970]. Like poverty, self-care had 'always been with us', but

Ilona Kickbusch



Social functioning and self-care in hospitalized psychogeriatric patients.  


Evaluations of social disability have been found useful in determining factors of diagnostic, therapeutic and prognostic significance in the management of psychogeriatric patients. A random sample of 100 psychogeriatric patients aged 65 or over admitted to three Toronto hospitals were studied prospectively. Standardized clinical and social interview schedules were used to assess patients' mental state, self-care capacity, social isolation, burden on the family and household contribution before admission. These assessments were carried out to determine their significance with respect to diagnosis and outcome. Self-care capacity, as measured by the Activities of Daily Living Performance Test or by informant report, was related to diagnosis and outcome measures in this sample. Social isolation was significantly correlated with length of hospital stay. Burden on the family was not found to be significantly associated with diagnosis or outcome although there was a tendency for patients with organic disorders to present more difficulties for their families. The severe burden imposed on relatives suggests the need for utilization of community social and medical services to provide relief for families of psychogeriatric patients. The implications for management are considered in the light of the above findings. PMID:619000

Ross, H E; Kedward, H B



Predictors of self-care in adolescents with cystic fibrosis: A test and explication of Orem's theories of self-care and self-care deficit  

Microsoft Academic Search

Adolescents with Cystic Fibrosis (CF) frequently do not engage in self-care that is essential to their health. Nurses need a systematic way of viewing the self-care behaviors of this population. The purpose of this descriptive multivariate correlational study was twofold: (a) to test Orem's (1991) theoretical propositions about the relationships between selected basic conditioning factors, dimensions of self-care agency, and

Lois K Baker



Neighborhood Crime and Self-Care: Risks for Aggression and Lower Academic Performance  

ERIC Educational Resources Information Center

|This longitudinal study evaluated associations among official rates of neighborhood crime, academic performance, and aggression in a sample of 581 children in 1st-3rd grade (6.3-10.6 years old). It was hypothesized that the influence of crime depends on children's unsupervised exposure to the neighborhood context through self-care. Average weekly…

Lord, Heather; Mahoney, Joseph L.



Spirituality and spiritual self-care: expanding self-care deficit nursing theory.  


The authors propose an integration of the concepts of spirituality and spiritual self-care within Orem's self-care deficit nursing theory as a critical step in theory development. Theoretical clarity is needed to understand the contributions of spirituality to health and well-being. Spirituality is the beliefs persons hold related to their subjective sense of existential connectedness including beliefs that reflect relationships with others, acknowledge a higher power, recognize an individual's place in the world, and lead to spiritual practices. Spiritual self-care is the set of spiritually-based practices in which people engage to promote continued personal development and well-being in health and illness. PMID:21220576

White, Mary L; Peters, Rosalind; Schim, Stephanie Myers



Families dealing with stroke desire information about self-care needs.  


As hospital lengths of stay have decreased, healthcare professionals have less opportunity to fully educate stroke patients and their families regarding self-care before the patient is discharged home. Consequently, families often need continuing education provided to them in outpatient settings. The purpose of this study was to identify the self-care needs about which people dealing with stroke most frequently want information. Twenty-four people responded to a survey that listed 48 self-care needs structured within Orem's universal self-care requisites (USCRs). The top five self-care needs about which information was desired were: preventing falls; maintaining adequate nutrition; staying active; managing stress; and dealing with emotional and mood changes. These needs correlated with several of Orem's USCRs. By keeping these needs in mind, healthcare professionals can develop better educational materials and provide more pertinent information to stroke patients and their families during homecare or office visits, support group meetings, or via the Internet. PMID:14727471

Pierce, Linda L; Gordon, Michael; Steiner, Victoria


Nursing and Self-Care Theory Applied to Utilization Review: Concepts and Cases  

Microsoft Academic Search

The following article demonstrates how Dorothea Orem's Self-Care Theory of Nursing serves as a the oretical framework for the hospital-based utilization review process. Orem's theory is a popular and prac tical one which dovetails beautifully with the goals of any department of utilization management.

Kimberly Harrison-Raines



Theory of Planned Behavior, Self-Care Motivation, and Blood Pressure Self-Care  

PubMed Central

The theory of planned behavior (TPB) was integrated within the theory of self-care (SCT) to explore the predictive value of extending TPB to measure attitudes and beliefs regarding a behavioral goal, and determine the ability of goal beliefs to predict engagement in the combined, multiple behaviors necessary to control BP. The hypothesized model was evaluated in a sample of 306 community-dwelling African Americans between 21 and 65 years of age. Scales developed for the study achieved acceptable reliability (?=.68–95). Structural equation modeling analysis resulted in a second-order factor structure with attitude, subjective norm, perceived behavioral control, and intention modeled as indicators of a construct representing goal beliefs related to keeping BP within normal limits. This latent construct was conceptualized within the theory of self-care as “self-care motivation,” and predicted 18% of the variance in self-care behaviors necessary for BP control. The model achieved acceptable fit (CMIN/df = 2.32; CFI = .95; RMSEA = .066). Final assessment of fit was done using multi-group SEM and bootstrapping techniques. In this extension of the TPB attitudes and beliefs regarding the goal of keeping BP within normal limits were found to determine one's motivation to engage in the multiple behaviors necessary for BP control.

Peters, Rosalind M.; Templin, Thomas N.



Phenomenological perspectives on self-care in aging  

PubMed Central

Self-care is a central concept in health care and may be considered as a means to maintain, restore, and improve one’s health and well-being. When performed effectively, self-care contributes not only to human functioning but also to human structural integrity and human development (ie, to a dynamic and holistic state of health). Self-care as a clinical concept is relevant for health care professionals, and it should be meaningful to investigate it at a philosophical level and to further elaborate upon this concept. The aim of this article is to discuss and elaborate upon a phenomenological perspective on self-care in aging that is relevant for the health sciences. Self-care may be preliminarily regarded as a fundamental perspective for the conscious older individual, and as a way of being in the world with both the objective body and with the lived body. The lived body is the personal center of perception and the field of action, and it is also the center of self-care. The potentiality or ability for self-care activity and self-care activity itself are structures given to perception, with self-care ability as an integral part of the lived body. The actualization of self-care ability comes about through a certain meaning, which can be regarded as an important driving force. It is constituted by communication, a healthy lifestyle, and by building meaning and socializing. Successful self-care involves having contacts with the health care system, being conscious of a sound lifestyle, being physically and mentally active, being engaged, having social contacts with family and others, as well as being satisfied, positive, and being able to look forward. One fundamental cornerstone is serenity on behalf of the individual. Self-care can facilitate transitions, and it may also be an outcome of transitions.

Soderhamn, Olle



Phenomenological perspectives on self-care in aging.  


Self-care is a central concept in health care and may be considered as a means to maintain, restore, and improve one's health and well-being. When performed effectively, self-care contributes not only to human functioning but also to human structural integrity and human development (ie, to a dynamic and holistic state of health). Self-care as a clinical concept is relevant for health care professionals, and it should be meaningful to investigate it at a philosophical level and to further elaborate upon this concept. The aim of this article is to discuss and elaborate upon a phenomenological perspective on self-care in aging that is relevant for the health sciences. Self-care may be preliminarily regarded as a fundamental perspective for the conscious older individual, and as a way of being in the world with both the objective body and with the lived body. The lived body is the personal center of perception and the field of action, and it is also the center of self-care. The potentiality or ability for self-care activity and self-care activity itself are structures given to perception, with self-care ability as an integral part of the lived body. The actualization of self-care ability comes about through a certain meaning, which can be regarded as an important driving force. It is constituted by communication, a healthy lifestyle, and by building meaning and socializing. Successful self-care involves having contacts with the health care system, being conscious of a sound lifestyle, being physically and mentally active, being engaged, having social contacts with family and others, as well as being satisfied, positive, and being able to look forward. One fundamental cornerstone is serenity on behalf of the individual. Self-care can facilitate transitions, and it may also be an outcome of transitions. PMID:23807842

Söderhamn, Olle



Self-care for stoma surgery: mastering independent stoma self-care skills in an elderly woman.  


According to Orem, active participation in caring for self contributes to the behavior of self-care. Before an individual is able to care for oneself, however, many factors must be considered. This article is based on an alert, oriented 85-year old widow, known as EL, who was recently diagnosed with rectal cancer. With postoperative hypertension and sinus tachycardia, EL is having difficulty learning self-care. This article demonstrates a scenario where Orem's self-care deficit theory of nursing assisted in developing an effective plan of self-care for an elderly woman who underwent an ileostomy. PMID:15574699

Martínez, Laurie A



Self-care behaviors among patients with heart failure  

Microsoft Academic Search

Background: One way to prevent frequent hospitalizations and promote positive health outcomes among patients with heart failure (HF) is to ensure that the amount and quality of self-care used is appropriate to the patient's situation. Objectives: The following are the purposes of this study: (a) examine the frequency of performance of self-care behaviors, (b) describe personal and environmental factors (basic

Nancy T. Artinian; Morris Magnan; Michelle Sloan; M. Patricia Lange



Self-care behaviour of patients with heart failure.  


Heart failure-related self-care behaviour is important to optimize outcomes for patients with heart failure. Such behaviours include adherence to medication, diet and exercise, but self-care also refers to such things as seeking assistance when symptoms occur, and daily weighing. The study aim was to describe heart failure-related self-care behaviour, to test the effect of education and support on self-care behaviour and to discuss limitations. Data were collected from 128 heart failure patients during their hospital stay and at 1-, 3-, and 9-month follow-ups. Concepts from Orem's general theory of nursing were used to describe heart failure-related self-care behaviour and its limitations. The effects of intensive systematized and planned education from a nurse in hospital and at home were evaluated in an experimental design. Results showed that education enhanced self-care behaviour significantly at 1 and 3 months after discharge. Despite intensive education and support, patients did not manifest all self-care behaviours that might be expected. Patients in both the intervention and control groups described limitations in knowledge, judgement/decision-making and skills. It can be concluded that supportive-educative intervention is effective in enhancing heart failure-related self-care behaviour early after discharge. To optimize such intervention, more emphasis must be placed on behavioural strategies (e.g. self-medication), social support (e.g. from family members) and reinforcement (e.g. home visits). PMID:12035274

Jaarsma, T; Abu-Saad, H H; Dracup, K; Halfens, R



Self care for chronic illness: Older African Americans and whites  

Microsoft Academic Search

In-person interviews with two hundred and twenty-one older African Americans and whites in Allegheny County, Pennsylvania on their use of self care activities in the care of one of four chronic illnesses (chronic obstructive pulmonary disease (COPD), heart disease, diabetes mellitus, and arthritis, addressed which types of self care they used for each of these illnesses) the similarities and differences

Myrna Silverman; Donald Musa; Brenda Kirsch; Laura A. Siminoff



Sociocultural influences and self-care practices of middle adolescents.  


The purpose of this study was to describe general self-care practices of middle adolescents. In addition, the relation between general self-care practices and specific sociocultural characteristics including socioeconomics and church attendance were explored. Orem's self-care theory and developmental theory provided the framework for the investigation. Findings from the sample of 15- and 16-year-old adolescents (n = 425) showed that they are engaging in self-care practices. The influence of sociocultural characteristics on self-care practices was supported. Implications from the study include the need to continue research endeavors that describe, explain, and predict health behavior in child and adolescent populations. Practicing nurses in diverse health care settings should consider the results of this study when working with adolescents and their families from diverse sociocultural backgrounds. Results from this investigation should be incorporated into the planning of health education programs for the adolescent population. PMID:10714036

McCaleb, A; Cull, V V



[OREM's self-care deficit theory applied to hypertensive patients].  


A study carried out with the objective of evaluating Orem's nursing self-care theory (TDAC) in women with hypertension. Four hypertensive women in an outpatient clinic were interviewed using a form with open and multiple-choice questions on conditioning factors and self-care requirements. The data were analyzed according to the TDAC theoretical framework. Based on the self-care requirements for hypertensive people, the existence or non-existence of adjustment between self-care capacity and self-care need as well as the inhibitors and enhancers of such adjustment were identified. It was concluded that TDAC allowed to identify important aspects related to hypertensive people which must be dealt with by nurses. PMID:12040790

Cade, N V



A Supportive-Educational Intervention for Heart Failure Patients in Iran: The Effect on Self-Care Behaviours  

PubMed Central

Background. Chronic heart failure is a major health and social problem. The promotion of self-care behaviours can potentially assist patients to effectively manage this chronic condition and prevent worsening of the disease. Formal personalized educational interventions that provide support and take into consideration the cultural context are needed. Objective. The objective of this research was to evaluate the effect of a supportive-educational intervention on self-care behaviours of heart failure patients in Iran. Methods. This research was a prospective, randomized trial of a supportive-educational intervention. Eighty heart failure patients were randomly assigned to receive the supportive-educational intervention or usual care. The intervention consisted of a one-hour, nurse-led, in-person education session and postdischarge followup by telephone over three months. Data were collected at baseline, one, two, and three months. Results. The control and intervention groups did not differ in self-care scores at baseline (P > 0.05). Each of the self-care scores was significantly higher in the intervention group than the control group at 1, 2, and 3 months (P < 0.001). There were significant differences in self-care behaviours over the three months, among participants in the intervention group. Conclusion. This study provides support for the effectiveness of a supportive-educational intervention to increase self-care behaviours among Iranian patients suffering from chronic heart failure.

Zamanzadeh, Vahid; Valizadeh, Leila; Howard, A. Fuchsia; Jamshidi, Fatemeh



Informing the development of services supporting self-care for severe, long term mental health conditions: a mixed method study of community based mental health initiatives in England  

PubMed Central

Background Supporting self-care is being explored across health care systems internationally as an approach to improving care for long term conditions in the context of ageing populations and economic constraint. UK health policy advocates a range of approaches to supporting self-care, including the application of generic self-management type programmes across conditions. Within mental health, the scope of self-care remains poorly conceptualised and the existing evidence base for supporting self-care is correspondingly disparate. This paper aims to inform the development of support for self-care in mental health by considering how generic self-care policy guidance is implemented in the context of services supporting people with severe, long term mental health problems. Methods A mixed method study was undertaken comprising standardised psychosocial measures, questionnaires about health service use and qualitative interviews with 120 new referrals to three contrasting community based initiatives supporting self-care for severe, long term mental health problems, repeated nine months later. A framework approach was taken to qualitative analysis, an exploratory statistical analysis sought to identify possible associations between a range of independent variables and self-care outcomes, and a narrative synthesis brought these analyses together. Results Participants reported improvement in self-care outcomes (e.g. greater empowerment; less use of Accident and Emergency services). These changes were not associated with level of engagement with self-care support. Level of engagement was associated with positive collaboration with support staff. Qualitative data described the value of different models of supporting self-care and considered challenges. Synthesis of analyses suggested that timing support for self-care, giving service users control over when and how they accessed support, quality of service user-staff relationships and decision making around medication are important issues in supporting self-care in mental health. Conclusions Service delivery components – e.g. peer support groups, personal planning – advocated in generic self-care policy have value when implemented in a mental health context. Support for self-care in mental health should focus on core, mental health specific qualities; issues of control, enabling staff-service user relationships and shared decision making. The broad empirical basis of our research indicates the wider relevance of our findings across mental health settings.



Dynamic Power Management for Sensor Node in WSN Using Average Reward MDP  

NASA Astrophysics Data System (ADS)

Reducing energy consumption is one of the key challenges in sensor networks. One technique to reduce energy consumption is dynamic power management. In this paper we model power management problem in a sensor node as an average reward Markov Decision Process and solve it using dynamic programming. We achieve an optimal policy that maximizes long-term average of utility per energy consumption. Simulation results show our approach has the ability of reaching to the same amount of utility as always on policy while consuming less energy than always on policy.

Kianpisheh, Somayeh; Charkari, Nasrolah Moghadam


The Effect of self-care on the lives of children suffering from acute lymphocytic leukemia  

PubMed Central

BACKGROUND: Acute lymphocytic leukemia is one of the common cancers of childhood and currently, 80 percent of these children survive more than 5 years by getting the right treatment. Since long-term treatment is painful and invasive, preventing the side effects and their influence on quality of life is an important issue which introduces consideration for self-care. Consequently, the present study was conducted in 2007-2008 about the effects of self-care on the lives of children suffering from acute lymphocytic leukemia, referring to treatment centers in Isfahan City. METHODS: The present study was a two-staged, two-group clinical trial. 48 children aging 5-18 and suffering from acute lymphocytic leukemia were selected through convenient sampling method and the training program was administered before them and afterwards, they were divided randomly into two groups of experiment (n = 24) and control (n = 24). The General Scale and Cancer Scale Quality of Life Identification Questionnaires were used to define the quality of life of the children. The validity and reliability of the questionnaire were in turn defined by content validity method and Cronbach's alpha test. The experiment group received the self-care checklist after training and was controlled and examined for 3 months. The pre-and-post self care Quality of Life Questionnaire were both filled out in both groups and accordingly, the SPSS software, independent t test, chi-square and paired t tests were used to analyze the data. RESULTS: The findings of the study showed that both groups were homogeneous by virtue of influential factors on quality of life, like age, gender, type, stage and duration of treatment (p > 0.05). There was no significant difference between the experiment and control groups’ quality of life average scores before administering the self-care training program. The results of paired-t test in the experiment group after administering the self-care program showed a significant difference in General and Cancer Scale Questionnaires Quality of Life with that before administering the program, while no significant difference was observed in the control group. Also, the independent t-test showed a significant difference in the average of quality of life score shift after administering the self care between the experiment and control groups. CONCLUSIONS: Quality of life improved after administering self-care training program in the experiment group while it did not improve in the control group and even the increase in average score of quality of life in Cancer Scale in this group was an indicator of an increase in problems related to disease, treatment and care. The results of this study showed the positive effects of administering self-care on the quality of life of children suffering from acute lymphocytic leukemia.

Golchin, Mehri; Sharifi, Najmeh; Ziaee, Shohreh; Taheri, Parvin



The relationship of depressive symptoms to symptom reporting, self-care and glucose control in diabetes  

Microsoft Academic Search

Depressive symptoms are common among patients with diabetes and may have a significant impact on self-management and health outcomes. In this study we predicted that: 1) there would be a significant association between depressive symptoms and diabetes symptom burden, physical functioning, diabetes self-care, and HbA1c levels; and, 2) that the association between depressive symptoms and HbA1c levels would be significantly

Paul S Ciechanowski; Wayne J Katon; Joan E Russo; Irl B Hirsch



Pharmacy personnel and fever: A study on perception, self-care and information to customers  

Microsoft Academic Search

To study the fever perception and self-care of pharmacy personnel as well as the information given to customers about the\\u000a management of fever problems, a random sample of 152 Norwegian pharmacists and 150 pharmacy technicians were interviewed,\\u000a in 1989, by a national opinion poll company. One-third thought that body temperatures between 39.0°C and 40.5°C could be lifethreatening.\\u000a Of all respondents

J. R. Eskerud; M. Andrew; B. Strømnes; E.-L. Toverud



Self-Care Practices and Perceived Stress Levels Among Psychology Graduate Students  

Microsoft Academic Search

It is well known that stress among psychology graduate students can negatively impact academic performance, clinical skills, and personal well-being. However, less is known about factors related to stress management among psychology graduate students. The current study examined self-care practices and perceived stress among psychology graduate students Four hundred eighty-eight psychology graduate students from across the United States completed an

Shannon B. Myers; Alison C. Sweeney; Victoria Popick; Kimberly Wesley; Amanda Bordfeld; Randy Fingerhut



Orem's Self-Care Model of Nursing: An Enumerative Bibliography.  

ERIC Educational Resources Information Center

|This document is a 119-item bibliography of literature which deals with Orem's self-care model of nursing. Sources of entries include journals, doctoral dissertations, abstracts, books, and conference papers. (JN)|

Sanchez, James Joseph, Comp.


Therapist’s Perceptions of Self-Care  

Microsoft Academic Search

Mental health professionals experience tremendous work-related stressors due to the emotionally demanding nature of the role they play in their client’s lives. The goal of this research was to identify relationships between a therapist’s level of engagement in self-care activities, and compassion satisfaction, burnout, and secondary traumatic stress. Forty-six mental health therapists were surveyed on their reported engagement in self-care

Stephanie Catlin-Rakoski



Self-care: Why do parents leave their children unsupervised?  

Microsoft Academic Search

We used a preferences-and-constraints model to develop four hypotheses to explain why parents may choose self-care (an unsupervised\\u000a arrangement) as the primary child care arrangement for their children over supervised alternatives and tested them in a multivariate\\u000a framework using 1995 data from the Survey of Income and Program Participation. We found that the choice of self-care over\\u000a supervised care alternatives

Lynne M. Casper; Kristin E. Smith



Investing Time in Health: Do Socioeconomically Disadvantaged Patients Spend More or Less Extra Time on Diabetes Self-Care?  

PubMed Central

Summary Background Research on self-care for chronic disease has not examined time requirements. TRIAD, a multi-site study of managed care patients with diabetes, is among the first to assess self-care time. Objective To examine associations between socioeconomic position and extra time patients spend on foot care, shopping/cooking, and exercise due to diabetes. Data 11,927 patient surveys from 2000–01. Methods Bayesian two-part models were used to estimate associations of self-reported extra time spent on self-care with race/ethnicity, education, and income, controlling for demographic and clinical characteristics. Results Proportions of patients spending no extra time on foot care, shopping/cooking and exercise were respectively 37%, 52% and 31%. Extra time spent on foot care and shopping/cooking was greater among racial/ethnic minorities, less-educated and lower-income patients. For example, African-Americans were about 10 percentage points more likely to report spending extra time on foot care than whites and extra time spent was about three more minutes/day. Discussion Extra time spent on self-care was greater for socioeconomically disadvantaged patients than for advantaged patients, perhaps because their perceived opportunity cost of time is lower or they cannot afford substitutes. Our findings suggest that poorly controlled diabetes risk factors among disadvantaged populations may not be attributable to self-care practices.

Ettner, Susan L.; Cadwell, Betsy L.; Russell, Louise B.; Brown, Arleen; Karter, Andrew J.; Safford, Monika; Mangione, Carol; Beckles, Gloria; Herman, William H.; Thompson, Theodore J.



Preliminary Validation of the Hypertension Self-Care Activity Level Effects (H-SCALE) and Clinical Blood Pressure Among Patients With Hypertension.  


This study establishes preliminary validation of a measure that assesses hypertension self-care activities with clinical blood pressure (BP). The Hypertension Self-Care Activity Level Effects (H-SCALE) was administered to patients with hypertension to assess levels of self-care. Patients (n=154) were predominantly female (68.6%) and black (79.2%). Greater adherence to self-care was associated with lower systolic and diastolic BP for 5 of the 6 self-care behaviors. Medication adherence was correlated with systolic BP (r=-0.19, P<.05) and weight management adherence was correlated with diastolic BP (r=-0.22, P<.05) after controlling for other covariates. Increased adherence to recommended dietary practices was strongly correlated with higher systolic (r=0.29, P<.05) and diastolic BP (r=0.32, P<.05). The H-SCALE was acceptable for use in clinical settings, and adherence to self-care was generally aligned with lower BP. Assessment of hypertension self-care is important when working with individuals to control their BP. PMID:24034656

Warren-Findlow, Jan; Basalik, Debra W; Dulin, Michael; Tapp, Hazel; Kuhn, Lindsay



The meaning of self-care in persons with cervical spinal cord injury in Japan: a qualitative study  

PubMed Central

Background Professionals in Japan tend to regard the individual contexts of persons with spinal cord injury (SCI) as the cause of their passive participation in self-care activities or self-management. However, the meaning of self-care involves variables that interrelate with sociocultural factors. Thus, it is necessary to uncover its meaning in the perceptions of persons with cervical spinal cord injury (CSCI) in order not only to implement better rehabilitation but also to understand the sociocultural constraints that determine the injured person’s attitudes to self-care and long-term health outcomes. Methods Semi-structured interviews with 29 CSCI participants from fourteen municipalities of Osaka, Hyogo, and Ehime prefectures were conducted. Participants contributed diverse perspectives on rehabilitation, lay-professional and family relationships, health promotion, and body conceptions. Interviews were recorded, transcribed and analyzed using the grounded theory approach to inter-relate categories and to develop theoretical constructions. Results Four main themes emerged from the data: rehabilitation for independence in ADLs; detachment from the body and self; embodiment; and self-management. From the participants’ point of view, rehabilitation programs in Japan aim at improving body functions for ADL performance, but provide little health education. These rehabilitation values might hinder some participants from developing self-esteem for their bodies. Moreover, socially-shaped family caregivers’ active engagement in the participants’ self-care allowed many participants to entirely rely on them for care. Through embodiment, participants found that self-care was not merely a means of independence in ADLs but also of self-management to enhance health and well-being, requiring collaborative relationships with caregivers. Conclusion Personal factors such as low motivation for self-care might be in part a reflection of social expectations of dependence for persons with CSCI. However, the shift in the meaning of self-care from ADLs to self-management implies more active participation in health care needs, shaped through social exchanges. Not only personal factors but also sociocultural factors influence the injured person’s valuation of self-care. There is a need for further research to better understand sociocultural influences on illness behaviors among persons with CSCI, so that clinical and community practice can develop accordingly.



Adequate health literacy is associated with higher heart failure knowledge and self care confidence in hospitalized patients  

PubMed Central

Heart failure (HF) patients with inadequate health literacy are at increased risk for poor self care and negative health outcomes such as hospital readmission. The purpose of this study was to examine prevalence of inadequate health literacy; reliability of the Dutch HF Knowledge Scale (DHFKS) and Self Care of Heart Failure Index (SCHFI); and differences in HF knowledge, HF self care, and 30-day readmission rate by health literacy level among patients hospitalized with HF. The convenience sample included adults (N=95) admitted to a large urban teaching hospital with primary diagnosis of HF. Measures included the Short Test of Functional Health Literacy in Adults, DHFKS, SCHFI, and readmission at 30 days post-discharge. The sample was 59 ± 14 years in age, 51% male, 67% African American; 35% had less than high school education, 35% were employed, 73% lived with someone who helps with their HF care, and 16% were readmitted within 30 days of index admission. Health literacy was inadequate for 42%, marginal for 19%, and adequate for 39%. Reliability of the DHFKS and SCHFI scales was comparable to prior reports. Mean knowledge score was 11.43 ± 2.26, SCHFI subscale scores were 56.82 ± 17.12 for maintenance, 63.64 ± 18.29 for management, and 65.02 ± 16.34 for confidence. Those with adequate health literacy were younger and had higher education level, HF knowledge scores, and HF self care confidence compared to those with marginal or inadequate health literacy. Self care maintenance and management scores and 30-day readmission rate did not differ by health literacy level. These findings demonstrate the high prevalence of inadequate and marginal health literacy and that health literacy is an important consideration in promoting HF knowledge and confidence in self care behaviors, particularly among older adults and those with less than high school education.

Dennison, Cheryl R.; McEntee, Mindy L.; Samuel, Laura; Johnson, Brandon J.; Rotman, Stacey; Kielty, Alexandra; Russell, Stuart D.



Adherence to diabetes self-care behaviors in English- and Spanish-speaking Hispanic men  

PubMed Central

We conducted a qualitative study to elicit attitudes, attributions, and self-efficacy related to diabetes self-care in both English- and Spanish-speaking Hispanic men. Transcripts from six focus groups (three in English and three in Spanish) were reviewed by the authors to extract principal and secondary themes. Participants could describe their medication and lifestyle regimens and were aware of whether they were adherent or nonadherent to physician recommendations. Lack of skills on how to incorporate diet and regular physical activity into daily living, lack of will power, and reluctance to change culturally rooted behaviors emerged as significant barriers to diabetes self-management. Medication adherence is for some men the principal diabetes self-care behavior. Nonadherence appeared to fit two profiles: 1) intentional, and 2) nonintentional. In both instances low self-efficacy emerged as a significant influence on attainment and maintenance of diabetes self-care goals. Participants also expressed a strong sense of fatalism regarding the course of their disease, and seemed to have little motivation to attempt long-term dietary control. Educational and counseling messages should stress that a diagnosis of diabetes is not a death sentence, and full functional capacity can be maintained with good control.

Rustveld, Luis O; Pavlik, Valory N; Jibaja-Weiss, Maria L; Kline, Kimberly N; Gossey, J Travis; Volk, Robert J



Self-care strategies and barriers among kidney transplant recipients: a qualitative study  

PubMed Central

Objectives We investigated kidney transplant recipients’ self-reported levels of exercise and fluid intake. We also examined attitudes about, barriers to undertaking, and strategies used to initiate and maintain adequate self-care for fluid intake, exercise and dietary practices. Methods A qualitative approach was used and supplemented by quantitative data to examine self-care among kidney transplant recipients (n = 82), including a semi-structured interview and survey of physical activity. Results One-third of patients (33%) reported drinking the recommended 3 L of fluid each day. However, the majority (60%) reported not receiving this or any specific fluid intake recommendation. Twenty percent reported engaging in moderate to regular physical activity while 78% were sedentary. However, many reported that clinicians did not specify the amount of exercise (39%) or did not discuss exercise (15%). Attitudes towards fluid intake, exercise and maintaining a low-salt diet were mostly positive; patients expressed relatively more negative attitudes towards maintaining a low-cholesterol diet. Major barriers to fluid intake were not feeling thirsty, difficulty breaking the habit of limiting fluid intake formed while on dialysis, feeling full and limited access to fluids. Patients devised creative strategies to initiate and maintain appropriate hydration, physical activity and dietary levels, including intentionally drinking when not thirsty, modifying the environment, tracking intake and relying on social supports. Conclusions Few kidney recipients practiced optimal self-care for fluid intake or physical activity. Most patients encountered barriers to self-care that should be ameliorated to assist patients with managing their transplant. Understanding barriers and strategies is essential for developing educational interventions.

Gordon, Elisa J.; Prohaska, Thomas R.; Gallant, Mary; Siminoff, Laura A.



Diabetes Empowerment, Medication Adherence and Self-Care Behaviors in Adults with Type 2 Diabetes  

PubMed Central

Abstract Background Evidence suggests that empowerment is an important factor to address everyday aspects of dealing with a chronic disease. This study evaluated the effect of diabetes empowerment on medication adherence and self-care behaviors in adults with type 2 diabetes. Subjects and Methods Data on 378 subjects with type 2 diabetes recruited from two primary care clinics in the southeastern United States were examined. Previously validated scales were used to measure diabetes empowerment, medication adherence, diabetes knowledge, and diabetes self-care behaviors (including diet, physical activity, blood sugar testing, and foot care). Multiple linear regression was used to assess the independent effect of diabetes empowerment on medication adherence and self-care behaviors controlling for relevant covariates. Results Eighty-three percent were non-Hispanic blacks, 69% were women, 22% were 65 years or older, 68% were not married, 26% had less than high school education, 60% were unemployed, 39% were uninsured, and 47% had a yearly income <$10,000. Empowerment had significant correlations with medication adherence (r=0.17, P<0.003), diabetes knowledge (r=0.16, P=0.007), diet (r=0.24, P<0.001), exercise (r=0.25, P<0.001), blood sugar testing (r=0.12, P=0.043), and foot care (r=0.18, P=0.002). In the regression model, diabetes empowerment was significantly associated with medication adherence (?=?0.04, P=0.001), diabetes knowledge (?=0.09, P=0.012), diet (?=0.09, P<0.001), exercise (?=0.10, P<0.001), blood sugar testing (?=0.07, P=0.016), and foot care (?=0.08, P=0.001). Conclusions In this sample, diabetes empowerment was related to better diabetes knowledge, medication adherence and improved self-care behaviors. Emphasis on empowerment and self-efficacy is relevant to improve outcomes in the management of diabetes.

Hernandez-Tejada, Melba A.; Campbell, Jennifer A.; Walker, Rebekah J.; Smalls, Brittany L.; Davis, Kimberly S.



Pulmonary rehabilitation and self-care after ambulatory surgery.  


Over 30 million Americans are living with chronic lung disease in the United States. The long-term ongoing care required by these individuals is a major contributor to American health care costs. Clinicians caring for persons with chronic respiratory disease are faced with minimal time in which to prepare patients for adequate self-care abilities. Often times, the clinician may assume that all of the "bases have been covered." In reality, it is because this assumption is made that persons with chronic respiratory disease are often not receiving the full breadth of information that they need to increase their self-care abilities and optimize their quality of life. This article prepares the perianesthesia clinician to ensure that the important tenets of self-care information are addressed for the person with overt and/or underlying chronic respiratory disease. PMID:9934079

Geiger-Bronsky, M



Family Influences on Heart Failure Self-care and Outcomes  

PubMed Central

Many patient education guidelines for teaching heart failure patients recommend inclusion of the family; however, family-focused interventions to promote self-care in heart failure are few. This article reviews the state of the science regarding family influences on heart failure self-care and outcomes. The literature and current studies suggest that family functioning, family support, problem solving, communication, self-efficacy, and caregiver burden are important areas to target for future research. In addition, heart failure patients without family and those who live alone and are socially isolated are highly vulnerable for poor self-care and should receive focused attention. Specific research questions based on existing science and gaps that need to be filled to support clinical practice are posed.

Dunbar, Sandra B.; Clark, Patricia C.; Quinn, Christina; Gary, Rebecca A.; Kaslow, Nadine J.



Self-care needs of caregivers dealing with stroke.  


Education is essential for successful transition from hospital to home, for both persons with stroke and their caregivers. Guided by Orem's self-care deficit nursing theory, this article identifies self-care needs about which physical and occupational therapists believe caregivers most frequently want information. The therapists (N=113), who responded to a mailed survey, were mostly White women prepared at the graduate educational level in the eastern United States. Descriptive statistics revealed that demonstrating safe transfer techniques was the most frequently chosen information need (82%) identified by physical and occupational therapists surveyed. PMID:16568811

Cook, Amanda M; Pierce, Linda L; Hicks, Barbara; Steiner, Victoria




Microsoft Academic Search

AS the population ages and the healthcare crisis is upon us, prevention and self-care practices throughout our life span make both fiscal and physical sense. Chronic illnesses such as those frequently seen in older people - arthritis, hypertension, cancer, asthma, chronic pain - are costly, and symptoms are not eradicated by conventional biomedicine (Ingelfinger 1977; Bailar and Smith, 1986). Common



Self-care for job stress in the workplace.  


In order to assess the significance of self-care in stress prevention at an enterprises level, a questionnaire survey was conducted. The questionnaire was mailed to 678 occupational physicians and 320 responded (response ratio 47.5%), among whom 229 (71.6%) were full-time occupational physicians. Forty-five percent answered that self-care was important and practiced it actively; however, almost the same percentage of occupational physicians complained that there ware no appropriate procedures for self-care, nor enough time to introduce them. When a comparison was made between full-time and part-time, the full-time occupational physicians showed a more positive attitude. The same comparison made based on specialties in mental-health demonstrated that the doctors with higher specialty had a more positive attitude toward self-care than those with lower specialty. The main procedures or techniques applied to improve job-stress were group lecture, personal interview, and/or questionnaire. The occupational physicians who applied psychological techniques, such as the autogenic training and/or the transactional analysis, were few in number, 17.8% and 14.8% of the total respectively. Both autogenic training and transactional analysis were applied by full-time and highly specialized occupational physicians. These results suggest that self-care is recognized as being important for preventing job stress and for promoting mental health of employees; however, the usefulness and effectiveness of each technique at the worksite should be evaluated carefully. Education of occupational physicians is considered be indispensable for the acceptance of autogenic training and transactional analysis. PMID:18270480

Ishikawa, Koji; Saito, Masahiko



Orem's self-care deficit nursing theory: pediatric asthma as exemplar.  


Asthma is the most frequent reason for preventable hospital admissions among children regardless of race or socioeconomic status. Since hospitalizations are preventable, a reasonable assumption is that parents are not optimally managing their child's asthma. Using Orem's self-care deficit nursing theory, 14 conditions were uncovered in the pediatric asthma literature that influence development of competency by parents. Twelve of the 14 antecedent conditions are influenced by factors partly or completely controlled by the healthcare system. Healthcare system gaps associated with asthma symptom control have come to light through the articulation of the pediatric asthma literature and Orem's theory. PMID:15976048

Cox, Karen R; Taylor, Susan G



“I'm a Health Nut!” Street Drug Users' Accounts of Self-Care Strategies  

Microsoft Academic Search

This qualitative study analyzes data from in-depth interviews to describe self-care strategies among chronic and injecting drug users. While the types of strategies varied from participant to participant, the theme of proactive self-care remained strong throughout the data. Researchers identified five self-care domains discussed by the study participants. The self-care domains include strategies to improve nutrition, increase physical activity, address

Rene‘ D. Drumm; Duane McBride; Lisa Metsch; Melodie Neufeld; Alex Sawatsky



Self-care at school: perceptions of 6-year-old children.  


Occupational therapists who work with young children routinely evaluate self-care and consider it an important domain of practice. Little is known about what children perceive is important self-care or what they experience as self-care within a school context. Without knowledge about children's perspectives of self-care, occupational therapists cannot know whether or not they are targeting areas that are central to children's needs. The purpose of this naturalistic study was to explore 6-year-old children's perceptions of self-care in their school day. Participant observation and group interviewing were used to elicit descriptive information from 24 Grade One children, attending an elementary school located in Sydney, Australia. A fishing game, drawing activity, and excerpts from a videotape of their day at school were used as stimuli to explore how the children described and attributed meaning to their self-care occupations. Findings showed that children described self-care at school two ways. First, they named specific self-care tasks that mirrored adult views of self-care and represented culturally shared views of the concept of self-care across ages. Second, children described highly individual views about self-care that were derived from their own experience of doing self-care at school. These views seemed to be based on their personal perceptions of salient factors in operation at the time of self-care performance such as social and physical contexts, perceived skill, and expectations of others. The findings suggest that occupational therapy assessment and intervention for self-care include sensitivity to experiential differences between adult views of self-care and those of children. This sensitivity should include an attempt to understand children's experiences of self-care in specific contexts such as school. PMID:15707125

Chapparo, Christine J; Hooper, Elizabeth


Self-care agency and factors related to this agency among patients with coronary heart disease  

Microsoft Academic Search

The aim of this study was to assess the self-care agency and factors related to this agency among patients with coronary heart disease (N = 250) measured with a self-care inventory (Self-as-Carer Inventory, SCI). A secondary aim was to analyze the ability of the SCI inventory based on Orem's self-care deficit theory to measure the self-care agency of patients with

Hannele Lukkarinen; Maija Hentinen



Explication of the structure of the secondary concept of women's self-care developed within Orem's Self-Care Deficit Theory: Instrumentation, psychometric evaluation and theory-testing  

Microsoft Academic Search

The purpose of this study was the conceptualization, instrumentation, psychometric evaluation and theory-testing of a new secondary concept, women's self-care. It was the product of conjoining the theoretical frameworks of Self-In-Relation and Orem's Self-Care Deficit Theory of Nursing and the specific concepts of self-in-relation and self-care. Its significance was to provide a more general, abstract or theoretical level to particularized

Nancy Ann Weber



Self-care for the obstetrical patient. A nursing framework.  


In using Orem's self-care framework, the nurse operates within a client-centered system which encourages the individual to be responsible for her own care. The philosophy changes from "I am here to take care of you" (maternalistic) to "I am here to assist you in taking care of yourself" (helping relationship). Even very ill or disabled persons (or their families) can be included in decision-making processes when actual self-care is not possible. Every effort must be made to have the individual's self-worth and dignity remain intact. Perhaps ultimately, credibility may be added to the words "health" and "care" in health-care delivery systems. PMID:6550143

Woolery, L F


Integrating Virtual Patients Into a Self-Care Course  

PubMed Central

Objective To develop, implement, and evaluate the use of virtual patients as a teaching tool for third-professional year PharmD students within an advanced elective self-care course. Design Practicing community pharmacists, faculty members, and pharmacy residents with alias e-mail accounts served as virtual patients and corresponded on a weekly basis via e-mail with pharmacy students regarding an assortment of fictional health concerns. Self-care inquiries were e-mailed to the students who replied and then forwarded their response to the course coordinator for evaluation and class discussion. At the end of the course, students were asked to assess the value of the learning activity. Assessment Students demonstrated significant improvement in knowledge, problem-solving, communication, and professional skills upon course completion. Student's assessments of the virtual patient activity have suggested positive feedback on developing self-care skills, patient interactions, and group dynamics. Conclusion This teaching tool was designed to enhance student's knowledge base, assessment, and counseling skills when interacting with patients in various situations. Instructor evaluation of responses, student feedback, and self-evaluation indicated the activity improved overall knowledge and communication skills.



Parent training plus contingency management for substance abusing families: A Complier Average Causal Effects (CACE) analysis*  

PubMed Central

Background Children of substance abusers are at risk for behavioral/emotional problems. To improve outcomes for these children, we developed and tested an intervention that integrated a novel contingency management (CM) program designed to enhance compliance with an empirically-validated parent training curriculum. CM provided incentives for daily monitoring of parenting and child behavior, completion of home practice assignments, and session attendance. Methods Forty-seven mothers with substance abuse or dependence were randomly assigned to parent training + incentives (PTI) or parent training without incentives (PT). Children were 55% male, ages 2-7 years. Results Homework completion and session attendance did not differ between PTI and PT mothers, but PTI mothers had higher rates of daily monitoring. PTI children had larger reductions in child externalizing problems in all models. Complier Average Causal Effects (CACE) analyses showed additional significant effects of PTI on child internalizing problems, parent problems and parenting. These effects were not significant in standard Intent-to-Treat analyses. Conclusion Results suggest our incentive program may offer a method for boosting outcomes.

Stanger, Catherine; Ryan, Stacy R.; Fu, Hongyun; Budney, Alan J.



Status and Recommendations for Self-Care Instruction in US Colleges and Schools of Pharmacy, 2006  

PubMed Central

Teachers of pharmacy self-care courses have met annually since 1998 at the Nonprescription Medicines Academy (NMA) held in Cincinnati, Ohio. During these meetings, self-care faculty members discuss methods of enhancing the teaching of self-care in US colleges and schools of pharmacy. Self-care courses are taught using a variety of methods and content is woven into pharmacy curricula in many different ways. This manuscript sets forth the current state of self-care instruction in pharmacy curricula including the recommended core curriculum, instructional methodologies, course mechanics, existing standards, and assessment and curricular placement, and makes recommendations for the future.

Zierler-Brown, Seena L.; VanAmburgh, Jenny A.; Casper, Kristin A.; Krypel, Linda L.; Salcido, Amista Lone; Padron, Victor A.; Pray, W. Steven; Wall, Andrea L.; Sobotka, Jenelle L.; Engle, Janet P.



Appalachian women: health beliefs, self-care, and basic conditioning factors.  


The purposes of this study were to: (a) describe the health beliefs and self-care of Appalachian women; and (b) describe the relationships among health beliefs, self-care, and the basic conditioning factors of Appalachian women. Orem's SCDNT was used as the theory for this study. This study used qualitative and quantitative methodologies. The study participants included 129 Appalachian women. Health beliefs and self-care were described. Significant correlations were found between components of the basic conditioning factors and definition of health beliefs and self-care. The outcomes from this research study support that Appalachian women do participate in self-care in promoting their health. PMID:20860332

Slusher, Ida L; Withrow-Fletcher, Cora; Hauser-Whitaker, Mary



The structure of self-care in a group of elderly people.  


According to Orem's self-care deficit theory of nursing, the structure of self-care consists of self-care agency balanced by therapeutic self-care demand. Different conditioning factors constitute these two constructs. The aim of this study was to investigate through secondary analysis the structure of self-care in a group of elderly. Data were originally collected from a total of 125 randomly chosen elderly individuals (65+ years of age) in Sweden by means of a mailed questionnaire. Confirmatory factor analysis was used to show that self-care agency was totally and significantly balanced against therapeutic self-care demand and explained by five conditioning factors. PMID:11873355

Söderhamn, O; Cliffordson, C



Self-Care Management of Older Military Retirees.  

National Technical Information Service (NTIS)

Recent changes in the Military Health Services System (MHSS) have resulted in older military retirees feeling stripped of 'promised' health care benefits. Despite these changes, older military retirees remain eligible for full participation in MHSS health...

K. A. Dillow



Health Literacy Influences Heart Failure Knowledge Attainment but Not Self-Efficacy for Self-Care or Adherence to Self-Care over Time  

PubMed Central

Background. Inadequate health literacy may be a barrier to gaining knowledge about heart failure (HF) self-care expectations, strengthening self-efficacy for self-care behaviors, and adhering to self-care behaviors over time. Objective. To examine if health literacy is associated with HF knowledge, self-efficacy, and self-care adherence longitudinally. Methods. Prior to education, newly referred patients at three HF clinics (N = 51, age: 64.7 ± 13.0 years) completed assessments of health literacy, HF knowledge, self-efficacy, and adherence to self-care at baseline, 2, and 4 months. Repeated measures analysis of variance with Bonferroni-adjusted alpha levels was used to test longitudinal outcomes. Results. Health literacy was associated with HF knowledge longitudinally (P < 0.001) but was not associated with self-efficacy self-care adherence. In posthoc analyses, participants with inadequate health literacy had less HF knowledge than participants with adequate (P < 0.001) but not marginal (P = 0.073) health literacy. Conclusions. Adequate health literacy was associated with greater HF knowledge but not self-efficacy or adherence to self-care expectations over time. If nurses understand patients' health literacy level, they may educate patients using methods that promote understanding of concepts. Since interventions that promote self-efficacy and adherence to self-care were not associated with health literacy level, new approaches must be examined.

Chen, Aleda M. H.; Yehle, Karen S.; Albert, Nancy M.; Ferraro, Kenneth F.; Mason, Holly L.; Murawski, Matthew M.; Plake, Kimberly S.



Cross-Cultural Adaptation and Psychometric Testing of the Brazilian Version of the Self-Care of Heart Failure Index Version 6.2  

PubMed Central

Objective. To adapt and evaluate the psychometric properties of the Brazilian version of the SCHFI v 6.2. Methods. With the approval of the original author, we conducted a complete cross-cultural adaptation of the instrument (translation, synthesis, back translation, synthesis of back translation, expert committee review, and pretesting). The adapted version was named Brazilian version of the self-care of heart failure index v 6.2. The psychometric properties assessed were face validity and content validity (by expert committee review), construct validity (convergent validity and confirmatory factor analysis), and reliability. Results. Face validity and content validity were indicative of semantic, idiomatic, experimental, and conceptual equivalence. Convergent validity was demonstrated by a significant though moderate correlation (r = ?0.51) on comparison with equivalent question scores of the previously validated Brazilian European heart failure self-care behavior scale. Confirmatory factor analysis supported the original three-factor model as having the best fit, although similar results were obtained for inadequate fit indices. The reliability of the instrument, as expressed by Cronbach's alpha, was 0.40, 0.82, and 0.93 for the self-care maintenance, self-care management, and self-care confidence scales, respectively. Conclusion. The SCHFI v 6.2 was successfully adapted for use in Brazil. Nevertheless, further studies should be carried out to improve its psychometric properties.

Avila, Christiane Wahast; Riegel, Barbara; Pokorski, Simoni Chiarelli; Camey, Suzi; Silveira, Luana Claudia Jacoby; Rabelo-Silva, Eneida Rejane



Narrated lived experiences of self-care and health among rural-living older persons with a strong sense of coherence  

PubMed Central

Sense of coherence (SOC), with its components comprehensibility, manageability, and meaningfulness, is a major factor in the ability to cope successfully with stressors and is closely related to health. Qualitative studies related to SOC are scarce, and in this phenomenological interview study, self-care is investigated in relation to SOC. The aim of this study was to describe the lived experiences of self-care and features that may influence health and self-care among older home-dwelling individuals living in rural areas and who have a strong SOC. Eleven persons with a mean age of 73.5 years and a SOC value in the range of 153–188, measured by Antonovsky’s 29-item SOC scale, were interviewed. The interviews were recorded, transcribed verbatim, and analyzed with a phenomenological descriptive method. The findings showed that successful self-care involves having, when needed, contact with the health care system, being conscious of a sound lifestyle, being physically and mentally active, being engaged, having social contacts with family and/or others, and being satisfied and positive and looking forward. Formal and informal caregivers should be conscious of the importance of motivating and supporting older individuals with respect to these dimensions of self-care.

Soderhamn, Ulrika; Dale, Bj?rg; Soderhamn, Olle



Cross-cultural adaptation and psychometric testing of the brazilian version of the self-care of heart failure index version 6.2.  


Objective. To adapt and evaluate the psychometric properties of the Brazilian version of the SCHFI v 6.2. Methods. With the approval of the original author, we conducted a complete cross-cultural adaptation of the instrument (translation, synthesis, back translation, synthesis of back translation, expert committee review, and pretesting). The adapted version was named Brazilian version of the self-care of heart failure index v 6.2. The psychometric properties assessed were face validity and content validity (by expert committee review), construct validity (convergent validity and confirmatory factor analysis), and reliability. Results. Face validity and content validity were indicative of semantic, idiomatic, experimental, and conceptual equivalence. Convergent validity was demonstrated by a significant though moderate correlation (r = -0.51) on comparison with equivalent question scores of the previously validated Brazilian European heart failure self-care behavior scale. Confirmatory factor analysis supported the original three-factor model as having the best fit, although similar results were obtained for inadequate fit indices. The reliability of the instrument, as expressed by Cronbach's alpha, was 0.40, 0.82, and 0.93 for the self-care maintenance, self-care management, and self-care confidence scales, respectively. Conclusion. The SCHFI v 6.2 was successfully adapted for use in Brazil. Nevertheless, further studies should be carried out to improve its psychometric properties. PMID:24163765

Avila, Christiane Wahast; Riegel, Barbara; Pokorski, Simoni Chiarelli; Camey, Suzi; Silveira, Luana Claudia Jacoby; Rabelo-Silva, Eneida Rejane



“I Am a Blood Sugar Checker”: Intervening Effects of Self-as-doer Identity on the Relationship between Self-efficacy and Diabetes Self-care Behaviors  

Microsoft Academic Search

The mechanisms by which self-efficacy contribute to improved diabetes self-care behaviors are poorly understood. We propose that the “self-as-doer” identity might help explain the relationship between behavioral self-efficacy and health behavior enactment. Adults with diabetes (type I = 200, type II = 130) completed self-report measures assessing diabetes management-specific self-efficacy, self-as-doer, and self-care behaviors. We tested the intervening effects of the “self-as-doer” identity on

Amanda M. Brouwer; Katie E. Mosack



“I am a blood sugar checker”: Intervening effects of self-as-doer identity on the relationship between self-efficacy and diabetes self-care behaviors  

Microsoft Academic Search

The mechanisms by which self-efficacy contribute to improved diabetes self-care behaviors are poorly understood. We propose that the “self-as-doer” identity might help explain the relationship between behavioral self-efficacy and health behavior enactment. Adults with diabetes (type I = 200, type II = 130) completed self-report measures assessing diabetes management-specific self-efficacy, self-as-doer, and self-care behaviors. We tested the intervening effects of the “self-as-doer” identity on

Amanda M. Brouwer; Katie E. Mosack



Supporting Diabetes Self-Care in Underserved Populations  

PubMed Central

Purpose The purpose of this study was to evaluate the impact of an innovative intervention that utilized a certified medical assistant with specific diabetes training to work with a multidisciplinary diabetes care team to help provide basic diabetes education and self-care support in low-income minority populations with type 2 diabetes. Methods Enrolled participants were randomized to either the medical assistant coaching (MAC) group (N = 25) or the treatment as usual (TAU) group (N = 25). Deidentified data was obtained on a matched no contact control (NCC) group (N = 50). Results Analysis of covariance (ANCOVA) comparisons revealed no significant differences between the 3 groups on A1C, but a trend was observed. A1Cs decreased across time for the MAC group, while increasing for the TAU and NCC groups. ANCOVA comparisons also indicated that the MAC group experienced significantly greater increases in perceived empowerment and a larger, although non-significant, reduction in perceived diabetes related problems than the TAU group. Conclusions This randomized controlled pilot study suggests that the inclusion of a medical assistant self-care coach as part of the diabetes care team holds promise in improving outcomes and should be further examined in a large-scale study.

Ruggiero, Laurie; Moadsiri, Ada; Butler, Paula; Oros, Susan M.; Berbaum, Michael L.; Whitman, Steven; Cintron, Daisy



Personality, Personal Model Beliefs, and Self-Care in Adolescents and Young Adults With Type 1 Diabetes  

Microsoft Academic Search

This study compared 3 models of association between personality, personal model beliefs, and self-care in a cross-sectional design. These models were as follows: (a) Emotional stability determines self-care indirectly through personal model beliefs, and conscientiousness is a direct predictor of self-care; (b) emotional stability determines self-care indirectly through personal model beliefs, and conscientiousness moderates the association between beliefs and self-care;

T. Chas Skinner; Sarah E. Hampson; Chris Fife-Schaw



Self-care operations and nursing interventions for children with cancer and their parents.  


As individuals assume more responsibility for their healthcare, nurses need to explore methods to support families' self-care practices. The purpose of this qualitative study was to: (a) determine what self-care and dependent-care operations children and parents perform to address self-care requisites, and (b) explore nursing interventions to promote operations. Orem's theory of self-care, theory of self-care deficit, and theory of nursing system were employed. Twenty-seven participants were interviewed about their cancer experiences. Results were that children and parents performed estimative, transitional, and productive operations to meet self-care requisites. Various nursing interventions that promoted these operations were identified. Recommendations were made for further interventions to support families. PMID:16624985

Moore, Jean Burley; Beckwitt, Asher E



Corps of Engineers Military Construction: Management Costs Below the Industry Average.  

National Technical Information Service (NTIS)

The United States Army Corps of Engineers (USACE) manages more than $3 billion of Federal Government construction each year. Its Federal customers include the Office of the Secretary of Defense (OSD), the Military Services, and Federal agencies. The const...

W. C. Moore T. L. Neve J. A. Hawkins



Sex disparities in diabetes process of care measures and self-care in high-risk patients.  


Patients with chronic diabetic complications experience high morbidity and mortality. Sex disparities in modifiable factors such as processes of care or self-care activities have not been explored in detail, particularly in these high-risk patients. Sex differences in processes of care and self-care activities were assessed in a cross-sectional analysis of the Pathways Study, an observational cohort of primary care diabetic patients from a managed care organization (N = 4,839). Compared to men, women had decreased odds of dyslipidemia screening (adjusted odds ratio (AOR) 0.73, 95% CI 0.62-0.85), reaching low-density lipoprotein goal (AOR 0.70, 95% CI 0.58-0.86), and statin use (AOR 0.69, 95% CI 0.58-0.81); women had 19% greater odds of reaching hemoglobin A1c <7% (95% CI 1.02-1.41). There were no sex differences in hemoglobin A1c testing, microalbuminuria screening, or angiotensin-converting enzyme inhibitor use. Women were less likely to report regular exercise but had better adherence to healthy diet, glucose monitoring, and self-foot examination compared to men. Patterns of sex differences were consistent in subjects with diabetic complications. Significant sex disparities exist in diabetes process of care measures and self-care, even amongst patients known to have chronic diabetic complications. PMID:23671877

Yu, Margaret K; Lyles, Courtney Rees; Bent-Shaw, Luis A; Young, Bessie A



Assessment of oral self-care in patients with periodontitis: a pilot study in a dental school clinic in Japan  

PubMed Central

Background Oral hygiene education is central to every stage of periodontal treatment. Successful management of periodontal disease depends on the patient's capacity for oral self-care. In the present study, the oral self-care and perceptions of patients attending a dental school clinic in Japan were assessed using a short questionnaire referring to existing oral health models. Methods A cross-sectional study design was used. The study population consisted of sixty-five patients (age range 23-77) with chronic periodontitis. The pre-tested 19-item questionnaire comprised 3 domains; 1) oral hygiene, 2) dietary habits and 3) perception of oral condition. The questionnaire was used as a part of the comprehensive assessment. Results Analyses of the assessment data revealed no major problems with the respondents' perceived oral hygiene habits, although their actual plaque control levels were not entirely adequate. Most of the respondents acknowledged the importance of prevention of dental caries and periodontal diseases, but less than one third of them were regular users of the dental care system. Twenty-five percent of the respondents were considered to be reluctant to change their daily routines, and 29% had doubts about the impact of their own actions on oral health. Analyzing the relationships between patient responses and oral hygiene status, factors like 'frequency of tooth brushing', 'approximal cleaning', 'dental check-up' and 'compliance with self-care advice' showed statistically significant associations (P < 0.05) with the plaque scores. Conclusion The clinical utilization of the present questionnaire facilitates the inclusion of multiple aspects of patient information, before initiation of periodontal treatment. The significant associations that were found between some of the self-care behaviors and oral hygiene levels document the important role of patient-centered oral health assessment in periodontal care.

Saito, Atsushi; Kikuchi, Momomi; Ueshima, Fumie; Matsumoto, Shinya; Hayakawa, Hiroki; Masuda, Hitomi; Makiishi, Takemi



Self-care requirements for activity and rest: an Orem nursing focus.  


According to Orem's self-care deficit nursing theory, helping people to maintain a balance between activity and rest (a universal self-care requisite) is a legitimate concern of nursing. The meaning of activity and rest, the requirements and potential measures for meeting this self-care requisite, and factors that might influence the process are explored. Criteria for determining a need for nursing, guides for a nursing clinical assessment, and guides for nursing action are suggested as potential ways to assist persons to meet the action demands associated with this self-care requisite. PMID:17202518

Allison, Sarah E



Empowering Older Patients to Engage in Self Care: Designing an Interactive Robotic Device  

PubMed Central

Objectives: To develop and test an interactive robot mounted computing device to support medication management as an example of a complex self-care task in older adults. Method: A Grounded Theory (GT), Participatory Design (PD) approach was used within three Action Research (AR) cycles to understand design requirements and test the design configuration addressing the unique task requirements. Results: At the end of the first cycle a conceptual framework was evolved. The second cycle informed architecture and interface design. By the end of third cycle residents successfully interacted with the dialogue system and were generally satisfied with the robot. The results informed further refinement of the prototype. Conclusion: An interactive, touch screen based, robot-mounted information tool can be developed to support healthcare needs of older people. Qualitative methods such as the hybrid GT-PD-AR approach may be particularly helpful for innovating and articulating design requirements in challenging situations.

Tiwari, Priyadarshi; Warren, Jim; Day, Karen



The average cost of pressure ulcer management in a community dwelling spinal cord injury population.  


Pressure ulcers (PUs) are a common secondary complication experienced by community dwelling individuals with spinal cord injury (SCI). There is a paucity of literature on the health economic impact of PU in SCI population from a societal perspective. The objective of this study was to determine the resource use and costs in 2010 Canadian dollars of a community dwelling SCI individual experiencing a PU from a societal perspective. A non-comparative cost analysis was conducted on a cohort of community dwelling SCI individuals from Ontario, Canada. Medical resource use was recorded over the study period. Unit costs associated with these resources were collected from publicly available sources and published literature. Average monthly cost was calculated based on 7-month follow-up. Costs were stratified by age, PU history, severity level, location of SCI, duration of current PU and PU surface area. Sensitivity analyses were also carried out. Among the 12 study participants, total average monthly cost per community dwelling SCI individual with a PU was $4745. Hospital admission costs represented the greatest percentage of the total cost (62%). Sensitivity analysis showed that the total average monthly costs were most sensitive to variations in hospitalisation costs. PMID:22715990

Chan, Brian C; Nanwa, Natasha; Mittmann, Nicole; Bryant, Dianne; Coyte, Peter C; Houghton, Pamela E



Development of an educational module on provider self-care.  


Intensive care providers who care for traumatized populations often face multiple traumas for extended periods and are vulnerable to developing lasting symptoms of compassion fatigue and secondary traumatization. Symptoms are often not recognizable until compassion fatigue or secondary traumatization negatively affects the providers' ability to care for their patients. More attention needs to be given to the care of the provider to ensure high-quality patient care, decrease turnover in the profession, and increase productivity. This article provides a framework for the development of an educational module for healthcare providers' self-care. This educational module created the opportunity to share with providers (a) how to explore their own professional experience; (b) how to recognize the different symptoms of compassion fatigue, primary traumatization, and secondary traumatization; (c) factors related to grief reactions; and (d) personal and professional strategies to decrease compassion fatigue and secondary traumatization. PMID:20683299

Meadors, Patrick; Lamson, Angela; Sira, Natalia


[Searching for the biological roots of self-care and care behavior. 1. The evolutional importance of self-care and care].  


In search of biological roots for self-care and for caring behavior. Part 1: Evolution and the significance of self-care and of care. Care and self-care are not exclusively human activities. They occur widely in the animal kingdom, in the form of hygiene related and pro-social behaviour. This has fundamental evolutionary significance. Examples of caring among animals will be used to point out the existence of biological roots for human caring behaviour. Self-care and care can, theoretically, be classified within the concept of self-preservation, largely congruent with nursing theories and models and with relevant research. The possibility therefore exists to develop interdisciplinary research programmes with a view to gaining biological insights about the origins and the meaning of caring behaviour. This will help to understand that the human body is a medium for expression and interaction in the context of nursing. PMID:8717914

Wiese, M



Periodontal self-care: evidence-based support.  


The focus of this review on periodontal self-care will be based primarily on the results of systematic reviews and meta-analyses. Based on the evidence gleaned from systematic reviews, it is notable that most authors of these reviews commented on the relatively small number of trials that could pass the quality-assessment inclusion in the systematic review. Interproximal devices, namely interproximal brushes, are more effective for reducing interproximal plaque and gingivitis than are flossing or brushing alone. Some added benefit may be attributed to the use of rotational oscillation powered toothbrushes over manual toothbrushes. Recommendations by the dentist and dental hygienist to add one or more chemotherapeutic agents to the typical oral hygiene regimen has been shown, in systematic reviews and meta-analyses, to reduce the level of plaque and gingival inflammation in patients. Oral irrigation does not seem to reduce visible plaque but does tend to reduce inflammation, determined by the presence of bleeding on probing, the gingival index score and probing depth measurements. To date, high-quality evidence is either lacking or weak in some areas regarding the efficacy of self-care and periodontal disease. Low educational attainment, smoking and socio-economic status are related to adverse periodontal health outcomes. Variation in self-esteem, self-confidence and perfectionism are associated with oral health status and oral health behaviors. Better understanding of the psychological factors associated with oral hygiene would be of benefit in further developing strategies to help patients improve their oral hygiene in addition to helping professionals design better programs on prevention and education. PMID:23574470

Drisko, Connie L



Hemodialysis patients' perceptions of home hemodialysis and self-care.  


Home hemodialysis (HHD) is an optimal option for patients requiring renal replacement therapy. It has been noted through research that this type of therapy is more cost-effective than in-centre therapies, and the benefits to patients are well documented (Harwood & Leitch, 2006). As stated by the Ministry of Health and Long-Term Care (MoHLTC), a total of 40% of renal failure patients are expected to do home dialysis (either peritoneal dialysis or HHD) by the year 2010 (Kashani & Motiwala, 2007). Even though the literature indicates that the numbers of those doing home dialysis are declining every year, there is no evidence to demonstrate why the numbers are declining. A quantitative cross-sectional descriptive study was conducted using the Patient Perception Survey and the Jo Pre-Training Assessment Tool (JPAT) to assess in-centre hemodialysis patients' perceptions regarding home dialysis, as well as their self-care ability. The two frameworks utilized were the Theory of Planned Behavior and Orem's Theory of Self-Care. According to the Theory of Planned Behavior, the 26 patients out of 49 who had positive perceptions regarding home dialysis would be expected to participate in home dialysis. However, according to the patients' responses to the domains within the JPAT, only eight out of the 26 would be considered suitable to participate in home dialysis. Only two of the domains, communication and social support, were found to be significantly related to patients'perceptions regarding home dialysis. Health care professionals need to implement interventions that incorporate assessment of communication and social support when addressing home dialysis therapy with a patient with end-stage renal disease (ESRD). PMID:20642162

Visaya, Marie Angela


Self Care Behavior among Patients with Diabetes in Harari, Eastern Ethiopia: The Health Belief Model Perspective  

PubMed Central

Background Diabetes mellitus is a chronic disease that requires lifelong medical treatments and a life style adjustment. To prevent serious morbidity and mortality, it requires dedication to demanding self-care behaviors in multiple domains. The objective of this study was to identify predictors of self care behaviors among patients with diabetes. Methods From a total of 425 follow up diabetic patients, a quantitative cross sectional study was conducted among 222 of them from three different hospitals in Harar town, from March to April, 2011. The sample was taken using simple random sampling method. Data was collected using pretested questionnaire. Descriptive statistics multiple logistic regression analysis were also used to assess the predicators of self care behaviors among patients with diabetes. Result Majority of the study respondents 134 (60.4%) were female and the mean age was 49.7 (SD±14.7) years. More than half 147(66.2%) of them were medically diagnosed with type-2 diabetes. 208(93.7%) had general knowledge about diabetes and specific knowledge about diabetes self care 207(93.2%). Large proportion of them had moderate perceived susceptibility 174(78.4%) and severity 112(50.5%). More than half of the respondents 149(67.1%) had less perceived barrier while only 30 (13.5%) of them had high self efficacy to self care practices related to diabetes mellitus. Only 87(39.2%) followed the recommended self care practices on diabetes. Conclusions Patients with less frequent information were less likely to take diabetes self care. Patients who were more educated, middle income, had high perceived severity of diabetes and less perceived barrier to self care were more likely to take diabetes self care. To increase the self care behavior, diabetes messages should focus on severity of diabetes and how to overcome barriers for self care by segmenting the audiences based on income and educational status with increasing the frequency and reach of message on diabetes.

Girma, Eshetu



Self-care and health in persons with cancer-related fatigue: Refinement and evaluation of Orem's self-care framework  

Microsoft Academic Search

The focus of this theory-development and theory-testing inquiry was on the relationship of self-care to health. Orem, a nurse theorist, has made the assertion that self-care contributes to health, but the mechanisms underlying this process have not been fully illuminated. An analysis of Orem's theoretical work, suggests that two new concepts—desired focal condition and regulatory outcome—bring needed dimensions of explanation

Morris A Magnan



[The extended self-care concept. Use of practitioners of alternative medicine and layman control of health services regarded as self-care].  


Research and discussions on self-care have been concentrated mainly on what happens before the patient decides to see a doctor. Attention could just as well be given to the forms of self-care used while the patient is under medical treatment, and perhaps even more to what self-care is used after the treatment has ended. Data from the Health Survey of 1985 indicate that patients who have seen a practitioner who practises alternative medicine are more likely to use a suitable form of self-care afterwards. This is supported by an interview survey of 150 patients who had visited such practitioners. The patients' attempts to influence the health system have to be regarded as a form of self-care. Many patients' organizations also function as centers which provide information about the quality of the practitioners. The extended health concept gives more authority to health personnel, the extended self-care concept gives more authority to the patients. PMID:2321227

Christie, V M



Social support, self-care, and quality of life in cancer patients receiving radiotherapy in Thailand  

SciTech Connect

The purpose of the study was two-fold: (1) to examine the relationships among self-care, social support, and quality of life in adult cancer patients receiving radiotherapy while the selected basic conditioning factors of age, marital and socio-economic status, living arrangement, stage and site of cancer were statistically controlled; and (2) to test a theoretical model which postulated that (a) quality of life was predicted jointly by the selected basic conditioning factors, social support and self-care, and (b) self-care was predicted jointly by the selected basic conditioning factors and social support. A convenience sample of 112 adult cervical and head/neck cancer patients receiving radiotherapy was obtained from radiotherapy outpatient clinic in three hospitals located in Bangkok, Thailand. Results of the study indicated positive relationships among self-care, social support, and quality of life. Socio-economic status, site of cancer, and self-care were significant predictors for reported quality of life. Social support appeared to be a significant predictor of quality of life indirectly through self-care. Socio-economic status and social support were also significant predictors of self-care, whereas, stage and site of cancer seemed to predict self-care indirectly through social support.

Hanucharurnkul, S.



Parent and Adolescent Distribution of Responsibility for Diabetes Self-care: Links to Health Outcomes  

Microsoft Academic Search

Objective To examine the relation of adolescent and parent responsibility distribution for diabetes self-care to psychological and physical health. Methods We interviewed children (mean age 12 years) annually for 3 years and asked parents to complete a questionnaire. Both reported how diabetes self-care was distributed in the family. Amount of responsibility held by the child only, the parent only, and

Vicki S. Helgeson; Kerry A. Reynolds; Linda Siminerio; Oscar Escobar; Dorothy Becker



Elderly Self Care Education: A Low Technology Primary Health Care Option for Developing Countries  

Microsoft Academic Search

This article presents a number of perspectives on the curriculum building processes as well as the methodology and content of a self care training curriculum and Information packet that were prepared and field for the development of a model self care education program for older persons. Course content and topical areas are outlined, and various training agenda and educational materials

Lawrence K. Koseki; Sue E. Reid



Learning Self-Care Skills. Functional Programming for People with Autism: A Series.  

ERIC Educational Resources Information Center

|Many individuals with autism need systematic, intensive teaching in self-care skills due to deficits in language and attention skills, interfering behaviors, and/or sensory impairments. Teaching self-care skills should occur naturally during daily routines, in all environments. Assessments are done to determine current abilities, strengths, and…

DePalma, Valerie; Wheeler, Marci


Self-care components of lifestyles: The importance of gender, attitudes and the social situation  

Microsoft Academic Search

Self-care practises of individuals are health related elements of lifestyles. In order to understand the influences that shape and maintain the self-care patterns of behaviour that determine health and functional ability, research frameworks for study of the social situations in which people live and the levels of influence among variables are needed. This paper reports on findings from an investigation

Kathryn Dean



Self-care and HIV/AIDS patients: nursing care systematization.  


This research aimed at systematizing nursing care to HIV/aids patients in view of Orem's Self-care Deficit Nursing Theory, using the convergent-care method and the Self-Care Nursing Process. Subjects were thirteen HIV/AIDS patients attended at a non-governmental organization in Fortaleza/CE, Brazil. We used interview techniques, physical examination, observation and information records, with a structured instrument, addressing requisites related to universal self-care, development and health alterations. Self-care deficits corresponded to nineteen nursing diagnoses, named according to NANDA's Taxonomy II, ten of which were based on the requisites for universal self-care, five on the requisites for self-care related to development and four on the requisites for self-care related to health deviations. In care planning, goals were established and the system and health methods were selected, prioritizing support-education actions in order to engage HIV/aids patients in self-care. PMID:16926989

Caetano, Joselany Afio; Pagliuca, Lorita Marlena Freitag


How Do Cognitive Function and Knowledge Affect Heart Failure Self-Care?  

ERIC Educational Resources Information Center

|Despite extensive patient education, few heart failure (HF) patients master self-care. Impaired cognitive function may explain why patient education is ineffective. A concurrent triangulation mixed methods design was used to explore how knowledge and cognitive function influence HF self-care. A total of 41 adults with HF participated in…

Dickson, Victoria Vaughan; Lee, Christopher S.; Riegel, Barbara



Meaning attached to compliance with self-care, and conditions for compliance among young diabetics.  


This paper presents a hypothetical model of the compliance with self-care of young diabetics, its features, its meaning to them and the preconditions for compliance with self-care. The aim of this research was to develop a model to clarify and expand existing knowledge concerning compliance with self-care among young diabetics and to produce new ideas for planning and implementing this care. Four categories of behavioural pattern were identified. Those young people with good compliance experienced a sense of well-being, health, and freedom. They were responsible, active, and well motivated in voluntarily implementing self-care. The second group were those whose actions deviated only slightly from health regimens but who had undergone many negative experiences with self-care. Their actions were guided only by compulsion. The third group were consciously non-compliant. Their constant neglect of health regimens was associated with feelings of poor health, fears and indifference. They were not motivated to comply, felt that the aims set were too high and the self-care programme too tightly regimented. They felt that they received no encouragement. The young people belonging to the fourth group frankly refused to pursue self-care. Their non-compliance was seen by them as an issue of freedom. In effect, their friends controlled their lives, and they felt that their self-care was all the more unnecessary since nobody encouraged them to keep to it. PMID:7797710

Kyngäs, H; Hentinen, M



Econometric analysis to evaluate the effect of community-based health insurance on reducing informal self-care in Burkina Faso  

PubMed Central

Objective This study examines the role of community-based health insurance (CBHI) in influencing health-seeking behaviour in Burkina Faso, West Africa. Community-based health insurance was introduced in Nouna district, Burkina Faso, in 2004 with the goal to improve access to contracted providers based at primary- and secondary-level facilities. The paper specifically examines the effect of CBHI enrolment on reducing the prevalence of seeking modern and traditional methods of self-treatment as the first choice in care among the insured population. Methods Three stages of analysis were adopted to measure this effect. First, propensity score matching was used to minimize the observed baseline differences between the insured and uninsured populations. Second, through matching the average treatment effect on the treated, the effect of insurance enrolment on health-seeking behaviour was estimated. Finally, multinomial logistic regression was applied to model demand for available health care options, including no treatment, traditional self-treatment, modern self-treatment, traditional healers and facility-based care. Results For the first choice in care sought, there was no significant difference in the prevalence of self-treatment among the insured and uninsured populations, reaching over 55% for each group. When comparing the alternative option of no treatment, CBHI played no significant role in reducing the demand for self-care (either traditional or modern) or utilization of traditional healers, while it did significantly increase consumption of facility-based care. The average treatment effect on the treated was insignificant for traditional self-care, modern self-care and traditional healer, but was significant with a positive effect for use of facility care. Discussion While CBHI does have a positive impact on facility care utilization, its effect on reducing the prevalence of self-care is limited. The policy recommendations for improving the CBHI scheme’s responsiveness to population health care demand should incorporate community-based initiatives that offer attractive and appropriate alternatives to self-care.

Robyn, Paul Jacob; Hill, Allan; Liu, Yuanli; Souares, Aurelia; Savadogo, Germain; Sie, Ali; Sauerborn, Rainer



[Assessment of self-care competence of elderly people with diabetes].  


This descriptive, cross-sectional and correlational study aimed to assess the self-care competencies of senior citizens with diabetes using the Scale to Identify Diabetes Mellitus Patients' Competence for Self-Care and personal factors associated with it. The study population consisted of seniors registered in primary healthcare units in Fortaleza, CE, Brazil. Only 6% of the patients were considered to have diabetes self-care competence. Low educational level and decreased visual acuity were identified as factors that influenced these low scores. The results, which showed that a small number of seniors were considered competent to practice self-care, indicated the importance of developing health promotion activities targeted to this population, assessing skills and encouraging self-care practices to facilitate the planning of health interventions. PMID:23743909

Marques, Marília Braga; da Silva, Maria Josefina; Coutinho, Janaína Fonseca Victor; Lopes, Marcos Venícios de Oliveira



Screening for determinants of self-care in patients with chronic heart failure.  


Heart failure self-care is vital to achieving clinical stability and improved health outcomes. Yet despite the attention it has been given, in both research and clinical practice, effective self-care remains elusive. It is recognised that there are many patient factors that impact on attaining effective self-care skills. Systematic research is warranted to resolve the knowledge gap of how patients process information and develop the necessary self-care skills. In addition, sound screening tools are needed to assess factors that hinder the development of effective heart failure self-care skills. In this manner, education and support strategies can be applied on an individualised needs basis to enhance health outcomes. PMID:22939110

Cameron, Jan; Ski, Chantal F; Thompson, David R



The relationship between neuropsychological measures and self-care skills in patients with cerebrovascular lesions.  

PubMed Central

The present investigation examined the relationship between performance on the Michigan Neuropsychological Battery (MNB) and selected self-care skills in a group of patients with unilateral cerebrovascular lesions. Among MNB measures, left-sided somatosensory and motor functions were the best predictors of self-care skills, showing that in these stroke patients lower level cerebral functions mediated by the right hemisphere are more strongly related to the self-care skills examined than higher cerebral functions. Also, evidence that patients with cerebrovascular lesions in the left hemisphere performed better than patients with right hemisphere lesions in several self-care categories is further indication that right hemisphere processes have a special role to play in the mediation of these self-care activities. The research and clinical implications of these findings are noted.

Campbell, A.; Brown, A.; Schildroth, C.; Hastings, A.; Ford-Booker, P.; Lewis-Jack, O.; Adams, C.; Gadling, A.; Ellis, R.; Wood, D.



Self-care of well adult Canadians and adult Canadians with end stage renal disease.  


Empirical support for Orem's Self-Care Deficit Theory of Nursing [Orem, D.E., 1995. Nursing: Concepts of practice, 5th. ed. Mosby, Toronto] is accumulating. However, little is known about the relative usefulness of the theory with well and chronically ill adults. This research examined multiple relationships deduced from Orem's Theory in 109 well adults and 141 adults with end stage renal disease (ESRD). Relations among personality traits, gender, age, socioeconomic status, self-care agency, and self-care were examined. Qualitative and quantitative differences were evident for the two samples. For example, self-care agency was a stronger predictor of self-care in well adults. Implications for development of disease-specific, mid-range theory are explored. PMID:10576115

Horsburgh, M E



Personal and cultural influences on diabetes self-care behaviors among older Hispanics born in the U.S. and Mexico.  


Older Hispanics are disproportionately affected by diabetes, but little is known about predictors of diabetes self-care among this group. This study compared the magnitude of three self-care behaviors (diet, physical activity (PA), and glucose monitoring) among older Hispanics with type 2 diabetes born in the United States (n = 59) to those born in Mexico (n = 179), and investigated the influence of personal and health indicators on each self-care behavior. Findings were based on data drawn from convenience sample data collected with a questionnaire. Self-care behaviors were moderately practiced (39.5-45.8 %) with no significant differences by nativity. Mexico-born seniors were less linguistically acculturated (P < 0.001). Being female (OR = 2.41) and PA levels (OR = 2.62) were significantly associated with diet. Being female (OR = 3.24), more educated (OR = 3.73), U.S.-born (OR = 2.84), and receiving diabetes education (OR = 3.67) were associated with PA. Diabetes education (OR = 2.41) was associated with glucose monitoring. Although acculturation influenced only PA and no other behaviors, personal and cultural factors require further investigation to design diabetes management strategies for Hispanic seniors at the border region. PMID:22729288

Mier, Nelda; Smith, Matthew Lee; Carrillo-Zuniga, Genny; Wang, Xiaohui; Garza, Norma; Ory, Marcia G



Virtual coach technology for supporting self-care.  


"Virtual Coach" refers to a coaching program or device aiming to guide users through tasks for the purpose of prompting positive behavior or assisting with learning new skills. This article reviews virtual coach interventions with the purpose of guiding rehabilitation professionals to comprehend more effectively the essential components of such interventions, the underlying technologies and their integration, and example applications. A design space of virtual coach interventions including self-monitoring, context awareness, interface modality, and coaching strategies were identified and discussed to address when, how, and what coaching messages to deliver in an automated and intelligent way. Example applications that address various health-related issues also are provided to illustrate how a virtual coach intervention is developed and evaluated. Finally, the article provides some insight into addressing key challenges and opportunities in designing and implementing virtual coach interventions. It is expected that more virtual coach interventions will be developed in the field of rehabilitation to support self-care and prevent secondary conditions in individuals with disabilities. PMID:19951785

Ding, Dan; Liu, Hsin-Yi; Cooper, Rosemarie; Cooper, Rory A; Smailagic, Asim; Siewiorek, Dan



Basic Conditioning Factors' Influences on Adolescents' Healthy Behaviors, Self-Efficacy, and Self-Care  

PubMed Central

This article reports a secondary statistical analysis of data from a study investigating the relationships among health-promoting self-care behaviors, self-care self-efficacy, and self-care agency in an adolescent population (Callaghan, 2005). The purpose of this study was to identify the influences of selected basic conditioning factors on the practice of healthy behaviors, self-efficacy beliefs, and ability for self-care in 256 adolescents. The research instruments used to collect data for this study include: Health-Promoting Lifestyle Profile II Scale; Self-Rated Abilities for Health Practices Scale; Exercise of Self-Care Agency Scale; demographic questionnaire assessing basic conditioning factors. The results of this analysis identified significant relationships between the following basic conditioning factors and adolescents' practice of healthy behaviors, self-efficacy of those behaviors, and self-care abilities: support system, adequate income, adequate living conditions, gender, routine practice of religion, and reported medical problems/disabilities. These findings can give adolescent health nurses direction in developing interventions that promote the self-care and health in this specific population.

Callaghan, Donna



Children with cancer and their parents: self-care and dependent-care practices.  


In this qualitative study the self-care practices of children with cancer and the dependent-care practices of their parents were examined. These practices were organized according to self-care requisites presented in Orem's theory of self-care. The intent of this examination was to determine the competency of participants, identify where self-care deficits occurred, and decide what nursing interventions were needed. A purposive sample of 9 children and 18 parents were interviewed to determine their experiences with cancer. Content analysis was conducted using a deductive approach to code and analyze the data according to Orem's universal, developmental, and health-deviation self-care requisites. NVivo qualitative analysis software was employed for data analysis. The findings of this study revealed that participants were competent agents, performing many practices in the areas of universal and developmental self-care requisites. Participants performed far fewer practices regarding health-deviation self-care requisites and interferences with development, however, indicating a need for supportive-educative nursing interventions in these areas. Future research should examine participants' operations and specific nursing interventions to support those operations. PMID:15204656

Moore, Jean Burley; Beckwitt, Asher E


What limits the expansion of self-care dialysis at home?  


Self-care dialysis at home, whether peritoneal dialysis or hemodialysis, is more cost-effective than in-center dialysis and treatment outcome is at least comparable. Still, both self-care modalities are considered underutilized and we wished to identify the perceived reasons for this underutilization among nephrology professionals. A questionnaire was distributed at 5 international nephrology meetings in 2006. Questions addressed the most important stakeholders and the most important issues for patients and nephrology professionals to enable the expansion of self-care dialysis and commonly mentioned barriers were given as alternative responses. The proportion of patients considered suitable for self-care was also investigated. Seven thousand responses were collected. The listed stakeholders, i.e., health care and reimbursement authorities, nurses and physicians, and finally patients and their families, are considered approximately equally important for the process. Nephrology professionals feel that patient motivation for choosing and performing self-care dialysis is the strongest driver. The need for dedicated resources for self-care is judged to be vital for the expansion of this modality of treatment. Thirty-two percent of incident patients are considered able to perform self-care dialysis at home. This international survey among 7000 nephrology professionals has identified patient motivation as one of the strongest drivers of self-care dialysis at home. The need for dedicated resources for the staff to devote time to developing such motivation is given as one of the major reasons for the slow adoption. Under ideal conditions, it is felt that one-third of all patients starting dialysis can be trained to perform self-care dialysis. PMID:18638243

Ledebo, Ingrid



Educational Needs for Improving Self-care in Heart Failure Patients with Diabetes  

PubMed Central

Purpose To explore the need for self-monitoring and self-care education in heart failure patients with diabetes (HF-DM patients) by describing cognitive and affective factors to provide guidance in developing effective self- management education. Method A cross-sectional correlation design was employed using baseline patient data from a study testing a 12 week patient and family dyad intervention to improve dietary and medication-taking self-management behaviors in HF patients. Data from 116 participants recruited from metropolitan Atlanta area were used. Demographic and co-morbidities, physical function, psychological distress, relationship with health care provider, self-efficacy (medication taking and low sodium diet), and behavioral outcomes (medications, dietary habits) were assessed. Descriptive statistics and a series of chi-square tests, t-tests or Mann Whitney tests were performed to compare HF patients with and without DM. Results HF-DM patients were older, heavier, had more co- morbidities, and took more daily medications than HF patients. High self-efficacy on medication and low sodium diet was reported in both groups with no significant difference. Although HF-DM patients took more daily medications than HF, both groups exhibited high HF medication taking behaviors. The HF-DM patients consumed significantly lower total sugar than HF patients, but clinically higher levels of sodium. Conclusions Diabetes educators need to be aware of potential conflicts of treatment regimens to manage two chronic diseases. Special and integrated diabetes self-management education programs which incorporate principles of HF self-management should be developed to improve self-management behavior in HF-DM patients.

Cha, Eun Seok; Clark, Patricia C.; Reilly, Carolyn Miller; Higgins, Melinda; Lobb, Maureen; Smith, Andrew L.; Dunbar, Sandra B.



A brief structured education programme enhances self-care practices and improves glycaemic control in Malaysians with poorly controlled diabetes.  


We assessed the effectiveness of a brief structured diabetes education programme based on the concept of self-efficacy on self-care and glycaemic control using single-blind study design. One hundred and sixty-four participants with poorly controlled diabetes from two settings were randomized using computer-generated list into control (n = 82) and intervention (n = 82) groups, of which 151 completed the study. Monthly interventions over 12 weeks addressed the self-care practices of diet, physical activity, medication adherence and self-monitoring of blood glucose (SMBG). These self-care practices were assessed at Weeks 0 and 12 using pre- and post-questionnaires in both groups together with glycated haemoglobin A1c (HbA1c) and diabetes knowledge. In the intention-to-treat analysis (n = 164), the intervention group improved their SMBG (P = <0.001), physical activity (P = 0.001), HbA1c (P = 0.03), diabetes knowledge (P = <0.001) and medication adherence. At Week 12, HbA1c difference adjusted for SMBG frequency, medication adherence and weight change remained significant (P = 0.03) compared with control group. For within group comparisons, diabetes knowledge (P = <0.001), HbA1c level (P = <0.001), SMBG (P = <0.001) and medication adherence (P = 0.008) improved from baseline in the intervention group. In the control group, only diabetes knowledge improved (P = <0.001). These findings can contribute to the development of self-management diabetes education in Malaysia. PMID:21715653

Tan, M Y; Magarey, J M; Chee, S S; Lee, L F; Tan, M H



Identification of Self-Care Behaviors Practiced by Community-Based Elderly: An Annotated Bibliography.  

National Technical Information Service (NTIS)

This document contains an annotated bibliography of published references appearing between 1975 and 1984 concerned with the self-care behaviors of the community-based elderly. The project has two principal objectives: (1) to develop and pretest a nursing ...

J. E. Kincade



[Self-care and the asthmatic adult: systematization of nursing care].  


This research aims at the systematization of nursing assistance under Orem's nursing theory of self-care deficit. In order to conduct this study, the convergent approach was used through the performance of the nursing processes in an adult with asthma. Interviews, physical examinations, observations, data record, observation of nursing assistance in policlinics along with home visits were the techniques used to gather data. After the observation of the nursing assistance, self-care deficits were identified and a new assistance plan and objectives were established, as well as a system and methods of support. The assistance plan was performed through the implementation of nursing assistance, prioritizing educational support. Based on the results, it was concluded that the application of the nursing processes through Orem's self-care referential is feasible and necessary for the engagement of clients and their family in self-care. PMID:12514833

Monteiro, Estela Maria Leite Meirelles; da Nóbrega, Maria Miriam Lima; de Lima, Luciane Soares


[Care, self-care and caring for yourself: a paradigmatic understanding thought for nursing care].  


This article presents a reflection about care, self-care and caring for oneself and establishes these issues' relations with the paradigms of totality and simultaneity. On the first part of the text, care and its general aspects are contextualized; the second part discusses about care in Martin Heidegger's philosophical perspective; the third part explores self-care on Dorothea Orem's conception; the fourth part considers Michel Foucault's care of oneself. And finally, the fifth part aims to establish the relationship between the concepts of self-care and care of oneself, and the totality and simultaneity paradigms. Self-care and care of oneself are connected to the objectivism of the totality, and to the subjectivism of the simultaneity. These subjects lead nursing to comprehend such paradigmatic inheritance and its implications on the nursing care. PMID:19842605

Silva, Irene de Jesus; de Oliveira, Marilia Fátima Vieira; da Silva, Sílvio Eder Dias; Polaro, Sandra Helena Isse; Radünz, Vera; dos Santos, Evanguelia Kotzias Atherino; de Santana, Mary Elizabeth



Nursing consultation applied to hypertensive clients: application of Orem's self-care theory.  


The objective was to implant the Nursing Consultation for hypertensive patients, using Orem's Self-Care Theory and to systematize nursing care. Thirty-six patients were interviewed. Of these, 58.9% were women, 75.0% of them ranging from 50 to 80 years of age, 76.4% were married, 42.9% were housewives, 47.2% were retired, and 67.3% completed elementary education. Patients were interviewed with a structured instrument addressing the requirements for universal, developmental, and health deviations self-care. Data analysis made it possible to assess the altered self-care requirements. In patient care planning, support-education actions were our top priority. Orem's self-care theory permitted identifying important aspects, which need to be developed by the nurses. PMID:19377816

Manzini, Fernanda Cristina; Simonetti, Janete Pessuto


[Self-care deficiencies in patients with gestational diabetes mellitus: a contribution to nursing].  


Gestational diabetes mellitus can be controlled and its complications prevented, provided clients take part in self-care actions. The objective of the present study was to identify self care deficiencies in pregnant women suffering from diabetes, and to provide inputs for their educational support. This descriptive study included 12 pregnant women cared at a diabetes and hypertension reference institution in Fortaleza, Ceará, Brazil, in April and May, 2007. Data were collected using a semistructured interview. Analysis was based on Orem's Nursing General Theory. Self-care deficiencies were related to eating habits, physical activities, sleep and rest, and social interaction. Nurses must provide educational support to these patients, evaluate their self-care capacity, and propose actions that involve the family, as well as group activities in health services. PMID:19068573

Landim, Camila Aparecida Pinheiro; Milomens, Kallyne Moreira Pequeno; Diógenes, Maria Albertina Rocha



Parent and Adolescent Distribution of Responsibility for Diabetes Self-care: Links to Health Outcomes  

PubMed Central

Objective?To examine the relation of adolescent and parent responsibility distribution for diabetes self-care to psychological and physical health.?Methods?We interviewed children (mean age 12 years) annually for 3 years and asked parents to complete a questionnaire. Both reported how diabetes self-care was distributed in the family. Amount of responsibility held by the child only, the parent only, and shared between child and parent was calculated. Psychological distress, competence, and diabetes outcomes were assessed at each wave.?Results?In both cross-sectional and longitudinal (lagged) analyses, multilevel modeling showed that shared responsibility was consistently associated with better psychological health, good self-care behavior, and good metabolic control, whereas child and parent responsibility were not. In some cases, links of shared responsibility to health outcomes were stronger among older adolescents.?Conclusions?These findings highlight the importance of shared responsibility for diabetes self-care through early to middle adolescence.

Reynolds, Kerry A.; Siminerio, Linda; Escobar, Oscar; Becker, Dorothy



Young Children's Self?care and Independence Tasks: Applying Self?Efficacy Theory  

Microsoft Academic Search

Social Psychologist, Albert Bandura, defines self?efficacy as the individual's belief in his or her own ability to perform a behavior. Self?efficacy for some self?care and independence tasks occurs in an early stage of young children's development. As caregivers take more responsibility for young children they must be aware of the child's need to become self?efficacious. Several self?care and independence tasks

Verna Hildebrand



Self-care strategy of elderly Korean immigrants in the Washington DC Metropolitan Area  

Microsoft Academic Search

The elderly Korean immigrants in the Greater Washington, DC Metropolitan Area use emotional self-care practices to counteract sad and depressive experiences. They tend not to use professional medical help and\\/or prescription medicine. Their choice of a self-care mental health strategy is a function of several sociocultural and historical factors: the Korean concept of self, life-long caring role, concepts of a

Keum Young Chung Pang; CHUNG PANG



Nutritional self-care in two older Norwegian males: a case study  

PubMed Central

Background: Knowledge about how to support nutritional self-care in the vulnerable elderly living in their own homes is an important area for health care professionals. The aim of this case study was to evaluate the effects of nutritional intervention by comparing perceived health, sense of coherence, self-care ability, and nutritional risk in two older home-dwelling individuals before, during, and after intervention and to describe their experiences of nutritional self-care before and after intervention. Methods: A study circle was established to support nutritional self-care in two older home-dwelling individuals (?65 years of age), who participated in three meetings arranged by health professionals over a period of six months. The effects of this study circle were evaluated using the Nutritional Form For the Elderly, the Self-care Ability Scale for the Elderly (SASE), the Appraisal of Self-care Agency scale, the Sense of Coherence (SOC) scale, and responses to a number of health-related questions. Qualitative interviews were performed before and after intervention to interpret the changes that occurred during intervention. Results: A reduced risk of undernutrition was found for both participants. A higher total score on the SASE was obtained for one participant, along with a slightly stronger preference for self-care to maintain sufficient food intake, was evident. For the other participant, total score on the SASE decreased, but the SOC score improved after intervention. Decreased mobility was reported, but this did not influence his food intake. The study circle was an opportunity to express personal views and opinions about food intake and meals. Conclusion: An organized meeting place for dialogue between older home-dwelling individuals and health care professionals can stimulate the older person’s engagement, consciousness, and learning about nutritional self-care, and thereby be of importance in reducing the risk of undernutrition.

Tomstad, Solveig T; Soderhamn, Ulrika; Espnes, Geir Arild; Soderhamn, Olle



Self-care ability and sense of coherence in older nutritional at-risk patients  

Microsoft Academic Search

Objective:To investigate self-care ability and sense of coherence in geriatric rehabilitation patients nutritionally screened using the Nutritional Form For the Elderly and to relate the patients' perceived health to self-care ability and sense of coherence.Design:Cross-sectional study.Setting:A geriatric rehabilitation ward in a hospital in western Sweden.Subjects:A sample of 172 consecutively recruited patients (65+ years) fulfilled the inclusion criteria. One hundred forty-four

U Söderhamn; M Bachrach-Lindström; A-C Ek



Acts-Hf: Attention, Cognition and Self-Care in Heart Failure  

Microsoft Academic Search

Background: Patients with heart failure (HF) are required to participate in self-care activities. This activities include taking prescribed medications, monitoring for symptoms, intervening appropriately and evaluating the response to the treatment. Cognitive impairment occurs relatively frequently in this population. Few studies have attempted to describe the nature of the relationship between self-care and cognitive impairment in this population.\\u000aPurpose:\\/ This

Catherine M. Murks



Evolution of self-care with over-the-counter medications  

Microsoft Academic Search

Self-care with over-the-counter (OTC) medicines has evolved from the “dark ages” of patent medicine manufacture and sale to a modern era of new drug development involving prescription-to-OTC switch. This evolution is largely due to the OTC Review, which placed science at the cornerstone of safety, effectiveness, and labeling of nonprescription medicines. As self-care with OTC drugs has evolved, the switching

R. William Soller



Health promotion self-care actions of healthy, middle-aged women  

Microsoft Academic Search

The purpose of the study was to determine the theoretical adequacy of health promotion self-care (HPSC) within Orem's general theory of nursing through describing self-care actions which healthy, middle-aged women perform to promote well-being. Utilizing a deliberate sampling model, 153 Black and White women, ages 40 to 59, with heterogeneous work and family patterns and from diverse socioeconomic conditions participated

Donna Lee Hartweg



Self?care capabilities in black girls in anticipation of menarche  

Microsoft Academic Search

Limited research exists on young girls’ expectations of self?care related to menarche. No studies specifically focus on black girls. This study describes the self?care agency of a group of black pre?menarcheal girls with respect to menarche. Data were collected through audiotaped interviews from a standardized schedule of questions based on Orem's theory. A verified content analysis was conducted. Family system

Carol J. Dashiff



Ethnic differences in illness perceptions, self-efficacy and diabetes self-care  

Microsoft Academic Search

This study assessed differences between Europeans, South Asians and Pacific Islanders in illness perceptions, self-efficacy, self-care, metabolic control and retinopathy in diabetes. We also evaluated the role of illness perceptions and self-efficacy in diabetes self-care and metabolic control within each group. A total of 86 Europeans, 86 South Asians, and 87 Pacific Islanders with type-2 diabetes completed self-report measures of

Debbie Bean; Tim Cundy; Keith J. Petrie



The Health Deviation of Post-Breast Cancer Lymphedema: Symptom Assessment and Impact on Self-Care Agency  

PubMed Central

Breast cancer is the leading cancer among women world-wide, affecting 1 of 8 women during their lifetimes. In the US alone, some 2 million breast cancer survivors comprise 20% of all cancer survivors. Conservatively, it is estimated that some 20-40% of all breast cancer survivors will develop the health deviation of lymphedema or treatment-related limb swelling over their lifetimes. This chronic accumulation of protein-rich fluid predisposes to infection, leads to difficulties in fitting clothing and carrying out activities of daily living, and impacts self-esteem, self-concept, and quality of life. Lymphedema is associated with self-care deficits (SCD) and negatively impacts self-care agency (SCA) and physiological and psychosocial well-being. Objectives of this report are two-fold: (1) to explore four approaches of assessing and diagnosing breast cancer lymphedema, including self-report of symptoms and the impact of health deviations on SCA; and (2) to propose the development of a clinical research program for lymphedema based on the concepts of Self-Care Deficit Nursing Theory (SCDNT). Anthropometric and symptom data from a National-Institutes-of-Health-funded prospective longitudinal study were examined using survival analysis to compare four definitions of lymphedema over 24 months post-breast cancer surgery among 140 of 300 participants (all who had passed the 24-month measurement). The four definitions included differences of 200 ml, 10% volume, and 2 cm circumference between pre-op baseline and/or contralateral limbs, and symptom self-report of limb heaviness and swelling. Symptoms, SCA, and SCD were assessed by interviews using a validated tool. Estimates of lymphedema occurrence varied by definition and time since surgery. The 2 cm girth change provided the highest estimation of lymphedema (82% at 24 months), followed by 200 ml volume change (57% at 24 months). The 10% limb volume change converged with symptom report of heaviness and swelling at 24 months (38-39% lymphedema occurrence), with symptom report being the earliest predictor of lymphedema occurrence than any other measurement. Findings verify the importance of subjective assessment by symptom report of limb changes and SCD following breast cancer treatment as an essential tool in early detection and treatment of lymphedema. Findings also support the importance of pre-operative baseline measurements, symptom history, and SCA for later post-op comparisons. These preliminary findings underscore the importance of strengthening SCA by educating breast cancer survivors. Self assessment, early detection, and early treatment hold the best promise for optimal management of this chronic condition, limiting detrimental effects on SCA, and improving quality of life and physiological and psychosocial well-being. These findings lay the foundation for a clinical research program in breast cancer lymphedema based on SCDNT in which education in and awareness for self-report of lymphedema-associated symptoms is a first step in screening. Increasing patient knowledge through education will increase SCA by identifying ane providing information to meet self-care requisites (SCR) related to the health deviation of lymphedema. The nurse has the opportunity to assist patients in developing self-care actions as needed to meet universal and health deviation therapeutic requisites to address self-care demands following breast cancer treatment.

Armer, Jane M.; Henggeler, Mary H; Brooks, Constance W.; Zagar, Eris A.; Homan, Sherri; Stewart, Bob R.



Diabetes Self-care among a Multiethnic Sample of Older Adults  

PubMed Central

Type 2 diabetes constitutes a leading and increasing cause of morbidity and mortality among older adults, particularly African Americans, Native Americans, Mexican Americans, and rural dwellers. To understand diabetes self-care, an essential determinant of diabetic and overall health outcomes, 80 middle aged and older adults from these four disproportionately affected racial/ethnic/residential groups engaged in in-depth interviews, focusing on approaches to and explanations for diabetes self-care. Certain self-care activities (medication-taking, diet, foot care) were performed regularly while others (blood glucose monitoring, exercise) were practiced less frequently. Despite research suggestions to the contrary, only one in four elders used unconventional diabetes therapies, and only one-third listed someone other than a health care provider as a primary information source. Few self-care differences emerged according to race/ethnicity/residence, perhaps because of the influential and common circumstance of low income. Thematic analyses suggest that inadequate resources, perceived efficacy of medication, great respect for biomedical authority, and lack of familiarity with and concerns about unconventional therapies are influential in establishing these patterns of self-care. We discuss the similarity of self-care practices and perspectives irrespective of race/ethnicity/residence and the predominance of biomedical acceptability.

Schoenberg, Nancy E.; Traywick, LaVona S.; Jacobs-Lawson, Joy; Kart, Cary S.



Objective assessment of self-care and non-professional care: a proposal.  


Nursing care today, both in theory and practice, consists not only of professional care rendered by nurse but, to a significant degree, involves also self-care and non-professional care. This tendency is also reflected in the philosophical premises of Polish Nursing. The interest in self-care and non-professional care in Poland, and, consequently, in the D. Orem's self-care deficit theory of nursing, as well as attempts at their implementation in nursing practice inspired the present attempt to develop a tool for objective assessment of these two types of care. The proposed Scale of Patient's and Care Provider's Agency (SPCPA) allows for the objective assessment of self-care as patient's self-care agency, and of non-professional care as the main care provider's agency measured in points. The aim of this study is to describe the tool and to assess its two psychometric properties: reliability and validity. The results of the statistical testing of the SPCPA show that the tool is capable of assessing precisely both the patient's self care agency and of the main provider's caring agency. PMID:12898967

Zarzycka, Danuta



'Self-care without a self': Alzheimer's disease and the concept of personal responsibility for health.  


The article focuses on the impact of the concept of self-care on persons who are understood as incapable of self-care due to their physical and/or mental 'incapacity'. The article challenges the idea of this health care concept as empowerment and highlights the difficulties for persons who do not fit into this concept. To exemplify this, the self-care concept is discussed with regard to persons with Alzheimer's disease (AD). In the case of persons with AD, self-care is interpreted in many different ways-depending on the point of view, for instance as an affected person or a carer. To prevent a marginalisation of the growing group of elderly persons with dementia, the article argues that concepts such as those of personhood, wellbeing, autonomy, rationality and normality have to be re-thought with regard to an increasingly ageing population. Taking into account that AD as a socio-medical construct has to be understood in the context of power relations, the article focuses on the mutual influence between the concepts of self-care and of AD and its possible impact on governing dementia and AD in particular. Michel Foucault's considerations on 'technologies of the self' provide the basis for the discussion of the self-care concept within existing societal power relations. PMID:18288589

Naue, Ursula



The sustainability of self-care in two counties of Guizhou Province, Peoples' Republic of China.  


This paper presents the findings of a follow-up survey conducted in two rural counties of Guizhou Province, PRC where a programme to prevent disabilities amongst leprosy affected people had been conducted. An initial 3-year programme had been conducted. One year after the final evaluation of the programme, a team was deployed to conduct a survey in the area. The objective of the survey was to establish the level of adherence to self-care. It was found that 87% of the sample of people living in leprosy villages that were surveyed (n = 31) and 50% of the sample of people living in general communities (n = 50) had continued to apply self-care. Interviews with family members suggested that 18 of the 27 self-care practising subjects living in the leprosy villages received encouragement or active support from family members (9 were single people). Twenty three of the 25 self-care practising subjects living in the communities also received family support (2 were single people). Family support was a highly significant factor influencing adherence in the community (OR = 15.8, CI = 3.0 to 83) but it may not have been the primary motivating factor in the leprosy villages where single people were just as likely to have adhered to self-care than people who were living in families (OR 0.5, CI = 0.06 to 4.2). The prevalence of foot ulceration among that population was recorded but a hypothetical association between the prevalence of foot ulceration and self-care adherence could not be investigated due to insufficient data to address the potential effects of confounding variables. Thirty-eight percent of subjects who did not practice self-care presented with ulceration or foot cracks (n = 29) compared with only 25% of people who did (n = 52). PMID:18540241

Li, Jinlan; Mu, Hongjiang; Ke, Wei; Bao, Xia; Wang, Ying; Wang, Zhenghua; Zeng, Bo; Cross, Hugh



Use and perceived efficacy of self-care activities in patients receiving chemotherapy.  


Information about chemotherapy side effects and the efficacy of self-care activities used to deal with these side effects is needed to direct nursing interventions for patients receiving chemotherapy. Using the self-care diary (SCD) developed for this study, a sample of 49 adult patients with cancer recorded their side effects, rated the severity of each side effect, and reported on the use and efficacy of self-care activities two days after treatment. Data were collected again five days after treatment to examine the test-retest reliability of the side effect severity component of the SCD. The most common side effect, experienced by 81% of the subjects, was fatigue. Other side effects reported by more than one-third of the subjects were sleeping difficulty, nausea, decreased appetite, and changes in taste or smell. The most frequently reported side effects received mean severity scores indicative of moderate severity. The most commonly used self-care activities were rated as providing some relief to moderate relief of individual side effects. None of the reported self-care activities received mean efficacy ratings that indicated complete side effect relief. PMID:1891417

Nail, L M; Jones, L S; Greene, D; Schipper, D L; Jensen, R



[Development of the "Whittener Activity Catalog of Self-Care in Venous Ulcer"].  


Poor rates of healing and high rates of re-ulceration are characteristic of venous leg ulcer. The performing of special health-deviation self-care is important for the successful treatment and prevention of this chronic disease. This study aimed to validate a newly designed instrument for the measurement of specific self-care. The "Wittener Aktivitätenkatalog der Selbstpflege bei venös bedingten offenen Beinen" (WAS-VOB) (a catalogue containing self-care activities for venous leg ulcer) was conceptualized on the basis of Orem's theory and on pathophysiological processes. The items were created by using patient interviews (n = 20) and a literature review. An analysis of the reliability was used to reduce the raw scale. The quality of the WAS-VOB was assessed for face-validity (n = 6), feasibility (n = 8), test-retest-reliability (n = 60) and the internal consistency (n = 234). The involvement of patients was based on an informed consent. The WAS-VOB is a self-describing instrument, includes 59 self-care activities and describes those in eight scales which deal with "general compression", "wearing compression bandages", "wearing compression hosiery", "mobility", "temperature", "overload of the venous system", "prevention of skin damage" and "wound healing". The WAS-VOB is practicable and has good psycho-metric characteristics. The test-retest-coefficient (Kendall's tau b) is 0.58, Cronbach's alpha 0.72. The instrument WAS-VOB is suitable for the assessment of self-care deficits. PMID:15040244

Panfil, Eva-Maria; Mayer, Herbert; Evers, Georges C




Microsoft Academic Search

The present study aimed to investigate the impact of a designed nursing intervention protocol on performing self-care activities among arthritic women. Four research hypothesis were formulated:1-the mean knowledge scores of patients who will receive instruction about self-care activities will be higher than that of a control group.2-the mean practice scores of patients who will apply self-care practices will be higher

Jehan S. Ali; Mimi M. Mekayee; Tayseer M. Khidre; Warda Y. Mohamed


What “Dr. Mom” ordered: A community-based exploratory study of parental self-care responses to children's ADHD symptoms  

Microsoft Academic Search

Little is known about family initiated self-care interventions in response to symptoms of attention deficit\\/hyperactivity disorder (ADHD), and how self-care may co-exist with professional treatments. This paper explores parental self-care strategies for children with hyperactivity or attention problems, and examines factors and domains that influence their use from the mixed method perspective. As part of a longitudinal cohort study of

Regina Bussing; Mirka E Koro-Ljungberg; Pamela Williamson; Faye A. Gary; Cynthia Wilson Garvan



Caring for oneself to care for others: physicians and their self-care.  


It is well known that clinicians experience distress and grief in response to their patients' suffering. Oncologists and palliative care specialists are no exception since they commonly experience patient loss and are often affected by unprocessed grief. These emotions can compromise clinicians' personal well-being, since unexamined emotions may lead to burnout, moral distress, compassion fatigue, and poor clinical decisions which adversely affect patient care. One approach to mitigate this harm is self-care, defined as a cadre of activities performed independently by an individual to promote and maintain personal well-being throughout life. This article emphasizes the importance of having a self-care and self-awareness plan when caring for patients with life-limiting cancer and discusses validated methods to increase self-care, enhance self-awareness and improve patient care. PMID:23967495

Sanchez-Reilly, Sandra; Morrison, Laura J; Carey, Elise; Bernacki, Rachelle; O'Neill, Lynn; Kapo, Jennifer; Periyakoil, Vyjeyanthi S; Thomas, Jane de Lima



Integration of Problem-based Learning and Innovative Technology Into a Self-Care Course.  


Objective. To assess the integration of problem-based learning and technology into a self-care course. Design. Problem-based learning (PBL) activities were developed and implemented in place of lectures in a self-care course. Students used technology, such as computer-generated virtual patients and iPads, during the PBL sessions. Assessments. Students' scores on post-case quizzes were higher than on pre-case quizzes used to assess baseline knowledge. Student satisfaction with problem-based learning and the use of technology in the course remained consistent throughout the semester. Conclusion. Integrating problem-based learning and technology into a self-care course enabled students to become active learners. PMID:23966730

McFalls, Marsha



A meta-analysis of self-care behavior research on elders in Thailand: an update.  


Self-care is essential for elderly individuals to maintain their optimal level of health. This meta-analysis was conducted to summarize research findings relating to self-care among the elderly in Thailand. Twenty studies undertaken from 1990 to 2008 were used and 328 effect sizes were computed. Most studies were unpublished master's theses guided by Orem's self-care deficit theory. Data were collected in these studies by face-to-face interviews. Variables with the largest effect sizes encompassed self-concept, social support, and self-efficacy. Those with medium effect sizes entailed family relationships, overall health beliefs, internal locus of control, health status, and external locus of control. Results from this meta-analysis is useful information for nursing. PMID:20167710

Klainin, Piyanee; Ounnapiruk, Liwan



An empirical test of a self-care model of women's responses to battering.  


A model of women's responses to battering was constructed based on Orem's theory of self-care deficit and on empirical and clinical observations. The model proposed that the age, educational level, and cultural influences as basic conditioning factors would all be directly related to relational conflict, which would be negatively related to self-care agency (as a mediator) and indirectly related to both outcomes of health and well-being. Using simultaneous structural equation modeling with specification searching, a modified model was derived that eliminated the mediation path but supported direct effects of both abuse and self-care agency on health. The derived model was found to be only a borderline fit with the data, probably due to measurement problems, lack of inclusion of important variables, and small sample size (N = 117). However, there was support for several of the relationships deduced from and/or congruent with Orem's theory. PMID:11847780

Campbell, J C; Weber, N



[Self-care in hospital discharge planning after bone-marrow transplantation: a case report].  


The purpose of this work was to construct an instrument that would enable the characterization of therapeutic self-care needs of an individual submitted to bone marrow transplantation (BMT) by reflecting on nursing interventions in the planning of hospital discharge based on Orem's self-care theory. The inclusion criteria consisted in the selection of allogenic clients who had been submitted to BMT and presented chronic myeloid leukemia. Data analysis enabled the evaluation of modified self-care requirements and nursing interventions were included in the support-education system and in the partly compensatory system. The instrument must be refined, but its use can be suggested as a support for the elaboration of the planning of hospital discharge for BMT patients. PMID:12040779

da Silva, L M



The effect of education given to patients with type 2 diabetes mellitus on self-care.  


This research was performed as a single group pretest--posttest experimental design to determine the effect of education given to patients with type 2 diabetes mellitus on self-care. The research was performed between October 2007 and June 2008 in the Internal Medicine Outpatient Clinics located in A and B Blocks of Erzincan State Hospital. The research population included 100 patients with type 2 diabetes mellitus who attended the above mentioned units between the specified dates and met the inclusion criteria. Patients were subjected to a pretest using a patient identification form, Diabetes Self-Care Scale (DSCS) form in Turkish language and metabolic control parameters. A statistically significant difference was found between the mean values of pre-education and posteducation DSCS scores with an increase in mean posteducation scores. These results demonstrate that the education given to patients improves their self-care and metabolic control variables. PMID:22435981

Karakurt, Papatya; Ka??kç?, Ma?firet Kara



Integration of Problem-based Learning and Innovative Technology Into a Self-Care Course  

PubMed Central

Objective. To assess the integration of problem-based learning and technology into a self-care course. Design. Problem-based learning (PBL) activities were developed and implemented in place of lectures in a self-care course. Students used technology, such as computer-generated virtual patients and iPads, during the PBL sessions. Assessments. Students’ scores on post-case quizzes were higher than on pre-case quizzes used to assess baseline knowledge. Student satisfaction with problem-based learning and the use of technology in the course remained consistent throughout the semester. Conclusion. Integrating problem-based learning and technology into a self-care course enabled students to become active learners.



Average Speed  

NSDL National Science Digital Library

This lab is not an inquiry activity but will help students understand the meaning of average velocity. Students do not easily understand from a textbook that an object's velocity changes over a period of acceleration. They have difficulty understanding wh

Horton, Michael



[Self-care theory: critical analysis of its usefulness in nursing practice].  


This study aims at evaluating the usefulness of Orem's theory of self-care, applied to the hypertense woman. The analysis criteria of nursing theories are classified into Internal and External Criteria. The usefulness of the theory, as one of the Internal Criteria, considers that the theory be useful when applied to professional practicing, be it in assistance, teaching, research or in administration. It has been found out that the theory is based on the basic needs of development. The application of the model in the health-disease cycle delimited the usefulness of Orem's self-care theory. PMID:15083787

Diógenes, Maria Albertina Rocha; Pagliuca, Lorita Marlena Freitag



The Self-Care Deficit Nursing Theory as a curriculum conceptual framework in baccalaureate education.  


Although Dorothea Orem's Self-Care Deficit Nursing Theory has been used for curricula framework for years, it was not until 2001 that Orem identified the nursing practice sciences and the foundational nursing sciences and specified the appropriate content for the two sciences. The broad purpose of this paper is to reinforce the importance of utilizing nursing theories as curricular conceptual frameworks. The specific purpose is to delineate the appropriate content for baccalaureate programs that adopt a Self-Care Deficit Nursing Theory conceptual framework for their curriculum. PMID:21471038

Berbiglia, Violeta A



Self-care behaviour, treatment satisfaction and quality of life in people on intensive insulin treatment.  


AIM: The aim of this cross-sectional study was to identify self-care behaviours and their relationships with treatment satisfaction and quality of life in people attending a structured educational programme for patients on intensive insulin therapy. METHODS: A sample of 104 people with diabetes (62 with type-1; 42 with type 2) was recruited from the National Institute of Endocrinology and Diabetology in ?uboch?a over six months. The majority of respondents were women (62.5%); had multiple daily injections of insulin (73%); diabetic late complications (68%) and had not previously participated in the structured educational programmes in the specialized diabetes centre (64.4%). Self-management behaviour data were collected by means of structured interviews with patients as well as during clinic visits. For measuring quality of life, the Audit Diabetes Dependent Quality of Life questionnaire and for measuring satisfaction with their treatment regimen, the Diabetes Treatment Satisfaction Questionnaire status version was used. RESULTS: General satisfaction with the treatment was significantly higher in people with diabetes, who implemented regular self-monitoring of the concentration of glucose in plasma (SMPG). We also demonstrated  low adherence in the frequency of SMPG. 17% of respondents in our study performed daily SMPG. However, 52% respondents reported adaptation of insulin dosage in relation to factors such as carbohydrate intake, glycaemia values or degree of physical activity. Differences in quality of life due to performing the regular self-monitoring of glycaemia, adjustments of insulin doses in specific situations as well as carbohydrate counting were not significant. CONCLUSION: Performing the regular self-monitoring of glycaemia was associated only with higher treatment satisfaction. No significant improvement in quality of life was seen in people performing the regular self-monitoring of glycaemia, adjustments of insulin doses in specific situations or carbohydrate counting. PMID:23549504

Gurkova, Elena; Ziakova, Katarina



Using Behavior Change Plans to Improve Medical Student Self-Care  

PubMed Central

Purpose To describe an innovative approach to teaching medical students the principles and practice of health behavior change and self-care using a Behavior Change Plan (BCP). Method Second-year medical students at Northwestern University Feinberg School of Medicine (n = 343) took a required Healthy Living unit in 2008 or 2009. They completed a BCP project in which they selected a personal behavior to change (exercise, nutrition, sleep, personal habits/hygiene, study/work habits, or mental/emotional health), set a goal, tracked progress, and self-assessed success. The authors employed a one-group posttest-only design to conduct a quantitative analysis and a qualitative evaluation of students' BCPs and their attitudes concerning the project. Results Among the 343 students, 299 (87.2%) set BCP goals related to exercise, nutrition, or sleep. BCP outcomes varied: 139 students (40.5%) achieved their goal, 170 (49.6%) failed to do so, and 34 (9.9%) were uncertain. Factor analysis produced two independent attitude scales: utility (? = .80) and burden (? = .67). Logistic regression showed that success approached statistical significance only in the sleep behavior category and for the utility attitude scale. Qualitative case reports provide insights about BCP targets, management, and results. After completing the assignment, 274 (79.9%) of the students considered themselves to be healthier and 281 (81.9%) indicated they would use the process again. Conclusions Completing a BCP is a valuable and effective exercise that enables medical students to practice the strategies and skills and experience the obstacles of changing health behavior.

Kushner, Robert F.; Kessler, Sheila; McGaghie, William C.



Embodied Learning and Patient Education: From Nurses' Self-Awareness to Patient Self-Caring  

ERIC Educational Resources Information Center

|This article is intended as a clear and practical introduction to use of a scientific perspective on embodied learning. It looks to embodied cognition and embodied cognitive science to explore education for self-care. The author presents a neurobiologic understanding of embodied learning to bridge adult education to the science-driven world of…

Swartz, Ann L.



Compassion Fatigue Risk and Self-Care Practices among Residential Treatment Center Childcare Workers  

ERIC Educational Resources Information Center

|Exploration of the presence of risk for compassion fatigue among residential childcare workers (RCW) at residential treatment facilities and the relationship between self-care practices and compassion fatigue were explored. Using the Professional Quality of Life Survey (ProQOL-R III) to assess compassion fatigue, burnout, and compassion…

Eastwood, Callum D.; Ecklund, Kathryn



Burnout in Mental Health Professionals as Related to Self-Care  

Microsoft Academic Search

Self care is frequently studied and described in modern psychology research and can be defined as any activity one engages in that fuels the body and mind and allows one to function more fully in daily life (Mahoney, 1997). Burnout is another frequently studied phenomenon, especially when considering those who work in mental health professions. It has been suggested that

Ann M. Miner



Support and Self-Care: Professional Reflections of Six New Zealand High School Counsellors  

ERIC Educational Resources Information Center

|In many Western societies there is increasing demand for counselling; in turn, heightened levels of support needs have been identified for counsellors themselves. Despite calls for practitioners to adopt a more proactive approach to self-care, research suggests many still pay insufficient attention to alleviating on-the-job stress or achieving…

Evans, Yvonne A.; Payne, Monica A.



Technology-Based Self-Care Methods of Improving Antiretroviral Adherence: A Systematic Review  

PubMed Central

Background As HIV infection has shifted to a chronic condition, self-care practices have emerged as an important topic for HIV-positive individuals in maintaining an optimal level of health. Self-care refers to activities that patients undertake to maintain and improve health, such as strategies to achieve and maintain high levels of antiretroviral adherence. Methodology/Principal Findings Technology-based methods are increasingly used to enhance antiretroviral adherence; therefore, we systematically reviewed the literature to examine technology-based self-care methods that HIV-positive individuals utilize to improve adherence. Seven electronic databases were searched from 1/1/1980 through 12/31/2010. We included quantitative and qualitative studies. Among quantitative studies, the primary outcomes included ARV adherence, viral load, and CD4+ cell count and secondary outcomes consisted of quality of life, adverse effects, and feasibility/acceptability data. For qualitative/descriptive studies, interview themes, reports of use, and perceptions of use were summarized. Thirty-six publications were included (24 quantitative and 12 qualitative/descriptive). Studies with exclusive utilization of medication reminder devices demonstrated less evidence of enhancing adherence in comparison to multi-component methods. Conclusions/Significance This systematic review offers support for self-care technology-based approaches that may result in improved antiretroviral adherence. There was a clear pattern of results that favored individually-tailored, multi-function technologies, which allowed for periodic communication with health care providers rather than sole reliance on electronic reminder devices.

Saberi, Parya; Johnson, Mallory O.



A Program Design To Motivate Individuals with SCI for Self-Care.  

ERIC Educational Resources Information Center

The report compares a skin care education program with a standard rehabilitation program to determine whether the program improved the self care motivations of spinal cord injury (SCI) paraplegic and quadriplegic inpatients (N=42). Study findings suggest that the skin care educational program was successful in changing patients' thinking about…

Scotzin, Martha


Measures of Self-Care Independence for Children with Osteochondrodysplasia: A Clinimetric Review  

ERIC Educational Resources Information Center

|This systematic review evaluates the validity, reliability, and clinical utility of outcome measures used to assess self-care skills among children with congenital musculoskeletal conditions and assesses the applicability of these measures for children with osteochondrodysplasia aged 0-12 years. Electronic databases were searched to identify…

Ireland, Penelope; Johnston, Leanne M.



Embodied Learning and Patient Education: From Nurses' Self-Awareness to Patient Self-Caring  

ERIC Educational Resources Information Center

This article is intended as a clear and practical introduction to use of a scientific perspective on embodied learning. It looks to embodied cognition and embodied cognitive science to explore education for self-care. The author presents a neurobiologic understanding of embodied learning to bridge adult education to the science-driven world of…

Swartz, Ann L.



Self Care Resource Corner: Its Impact on Appropriate Health Service Utilization.  

ERIC Educational Resources Information Center

|In an effort to intervene before students enter the medical care system at the University of Michigan, a Self Care Resource Corner and accompanying materials were developed and implemented. The objective was to encourage students to view themselves as the primary decision makers for health-related conditions before seeking care from clinicians.…

McClaran, Diane M.; Breakey, Robin Sarris


Self-Care and the Qualitative Researcher: When Collecting Data Can Break Your Heart  

ERIC Educational Resources Information Center

|Conducting qualitative research on topics that are emotionally laden can have a powerful impact on the researcher. Recent literature addresses the essential nature of the emotional connection that must be part of the qualitative research process. However, for the most part, it neglects the issue of self-care strategies for the researcher that are…

Rager, Kathleen B.



Hit for service: a model of self-care for parish nurses.  


The caregiving role of parish nurses extends to multiple settings including family, church, community, and secular employment. A lack of personal boundaries combined with the wholistic nature of parish nursing can produce caregiver role strain. Examining the life of Jesus reveals a pattern of intentional self-care practices that are a model for parish nurses. PMID:23607159

Daffron, Cristy


Physicians' understanding of patients' personal representations of their diabetes: accuracy and association with self-care.  


The degree of accuracy with which physicians understand their patients' views may be of central importance for promoting self-care in the majority of chronic illnesses and in type 2 diabetes in particular. The objectives of this study were to measure the accuracy of the general practitioners' understanding of the patients' views and relate it to health behavioural outcomes in patients with non-complicated type 2 diabetes. The participants in this cross-sectional study consisted of 14 clinicians and 78 of their patients from Paris, France. The predictors were levels of accuracy in understanding the patients' views derived from the illness perception questionnaire-revised (IPQ-R). The outcomes were patient-reported self-care measures. In regression models controlling for clinical and personal variables, higher accuracy on chronicity beliefs was associated with an improved diet and increased blood glucose self-testing and higher accuracy in identifying treatment control beliefs was associated with better dietary self-care. Accuracy was higher with regard to beliefs about causes, treatment control and consequences. These results suggest that accuracy may impact self-care in specific domains of illness perception but not others. The results may help identify useful avenues of communication training designed for professionals. PMID:21337260

Sultan, Serge; Attali, Claude; Gilberg, Serge; Zenasni, Franck; Hartemann, Agnès



Psychological distress and self-care engagement: healing after a cardiac intervention.  


Silencing the self, a relational concept, occurs when individuals overvalue others' standards, self-sacrifice their needs for others, inhibit self-expression, and experience a sense of dividedness between their inner and outer self. Given the emerging literature highlighting the importance of relational beliefs and experiences in coronary heart disease, the contribution of a concept such as self-silencing to the cardiac healing process is valuable to consider. This study investigated self-silencing dimensions, psychological distress (anxiety and depressive symptoms), and self-care engagement after a serious cardiac event. Forty women and 80 men attending a rehabilitation program completed a series of questionnaires six months post-cardiac intervention. Multivariate regression analyses were performed to examine the role of self-silencing after the influence of cardiac health and sociodemographics were taken into account. Self-silencing was positively associated with anxiety and depressive symptoms for both sexes. For self-care engagement, sex interacted with some of the silencing dimensions. The findings were interpreted in the context of participants' attendance in a rehabilitation program. Women who are self-silencing may benefit from the self-care expectations associated with a cardiac program whereas for men, even engaging in cardiac self-care may be perceived as self-silencing. PMID:21476171

Medved, Maria I; Piran, Niva



Mindfulness, Self-Care, and Wellness in Social Work: Effects of Contemplative Training  

Microsoft Academic Search

The demands placed on human service workers in supporting people through challenging circumstances can contribute to high levels of stress and burnout. Self-care practices implemented regularly may decrease the impact of the high levels of stress while also serving as strategies for coping during particularly stressful times. The interconnections between contemplative practices, including mindfulness, as coping and preventative strategies for

Tessa McGarrigle; Christine A. Walsh



Effects of Orem-based nursing intervention on nutritional self-care of myocardial infarction patients  

Microsoft Academic Search

The purpose of the study was to investigate the effect of nursing care based on Orem's nursing theory on nutritional self-care of myocardial infarction patients. Self-efficacy was explored as a disposition which may motivate behavioral change. One hundred and four subjects were randomly assigned to treatment or control groups. The nursing intervention, which took place during the first 6 weeks

Marjorie Isenberg



A philosophical inquiry of Orem's self-care deficit nursing theory  

Microsoft Academic Search

The purpose of this study was to investigate the metaphysical and epistemological foundations of Orem's self-care deficit nursing theory (SCDNT). Two conceptual problems were addressed: (a) the lack of explicitness of the philosophical position regarding the nature of human beings that is foundational to the SCDNT and (b) the absence of discussion and direction related to the identification of research

Barbara E Banfield



Applying Orem's Self-Care Deficit Theory of Nursing to continence care: Part 2.  


Theory based nursing practice provides a framework for initiation of the research process. Orem's Self-Care Deficit Theory of Nursing clearly relates and can be easily applied to continence care. Orem's Theory guides nursing practice with theoretical concepts and goal setting providing a foundation upon which nurses can question the practice and expand the avenue for nursing research. PMID:12593229

Bernier, Francie



[Self-care practice lived by hypertensive woman: analysis on the health education focus].  


This study approached the practice of self care lived by the women that suffer with high blood pressure. Descriptive-exploratory study which was inspired on the Orem's self-care theory and developed with 200 women who presented high blood pressure at a Public Health Agency, located in Fortaleza, Ceará, Brazil. The data were collected during nursing encounters, organized in categories, and analyzed according to the fundaments of the referred Theory. In this surveyed sample, about 172 (86%) women found out that they had high blood pressure problems by means of signs and symptoms related to the "climateric". It was evidenced on the women interviewed, that they presented knowledge knowledge about this syndrome, partial adherence to the treatment, and consequently inefficient practice of self-care, related to this deficit. In this way, it is possible to conclude that the self-care practice was influenced by the age, by disease stage development, and by the social, economic and health problems. PMID:17051892

Santos, Zélia Maria Souza Araújo; da Silva, Raimunda Magalhães


Physicians’ understanding of patients’ personal representations of their diabetes: Accuracy and association with self-care  

Microsoft Academic Search

The degree of accuracy with which physicians understand their patients’ views may be of central importance for promoting self-care in the majority of chronic illnesses and in type 2 diabetes in particular. The objectives of this study were to measure the accuracy of the general practitioners’ understanding of the patients’ views and relate it to health behavioural outcomes in patients

Serge Sultan; Claude Attali; Serge Gilberg; Franck Zenasni; Agnès Hartemann



A Program Design To Motivate Individuals with SCI for Self-Care.  

ERIC Educational Resources Information Center

|The report compares a skin care education program with a standard rehabilitation program to determine whether the program improved the self care motivations of spinal cord injury (SCI) paraplegic and quadriplegic inpatients (N=42). Study findings suggest that the skin care educational program was successful in changing patients' thinking about…

Scotzin, Martha


Testing Self-Efficacy as a Pathway that Supports Self-Care among Family Caregivers in a Psychoeducational Intervention  

ERIC Educational Resources Information Center

|This study investigated the extent to which a psychoeducational intervention supports family-centered care by influencing health risk and self-care behaviors of caregivers of individuals with Alzheimer's disease (N = 325). Moreover, this study investigated the extent to which changes in self-efficacy explained changes in health risk and self-care

Savundranayagam, Marie Y.; Brintnall-Peterson, Mary



Teaching Self-Care Through Mindfulness Practices: The Application of Yoga, Meditation, and Qigong to Counselor Training  

Microsoft Academic Search

Faculty in counseling training programs often give voice to the importance of self-care for students during the training period and into practice after training is completed. However, few programs specifically address this issue in their curricula. To address this perceived need, a course was developed to provide students with (a) personal growth opportunities through self-care practices and (b) professional growth

John Chambers Christopher; Suzanne E. Christopher; Tim Dunnagan; Marc Schure



Study to Determine the Feasibility of Establishing a Patient Self-Care Unit at Madigan Army Medical Center.  

National Technical Information Service (NTIS)

A case study of inpatient utilization at Madigan Army Medical Center was conducted in three phases to determine the number of inpatient bed days coded as self care to determine the potential for future populations of self care patients, and to conduct a c...

S. H. Chowen



Cancer treatment, symptom monitoring, and self-care in adults: pilot study.  


A descriptive study was conducted on self-reported symptoms and self-care by 37 adults receiving chemotherapy primarily for leukemia, lymphomas, or breast cancer or radiation therapy for head and neck or lung cancers. The Therapy-Related Symptom Checklist and demographic and interview forms on self-care for identified symptoms were used. Severe symptoms on the Therapy-Related Symptom Checklist subscales fatigue, eating, nausea, pain, numbness in fingers/toes, hair loss, and constipation were reported by patients on chemotherapy. Those on radiation therapy reported severe symptoms on the eating, fatigue, skin changes, oropharynx, and constipation subscales.Self-care strategies were in the following categories, using complementary medicine as framework: diet/nutrition/lifestyle change (eg, use of nutritional supplements; modifications of food and of eating habits; naps, sleep, and rest); mind/body control (eg, relaxation methods, prayer, music, attending granddaughter's sports events); biologic treatments (vitamins); herbal treatments (green mint tea); and ethnomedicine (lime juice and garlic). The first category was predominantly used by patients in both treatment types. Medications were prescribed also to help control symptoms (eg, pain and nausea). Symptom monitoring and self-care for symptoms identified may be facilitated by the Therapy-Related Symptom Checklist; based on reported symptom severity, care providers may prioritize interventions. A larger study needs to be done on (a) the use of the Therapy-Related Symptom Checklist as a clinical tool to assess symptoms that oncology patients experience during therapy; (b) whether care providers, based on patient-reported symptom severity, can prioritize interventions--and how this influences the efficiency of care; (c) the self-care strategies used by patients on chemotherapy or radiation therapy or both; and (d) how useful these strategies are in alleviating symptoms. PMID:17006107

Williams, Phoebe Dauz; Piamjariyakul, Ubolrat; Ducey, Kathleen; Badura, Jody; Boltz, Kristin D; Olberding, Karmen; Wingate, Anita; Williams, Arthur R


The effect of peer support groups on self-care for haemophilic patients with HIV in Japan.  


Experienced peer support groups (EPSG) are expected to improve self-care and complement professional health care for haemophilic patients, even those living in inconvenient clinical setting. However, these benefits have not been verified quantitatively. The structural equation modelling (SEM) was used to evaluate the effects of contact with EPSG on self-care for haemophilic patients in the Japanese clinical settings. Factors affecting self-care were compared between groups with and without EPSG contact. Self-reported questionnaires were mailed to 652 haemophilic patients with HIV in Japan (September 2005-January 2006). SEM demonstrated significant associations between EPSG contact, self-care scores and other social and individual factors. The total effect of EPSG contact on self-care was calculated. The structural differences between models were analysed in a multi-group analysis. Of the 257 respondents (response rate, 39.4%), 109 reported having contact with an EPSG (EPSG+ group) and 139 reported no contact (EPSG- group). EPSG contact was significantly associated with better self-care. In the multi-group analysis, the total effect of inconvenient access to medical services on self-care in the EPSG+ group was 10% of that in the EPSG- group and was significantly associated with poor illness-related knowledge and high anxiety level only in the EPSG- group. In the EPSG+ group, patient age was strongly associated with self-care than in the EPSG- group. These findings suggest that EPSG contact may alleviate inconvenience in medical services. Factors associated with self-care differed between groups. Health care professionals must carefully assess self-care behaviours and service accessibility based on these results. PMID:23834537

Omura, K; Ito, M; Eguchi, E; Imahuku, K; Kutsumi, M; Inoue, Y; Yamazaki, Y



Occupational therapy intervention: effects on self-care, performance, satisfaction, self-esteem/self-efficacy, and role functioning of older Hispanic females with arthritis.  


ABSTRACT The purpose of this pilot study was to compare the effectiveness of occupation-based and enabling/preparatory interventions on self-care, perceived performance, satisfaction, self-efficacy, and role function among older Hispanic females with arthritis. A pre- and post-outcome measures design with semi-structured interview and questionnaire/rating scales was used with matched participants assigned to one of two intervention groups or a control, non-intervention group. For measures of task-specific functioning and self-efficacy, there were no statistically significant differences in average gain scores between the two interventions. Average gain scores were higher for the enabling/preparatory intervention than for the control group. For the occupational intervention, the scores were higher than for the control group for self-care/activities of daily living (ADL) functioning and self-esteem/self-efficacy. The results suggest that client-centered occupational therapy intervention provided within the home environment is beneficial for occupational performance, participation, role competence, and quality of life. PMID:23899136

Landa-Gonzalez, Belkis; Molnar, David



Attitudes and awareness of web-based self-care resources in the military: a preliminary survey study.  


Web-based self-care resources have a number of potential benefits for military service members (SMs) and their families such as convenience, anonymity, and immediate 24/7 access to useful information. There is limited data available, however, regarding SM and military healthcare provider use of online self-care resources. Our goal with this study was to conduct a preliminary survey assessment of self-care Web site awareness, general attitudes about use, and usage behaviors of Web-based self-care resources among SMs and military healthcare providers. Results show that the majority of SMs and providers use the Internet often, use Internet self-care resources, and are willing to use additional Web-based resources and capabilities. SMs and providers also indicated a preference for Web-based self-care resources as adjunct tools to face-to-face/in-person care. Data from this preliminary study are useful for informing additional research and best practices for integrating Web-based self-care for the military community. PMID:21718091

Luxton, David D; Armstrong, Christina M; Fantelli, Emily E; Thomas, Elissa K



Predictors of Better Self-Care in Patients with Heart Failure after Six Months of Follow-Up Home Visits  

PubMed Central

This study aimed to examine the predictors of better self-care behavior in patients with heart failure (HF) in a home visiting program. This is a longitudinal study nested in a randomized controlled trial (ISRCTN01213862) in which the home-based educational intervention consisted of a six-month followup that included four home visits by a nurse, interspersed with four telephone calls. The self-care score was measured at baseline and at six months using the Brazilian version of the European Heart Failure Self-Care Behaviour Scale. The associations included eight variables: age, sex, schooling, having received the intervention, social support, income, comorbidities, and symptom severity. A simple linear regression model was developed using significant variables (P ? 0.20), followed by a multivariate model to determine the predictors of better self-care. One hundred eighty-eight patients completed the study. A better self-care behavior was associated with patients who received intervention (P < 0.001), had more years of schooling (P = 0.016), and had more comorbidities (P = 0.008). Having received the intervention (P < 0.001) and having a greater number of comorbidities (P = 0.038) were predictors of better self-care. In the multivariate regression model, being in the intervention group and having more comorbidities were a predictor of better self-care.

Trojahn, Melina Maria; Ruschel, Karen Brasil; Nogueira de Souza, Emiliane; Mussi, Claudia Motta; Naomi Hirakata, Vania; Nogueira Mello Lopes, Alexandra; Rabelo-Silva, Eneida Rejane



The chemistry laboratory. Development of average, fixed, and variable costs for incorporation into a management control system.  


In order to estimate real cost savings achievable from reductions in laboratory test volume and in order to provide a management tool to help achieve such savings, we developed a management system for our chemistry laboratory. The system estimates the fixed costs (i.e., equipment, direct overhead, and indirect overhead costs), the variable costs (i.e., labor and supplies), and the total costs for each of the 81 tests performed in our hospital's chemistry laboratory. A monthly management report compares predicted changes in total variable costs (based on test volume) to actual variable cost changes. One useful insight from the system is that substantial savings may be realized from reducing low-volume, high-variable cost tests that are not normally the target of test-reducing strategies. The savings per test not ordered was estimated to be $5.24 for the low-volume, high-variable cost tests but only $0.45 for the high-volume, low-variable cost tests, nearly a 12-fold difference. A 10% volume reduction of the former (a reduction of only 6,400 tests annually) would achieve 63% of the savings from a 10% volume reduction of the latter (a reduction of 120,000 tests annually). An effective management reporting system, which tracks actual cost savings, is probably necessary to achieve these savings. PMID:3695648

Trisolini, M G; McNeil, B J; Komaroff, A L



Spanish version of the Child and Adolescent Self-Care Performance Questionnaire: psychometric testing.  


This methodological study sought to determine the psychometric properties of the Spanish version of the Child and Adolescent Self-Care Performance Questionnaire originally developed by Moore (1995). In this study, the questionnaire, written originally in English, was translated into Spanish, and some items were adapted for the Latin American culture. The instrument was administered to 536 children of moderate socioeconomic status, ages 10 to 15 years, living in Chile. Evidence for reliability and validity involved examining Coefficient Alpha for the total scale and each of the subscales, item analysis, and factor analysis with varimax rotation. Coefficient alpha for the total scale (35 items) was 0.82, similar to the reliability reported by Moore (1995) for the original instrument. Factor analysis supported eight factors. Use of the instrument in Central and South America may assist in determining self-care practices of Latin American children and the effect of interventions to improve such practices. PMID:19472674

Jaimovich, Sonia; Campos, María Cecilia; Campos, María Sylvia; Moore, Jean Burley


A community-based oral health self-care intervention for Hispanic families.  


OBJECTIVES: A community-based intervention is described that targets oral health self-care practices among Hispanic children in the United States and is being tested in an ongoing trial. Descriptive results of baseline oral health variables are presented. METHODS: As of January 2013, 284 Hispanic children of ages 5-7 enrolled in the Healthy Families Study in Nashville, TN, USA. Families are randomized to one of two culturally appropriate interventions. RESULTS: At baseline, 69.6 % of children brushed at least twice daily, and 40.6 % brushed before bed daily. One-third of parents did not know if their children's toothpaste contained fluoride. CONCLUSIONS: This intervention fills the need for community-based interventions to improve oral health self-care practices that are culturally appropriate in Hispanic families. PMID:23612890

Hull, Pamela C; Reece, Michelle C; Patton, Marian; Williams, Janice; Beech, Bettina M; Canedo, Juan R; Zoorob, Roger



[An experience nursing a patient with amyotrophic lateral sclerosis using the theory of self-care].  


Amyotrophic lateral sclerosis (ALS) is a progressive and lethal motor neurodegenerative disease. The cause of the disease is unknown, and there is no cure current clinical treatment methods include Riluzole and supportive therapy. However, Riluzole only decelerates the patient's muscle strength loss and prolongs survival by about 3-5 months (Aventis Pharmaceutical, 2004). The patient will die eventually because of aspiration pneumonia or respiratory failure. This paper documents the use of Orem's self-care theory and holistic nursing assessment in a patient with amyotrophic lateral sclerosis. There are four areas of nursing concern: impaired self-care ability (dressing, feeding, toileting, and bathing), risk of falls, impaired verbal communication, and powerlessness. In terms of these problems suitable nursing activities are provided to develop the patient's ability to care for himself, prevent accidents, promote skills of non-verbal communication, and alleviate powerlessness in order to strengthen control. PMID:15986307

Chung, Kai-Chi; Shi, Shu-Feng; Tang, Yu-Ying; Wang, Kwua-Yun



Theoretical and empirical description of adult couples' collaborative self-care systems.  


Couples' collaborative care systems wherein work of self-care is shared are described from the perspective of Orem's nursing theory. Couples (N = 108) completed two forms of the Self-As-Carer Inventory: their perception of their own and of their partner's self-care agency. Each completed the Couple Form of the Family Adaptability and Cohesion Evaluation Scales and self-reports of health at this moment and of health in general. The person identified by the couple as having more caregiving responsibilities completed the Caregiver Reciprocity Scale. Stepwise multiple regression yielded a three-variable model (cohesion, dyad gender, and health now), which explained 27% of the variance of collaborative care system score. A collaborative care system model is proposed. PMID:11847639

Geden, E A; Taylor, S G



Vitamin C, chicken soup, and amulets: students view self-care practices.  


Students entering the community health nursing semester often express dismay at their diminished control of client behavior outside the hospital setting. A short case study of self-care practices, home remedies, and use of lay healers is helpful in establishing comfort with and respect for clients in their homes. Additionally, perspective about the medical system's relative place in the health-illness continuum is gained. The practices discovered by interview are exciting and almost limitless. PMID:2377323

Dehn, M A


Diabetes Self-care among a Multiethnic Sample of Older Adults  

Microsoft Academic Search

Type 2 diabetes constitutes a leading and increasing cause of morbidity and mortality among older adults, particularly African\\u000a Americans, Native Americans, Mexican Americans, and rural dwellers. To understand diabetes self-care, an essential determinant\\u000a of diabetic and overall health outcomes, 80 middle aged and older adults from these four disproportionately affected racial\\/ethnic\\/residential\\u000a groups engaged in in-depth interviews, focusing on approaches to

Nancy E. Schoenberg; LaVona S. Traywick; Joy Jacobs-Lawson; Cary S. Kart



Knowledge, attitudes and self-care practices related to sun protection among secondary students in Australia  

Microsoft Academic Search

The aim of this research was to ascertain changes in sun-related knowledge, attitudes and self-care practices among Australian secondary school students between 1993 and 1996. Two cross-sectional surveys of sun-related attitudes, beliefs and behavior of young people aged 12- 17 years of age, were conducted in 1993 and 1996. Over 80% of adolescents at both time periods knew about the

P. M. Livingston; V. M. White; A. M. Ugoni; Ron Borland



Development and validation of the dietary sodium reduction self-care agency scale.  


A scale did not exist for measuring the capability or self-care agency of lowering salt consumption in older adults with hypertension. Therefore, our objectives were to develop and validate the Dietary Sodium Reduction Self-Care Agency Scale (DSR-SCA Scale). A 24-item scale was developed and tested in 242 older adults with hypertension. Exploratory factor analysis using principal components extraction, Rasch analysis, and internal consistency reliability were used to evaluate the DSR-SCA Scale. Principal components extraction with Promax rotation was used. An 11-item DSR-SCA Scale with three factor loadings, which measure proficiency, persuasiveness, and resourcefulness, was finalized after it was found to meet the criteria of a minimal factor loading of 0.40, with eigenvalues of 2.20, 1.73, and 1.64, respectively. The Kaiser-Meyer-Olkin was 0.80, and Bartlett's test was significant, ?(2) (df = 55) 403.71, p < 0.0001. The measures accounted for 51% of the total variance. Item infit and outfit mean square ranged from 0.88 to 1.18 and the infit and outfit standardized mean square was -1.8 to 1.7. The 11-item scale demonstrated internal consistency with a Cronbach's alpha coefficient of 0.73 for the total scale. The results showed that the DSR-SCA Scale consisted of three factors that have adequate construct validity and reliability to measure power components and enabling capability related to Orem's self-care theory. This scale is brief, easy-to-complete, and useful for measuring salt reduction self-care agency in older adults with hypertension PMID:23330942

Smith, Pratsani; Phillips, Kenneth D



Self-care of well adult Canadians and adult Canadians with end stage renal disease  

Microsoft Academic Search

Empirical support for Orem's Self-Care Deficit Theory of Nursing [Orem, D.E., 1995. Nursing: Concepts of practice, 5th. ed. Mosby, Toronto] is accumulating. However, little is known about the relative usefulness of the theory with well and chronically ill adults. This research examined multiple relationships deduced from Orem's Theory in 109 well adults and 141 adults with end stage renal disease

Martha E. Horsburgh



An innovative self-care module for palliative care medical learners.  


Palliative care is a uniquely demanding field in that clinicians routinely address the complex needs of patients living with incurable illness. Due to their relative inexperience, medical learners completing a palliative care educational experience are particularly vulnerable to the stresses that are often encountered. To address this educational need, a structured Self-Care Module was developed for medical learners rotating through a palliative care clinical rotation. Components of this module include completion of a process recording exercise, a structured reflection, and participation in a facilitated group discussion. An examination of the acceptability, utility, and operational feasibility of the module demonstrated that 86% (n=35) of learners found the module helpful in reflecting on their clinical encounters, 86% (n=35) gained an appreciation for the importance of self-reflection and self-awareness as a component of self-care and 97% (n=35) gained a greater appreciation for sharing clinical experiences with other learners. This novel Self-Care Module was found to be a well accepted, useful, and operationally feasible educational experience for postgraduate and undergraduate learners completing a palliative care educational experience. PMID:23631613

Kim, Hyon C; Rapp, Elaine; Gill, Ashlinder; Myers, Jeff



Ability for self-care in urban living older people in southern Norway  

PubMed Central

Background The number of older people living in urban environments throughout the world will increase in the coming years. There is a trend in most European countries towards improved health among older people, and increased life expectancy for both women and men. Norway has experienced less increase in life expectancy than some other European countries, and it is therefore important to investigate older urban Norwegian people’s health and ways of living in a self-care environment, with special regard to health promotion. Aim The aim of this study was to describe self-care ability among home-dwelling older (65+ years) individuals living in urban areas in southern Norway in relation to general living conditions, sense of coherence (SOC), screened nutritional state, physical activity, perceived self-reported health, mental health, and perceived life situation. Methods In 2010, a randomized sample of 1044 men and women aged 65+ years who were living in urban areas in southern Norway answered a postal questionnaire consisting of five instruments, some background variables, and 17 health-related questions. Univariate and multivariate statistical methods were used in the analyses of the data. Results The mean age of the participants was 74.8 years (SD = 7.1). Eighty-three percent of the participants had higher abilities to care for themselves. Self-care agency, perceived good health, being active, being frequently active, good mental health, not being at risk of undernutrition, and satisfaction with life were all positively related to self-care ability. Negative factors were perceived helplessness, receiving home nursing, being anxious, and being at a more advanced age. People aged 85+ years had worse mental health, were less physically active, and more at risk of undernutrition. Conclusion Health professionals should focus on the health-promoting factors that reinforce older people’s ability to care for themselves, and be aware of important symptoms and signs associated with a reduction in a person’s self-care ability. Politicians should assume responsibility for health care with a special regard to senior citizens.

Sundsli, Kari; Soderhamn, Ulrika; Espnes, Geir Arild; Soderhamn, Olle



Orem's self-care deficit nursing theory: its philosophic foundation and the state of the science.  


There is a preponderance of descriptive studies, ranging from those using a simple descriptive correlational approach to multivariate approaches. Only one study is clearly identified as an experimental study (Moore, 1987) and two clearly identified as replication studies (Lenatsch, 1999; Schott-Baer, Fisher, & Gregory, 1995). Fewer than half make clear links between the variables being examined and situations of nursing practice; that is, they examine elements of the theory of self-care without making the link to nursing practice an explicit part of the study. While this work is increasing our knowledge about self-care (Stage II), further work needs to be done to put the results of these in the context of nursing practice as in Stages III, IV, or V. Most of the studies reviewed are Stage II and provide an enhanced or broader description of an element or component of the theory, empirically describing the relationships between or among age, gender, self-care actions, disease, and so forth. These studies add to our understanding of existing and known or proposed relationships within the extant theory. The majority of studies examine self-care and/or self-care deficits. There are many studies but little evidence that sustained research programs are developing and expanding the theory. The bricks are piling up around the framework, but only a few scholars are working on building the walls. These programs of research are occurring in universities where a critical mass of interested scholars and students can be found. The use of theoretical language is sometimes imprecise and at other times inaccurate. Valid new terms are introduced but the relationship to existing theoretical constructs is not always explicit. There is little critical review of research in the literature. Ongoing dialog among scholars is minimal. There is a need for nurse scholars to come together and to engage in such a dialogue to enhance the work. Given the relatively short history of nursing research and, more importantly, the conduct of nursing theory-based research, the number and quality of the work being conducted is quite remarkable. There has been a substantial amount of work produced and the quality of it has improved over time. Orem has provided nurse researchers with a theoretical system comprising an ontological structure, related epistemology, and numerous models that give direction to scholarly efforts. Scholars using this theoretical system would be well-advised to use these in conceptualizing and interpreting their work. PMID:11847693

Taylor, S G; Geden, E; Isaramalai, S; Wongvatunyu, S



A Study of the Relationship Between Self-Care, Compassion Satisfaction, Compassion Fatigue, and Burnout Among Hospice Professionals  

Microsoft Academic Search

Hospice care professionals (HCPs) experience a large number of stressors in their work settings. The purpose of this study was to investigate the relationship between self-care, compassion fatigue, burnout, and compassion satisfaction among HCPs. Thirty-seven HCPs were surveyed regarding their levels of compassion satisfaction, compassion fatigue, and burnout. Respondents also reported the types of self-care activities in which they took

Karen Alkema; Jeremy M. Linton; Randall Davies



The contribution of personality to adult well-being: A test and explication of Orem's theory of self-care  

Microsoft Academic Search

This cross-sectional, correlational research study explored the articulation of the Five Factor Model of Personality Traits (neuroticism, extroversion, openness, agreeableness, conscientiousness; McCrae & Costa, 1987) with Orem's Self-Care Deficit Theory of Nursing (1991) for the purpose of further explicating and testing Orem's Theory and enhancing nursing's understanding of how personality traits contribute to selected basic conditioning factors (BCFs), self-care agency

Martha Elizabeth Horsburgh



Mexican-American cultural meanings, expressions, self-care and dependent-care actions associated with experiences of pain  

Microsoft Academic Search

The purposes of this ethnographic study were to discover Mexican-American cultural meanings, expressions, self-care, and dependent-care actions associated with experiences of pain and to examine the appropriateness of Orem's Self-Care Deficit Theory of Nursing (1991) for use with Mexican-Americans. Data were obtained from 20 key informants from 13 families and 20 general informants in the family and community context. Thematic

Antonia Maria Villarruel



Testing Self-Efficacy as a Pathway That Supports Self-Care Among Family Caregivers in a Psychoeducational Intervention  

Microsoft Academic Search

This study investigated the extent to which a psychoeducational intervention supports family-centered care by influencing health risk and self-care behaviors of caregivers of individuals with Alzheimer's disease (N = 325). Moreover, this study investigated the extent to which changes in self-efficacy explained changes in health risk and self-care behaviors. Data were analyzed using repeated measures and multivariate analysis of variance and multiple

Marie Y. Savundranayagam; Mary Brintnall-Peterson



Developing a program to promote stress resilience and self-care in first-year medical students  

PubMed Central

Background Facilitating stress resilience in future physicians is an important role of medical educators and administrators. We developed an extracurricular program and pilot tested the program on first year medical students. Methods Presentations on topics related to mental health, help-seeking, and stress resilience were presented (one topic per session). Attendance was voluntary. Attendees were requested to complete anonymous evaluations following each presentation. Primary outcome variables were rates of agreement that the presentation (1) was interesting, (2) provided valuable information, and (3) provided information relevant for the student’s future practice as a physician. Results Each of the seven topics was attended on average by approximately half of the student body. Evaluations were very positive that presentations were interesting and provided information useful to maintaining balance during medical school (all had ?85% rates of agreement). Evaluations by students were variable (41%-88% rates of agreement) on whether each presented information relevant for future practice. Conclusions The results support that first-year medical students value explicit guidance on ways to bolster stress resilience and self-care during medical school. It is important to clarify with each presentation how the information is relevant to their future practice as a physician.

Thomas, Suzanne E.; Haney, Myra K.; Pelic, Chris M.; Shaw, Darlene; Wong, Jeffrey G.



Amount of health care and self-care following a randomized clinical trial comparing flexion-distraction with exercise program for chronic low back pain  

PubMed Central

Background Previous clinical trials have assessed the percentage of participants who utilized further health care after a period of conservative care for low back pain, however no chiropractic clinical trial has determined the total amount of care during this time and any differences based on assigned treatment group. The objective of this clinical trial follow-up was to assess if there was a difference in the total number of office visits for low back pain over one year after a four week clinical trial of either a form of physical therapy (Exercise Program) or a form of chiropractic care (Flexion Distraction) for chronic low back pain. Methods In this randomized clinical trial follow up study, 195 participants were followed for one year after a four-week period of either a form of chiropractic care (FD) or a form of physical therapy (EP). Weekly structured telephone interview questions regarded visitation of various health care practitioners and the practice of self-care for low back pain. Results Participants in the physical therapy group demonstrated on average significantly more visits to any health care provider and to a general practitioner during the year after trial care (p < 0.05). No group differences were noted in the number of visits to a chiropractor or physical therapist. Self-care was initiated by nearly every participant in both groups. Conclusion During a one-year follow-up, participants previously randomized to physical therapy attended significantly more health care visits than those participants who received chiropractic care.

Cambron, Jerrilyn A; Gudavalli, M Ram; McGregor, Marion; Jedlicka, James; Keenum, Michael; Ghanayem, Alexander J; Patwardhan, Avinash G; Furner, Sylvia E



Power, self-care and health in women living in urban squatter settlements in Karachi, Pakistan: a test of Orem's theory.  


This was a study of health in women living in urban squatter settlements in Karachi, Pakistan. The study grew out of the author's concern for the generally poor health status of Pakistani women. Orem's nursing theory was selected to examine health in these women. The purpose of the study was to examine relationships among basic conditioning factors, self-care agency (specifically, perception of power as a foundational capability of self-care agency and the enabling capabilities of self-care agency), self-care, and selected health outcomes of Pakistani women. Four hypotheses were developed and tested. They were that in a group of Pakistani women: (1) perception of power as a foundational capability and enabling capabilities of self-care agency and self-care will be related to selected basic conditioning factors; (2) perception of power, as a foundational capability of self-care agency, will be directly and positively related to enabling capabilities of self-care agency; (3) perception of power as a foundational capability and enabling capabilities of self-care agency will have a direct and positive relationship with self-care; and (4) self-care will be related to selected health outcomes. Hypotheses one, two and three were supported. Findings indicate that the basic conditioning factors, socioeconomic variables, ethnicity and roles, were predictive of perception of power, enabling capabilities of self-care agency, self-care and health. Hypothesis four was not supported; basic conditioning factors had more influence on health than self-care. PMID:10404002

Lee, M B



Asthma Self-Management Project.  

National Technical Information Service (NTIS)

This annual report describes the educational intervention and data analysis of the Asthma Self-Management Project, a health education project designed to teach self-care skills to families of asthmatic children.

C. Feldman N. Freudenberg



Asthma Self-Management Project.  

National Technical Information Service (NTIS)

This annual report describes the educational intervention and data analysis of the Asthma Self-management Project, a health education project designed to teach self-care skills to families of asthmatic children.

D. Evans C. Feldman



Validity and Reliability of an Adolescent and Parent Rating Scale of Type 1 Diabetes Adherence Behaviors: The Self-Care Inventory (SCI)  

PubMed Central

Objective?Accurate assessment of diabetes regimen adherence behaviors in youth is a challenging endeavor and is limited by a paucity of empirically supported measures. The purpose of this research is to further demonstrate the validity and reliability of the Self-Care Inventory (SCI), a youth and parent report measure of adherence with diabetes self-care behaviors. The SCI was chosen given its ease of implementation, applicability to multiple diabetes regimens, and dual parent/youth formats.?Methods?Participants were 164 youth with type 1 diabetes and a parent. Measures were administered at regular office visits to a tertiary care diabetes clinic.?Results?The SCI has strong psychometric properties, including adequate internal consistency, parent–youth agreement, and test-retest agreement. Relations between the SCI and a structured interview of diabetes adherence (the Diabetes Self-Management Profile; DSMP) and hemoglobin A1c (HbA1c) were strong.?Conclusions?In addition to demonstrating strong psychometrics, this research provides independent support for the SCI. Thus, the SCI is consistent with recent criteria proposed by Quittner et al. (Journal of Pediatric Psychology, 33, 916–936) for an empirically supported measure of regimen adherence. Although other methods of accessing adherence may provide more comprehensive assessments, the brevity, ease-of-implementation, and robustness for multiple regimens makes the SCI an ideal tool for clinicians and researchers.

LaGreca, Annette M.; Geffken, Gary R.; Williams, Laura B.; Duke, Danny C.; Storch, Eric A.; Silverstein, Janet H.



Self Care Activities, Diabetic Distress and other Factors which Affected the Glycaemic Control in a Tertiary Care Teaching Hospital in South India.  


Background: Interventions which were made to promote a better self-management have produced improvements in the glycaemic control in patients with Diabetes mellitus. An improved glycaemic control is known to prevent the long term complications. Method: This study was conducted at the Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, which is a rural tertiary health care centre. 546 patients were included in our study and they were assessed for the glycaemic control (HbA1c), diabetes distress (DDs), and self care activities. Results: Of the total 546 patients, 49% had a poor glycaemic control, as was indicated by HbA1c levels of >7%. The factors which are significantly associated with a poor glycaemic control are age (p=0.03 ), sex (p= 0.0415), literacy (p=0.0422), duration of the disease (p=0.0006), diabetic distress (p=0.0001) and self care activities like diet ( p=0.0001), medication (p=0.0001) and exercise (p=0.0001), whereas there was no significant effect of the BM I (p=0.094) on the glycaemic control. Conclusion: This study revealed the factors that could predict the glycaemic control in the diabetic patients who attended our tertiary care teaching hospital. The barriers that prevent these patients from meeting their goals must be explored, to improve their health outcomes. PMID:23814728

Sasi, Sekhar Tvd; Kodali, Madhavi; Burra, Kalyan Chakravarthy; Muppala, Baby Shalini; Gutta, Parvathi; Bethanbhatla, Murali Krishna



Telehomecare Communication and Self-Care in Chronic Conditions: Moving Towards a Shared Understanding  

PubMed Central

Background Remote telemonitoring of patients’ vital signs is a rapidly increasing practice. While methods of communication in remote electronic monitoring differ from those in traditional home health care, the understanding shared by the nurse, patient, and family members remains the same: patients’ self-care behaviors affect exacerbations of chronic health conditions. The purpose of this paper is to examine the relationship between communication and information integration into the daily lives of patients with chronic illnesses and offer best practice recommendations for telehomecare nurses. Methods The original study utilized the Social Relations Model to examine relationships within 43 triads composed of patients with chronic conditions, home helpers and their nurse (THN) involved in telehomecare at three Veterans Health Administrations. This secondary descriptive and correlational analysis compared 43 patients’ and 9 THNs’ ratings of themselves and each other on communication (frequency, timeliness and understanding) and the use of patients’ daily telemonitored information. Results There was almost no correlation between patients’ perception of THNs’ communication (frequency [r = .05], timeliness [r = .09] and understandability [r = .03]) and patients’ integration of information into daily health practices. However, significant correlations were found between the THNs’ perception of patients’ communication frequency and timeliness, and integration, (p = .02), (p < .001) respectively. Conclusions This study suggests that frequent phone communication may lead the remote THN to believe patients are integrating blood pressure, weight and other information into daily self-care behaviors, when in fact the patient reports that they are not. The influence of a halo effect on the THN may cloud an accurate perception of what is actually occurring. Remote communication may require more attention to THNs educating patients about shared understandings when using telemonitoring. Best practices for THN should include explicit goals and intentions for telemonitored home care with individualized instructions about how to use the information for self-care.

Shea, Kimberly; Chamoff, Breanna



Sex Differences in Muscle Pain: Self-care Behaviors and Effects on Daily Activities  

PubMed Central

Women have a higher prevalence of fibromyalgia and myofascial pain than men, but sex differences in muscle pain are inconsistently detected. We examined sex differences in ratings and effects of recalled and experimentally-induced muscle pain. In Study 1 (N = 188), participants completed a questionnaire about recalled muscle pain. In Study 2 (N = 55), participants’ described muscle pain from an exercise stimulus across three days by telephone. Muscle pain ratings, self-care behaviors for muscle pain, and effects of muscle pain on activities were measured. No significant sex differences were found except that women tended to view exercise as more effective for decreasing muscle pain than men (F1, 187 = 5.43, p = .02, ?2 = .03), fewer women performed exercise for induced muscle pain than men, and women’s activity interference was significantly higher than men’s at the third day post-exercise (F2, 42 = 6.54, p= .01, ?2 = .14). These findings support the absence of meaningful sex differences in muscle pain ratings. However, additional investigations are needed that consider the daily activities completed by people and the prevalence and incidence of performing a wide range of self-care behaviors for pain. Perspective: These studies support that sex differences are not present in recalled and experimentally-induced muscle pain ratings. Therefore, we must be cautious about generalizing the musculoskeletal pain literature to muscle pain. Additional research is needed to interpret potential sex differences in self-care behaviors for muscle pain and activity interference from muscle pain.

Dannecker, Erin A.; Knoll, Victoria; Robinson, Michael E



The effects of self-care training on quality of life in patients with multiple sclerosis  

PubMed Central

Background: Multiple sclerosis (MS) is a chronic and progressive disease of the central nervous system with debilitating symptoms and complications. Therefore, education and appropriate interventions, including self-care education, are necessary to increase the quality of life in these patients. The purpose of this study was to determine the influence of self-care education on quality of life in MS patients affiliated to Iranian MS Association. Materials and Methods: This quasi-experimental study assessed a single group of MS patients before and after training. Totally, 50 MS patients were selected non-randomly from the patients referring to Iranian MS Association. A two-part questionnaire was used to collect data. The first part included demographic information and the second part consisted of a quality of life questionnaire (MSQOL-54) including 54 items in 3 sections and 14 subgroups. The scores ranges from zero to a hundred in each subgroup. The reliability of the questionnaire has been confirmed (Cronbach's alpha = 0.96). The questionnaires were filled out by the patients before training. After at least six 50-minute training sessions during three months, the same questionnaire was again completed by the participants. Statistical analyses, including absolute and relative frequency tables and mean and standard deviation for descriptive analysis, and t-test and Pearson correlation for descriptive analysis, were performed by SPSS. Findings: The mean values of quality of life in physical health, pain, fatigue, health conception, changes in health status, sexual activities, as well as overall quality of life scores differed significantly after training. Moreover, except for cognitive activity, there were significant differences in values of mental health before and after training. Conclusions: Designing and applying the self-care programs based on the educational needs of MS patients has a positive effect on physical and psychological aspects of their quality of life.

Sahebalzamani, Mohammad; Zamiri, Maryam; Rashvand, Farnoosh



Social Support and Self-Care of Patients with Heart Failure  

Microsoft Academic Search

Background  Social support can influence treatment adherence of patients with chronic illnesses, which may explain the positive effects\\u000a of social support on heart failure (HF) outcomes.\\u000a \\u000a \\u000a \\u000a Purpose  To investigate the effects of social support among patients with HF, we examined whether aspects of social support were associated\\u000a with self-care, including medication adherence, dietary adherence, and HF symptom monitoring functions.\\u000a \\u000a \\u000a \\u000a Methods  We recruited 74

Steven L. Sayers; Barbara Riegel; Stephanie Pawlowski; James C. Coyne; Frederick F. Samaha



A theory of dependent-care: a corollary theory to Orem's theory of self-care.  


Dependent-care has its origins in people's requirements for regulatory care. The foundations for dependent-care are found in the ability of individuals to provide their required care. First introduced as a corollary to self-care, this work emerged through a process of reading and discussion. Models that support the theory of dependent-care are identified. Premises are stated. There is elaboration of the conceptualizations representing the work that has been done. There are still elements that need further development, such as specifying the enabling abilities of dependent-care agency and verifying and formalizing the various elements presented. PMID:11873353

Taylor, S G; Renpenning, K E; Geden, E A; Neuman, B M; Hart, M A



Evaluation of education materials using Orem's self-care deficit theory.  


This article presents Orem's self-care deficit nursing theory as the conceptual framework in the development, design, selection, and evaluation of appropriate written patient education materials for patients with low literacy skills. The model, which includes essential evaluation factors used in literacy research, offers nurses and other professionals a more comprehensive means to judge the suitability of health information and instructional materials. Nurses have a critical role in educating consumers and their families and for providing patients with useful information that will influence their decision-making and participation in care. PMID:12593317

Wilson, Feleta L; Mood, Darlene W; Risk, Joanna; Kershaw, Trace



The application of Orem's Self-Care Model to burn care.  


Although many studies from burn nurses are present in the literature, very little information is found that indicates a theory-based approach to care. The purpose of this article is to demonstrate the deficiency of nursing theory in the specialty of burn nursing and to suggest Orem's Self-Care Model as a valid basis for delivering care and increasing the level of professionalism in this specialty area. The correlation of Orem's three systems (ie, wholly compensatory system, partially compensatory system, and supportive/educative system) to the unique care needs of burn patients with varying levels of acuity are the keys to understanding the application of this theory to the practice of burn care. In applying theory to practice, clinicians discover that no single theory addresses each aspect of care precisely. Because of this characteristic, gaps in theory exist. Consideration of various components of alternate theories is appropriate as integration of theory and practice is developed. Although Orem's theory is quite applicable to burn care, certain components of Watson's Caring Theory and Roy's Adaptation Model is also applicable to those aspects of burn care not addressed by Orem. Those in the field of burn nursing should begin looking forward and adapting a specific theory to this specialty practice. Orem's Self-Care Model is the most applicable to burn care and provides a beginning point for theory usage in burn nursing care. PMID:19692925

Wilson, Joan; Gramling, Lou


Do employee health management programs work?  


Current peer review literature clearly documents the economic return and Return-on-Investment (ROI) for employee health management (EHM) programs. These EHM programs are defined as: health promotion, self-care, disease management, and case management programs. The evaluation literature for the sub-set of health promotion and disease management programs is examined in this article for specific evidence of the level of economic return in medical benefit cost reduction or avoidance. The article identifies the methodological challenges associated with determination of economic return for EHM programs and summarizes the findings from 23 articles that included 120 peer review study results. The article identifies the average ROI and percent health plan cost impact to be expected for both types of EHM programs, the expected time period for its occurrence, and caveats related to its measurement. PMID:19288852

Serxner, Seth; Gold, Daniel; Meraz, Angela; Gray, Ann


Effects of a family support program on self-care behaviors in patients with congestive heart failure  

PubMed Central

Background: Heart failure is one of the chronic heart diseases and a debilitating condition of increased prevalence in the elderly. One of the important and non-pharmacological strategies for improving clinical outcomes in these patients is promotion of the self-care. Background and social environment in which a patient is trying to control his disease is an important factor in the self-care. The aim of this study was to evaluate the effects of family support intervention on the self-care behaviors in patients with heart failure. Materials and Methods: This study was a randomized clinical trial conducted in university hospitals in Isfahan, Iran, in 2012. A total of 62 patients with heart failure were randomly assigned to experimental (n = 32) and control (n = 32) groups. Supportive intervention including three educational sessions with the delivery of educational booklet and follow-up by telephone was performed for caregivers of patients in the experimental group. Data were collected using the questionnaire of self-care behaviors, which was completed before and 1 month after the intervention in both the groups, and the questionnaires were analyzed using descriptive statistics and independent and paired t-tests. Results: The results indicate that after the intervention, self-care behavior scores in the experimental group and control group were 47.2 and 28.4, respectively, and independent t-test revealed that the difference was statistically significant. Conclusion: Family-focused supportive interventions can be used as an effective method for improving the self-care behaviors in patients with heart failure.

Shahriari, Mohsen; Ahmadi, Maryam; Babaee, Sima; Mehrabi, Tayebeh; Sadeghi, Masoumeh



Survey of CAM interest, self-care, and satisfaction with health care for type 2 diabetes at group health cooperative  

PubMed Central

Background Very little research has explored the factors that influence interest in complementary and alternative medicine (CAM) treatments. We surveyed persons with sub-optimally controlled type 2 diabetes to evaluate potential relationships between interest in complementary and alternative medicine (CAM) treatments, current self-care practices, motivation to improve self-care practices and satisfaction with current health care for diabetes. Methods 321 patients from a large integrated healthcare system with type 2 diabetes, who were not using insulin and had hemoglobin A1c values between 7.5-9.5%, were telephoned between 2009-2010 and asked about their self-care behaviors, motivation to change, satisfaction with current health care and interest in trying naturopathic (ND) care for their diabetes. Responses from patients most interested in trying ND care were compared with those from patients with less interest. Results 219 (68.5%) patients completed the survey. Nearly half (48%) stated they would be very likely to try ND care for their diabetes if covered by their insurance. Interest in trying ND care was not related to patient demographics, health history, clinical status, or self-care behaviors. Patients with greater interest in trying ND care rated their current healthcare as less effective for controlling their blood sugar (mean response 5.9 +/- 1.9 vs. 6.6 +/- 1.5, p = 0.003), and were more determined to succeed in self-care (p = 0.007). Current CAM use for diabetes was also greater in ND interested patients. Conclusions Patients with sub-optimally controlled type 2 diabetes expressed a high level of interest in trying ND care. Those patients with the greatest interest were less satisfied with their diabetes care, more motivated to engage in self-care, and more likely to use other CAM therapies for their diabetes.



Differentiating symptoms of depression from diabetes-specific distress: relationships with self-care in type 2 diabetes  

Microsoft Academic Search

Aims\\/hypothesis  The aim of this study was to examine the relationship between depressive symptoms and diabetes-specific distress and the independent\\u000a relationships of each of these factors with diabetes self-care. We expected that symptoms of depression would be associated\\u000a with poorer diabetes self-care, independent of diabetes-specific distress.\\u000a \\u000a \\u000a \\u000a Methods  We surveyed 848 primary care patients with type 2 diabetes using the Harvard Department of

J. S. Gonzalez; L. M. Delahanty; S. A. Safren; J. B. Meigs; R. W. Grant



[Nursing diagnoses in a high risk pregnant woman based on Orem's self-care theory: a case study].  


This work concerns a descriptive research with a qualitative approach which aimed to identify nursing diagnoses in high-risk pregnant women based on Orem's self-care theory. The following nursing diagnoses were identified: deficit of liquid volume, anxiety, altered family process, handicapped communication, handicapped physical mobility, among others. The results showed the importance of the nursing process execution supported on an assistance pattern, for the identification of nursing diagnoses as well as the feasibility of the patient's engagement in self-care. PMID:12046560

de Farias, M C; da Nóbrega, M M



Beginning the recovery journey in acute psychiatric care: using concepts from Orem's Self-Care Deficit Nursing Theory.  


A national agenda has been established for mental health systems to move toward a recovery model of care. Recovery principles are embedded in the foundations of nursing science and practice. Orem's Self-Care Deficit Nursing Theory (SCDNT) is in alignment with the ideals of recovery and can provide a structure for changing cultures on inpatient psychiatric units. SCDNT can guide research activities that link a patient's self-care abilities to improved recovery model outcomes. This paradigm shift is an opportunity for psychiatric nursing to return to its roots and deliver care that is patient-centered and conducive to recovering from mental illness. PMID:22646204

Seed, Mary S; Torkelson, Diane J



Self-care activities of women infected with human immunodeficiency virus.  


The article describes a qualitative focus group study exploring the self-care activities undertaken by women testing positive for human immunodeficiency virus (HIV) to promote and maintain their health. The sample included 27 women who participated in one of four focus group sessions. Participants represented women from both rural and urban settings in the South. Subjects talked about and described the ways in which they took care of themselves. Content analysis was used to code the data and to determine major categories of activities. Seven categories were identified: special dietary and nutrition practices, choosing not to use medically prescribed therapies, spiritual reliance and rituals, staying active, cognitive strategies, self-education, and adopting healthy life styles. These findings support the value of developing a holistic approach to health care of women infected with HIV. PMID:9035618

Sowell, R L; Moneyham, L; Guillory, J; Seals, B; Cohen, L; Demi, A



Validation of an instrument to measure exercise of self-care agency.  


The purpose of this study was to examine the reliability and construct validity of Kearney and Fleischer's (1979) Exercise of Self-Care Agency Scale. The Self-Directed Learning Readiness Scale (SDLRS) (Guglielmino, 1977) was used to test construct validity. Subjects consisted of 62 post-basic nursing students and 57 adult diabetic patients. The results showed significant correlations between the scales for both groups. However, the relationship was stronger for the student group (r = .505) than for the patient group (r = .302). The Exercise of Self-Control Agency Scale was significantly correlated with all eight factors of the SDLRS for the student group and with only three factors for the patient group. Split-half reliability for the former scale was similar for both groups (r = .78 and .74); test-retest reliability was lower for the patient group (r = .55) than for the student group (r = .76). PMID:3671778

McBride, S



Self-care 3 months after attending chronic obstructive pulmonary disease patient education: a qualitative descriptive analysis  

PubMed Central

Purpose The authors performed a qualitative descriptive analysis to explore how group patient education influences the self-care of patients with chronic obstructive pulmonary disease. Patients and methods In the period 2009–2010, eleven patients diagnosed with chronic obstructive pulmonary disease completed an 8-week group education program in a Danish community health center. The patients were interviewed 3 months after completion of the program. Findings Patients reported that their knowledge of chronic obstructive pulmonary disease had increased, that they had acquired tools to handle their symptoms, and that the social aspect of patient education had motivated them to utilize their new habits after finishing the course. The data indicate that patients need a period of adjustment (a “ripening period”): it took time for patients to integrate new habits and competencies into everyday life. Talking to health care professionals focused the patients’ attention on their newly acquired skills and the research interview made them more aware of their enhanced self-care. Conclusion Patients’ self-care may be enhanced through group education, even though the patients are not always able to see the immediate outcome. Some patients may require professional help to implement their newly acquired knowledge and skills in everyday life. A planned dialogue concentrating on self-care in everyday life 3 months after finishing the course may enhance patients’ awareness and appraisal of their newly acquired competencies.

Mousing, Camilla Askov; Lomborg, Kirsten



Effectiveness of Parent and Therapist Collaboration Program (PTCP) for Teaching Self-Care and Domestic Skills to Individuals with Autism  

ERIC Educational Resources Information Center

The purpose of this study was to develop and determine the effectiveness of a Parent and Therapist Collaboration Program for teaching self care and domestic skills to individuals with autism with varying educational needs, age, and severity of disability. Three individuals with autism, one habilitation provider, and three parents participated in…

Cavkaytar, Atilla; Pollard, Elena



Increasing Independence in Self-Care Tasks for Children with Autism Using Self-Operated Auditory Prompts  

ERIC Educational Resources Information Center

This study was conducted to determine the effects of self-operated auditory prompting systems (SOAPs) on independent self-care task completion of elementary-school-aged children with autism and intellectual disabilities. Prerecorded verbal prompts on a student-operated tape recorder were employed to facilitate independence in washing hands and…

Mays, Nicole McGaha; Heflin, L. Juane



Self-efficacy and self-care behavior of Malaysian patients with type 2 diabetes: a cross sectional survey.  


This study investigated the association between self-efficacy and self-care behavior to determine the degree of self-efficacy and to examine differences in self-efficacy according to patient variables, including state of health, of Malaysian patients with type 2 diabetes. The sample comprised 388 patients (respondents). We collected the data from December 2010 to February 2011. We found a significant positive relationship between self-efficacy and self-care behavior (r(s) = 0.481, P < 0.001). The degree of self-efficacy was moderately high (mean = 7.570). We found significant differences between self-efficacy and education level (Wilk's Lambda = 0.918, F[12, 1008] = 2.779, P < 0.05), duration of diabetes (Wilk's Lambda = 0.954, F[8, 736] = 2.264, P < 0.05), other chronic conditions (Wilk's Lambda = 0.967, F[4, 383] = 3.304, P < 0.05) and diabetic complications (Wilk's Lambda = 0.963, F[4, 383] = 3.653, P < 0.05). Self-efficacy can be used as a model to understand self-care behavior. Individualized nursing interventions based on self-efficacy theory should be utilized in high risk diabetic patients so as to assist and improve self-care behavior. PMID:22288688

Sharoni, Siti Khuzaimah Ahmad; Wu, Shu-Fang Vivienne



Prevalence rates of self-care behaviors and related factors in a rural hypertension population: a questionnaire survey.  


The objective of this study was to investigate the self-care behaviors among hypertensive patients in primary care. A cross-sectional survey, with 318 hypertensive patients, was conducted in a rural area in Beijing, China, in 2012. Participants were mainly recruited from a community health clinic and completed questionnaires assessing their self-care behaviors, including data on adherence to a prescribed medication regimen, low-salt diet intake, smoking habits, alcohol consumption, blood pressure monitoring, and physical exercise. The logistic regression model was used for the analysis of any association between self-care behaviors and age, gender, duration of hypertension, self-rated health, marital status, education level, diabetes status, or body mass index. Subjects that adhered to their medication schedule were more likely to have hypertension for a long duration (OR, 3.44; 95% CI 1.99-5.97). Older participants (OR, 1.80; 95% CI 1.08-2.99) were more likely to monitor their blood pressure. Subjects who did not partake in physical exercise were more likely to be men, although the difference between genders was not significant (OR, 0.60; 95% CI 0.36-1.01). Patients with shorter history of hypertension, younger and being males have lower self-care behaviors. Primary care providers and public health practitioner should pay more attention to patients recently diagnosed with hypertension as well as younger male patients. PMID:23819042

Hu, Huanhuan; Li, Gang; Arao, Takashi



Self-Efficacy as a Predictor of Regimen Adherence in Self-Care of Non- Insulin Dependent Diabetes Mellitus.  

National Technical Information Service (NTIS)

Self-Care is the most critical component of the non-insulin dependent diabetic's treatment regimen. The purpose of this study was to examine the relationship between perceived self-efficacy and demographic, disease-related, and behavior-related regimen va...

K. A. French



Health promotion through self-care and community participation: Elements of a proposed programme in the developing countries  

Microsoft Academic Search

BACKGROUND: The concepts of health promotion, self-care and community participation emerged during 1970s, primarily out of concerns about the limitation of professional health system. Since then there have been rapid growth in these areas in the developed world, and there is evidence of effectiveness of such interventions. These areas are still in infancy in the developing countries. There is a

Khanindra Kumar Bhuyan; Kumar Bhuyan



An investigation of a nursing system to support nutritional self-care in post myocardial infarction patients  

Microsoft Academic Search

This study of men and women (N = 104) who recently experienced myocardial infarction (MI), investigated the effect of nursing intervention based on Orem's (1991) theory of nursing on nutritional self-care related to dietary fat and cholesterol. An experimental pretest-posttest control group design was used. Patients were randomly assigned to groups before being interviewed in hospital (Time 1). The treatment

Arlene Elizabeth Aish



Gender and Health Lifestyle: An In-Depth Exploration of Self-Care Activities in Later Life  

ERIC Educational Resources Information Center

|Objective: Evaluate similarities and differences in the self-care domain of health lifestyle among older, rural-dwelling women and men. Method: Qualitative analysis of in-depth interview data from 62 community-dwelling older (M = 74.3 years) African and European American women and men. Results: Both older women and men rely heavily on…

Grzywacz, Joseph G.; Stoller, Eleanor Palo; Brewer-Lowry, A. Nichol; Bell, Ronny A.; Quandt, Sara A.; Arcury, Thomas A.



The Use of Self-Care Agency To Meet the Need for Solitude and Social Interaction by Chronically Ill Individuals.  

ERIC Educational Resources Information Center

|This study examined the effect of chronic illness on the individual's ability to meet his or her need for solitude and for social interaction by exploring how chronically ill individuals used their own ability (self-care agency) to meet these needs. Subjects were 90 chronically ill older persons, 30 of whom were living at home, 30 who lived in a…

Burns, Margaret A.


Self-Care Independence in Children With Neurological Disorders: An Interactional Model of Adaptive Demands and Executive Dysfunction  

Microsoft Academic Search

Objective: To describe a neuropsychological assessment model that proposes executive functioning as a key moderator in the development of self-care independence. Setting: Inpatient and outpatient rehabilitation facilities. Participants: Transition-age youths with congenital and acquired neurological disorders. Intervention: Transition to the adaptive roles and expectations of adulthood can be challenging for adolescents with neurological disorders and other chronic medical conditions. These

Reem A. Tarazi; E. Mark Mahone; T. Andrew Zabel



The role of family configuration, income, and gender in the academic achievement of young self?care children  

Microsoft Academic Search

Two hundred and thirty nine self?care children from grades three to five were selected from eight different sites to investigate the effects of family configuration, income, and gender on academic achievement as measured by the Reading, Language, and Math subscales of the California Achievement Test. The data indicated that girls scored higher than boys on reading in grade 4 but

Javaid Kaiser



Relationships among basic conditioning factors, motivational dispositions, and the power element of self-care agency in people beginning a weight loss program  

Microsoft Academic Search

This descriptive correlational study examined the relationships among motivational dispositions, basic conditioning factors, and the power element of self-care agency in people who had just begun a weight loss program. Orem's self-care agency model provided the organizing framework for the research. The motivational dispositions studied included affiliation motivation, power motivation, achievement motivation, and specific motivations for weight loss. The study

Barbara Elizabeth Vannoy



Use of Self-Care and Practitioner-Based Forms of Complementary and Alternative Medicine before and after a Diagnosis of Breast Cancer  

PubMed Central

Purpose. We examine factors associated with self-care, use of practitioner-based complementary and alternative medicine (CAM), and their timing in a cohort of women with breast cancer. Methods. Study participants were women with breast cancer who participated in the Long Island Breast Cancer Study Project. Self-care is defined as the use of multivitamins, single vitamins, botanicals, other dietary supplements, mind-body practices, special diets, support groups, and prayer. Within each modality, study participants were categorized as continuous users (before and after diagnosis), starters (only after diagnosis), quitters (only before diagnosis), or never users. Multivariable logistic regression was used for the main analyses. Results. Of 764 women who provided complete data, 513 (67.2%) initiated a new form of self-care following breast cancer diagnosis. The most popular modalities were those that are ingestible, and they were commonly used in combination. The strongest predictor of continuous use of one type of self-care was continuous use of other types of self-care. Healthy behaviors, including high fruit/vegetable intake and exercise, were more strongly associated with continuously using self-care than starting self-care after diagnosis. Conclusions. Breast cancer diagnosis was associated with subsequent behavioral changes, and the majority of women undertook new forms of self-care after diagnosis. Few women discontinued use of modalities they used prior to diagnosis.

Link, Alissa R.; Gammon, Marilie D.; Jacobson, Judith S.; Abrahamson, Page; Bradshaw, Patrick T.; Terry, Mary Beth; Teitelbaum, Susan; Neugut, Alfred



Psychometric validation of the Self-Care Inventory-Revised (SCI-R) in UK adults with type 2 diabetes using data from the AT.LANTUS Follow-on study  

PubMed Central

Background Achieving optimal outcomes in type 2 diabetes (T2DM) involves several demanding self-care behaviours, e.g. managing diet, activity, medications, monitoring glucose levels, footcare. The Self-Care Inventory-Revised (SCI-R) is valid for use in people with T2DM in the US. Our aim was to determine its suitability for use in the UK. Methods 353 people with T2DM participated in the AT.LANTUS Follow-on study, completing measures of diabetes self-care (SCI-R), generic and diabetes-specific well-being (W-BQ28), and diabetes treatment satisfaction (DTSQ). Statistical analyses were conducted to explore structure, reliability, and validity of the SCI-R. Results Principal components analysis indicated a 13-item scale (items loading >0.39) with satisfactory internal consistency reliability (??=?0.77), although neither this model nor any alternatives were confirmed in the confirmatory factor analysis. Acceptability was high (>95% completion for all but one item); ceiling effects were demonstrated for six items. As expected, convergent validity (correlations between self-care behaviours) was found for few items. Divergent validity was supported by expected low correlations between SCI-R total and well-being (rs?=?0.02-0.21) and treatment satisfaction (rs?=?0.29). Known-groups validity was partially supported with significant differences in SCI-R total by HbA1c (?7.5% (58 mmol/mol): 72?±?11, >7.5% (58 mmol/mol): 68?±?14, p?16 years: 71?±?12, p?self-care in people with T2DM in the UK. However, ceiling effects raise concerns about its potential for responsiveness in clinical trials. Individual items may be more useful clinically than the total score.



PS3-51: Variation in the Self-Care Behaviors of Healthcare Personnel: Physicians, Nurses, and Others.  


Background/Aims The personal self-care and health habits of healthcare personnel may influence patients' own health-related behaviors including smoking, physical activity, weight management, and alcohol consumption. This study describes the degree to which healthcare providers adhere to recommended health-enhancing behaviors, and whether adherence differs by occupation. Methods A prospective cohort of healthcare personnel was enrolled in fall 2010 from two large health care organizations: Scott & White Healthcare, and Kaiser Permanente Northwest. Participants were physicians, nurses, and other healthcare personnel providing direct patient care and working full time. Potential participants were invited to take part in a study of "respiratory illness and healthcare workers." Participation was voluntary. The study tool was a self-administered internet-based questionnaire which participants completed at home or on facility computers. The questionnaire included items on demographic information, occupational factors, and health-related behaviors. Upon completion of the enrollment questionnaire, participants received a small incentive in the form of cash or gift card. Results Data are presented for 1701 participants who completed the enrollment survey. Participants were grouped in three occupational categories: Physicians (n = 175), Nurses (n = 484), and Other Providers (n = 404). Significant differences emerged in demographic characteristics, with physicians being younger, more likely to be male, married, having a higher median household income, and higher level of education (P <0.001). In terms of body mass index (BMI) physicians were more likely to report a normal weight (55%), and were the least likely group to be obese (10%; P <0.001). By contrast, nurses and other healthcare providers were evenly distributed along three BMI categories (normal weight, overweight, obese). Physicians were more likely to report engaging in exercise at least once per week (85%) than the other two occupational categories (74%; p < 0.005). Approximately 5% of nurses and nearly 10% of other healthcare providers reported smoking, compared to less than 1% of physicians (P <0.001). No differences were found in the self-report alcohol consumption by occupational category. Conclusions Results suggest the need to target healthcare personnel in health promotion interventions, particularly those focused on weight management and physical activity. PMID:24086021

Lindberg, Nangel; Naleway, Allison; Ball, Sarah; Gaglani, Manjusha



PS3-51: Variation in the Self-Care Behaviors of Healthcare Personnel: Physicians, Nurses, and Others  

PubMed Central

Background/Aims The personal self-care and health habits of healthcare personnel may influence patients’ own health-related behaviors including smoking, physical activity, weight management, and alcohol consumption. This study describes the degree to which healthcare providers adhere to recommended health-enhancing behaviors, and whether adherence differs by occupation. Methods A prospective cohort of healthcare personnel was enrolled in fall 2010 from two large health care organizations: Scott & White Healthcare, and Kaiser Permanente Northwest. Participants were physicians, nurses, and other healthcare personnel providing direct patient care and working full time. Potential participants were invited to take part in a study of “respiratory illness and healthcare workers.” Participation was voluntary. The study tool was a self-administered internet-based questionnaire which participants completed at home or on facility computers. The questionnaire included items on demographic information, occupational factors, and health-related behaviors. Upon completion of the enrollment questionnaire, participants received a small incentive in the form of cash or gift card. Results Data are presented for 1701 participants who completed the enrollment survey. Participants were grouped in three occupational categories: Physicians (n = 175), Nurses (n = 484), and Other Providers (n = 404). Significant differences emerged in demographic characteristics, with physicians being younger, more likely to be male, married, having a higher median household income, and higher level of education (P <0.001). In terms of body mass index (BMI) physicians were more likely to report a normal weight (55%), and were the least likely group to be obese (10%; P <0.001). By contrast, nurses and other healthcare providers were evenly distributed along three BMI categories (normal weight, overweight, obese). Physicians were more likely to report engaging in exercise at least once per week (85%) than the other two occupational categories (74%; p < 0.005). Approximately 5% of nurses and nearly 10% of other healthcare providers reported smoking, compared to less than 1% of physicians (P <0.001). No differences were found in the self-report alcohol consumption by occupational category. Conclusions Results suggest the need to target healthcare personnel in health promotion interventions, particularly those focused on weight management and physical activity.

Lindberg, Nangel; Naleway, Allison; Ball, Sarah; Gaglani, Manjusha



The role of information in supporting self-care in vascular conditions: a conceptual and empirical review.  


Self-care has the potential to make a significant contribution to vascular conditions, but engagement with self-care support has been limited. Lack of relevant information is highlighted by patients and policy-makers as an important barrier to effective self-care, and information provides a potentially efficient platform for changing behaviour. However, work within the social sciences has generally seen information as a necessary but insufficient driver of health behaviours. Furthermore, some groups (such as the socially disadvantaged) are expected to be less amenable to information interventions. We conducted an integrated conceptual and empirical review on information-based interventions for people with vascular disease (diabetes, heart disease and kidney disease). We reviewed conceptual and empirical work concerning the role and impact of information in self-care support to generate an explanatory framework to determine why information was effective or ineffective in encouraging self-care in patients with vascular conditions. This involved mapping relevant theories and models linking information and self-care. We also explored published systematic reviews of educational interventions in diabetes, coronary heart disease and chronic kidney disease to examine the role of information and evidence concerning its effectiveness and impact in different patient populations. The conceptual review identified variation among information interventions in terms of type, function, and their relationship to behaviour change techniques and psychological mediators of behaviour change. Key moderators of the effect of information included types of disorder, and patient capacity and resources. A wealth of educational interventions exists for diabetes and heart conditions, but the precise components of these interventions that are effective are difficult to identify. There is little evidence concerning optimal ways of tailoring interventions for socially disadvantaged groups other than ethnic minorities. A focus on printed information may not provide access to effective methods of information delivery (e.g. tailored information, use of narratives and user generated content). Developing a framework for the effective use of information needs to take account the full range of the factors identified. PMID:21158998

Blickem, Christian; Bower, Peter; Protheroe, Joanne; Kennedy, Anne; Vassilev, Ivaylo; Sanders, Caroline; Kirk, Sue; Chew-Graham, Carolyn; Rogers, Anne



What "Dr. Mom" ordered: a community-based exploratory study of parental self-care responses to children's ADHD symptoms.  


Little is known about family initiated self-care interventions in response to symptoms of attention deficit/hyperactivity disorder (ADHD), and how self-care may co-exist with professional treatments. This paper explores parental self-care strategies for children with hyperactivity or attention problems, and examines factors and domains that influence their use from the mixed method perspective. As part of a longitudinal cohort study of ADHD detection and service use, caregivers of a representative US community sample of 266 children at high risk for ADHD completed a questionnaire that assessed five self-care strategies (behavior modification, coping, diet, over-the-counter medication use and religious practices), and made open-ended inquiry about discipline changes in response to behavioral concerns. Questionnaire responses were analyzed using logistic regression approaches. Open-ended answers were open coded; secondary analysis followed Spradley's model of domain analysis. Quantitative findings showed that behavior modification was the most commonly tried self-care strategy, followed by coping, diet, and religious practices. Over-the-counter trial was least common. The parents of professionally treated children were more likely to have employed behavior modification, coping strategies and over-the-counter medications than the parents of untreated children. Two-thirds of parents had changed their disciplinary action within three domains that were identified through qualitative analysis, including changes related to (a) the prevention of disciplinary problems (e.g., sustain eye contact, activation, consistency, clear instructions), (b) the solution of disciplinary problems (e.g., time-outs; privilege removal), and (c) parental coping associated with disciplinary problems (e.g., control own emotions, become less judgmental and more tolerant, and develop more appropriate expectations). These findings suggest that self-care strategies are commonly employed and appear to co-exist with professional treatment. Therefore, healthcare providers should actively explore parents' use of such strategies as some of them may interfere with prescribed treatments (e.g., over-the-counter) or absorb parental resources without likely benefit (e.g., diet). PMID:16644078

Bussing, Regina; E Koro-Ljungberg, Mirka; Williamson, Pamela; Gary, Faye A; Wilson Garvan, Cynthia



Hygiene Self-Care of Older Adults in West Virginia: Effects of Gender  

PubMed Central

Purpose This study investigated whether oral hygiene self-care behavior differs between genders in older adults in Appalachia, a geographic area with significant oral health concerns. Identifying the practices of older adults may provide valuable information for designing interventions, and improving overall oral health outcomes. Methods As part of a larger, on-going study on cognition and oral health in later life in Appalachia, a sample of dentate, older adults without dementia aged 70 and above (n =245, 86 men and 159 women) received an oral assessment by either a dentist or dental hygienist. Psychometricians assessed cognition using a standardized battery of neuropsychological tests. They also administered the General Oral Health Assessment Index and conducted structured interviews concerning diet, oral hygiene practices, oral health, social support, income, and years of education. Results Over 80% of women (n = 128) and 52.3% of men (n = 45) reported brushing their teeth twice daily. Multivariate logistic regression analysis was conducted, controlling for socioeconomic status, social support (i.e., frequency of contacting friends and relatives), general oral health assessment items, number of decayed, missing, and filled surfaces, plaque index, and having regular dental visits. The results showed that women reported more frequent toothbrushing than their male counterparts (OR=4.04, 95% CI:1.93,8.42). Conclusion Older women in West Virginia had significantly better oral hygiene practices than older men, particularly regarding toothbrushing. Interventions are needed to improve older men’s dental hygiene behaviors to improve overall oral health outcomes.

Wiener, R. Constance; Wu, Bei; Crout, Richard J.; Plassman, Brenda L.; McNeil, Daniel W.; Wiener, Michael A.; Kao, Elizabeth C.; Caplan, Daniel J.



Self-care predictors for success post-bariatric surgery: a literature review.  


The prevalence of obesity in the United States has more than doubled from 1980 to 2008. Obesity leads to a multitude of comorbidities, most notably diabetes and cardiovascular diseases, resulting in more than $147 billion annually in healthcare costs. Bariatric surgery is becoming a common weight loss option for morbidly obese individuals. Studies in this review examine patients who have undergone laparoscopic adjustable gastric banding or Roux-en-Y gastric bypass surgery. Patients initially lose large amounts of weight postoperatively; unfortunately, around 30% of these individuals begin to regain weight 18-24 months after surgery. The purpose of this article is to analyze the current literature to ascertain which self-care variables are predictors of successful long-term weight loss after bariatric surgery. The studies analyzed in this review found that patients who undergo a surgical weight loss intervention lose more weight faster than patients who do not have a surgical weight loss intervention. However, patients reported feeling unprepared for the extreme psychosocial and lifestyle changes after bariatric surgery. Findings from these studies point to the need for future research in the area of postsurgical psychosocial support for successful long-term weight loss maintenance. PMID:23549216

Wykowski, Karen; Krouse, Helene J


Early self-care rehabilitation of head and neck cancer patients  

PubMed Central

Conclusions: No positive effects of early preventive rehabilitation could be identified. The results do not contradict the proposition that rehabilitation based on self-care can be effective but it is important to establish evidence-based training programs and identify proper instruments for selection of patients and evaluation of intervention. Objectives: Patients with head and neck cancer suffer from functional impairments due to intense treatment. In this study, we investigated the effectiveness of an experimental early preventive rehabilitation using hard, objective end points in a nonselective, longitudinal, prospective cohort study. Methods: In all, 190 patients were included in the program and received instructions for training before the start of treatment with the aim of reducing swallowing problems and reducing mouth opening and stiffness in the neck. A control group of 184 patients was recruited. Results: There was no difference in weight loss and 2-year survival between the two groups. No positive effects concerning functional impairments were found in patient-reported outcome measures.

Ahlberg, Alexander; Engstrom, Therese; Nikolaidis, Polymnia; Gunnarsson, Karin; Johansson, Hemming; Sharp, Lena; Laurell, Goran



The effect of empowerment program on empowerment level and self-care self-efficacy of patients on hemodialysis treatment  

PubMed Central

Background: Patients with end-stage renal disease (ESRD) who receive dialysis confront the burdens of long-term illness and numerous physical problems. Materials and Methods: This was a quasi-experimental study. The selected patients from Gorgan Dialysis Centre were randomly assigned into an empowerment group (n = 40) and a control group (n = 40). Instruments comprised scales of Empowerment and the Strategies Used by People to Promote Health (SUPPH). Data were collected at baseline and at 6 weeks following the intervention. The data were analyzed by descriptive and inferential statistics through SPSS (version 17). Results: The results indicate that scores of the empowerment (P ? 0.001) and self-care self-efficacy (P = 0.003) in the empowerment group showed a significantly greater improvement than the control group. Conclusions: The study supports the effectiveness of the empowerment program to promote empowerment level and self-care self-efficacy of hemodialysis patients.

Royani, Zahra; Rayyani, Masoud; Behnampour, Naser; Arab, Mansour; Goleij, Javad



Effects of education and support on self-care and resource utilization in patients with heart failure  

Microsoft Academic Search

Aims To test the eVect of education and support by a nurse on self-care and resource utilization in patients with heart failure. Methods A total of 179 patients (mean age 73, 58% male, NYHA III-IV) hospitalized with heart failure were evalu- ated prospectively. Patients were randomized to the study intervention or to 'care as usual'. The supportive educative intervention consisted

T. Jaarsma; R. Halfens; H. Huijer Abu-Saad; K. Dracup; T. Gorgels; J. van Ree; J. Stappers



The importance of health literacy in the development of 'Self Care'' cards for community pharmacies in Ireland  

PubMed Central

Objective 'Self Care’'cards play a significant role in delivering health education via community pharmacies in Australia and New Zealand. The primary objective of this study was to evaluate whether such an initiative could have a similar impact in an Irish context. The secondary objective was to understand the importance of health literacy to this initiative. Methods Ten cards were developed for the Irish healthcare setting and trialed as a proof of concept study. The pilot study ran in ten community pharmacies in the greater Cork area for a six-month period. Using a mixed methods approach (Questionnaires & focus group) staff and patient reactions to the initiative were obtained. Concurrent to the pilot study, readability scores of cards (Flesch-Kincaid, Fry, SMOG methods) and the Rapid Estimate of Adult Literacy in Medicine (REALM) health literacy screening tool was administered to a sample of patients. Results 88.7% of patient respondents (n=53) liked the concept of the 'Self Care’' cards and 83% of respondents agreed that the use of the card was beneficial to their understanding of their ailment. Focus groups with Pharmacy staff highlighted the importance of appropriate training for the future development of this initiative. An emerging theme from designing the cards was health literacy. The pilot 'Self Care’'cards were pitched at too high a literacy level for the general Irish public to understand as determined by readability score methods. It was found that 19.1% of a sample population (n=199) was deemed to have low health literacy skills. Conclusions The 'Self Care’'initiative has the potential to be Pharmacy’s contribution to health education in Ireland. The initiative needs to be cognizant of the health literacy framework that equates the skills of individuals to the demands placed upon them.

Coughlan, Diarmuid; Sahm, Laura; Byrne, Stephen


A Randomized Trial Comparing Yoga, Stretching, and a Self-care Book for Chronic Low Back Pain  

PubMed Central

Background Chronic low back pain is a common problem lacking highly effective treatment options. Small trials suggest that yoga may have benefits for this condition. This trial was designed to determine whether yoga is more effective than conventional stretching exercises or a self-care book for primary care patients with chronic low back pain. Methods 228 adults with chronic low back pain were randomized to 12 weekly classes of yoga (n=92) or conventional stretching exercises (n=91) or a self-care book (n=45). Back-related functional status (modified Roland Disability Questionnaire, 23-point scale) and bothersomeness of pain (11-point numerical scale) at 12 weeks were the primary outcomes. Outcomes were assessed at baseline, 6, 12 and 26 weeks by interviewers unaware of treatment group. Results After adjustment for baseline values, 12-week outcomes for the yoga group were superior to those for the self-care group (mean difference for function = ?2.5 [95% CI= ?3.7 to ?1.3; P<0.001]; mean difference for symptoms = ?1.1 [95% CI= ?1.7 to ?0.4; P<0.001]). At 26 weeks, function for the yoga group remained superior (mean difference = ?1.8 [95% CI= ? 3.1 to ?0.5; P<0.0001]). Yoga was not superior to conventional stretching exercises at any time point. Conclusions Yoga classes were more effective than a self-care book, but not stretching classes, in improving function and reducing symptoms due to chronic low back pain, with benefits lasting at least several months.

Sherman, Karen J.; Cherkin, Daniel C.; Wellman, Robert D.; Cook, Andrea J.; Hawkes, Rene J.; Delaney, Kristin; Deyo, Richard A.



Family culture, family resources, dependent care, caregiver burden and self-care agency of spouses of cancer patients  

Microsoft Academic Search

A descriptive correlational design was used to examine the relationship between the self-care agency of caregivers providing dependent-care to a spouse with cancer and a set of variables assessing the family system. The following basic conditioning factors associated with the family system were selected for this study: family culture, family resources, level of dependent-care, and caregiver burden. Spouses (N =

Darlene Schott-Baer



Social support and psychological adjustment to SARS: The mediating role of self-care self-efficacy  

Microsoft Academic Search

The study tested the model of perceived support from medical staff and family\\/friends on severe acute respiratory syndrome (SARS) survivors’ mental health as mediated by self-care self-efficacy. One hundred and forty-three SARS survivors recruited from the Hong Kong Hospital Authority following 18 months recovery were surveyed by trained interviewers using structured questionnaires. Based on structural equation modeling, findings showed that

Winnie W. S. Mak; Rita W. Law; Jean Woo; Fanny M. Cheung; Dominic Lee



Increasing independence in self-care tasks for children with autism using self-operated auditory prompts  

Microsoft Academic Search

This study was conducted to determine the effects of self-operated auditory prompting systems (SOAPs) on independent self-care task completion of elementary-school-aged children with autism and intellectual disabilities. Prerecorded verbal prompts on a student-operated tape recorder were employed to facilitate independence in washing hands and brushing teeth. The participants were three students enrolled in a self-contained class for students with autism

Nicole McGaha Mays; L. Juane Heflin



Development of self-care educational material for patients with heart failure in Japan: a pilot study.  


This study assessed the need for information regarding heart failure and self-care, developed self-care educational material, and investigated the feasibility of the material. A total of 22 hospitalized heart failure patients (mean age: 63 years) completed a self-administered questionnaire. We found that more than 90% of patients desired information, particularly about heart failure symptoms, time to notify healthcare providers, prognosis, and exercise/physical activity. After examining the eight existing brochures for Japanese heart failure patients, we developed self-care educational material. This was based on heart failure guidelines and on the results of our inquiry regarding information needs. Finally, a pilot study was conducted in nine hospitalized heart failure patients (mean age: 57 years). None of the patients had difficulty reading or understanding the educational material. The self-administrated questionnaire survey revealed that comprehension of the following improved after the educational sessions with the material: heart failure symptoms, medication, weighing, sodium intake, and fluid intake (P < 0.05). In conclusion, heart failure patients have a great need for information about heart failure. Our pilot study suggests that the material was readable and had a beneficial effect on heart failure comprehension. PMID:22339764

Kato, Naoko; Kinugawa, Koichiro; Sano, Miho; Seki, Satomi; Kogure, Asuka; Kobukata, Kihoko; Ochiai, Ryota; Wakita, Sanae; Kazuma, Keiko



The role of email guidance in internet-based cognitive-behavioural self-care treatment for bulimia nervosa.  


Email has been progressively used as a means for providing therapeutic guidance and support for cognitive behavioural treatment (CBT) self-care programmes. Many aspects of the use of email in self-care need to be explored such as the content of therapists' emails. Such information would optimise the delivery of self-care treatments. To date no study has looked at the content of the therapists' emails. We analysed the content of emails (n?=?712) sent by therapists to participants (n?=?71) of a randomised controlled trial (RCT) of internet-based CBT with email support for bulimic disorders. 14.7% of the emails therapists sent contained at least one CBT comment, while 95.4% had at least one supportive comment and 13.6% had at least one technical comment. The mean time spent on providing email support to each participant across the complete programme was 45 minutes. Emails sent by therapists were mainly supportive in content, with only a small amount of time being required by therapists to provide email support. PMID:21394832

Sánchez-Ortiz, Varinia C; Munro, Calum; Startup, Helen; Treasure, Janet; Schmidt, Ulrike



The Appraisal of Self-Care Agency Scale - Revised (ASAS-R): adaptation and construct validity in the Brazilian context.  


This study presents the psychometric properties of the Brazilian version of the Appraisal of Self-Care Agency Scale - Revised (ASAS-R). The sample was made up of 627 subjects (69.8% women) aged between 18 and 88 years (mean = 38.3; SD = 13.26) from 17 Brazilian states. Exploratory factor analysis of part of the sample (n1 = 200) yielded a three-factor solution which showed adequate levels of reliability. Two confirmatory factor analyses of the other part of the sample (n2 = 427) tested both the exploratory and the original model. The analysis of convergent validity using the Subjective Happiness Scale, the Satisfaction with Life Scale, and the 36-item Short Form Health Survey Version 2 (SF-36v2) demonstrated adequate levels of validity. A significant correlation was found between levels of self-care agency and age, level of education and income. The analysis of sample members with chronic disease (n = 134) showed that higher levels of self-care agency indicated lower levels of negative impact of the chronic illness in the individual's everyday life. PMID:24127101

Damásio, Bruno Figueiredo; Koller, Silvia Helena



Measures of Diabetic Patient Knowledge, Attitudes, and Behavior Regarding Self-Care. Appendix B to Summary Report: An Evaluation of Published Measures of Diabetes Self-Care Variables.  

National Technical Information Service (NTIS)

This appendix identifies and evaluates published measures of diabetic self-management variables using secondary data sources. Attention is focused on the patient behavioral, knowledge, and attitudinal areas that an expert panel judged to be 'very importan...

K. H. Marquis J. E. Ware R. Johnston S. Marquis M. Michnich



Consumer Self-Care in Health; Proceedings of Conference Held at Dulles Airport Marriott, Fairfax County, Virginia on March 24-26, 1976.  

National Technical Information Service (NTIS)

Consumer self-care in health is a growing movement wherein lay persons increasingly function for themselves to prevent, detect, and treat health problems, and promote good health in a manner which supplements or substitutes for professional services. The ...

J. D. Gallicchio



Measures of Diabetic Patient Knowledge, Attitudes, and Behavior Regarding Self-Care. Appendix C to Summary Report: New Measures of Diabetic Patient Behavior, Knowledge, and Attitudes.  

National Technical Information Service (NTIS)

The research goal was to develop a battery of reliable and valid questions that measure the self-care knowledge, attitudes, and behavior of diabetic patients in content areas specified by experts as most important. Questionnaires were developed and admini...

K. H. Marquis J. E. Ware D. A. Relles



The effect of community health nurse home visit on self-care self-efficacy of the elderly living in selected Falavarjan villages in Iran in 2010  

PubMed Central

Background: Perceived self-efficacy is a strong predictor for behavior. Considering the importance of health-promoting self-care behaviors in increasing quality of life in the elderly, this study was aimed at defining the effect of nurse home visits on self-care self-efficacy of the elderly in rural areas. Materials and Methods: This is a pre and post quasi-experimental study conducted on 33 older adults randomly selected from five villages in Falavarjan province in Iran. Intervention program was in the direction of self-care self-efficacy in four domains including nutrition, health practice, physical activity, and well-being in the form of five home visit programs and one group session by a nurse during 6 weeks, and included two different sections of education and nursing interventions administered based on needs assessment and determination of the tasks for the clients and their families. Theoretical framework of this study was supported by Bandura's self-efficacy, Orem's self-care theory, and Pender's revised health promotion model. The data were collected by self-care self-efficacy and demographic information questionnaire before and after the intervention. Data were analyzed by descriptive statistics and paired t-test. Results: The mean elderly score in the four aforementioned domains increased after the home visit program. A significant difference was seen in the mean total scores of self-care self-efficacy and its subscales by paired t-test before and after intervention (P < 0.001). Conclusions: It was observed that home visit program, integrated with the theories, had a positive influence on improving self-care self-efficacy of the elderly, and was supported by Bandura's theory of self-efficacy suggesting four sources of performance accomplishment, vicarious experience, verbal persuasion, and emotional arousal. With regard to the importance of self-care behavior in health promotion of the elderly, multifaceted low-cost interventions with the highest effect seem essential.

Hosseini, Habibollah; Torkani, Sara; Tavakol, Khosrow



The effect of group-based exercise on cognitive performance and mood in seniors residing in intermediate care and self-care retirement facilities: a randomised controlled trial  

Microsoft Academic Search

Objective:To determine the effect of a general group-based exercise programme on cognitive performance and mood among seniors without dementia living in retirement villages.Design:Randomised controlled trial.Setting:Four intermediate care and four self-care retirement village sites in Sydney, Australia.Participants:154 seniors (19 men, 135 women; age range 62 to 95 years), who were residents of intermediate care and self-care retirement facilities.Intervention:Participants were randomised to

A K Brown; T Liu-Ambrose; R Tate; S R Lord



Teaching Self-Care to Caregivers: Effects of Mindfulness-Based Stress Reduction on the Mental Health of Therapists in Training  

Microsoft Academic Search

Preparation for the role of therapist can occur on both professional and personal levels. Research has found that therapists are at risk for occupationally related psychological problems. It follows that self-care may be a useful complement to the professional training of future therapists. The present study examined the effects of one approach to self-care, Mindfulness-Based Stress Reduction (MBSR), for therapists

Shauna L. Shapiro; Kirk Warren Brown; Gina M. Biegel



Intra-oral myofascial therapy versus education and self-care in the treatment of chronic, myogenous temporomandibular disorder: a randomised, clinical trial.  


BACKGROUND: Myogenous temporomandibular disorders (TMD) are considered to be a common musculoskeletal condition. No studies exist comparing intra-oral myofascial therapies to education, self-care and exercise (ESC) for TMD. This study evaluated short-term differences in pain and mouth opening range between intra-oral myofascial therapy (IMT) and an ESC program. METHODS: Forty-six participants with chronic myogenous TMD (as assessed according to the Research Diagnostic Criteria Axis 1 procedure) were consecutively block randomised into either an IMT group or an ESC group. Each group received two sessions per week (for five weeks) of either IMT or short talks on the anatomy, physiology and biomechanics of the jaw plus instruction and supervision of self-care exercises. The sessions were conducted at the first author's jaw pain and chiropractic clinic in Sydney, Australia. Primary outcome measures included pain at rest, upon opening and clenching, using an eleven point ordinal self reported pain scale. A secondary outcome measure consisted of maximum voluntary opening range in millimetres. Data were analysed using linear models for means and logistic regression for responder analysis. RESULTS: After adjusting for baseline, the IMT group had significantly lower average pain for all primary outcomes at 6 weeks compared to the ESC group (p < 0.001). These differences were not clinically significant but the IMT group had significantly higher odds of a clinically significant change (p < 0.045)..There was no significant difference in opening range between the IMT and ESC groups. Both groups achieved statistically significant decreases in all three pain measures at six weeks (p <= 0.05), but only the IMT group achieved clinically significant changes of 2 or more points. CONCLUSION: This study showed evidence of superiority of IMT compared to ESC over the short-term but not at clinically significant levels. Positive changes over time for both IMT and ESC protocols were noted. A longer term, multi-centre study is warranted.Trial registration: Australian and New Zealand Clinical Trials Registry ACTRN12610000508077. PMID:23738586

Kalamir, Allan; Graham, Petra L; Vitiello, Andrew L; Bonello, Rodney; Pollard, Henry



Strategies for self-management of HIV-related anxiety  

Microsoft Academic Search

This study examines the frequency and effectiveness of commonly used strategies for self management of anxiety in an international sample of 502 participants from Norway (n=42, 8%), Taiwan (n=35, 7%), and the US (n=426, 85%). An activities checklist summarized into five categories of self-care behaviours including activities\\/thoughts, exercise, medications, complementary therapies, and substance use determined self-care behaviours. Ratings of frequency

J. K. Kemppainen; L. S. Eller; E. Bunch; M. J. Hamilton; P. Dole; W. Holzemer; K. Kirksey; P. K. Nicholas; I. B. Corless; C. Coleman; K. M. Nokes; N. Reynolds; L. Sefcik; D. Wantland; Y-F Tsai



One-hour and eight-hour average ozone in the California South Coast air quality management district: trends in peak values and sensitivity to precursors  

Microsoft Academic Search

Exceedences of the 1 and 8h O3 air quality standard were identified for 24 routine air quality monitor stations in the California South Coast Air Quality Management District (AQMD) from 1980 to 2001. Yearly trends, temporal and spatial distributions of O3 exceedences and “weekend effect” on O3 exceedences are presented. There were considerably more exceedences of the 8h O3 standard

Y. Qin; G. S. Tonnesen; Z. Wang



Women with heart failure are at high psychosocial risk: a systematic review of how sex and gender influence heart failure self-care.  


To improve patient support, it is important to understand how people view and experience Heart Failure (HF) self-care. This systematic review of qualitative studies included all published studies that examine the influence of sex and gender on HF self-care. A systematic search was done for papers (1995-2010) indexed in Ovid MEDLINE, Ovid Medline, Ovid EMBASE, Ovid PsycINFO, CSA Sociological Abstracts, OVID AARP Ageline, EBSCO Academic Search Complete, EBSCO CINAHL, EBSCO SocINDEX, ISI Web of Science: Social Sciences Citation Index and Science Citation Index Expanded, and Scopus. After screening of 537 citations, six qualitative studies identified that differences existed in perceptions of symptoms with women having less family involvement and psychosocial support around self-care. Moreover, women had considerably more negative views of the future, themselves and their ability to fulfill social self-care roles. Women with HF represent a highly vulnerable population and need more support for psychosocial wellbeing and self-care. PMID:21403845

Thomas, Jody R; Clark, Alexander M



Influence of Patient Attachment Style on Self-care and Outcomes in Diabetes  

Microsoft Academic Search

Objective: Difficulties collaborating with providers and important others may adversely influence self-management in patients with diabetes. We predicted that dismissing attachment style, characterized by high interpersonal self-reliance and low trust of others, would be associated with poorer self-management in patients with diabetes. Methods: A population-based mail survey was sent to all patients with diabetes from nine primary care clinics of




The contributing role of real-life hand skill performance in self-care function of children with and without disabilities.  


BACKGROUND: Children's hand skills when performing in real-life contexts have been commonly thought as a possible determinant of their self-care function; however, there is a paucity of research investigating this potential predictive relationship. The purpose of this study was to provide evidence regarding whether children's real-life hand skill performance is contributive to or predictive of their self-care function by considering other child and cultural factors. METHODS: A total of 139 typically developing children and 114 with disabilities, ages 2-12 years from Australia and Taiwan, participated in the study. The outcome measures used were the Assessment of Children's Hand Skills (a measure of real-life hand skill performance) and the Personal Living Skills subscale of the Vineland Adaptive Behavior Scales - Classroom Edition (a measure of self-care function). RESULTS: Hierarchical regression analysis revealed that the children's demographic variables (age, gender, disability status, handedness and cultural context) accounted for 43% of the variance of the self-care function in the combined group of children with and without disabilities. Age, presence of disability and cultural context were the statistically significant independent factors. However, after the entry of the real-life hand skill performance factor, the contributing values of age and disability status decreased and the age factor became non-significant. The hand skill performance factor was found to be the strongest, and its addition led to significant increments of 24.6% of the explained variance for children's self-care function. Similar results were also found in the regression analyses based on separate groups of typically developing children or those with disabilities. CONCLUSIONS: The findings provide evidence that children's real-life hand skill performance is a contributing factor of their self-care function. The assessment of children's hand skill performance in real-life contexts is therefore needed. PMID:22928608

Chien, C-W; Brown, T; McDonald, R; Yu, M-L



Psychometric analysis of the Spanish and Catalan versions of the Diabetes Self-Care inventory-revised version questionnaire  

PubMed Central

Background The purpose of this study was to validate the Spanish and Catalan versions of the Diabetes Self-Care Inventory-Revised Version (SCI-R) questionnaire to assess the degree of adherence to self-care among adults with diabetes. Methods We validated the Spanish and Catalan translation from, and back translation to, English and cultural adaptation of the SCI-R in type 1 diabetes patients on multiple insulin doses or continuous subcutaneous insulin infusion and in type 2 diabetes patients on oral agents and/or insulin. Internal reliability, structural validity, and external validity (correlation with glycated hemoglobin) were evaluated. Responsiveness to change was assessed in patients 1 year after onset of type 1 diabetes and following a structured education program. Results The SCI-R presented good internal reliability Cronbach’s ?: 0.75, test-retest reliability (r = 0.82) and structural validity (r > 0.40). The external validity was also good; the SCI-R correlated with HbA1c in patients with type 1 diabetes on multiple insulin doses (r = ?0.50) or continuous subcutaneous insulin infusion (r = ?0.66) and in patients with type 2 diabetes on multiple insulin doses (r = ?0.62). However, it was not satisfactory in patients on oral agents (r = ?0.20) and/or bedtime insulin (r = ?0.35). Responsiveness to change was analyzed in 54 patients (age 27.3±7.4 years, 26% men, HbA1c 6.8% ±1.1%); the SCI-R score was 72.3% ±13.7% and correlated negatively with glycated hemoglobin (r = ?0.42) and 3 scales of the Diabetes Quality of Life questionnaire (lower score indicating better perception): Impact (r = ?0.37), Social Worry (r = ?0.36) and Diabetes Worry (r = ?0.38), all at P < 0.05. Conclusion The Spanish and Catalan versions of the SCI-R questionnaire show good psychometric properties and both could be considered as useful tools for evaluating self-care behavior in patients with type 1 or type 2 diabetes. However, there are still some subgroups of patients with type 2 diabetes in which the validity of this questionnaire needs further evaluation.

Jansa, Margarida; Vidal, Merce; Gimenez, Marga; Conget, Ignacio; Galindo, Mercedes; Roca, Daria; Colungo, Cristina; Esmatjes, Enric; Salamero, Manel



Relationship of a pelvic floor rehabilitation program for urinary incontinence to Orem's Self-Care Deficit Theory of Nursing: Part 1.  


Urinary incontinence is considered a significant social problem affecting many individuals' quality of life. Nursing theory is a set of concepts or propositions derived from philosophical beliefs about the phenomena of interest to the discipline. The ability to use theory to guide nursing practice brings reasoning and logic to professional nursing practice. Orem's Self-Care Deficit Theory of Nursing gets to the heart of what nursing is and how continence nursing care can be offered and delivered as a broadly inclusive professional, rather than narrowly procedural, practice offering individual care targeting the self-care agent (client) rather than the medical diagnosis. PMID:12593228

Bernier, Francie



Breathing Words Slowly: Creative Writing and Counselor Self-Care--The Writing Workout  

ERIC Educational Resources Information Center

|Professional counselors work daily with compassion and connection, yet must also manage trauma and pain. Clients' stories of loneliness, fear, abuse, and anger frequently fill the landscape of a counselor's work. Counselors may experience burnout, compassion fatigue, and vicarious trauma by failing to recognize and adequately address the negative…

Warren, Jane; Morgan, Michael M.; Morris, Lay-Nah Blue; Morris, Tanaya Moon



Average Rate of Change  

NSDL National Science Digital Library

This demo provides students with a concrete understanding of the average rate of change for physical situations and for functions described in tabular or graphic form. Animations in gif and Quicktime format are available, as well as Excel programs for classroom or student use.

Roberts, Lila F.; Hill, David R.



[Diabetes case management].  


Diabetes case management and self-care education can effectively improve patient clinical outcomes and quality of life. Diabetes case management should be provided by an interdisciplinary team. Diabetes education has evolved from its previous focus on "teaching proper content" to "achieving successful patient outcomes" in line with the current emphasis in health education on patient-centered goals. Behavioral changes are facilitated based on these goals. Behavioral change directed at successful diabetes self-care was adopted as one of the desired outcomes of diabetes case management. The American Association of Diabetes Educators developed seven diabetes self-care behaviors as behavior objectives and evaluation indicators of diabetes education. These indicators include healthy eating, being active, monitoring, taking medication, problem solving, healthy coping, and reducing risks. The process of diabetes case management includes assessment, expected outcome identification, planning, implementation, evaluation, and documentation. In Taiwan, the Diabetes Share Care Network has promoted the advantages and techniques of diabetes case management. Based on network recommendations, the improvement program of National Health Insurance payment for diabetes medical treatment under the Bureau of National Health Insurance now provides package payment and requires quality interdisciplinary care and case management. PMID:19319800

Yeh, Mei Chang



“When It's Just Me at Home, It Hits Me That I'm Completely Alone”: An Online Survey of Adolescents in Self-Care  

Microsoft Academic Search

The present study examined adolescents' experiences of loneliness and solitude in their responses to an online survey on self-care. Both quantitative (n = 272) and qualitative (n = 150) responses were coded for these feelings when home alone. Results indicate that adolescents experience the duality of aloneness, including both positive solitude and negative loneliness. Adolescents' responses range from embraced solitude

Mónica Ruiz-Casares



The Effect of Progressive, Reinforcing Telephone Education and Counseling vs. Brief Educational Intervention on Knowledge, Self-Care Behaviors and Heart Failure Symptoms  

PubMed Central

Background The optimal strategy for promoting self-care for heart failure (HF) is unclear. Methods and Results We conducted a randomized trial to determine whether a “teach to goal” (TTG) educational and behavioral support program provided incremental benefits to a brief (one hour) educational intervention (BEI) for knowledge, self-care behaviors, and HF-related quality of life (HFQOL). The TTG program taught use of adjusted-dose diuretics and then reinforced learning goals and behaviors with 5-8 telephone counseling sessions over one month. Participants’ (N=605) mean age was 61 years; 37% had marginal or inadequate literacy; 69% had ejection fraction < 0.45; and 31% had class III or IV symptoms. The TTG group had greater improvements in general and salt knowledge (p < 0.001) and greater increases in self-care behaviors (from mean 4.8 to 7.6 for TTG vs. 5.2 to 6.7 for BEI; p<0.001). HFQOL improved from 58.5 to 64.6 for the TTG group but did not change for the BEI group (64.7 to 63.9; p < 0.001 for the difference in change scores). Improvements were similar regardless of participants’ literacy level. Conclusions Telephone reinforcement of learning goals and self-care behaviors improved knowledge, health behaviors, and HF-related QOL compared to a single education session.

Baker, David W; DeWalt, Darren A; Schillinger, Dean; Hawk, Victoria; Ruo, Bernice; Bibbins-Domingo, Kirsten; Weinberger, Morris; Macabasco-O'Connell, Aurelia; Grady, Kathy L.; Holmes, George M.; Erman, Brian; Broucksou, Kimberly A; Pignone, Michael



Space, Place, and Objects: A Cross-National Study of Environmental Barriers and Enablers that Influence the Self-Care Participation of Disabled Community-Dwelling Older Adults  

Microsoft Academic Search

Background and Significance: Most research about the occupation of self-care focuses on the individual level of performance and\\/or how technology impacts performance. Yet occupations occur within a sociocultural context that frames how spaces, places, and objects are designed, used, and hold meaning for the individual. Even so, sociocultural aspects of human occupations and environmental design are often barely addressed or

Maryanne Sacco-Peterson; Margareta Lilja; Joy Hammel



Power, self-care, and health in women living in urban squatter settlements in Karachi, Pakistan: A test of Orem's theory  

Microsoft Academic Search

The purpose of this study was to explore the contribution of selected conditioning factors, perceptions of power, and other components of self-care in explaining health outcomes of women living in urban squatter settlements was conducted in Karachi, Pakistan. Statement's in Orem's theory were used to construct a theoretical model which was tested using four hypotheses about: (a) the role of

Marilyn Bell Lee



A Multivariate Model of Determinants of Change in Gross-Motor Abilities and Engagement in Self-Care and Play of Young Children with Cerebral Palsy  

ERIC Educational Resources Information Center

|A multivariate model of determinants of change in gross-motor ability and engagement in self-care and play provides physical and occupational therapists a framework for decisions on interventions and supports for young children with cerebral palsy and their families. Aspects of the child, family ecology, and rehabilitation and community services…

Chiarello, Lisa A.; Palisano, Robert J.; Bartlett, Doreen J.; McCoy, Sarah Westcott



A Social-Cognitive Model to Predict the Use of Assistive Devices for Mobility and Self-Care in Elderly People  

Microsoft Academic Search

Purpose: To provide insight into the contribution of psycho- logical variables in understanding use and nonuse of assis- tive devices (ADs) for self-care and mobility. Design and Methods: A survey on a representative sample of 491 community-dwelling elderly people in Flanders was con- ducted. A theoretical model of the factors predicting the use of ADs was tested with path analysis.

Marc Roelands; Paulette Van Oost; AnneMarie Depoorter



Reliability of a New Classification System for Mobility and Self-Care in Spinal Cord Injury Rehabilitation: The Spinal Cord Injury-Interventions Classification System  

Microsoft Academic Search

van Langeveld SA, Post MW, van Asbeck FW, ter Horst P, Leenders J, Postma K, Lindeman E. Reliability of a new classification system for mobility and self-care in spinal cord injury rehabilitation: the Spinal Cord Injury-Interventions Classification System.

Sacha A. van Langeveld; Marcel W. Post; Floris W. van Asbeck; Paul ter Horst; Jacqueline Leenders; Karin Postma; Eline Lindeman



An Average Lunch?  

NSDL National Science Digital Library

This statistics activity requires students to find the mean using their TI-10 or TI-15 Explorer calculators. The task asks students to read part of Sideways Stories of Wayside School by Louis Sachar and find different combinations of lunches that would give an average price of $1.85. This resource includes a three-page PDF lesson plan with guiding questions, data collection page, and calculator instructions.



Average density in cosmology  

SciTech Connect

The Einstein-Straus (1945) vacuole is here used to represent a bound cluster of galaxies embedded in a standard pressure-free cosmological model, and the average density of the cluster is compared with the density of the surrounding cosmic fluid. The two are nearly but not quite equal, and the more condensed the cluster, the greater the difference. A theoretical consequence of the discrepancy between the two densities is discussed. 25 references.

Bonnor, W.B.



Being prepared: essential to self-care and quality of life for the person with cancer.  


Being adequately prepared for an experience such as cancer empowers patients, lowers distress, improves coping, supports self-management, promotes recovery, and improves quality of life. However, patients with cancer report unmet informational and support needs across the cancer trajectory. The purpose of this article is to describe the relationship of information preparation and patient outcomes, identify information and support needs across the cancer trajectory, and describe the role of oncology nurses in the delivery of high-quality patient-centered cancer care. The middle range theory of "Carrying On" was used to identify information and support needs during different phases of the cancer trajectory from treatment to survivorship. The authors concluded that nurses should engage the patient in a relational exchange of information; provide concrete, understandable information across specific times in the cancer experience; and use creative approaches to minimize barriers in meeting patient needs to achieve high-quality patient-centered cancer care. PMID:23715703

Knobf, M Tish



Dimensions of patient-provider communication and diabetes self-care in an ethnically diverse population  

Microsoft Academic Search

BACKGROUND: Patient-provider communication is essential for effective care of diabetes and other chronic illnesses. However, the relative\\u000a impact of general versus disease-specific communication on self-management is poorly understood, as are the determinants of\\u000a these 2 communication dimensions.\\u000a \\u000a \\u000a DESIGN: Cross-sectional survey.\\u000a \\u000a \\u000a \\u000a \\u000a SETTING: Three VA heath care systems, 1 county health care system, and 1 university-based health care system.\\u000a \\u000a \\u000a \\u000a \\u000a PATIENTS: Seven hundred

John D. Piette; Dean Schillinger; Michael B. Potter; Michele Heisler



Authoritative Parenting, Parenting Stress, and Self-Care in Pre-Adolescents with Type 1 Diabetes  

PubMed Central

Parent involvement in type 1 diabetes (T1DM) care leads to improved adherence; however, the manner in which parents approach illness management interactions with children must also be considered. It was hypothesized that greater use of an authoritative parenting style and less parenting stress would be associated with greater behavioral adherence and better metabolic control. Ninety-five primary caregivers of preadolescents (ages 8-11) with T1DM completed questionnaires assessing parenting style, pediatric parenting stress, and child behavioral adherence. Caregivers primarily self-identified as using an authoritative parenting style. Greater authoritative parenting was associated with greater behavioral adherence and less difficulty with pediatric parenting stress; no differences in metabolic control were observed. Greater engagement in authoritative parenting behaviors may contribute to increased age-appropriate child behavioral adherence and less pediatric parenting stress. Interventions highlighting diabetes-specific authoritative parenting techniques may enhance health outcomes and improve overall family functioning.

Monaghan, Maureen; Horn, Ivor B.; Alvarez, Vanessa; Cogen, Fran R.; Streisand, Randi



Comparison of yoga versus stretching for chronic low back pain: protocol for the Yoga Exercise Self-care (YES) trial  

PubMed Central

Background Back pain, one of the most prevalent conditions afflicting American adults, is the leading reason for using complementary and alternative medicine (CAM) therapies. Yoga is an increasingly popular "mind-body" CAM therapy often used for relieving back pain and several small studies have found yoga effective for this condition. This study will assess whether yoga is effective for treating chronic low back pain compared with self care and exercise and will explore the mechanisms responsible for any observed benefits. Methods/Design A total of 210 participants with low back pain lasting at least 3 months will be recruited from primary care clinics of a large healthcare system based in Seattle. They will be randomized in a 2:2:1 ratio to receive 12 weekly yoga classes, 12 weekly conventional therapeutic exercise classes of comparable physical exertion, or a self-care book. Interviewers masked to participants' treatment group will assess outcomes at baseline and 6, 12 and 26 weeks after randomization. Primary outcomes will be back-related dysfunction and symptom bothersomeness. In addition, data will be collected on physical measurements (e.g., flexion) at baseline and 12 weeks and saliva samples will be obtained at baseline, 6 and 12 weeks. Information will be collected on specific physical, psychological, and physiological factors to allow exploration of possible mechanisms of action through which yoga could relieve back pain and dysfunction. The effectiveness of yoga will be assessed using analysis of covariance (using general estimating equations - GEE) within an intention-to-treat context. If yoga is found effective, further analyses will explore whether yoga's benefits are attributable to physical, psychological and/or physiological factors. Conclusions This study will provide the clearest evidence to date about the value of yoga as a therapeutic option for treating chronic back pain, and if the results are positive, will help focus future, more in-depth, research on the most promising potential mechanisms of action identified by this study. Trial registration This trial is registered in, with the ID number of NCT00447668.



Americans' Average Radiation Exposure  

SciTech Connect

We live with radiation every day. We receive radiation exposures from cosmic rays, from outer space, from radon gas, and from other naturally radioactive elements in the earth. This is called natural background radiation. It includes the radiation we get from plants, animals, and from our own bodies. We also are exposed to man-made sources of radiation, including medical and dental treatments, television sets and emission from coal-fired power plants. Generally, radiation exposures from man-made sources are only a fraction of those received from natural sources. One exception is high exposures used by doctors to treat cancer patients. Each year in the United States, the average dose to people from natural and man-made radiation sources is about 360 millirem. A millirem is an extremely tiny amount of energy absorbed by tissues in the body.




Conceptual challenges and practical approaches to screening capacity for self-care and protection in vulnerable older adults.  


Identifying impairments in the capacity to make and execute decisions is critical to the assessment and remediation of elder self-neglect. Few capacity assessment tools are available for use outside of healthcare settings, and none have been validated in the context of elder self-neglect. Health and social services professionals are in need of validated tools to assess capacity for self-care and self-protection (SC&P) during initial evaluations of older adults with suspected self-neglect syndrome. Currently, legal and medical declarations of incapacity and guardianship rely on clinical evaluations and instruments developed to assess only decision-making capacity. This article first describes the conceptual and methodological challenges to assessing the capacity to make and execute decisions regarding safe and independent living. Second, the article describes the pragmatic obstacles to developing a screening tool for the capacity for SC&P. Finally, the article outlines the process for validation and field testing of the screening tool. Social services professionals can then use a valid and feasible screening tool during field assessments to screen for potential impairments in the capacity for SC&P in vulnerable older adults. PMID:19016970

Naik, Aanand D; Teal, Cayla R; Pavlik, Valory N; Dyer, Carmel B; McCullough, Laurence B



Improving self-care for heart failure for seniors: the impact of video and written education and decision aids.  


Heart failure poses a substantial burden on health care expenditures and quality of life; therefore, strategies to improve health behaviors for heart failure are essential. Highly effective medical decision aids can enable health improvements for people with heart failure. In this randomized controlled study, individuals with heart failure in a private Medicare plan were randomized into either an intervention or control group. Participants in the intervention group received basic program information and a simple fact sheet about heart failure, plus a medical decision aid, Living with Heart Failure DVD and booklet; patients randomized to the control group received the basic written materials only. The study was powered to detect a 5% difference in the primary outcome measure (daily weight monitoring). Participants were surveyed 4 weeks after outreach materials were mailed. There were 480 survey respondents: 246 in the intervention group; 234 in the control group. Intervention group respondents were significantly more likely to weigh themselves daily (P=0.05) than control group respondents (44% versus 38%). The intervention group was more likely than the control group to monitor fluid intake (47% versus 44%) and follow a low-sodium diet (83% versus 77%). Other health behavior differences were not statistically significant. The DVD decision aid increased levels of daily weight monitoring and other important health behaviors. Broad application of inexpensive behavior change interventions, such as a DVD/booklet program, should help to facilitate important, routine self-care behaviors for individuals with heart failure. PMID:22004181

Veroff, David R; Sullivan, Lisa A; Shoptaw, E J; Venator, Benjamin; Ochoa-Arvelo, Tamara; Baxter, Jonathan R; Manocchia, Michael; Wennberg, David



Family Influences on Self-Management Among Functionally Independent Adults with Diabetes or Heart Failure: Do Family Members Hinder As Much As They Help?  

PubMed Central

Objectives Among functionally independent patients with diabetes or heart failure, we examined family member support and family-related barriers to self-care. We then identified patient characteristics associated with family support and family barriers and how each was associated with self-management adherence. Methods Cross-sectional survey of 439 patients with diabetes or heart failure (74% response rate). Results 75% of respondents reported supportive family involvement in self-care, however 25% reported frequent family-related barriers to self-care. Women reported family support less often (64% vs. 77%) and family barriers to self-care more often (30% vs. 21%) than men. 78% of respondents reported involved family members nagged or criticized them about illness care. In multivariate models, low health literacy, partnered status, and higher family function were associated with higher family support levels, while female gender, older age, higher education, and more depression symptoms were associated with family barriers to self-care. Family barriers were associated with lower disease care self-efficacy (p<.0.01), and both barriers and family support were associated with patients’ self-management adherence (both p<0.05). Discussion Family members are highly involved in the self-care of these higher-functioning patients. Interventions should help patients with chronic illness overcome family barriers to self-care and help families use positive and effective support techniques.

Rosland, Ann-Marie; Heisler, Michele; Choi, HwaJung; Silveira, Maria J.; Piette, John D



Panchromatic averaged stellar populations  

NASA Astrophysics Data System (ADS)

We study how the spectral fitting of galaxies, in terms of light fractions, derived in one spectral region translates into another region, by using results from evolutionary synthesis models. In particular, we examine propagation dependencies on evolutionary population synthesis (EPS) models (GRASIL, GALEV, Maraston and GALAXEV), age, metallicity and stellar evolution tracks over the near-ultraviolet-near-infrared (NUV-NIR, 3500 Å to 2.5 ?m) spectral region. Our main results are as follows: as expected, young (t? 400 Myr) stellar population fractions derived in the optical cannot be directly compared to those derived in the NIR, and vice versa. In contrast, intermediate to old age (t? 500 Myr) fractions are similar over the whole spectral region studied. The metallicity has a negligible effect on the propagation of the stellar population fractions derived from NUV to NIR. The same applies to the different EPS models, but restricted to the range between 3800 and 9000 Å. However, a discrepancy between GALEV/Maraston and GRASIL/GALAXEV models occurs in the NIR. Furthermore, the initial mass function is not important for the synthesis propagation. Compared to STARLIGHT synthesis results, our propagation predictions agree at ˜95 per cent confidence level in the optical, and ˜85 per cent in the NIR. In summary, spectral fitting performed in a restricted spectral range should not be directly propagated from the NIR to the UV/optical, or vice versa. We provide equations and an on-line form [panchromatic averaged stellar population (PaASP)] to be used for this purpose.

Riffel, R.; Bonatto, C.; Cid Fernandes, R.; Pastoriza, M. G.; Balbinot, E.



Beyond good intentions: The role of proactive coping in achieving sustained behavioural change in the context of diabetes management  

Microsoft Academic Search

This study examines the effectiveness of a brief self-management intervention to support patients recently diagnosed with type-2 diabetes to achieve sustained improvements in their self-care behaviours. Based on proactive coping, the intervention emphasizes the crucial role of anticipation and planning in maintaining self-care behaviours. In a randomised controlled trial among recent screen-detected patients, participants who received the intervention were compared

Bart Johan Thoolen; Denise de Ridder; Jozien Bensing; Kees Gorter; Guy Rutten



Development and psychometric properties of a new social support scale for self-care in middle-aged patients with type II diabetes (S4-MAD)  

PubMed Central

Background Social support has proved to be one of the most effective factors on the success of diabetic self-care. This study aimed to develop a scale for evaluating social support for self-care in middle-aged patients (30–60 years old) with type II diabetes. Methods This was a two-phase qualitative and quantitative study. The study was conducted during 2009 to 2011 in Tehran, Iran. In the qualitative part, a sample of diabetic patients participated in four focus group discussions in order to develop a preliminary item pool. Consequently, content and face validity were performed to provide a pre-final version of the questionnaire. Then, in a quantitative study, reliability (internal consistency and test-retest analysis), validity and factor analysis (both exploratory and confirmatory) were performed to assess psychometric properties of the scale. Results A 38-item questionnaire was developed through the qualitative phase. It was reduced to a 33-item after content validity. Exploratory factor analysis loaded a 30-item with a five-factor solution (nutrition, physical activity, self monitoring of blood glucose, foot care and smoking) that jointly accounted for 72.3% of observed variance. The confirmatory factor analysis indicated a good fit to the data. The Cronbach’s alpha coefficient showed excellent internal consistency (alpha=0.94), and test-retest of the scale with 2-weeks intervals indicated an appropriate stability for the scale (ICC=0.87). Conclusion The findings showed that the designed questionnaire was a valid and reliable instrument for measuring social support for self-care in middle-aged patients with type II diabetes. It is an easy to use questionnaire and contains the most significant diabetes related behaviors that need continuous support for self-care.



Negotiating boundaries: managing disease at home  

Microsoft Academic Search

To move treatment successfully from the hospital to that of technology assisted self-care at home, it is vital in the design of such technologies to understand the setting in which the health IT should be used. Based on qualitative studies we find that people engage in elaborate boundary work to maintain the order of the home when managing disease and

Rikke Aarhus; Stinne Aaløkke Ballegaard



Long-term effects of one year of intensified podiatric activities on foot-care knowledge and self-care habits in patients with diabetes.  


The purpose of this study was to evaluate the effectiveness of the activities of a podiatrist in the outpatient foot care of patients with diabetes. Patients from southwestern Finland, ages 10 to 80 years, were selected from the national diabetes register. Those without a recent visit to a podiatrist and without any obvious need for foot care (n = 530) were randomized into a podiatric care group (individual counseling and primary prevention measures, n = 267) and a control group (written instructions only, n = 263). Knowledge of foot care and self-care habits were evaluated by means of structured interviews, and a podiatric examination was performed at baseline and 1 and 7 years later. Compared with the baseline scores, the knowledge score was higher at the 7-year follow-up in both the podiatric and control group and similarly in men and women. Self-care score increased in men similarly in both treatment groups. The self-care score for women increased more in the podiatric group during the first year and the difference between the groups remained for up to 7 years. There were no significant differences between the groups in the podiatric findings. PMID:10025296

Hämäläinen, H; Rönnemaa, T; Toikka, T; Liukkonen, I


Vaginitis - self-care  


... of all ages. It can be caused by: Yeast, bacteria, viruses, and parasites Bubble baths, soaps, vaginal ... Creams or suppositories are used to treat yeast infections in the ... some grocery stores, and other stores. Treating yourself ...


Problem solving in diabetes self-management: A model of chronic illness self-management behavior  

Microsoft Academic Search

Management of chronic illnesses is a significant public health concern that is made more challenging by problems of regimen\\u000a adherence. Effective self-management of chronic illnesses such as diabetes requires not only technical skill to perform regimen\\u000a behaviors but also problem-solving skills to manage daily barriers to regimen adherence and to make appropriate adjustment\\u000a to the self-care regimen. A review of

Felicia Hill-Briggs



Health care utilization and self-care behaviors of Medicare beneficiaries with diabetes: comparison of national and ethnically diverse underserved populations.  


Caring for persons with diabetes is expensive, and this burden is increasing. Little is known about service use, behaviors, and self-care of older individuals with diabetes who live in underserved communities. Information about self-care, informal care, and service utilization in urban (largely Latino, n = 695) and rural (mostly white, n = 819) Medicare beneficiaries with diabetes living in federally designated medically underserved areas was collected using computer-aided telephone interviews as part of the baseline assessment in the Informatics and Diabetes Education and Telemedicine (IDEATel) Project. Where items were comparable, service use was compared with that of a nationally representative group of Medicare beneficiaries with diabetes, using data from the Medical Expenditure Panel Survey. Compared to nationally representative groups, the underserved groups reported worse general health but similar health care service use, with the exception of home care. However, compared to the underserved rural group, the underserved, largely minority urban group, reported worse general health (P < 0.0001); more inpatient nights (P = 0.003), emergency room visits (P < 0.001), and home health care (P < 0.001); spent more time on self-care; and had more difficulty with housework, meal preparation, and personal care. Differences in service use between urban and rural groups within the underserved group substantially exceeded differences between the underserved and nationally representative groups. These findings address a gap in knowledge about older, ethnically diverse individuals with diabetes living in medically underserved areas. This profile of disparate service use and health care practices among urban minority and rural majority underserved adults with diabetes can assist in the planning of future interventions. PMID:21241171

Remler, Dahlia K; Teresi, Jeanne A; Weinstock, Ruth S; Ramirez, Mildred; Eimicke, Joseph P; Silver, Stephanie; Shea, Steven



Effect of a self-care program on oxidative stress and cognitive function in an older Mexican urban-dwelling population  

Microsoft Academic Search

Objective  To determine the effect of a self-care program on oxidative stress (OxS) and cognitive function in an older, Mexican, urban-dwelling\\u000a population.\\u000a \\u000a \\u000a \\u000a Design  A longitudinal and pre-experimental study was carried out in a sample of 79 older healthy, urban-dwelling individuals residing\\u000a in Mexico City, (62 females and 17 males), of which 71 of them (59 women and 12 males) complied with the

M. A. Sánchez-Rodríguez; A. Arronte-Rosales; V. M. Mendoza-Núñez



Striving for Control: Cognitive, Self-Care, and Faith Strategies Employed by Vulnerable Black and White Older Adults with Multiple Chronic Conditions  

Microsoft Academic Search

The average older adult reaches age 65 with at least two chronic, co-occurring illnesses, or multiple morbidities (MM). We\\u000a currently lack critical information about the specific strategies older adults use to attempt to control these MM. To increase\\u000a our understanding of how older adults attempt to manage these MM and retain control of their health, in-depth interviews were\\u000a conducted with

Corinne R. Leach; Nancy E. Schoenberg



Factors Influencing the Use of a Web-Based Application for Supporting the Self-Care of Patients with Type 2 Diabetes: A Longitudinal Study  

PubMed Central

Background The take-up of eHealth applications in general is still rather low and user attrition is often high. Only limited information is available about the use of eHealth technologies among specific patient groups. Objective The aim of this study was to explore the factors that influence the initial and long-term use of a Web-based application (DiabetesCoach) for supporting the self-care of patients with type 2 diabetes. Methods A mixed-methods research design was used for a process analysis of the actual usage of the Web application over a 2-year period and to identify user profiles. Research instruments included log files, interviews, usability tests, and a survey. Results The DiabetesCoach was predominantly used for interactive features like online monitoring, personal data, and patient–nurse email contact. It was the continuous, personal feedback that particularly appealed to the patients; they felt more closely monitored by their nurse and encouraged to play a more active role in self-managing their disease. Despite the positive outcomes, usage of the Web application was hindered by low enrollment and nonusage attrition. The main barrier to enrollment had to do with a lack of access to the Internet (146/226, 65%). Although 68% (34/50) of the enrollees were continuous users, of whom 32% (16/50) could be defined as hardcore users (highly active), the remaining 32% (16/50) did not continue using the Web application for the full duration of the study period. Barriers to long-term use were primarily due to poor user-friendliness of the Web application (the absence of “push” factors or reminders) and selection of the “wrong” users; the well-regulated patients were not the ones who could benefit the most from system use because of a ceiling effect. Patients with a greater need for care seemed to be more engaged in long-term use; highly active users were significantly more often medication users than low/inactive users (P = .005) and had a longer diabetes duration (P = .03). Conclusion Innovations in health care will diffuse more rapidly when technology is employed that is simple to use and has applicable components for interactivity. This would foresee the patients’ need for continuous and personalized feedback, in particular for patients with a greater need for care. From this study several factors appear to influence increased use of eHealth technologies: (1) avoiding selective enrollment, (2) making use of participatory design methods, and (3) developing push factors for persistence. Further research should focus on the causal relationship between using the system’s features and actual usage, as such a view would provide important evidence on how specific technology features can engage and captivate users.

van Gemert-Pijnen, Julia EWC; Kelders, Saskia M; Brandenburg, Bart J; Seydel, Erwin R



Modular Approach to Physics: Average Speed versus Average Velocity  

NSDL National Science Digital Library

This applet is an interactive demonstration of average speed and velocity. The user can move the object, while average speed and velocity is calculated and available through the Data panel. A full lesson plan is available through the Help menu. This item is part of a larger collection of simulation based physics modules sponsored by the MAP project (Modular Approach to Physics).

Austin, David; Martin, Brian



Spacetime averaged null energy condition  

SciTech Connect

The averaged null energy condition has known violations for quantum fields in curved space, even when one considers only achronal geodesics. Many such examples involve rapid variation in the stress-energy tensor in the vicinity of the geodesic under consideration, giving rise to the possibility that averaging in additional dimensions would yield a principle universally obeyed by quantum fields. However, after discussing various procedures for additional averaging, including integrating over all dimensions of the manifold, we give here a class of examples that violate any such averaged condition.

Urban, Douglas; Olum, Ken D. [Institute of Cosmology, Department of Physics and Astronomy, Tufts University, Medford, Massachusetts 02155 (United States)



Staging Activity Limitation and Participation Restriction in Elderly Community-Dwelling Persons According to Difficulties in Self-Care and Domestic Life Functioning  

PubMed Central

Objective This study aimed to describe the conceptual foundation and development of an activity limitation and participation restriction staging system for community-dwelling people 70 yrs or older according to the severity and types of self-care (activities of daily living [ADLs]) and domestic life (instrumental ADLs (IADLs)) limitations experienced. Design Data from the second Longitudinal Study of Aging (N = 9447) were used to develop IADL stages through the analyses of self- and proxy-reported difficulties in performing IADLs. An analysis of activity limitation profiles identified hierarchical thresholds of difficulty that defined each stage. IADL stages are combined with ADL stages to profile status for independent living. Results IADL stages define five ordered thresholds of increasing activity limitations and a “not relevant” stage for those who normally have someone else do those activities. Approximately 42% of the population experience IADL limitations. To achieve a stage, a person must meet or exceed stage-specific thresholds of retained functioning defined for each activity. Combined ADL and IADL stages de-fine 29 patterns of activity limitations expressing the individual’s potential for participating in life situations pertinent to self-care and independent community life. Conclusions ADL and IADL stages can serve to distinguish between groups of people according to both severity and the types of limitations experienced during home or outpatient assessments, in population surveillance, and in research.

Stineman, Margaret G.; Henry-Sanchez, John T.; Kurichi, Jibby E.; Pan, Qiang; Xie, Dawei; Saliba, Debra; Zhang, Zi; Streim, Joel E.



The Limits of Self-Management: Community and Health Care System Barriers Among Latinos With Diabetes  

Microsoft Academic Search

Although numerous studies examine diabetes self-care, few regard ecological framework correlates such as community and institutional level factors as fundamental for understanding diabetes management for Latinos. This article addresses the dearth of research that exists regarding social contextual forces and diabetes management for Latinos. Given the scarcity of research on this topic, studies of non-Latino groups were reviewed to illustrate

Janine Jurkowski



Stimulating Healthy Aging with a Model Nurse-Managed Free Clinic in a Senior Center.  

ERIC Educational Resources Information Center

|As part of a Geriatric Education and Health Management program, a model nurse-managed free clinic has been established at an urban senior center by faculty and students of the University of New Mexico College of Nursing. Funded by a 3-year grant from the Department of Health and Human Services, the weekly clinic is based on Orem's self-care

Franklin, Ruth H.


Stimulating Healthy Aging with a Model Nurse-Managed Free Clinic in a Senior Center.  

ERIC Educational Resources Information Center

As part of a Geriatric Education and Health Management program, a model nurse-managed free clinic has been established at an urban senior center by faculty and students of the University of New Mexico College of Nursing. Funded by a 3-year grant from the Department of Health and Human Services, the weekly clinic is based on Orem's self-care theory…

Franklin, Ruth H.


The Averaging Problem in Cosmology  

NASA Astrophysics Data System (ADS)

This thesis deals with the averaging problem in cosmology, which has gained considerable interest in recent years, and is concerned with correction terms (after averaging inhomogeneities) that appear in the Einstein equations when working on the large scales appropriate for cosmology. It has been claimed in the literature that these terms may account for the phenomenon of dark energy which causes the late time universe to accelerate. We investigate the nature of these terms by using averaging schemes available in the literature and further developed to be applicable to the problem at hand. We show that the effect of these terms when calculated carefully, remains negligible and cannot explain the late time acceleration.

Paranjape, Aseem



Averaging in spherically symmetric cosmology  

SciTech Connect

The averaging problem in cosmology is of fundamental importance. When applied to study cosmological evolution, the theory of macroscopic gravity (MG) can be regarded as a long-distance modification of general relativity. In the MG approach to the averaging problem in cosmology, the Einstein field equations on cosmological scales are modified by appropriate gravitational correlation terms. We study the averaging problem within the class of spherically symmetric cosmological models. That is, we shall take the microscopic equations and effect the averaging procedure to determine the precise form of the correlation tensor in this case. In particular, by working in volume-preserving coordinates, we calculate the form of the correlation tensor under some reasonable assumptions on the form for the inhomogeneous gravitational field and matter distribution. We find that the correlation tensor in a Friedmann-Lemaitre-Robertson-Walker (FLRW) background must be of the form of a spatial curvature. Inhomogeneities and spatial averaging, through this spatial curvature correction term, can have a very significant dynamical effect on the dynamics of the Universe and cosmological observations; in particular, we discuss whether spatial averaging might lead to a more conservative explanation of the observed acceleration of the Universe (without the introduction of exotic dark matter fields). We also find that the correlation tensor for a non-FLRW background can be interpreted as the sum of a spatial curvature and an anisotropic fluid. This may lead to interesting effects of averaging on astrophysical scales. We also discuss the results of averaging an inhomogeneous Lemaitre-Tolman-Bondi solution as well as calculations of linear perturbations (that is, the backreaction) in an FLRW background, which support the main conclusions of the analysis.

Coley, A. A.; Pelavas, N. [Department of Mathematics and Statistics, Dalhousie University, Halifax, Nova Scotia (Canada)



Patient Understanding of Diabetes Self-Management: Participatory Decision-Making in Diabetes Care  

PubMed Central

Objective: Our aim was to determine whether patient participation in decision-making about diabetes care is associated with understanding of diabetes self-management and subsequent self-care practices. We also identified issues that would impact messaging for use in mobile diabetes communication. Research Design and Methods: A cross-sectional observational study was conducted with type 2 diabetes patients (n = 81) receiving their care at the University of Maryland Joslin Diabetes Center. A convenience sample of patients were eligible to participate if they were aged 25–85 years, had type 2 diabetes, spoke English, and visited their physician diabetes manager within the past 6 months. In-person patient interviews were conducted at the time of clinic visits to assess patient understanding of diabetes management, self-care practices, and perceptions of participation in decision-making about diabetes care. Results: African Americans reported fewer opportunities to participate in decision-making than Caucasians, after controlling for education [mean difference (MD) = -2.4, p = .02]. This association became insignificant after controlling for patient–physician race concordance (MD = -1.5, p = .21). Patient understanding of self-care was predicted by having greater than high school education (MD = 3.6, p = .001) and having physicians who involved them in decision-making about their care. For each unit increase in understanding of diabetes self-care, the mean patient self-care practice score increased by 0.16 (p = .003), after adjustment for patient race and education. Conclusions: Patient participation in decision-making is associated with better understanding of care. Participation in decision-making plays a key role in patient understanding of diabetes self-management and subsequent self-care practices. Patients with limited education need specific instruction in foot care, food choices, and monitoring hemoglobin A1c.

Quinn, Charlene C; Royak-Schaler, Renee; Lender, Dan; Steinle, Nanette; Gadalla, Shahinaz; Zhan, Min



Patient understanding of diabetes self-management: participatory decision-making in diabetes care.  


Objective: Our aim was to determine whether patient participation in decision-making about diabetes care is associated with understanding of diabetes self-management and subsequent self-care practices. We also identified issues that would impact messaging for use in mobile diabetes communication. Research Design and Methods: A cross-sectional observational study was conducted with type 2 diabetes patients (n = 81) receiving their care at the University of Maryland Joslin Diabetes Center. A convenience sample of patients were eligible to participate if they were aged 25-85 years, had type 2 diabetes, spoke English, and visited their physician diabetes manager within the past 6 months. In-person patient interviews were conducted at the time of clinic visits to assess patient understanding of diabetes management, self-care practices, and perceptions of participation in decision-making about diabetes care. Results: African Americans reported fewer opportunities to participate in decision-making than Caucasians, after controlling for education [mean difference (MD) = -2.4, p = .02]. This association became insignificant after controlling for patient-physician race concordance (MD = -1.5, p = .21). Patient understanding of self-care was predicted by having greater than high school education (MD = 3.6, p = .001) and having physicians who involved them in decision-making about their care. For each unit increase in understanding of diabetes self-care, the mean patient self-care practice score increased by 0.16 (p = .003), after adjustment for patient race and education. Conclusions: Patient participation in decision-making is associated with better understanding of care. Participation in decision-making plays a key role in patient understanding of diabetes self-management and subsequent self-care practices. Patients with limited education need specific instruction in foot care, food choices, and monitoring hemoglobin A1c. PMID:21722588

Quinn, Charlene C; Royak-Schaler, Renee; Lender, Dan; Steinle, Nanette; Gadalla, Shahinaz; Zhan, Min



Evaluations of average level spacings  

SciTech Connect

The average level spacing for highly excited nuclei is a key parameter in cross section formulas based on statistical nuclear models, and also plays an important role in determining many physics quantities. Various methods to evaluate average level spacings are reviewed. Because of the finite experimental resolution, to detect a complete sequence of levels without mixing other parities is extremely difficult, if not totally impossible. Most methods derive the average level spacings by applying a fit, with different degrees of generality, to the truncated Porter-Thomas distribution for reduced neutron widths. A method that tests both distributions of level widths and positions is discussed extensivey with an example of /sup 168/Er data. 19 figures, 2 tables.

Liou, H.I.



On generalized averaged Gaussian formulas  

NASA Astrophysics Data System (ADS)

We present a simple numerical method for constructing the optimal (generalized) averaged Gaussian quadrature formulas which are the optimal stratified extensions of Gauss quadrature formulas. These extensions exist in many cases in which real positive Kronrod formulas do not exist. For the Jacobi weight functions w(x)equiv w^{(alpha,beta)}(x)D(1-x)^alpha(1+x)^beta ( alpha,beta>-1 ) we give a necessary and sufficient condition on the parameters alpha and beta such that the optimal averaged Gaussian quadrature formulas are internal.

Spalevic, Miodrag M.



Averaging facial expression over time  

PubMed Central

The visual system groups similar features, objects, and motion (e.g., Gestalt grouping). Recent work suggests that the computation underlying perceptual grouping may be one of summary statistical representation. Summary representation occurs for low-level features, such as size, motion, and position, and even for high level stimuli, including faces; for example, observers accurately perceive the average expression in a group of faces (J. Haberman & D. Whitney, 2007, 2009). The purpose of the present experiments was to characterize the time-course of this facial integration mechanism. In a series of three experiments, we measured observers’ abilities to recognize the average expression of a temporal sequence of distinct faces. Faces were presented in sets of 4, 12, or 20, at temporal frequencies ranging from 1.6 to 21.3 Hz. The results revealed that observers perceived the average expression in a temporal sequence of different faces as precisely as they perceived a single face presented repeatedly. The facial averaging was independent of temporal frequency or set size, but depended on the total duration of exposed faces, with a time constant of ~800 ms. These experiments provide evidence that the visual system is sensitive to the ensemble characteristics of complex objects presented over time.

Haberman, Jason; Harp, Tom; Whitney, David



Average Cost of Common Schools.  

ERIC Educational Resources Information Center

|The paper shows costs of elementary and secondary schools applicable to Oklahoma rural areas, including the long-run average cost curve which indicates the minimum per student cost for educating various numbers of students and the application of the cost curves determining the optimum school district size. In a stratified sample, the school…

White, Fred; Tweeten, Luther


Intergenerational Transmission of Chronic Illness Self-Care: Results from the Caring for Hypertension in African American Families Study  

ERIC Educational Resources Information Center

|Purpose of the study: African Americans often experience early onset of hypertension that can result in generations of adults managing high blood pressure concurrently. Using a model based on the Theory of Interdependence, this study examined whether intergenerational transmission of hypertension knowledge and self-efficacy would affect…

Warren-Findlow, Jan; Seymour, Rachel B.; Shenk, Dena



Towards a Personal Health Management Assistant.  


We describe design and prototyping efforts for a Personal Health Management Assistant for heart failure patients as part of Project HealthDesign. An assistant is more than simply an application. An assistant understands what its users need to do, interacts naturally with them, reacts to what they say and do, and is proactive in helping them manage their health. In this project, we focused on heart failure, which is not only a prevalent and economically significant disease, but also one that is very amenable to self-care. Working with patients, and building on our prior experience with conversational assistants, we designed and developed a prototype system that helps heart failure patients record objective and subjective observations using spoken natural language conversation. Our experience suggests that it is feasible to build such systems and that patients would use them. The system is designed to support rapid application to other self-care settings. PMID:20937478

Ferguson, G; Quinn, J; Horwitz, C; Swift, M; Allen, J; Galescu, L



The role of partner relationships in the young person’s adherence to the diabetes self-care regime  

Microsoft Academic Search

Background: This study investigated the role of partner relationships in the young person’s experience of diabetes. It was\\u000a predicted that those people reporting a better quality relationship would report greater social support and better diabetes\\u000a management. Method: Fifty young adults with diabetes and their spouse\\/partner completed web-based questionnaires. Results:\\u000a A better quality relationship did not correlate with high reported levels

Rachel Gillibrand; Jim Stevenson



Geodesic shape-based averaging.  


A new method for the geometrical averaging of labels or landmarks is presented. This method expands the shape-based averaging framework from an Euclidean to a geodesic based distance, incorporating a spatially varying similarity term as time cost. This framework has unique geometrical properties, making it ideal for propagating very small structures following rigorous labelling protocols. The method is used to automate the seeding and way-pointing of optic radiation tractography in DTI imaging. The propagated seeds and waypoints follow a strict clinical protocol by being geometrically constrained to one single slice and by guaranteeing spatial contiguity. The proposed method not only reduces the fragmentation of the propagated areas but also significantly increases the seed positioning accuracy and subsequent tractography results when compared to state-of-the-art label fusion techniques. PMID:23286110

Cardoso, M Jorge; Winston, Gavin; Modat, Marc; Keihaninejad, Shiva; Duncan, John; Ourselin, Sebastien



Average trajectory of returning walks.  


We compute the average shape of trajectories of some one-dimensional stochastic processes x(t) in the (t,x) plane during an excursion, i.e., between two successive returns to a reference value, finding that it obeys a scaling form. For uncorrelated random walks the average shape is semicircular, independent from the single increments distribution, as long as it is symmetric. Such universality extends to biased random walks and Levy flights, with the exception of a particular class of biased Levy flights. Adding a linear damping term destroys scaling and leads asymptotically to flat excursions. The introduction of short and long ranged noise correlations induces nontrivial asymmetric shapes, which are studied numerically. PMID:15169006

Colaiori, Francesca; Baldassarri, Andrea; Castellano, Claudio



Robust averaging during perceptual judgment  

PubMed Central

An optimal agent will base judgments on the strength and reliability of decision-relevant evidence. However, previous investigations of the computational mechanisms of perceptual judgments have focused on integration of the evidence mean (i.e., strength), and overlooked the contribution of evidence variance (i.e., reliability). Here, using a multielement averaging task, we show that human observers process heterogeneous decision-relevant evidence more slowly and less accurately, even when signal strength, signal-to-noise ratio, category uncertainty, and low-level perceptual variability are controlled for. Moreover, observers tend to exclude or downweight extreme samples of perceptual evidence, as a statistician might exclude an outlying data point. These phenomena are captured by a probabilistic optimal model in which observers integrate the log odds of each choice option. Robust averaging may have evolved to mitigate the influence of untrustworthy evidence in perceptual judgments.

de Gardelle, Vincent; Summerfield, Christopher



An orbit averaged particle code  

Microsoft Academic Search

A new method for efficient computer simulation of long time-scale plasma physics phenomena is proposed which has proved successful in one- and two-dimensional magneto-inductive particle codes. The method relies on orbit-averaging charge and current densities in Maxwell's equations before solving for the self-consistent electric and magnetic fields in order to filter out unwanted high-frequency oscillations and reduce the number of

B. I. Cohen; T. A. Brengle; D. B. Conley; R. P. Freis



MODELO DE ATENCIÓN DOROTHEA OREM Y CAMBIOS ACTITUDINALES DEL PACIENTE PEDIÁTRICO ESCOLAR CON CRISIS ASMÁTICA EN ESSALUD Y MINSA 2006 Dorothea Orems Self Care Model and Actitudinal Change of School Pediatric Patient with Asthmatic Crisis in Essalud and Minsa 2006  

Microsoft Academic Search

Objective: To determine the influence of the application of Dorotea Orems self care model in the actitudinal changes of the school pediatric patients with asthmatic crisis in EsSALUD and MINSA 2006. Material and method: qualitative, quantitative, cuasi experimental, prospective, cross sectional study. We worked with groups already formed before the experiment. A pretest was applied to the school children of

Natalia Verán Aylas



Developmental issues in managing children with diabetes.  


Children who are newly diagnosed with insulin dependent diabetes mellitus (IDDM) are expected to learn a substantial amount of new information within a few hospital days. It is important for nurses who design lesson plans for the child with IDDM to assess the child's developmental capabilities in relation to the necessary skills required of diabetes management and understand the family influence on the child's ability to perform self-care. PMID:8159478

Savinetti-Rose, B


Disease management programs: program intervention, behavior modification, and dosage effect  

Microsoft Academic Search

Disease management programs provide highly personalized self-\\u0009management support to consumers afflicted with chronic illnesses. Program interventions include the provision of health information, ongoing motivation, and support for behavior change, adherence to pharmacotherapy, development of self-efficacy, and the distribution of self-care tools. Interactions between program and patients are structured and repetitive over time. Consumer behavior change can result in measurable

Tamim Ahmed; Victor G. Villagra



A Nurse-Managed Discharge Program for Congestive Heart Failure Patients: Outcomes and Costs  

Microsoft Academic Search

This experimental study determined the effect of a structured nurse-managed postdischarge program for congestive heart failure (CHF) patients. The program consisted of telephone calls to participants in the experimental group 72 hours postdischarge, 72 hours later, and then every 2 weeks for 2 months. Patient self-care for CHF was evaluated. Data on unexpected office visits, emergency room visits, and readmissions

Vickie Barth



Culturally Competent Diabetes Self-Management Education for Mexican Americans: The Starr County Border Health Initiative.  

ERIC Educational Resources Information Center

|In a culturally competent diabetes self-management intervention in Starr County, Texas, bilingual Mexican American nurses, dieticians, and community workers provided weekly instruction on nutrition, self-monitoring, exercise and other self-care topics. A biweekly support group promoted behavior change. Interviews and examinations with 256 Mexican…

Brown, Sharon A.; Garcia, Alexandra A.; Kouzekanani, Kamiar; Hanis, Craig L.



Disease Management of Chronic Heart Failure in the Elderly: Issues and Options  

Microsoft Academic Search

There is now conclusive evidence to support the widely prescribed application of disease management programs in heart failure care. These strategies result in significant improvement in many barometers of care, including admission rates, prescription of disease modifying therapy, and improved patient understanding and involvement in self care. Of particular importance in the future will be research designed to address the

Ken McDonald



Design of a Randomised Controlled Trial (RCT) on the effectiveness of a Dutch patient advocacy case management intervention among severely disabled Multiple Sclerosis patients  

Microsoft Academic Search

BACKGROUND: Case management has been suggested as an innovative strategy that facilitates the improvement of a patient's quality of life, reduction of hospital length of stay, optimization of self-care and improvement of satisfaction of patients and professionals involved. However, there is little evidence about the effectiveness of the patient advocacy case management model in clinical practice. Therefore, the objective of

Klaske Wynia; Coby Annema; Hans Nissen; Jacques De Keyser; Berrie Middel



Achronal averaged null energy condition  

SciTech Connect

The averaged null energy condition (ANEC) requires that the integral over a complete null geodesic of the stress-energy tensor projected onto the geodesic tangent vector is never negative. This condition is sufficient to prove many important theorems in general relativity, but it is violated by quantum fields in curved spacetime. However there is a weaker condition, which is free of known violations, requiring only that there is no self-consistent spacetime in semiclassical gravity in which ANEC is violated on a complete, achronal null geodesic. We indicate why such a condition might be expected to hold and show that it is sufficient to rule out closed timelike curves and wormholes connecting different asymptotically flat regions.

Graham, Noah; Olum, Ken D. [Department of Physics, Middlebury College, Middlebury, Vermont 05753 (United States) and Center for Theoretical Physics, Laboratory for Nuclear Science, and Department of Physics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139 (United States); Institute of Cosmology, Department of Physics and Astronomy, Tufts University, Medford, Massachusetts 02155 (United States)



Flexible time domain averaging technique  

NASA Astrophysics Data System (ADS)

Time domain averaging(TDA) is essentially a comb filter, it cannot extract the specified harmonics which may be caused by some faults, such as gear eccentric. Meanwhile, TDA always suffers from period cutting error(PCE) to different extent. Several improved TDA methods have been proposed, however they cannot completely eliminate the waveform reconstruction error caused by PCE. In order to overcome the shortcomings of conventional methods, a flexible time domain averaging(FTDA) technique is established, which adapts to the analyzed signal through adjusting each harmonic of the comb filter. In this technique, the explicit form of FTDA is first constructed by frequency domain sampling. Subsequently, chirp Z-transform(CZT) is employed in the algorithm of FTDA, which can improve the calculating efficiency significantly. Since the signal is reconstructed in the continuous time domain, there is no PCE in the FTDA. To validate the effectiveness of FTDA in the signal de-noising, interpolation and harmonic reconstruction, a simulated multi-components periodic signal that corrupted by noise is processed by FTDA. The simulation results show that the FTDA is capable of recovering the periodic components from the background noise effectively. Moreover, it can improve the signal-to-noise ratio by 7.9 dB compared with conventional ones. Experiments are also carried out on gearbox test rigs with chipped tooth and eccentricity gear, respectively. It is shown that the FTDA can identify the direction and severity of the eccentricity gear, and further enhances the amplitudes of impulses by 35%. The proposed technique not only solves the problem of PCE, but also provides a useful tool for the fault symptom extraction of rotating machinery.

Zhao, Ming; Lin, Jing; Lei, Yaguo; Wang, Xiufeng



Health coaching by telephony to support self-care in chronic diseases: clinical outcomes from The TERVA randomized controlled trial  

PubMed Central

Background The aim was to evaluate the effect of a 12-month individualized health coaching intervention by telephony on clinical outcomes. Methods An open-label cluster-randomized parallel groups trial. Pre- and post-intervention anthropometric and blood pressure measurements by trained nurses, laboratory measures from electronic medical records (EMR). A total of 2594 patients filling inclusion criteria (age 45?years or older, with type 2 diabetes, coronary artery disease or congestive heart failure, and unmet treatment goals) were identified from EMRs, and 1535 patients (59%) gave consent and were randomized into intervention or control arm. Final analysis included 1221 (80%) participants with data on primary end-points both at entry and at end. Primary outcomes were systolic and diastolic blood pressure, serum total and LDL cholesterol concentration, waist circumference for all patients, glycated hemoglobin (HbA1c) for diabetics and NYHA class in patients with congestive heart failure. The target effect was defined as a 10-percentage point increase in the proportion of patients reaching the treatment goal in the intervention arm. Results The proportion of patients with diastolic blood pressure initially above the target level decreasing to 85?mmHg or lower was 48% in the intervention arm and 37% in the control arm (difference 10.8%, 95% confidence interval 1.5–19.7%). No significant differences emerged between the arms in the other primary end-points. However, the target levels of systolic blood pressure and waist circumference were reached non-significantly more frequently in the intervention arm. Conclusions Individualized health coaching by telephony, as implemented in the trial was unable to achieve majority of the disease management clinical measures. To provide substantial benefits, interventions may need to be more intensive, target specific sub-groups, and/or to be fully integrated into local health care. Trial registration Identifier: NCT00552903



Measuring exertion during caregiving of children and young adults with cerebral palsy who require assistance for mobility and self-care.  


Our purpose was to compare objective and subjective measures of energy exertion during caregiving tasks. Participants were primary caregivers (N = 19) of children and young adults (aged 3 -22 years) with cerebral palsy (CP) who require assistance for mobility and self-care (67% classified in level V on the Gross Motor Function Classification System). Measures of exertion were collected during two caregiving tasks: (1) transfers and (2) dressing. Objective measures included volume of oxygen (V02), heart rate (HR), and the subjective measure was a rating of perceived exertion (Borg RPE). Controlling for baseline status, perceived exertion correlated with VO2 (0.43, p < .01) and HR (0.29, p < .01) during the tasks. Caregivers with high baseline HR and VO2, had high Borg RPE scores following a task. Correlations were found between HR and VO2 during caregiving tasks (0.63, p < .01). Patterns of association with caregiver and child characteristics were similar for VO2 and Borg RPE. Subjective measures of exertion appear to capture the strain of caregiving. Understanding a caregiver's perception of exertion can guide therapists in assessing the need for equipment, pharmacological, or respite interventions. PMID:23356332

Andrews, Marcella; Bolt, Daniel M; Braun, Michael; Benedict, Ruth E



Factors associated with successful completion of the chronic disease self-management program by adults with type 2 diabetes.  


This study examines factors associated with completion (attendance ?4 of 6 sessions) of the Chronic Disease Self-Management Program (CDSMP) by adults with type 2 diabetes. Patients with glycated hemoglobin ? 7.5 within 6 months were enrolled and completed self-report measures on demographics, health status, and self-care (n = 146). Significant differences in completion status were found for several self-care factors including healthful eating plan, spacing carbohydrates, frequent exercise, and general health. Completion was not influenced by race/ethnicity or socioeconomics. Results suggest better attention to exercise and nutrition at the start of CDSMP may be associated with completion, regardless of demographic subgroup. PMID:23455685

Helduser, Janet W; Bolin, Jane N; Vuong, Ann M; Moudouni, Darcy M; Begaye, Dawn S; Huber, John C; Ory, Marcia G; Forjuoh, Samuel N



The effectiveness of selected Tai Chi exercises in a program of strategic rehabilitation aimed at improving the self-care skills of patients aroused from prolonged coma after severe TBI.  


Background Difficulties in self-care constitute a very common problem for patients recovering from prolonged coma after a severe TBI, and a major factor reducing their quality of life. Effective new rehabilitation programs that would help solve this problem are urgently needed. The purpose of our experiment was to evaluate improvement in this respect in a group of patients aroused from prolonged coma who participated in a goal-oriented rehabilitation program (Rehab-3), enhanced with selected elements of Tai-Chi. Material and Methods We examined 40 patients aroused from prolonged coma after a severe TBI, undergoing long-term rehabilitation according to a standard phased rehabilitation program. These patients were divided into two numerically even groups: a control group treated according to the standard program, and an experimental group, who received an additional goal oriented program enhanced with selected Tai-Chi exercises. The research methods included analysis of documentation (MRI, CT), a structured clinical interview, and the Standard Self-Care Scale. Results The experimental group achieved significant improvement of self-care skills, whereas in the control group the improvement was slight and not statistically significant. The value of co-efficient j (0.64) indicates a very strong association between the rehabilitation procedure and improved self-care in the experimental group, but not in the control group. Conclusions Our results confirmed that a goal-oriented rehabilitation program enhanced with elements of Tai-Chi was more effective than the standard program in improving the performance of activities of daily living. PMID:24036691

Ma?ko, Grzegorz; Zió?kowski, Artur; Mirski, Andrzej; K?osi?ski, Micha?



The effectiveness of selected Tai Chi exercises in a program of strategic rehabilitation aimed at improving the self-care skills of patients aroused from prolonged coma after severe TBI  

PubMed Central

Background Difficulties in self-care constitute a very common problem for patients recovering from prolonged coma after a severe TBI, and a major factor reducing their quality of life. Effective new rehabilitation programs that would help solve this problem are urgently needed. The purpose of our experiment was to evaluate improvement in this respect in a group of patients aroused from prolonged coma who participated in a goal-oriented rehabilitation program (Rehab-3), enhanced with selected elements of Tai-Chi. Material/Methods We examined 40 patients aroused from prolonged coma after a severe TBI, undergoing long-term rehabilitation according to a standard phased rehabilitation program. These patients were divided into two numerically even groups: a control group treated according to the standard program, and an experimental group, who received an additional goal oriented program enhanced with selected Tai-Chi exercises. The research methods included analysis of documentation (MRI, CT), a structured clinical interview, and the Standard Self-Care Scale. Results The experimental group achieved significant improvement of self-care skills, whereas in the control group the improvement was slight and not statistically significant. The value of co-efficient j (0.64) indicates a very strong association between the rehabilitation procedure and improved self-care in the experimental group, but not in the control group. Conclusions Our results confirmed that a goal-oriented rehabilitation program enhanced with elements of Tai-Chi was more effective than the standard program in improving the performance of activities of daily living.

Manko, Grzegorz; Ziolkowski, Artur; Mirski, Andrzej; Klosinski, Michal



Using the teach-back and Orem's Self-care Deficit Nursing theory to increase childhood immunization communication among low-income mothers.  


Guided by Orem's Self-care Deficit Nursing theory, the purpose of the pilot study was to assess the relationship between maternal health literacy and the mother's ability to comprehend and communicate information about childhood immunizations. Communication is the key to positive health results, particularly for patients with low literacy skills, yet few studies have examined patients' ability to converse about health information taught to them by providers. The study was conducted in an urban walk-in immunization clinic. A quantitative-qualitative research design was used. Convenience sampling was applied to obtain 15 mothers with one child (M1) and 15 mothers with more than one child (M>1). The Rapid Estimate of Adult Literacy (REALM) was used to assess literacy level. Vaccine information statements on inactive poliovirus (IPV) and pneumococcal conjugate vaccine (PCV) were instructional materials used in the teach- back procedure. Although the results of the study were mixed, patterns and trends were noted. Mothers with higher literacy levels provided more correct responses for the benefits of the polio vaccine than did those mothers with lower literacy levels (F(2,25)=4.70, p= .02). For both IPV and PCV vaccines, more mothers gave correct answers for risks and benefits, but more mothers gave incorrect answers for safety. There also was some relationship between mother's age and correctness of responses regarding risk of pneumonia vaccination (F(2,24)=3.79, p= .04). The inconsistency of the mothers' responses to communicate critical immunization information about vaccines indicates the need to further assess how best to increase parents' vaccine knowledge and communication skills. PMID:18300059

Wilson, Feleta L; Baker, Lynda M; Nordstrom, Cheryl K; Legwand, Carol


Factors associated with self-management by people undergoing hemodialysis: A descriptive study.  


BACKGROUND: Improving the level of self-management by people undergoing hemodialysis is an effective way to reduce the incidence of mortality and complications and improve quality of life. A better understanding of what influences an individual's level of self-management can help nurses find appropriate ways to improve self-management. OBJECTIVES: To examine self-management levels, and discuss the factors influencing self-management, in a sample of patients undergoing hemodialysis in Beijing. DESIGN: A descriptive study design was chosen. SETTINGS AND METHODS: A convenience sample of 216 patients undergoing hemodialysis was recruited from dialysis centers in three tertiary hospitals in Beijing from September 2010 to January 2011. Questionnaires were used to examine the variables: level of self-management; knowledge of hemodialysis; self-efficacy; anxiety and depression; and social support. Data analysis involved descriptive statistics, including frequency, percentage, mean and standard deviations, while Spearman correlation, non-parametric Z and ?(2) and multiple linear regression were used for comparative purposes. RESULTS: The number of returned questionnaires was 198 (91.67% response rate). The overall score of self-management was 56.01 (SD=10.75). The average item scores for each of the four self-management subscales were 3.02 for partnership, 2.98 for problem-solving skills, 2.74 for self-care and 2.47 for emotional management. Multiple linear regression analyses for overall self-management and the four subscales indicated that knowledge, self-efficacy, the availability of social support and depression were the main influencing factors which explained 34.1% of the variance of self-management. CONCLUSION: The level of self-management by those undergoing hemodialysis in this study was less than ideal, varying from 'rare' to 'sometimes' for use of self-management behaviors. For the different subscales of self-management, partnership was the most used and emotional management the least used strategy. Patients' knowledge, self-efficacy, the availability of social support and depression were the main factors influencing self-management. PMID:23768411

Li, Hui; Jiang, Ya-Fang; Lin, Chiu-Chu



Menopause, a Self Care Manual.  

ERIC Educational Resources Information Center

Written for women from the three main cultural groups in New Mexico (Native American, Hispanic, and Anglo), this pamphlet discusses the causes and symptoms, some remedies for the symptoms of menopause, and presents ideas for organizing support groups to help middle-aged women and their families deal with menopausal problems. Explanations of the…

Lopez, Maria Cristina; And Others


Atopic dermatitis - self-care  


Breternitz M. Placebo-controlled, double-blind, randomized, prospective study of a glycerol-based emollient on eczematous skin in atopic dermatitis: biophysical and clinical evaluation. Skin Pharmacol Physiol. 2008 Jan; 21(1): 39- ...


Self-Care After Disasters  


... and volunteers are also affected. Disasters can also impact members of the media, as well as citizens of the community, the country, and the world. Disasters can cause a number of different stress reactions in those affected. The steps that can be taken ...


Rotator cuff - self-care  


... injury and avoid re-injury. Your position and posture during the day and night can help relieve ... of pillows may help. When sitting, use good posture. This means keeping your head over your shoulder ...


Premenstrual syndrome - self-care  


... at least during the second half of your cycle: Eat a balanced diet that includes lots of whole grains, vegetables, and fruit. Have little or no salt or sugar. Drink plenty of fluids like water or juice. Avoid soft drinks, alcohol, or anything ...


Below-Average, Average, and Above-Average Readers Engage Different and Similar Brain Regions while Reading  

ERIC Educational Resources Information Center

|Event-related potentials (ERPs) were recorded from 27 children (14 girls, 13 boys) who varied in their reading skill levels. Both behavior performance measures recorded during the ERP word classification task and the ERP responses themselves discriminated between children with above-average, average, and below-average reading skills. ERP…

Molfese, Dennis L.; Key, Alexandra Fonaryova; Kelly, Spencer; Cunningham, Natalie; Terrell, Shona; Ferguson, Melissa; Molfese, Victoria J.; Bonebright, Terri



Spiritual Self-Management: A Look at Older Adults with Chronic Illness  

Microsoft Academic Search

Individuals with chronic illness experience myriad adaptations in self-management practices, which often evolve over time. This study examines the role of spirituality in the self-management of chronic illness among older adults by using criterion sampling between African-American and non-Hispanic white elderly adults enrolled in the “Process of Self-Care,” a National Institute on Aging funded study. Data analyzed from in-depth interviews

Idethia S. Harvey



40 CFR 86.449 - Averaging provisions.  

Code of Federal Regulations, 2011 CFR

...States. (c) To use the averaging program, do the following things: (1) Certify each vehicle to a family emission (1) Make sure your report includes the following things: (i) Calculate in detail your average emission level...



RHIC BPM System Average Orbit Calculations.  

National Technical Information Service (NTIS)

RHIC beam position monitor (RPM) system average orbit was originally calculated by averaging positions of 10000 consecutive turns for a single selected bunch. Known perturbations in RHIC particle trajectories, with multiple frequencies around 10 Hz, contr...

C. Degen M. Minty P. Cerniglia R. Hulsart R. Michnoff



RHIC BPM system average orbit calculations  

SciTech Connect

RHIC beam position monitor (BPM) system average orbit was originally calculated by averaging positions of 10000 consecutive turns for a single selected bunch. Known perturbations in RHIC particle trajectories, with multiple frequencies around 10 Hz, contribute to observed average orbit fluctuations. In 2006, the number of turns for average orbit calculations was made programmable; this was used to explore averaging over single periods near 10 Hz. Although this has provided an average orbit signal quality improvement, an average over many periods would further improve the accuracy of the measured closed orbit. A new continuous average orbit calculation was developed just prior to the 2009 RHIC run and was made operational in March 2009. This paper discusses the new algorithm and performance with beam.

Michnoff,R.; Cerniglia, P.; Degen, C.; Hulsart, R.; et al.



Synchronous averaging of epicyclic sun gear vibration  

US Patent & Trademark Office Database

In the method of detecting a localized sun gear fault, in the operation of an epicyclic gear train having ring, planet and sun gears, and a planet carrier, the steps that include detecting sun gear vibrations transmitted through each planet gear, computing separated averages of such detected vibrations, phase shifting the averages to account for the differences in gear meshing positions, and re-combining the phase shifted averages to produce a modified average value of the sun gear vibration.

Blunt; David Mark (Fishermans Bend, AU)



The average mental age of adults  

Microsoft Academic Search

Investigates the average mental age of adults by comparing the average intelligence of 9500 native whites, 3700 foreign-born men and 3300 Negroes. The intelligence of the former was judged on the basis of Army Mental Tests and that of the two latter groups was on the basis of the Surgeon General's report. The average mental age of adults was found

Edgar A. Doll



Assessing self-care and social function using a computer adaptive testing version of the Pediatric Evaluation of Disability Inventory Accepted for Publication, Archives of Physical Medicine and Rehabilitation  

PubMed Central

Objective To examine score agreement, validity, precision, and response burden of a prototype computer adaptive testing (CAT) version of the Self-Care and Social Function scales of the Pediatric Evaluation of Disability Inventory (PEDI) compared to the full-length version of these scales. Design Computer simulation analysis of cross-sectional and longitudinal retrospective data; cross-sectional prospective study. Settings Pediatric rehabilitation hospital, including inpatient acute rehabilitation, day school program, outpatient clinics; community-based day care, preschool, and children’s homes. Participants Four hundred sixty-nine children with disabilities and 412 children with no disabilities (analytic sample); 38 children with disabilities and 35 children without disabilities (cross-validation sample). Interventions Not applicable. Main Outcome Measures Summary scores from prototype CAT applications of each scale using 15-, 10-, and 5-item stopping rules; scores from the full-length Self-Care and Social Function scales; time (in seconds) to complete assessments and respondent ratings of burden. Results Scores from both computer simulations and field administration of the prototype CATs were highly consistent with scores from full-length administration (all r’s between .94 and .99). Using computer simulation of retrospective data, discriminant validity and sensitivity to change of the CATs closely approximated that of the full-length scales, especially when the 15- and 10-item stopping rules were applied. In the cross-validation study the time to administer both CATs was 4 minutes, compared to over 16 minutes to complete the full-length scales. Conclusions Self-care and Social Function score estimates from CAT administration are highly comparable to those obtained from full-length scale administration, with small losses in validity and precision and substantial decreases in administration time.

Coster, Wendy J.; Haley, Stephen M.; Ni, Pengsheng; Dumas, Helene M.; Fragala-Pinkham, Maria A.



The effectiveness of hospital-based diabetes case management: an example from a northern Taiwan regional hospital.  


The aim of this study was to design, implement and evaluate disease outcomes at a regional hospital- based case management program of care for patients with type 2 diabetes. A medical team and practice guidelines were established in line with the health insurance strategy of Taiwan's Bureau of National Health Insurance (BNHI) and American Diabetes Association (ADA) Standards of Care for Diabetes (2003 edition). Also, a set of self-care booklets was designed suitable for use by the subject group. The study was prospective and followed the patients from enrollment to one year. Patient outcomes were determined based on laboratory examinations and recorded self-care behavior. Data were collected at enrollment and over 4 follow-up times within a one year period. Generalized Estimating Equation (GEE) multiple linear regression and logistic regression were used for repeated measurements and adjustments of the effects of specific prognostic factors. Sixty subjects diagnosed with type 2 diabetes (mean duration 3.25 years) were recruited. All participants were married with a mean age of 52.5 years. A majority (58.3%) was male and 65% were ethnic Hakka. Self-care knowledge and behavior accomplishment rates were: taking medications by oneself, 91.3% (knowing medicines, 25.4%); hypoglycemia management, 23.3%; monitoring blood sugar, 46.7%; exercise, 35.8%; diet management, 51.7% and foot care, 92.8%. Significantly improved ADA diabetes care standard items included HbA1C (p< .0001), fasting glucose (p< .01) and triglycerides (p< .05). The study incorporated evidence-based guidelines, public health insurance strategies and self-care booklets into a protocol to provide comprehensive care. The implemented diabetes program achieved diabetes care goals and improved patient self-care. PMID:18080974

Chang, Huan-Cheng; Chang, Yue-Cune; Lee, Su-Mei; Chen, Mei-Fang; Huang, Mei-Ching; Peng, Chin-Lin; Yan, Ching-Yun



Attitude stabilization of averaging magnetic torque  

Microsoft Academic Search

The stability problems of two magnetic control systems are discussed. One uses a three-axis magnetic actuator only; the other includes an additional momentum-biased wheel. The so-called orbit-averaged magnetic controllers, derived from the orbit-averaged magnetic field, show an ability to ensure the global attitude stabilization. This is supported theoretically by the averaging method and Lyapunov theories, and also illustrated by the

Lin Huang; Wuxing Jing



Spacetime averaging of exotic singularity universes  

NASA Astrophysics Data System (ADS)

Taking a spacetime average as a measure of the strength of singularities we show that big-rips (type I) are stronger than big-bangs. The former have infinite spacetime averages while the latter have them equal to zero. The sudden future singularities (type II) and w -singularities (type V) have finite spacetime averages. The finite scale factor (type III) singularities for some values of the parameters may have an infinite average and in that sense they may be considered stronger than big-bangs.

d?browski, Mariusz P.



Modular Approach to Physics: Weighted Average  

NSDL National Science Digital Library

This resource is a multi-exercise module relating to average speed. It contains an interactive Java simulation featuring a car that the user controls for speed. Graphs of instantaneous and average velocities are simultaneously displayed, helping the user to understand the concept of time-weighted average. The lesson plan available through the Help menu explains how to calculate a weighted average, first with two speeds, and then with multiple. This item is part of a larger collection of simulation based physics models sponsored by the MAP project (Modular Approach to Physics).

Austin, David; Martin, Brian



Statistics of time averaged atmospheric scintillation  

SciTech Connect

A formulation has been constructed to recover the statistics of the moving average of the scintillation Strehl from a discrete set of measurements. A program of airborne atmospheric propagation measurements was analyzed to find the correlation function of the relative intensity over displaced propagation paths. The variance in continuous moving averages of the relative intensity was then found in terms of the correlation functions. An empirical formulation of the variance of the continuous moving average of the scintillation Strehl has been constructed. The resulting characterization of the variance of the finite time averaged Strehl ratios is being used to assess the performance of an airborne laser system.

Stroud, P.



Improving consensus structure by eliminating averaging artifacts  

PubMed Central

Background Common structural biology methods (i.e., NMR and molecular dynamics) often produce ensembles of molecular structures. Consequently, averaging of 3D coordinates of molecular structures (proteins and RNA) is a frequent approach to obtain a consensus structure that is representative of the ensemble. However, when the structures are averaged, artifacts can result in unrealistic local geometries, including unphysical bond lengths and angles. Results Herein, we describe a method to derive representative structures while limiting the number of artifacts. Our approach is based on a Monte Carlo simulation technique that drives a starting structure (an extended or a 'close-by' structure) towards the 'averaged structure' using a harmonic pseudo energy function. To assess the performance of the algorithm, we applied our approach to C? models of 1364 proteins generated by the TASSER structure prediction algorithm. The average RMSD of the refined model from the native structure for the set becomes worse by a mere 0.08 Å compared to the average RMSD of the averaged structures from the native structure (3.28 Å for refined structures and 3.36 A for the averaged structures). However, the percentage of atoms involved in clashes is greatly reduced (from 63% to 1%); in fact, the majority of the refined proteins had zero clashes. Moreover, a small number (38) of refined structures resulted in lower RMSD to the native protein versus the averaged structure. Finally, compared to PULCHRA [1], our approach produces representative structure of similar RMSD quality, but with much fewer clashes. Conclusion The benchmarking results demonstrate that our approach for removing averaging artifacts can be very beneficial for the structural biology community. Furthermore, the same approach can be applied to almost any problem where averaging of 3D coordinates is performed. Namely, structure averaging is also commonly performed in RNA secondary prediction [2], which could also benefit from our approach.

KC, Dukka B



Dynamic Multiscale Averaging (DMA) of Turbulent Flow  

SciTech Connect

A new approach called dynamic multiscale averaging (DMA) for computing the effects of turbulent flow is described. The new method encompasses multiple applications of temporal and spatial averaging, that is, multiscale operations. Initially, a direct numerical simulation (DNS) is performed for a relatively short time; it is envisioned that this short time should be long enough to capture several fluctuating time periods of the smallest scales. The flow field variables are subject to running time averaging during the DNS. After the relatively short time, the time-averaged variables are volume averaged onto a coarser grid. Both time and volume averaging of the describing equations generate correlations in the averaged equations. These correlations are computed from the flow field and added as source terms to the computation on the next coarser mesh. They represent coupling between the two adjacent scales. Since they are computed directly from first principles, there is no modeling involved. However, there is approximation involved in the coupling correlations as the flow field has been computed for only a relatively short time. After the time and spatial averaging operations are applied at a given stage, new computations are performed on the next coarser mesh using a larger time step. The process continues until the coarsest scale needed is reached. New correlations are created for each averaging procedure. The number of averaging operations needed is expected to be problem dependent. The new DMA approach is applied to a relatively low Reynolds number flow in a square duct segment. Time-averaged stream-wise velocity and vorticity contours from the DMA approach appear to be very similar to a full DNS for a similar flow reported in the literature. Expected symmetry for the final results is produced for the DMA method. The results obtained indicate that DMA holds significant potential in being able to accurately compute turbulent flow without modeling for practical engineering applications.

Richard W. Johnson



A note on generalized averaged Gaussian formulas  

NASA Astrophysics Data System (ADS)

We have recently proposed a very simple numerical method for constructing the averaged Gaussian quadrature formulas. These formulas exist in many more cases than the real positive Gauss?Kronrod formulas. In this note we try to answer whether the averaged Gaussian formulas are an adequate alternative to the corresponding Gauss?Kronrod quadrature formulas, to estimate the remainder term of a Gaussian rule.

Spalevic, Miodrag



Bayes model averaging with selection of regressors  

Microsoft Academic Search

When a number of distinct models contend for use in prediction, the choice of a single model can offer rather unstable predictions. In regression, stochastic search variable selection with Bayesian model averaging offers a cure for this robustness issue but at the expense of requiring very many predictors. Here we look at Bayes model averaging incorporating variable selection for prediction.

P. J. Brown; M. Vannucci; T. Fearn



Average Transmission Probability of a Random Stack  

ERIC Educational Resources Information Center

|The transmission through a stack of identical slabs that are separated by gaps with random widths is usually treated by calculating the average of the logarithm of the transmission probability. We show how to calculate the average of the transmission probability itself with the aid of a recurrence relation and derive analytical upper and lower…

Lu, Yin; Miniatura, Christian; Englert, Berthold-Georg



Generalized averaging method for power conversion circuits  

Microsoft Academic Search

A more general averaging procedure that encompasses state-space averaging and that is potentially applicable to a much broader class of circuits and systems is presented. Examples of its application in resonant and PWM power convertors are presented. The technique is shown to be effective on a number of examples. including resonant type converters. The approach offers refinements to the theory

Seth R. Sanders; J. M. Noworolski; X. Z. Liu; G. C. Verghese



Evaluating template bias when synthesizing population averages  

NASA Astrophysics Data System (ADS)

Establishing the average shape and spatial variability for a set of similar anatomical objects is important for detecting and discriminating morphological differences between populations. This may be done using deformable templates to synthesize a 3D CT/MRI image of the average anatomy from a set of CT/MRI images collected from a population of similar anatomical objects. This paper investigates the error associated with the choice of template selected from the population used to synthesize the average population shape. Population averages were synthesized for a population of five infant skulls with sagittal synostosis and a population of six normal adult brains using a consistent linear-elastic image registration algorithm. Each data set from the populations was used as the template to synthesize a population average. This resulted in five different population averages for the skull population and six different population averages for the brain population. The displacement variance distance from a skull within the population to the other skulls in the population ranged from 5.5 to 9.9 mm2 while the displacement variance distance from the synthesized average skulls to the population ranged from 2.2 to 2.7 mm2. The displacement variance distance from a brain within the population to the other brains in the population ranged from 9.3 to 14.2 mm2 while the displacement variance distance from the synthesized average brains to the population ranged from 3.2 to 3.6 mm2. These results suggest that there was no significant difference between the choice of template with respect to the shape of the synthesized average data set for these two populations.

Carlson, Blake L.; Christensen, Gary E.; Johnson, Hans J.; Vannier, Michael W.



Time averaging of instantaneous quantities in HYDRA  

SciTech Connect

For turbulent flow the evaluation of direct numerical simulations (DNS) where all scales are resolved and large-eddy simulation (LES) where only large-scales are resolved is difficult because the results are three-dimensional and transient. To simplify the analysis, the instantaneous flow field can be averaged in time for evaluation and comparison to experimental results. The incompressible Navier-Stokes flow code HYDRA has been modified for calculation of time-average quantities for both DNS and LES. This report describes how time averages of instantaneous quantities are generated during program execution (i.e., while generating the instantaneous quantities, instead of as a postprocessing operation). The calculations are performed during program execution to avoid storing values at each time step and thus to reduce storage requirements. The method used in calculating the time-average velocities, turbulent intensities, <{ital u}{sup ``}{sup 2}>, <{ital va}{sup ``}{sup 2}>, and <{ital w}{sup ``}{sup 2}>, and turbulent shear, <{ital u}{sup ``}{ital v}{sup ``}> are outlined. The brackets <> used here represent a time average. the described averaging methods were implemented in the HYDRA code for three-dimensional problem solutions. Also presented is a method for taking the time averages for a number of consecutive intervals and calculating the time average for the sum of the intervals. This method could be used for code restarts or further postprocessing of the timer averages from consecutive intervals. This method was not used in the HYDRA implementation, but is included here for completeness. In HYDRA, the running sums needed fro time averaging are simply written to the restart dump.

McCallen, R.C.



The causal meaning of Fisher's average effect  

PubMed Central

Summary In order to formulate the Fundamental Theorem of Natural Selection, Fisher defined the average excess and average effect of a gene substitution. Finding these notions to be somewhat opaque, some authors have recommended reformulating Fisher’s ideas in terms of covariance and regression, which are classical concepts of statistics. We argue that Fisher intended his two averages to express a distinction between correlation and causation. On this view, the average effect is a specific weighted average of the actual phenotypic changes that result from physically changing the allelic states of homologous genes. We show that the statistical and causal conceptions of the average effect, perceived as inconsistent by Falconer, can be reconciled if certain relationships between the genotype frequencies and non-additive residuals are conserved. There are certain theory-internal considerations favouring Fisher’s original formulation in terms of causality; for example, the frequency-weighted mean of the average effects equaling zero at each locus becomes a derivable consequence rather than an arbitrary constraint. More broadly, Fisher’s distinction between correlation and causation is of critical importance to gene-trait mapping studies and the foundations of evolutionary biology.




Risk assessment and management in bipolar disorders.  


Bipolar affective disorders carry significant risks to the patient and sometimes others. The form of the illness relapse needs to be determined, and high-risk features such as psychosis and suicide considered. Gathering collateral information from others is invaluable. Mania brings particular risks of disinhibition, poor judgement, risk taking and sometimes aggression. Depression carries notable risks of suicidal behaviour, poor self-care and homicide. Both mania and depression bring risks of substance misuse and disrupted relationships. Management requires an optimal therapeutic alliance with good communication, appropriate treatment and sometimes compulsory care during crises. Preventive strategies are invaluable. PMID:20712556

Bassett, Darryl L



Cosmic inhomogeneities and averaged cosmological dynamics.  


If general relativity (GR) describes the expansion of the Universe, the observed cosmic acceleration implies the existence of a "dark energy." However, while the Universe is on average homogeneous on large scales, it is inhomogeneous on smaller scales. While GR governs the dynamics of the inhomogeneous Universe, the averaged homogeneous Universe obeys modified Einstein equations. Can such modifications alone explain the acceleration? For a simple generic model with realistic initial conditions, we show the answer to be "no." Averaging effects negligibly influence the cosmological dynamics. PMID:18999811

Paranjape, Aseem; Singh, T P



Modification of turbulent transport by orbit averaging.  

National Technical Information Service (NTIS)

The effect on plasma turbulence of orbit averaging by thermal ions is considered, and illustrated for two modes of potential importance for tokamaks. The effect can reduce the ion response below that in earlier treatments, modifying the predicted mode gro...

H. E. Mynick S. J. Zweben



40 CFR 76.11 - Emissions averaging.  

Code of Federal Regulations, 2013 CFR

...PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) ACID RAIN NITROGEN OXIDES EMISSION REDUCTION PROGRAM § an approved averaging plan is in compliance with the Acid Rain emission limitation for NOX under the plan only if...



Reasonable Averages That Give Wrong Answers  

NSDL National Science Digital Library

Averages are meant to convey the essential features of a set of data, or a random variable, in a simple and a concise way. Like any other summary, an average can be misleading, misused and abused; there is a fair amount of literature on this aspect of averages, the book by D. Huff(1973) being a particularly readable account. In one intuitive use of averages there is a source of error which can be quite serious and which is often not recognized. This source of error is illustrated below by a quality control problem, a project, an experiment and a game. A Taylor series expansion gives an insight into the nature of the error.

Shahani, A. K. (Arjan Kewalram)



Univariate Lp and lp Averaging, 0.  

National Technical Information Service (NTIS)

We present evidence that one can calculate generically combinatorially expensive Lp and lp averages, 0. < p < 1, in polynomial time by restricting the data to come from a wide class of statistical distributions. Our approach differs from the approaches in...

J. E. Lavery



Average Passenger Occupancy (APO) in Your Community.  

ERIC Educational Resources Information Center

Provides details of an activity in which students in grades 4-10 determine the Average Passenger Occupancy (APO) in their community and develop, administer, and analyze a survey to determine attitudes toward carpooling. (DDR)

Stenstrup, Al



Approximation Algorithms for Minimizing Average Distortion  

Microsoft Academic Search

This paper considers embeddings f of arbitrary finite metrics into the line metric ? so that none of the distances is shrunk\\u000a by the embedding f; the quantity of interest is the factor by which the average distance in the metric is stretched. We call\\u000a this quantity the average distortion of the non-contracting map f. We prove that finding the

Kedar Dhamdhere; Anupam Gupta; R. Ravi



Orbit-averaged implicit particle codes  

Microsoft Academic Search

The merging of orbit-averaged particle code techniques with recently developed implicit methods to perform numerically stable and accurate particle simulations are reported. Implicitness and orbit averaging can extend the applicability of particle codes to the simulation of long time-scale plasma physics phenomena by relaxing time-step and statistical constraints. Difference equations for an electrostatic model are presented, and analyses of the

B. I. Cohen; R. P. Frieis; V. Thomas



Multifrequency averaging of DC\\/DC converters  

Microsoft Academic Search

This paper presents some of the issues involved in applying frequency-selective averaging to modeling the dynamic behavior of pulsewidth-modulated (PWM) DC-DC converters. We use the boost converter as an example to show the details involved in deriving some novel extended averaged models, and we use simulations to highlight the accuracy of the models even when traditional small-ripple conditions are not

V. A. Caliskan; O. C. Verghese; A. M. Stankovic



Monthly average polar sea-ice concentration  

USGS Publications Warehouse

The data contained in this CD-ROM depict monthly averages of sea-ice concentration in the modern polar oceans. These averages were derived from the Scanning Multichannel Microwave Radiometer (SMMR) and Special Sensor Microwave/Imager (SSM/I) instruments aboard satellites of the U.S. Air Force Defense Meteorological Satellite Program from 1978 through 1992. The data are provided as 8-bit images using the Hierarchical Data Format (HDF) developed by the National Center for Supercomputing Applications.

Schweitzer, Peter N.



Lay Explanations and Self-Management of Diabetes in Kathmandu, Nepal  

Microsoft Academic Search

Objectives: This research explores the lay explanations and self-management of diabetes among residents in greater Kathmandu, Nepal. Methods: Interviews were done with 300 respondents drawn from diabetes patient listings and members of a national diabetes club. Sociodemographic and health-related data were collected with two standardized instruments: the Illness Perception Questionnaire and the Summary of Diabetes Self-Care Activities. Hierarchical ordinary least

Cary S. Kart; Jennifer M. Kinney; Janardan Subedi; Kelina B. Basnyat; Mary F. Vadakkan



Role of Culture and Health Literacy in Diabetes Self-Management and Education  

Microsoft Academic Search

To educate patients with diabetes in a multicultural society presents educators with the challenge of becoming culturally\\u000a sensitive in order to understand and convey the meaning of untranslatable education messages for patients of all health literacy\\u000a levels. The goal of this chapter is to raise awareness about the most common cultural and social factors that may influence\\u000a diabetes self-care management

Andreina Millan-Ferro; Enrique Caballero


Social support and personal models of diabetes in relation to self-care and well-being in adolescents with type I diabetes mellitus  

Microsoft Academic Search

This study set out to examine whether peer support and illness representation mediates the link between family support, self-management and well-being. Seventy-four participants (12–18-years-old) with type I diabetes mellitus completed questionnaires assessing their self-management, depression, anxiety, perceived social support and personal models of diabetes. Perceived impact of diabetes, but not perceived seriousness, and peer support were significant predictors of depression.

T. Chas Skinner; Sarah E Hampson



Changes in global average surface temperature, global average sea level, and northern hemisphere snow cover  

NSDL National Science Digital Library

Key figure from the 2007 Intergovernmental Panel on Climate Change (IPCC) report that shows changes in global average surface temperature, global average sea level, and Northern Hemisphere snow cover from as far back as 1850.

IPCC (Intergovernmental Panel on Climate Change) AR4 Synthesis Report


Improved averaging for non-null interferometry  

NASA Astrophysics Data System (ADS)

Arithmetic averaging of interferometric phase measurements is a well-established method for reducing the effects of time varying disturbances, such as air turbulence and vibration. Calculating a map of the standard deviation for each pixel in the average map can provide a useful estimate of its variability. However, phase maps of complex and/or high density fringe fields frequently contain defects that severely impair the effectiveness of simple phase averaging and bias the variability estimate. These defects include large or small-area phase unwrapping artifacts, large alignment components, and voids that change in number, location, or size. Inclusion of a single phase map with a large area defect into the average is usually sufficient to spoil the entire result. Small-area phase unwrapping and void defects may not render the average map metrologically useless, but they pessimistically bias the variance estimate for the overwhelming majority of the data. We present an algorithm that obtains phase average and variance estimates that are robust against both large and small-area phase defects. It identifies and rejects phase maps containing large area voids or unwrapping artifacts. It also identifies and prunes the unreliable areas of otherwise useful phase maps, and removes the effect of alignment drift from the variance estimate. The algorithm has several run-time adjustable parameters to adjust the rejection criteria for bad data. However, a single nominal setting has been effective over a wide range of conditions. This enhanced averaging algorithm can be efficiently integrated with the phase map acquisition process to minimize the number of phase samples required to approach the practical noise floor of the metrology environment.

Fleig, Jon F.; Murphy, Paul E.



When Is the Local Average Treatment Close to the Average? Evidence from Fertility and Labor Supply  

ERIC Educational Resources Information Center

The local average treatment effect (LATE) may differ from the average treatment effect (ATE) when those influenced by the instrument are not representative of the overall population. Heterogeneity in treatment effects may imply that parameter estimates from 2SLS are uninformative regarding the average treatment effect, motivating a search for…

Ebenstein, Avraham



Neutron average cross sections of Np237  

NASA Astrophysics Data System (ADS)

This work reports Np237 neutron resonance parameters obtained from the simultaneous analysis of time-of-flight data measured at the GELINA, ORELA, KURRI, and LANSCE facilities. A statistical analysis of these resonances relying on average R-matrix and optical model calculations was used to establish consistent l-dependent average resonance parameters involved in the description of the unresolved resonance range of the Np237 neutron cross sections. For neutron orbital angular momentum l=0, we obtained an average radiation width =39.3±1.0 meV, a neutron strength function 104S0=1.02±0.14, a mean level spacing D0=0.60±0.03 eV, and a potential scattering length R'=9.8±0.1 fm.

Noguere, G.




SciTech Connect

The objective of this calculation is to generate source terms for each type of Department of Energy (DOE) spent nuclear fuel (SNF) canister that may be disposed of at the potential repository at Yucca Mountain. The scope of this calculation is limited to generating source terms for average DOE SNF canisters, and is not intended to be used for subsequent calculations requiring bounding source terms. This calculation is to be used in future Performance Assessment calculations, or other shielding or thermal calculations requiring average source terms.

K. L. Goluoglu



40 CFR 89.204 - Averaging.  

Code of Federal Regulations, 2012 CFR

...exceedance of a nonroad engine family caused by a NOX FEL above the applicable emission standard. NOX credits used in averaging may be obtained...a nonroad engine family caused by an NMHC+;NOX FEL or a PM FEL above the applicable...



Average Values of Mean Squares in Factorials  

Microsoft Academic Search

The assumptions appropriate to the application of analysis of variance to specific examples, and the effects of these assumptions on the resulting interpretations, are today a matter of very active discussion. Formulas for average values of mean squares play a central role in this problem, as do assumptions about interactions. This paper presents formulas for crossed (and, incidentally, for nested

Jerome Cornfield; John W. Tukey



World average top-quark mass  

SciTech Connect

This paper summarizes a talk given at the Top2008 Workshop at La Biodola, Isola d Elba, Italy. The status of the world average top-quark mass is discussed. Some comments about the challanges facing the experiments in order to further improve the precision are offered.

Glenzinski, D.; /Fermilab