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Sample records for average self-care management

  1. Self-care and postoperative dressing management.

    PubMed

    Dawn Hunt, Sharon

    2016-08-11

    As the increasing burden on healthcare costs continues to rise, posing clinical and financial challenges for all healthcare providers attempting to provide optimal, evidence-based wound care, the situation appears to be reaching the tipping point with regard to reduced resources, increasing patient groups with complex wounds and financial restraints. It is clearly time for action and new ways of working that include empowering patients and carers to take appropriate ownership within their personal wound-care journey. This observational evaluation explores 10 community-based patients presenting with postoperative acute surgical wounds; it examines and evaluates the patients' experience with regard to self-care satisfaction, Leukomed Control product satisfaction and actual traditional/personal costs incurred up to a 4-week period. The evaluation highlights not only an overall positive improvement within patient satisfaction and experience, alongside optimised wound progression and related cost savings, but also offers a valuable insight into the promotion and success of patients taking ownership of their wound-care journey. PMID:27523771

  2. Determinants of Heart Failure Self-Care Maintenance and Management in Patients and Caregivers: A Dyadic Analysis.

    PubMed

    Bidwell, Julie T; Vellone, Ercole; Lyons, Karen S; D'Agostino, Fabio; Riegel, Barbara; Juárez-Vela, Raúl; Hiatt, Shirin O; Alvaro, Rosaria; Lee, Christopher S

    2015-10-01

    Disease self-management is a critical component of maintaining clinical stability for patients with chronic illness. This is particularly evident in the context of heart failure (HF), which is the leading cause of hospitalization for older adults. HF self-management, commonly known as HF self-care, is often performed with the support of informal caregivers. However, little is known about how a HF dyad manages the patient's care together. The purpose of this study was to identify determinants of patient and caregiver contributions to HF self-care maintenance (daily adherence and symptom monitoring) and management (appropriate recognition and response to symptoms), utilizing an approach that controls for dyadic interdependence. This was a secondary analysis of cross-sectional data from 364 dyads of Italian HF patients and caregivers. Multilevel modeling was used to identify determinants of HF self-care within patient-caregiver dyads. Patients averaged 76.2 (SD = 10.7) years old, and a slight majority (56.9%) was male, whereas caregivers averaged 57.4 (SD = 14.6) years old, and about half (48.1%) were male. Most caregivers were adult children (48.4%) or spouses (32.7%) of patients. Both patients and caregivers reported low levels of HF maintenance and management behaviors. Significant individual and dyadic determinants of self-care maintenance and self-care management included gender, quality of life, comorbid burden, impaired ADLs, cognition, hospitalizations, HF duration, relationship type, relationship quality, and social support. These comprehensive dyadic models assist in elucidating the complex nature of patient-caregiver relationships and their influence on HF self-care, leading to more effective ways to intervene and optimize outcomes.

  3. Determinants of Heart Failure Self-Care Maintenance and Management in Patients and Caregivers: A Dyadic Analysis.

    PubMed

    Bidwell, Julie T; Vellone, Ercole; Lyons, Karen S; D'Agostino, Fabio; Riegel, Barbara; Juárez-Vela, Raúl; Hiatt, Shirin O; Alvaro, Rosaria; Lee, Christopher S

    2015-10-01

    Disease self-management is a critical component of maintaining clinical stability for patients with chronic illness. This is particularly evident in the context of heart failure (HF), which is the leading cause of hospitalization for older adults. HF self-management, commonly known as HF self-care, is often performed with the support of informal caregivers. However, little is known about how a HF dyad manages the patient's care together. The purpose of this study was to identify determinants of patient and caregiver contributions to HF self-care maintenance (daily adherence and symptom monitoring) and management (appropriate recognition and response to symptoms), utilizing an approach that controls for dyadic interdependence. This was a secondary analysis of cross-sectional data from 364 dyads of Italian HF patients and caregivers. Multilevel modeling was used to identify determinants of HF self-care within patient-caregiver dyads. Patients averaged 76.2 (SD = 10.7) years old, and a slight majority (56.9%) was male, whereas caregivers averaged 57.4 (SD = 14.6) years old, and about half (48.1%) were male. Most caregivers were adult children (48.4%) or spouses (32.7%) of patients. Both patients and caregivers reported low levels of HF maintenance and management behaviors. Significant individual and dyadic determinants of self-care maintenance and self-care management included gender, quality of life, comorbid burden, impaired ADLs, cognition, hospitalizations, HF duration, relationship type, relationship quality, and social support. These comprehensive dyadic models assist in elucidating the complex nature of patient-caregiver relationships and their influence on HF self-care, leading to more effective ways to intervene and optimize outcomes. PMID:26355702

  4. Testing the Theory of Self-care Management for sickle cell disease.

    PubMed

    Jenerette, Coretta M; Murdaugh, Carolyn

    2008-08-01

    Factors predicting health outcomes in persons with sickle cell disease (SCD) were investigated within the framework of the theory of self-care management for SCD, which proposes that vulnerability factors negatively affect health care outcomes and self-care management resources and positively mediate the relationship between vulnerability factors and health care outcomes. A cross-sectional descriptive design was used to test the model with a sample of 232 African American adults with SCD. Results supported the negative effect of vulnerability factors on health outcomes. The overall model was supported, however, self-care management resources did not mediate the relationship between vulnerability and health care outcomes. The findings provide support for interventions to increase self-care management resources to improve health care outcomes.

  5. Health Care Autonomy in Children with Chronic Conditions: Implications for Self Care and Family Management

    PubMed Central

    Beacham, Barbara L.; Deatrick, Janet A.

    2013-01-01

    Synopsis Health care autonomy typically occurs during late adolescence but health care providers and families often expect children with chronic health conditions to master self-care earlier. Few studies have examined the development of health care autonomy as it pertains to self-care and family management. This review will link the three concepts and discuss implications for families and health care providers. Case studies are provided as exemplars to highlight areas where intervention and research is needed. PMID:23659815

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

    PubMed

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

    2007-02-01

    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 collection sites in several US cities, Puerto Rico, Colombia and Taiwan. Results of the study indicated that respondents with peripheral neuropathy (n=450) identified 20 self-care behaviors including complementary therapies, use of medications, exercise and rest and/or elevation of extremities. Ratings of frequency and effectiveness were also included. An activities checklist summarized into five categories of self-care behaviors including activities/thoughts, exercise, medications, complementary therapies and substance was used to determine self-care behaviors. Taking a hot bath was the most frequent strategy used by those with peripheral neuropathy (n=292) and received the highest overall rating of effectiveness of any self-management strategies included in this study at 8.1 (scale 1-10). Other self-care strategies to manage this symptom included: staying off the feet (n=258), rubbing the feet with cream (n=177), elevating the feet (n=236), walking (n=262), prescribed anti-epileptic agent (n=80), prescribed analgesics (n=84), over-the-counter medications (n=123), vitamin B (n=122), calcium supplements (n=72), magnesium (n=48), massage (n=156), acupuncture (n=43), reflexology (n=23) and meditation (n=80). Several behaviors that are often deemed unhealthy were included among the strategies reported to alleviate peripheral neuropathy including use of marijuana (n=67), cigarette smoking (n=139), drinking alcohol (n=81) and street drugs (n=30).

  7. Self-Care Management among Patients with Type 2 Diabetes in East Jerusalem

    ERIC Educational Resources Information Center

    Daoud, Nihaya; Osman, Amira; Hart, Trevor A.; Berry, Elliott M.; Adler, Bella

    2015-01-01

    Objective: Little research exists on diabetes self-care management (DSCM) in Arab populations. We examined the contribution of health belief constructs, socioeconomic position (SEP) and clinical factors (glycated haemoglobin [HbA1C] level, type of diabetes treatments, and receiving professional guidance) to DSCM among Arab patients in East…

  8. The self-care series: Part II, stress management.

    PubMed

    1998-01-01

    Inmates have special needs in terms of their emotional and physical health and this second in a series is designed to give inmates living with HIV/AIDS practical advice on handling stress. Stress is a major problem for all who are diagnosed with HIV, particularly for inmates who may have limited access to drugs or health care providers. Several stress management techniques are described, including meditation. The importance of proper nutrition and exercise is addressed. Progressive relaxation and visualization techniques may also be useful in managing the stress associated with HIV diagnoses.

  9. A group self-care approach to stress management.

    PubMed

    Garrison, J; Scott, P A

    1979-06-01

    A procedure is described for teaching patients the use of relaxation as a coping skill. The procedure, called Stress Management Training, combines Progressive Relaxation and Clinical Meditation into a standardized but flexible seven-session protocol. The technique has been used to treat a variety of stress-related medical and psychological problems. The training consists of three components. The first is giving the patient a cognitive understanding of stress and relaxation. The second, teaching the patient to relax by controlling the muscle tension and sympathetic nervous system activity. The third, teaching the patient to generalize the relaxation skill to real-life stress situations. Patients are also instructed in the relationship between stress, basic health practices, and physical health status.

  10. mHealth self-care interventions: managing symptoms following breast cancer treatment

    PubMed Central

    Fu, Mei R.; Axelrod, Deborah; Guth, Amber A.; Rampertaap, Kavita; El-Shammaa, Nardin; Hiotis, Karen; Scagliola, Joan; Yu, Gary; Wang, Yao

    2016-01-01

    Background Many women suffer from daily distressing symptoms related to lymphedema following breast cancer treatment. Lymphedema, an abnormal accumulation of lymph fluid in the ipsilateral body area or upper limb, remains an ongoing major health problem affecting more than 40% of 3.1 million breast cancer survivors in the United States. Patient-centered care related to lymphedema symptom management is often inadequately addressed in clinical research and practice. mHealth plays a significant role in improving self-care, patient-clinician communication, and access to health information. The-Optimal-Lymph-Flow health IT system (TOLF) is a patient-centered, web-and-mobile-based educational and behavioral mHealth interventions focusing on safe, innovative, and pragmatic electronic assessment and self-care strategies for lymphedema symptom management. The purpose of this paper is to describe the development and test of TOLF system. Methods The development of TOLF was guided by the Model of Self-Care for Lymphedema Symptom Management and designed based on principles fostering accessibility, convenience, and efficiency of mHealth system to enhance training and motivating assessment of and self-care for lymphedema symptoms. Test of TOLF was accomplished by conducting a psychometric study to evaluate reliability, validity, and efficiency of the electronic version of Breast Cancer and Lymphedema Symptom Experience Index (BCLE-SEI), a usability testing and a pilot feasibility testing of mHealth self-care interventions. Results Findings from the psychometric study with 355 breast cancer survivors demonstrated high internal consistency of the electronic version of the instrument: a Cronbach’s alpha coefficient of 0.959 for the total scale, 0.919 for symptom occurrence, and 0.946 for symptom distress. Discriminant validity of the instrument was supported by a significant difference in symptom occurrence (z=−6.938, P<0.000), symptom distress (z=−5.894, P<0.000), and total

  11. Connecting Patients to mHealth Applications to Enhance Self-care Management.

    PubMed

    Conroy, Meghan K

    2015-09-01

    Smartphone use and the desire to use mHealth are growing in the population of patients who most commonly use home healthcare (HHC) services, a population with chronic conditions and complex healthcare management needs. HHC nurses are positioned to connect HHC patients with mHealth Apps to access health-related information, engage in interactive monitoring, and manage self-care activities. The challenge of finding reputable Apps is discussed and resources are presented to overcome this challenge at the business orindividual level. PMID:26323008

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

    PubMed

    Delpech, A

    2000-03-01

    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

  13. Self-care behaviors and activities for managing HIV-related anxiety.

    PubMed

    Kemppainen, Jeanne K; Wantland, Dean; Voss, Joachim; Nicholas, Patrice; Kirksey, Kenn M; Corless, Inge B; Willard, Suzanne; Holzemer, William L; Robinson, Linda; Hamilton, Mary Jane; Sefcik, Elizabeth; Eller, Lucille Sanzero; Huang, Emily; Arudo, John; Moezzi, Shahnaz; Rivero-Mendez, Marta; Rosa, Maria; Human, Sarie; Cuca, Yvette; Lindgren, Terri; Portillo, Carmen J; Maryland, Mary

    2012-01-01

    The goal of this study was to identify the baseline prevalence and effectiveness of anxiety self-management strategies in a convenience sample of persons living with HIV (PLWH; n = 343) in the United States, Puerto Rico, Kenya, and South Africa who reported HIV-related anxiety symptoms. Relationships between demographics and anxiety characteristics were determined, as was the effectiveness of self-care activities/behaviors to reduce anxiety. We found that the use of anxiety self-management strategies varied by gender and that ratings of effectiveness varied by country. Highest anxiety intensity scores were found in participants who were taking antiretroviral medications and who had undetectable viral loads. Forty-five percent of the persons with a diagnosis of AIDS reported anxiety symptoms. As HIV increases in areas of the world where self-care is the primary approach to managing HIV, additional research will be needed to address the effectiveness of cross-cultural differences in strategies for self-managing HIV-related anxiety. PMID:21839652

  14. Self-Care for Management of Secondary Lymphedema: A Systematic Review

    PubMed Central

    Graves, Patricia; Gordon, Susan

    2016-01-01

    Background Lymphedema is a debilitating and disfiguring sequela of an overwhelmed lymphatic system. The most common causes of secondary lymphedema are lymphatic filariasis (LF), a vector-borne, parasitic disease endemic in 73 tropical countries, and treatment for cancer in developed countries. Lymphedema is incurable and requires life-long care so identification of effective lymphedema management is imperative to improve quality of life, reduce the burden on family resources and benefit the local community. This review was conducted to evaluate the evidence for effective lymphedema self-care strategies that might be applicable to management of all types of secondary lymphedema. Methodology/Principal Findings Searches were conducted in Medline, CINAHL and Scopus databases in March 2015. Included studies reported before and after measures of lymphedema status or frequency of acute infections. The methodological quality was assessed using the appropriate Critical Appraisal Skills Program checklist. Descriptive synthesis and meta-analysis were used to evaluate effectiveness of the outcomes reported. Twenty-eight papers were included; two RCTs were found to have strong methodology, and overall 57% of studies were rated as methodologically weak. Evidence from filariasis-related lymphedema (FR-LE) studies indicated that hygiene-centred self-care reduced the frequency and duration of acute episodes by 54%, and in cancer-related lymphedema (CR-LE) home-based exercise including deep breathing delivered significant volume reductions over standard self-care alone. Intensity of training in self-care practices and frequency of monitoring improved outcomes. Cultural and economic factors and access to health care services influenced the type of intervention delivered and how outcomes were measured. Conclusions/Significance There is evidence to support the adoption of remedial exercises in the management of FR-LE and for a greater emphasis on self-treatment practices for people

  15. Determinants of Heart Failure Self-Care Maintenance and Management in Patients and Caregivers: A Dyadic Analysis

    PubMed Central

    Bidwell, Julie T.; Vellone, Ercole; Lyons, Karen S.; D’Agostino, Fabio; Riegel, Barbara; Vela, Raúl Juárez; Hiatt, Shirin O.; Alvaro, Rosaria; Lee, Christopher S.

    2015-01-01

    Disease self-management is a critical component of maintaining clinical stability for patients with chronic illness. This is particularly evident in the context of heart failure (HF), which is the leading cause of hospitalization for older adults. HF self- management, commonly known as HF self-care, is often performed with the support of informal caregivers. However, little is known about how HF dyads manage the patient’s care together. The purpose of this study was to identify determinants of patient and caregiver contributions to HF self-care maintenance (i.e., daily adherence and symptom monitoring) and management (i.e., appropriate recognition & response to symptoms), utilizing an approach that controls for dyadic interdependence. This was a secondary analysis of cross-sectional data from 364 Italian HF patients and caregivers. Multilevel modeling was used to identify determinants of HF self-care within patient-caregiver dyads. Patients were 76.2 (SD=10.7) years, a slight majority (56.9%) was male, while caregivers were 57.4 (SD=14.6) years, and fewer than half (48.1%) were male. Most caregivers were adult children (48.4%) or spouses (32.7%) of patients. Both patients and caregivers reported low levels of HF maintenance and management behaviors. Several significant individual and dyadic determinants of self-care maintenance and self-care management were identified, including gender, quality of life, comorbid burden, impaired ADLs, cognition, hospitalizations, HF duration, relationship type, relationship quality, and social support. These comprehensive dyadic models assist in elucidating the complex nature of patient-caregiver relationships and their influence on HF self-care, leading to more effective ways to intervene and maximize outcomes. PMID:26355702

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

    ERIC Educational Resources Information Center

    Holt, Martin; Treloar, Carla

    2008-01-01

    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.…

  17. How Technology in Care at Home Affects Patient Self-Care and Self-Management: A Scoping Review

    PubMed Central

    Peeters, José M.; Wiegers, Therese A.; Friele, Roland D.

    2013-01-01

    The use of technology in care at home has potential benefits such as improved quality of care. This includes greater focus on the patients’ role in managing their health and increased patient involvement in the care process. The objective of this scoping review is to analyse the existing evidence for effects of technology in home-based care on patients’ self-care and self-management. Using suitable search terms we searched the databases of Pubmed, Embase, Cochrane Library, Cinahl, Picarta and NIVEL dating from 2002 to 2012. Thirty-three studies (six review studies and twenty-seven individual studies) were selected. Effects were extracted from each study and were classified. In almost all the studies, the concepts self-care and self-management are not clearly defined or operationalized. Therefore, based on a meta-analysis, we made a new classification of outcome measures, with hierarchical levels: (1) competence (2) illness-management (3) independence (social participation, autonomy). In general, patient outcomes appear to be positive or promising, but most studies were pilot studies. We did not find strong evidence that technology in care at home has (a positive) effect on patient self-care and self-management according to the above classification. Future research is needed to clarify how technology can be used to maximize its benefits. PMID:24173139

  18. Engaging Patients in Online Self-Care Technologies for Chronic Disease Management.

    PubMed

    Picton, Peter; Wiljer, David; Urowitz, Sara; Cafazzo, Joseph A

    2016-01-01

    A common perception is that the use of Internet-based self-care systems is best suited for a younger, tech-proficient population, and that these systems will increase the burden on patients with complex chronic conditions. The study stratified patients with diabetes into three regimens of use of an Internet-based diabetes self-care portal. Results show that patients were more likely to adhere to a diurnal regimen than a variable regimen, and older patients, over the age of 60, were more adherent than younger patients, regardless of regimen. This suggests that common misconceptions should be reconsidered when prescribing Internet-based interventions for patients with chronic illness.

  19. Everyday life, healthcare, and self-care management among people with irritable bowel syndrome: an integrative review of qualitative research.

    PubMed

    Håkanson, Cecilia

    2014-01-01

    Irritable bowel syndrome is a commonly recognized chronic disease in all healthcare settings. This integrative review investigated current knowledge about adults' illness-related experiences of this disease from the perspectives of everyday life, healthcare, and self-care management. The overarching findings related to everyday life with irritable bowel syndrome were life-limiting experiences of the body-self as unfamiliar and of the body and symptoms as shameful and unpredictable. The limitations manifested as lack of ability to move about freely, fulfill ambitions or commitments at work, maintain social activities, uphold or develop close and/or sexual relationships and parenting, and live a life with spontaneity. Physical condition, knowledge about disease/illness-related matters, and one's own perceived ability to find adequate strategies were significant for the ability of self-care management. Healthcare was experienced as being unsupportive and not providing information and guidance for enabling self-care management. These results suggest a need for controlled intervention trials of healthcare models that take as their point of departure the individual's experience of illness, needs, and life situation, and that enable learning and sharing of illness experiences, combined with the provision of scientific knowledge and advice from healthcare professionals. PMID:24871667

  20. [Community resources prescription for self-care improvement in chronic illnesses. Clinical case management in Primary Health Care].

    PubMed

    Pérez-Vico-Díaz de Rada, Lucía; González-Suárez, Miriam; Duarte-Clíments, Gonzalo; Brito-Brito, Pedro Ruymán

    2014-01-01

    A case is presented of a 52 year-old male seen in a Primary Care nursing clinic for a type 2 diabetes mellitus metabolic control. The frequency of the visits increased due to perceived difficulties caused by changing the medical treatment. A focused interview was conducted under functional health patterns framework. The patient was unable to write or read, had not worked for the last 25 years, and expressed a lack of control over his self-care. An action plan was prepared, prioritizing Ineffective Health Maintenance, Powerlessness, and Impaired Social Interaction NANDA-I nursing diagnoses. The goals were set at improving knowledge and control over his disease and participating in leisure activities. To achieve these, the social health resources in the area were contacted, and agreed that the patient could attend activities that could improve his self-care and his quality of life. An improvement in his diabetes control was observed in the following evaluations, with an increase in his level of knowledge and self-care. The Primary Health care nurse should consider available community resources by using a comprehensive approach to chronic diseases for their therapeutic benefit and management, especially in those patients with adverse sociocultural conditions.

  1. Engaging Patients in Online Self-Care Technologies for Chronic Disease Management.

    PubMed

    Picton, Peter; Wiljer, David; Urowitz, Sara; Cafazzo, Joseph A

    2016-01-01

    A common perception is that the use of Internet-based self-care systems is best suited for a younger, tech-proficient population, and that these systems will increase the burden on patients with complex chronic conditions. The study stratified patients with diabetes into three regimens of use of an Internet-based diabetes self-care portal. Results show that patients were more likely to adhere to a diurnal regimen than a variable regimen, and older patients, over the age of 60, were more adherent than younger patients, regardless of regimen. This suggests that common misconceptions should be reconsidered when prescribing Internet-based interventions for patients with chronic illness. PMID:27009709

  2. Review and Analysis of Existing Mobile Phone Apps to Support Heart Failure Symptom Monitoring and Self-Care Management Using the Mobile Application Rating Scale (MARS)

    PubMed Central

    Maurer, Mathew S; Reading, Meghan; Hiraldo, Grenny; Hickey, Kathleen T; Iribarren, Sarah

    2016-01-01

    Background Heart failure is the most common cause of hospital readmissions among Medicare beneficiaries and these hospitalizations are often driven by exacerbations in common heart failure symptoms. Patient collaboration with health care providers and decision making is a core component of increasing symptom monitoring and decreasing hospital use. Mobile phone apps offer a potentially cost-effective solution for symptom monitoring and self-care management at the point of need. Objective The purpose of this review of commercially available apps was to identify and assess the functionalities of patient-facing mobile health apps targeted toward supporting heart failure symptom monitoring and self-care management. Methods We searched 3 Web-based mobile app stores using multiple terms and combinations (eg, “heart failure,” “cardiology,” “heart failure and self-management”). Apps meeting inclusion criteria were evaluated using the Mobile Application Rating Scale (MARS), IMS Institute for Healthcare Informatics functionality scores, and Heart Failure Society of America (HFSA) guidelines for nonpharmacologic management. Apps were downloaded and assessed independently by 2-4 reviewers, interclass correlations between reviewers were calculated, and consensus was met by discussion. Results Of 3636 potentially relevant apps searched, 34 met inclusion criteria. Most apps were excluded because they were unrelated to heart failure, not in English or Spanish, or were games. Interrater reliability between reviewers was high. AskMD app had the highest average MARS total (4.9/5). More than half of the apps (23/34, 68%) had acceptable MARS scores (>3.0). Heart Failure Health Storylines (4.6) and AskMD (4.5) had the highest scores for behavior change. Factoring MARS, functionality, and HFSA guideline scores, the highest performing apps included Heart Failure Health Storylines, Symple, ContinuousCare Health App, WebMD, and AskMD. Peer-reviewed publications were identified

  3. Genital herpes - self-care

    MedlinePlus

    Herpes - genital -self-care; Herpes simplex - genital - self-care; Herpesvirus 2 - self-care; HSV-2 - self-care ... genital herpes can be treated. Follow your health care provider's instructions for treatment and follow-up.

  4. Kidney stones - self-care

    MedlinePlus

    Renal calculi - self-care; Nephrolithiasis - self-care; Stones - kidney - self-care ... You visited your health care provider or the hospital because you have a kidney stone. You will need to take self-care steps. Which steps ...

  5. Factors Associated with Women's Chronic Disease Management: Associations of Healthcare Frustrations, Physician Support, and Self-Care Needs.

    PubMed

    Smith, Matthew Lee; Ory, Marcia G; Ahn, Sangnam; Miles, Toni P

    2013-01-01

    Previous research emphasizes the importance of reducing healthcare frustrations and enhancing physician supports to help patients engage in recommended healthcare regimens. However, less is known about how these factors are associated with aging women's knowledge about self-care behavior. This study examined the sociodemographics, health indicators, healthcare-related frustrations, and perceptions of physician support associated with middle-aged and older adult females' self-reported need for help to learn how to take better care of their health. Data were analyzed from 287 females with one or more chronic conditions who completed The National Council on Aging (NCOA) Chronic Care Survey. A logistic regression model was developed. Women who were non-White (OR = 2.26, P = 0.049) were more likely to need help learning how to better manage their health. Those who had some college education or more (OR = 0.55, P = 0.044) and lower healthcare-related frustrations (OR = 0.44, P = 0.017) and perceived to have more physician support (OR = 0.49, P = 0.033) were less likely to need help learning how to better manage their health. Findings can inform the planning, implementation, assessment, and dissemination of evidence-based self-management programs for middle-aged and older women within and outside of clinical settings.

  6. Psychosocial factors associated with poor diabetes self-care management in a specialized center in Mexico City.

    PubMed

    Lerman, Israel; Lozano, Liliana; Villa, Antonio R; Hernández-Jiménez, Sergio; Weinger, Katie; Caballero, A Enrique; Salinas, Carlos Aguilar; Velasco, Maria Luisa; Gómez-Pérez, Francisco Javier; Rull, Juan A

    2004-12-01

    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 +/- 11 years, mean diabetes duration of 12 +/- 8 years and HbA1c of 9.0 +/- 2.0%, 78.4% reported following the correct dose of diabetes pills or insulin, 58% ate the recommended food portions, and 44.3% did exercise three or more times per week. A good adherence to these three recommendations was observed in only 26.1% of the patients. These patients considered as a group were characterized by a greater knowledge about the disease (P < 0.00001), regular home blood glucose monitoring (P < 0.01), an inner perception of better diabetes control (P = 0.007), good health (P = 0.004) and better communication with their physician (P < 0.02). A poor adherence to two or the three main diabetes care recommendations was associated with a depressive state (OR 2.38, 95% CI 1.1-4.9, P < 0.01) and a history of excessive alcohol intake (OR 4.03, 95% CI 1.1-21.0, P = 0.03). Poor adherence to standard diabetes care recommendations is frequently observed in patients with type 2 diabetes attending a specialized health care center in Mexico City. Depression must be identified and treated effectively. PMID:15589064

  7. Allergic rhinitis - self-care

    MedlinePlus

    Hay fever - self-care; Seasonal rhinitis - self-care; Allergies - allergic rhinitis - self-care ... in a row. Talk to your child's health care provider before giving your child decongestants. Nasal corticosteroid ...

  8. Broken toe - self-care

    MedlinePlus

    Fractured toe - self-care; Broken bone - toe - self-care; Fracture - toe - self-care; Fracture phalanx - toe ... often treated without surgery and can be taken care of at home. Severe injuries include: Breaks that ...

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

    ERIC Educational Resources Information Center

    Chou, Pak Hei Benedito; Wister, Andrew V.

    2005-01-01

    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…

  10. Vaginitis - self-care

    MedlinePlus

    Vulvovaginitis - self-care; Yeast infections - vaginitis ... Creams or suppositories are used to treat yeast infections in the vagina. You can buy most of them without a prescription at drug stores, some grocery stores, and other stores. Treating yourself ...

  11. Perspectives on Self-Care

    ERIC Educational Resources Information Center

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

    2010-01-01

    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 experiences…

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

    PubMed Central

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

    2013-01-01

    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. PMID:24083287

  13. iMHere: A Novel mHealth System for Supporting Self-Care in Management of Complex and Chronic Conditions

    PubMed Central

    Pramana, Gede; Yu, Daihua Xie; Fairman, Andrea D; Dicianno, Brad E; McCue, Michael P

    2013-01-01

    Background Individuals with chronic conditions are vulnerable to secondary complications that can be prevented with adherence to self-care routines. They benefit most from receiving effective treatments beyond acute care, usually in the form of regular follow-up and self-care support in their living environments. One such population is individuals with spina bifida (SB), the most common permanently disabling birth defect in the United States. A Wellness Program at the University of Pittsburgh in which wellness coordinators supervise the care of individuals with chronic disease has produced remarkably improved outcomes. However, time constraints and travel costs have limited its scale. Mobile telehealth service delivery is a potential solution for improving access to care for a larger population. Objective The project’s goal was to develop and implement a novel mHealth system to support complex self-care tasks, continuous adherence to regimens, monitoring of adherence, and secure two-way communications between patients and clinicians. Methods We developed and implemented a novel architecture of mHealth system called iMHere (iMobile Health and Rehabilitation) consisting of smartphone apps, a clinician portal, and a two-way communication protocol connecting the two. The process of implementing iMHere consisted of: (1) requirement analysis to identify clinically important functions that need to be supported, (2) design and development of the apps and the clinician portal, (3) development of efficient real-time bi-directional data exchange between the apps and the clinician portal, (4) usability studies on patients, and (5) implementation of the mHealth system in a clinical service delivery. Results There were 9 app features identified as relevant, and 5 apps were considered priority. There were 5 app features designed and developed to address the following issues: medication, skin care, bladder self-catheterization, bowel management, and mental health. The apps were

  14. Self-care in heart failure patients 1

    PubMed Central

    da Conceição, Ana Paula; dos Santos, Mariana Alvina; dos Santos, Bernardo; da Cruz, Diná de Almeida Lopes Monteiro

    2015-01-01

    Abstract Objective: to describe self-care behavior and its associated factors in a sample of heart failure Brazilian patients. Method: descriptive cross-sectional study with non-probabilistic sample of 116 ambulatory patients undergoing heart failure treatment. Self-care was evaluated using the Self-Care of Heart Failure Index, (scores ≥70 points=appropriate self-care). Association tests were applied, considering a descriptive level of 0.05. Results: the mean age of participants was 57.7 (SD =11.3) years; 54.3% were male; the mean schooling was 5.5 (SD = 4.0) years; and 74.1% had functional class II-III. The mean scores on the subscales of the Self-Care of Heart Failure Index indicated inappropriate self-care (self-care maintenance: 53.2 (SD =14.3), selfcare management: 50.0 (SD = 20.3) and self-care confidence: 52.6 (SD=22.7)) and it was found low frequencies of participants with appropriate self-care (self-care maintenance, 6.9%), self-care management (14.7%) and self-care confidence (19%). Higher scores of the Self-Care of Heart Failure Index were associated with: reduced left ventricular ejection fraction (p=0.001), longer time of experience with the disease (p=0.05) and joint monitoring by physician and nurse (p=0.007). Conclusion: investments are needed to improve the self-care behavior and the nursing can play a relevant role in this improvement. PMID:26444158

  15. Premenstrual syndrome - self-care

    MedlinePlus

    PMS - self-care; Premenstrual dysphoric disorder - self-care ... Your health care provider may recommend that you take vitamins or supplements. Vitamin B6, calcium, and magnesium may be recommended. Tryptophan ...

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

    PubMed Central

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

    2006-01-01

    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

  17. Type D personality negatively associated with self-care in Chinese heart failure patients

    PubMed Central

    Cao, Xi; Wang, Xiu-Hua; Wong, Eliza ML; Chow, Choi Kai; Chair, Sek Ying

    2016-01-01

    Background Little is known about the association between type D personality and self-care behaviors in heart failure (HF) patients. We examined the effect of type D personality on self-care behaviors and self-efficacy among Chinese HF patients. Methods A cross-sectional study with a convenience sample was conducted. All participants completed the questionnaires of the self-care of HF index (V6) and type D personality scale. Demographic and clinical variables were obtained from medical records and patient interviews. The methods used for data analysis included descriptive analysis, independent-sample t-test, χ2 test, and multiple linear regression. Results A total of 127 HF patients were included and 61.4% of them were male. The average age for this study sample was 64.9 ± 12.34 years. The majority of the participants were in a New York Heart Association class III or IV (87%), and the average length of living with HF was 38.24 ± 41.1 months. A total of 33.1% of the participants were identified as having type D personality. No significant differences were determined in the demographic and clinical variables between type D and non-type D patients, except for the mean age and the length of living with HF. Type D patients were younger and had a shorter time of living with HF than their non-type D counterparts. Multiple regression demonstrated significant associations between type D personality and self-care maintenance and self-efficacy after adjusting the demographic and clinical factors. However, type D personality was not significantly associated with self-care management behaviors. Conclusions Type D personality was negatively related to self-care maintenance and self-efficacy in Chinese HF patients. Future study is warranted to develop a tailored intervention to improve engagement in self-care behaviors in HF patients with type D personality. PMID:27594867

  18. [Self care in adolescents].

    PubMed

    Rodríguez de la Parra, S; Carbelo Baquero, B

    1999-01-01

    The purpose of this work is to offer an analysis on the adolescence as stage of the life with some specific characteristics due to the transformations that happen so much at biological level as cognitive and psychosocial. During this period, the adolescent develops their autonomy and by so much starts their independence of the parents, some and other will experience situations that them will make be felt insecure in their/its performances until each one assume their new paper in the familiar environment and before itself. Parents and adolescent can need support and advice to obtain that this stage, in conflicting occasions, is developed normally, so that the adolescent become a capable adult about caring whether same and about others, with a life style that favor the integrated operation and the continued development. The family nurse can lend them the support and advice that need, since occupies a privileged place in the health equipment to guarantee the continuity of the assistance to the familiar group from the birth until the maturity. Basing us on the theory of the self-care developed by D. Orem, we will check the specific requirements of self-care of this stage of the vital cycle, of great transcendency for the step to the adult age. PMID:10514786

  19. What level of self-care agency in mental illness? The factors affecting self-care agency and self-care agency in patients with mental illness.

    PubMed

    Çiftçi, Bahar; Yıldırım, Naci; Şahin Altun, Özlem; Avşar, Gülçin

    2015-12-01

    The purpose of this study is to evaluate self-care agency and the factors affecting self-care agency in patients with psychiatric disorders. The population of the study comprised patients diagnosed with mental disorders at the clinics of psychiatry in Erzurum Regional Training and Research Hospital and Atatürk University Research Hospital. Patient information forms and the Self-Care Agency Scale were used to collect the study data. Psychiatric nurse collected the data from the patients face to face. This study determined that the average age of the patients was determined to be 32.19±1.11. The findings indicated that the mean self-care agency level of the patients was 79.3±23.2. It was also found that the differences between sex, educational status, socio-economic status, and self-care agency levels were statistically significant (p<0.05). In conclusion, the patients' self-care agency levels were determined to be mid-level. The findings suggest that people with mental disorders have difficulty identifying their need for self-care. Thus, periodic training programs are necessary to increase self-care levels and further research studies of this type should be done on larger groups.

  20. Self-Care Among Patients With Inflammatory Bowel Disease

    PubMed Central

    Yngman-Uhlin, Pia; Hjortswang, Henrik; Riegel, Barbara; Stjernman, Henrik; Hollman Frisman, Gunilla

    2016-01-01

    Inflammatory bowel disease (IBD) is a chronic disease of unknown etiology. The disease occurs early in life and the burden of symptoms is significant. Patients need to perform self-care to handle their symptoms, but knowledge about what kind of self-care patients do is limited and these individuals need to learn how to manage the symptoms that arise. The aim of this study was to explore self-care among patients with IBD. Twenty adult patients with IBD, 25–66 years of age, were interviewed. Data were analyzed by performing a qualitative content analysis. Four categories with 10 subcategories emerged from the analysis of the interviews. The self-care patients perform consists of symptom recognition (subcategories: physiological sensations and psychological sensations), handling of symptoms (subcategories: adapting the diet, using medical treatment, stress management, and using complementary alternative medicine), planning life (subcategories: planning for when to do activities and when to refrain from activities), and seeking new options (subcategories: seeking knowledge and personal contacts). Self-care consists of symptom recognition, handling life through planning, and accommodating the existing situation with the ultimate goal of maintaining well-being. Being one step ahead facilitates living with IBD. A decision to actively participate in care of a chronic illness is a prerequisite for self-care. Healthcare professionals must consider patients' potential for and desire for self-care when giving advice on self-care activities. Doing so may help people better cope with IBD. PMID:26166423

  1. Skin flaps and grafts - self-care

    MedlinePlus

    ... Free flap - self-care; Skin autografting - self-care; Pressure ulcer skin flap self-care; Burns skin flap self- ... skin infection Surgery for skin cancer Venous ulcers , pressure ulcers , or diabetic ulcers that DO NOT heal After ...

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

    PubMed

    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

    2012-06-01

    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= < 0.001) less engaged with their healthcare providers. Given the difference in substance use by perceived GSE, and the importance of engagement with the healthcare provider, more attention to the resolution of the concerns of those with low GSE by healthcare providers is warranted. PMID:22612448

  3. Human bites - self-care

    MedlinePlus

    Bites - human - self-care ... Human bites can occur in 2 ways: If someone bites you If your hand comes into contact ... bite to express anger or other negative feelings. Human bites may be more dangerous than animal bites. ...

  4. An integrative literature review on nursing interventions aimed at increasing self-care among heart failure patients 1

    PubMed Central

    Boisvert, Sophie; Proulx-Belhumeur, Alexandra; Gonçalves, Natalia; Doré, Michel; Francoeur, Julie; Gallani, Maria Cecilia

    2015-01-01

    Abstract Objective: to analyze and summarize knowledge concerning critical components of interventions that have been proposed and implemented by nurses with the aim of optimizing self-care by heart failure patients. Methods: PubMed and CINAHL were the electronic databases used to search full peer-reviewed papers, presenting descriptions of nursing interventions directed to patients or to patients and their families and designed to optimize self-care. Forty-two studies were included in the final sample (n=4,799 patients). Results: this review pointed to a variety and complexity of nursing interventions. As self-care encompasses several behaviors, interventions targeted an average of 3.6 behaviors. Educational/counselling activities were combined or not with cognitive behavioral strategies, but only about half of the studies used a theoretical background to guide interventions. Clinical assessment and management were frequently associated with self-care interventions, which varied in number of sessions (1 to 30); length of follow-up (2 weeks to 12 months) and endpoints. Conclusions: these findings may be useful to inform nurses about further research in self-care interventions in order to propose the comparison of different modalities of intervention, the use of theoretical background and the establishment of endpoints to evaluate their effectiveness. PMID:26444179

  5. Animal bites - self-care

    MedlinePlus

    Bites - animals - self-care ... Most animal bites come from pets. Dog bites are common and most often happen to children. Cat bites are ... which can cause deeper puncture wounds. Most other animal bites are caused by stray or wild animals, ...

  6. Teaching Self-Care Skills.

    ERIC Educational Resources Information Center

    Koblinsky, Sally A.; Todd, Christine M.

    1991-01-01

    Survival skills instruction for latchkey kids with special needs is discussed. Methods for cultivation of skills pertaining to physical well-being, accident prevention, emergency procedures, healthy lifestyles, and mental, social and emotional well-being are described. Sources of model programs and curriculum materials for self-care skills…

  7. Diabetes - low blood sugar - self-care

    MedlinePlus

    Hypoglycemia - self-care; Low blood glucose - self-care ... Talk with your health care provider about when you should check your blood sugar every day. People who have low blood sugar need to check ...

  8. Cardiac rehabilitation with a nurse case manager (GoHeart) across local and regional health authorities improves risk factors, self-care and psychosocial outcomes. A one-year follow-up study

    PubMed Central

    Maindal, Helle Terkildsen

    2014-01-01

    Objectives In Denmark, the local and regional health authorities share responsibility for cardiac rehabilitation (CR). The objective was to assess effectiveness of CR across sectors coordinated by a nurse case manager (NCM). Design A one-year follow-up study. Setting A CR programme (GoHeart) was evaluated in a cohort at Lillebaelt Hospital Vejle, DK from 2010 to 2011. Participants Consecutive patients admitted to CR were included. The inclusion criteria were the event of acute myocardial infarction or stable angina and invasive revascularization (left ventricular ejection fraction (LVEF) ≥45%). Main outcome measures Cardiac risk factors, stratified self-care and self-reported psychosocial factors (SF12 and Hospital Anxiety and Depression Scale (HADS)) were assessed at admission (phase IIa), at three months at discharge (phase IIb) and at one-year follow-up (phase III). Intention-to-treat and predefined subgroup analysis on sex was performed. Results Of 241 patients, 183 (75.9%) were included (mean age 63.8 years). At discharge improvements were found in total-cholesterol (p < 0.001), low density lipoprotein (LDL; p < 0.001), functional capacities (metabolic equivalent of tasks (METS), p < 0.01), self-care management (p < 0.001), Health status Short Form 12 version (SF12; physical; p < 0.001 and mental; p < 0.01) and in depression symptoms (p < 0.01). At one-year follow-up these outcomes were maintained; additionally there was improvement in body mass index (BMI; p < 0.05), and high density lipoprotein (HDL; p < 0.05). There were no sex differences. Conclusion CR shared between local and regional health authorities led by a NCM (GoHeart) improves risk factors, self-care and psychosocial factors. Further improvements in most variables were at one-year follow-up. PMID:25396055

  9. Care for the Caregiver: Evaluation of Mind-Body Self-Care for Accelerated Nursing Students.

    PubMed

    Drew, Barbara L; Motter, Tracey; Ross, Ratchneewan; Goliat, Laura M; Sharpnack, Patricia A; Govoni, Amy L; Bozeman, Michelle C; Rababah, Jehad

    2016-01-01

    Stress affects the well-being of both nursing students and the individuals with whom they work. With the theory of cognitive appraisal as a framework for this study, it is proposed that mind-body self-care strategies promote stress management by stabilization of emotions. Outcomes will be a perception of less stress and more mindful engagement with the environment. Objective of the study was to describe an evaluation of student perceived stress and mindfulness to 1-hour per week of class time dedicated to mind-body self-care (yoga, mindful breathing, Reiki, and essential oil therapy). It was a quasi-experimental study; data collection took place at 4 time points. Participants were entry-level accelerated nursing students from 3 US universities: 50 in the treatment group, 64 in the comparison group. Data included health-promoting practices using Health-Promoting Promotion Lifestyle Profile II as a control variable, stress and mindfulness (Perceived Stress Scale [PSS] and Mindful Attention Awareness Scale [MAAS]), and demographic information; analysis using mixed-design repeated-measures analysis of variances. There was a statistically significant interaction between intervention and time on PSS scores, F(3, 264) = 3.95, P = .009, partial η(2) = 0.043, with PSS scores of the intervention group decreasing from baseline to T3 when intervention ended whereas PSS scores of the comparison group increased from baseline. The average scores on the MAAS did not differ significantly. Evaluation of an embedded mind-body self-care module in the first nursing course demonstrated promising improvements in stress management. The findings support the appropriateness of integrating mind-body self-care content into nursing curricula to enhance students' ability to regulate stress.

  10. Care for the Caregiver: Evaluation of Mind-Body Self-Care for Accelerated Nursing Students.

    PubMed

    Drew, Barbara L; Motter, Tracey; Ross, Ratchneewan; Goliat, Laura M; Sharpnack, Patricia A; Govoni, Amy L; Bozeman, Michelle C; Rababah, Jehad

    2016-01-01

    Stress affects the well-being of both nursing students and the individuals with whom they work. With the theory of cognitive appraisal as a framework for this study, it is proposed that mind-body self-care strategies promote stress management by stabilization of emotions. Outcomes will be a perception of less stress and more mindful engagement with the environment. Objective of the study was to describe an evaluation of student perceived stress and mindfulness to 1-hour per week of class time dedicated to mind-body self-care (yoga, mindful breathing, Reiki, and essential oil therapy). It was a quasi-experimental study; data collection took place at 4 time points. Participants were entry-level accelerated nursing students from 3 US universities: 50 in the treatment group, 64 in the comparison group. Data included health-promoting practices using Health-Promoting Promotion Lifestyle Profile II as a control variable, stress and mindfulness (Perceived Stress Scale [PSS] and Mindful Attention Awareness Scale [MAAS]), and demographic information; analysis using mixed-design repeated-measures analysis of variances. There was a statistically significant interaction between intervention and time on PSS scores, F(3, 264) = 3.95, P = .009, partial η(2) = 0.043, with PSS scores of the intervention group decreasing from baseline to T3 when intervention ended whereas PSS scores of the comparison group increased from baseline. The average scores on the MAAS did not differ significantly. Evaluation of an embedded mind-body self-care module in the first nursing course demonstrated promising improvements in stress management. The findings support the appropriateness of integrating mind-body self-care content into nursing curricula to enhance students' ability to regulate stress. PMID:27078809

  11. Thermal management in high average power pulsed compression systems

    SciTech Connect

    Wavrik, R.W.; Reed, K.W.; Harjes, H.C.; Weber, G.J.; Butler, M.; Penn, K.J.; Neau, E.L.

    1992-08-01

    High average power repetitively pulsed compression systems offer a potential source of electron beams which may be applied to sterilization of wastes, treatment of food products, and other environmental and consumer applications. At Sandia National Laboratory, the Repetitive High Energy Pulsed Power (RHEPP) program is developing a 7 stage magnetic pulse compressor driving a linear induction voltage adder with an electron beam diode load. The RHEPP machine is being design to deliver 350 kW of average power to the diode in 60 ns FWHM, 2.5 MV, 3 kJ pulses at a repetition rate of 120 Hz. In addition to the electrical design considerations, the repetition rate requires thermal management of the electrical losses. Steady state temperatures must be kept below the material degradation temperatures to maximize reliability and component life. The optimum design is a trade off between thermal management, maximizing overall electrical performance of the system, reliability, and cost effectiveness. Cooling requirements and configurations were developed for each of the subsystems of RHEPP. Finite element models that combine fluid flow and heat transfer were used to screen design concepts. The analysis includes one, two, and three dimensional heat transfer using surface heat transfer coefficients and boundary layer models. Experiments were conducted to verify the models as well as to evaluate cooling channel fabrication materials and techniques in Metglas wound cores. 10 refs.

  12. Thermal management in high average power pulsed compression systems

    SciTech Connect

    Wavrik, R.W.; Reed, K.W.; Harjes, H.C.; Weber, G.J.; Butler, M.; Penn, K.J.; Neau, E.L.

    1992-01-01

    High average power repetitively pulsed compression systems offer a potential source of electron beams which may be applied to sterilization of wastes, treatment of food products, and other environmental and consumer applications. At Sandia National Laboratory, the Repetitive High Energy Pulsed Power (RHEPP) program is developing a 7 stage magnetic pulse compressor driving a linear induction voltage adder with an electron beam diode load. The RHEPP machine is being design to deliver 350 kW of average power to the diode in 60 ns FWHM, 2.5 MV, 3 kJ pulses at a repetition rate of 120 Hz. In addition to the electrical design considerations, the repetition rate requires thermal management of the electrical losses. Steady state temperatures must be kept below the material degradation temperatures to maximize reliability and component life. The optimum design is a trade off between thermal management, maximizing overall electrical performance of the system, reliability, and cost effectiveness. Cooling requirements and configurations were developed for each of the subsystems of RHEPP. Finite element models that combine fluid flow and heat transfer were used to screen design concepts. The analysis includes one, two, and three dimensional heat transfer using surface heat transfer coefficients and boundary layer models. Experiments were conducted to verify the models as well as to evaluate cooling channel fabrication materials and techniques in Metglas wound cores. 10 refs.

  13. Implementation of a self-care of heart failure program among home-based clients.

    PubMed

    Bryant, Rebecca; Gaspar, Phyllis

    2014-01-01

    Heart failure is the most common admission in hospitals among Medicare recipients aged 65 years or older. Self-care management of heart failure has been reported to decrease heart failure hospital admission rates. The purpose of this evidence-based practice project was to examine how a self-care of heart failure program (Heart Failure Self-care to Success) impacts hospital admissions and patient perceptions of self-care management. Heart Failure Self-care to Success (HF S2S) was successfully implemented with 18 participants by nurse practitioners in a house call practice. Six months following implementation of the self-care of heart failure program no heart failure admissions occurred among participants and a significant increase in their self-care of heart failure behaviors (p < .01) was reported by participants. Nurse practitioners using HF S2S can decrease health care costs and improve self-care behaviors in the older, homebound heart failure patient. Further testing of HF S2S is recommended in different practice settings, sample populations, and geographic locations.

  14. Prevalence, self-care behaviors, and self-care activities for peripheral neuropathy symptoms of HIV/AIDS.

    PubMed

    Nicholas, Patrice K; Voss, Joachim; Wantland, Dean; Lindgren, Teri; Huang, Emily; Holzemer, William L; Cuca, Yvette; Moezzi, Shahnaz; Portillo, Carmen; Willard, Suzanne; Arudo, John; Kirksey, Kenn; Corless, Inge B; Rosa, María E; Robinson, Linda; Hamilton, Mary J; Sefcik, Elizabeth; Human, Sarie; Rivero-Mendez, Marta; Maryland, Mary; Nokes, Kathleen M; Eller, Lucille; Kemppainen, Jeanne; Dawson-Rose, Carol; Brion, John M; Bunch, Elli H; Shannon, Maureen; Nicholas, Thomas P; Viamonte-Ros, Ana; Bain, Catherine A

    2010-03-01

    As part of a larger randomized controlled trial examining the efficacy of an HIV/AIDS symptom management manual (n = 775), this study examined the prevalence of peripheral neuropathy in HIV-infected individuals at 12 sites in the USA, Puerto Rico, and Africa. Neuropathy was reported by 44% of the sample; however, only 29.4% reported initiating self-care behaviors to address the neuropathy symptoms. Antiretroviral therapy was found to increase the frequency of neuropathy symptoms, with an increased mean intensity of 28%. A principal axis factor analysis with Promax rotation was used to assess the relationships in the frequency of use of the 18 self-care activities for neuropathy, revealing three distinct factors: (i) an interactive self-care factor; (ii) a complementary medicine factor; and (iii) a third factor consisting of the negative health items of smoking, alcohol, and street drugs. The study's results suggest that peripheral neuropathy is a common symptom and the presence of neuropathy is associated with self-care behaviors to ameliorate HIV symptoms. The implications for nursing practice include the assessment and evaluation of nursing interventions related to management strategies for neuropathy. PMID:20487335

  15. Urinary tract infection in women - self-care

    MedlinePlus

    UTI - self-care; Cystitis - self-care; Bladder infection - self-care ... BATHING AND HYGIENE To prevent future urinary tract infections, you should: Choose sanitary pads instead of tampons, which some doctors believe make infections more likely. Change your ...

  16. Using an electronic self-management tool to support patients with chronic kidney disease (CKD): a CKD clinic self-care model.

    PubMed

    Ong, Stephanie W; Jassal, Sarbjit V; Porter, Eveline; Logan, Alexander G; Miller, Judith A

    2013-01-01

    New healthcare delivery models are needed to enhance the patient experience and improve quality of care for individuals with chronic conditions such as kidney disease. One potential avenue is to implement self-management strategies. There is growing evidence that self-management interventions help optimize various aspects of chronic disease management. With the increasing use of information technology (IT) in health care, chronic disease management programs are incorporating IT solutions to support patient self-management practices. IT solutions have the ability to promote key principles of self-management, namely education, empowerment, and collaboration. Positive clinical outcomes have been demonstrated for a number of chronic conditions when IT solutions were incorporated into self-management programs. There is a paucity of evidence for self-management in chronic kidney disease (CKD) patients. Furthermore, IT strategies have not been tested in this patient population to the same extent as other chronic conditions (e.g., diabetes, hypertension). Therefore, it is currently unknown if IT strategies will promote self-management behaviors and lead to improvements in overall patient care. We designed and developed an IT solution called My KidneyCare Centre to support self-management strategies for patients with CKD. In this review, we discuss the rationale and vision of incorporating an electronic self-management tool to support the care of patients with CKD.

  17. Peripheral artery disease of the legs - self-care

    MedlinePlus

    Peripheral vascular disease - self-care; Intermittent claudication - self-care ... may prescribe the following medicines to control your peripheral artery disease. DO NOT stop taking these medicines ...

  18. Self-Care Behaviors and Related Factors in Hypertensive Patients

    PubMed Central

    Zinat Motlagh, Sayed Fazel; Chaman, Reza; Sadeghi, Erfan; Eslami, Ahmad Ali

    2016-01-01

    Background An assessment of an individual’s hypertension self-care behavior may provide clinicians and practitioners with important information regarding how to better control hypertension. Objectives The objective of this study was to investigate the self-care behaviors of hypertensive patients. Patients and Methods This cross-sectional study was conducted in 2014 in a sample of 1836 patients of both genders who had been diagnosed with hypertension in urban and rural health centers in the Kohgiluyeh Boyerahmad Province in southern Iran. They were randomly selected and were invited to participate in the study. Self-care activities were measured using the H-hypertension self-care activity level effects. Results The mean age of the respondents was 63 (range: 30 - 92), and 36.1% reported adherence to the recommended levels of medication; 24.5% followed the physical activity level guidelines. Less than half (39.2%) met the criteria for practices related to weight management, and adherence to low-salt diet recommendations was also low (12.3%). Overall, 86.7% were nonsmokers, and 100% abstained from alcohol. The results of a logistic regression indicated that gender was significantly associated with adherence to physical activity (OR = 0.716) and non-smoking (OR = 1.503) recommendations; that is, women were more likely to take part in physical activity than men. There was also a significant association between age and adherence to both a low-salt diet (OR = 1.497) and medication (OR = 1.435). Conclusions Based on our findings, it is crucial to implement well-designed educational programs to improve hypertension self-care behaviors.

  19. Self-Care Behaviors and Related Factors in Hypertensive Patients

    PubMed Central

    Zinat Motlagh, Sayed Fazel; Chaman, Reza; Sadeghi, Erfan; Eslami, Ahmad Ali

    2016-01-01

    Background An assessment of an individual’s hypertension self-care behavior may provide clinicians and practitioners with important information regarding how to better control hypertension. Objectives The objective of this study was to investigate the self-care behaviors of hypertensive patients. Patients and Methods This cross-sectional study was conducted in 2014 in a sample of 1836 patients of both genders who had been diagnosed with hypertension in urban and rural health centers in the Kohgiluyeh Boyerahmad Province in southern Iran. They were randomly selected and were invited to participate in the study. Self-care activities were measured using the H-hypertension self-care activity level effects. Results The mean age of the respondents was 63 (range: 30 - 92), and 36.1% reported adherence to the recommended levels of medication; 24.5% followed the physical activity level guidelines. Less than half (39.2%) met the criteria for practices related to weight management, and adherence to low-salt diet recommendations was also low (12.3%). Overall, 86.7% were nonsmokers, and 100% abstained from alcohol. The results of a logistic regression indicated that gender was significantly associated with adherence to physical activity (OR = 0.716) and non-smoking (OR = 1.503) recommendations; that is, women were more likely to take part in physical activity than men. There was also a significant association between age and adherence to both a low-salt diet (OR = 1.497) and medication (OR = 1.435). Conclusions Based on our findings, it is crucial to implement well-designed educational programs to improve hypertension self-care behaviors. PMID:27621938

  20. Evolution of self-care education.

    PubMed

    Ambizas, Emily M; Bastianelli, Karen M S; Ferreri, Stefanie P; Haines, Seena L; Orr, Katherine Kelly; Stutz, Misty M; Vanamburgh, Jenny A; Wilhelm, Miranda

    2014-03-12

    During the past 15 years, the curriculum content for nonprescription medication and self-care therapeutics has expanded significantly. Self-care courses ranging from stand-alone, required courses to therapeutic content and skills laboratories, have evolved in colleges and schools of pharmacy to accommodate rapid changes related to nonprescription medications and to meet the needs of students. The design of and content delivery methods used in self-care courses vary among institutions. Teaching innovations such as team-based learning, role playing/vignettes, videos, and social media, as well as interdisciplinary learning have enhanced delivery of this content. Given that faculty members train future pharmacists, they should be familiar with the new paradigms of Nonprescription Safe Use Regulatory Expansion (NSURE) Initiative, nonprescription medications for chronic diseases, and the growing trends of health and wellness in advancing patient-care initiatives. This paper reviews the significant changes that may be impacting self-care curriculums in the United States.

  1. A study of self-care among Irish doctors.

    PubMed

    Clarke, J; O'Sullivan, Y; Maguire, N

    1998-01-01

    Little is known about the self care employed by Irish doctors, though studies in other countries suggest this is likely to be less than ideal. In this study 76 doctors; general practitioner trainees, general practitioners and hospital consultants, completed a questionnaire on their self management of illness. High levels of self-prescribing and referral were discovered. The implications for the health of doctors in Ireland and the need for an occupational health service for doctors are discussed. PMID:9973754

  2. Support for disease management, depression, self-care, and clinical indicators among Hispanics with type 2 diabetes in San Diego County, United States of America.

    PubMed

    Fortmann, Addie L; Gallo, Linda C; Walker, Chris; Philis-Tsimikas, Athena

    2010-09-01

    This study used a social-ecological framework to examine predictors of depression, diabetes self-management, and clinical indicators of health risk among Hispanics with type 2 diabetes residing in the United States (U.S.)-Mexico border region in San Diego County, California, United States of America. Important links were observed between greater social-environmental support for disease management and less depression, better diabetes self-management, and lower body mass index and serum triglyceride concentrations. Less depressive symptomatology was also related to lower hemoglobin A1c levels. Findings suggest that programs aiming to improve diabetes self-management and health outcomes in Hispanics with type 2 diabetes should consider multilevel, social, and environmental influences on health, behavior, and emotional well-being.

  3. Educating Home Healthcare Nurses About Heart Failure Self-Care.

    PubMed

    Ekong, Joyce; Radovich, Patti; Brown, Gina

    2016-10-01

    The ability of home healthcare nurses to effectively educate patients with heart failure (HF) on appropriate self-care is key to lowering the hospital readmission rates and other adverse outcomes. Evidence indicates, however, that nurses often lack current knowledge about HF self-care. Furthermore, patient education often fails to produce health literacy. Thus, this educational intervention for home healthcare nurses included content about key aspects of managing HF (e.g., diet, medications), as well as how to use the teach-back method during patient education. Pre- and posttesting (using the Nurses' Knowledge of HF Education Principles Questionnaire) and role-playing were used to evaluate the intervention delivered to 33 home care nurses. Findings exposed knowledge deficits regarding high-sodium foods, symptoms indicating deterioration, problematic weight gain, fluid management, as well as other topics related to HF. The education was partially effective in addressing these nurses' knowledge gaps. The evidence-based education for home healthcare nurses suggests that not only may nurses lack knowledge essential to teaching HF self-care; they may also lack effective patient education skills such as using the teach-back method. PMID:27677064

  4. Young People's Participation in the Development of a Self-Care Intervention--A Multi-Site Formative Research Study

    ERIC Educational Resources Information Center

    Kime, Nicola; McKenna, Jim; Webster, Liz

    2013-01-01

    The poor outcomes of young people with chronic health conditions indicate that current services and self-care programmes are not meeting the needs of young people. How young people self-manage their condition impacts on long-term health outcomes, but there is little published evidence that details the development of self-care programmes and their…

  5. Large-Scale Survey Findings Inform Patients’ Experiences in Using Secure Messaging to Engage in Patient-Provider Communication and Self-Care Management: A Quantitative Assessment

    PubMed Central

    Patel, Nitin R; Lind, Jason D; Antinori, Nicole

    2015-01-01

    Background Secure email messaging is part of a national transformation initiative in the United States to promote new models of care that support enhanced patient-provider communication. To date, only a limited number of large-scale studies have evaluated users’ experiences in using secure email messaging. Objective To quantitatively assess veteran patients’ experiences in using secure email messaging in a large patient sample. Methods A cross-sectional mail-delivered paper-and-pencil survey study was conducted with a sample of respondents identified as registered for the Veteran Health Administrations’ Web-based patient portal (My HealtheVet) and opted to use secure messaging. The survey collected demographic data, assessed computer and health literacy, and secure messaging use. Analyses conducted on survey data include frequencies and proportions, chi-square tests, and one-way analysis of variance. Results The majority of respondents (N=819) reported using secure messaging 6 months or longer (n=499, 60.9%). They reported secure messaging to be helpful for completing medication refills (n=546, 66.7%), managing appointments (n=343, 41.9%), looking up test results (n=350, 42.7%), and asking health-related questions (n=340, 41.5%). Notably, some respondents reported using secure messaging to address sensitive health topics (n=67, 8.2%). Survey responses indicated that younger age (P=.039) and higher levels of education (P=.025) and income (P=.003) were associated with more frequent use of secure messaging. Females were more likely to report using secure messaging more often, compared with their male counterparts (P=.098). Minorities were more likely to report using secure messaging more often, at least once a month, compared with nonminorities (P=.086). Individuals with higher levels of health literacy reported more frequent use of secure messaging (P=.007), greater satisfaction (P=.002), and indicated that secure messaging is a useful (P=.002) and easy

  6. Helping Your Child Learn Self-Care.

    ERIC Educational Resources Information Center

    Murphy, Linda; Corte, Suzanne Della

    1987-01-01

    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…

  7. Evolution of self-care education.

    PubMed

    Ambizas, Emily M; Bastianelli, Karen M S; Ferreri, Stefanie P; Haines, Seena L; Orr, Katherine Kelly; Stutz, Misty M; Vanamburgh, Jenny A; Wilhelm, Miranda

    2014-03-12

    During the past 15 years, the curriculum content for nonprescription medication and self-care therapeutics has expanded significantly. Self-care courses ranging from stand-alone, required courses to therapeutic content and skills laboratories, have evolved in colleges and schools of pharmacy to accommodate rapid changes related to nonprescription medications and to meet the needs of students. The design of and content delivery methods used in self-care courses vary among institutions. Teaching innovations such as team-based learning, role playing/vignettes, videos, and social media, as well as interdisciplinary learning have enhanced delivery of this content. Given that faculty members train future pharmacists, they should be familiar with the new paradigms of Nonprescription Safe Use Regulatory Expansion (NSURE) Initiative, nonprescription medications for chronic diseases, and the growing trends of health and wellness in advancing patient-care initiatives. This paper reviews the significant changes that may be impacting self-care curriculums in the United States. PMID:24672061

  8. College Student Self-Care Diary.

    ERIC Educational Resources Information Center

    Greenberg, Jerrold S.; Dintiman, George B.

    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…

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

    ERIC Educational Resources Information Center

    Lin, Yii-Nii

    2012-01-01

    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…

  10. Self-care Concept Analysis in Cancer Patients: An Evolutionary Concept Analysis

    PubMed Central

    Hasanpour-Dehkordi, Ali

    2016-01-01

    Background: Self-care is a frequently used concept in both the theory and the clinical practice of nursing and is considered an element of nursing theory by Orem. The aim of this paper is to identify the core attributes of the self-care concept in cancer patients. Materials and Methods: We used Rodgers’ evolutionary method of concept analysis. The articles published in English language from 1980 to 2015 on nursing and non-nursing disciplines were analyzed. Finally, 85 articles, an MSc thesis, and a PhD thesis were selected, examined, and analyzed in-depth. Two experts checked the process of analysis and monitored and reviewed the articles. Results: The analysis showed that self-care concept is determined by four attributes of education, interaction, self-control, and self-reliance. Three types of antecedents in the present study were client-related (self-efficacy, self-esteem), system-related (adequate sources, social networks, and cultural factors), and healthcare professionals-related (participation). Conclusion: The self-care concept has considerably evolved among patients with chronic diseases, particularly cancer, over the past 35 years, and nurses have managed to enhance their knowledge about self-care remarkably for the clients so that the nurses in healthcare teams have become highly efficient and able to assume the responsibility for self-care teams. PMID:27803559

  11. Complementary Self-Care Strategies for Healthy Aging.

    ERIC Educational Resources Information Center

    Barrett, Sondra

    1993-01-01

    Focuses on alternative self-care practices in terms of collaboration with the primary care physician and individual exploration of self-care practices such as acupuncture, meditation, and nutrition counseling. (JOW)

  12. Teaching Counselors Self-Care through Mindfulness Practices

    ERIC Educational Resources Information Center

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

    2006-01-01

    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…

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

    ERIC Educational Resources Information Center

    Lord, Heather; Mahoney, Joseph L.

    2007-01-01

    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…

  14. Patients’ Perspectives on Factors that Influence Diabetes Self-Care

    PubMed Central

    Shakibazadeh, E; Larijani, B; Shojaeezadeh, D; Rashidian, A; Forouzanfar, MH; Bartholomew, LK

    2011-01-01

    Background Although diabetes mellitus is of high concern in Iran, and the level of control is unacceptable, few qualitative studies have been carried out to reflect the experiences of patients on the barriers and motivators to self-care. This study aimed to explore a culturally based experience of Iranian diabetic patients regarding the personal and environmental barriers to and facilitating factors for diabetes self-care. Methods: Six focus groups were conducted among type 2 diabetic patients in the Charity Foundation for Special Diseases’ diabetes clinic. Purposeful sampling was used. Newly diagnosed patients (less than six months) and all type 1 diabetic patients were excluded. Three focus groups were held on for each sex. A total of 43 patients participated in the study. Frame-work analysis was used to extract the themes from the data. Results: Data analysis showed five main barriers: physical barriers (such as physical effects of diabetes); psychological barriers (such as health beliefs); educational barriers (such as lack of knowledge about diabetes); social barriers (such as group pressure); and care system barriers (such as service availability). Along with the barriers, there were some motivators that the participants mentioned as a stimuli to control their diabetes. They include beliefs about diabetes, perceived responsibility for family, religious beliefs, and the views of significant others. Conclusion: Culturally based interventions are needed to improve diabetes care management in Iran. In addition to personal factors, diabetes health educators should pay attention to the environmental factors when they develop programs. PMID:23113114

  15. Self-Care Strategies among Chinese Adolescent Girls with Dysmenorrhea: A Qualitative Study.

    PubMed

    Wong, Cho Lee; Ip, Wan Yim; Lam, Lai Wah

    2016-08-01

    Little is known about how Chinese adolescent girls manage dysmenorrhea. This study aims to explore self-care strategies among Chinese adolescent girls with dysmenorrhea. The study uses a mixed methods design with two phases: a cross-sectional survey in phase I and semistructured interviews in phase II. This paper reports phase II. In line with the phase I findings, 28 adolescent girls with different characteristics (high or low levels of self-care behavior and pain intensity, who did or did not self-medicate, and who had or had not received menstrual education) were recruited for interviews. Content analysis was used for data analysis. Four categories emerged from the data: lifestyle changes, symptom management, communicating dysmenorrhea with others, and seeking medical advice. Girls selected their diets carefully and reduced physical activity during menstruation to avoid aggravating symptoms. Heat therapy commonly was employed for symptom management. A few girls self-medicated to obtain immediate relief from pain, but the majority expressed reservations about using medication because they worried about dependence and side effects. Some girls communicated dysmenorrhea with their family and friends, but the majority did not seek medical advice. The present study showed that girls employed various self-care strategies for dysmenorrhea, including some strategies stemming from traditional Chinese medicine. The findings revealed menstrual etiquette among Chinese adolescent girls with dysmenorrhea, and demonstrated that self-medication was not part of most girls' self-care. Understanding the self-care strategies of these girls is important, as it can help nurses develop a culturally-specific intervention to promote self-care among adolescent girls with dysmenorrhea.

  16. Self-Care Strategies among Chinese Adolescent Girls with Dysmenorrhea: A Qualitative Study.

    PubMed

    Wong, Cho Lee; Ip, Wan Yim; Lam, Lai Wah

    2016-08-01

    Little is known about how Chinese adolescent girls manage dysmenorrhea. This study aims to explore self-care strategies among Chinese adolescent girls with dysmenorrhea. The study uses a mixed methods design with two phases: a cross-sectional survey in phase I and semistructured interviews in phase II. This paper reports phase II. In line with the phase I findings, 28 adolescent girls with different characteristics (high or low levels of self-care behavior and pain intensity, who did or did not self-medicate, and who had or had not received menstrual education) were recruited for interviews. Content analysis was used for data analysis. Four categories emerged from the data: lifestyle changes, symptom management, communicating dysmenorrhea with others, and seeking medical advice. Girls selected their diets carefully and reduced physical activity during menstruation to avoid aggravating symptoms. Heat therapy commonly was employed for symptom management. A few girls self-medicated to obtain immediate relief from pain, but the majority expressed reservations about using medication because they worried about dependence and side effects. Some girls communicated dysmenorrhea with their family and friends, but the majority did not seek medical advice. The present study showed that girls employed various self-care strategies for dysmenorrhea, including some strategies stemming from traditional Chinese medicine. The findings revealed menstrual etiquette among Chinese adolescent girls with dysmenorrhea, and demonstrated that self-medication was not part of most girls' self-care. Understanding the self-care strategies of these girls is important, as it can help nurses develop a culturally-specific intervention to promote self-care among adolescent girls with dysmenorrhea. PMID:27292081

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

    PubMed Central

    Peters, Rosalind M.; Templin, Thomas N.

    2013-01-01

    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 (α=.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. PMID:20949834

  18. Theory of planned behavior, self-care motivation, and blood pressure self-care.

    PubMed

    Peters, Rosalind M; Templin, Thomas N

    2010-01-01

    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 (alpha = .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.

  19. Bridging the Self-care Deficit Gap: Remote Patient Monitoring and the Hospital-at-Home

    NASA Astrophysics Data System (ADS)

    Cafazzo, Joseph A.; Leonard, Kevin; Easty, Anthony C.; Rossos, Peter G.; Chan, Christopher T.

    This study examines the use of a remote patient monitoring intervention to address the challenge of patient self-care in complex hospital-at-home therapies. It was shown that in a home hemodialysis patient group, remote patient monitoring facilitated self-care and was supported by patients and, in particular, family caregivers. This does not come without cost to the patient however, who now has greater personal responsibility and accountability for their health management. Promising results from this study indicate that most patients are willing to assume this cost in exchange for the possibility of improved health outcomes.

  20. Self-care actions taken by older adults for influenza and colds.

    PubMed

    Conn, V

    1991-01-01

    The purpose of this study was to examine self-care behaviors that older adults use to manage cold and influenza episodes. Interviews were conducted with 160 adults aged 65 to 94. A large number and a variety of cold- and influenza-related self-care actions were reported. Medication administration was found to be common for colds (79% of subjects) and influenza (95%). Subjects reported more illness-specific preventive behaviors for influenza than for colds. Influenza vaccination behavior was related to experiences with vaccination-associated illness, health state, and talking with physicians about vaccination. Few subjects identified potential hazards associated with influenza or colds.

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

    PubMed Central

    Hanna, Kathleen M.; Decker, Carol L.

    2009-01-01

    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. PMID:20367781

  2. Self-care and mothering in African American women with HIV/AIDS.

    PubMed

    Shambley-Ebron, Donna Z; Boyle, Joyceen S

    2006-02-01

    African American women are the most rapidly growing group of people in the United States diagnosed with HIV/AIDS. The purpose of this study was to explore experiences of self-care and mothering among African American women with HIV/AIDS. It is important to recognize how culture affects illness management, childrearing, and daily living to design culturally appropriate nursing interventions for African American women. Critical ethnography was used to study 10 African American mothers from the rural Southeast who were HIV positive and mothered children who were HIV positive. Domains derived from the research were disabling relationships, strong mothering, and redefining self-care. The cultural theme was creating a life of meaning. African American mothers with HIV/AIDS in the rural Southeast used culturally specific self-care and mothering strategies reflective of cultural traditions. This study acknowledges strengths of African American women and generates theory that will enhance nursing care to this population. PMID:16676725

  3. Using the Open Airways Curriculum to Improve Self-Care for Third Grade Children with Asthma.

    ERIC Educational Resources Information Center

    Horner, Sharon D.

    1998-01-01

    Examined the effect of a school-based asthma management program, which featured brief class sessions, for improving the knowledge and self-care of third graders with asthma and increasing parents' awareness. Pre- and postintervention parent and student surveys indicated that brief class sessions were feasible, and children demonstrated increased…

  4. Phenomenological perspectives on self-care in aging

    PubMed Central

    Söderhamn, Olle

    2013-01-01

    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

  5. Illness Beliefs in End Stage Renal Disease and Associations with Self-Care Modality Choice

    PubMed Central

    Jayanti, Anuradha; Foden, Philip; Wearden, Alison; Mitra, Sandip

    2016-01-01

    Background Interest in self-care haemodialysis (HD) has increased because it improves patients’clinical and quality-of-life outcomes. Patients who undertake self-management for haemodialysis may hold illness beliefs differently to those choosing institutional care at the time of making the modality choice or moulded by their illness and dialysis treatment experience. Illness perceptions amongst predialysis patients and in those undertaking fully-assisted and self-care haemodialysis are being investigated in a combined cross-sectional and longitudinal study. Study Design The study data are derived from the BASIC-HHD study, a multicentre observational study on factors influencing home haemodialysis uptake. 535 patients were enrolled into three groups: Predialysis CKD-5 group, prevalent ‘in-centre’ HD and self-care HD groups (93% at home). We explore illness perceptions in the cross-sectional analyses of the three study groups, using the revised Illness Perception Questionnaire (IPQ-R). Predialysis patients’ illness beliefs were reassessed prospectively, typically between 4 and 12 months after dialysis commencement. Results Illness belief subscales are significantly different between in-centre and self-care HD groups. In a step-wise hierarchical regression analysis, after adjustment for age, education, marital status, diabetes, dialysis vintage, depression, anxiety scores, and IPQ-R subscales, personal control (p = 0.01) and illness coherence (p = 0.04) are significantly higher in the self-care HD group. In the predialysis group, no significant associations were found between illness representations and modality choices. In prospectively observed predialysis group, scores for personal control, treatment control, timeline cyclical and emotional representations reduced significantly after commencing dialysis and increased significantly for illness coherence. Conclusions Illness beliefs differ between hospital and self-care haemodialysis patients. Patient

  6. Children in Self-Care: An Exploratory Study.

    ERIC Educational Resources Information Center

    Stewart, Martha

    Before- and after-school care arrangements for third- and fifth-grade students were investigated, with specific attention given to the extent of self-care arrangements, satisfaction levels of parents and children using self-care, and variables contributing to satisfaction. The sample included 675 students attending Newington Elementary School in…

  7. Introducing Medical Self-Care in the Curriculum.

    ERIC Educational Resources Information Center

    Keever, Bill D.; Lelm, Kathy

    1984-01-01

    Medical self-care is the involvement of laypersons, on their own behalf, in health promotion and decision making, disease prevention, and disease detection and treatment. A description of a self-care course that was designed and taught at Western Illinois University is offered. Results of a postcourse evaluation are presented. (DF)

  8. Certificate Program in Self-Care for Pharmacy Practice.

    ERIC Educational Resources Information Center

    Blank, Jerome W.; Popovich, Nicholas G.

    The Purdue University School of Pharmacy and Pharmacal Sciences initiated a Certificate Program in Self-Care for Pharmacy Practice. The program aimed to enable pharmacists to develop their practice to better serve the self-care needs of customers. In a pilot group 26 participating pharmacists took a sequence of home study modules and workshops…

  9. Self-care behaviour of patients with heart failure.

    PubMed

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

    2000-01-01

    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).

  10. The Practice of Self-Care among Counseling Students

    ERIC Educational Resources Information Center

    Mayorga, Mary G.; Devries, Sabina R.; Wardle, Elizabeth Ann

    2015-01-01

    Self-care behavior is recognized as an important component for the helping professional who practices in the field of counseling or who is training to become a helping professional. Occupational stress and burnout in the field of counseling is of great concern. This study examined the practice of self-care among master level counseling students to…

  11. Self-care behaviour of patients with heart failure.

    PubMed

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

    2000-01-01

    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

  12. Communication Strategies for Improving Diabetics' Self-Care.

    ERIC Educational Resources Information Center

    Pryor, Burt; Mengel, Marvin C.

    1987-01-01

    Focuses on various levels of diabetic patients' involvement in the care of their disease and effects of these levels on how closely they later followed self-care programs. Suggests that by participating in group discussions about excuses for not following a self-care regimen, and offering solutions to counter those excuses, diabetic patients…

  13. The changes and factors associated with post-discharge self-care behaviors among Chinese patients with heart failure

    PubMed Central

    Hu, Xiaolin; Hu, Xiuying; Su, Yonglin; Qu, Moying; Dolansky, Mary A

    2015-01-01

    Background Self-care behavior is essential for achieving good outcomes among patients with heart failure. Understanding the factors associated with self-care over time is important for the provision of appropriate and targeted interventions. However, little is known regarding the changes and factors associated with post-discharge self-care behaviors among Chinese patients with heart failure. Objective To investigate the changes and factors of self-care behaviors during the first 3 months following discharge among patients with heart failure in the People’s Republic of China. Methods A descriptive design with a convenience sample was utilized in this study. Patients (N=128) from two hospitals, West China Hospital and Angjin Hospital, in Chengdu, People’s Republic of China, were recruited from June 2013 to June 2014. The instruments used in the study included the following: the Social Support Rating Scale, the Hospital Anxiety and Depression Scale, the Self-Efficacy for Managing Chronic Disease 6-Item Scale, and the European Heart Failure Self-Care Behaviour Scale. Multivariate linear regression analyses were used to identify the factors related to self-care behaviors at baseline, 1 month, and 3 months following discharge. Results Patients’ self-care behaviors were poor and decreased significantly over time (F=4.09, P<0.05). The factors associated with self-care behaviors at baseline included the following: education level, comorbidities, and social support. The factors related to self-care behaviors at 1 and 3 months following discharge included the following: education level, comorbidities, social support, and self-efficacy. The variances in self-care behaviors attributed to these factors were 43%, 46%, and 42% at baseline, 1 month, and 3 months following discharge, respectively. Conclusion Additional support should be provided to patients with heart failure with low educational levels and patients with multiple comorbidities. Follow-up, continuity of care

  14. Determinants of adherence to self-care behavior among women with type 2 diabetes: an explanation based on health belief model

    PubMed Central

    Karimy, Mahmood; Araban, Marzieh; Zareban, Iraj; Taher, Mohammad; Abedi, Ahmadreza

    2016-01-01

    Background: Self-care is an essential element in treating a person with diabetes; and managing diabetes is of prime importance. The aim of this study was to investigate the predictors of adherence to self-care behavior among women with Type 2 diabetes. Methods: This cross-sectional study was conducted on 210 female patients aged 30 to 60. Data collection tool was an anonymous valid and reliable questionnaire designed based on the Health Belief Model (HBM), which acquired information about the followings: Perceived susceptibility, severity, benefits, barriers, self-efficacy and diabetes self-care behavior. Data were analyzed by t-test, chisquare and regression analysis. Results: The multiple regression models revealed 59.9% of the variance of self-care behavior with self-efficacy, perceived barrier, benefit and susceptibility. Additionally, the highest weight for β (β=0.87) was found for self-efficacy. Self-care behavior was positively correlated with all HBM variables except for perceived barriers showing a negative correlation. Conclusion: The Health Belief Model may be used as a framework to design intervention programs in an attempt to improve adherence to self-care behaviors of women with diabetes. In addition, the results indicated that self-efficacy might play a more crucial role in developing self-care behaviors than t other HBM components. Therefore, if the focus is placed on self-efficacy when developing educational programs, it may increase the likelihood of adherence to self-care behavior. PMID:27493912

  15. Evaluation of self-care practices and emotional distress among people with Type 2 diabetes mellitus in Dar es Salaam, Tanzania.

    PubMed

    Mosha, Theobald C E; Rashidi, Heri

    2009-01-01

    This study was conducted to determine self-care practices and diabetes related emotional distress among people with Type 2 diabetes mellitus in Dar es Salaam, Tanzania. A cross sectional survey-involving 121 Types 2 diabetics was conducted in 4 diabetic clinics located in Dar es Salaam. Anthropometric and biomedical measurements namely weight, height, waist, hip, mid-upper arm circumference, blood pressure and fasting blood glucose were measured. Self-care practices and diabetic related emotion distress were evaluated by using validated instruments. Results revealed that, the average fasting plasma glucose was 11.2 ± 5.5 mmol/l, blood pressure was 134.7/86.1 mm/Hg and the mean BMI for males and females were 25.0 ± 4.3 and 27.0 ± 5.1 kg/m(2), respectively. Subject's self-care score for general diet, specific diet, physical exercise, foot-care and medication were 4.6 ± 2.4, 3.7 ± 1.5, 3.4 ± 1.8, 3.6 ± 2.8 and 5.5 ± 2.8 days per week, respectively. Self-monitoring of blood glucose was irregular and only 46.3% of the subjects tested their levels of blood glucose at least once in between the appointments (90 days). Low income was the major limitation for complying with the self-care practices related to diet, blood glucose testing and medication. It is recommended that, the Government of Tanzania should in the short run subsidize the prices of diabetes drugs, remove all taxes on the glucose test kits and establish a national diabetes program that would coordinate and oversee provision of the basic services such as screening, glucose testing, medication, counseling and management of the condition. In the long run, the government should establish a preventive public health program in order to curtail the escalation of diabetes. Further research should be conducted to determine how factors such as socio-cultural and demographic, self-care, and psychosocial distress interact to determine biomedical outcomes such as blood pressure, blood glucose and body mass index

  16. Yoga for Self-Care and Burnout Prevention Among Nurses.

    PubMed

    Alexander, Gina K; Rollins, Kari; Walker, Danielle; Wong, Lily; Pennings, Jacquelyn

    2015-10-01

    The promotion of self-care and the prevention of burnout among nurses is a public health priority. Evidence supports the efficacy of yoga to improve physical and mental health outcomes, but few studies have examined the influence of yoga on nurse-specific outcomes. The purpose of this pilot-level randomized controlled trial was to examine the efficacy of yoga to improve self-care and reduce burnout among nurses. Compared with controls (n = 20), yoga participants (n = 20) reported significantly higher self-care as well as less emotional exhaustion and depersonalization upon completion of an 8-week yoga intervention. Although the control group demonstrated no change throughout the course of the study, the yoga group showed a significant improvement in scores from pre- to post-intervention for self-care (p < .001), mindfulness (p = .028), emotional exhaustion (p = .008), and depersonalization (p = .007) outcomes. Implications for practice are discussed. PMID:26419795

  17. Patient Education and Self-Care: How Do They Differ?

    ERIC Educational Resources Information Center

    Levin, Lowell S.

    1978-01-01

    The author discusses health education for the patient and the differences between patient education and the concept of self-care. Both types of programs may contribute to the public's health at different points on the same continuum. (MF)

  18. Practicing Self-Care for Nurses: A Nursing Program Initiative.

    PubMed

    Blum, Cynthia A

    2014-09-01

    Self-care is imperative to personal health, sustenance to continue to care for others, and professional growth. This article briefly reviews stressors common to students and nurses and the importance of practicing self-care to combat stress and promote health in practice. Florida Atlantic University offers a course for all levels of undergraduate nursing students called Caring for Self. The course, supported by principles of Adult Learning Theory, focuses on guiding the nurse to practice and model self-care. The author describes the evolution of this self-care initiative by discussing the needs assessment, course description and strategies, examples of course activities, and an exemplar of student impact. The conclusion offers discussion of challenges and lessons noted by faculty and students.

  19. The Integrated Patient's Self-Care Process Model.

    PubMed

    Milavec Kapun, Marija; Šusteršič, Olga; Rajkovič, Vladislav

    2016-01-01

    Long-term care is more efficient and effective when it involves the active participation of the empowered patient and informal caregivers. To achieve this, it is necessary to guide the patient and informal caregivers through the systematic process of self-care. Well-documented observations and assessments are fundamental to plan further interventions of the interdisciplinary team. A systematic literature review revealed that the self-care process and the support of information technology are focused on just one chronic disease. Defined self-care process has a positive impact on the functionality and satisfaction of patients with comorbidity and on their caregivers. The model of the patient's self-care process should be an integral part of the long-term care. PMID:27332172

  20. Self-care in adults with asthma: how they cope.

    PubMed

    Mäkinen, S; Suominen, T; Lauri, S

    2000-07-01

    The purpose of this study was to find out how well adult asthma patients in Finland cope with self-care in three areas of asthma treatment. The areas of physical, psychological and social asthma treatment were examined. Associations between demographic background data and self-care were also studied. Data (n = 130) for the study were collected using a questionnaire specially developed for this study. A deductive perspective was employed in data analysis. Respondents showed fairly good competence in self-care in all three areas of asthma treatment. However, up to 30% of the asthma patients had pets and 16% were smokers. Extra stress was reduced by exercise and positive thinking. Humour was also important in helping most of the respondents cope mentally. Social support played a significant part in fighting the sense of powerlessness which is caused by asthma. According to the results, women coped better than men in the social area of self-care. PMID:11261136

  1. Hope, optimism, and self-care among Better Breathers Support Group members with chronic obstructive pulmonary disease.

    PubMed

    Alberto, June; Joyner, Barry

    2008-11-01

    The objective of this study was to determine the levels of hope, optimism, and self-care of persons with chronic obstructive pulmonary disease (COPD) who attend community-based Better Breathers Support Group (BBSG) meetings. A convenience sample of 68 BBSG members from 14 groups in three southeastern states participated. The data were collected with a questionnaire set composed of a demographic form and three previously tested research instruments: the Herth Hope Index (HHI), the Alberto Chronic Obstructive Pulmonary Disease Self-care Behavior Inventory (COPDSC), and the Life Orientation Test--Revised (LOT-R). The findings (n = 68) include a significant and positive relationship between the HHI and COPDSC (r = .39; p > .01), between the LOT-R and COPDSC (r = .41; p > .001), and between the LOT-R and HHI (r = .59; p > .001). So, those participants with higher Hope and Optimism have higher levels of Self-care. We concluded the participants were fairly optimistic (LOT-R average = 23.75+/-4.49) and hopeful (HHI average 39.47+/-5.61). The average score on the COPDSC was 141.57 (+/-14.76) indicating a high level of self-care.

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

    PubMed Central

    2013-01-01

    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

  3. Depression, self-esteem, diabetes care and self-care behaviors among middle-aged and older Mexicans☆

    PubMed Central

    Rivera-Hernandez, Maricruz

    2016-01-01

    Aims Examine the associations of depression and self-esteem on self-care activities and care received among Mexicans with diabetes. Methods Using data from the Mexican Nutrition and Health Survey 2012, logistic regression models were fit to test the associations between each self-care activity and diabetes care, and self-esteem and depression. Results People with low self-esteem were less likely to follow a diet, but no other associations were found. Contrary to what was expected, there were no relationships between depression and quality of care received or self-care behaviors. Conclusion Current findings support the importance of looking at mental health and emotional state among older adults with diabetes. Future studies should explore the relationship between different psychological barriers to proper diabetes management. PMID:24846446

  4. Psychometric Properties of the Arabic Version of the Summary of Diabetes Self-Care Activities Instrument.

    PubMed

    Sukkarieh-Haraty, Ola; Howard, Elizabeth

    2016-01-01

    Translation of instruments needs to ensure equivalence between the source and the target language to establish the psychometric properties of the translated version. The purpose of this study was to examine the psychometric properties of the Arabic version of the Summary of Diabetes Self-Care Activities (SDSCA) instrument. The 12-item English version of the SDSCA was translated into Arabic using back translation on a sample of 140 Lebanese participants with Type 2 diabetes. Construct validity was measured using exploratory factor analysis with varimax rotation. Multitrait scaling analysis was used to test for item convergent and discriminant validity based on item-scale correlations. Conceptual and content validity were examined by an expert panel in diabetes. Internal consistency reliability R was assessed using interitem correlations. The average interitem correlation for the four subscales ranged between--.05 for Diet and .66 for Glucose Testing. Factor analysis identified four factors which accounted for 60% of the variance. The preliminary results of Summary of Diabetes Self-Care Activities-Arabic Version (SDSCA-Ar) are comparable to the psychometric properties the original SDSCA. SDSCA-Ar is a valid measure of diabetes self-care in Lebanese patients with diabetes.

  5. Psychometric Properties of the Arabic Version of the Summary of Diabetes Self-Care Activities Instrument.

    PubMed

    Sukkarieh-Haraty, Ola; Howard, Elizabeth

    2016-01-01

    Translation of instruments needs to ensure equivalence between the source and the target language to establish the psychometric properties of the translated version. The purpose of this study was to examine the psychometric properties of the Arabic version of the Summary of Diabetes Self-Care Activities (SDSCA) instrument. The 12-item English version of the SDSCA was translated into Arabic using back translation on a sample of 140 Lebanese participants with Type 2 diabetes. Construct validity was measured using exploratory factor analysis with varimax rotation. Multitrait scaling analysis was used to test for item convergent and discriminant validity based on item-scale correlations. Conceptual and content validity were examined by an expert panel in diabetes. Internal consistency reliability R was assessed using interitem correlations. The average interitem correlation for the four subscales ranged between--.05 for Diet and .66 for Glucose Testing. Factor analysis identified four factors which accounted for 60% of the variance. The preliminary results of Summary of Diabetes Self-Care Activities-Arabic Version (SDSCA-Ar) are comparable to the psychometric properties the original SDSCA. SDSCA-Ar is a valid measure of diabetes self-care in Lebanese patients with diabetes. PMID:27025000

  6. Mental status tests and the capacity for self-care.

    PubMed

    Winograd, C H

    1984-01-01

    To test the hypothesis that self-care capacity can be predicted by tests of mental functioning, the performances of patients in a long-term care institution on a Self-Care Scale were compared with their scores on the Short Portable Mental Status Questionnaire (SPMSQ) and a Mental Competence Scale. The Self-Care Scale measures ability to perform activities of daily living; the SPMSQ assesses memory, orientation, and calculation; and the Mental Competence Scale measures ability to respond sensibly to interview questions and to judge the environment. Many people who had poor scores on the SPMSQ were able to perform activities of daily living in the nursing home setting, but none whose scores on the Mental Competence Scale were fair or poor were independent in activities of daily living. Despite the fact that both the Self-Care Scale and the Mental Competence Scale are still in the developmental stages, the author concludes that the SPMSQ is not an adequate predictor of capacity for self-care. Moreover, the ability to respond appropriately to an interview may be more relevant for daily functioning than are tests of mental status. The three methods of assessment used in this study measure distinct yet complementary components of functioning that need to be considered in evaluating a mentally impaired elderly person. PMID:6690576

  7. Using the Internet to support self-care.

    PubMed

    LaPerrière, B; Edwards, P; Romeder, J M; Maxwell-Young, L

    1998-05-01

    Nurses have long recognized the importance of self-care. In the current Information Age, nurses can use the Internet to locate computer- and non-computer-based programs and tools that encourage people to become active consumers who control decisions and actions related to their health. The Internet can support self-care in two main ways: by supplying information and by providing a medium for interactive social support. But there are pros and cons to such use of the Internet. PMID:9923213

  8. Striving for control: cognitive, self-care, and faith strategies employed by vulnerable black and white older adults with multiple chronic conditions.

    PubMed

    Leach, Corinne R; Schoenberg, Nancy E

    2008-12-01

    The average older adult reaches age 65 with at least two chronic, co-occurring illnesses, or multiple morbidities (MM). We currently lack critical information about the specific strategies older adults use to attempt to control these MM. To increase our understanding of how older adults attempt to manage these MM and retain control of their health, in-depth interviews were conducted with 41 Black and White middle aged and older men and women with MM. We were particularly interested in representing the experience of those groups more vulnerable to adverse health outcomes due to greater disease prevalence and low income. During in-depth interviews, we asked open-ended questions on life and health history and open-ended and semi-structured questions about self-care for multiple morbidities. Participants expressed a strong desire to remain in control of their health; to do so they employed a wide range of strategies including cognitive structuring techniques (being health vigilant, normalizing, resignation/relinquishing control, and social comparison), self-care activities (emphasizing diet, exercise, medication taking, modifying existing activities, going to the doctor), and faith orientations (prayer as a constructive support strategy, gaining strength from God, church as a central part of life). With the exception of faith orientations, there were no race/ethnicity differences in the strategies participants use. Future studies should expand on this knowledge by exploring the contextual, cultural, and psychological backdrop and characteristics that shape the use of these coping strategies. PMID:18987966

  9. Stress on the Job: Self-Care Resources for Counselors.

    ERIC Educational Resources Information Center

    O'Halloran, Theresa M.; Linton, Jeremy M.

    2000-01-01

    Counselors often encounter clients who have experienced forms of trauma. As a result, counselors may experience symptoms of secondary traumatic stress due to vicarious traumatization. To help with symptoms of burnout, this article offers a self-care prevention plan based on wellness concepts. Offers 30 references as a starting point for counselors…

  10. Peer Collaboration: A Model to Support Counsellor Self-Care

    ERIC Educational Resources Information Center

    Barlow, Constance A.; Phelan, Anne M.

    2007-01-01

    In the context of a larger case study on how continuous learning in the workplace could be achieved through the implementation of peer collaboration, the process of how counsellors engaged in self-care within a large health care organization became clearer. This article is based on data derived from a qualitative analysis of nine transcribed…

  11. Developing Self-Care Practices in a Trauma Treatment Course

    ERIC Educational Resources Information Center

    Shannon, Patricia J.; Simmelink-McCleary, Jennifer; Im, Hyojin; Becher, Emily; Crook-Lyon, Rachel E.

    2014-01-01

    This article describes the development of self-care practices of social work students who were part of a larger study of students' experiences in a graduate course on the treatment of trauma. Consensual qualitative research methods were used to analyze 17 participant journals submitted at 4 times during the course. Findings indicated that…

  12. Level of anxiety versus self-care in the preoperative and postoperative periods of total laryngectomy patients 1

    PubMed Central

    Almonacid, Clara Inés Flórez; Ramos, Alfredo Jurado; Rodríguez-Borrego, María-Aurora

    2016-01-01

    Abstract Objective: estimate the prevalence of anxiety in laryngectomy patients in the pre and postoperative periods and its relation with the self-care level. Method: observational research of 40 patients with stage IV laryngeal cancer. Three observations took place: in the preoperative phase, at seven and at 14 days after the surgery; between June 2010 and December 2012. Two self-care levels were defined: self-sufficient and needing help for activities of daily living and treatment-related activities. To assess the anxiety levels, Zigmond's hospital anxiety scale (1983) was used. Results: in the preoperative and postoperative phases, the patients presented high levels of anxiety. Concerning self-care, on average, self-sufficient patients presented lower levels of anxiety than patients who needed help to accomplish activities of daily living and activities deriving from the surgery, without significant differences. Conclusion: anxiety is present at all times in laryngectomy patients and the reduction of the self-care deficit seems to decrease it, without putting a permanent end to it. PMID:27305181

  13. A Health Collaborative Network Focus on Self-care Processes in Personal Assistant Practice

    NASA Astrophysics Data System (ADS)

    de La Fuente, Ma Victoria; Ros, Lorenzo

    Public health is oriented to the management of an adequate health atmosphere which acts directly on health, as well as health education work and the supervision of environmental health threats. The work presented in this paper aims to reduce inequality, and give disabled people the tools to be integrated more effectively, reducing social exclusion, removing obstacles and barriers, and facilitating mobility and the use of technology. The work is planned to design a special healthcare collaborative network as the best solution for addressing the needs of the disabled self-care and health care community through the creation and implementation of an interconnected, electronic information infrastructure and adoption of open data standards.

  14. From Doing to Bring: Incorporating Faith into Diabetes Self-Care Education.

    PubMed

    Ammerman, Cathy Eden; Harden, Kelly; Mitchell, C Ben

    2015-01-01

    Millions worldwide live with diabetes and are challenged to make lifestyle changes. Nurses help patients learn strategies necessary for successful diabetes management. However, patients frequently view long-term behavior change as unachievable. This article offers educational strategies based on liturgical anthropology that can be incorporated into any diabetic self-care education program, but particularly in faith communities. Lifestyle habits are tightly interwoven with cultural, social, and spiritual belief. Liturgical anthropology explores how cultural and spiritual customs mold us and influence our behavior choices.

  15. Oral health knowledge, attitude, and self-care practices among pharmacists in Riyadh, Riyadh Province, Saudi Arabia

    PubMed Central

    Baseer, Mohammad Abdual; Mehkari, Mohammed Aleemullah; Al-Marek, Fahad AbdulMohsen Fahad; Bajahzar, Omar Ahmad

    2016-01-01

    Aim: Identifying and addressing gaps in the oral health knowledge, attitude, and practices of pharmacists is important before they can be considered as a member of the oral health promotion team. The aim of this study was to determine the prevailing oral health knowledge, attitude, and self-care practices among a sample of pharmacists from Riyadh, Riyadh Province, Saudi Arabia. Materials and Methods: A cross-sectional study involving 200 pharmacists working in community- and hospital-based pharmacies was conducted using a structured, self-administered, close-ended questionnaire. The responses were collected and descriptive statistics of the mean scores of knowledge, attitude, and self-care practices were calculated. Mann–Whitney U and Kruskal–Wallis tests were performed to compare the different groups. Spearman's rank correlation coefficient was used to assess the association among knowledge–attitude, knowledge–practice, and attitude–practice. Results: Overall, the mean scores of oral health knowledge, attitude, and self-care practices were found to be 5.27 ± 1.05, 3.89 ± 0.83, and 2.1 ± 0.61, respectively. Male non-Saudi pharmacists working in chain pharmacies, having 11–15 years of experience with a Master's degree qualification showed significantly higher mean knowledge and practices scores as compared to their counterparts. Spearman's correlation tests revealed a significant positive correlation of knowledge–practice (r = 0.262, P < 0.01), whereas knowledge–attitude (r = -0.149, P < 0.05) as well as attitudes–practices (r = -0.196, P < 0.01) were negatively correlated. Conclusion: Pharmacists exhibited an average knowledge, negative attitude, and inadequate self-care practices toward oral health. However, increasing oral health knowledge can have profound improvement in oral self-care practices. PMID:27114953

  16. Academic and Behavioral Characteristics of Young Adolescents in Self-Care

    ERIC Educational Resources Information Center

    Shumow, Lee; Smith, Thomas J.; Smith, M. Cecil

    2009-01-01

    This study examines characteristics of young adolescents who experience self-care, associations between self-care and academic achievement, and whether associations of self-care with academic adjustment vary by child, family, or community characteristics. Using data from the nationally representative 1999 National Household Education Survey,…

  17. Processes of change in an asthma self-care intervention.

    PubMed

    Denford, Sarah; Campbell, John L; Frost, Julia; Greaves, Colin J

    2013-10-01

    In this article, we present a qualitative exploration of the psychological and communication processes that occur within an intervention to improve self-care for people with asthma. In the context of a primary-care-based trial of the intervention, we collected data at three time points for 21 patients, comprising 2 audiotaped consultations (nurse and patient together) and individual semistructured interviews 3 months after the second consultation. Using framework analysis, we identified both psychological processes (illness understanding, affective response to asthma, and reasoned motivation) and patient-provider interactions (active patient involvement and individual tailoring). We use these findings to extend and refine the pre-existing theoretical model of behavior change underpinning the intervention, in particular with relation to patient-provider interaction processes. We conclude that it is important for developers and providers of asthma self-care interventions to attend to the style of delivery as well as the behavior change techniques involved. PMID:24062418

  18. “We have become doctors for ourselves”: motives for malaria self-care among adults in southeastern Tanzania

    PubMed Central

    2014-01-01

    Background Prompt and appropriate treatment of malaria with effective medicines remains necessary if malaria control goals are to be achieved. The theoretical concepts from self-care and the health belief model were used to examine the motivations for malaria self-care among the adult population. Methods A qualitative study was conducted through eight focus group discussions with adult community members to explore their general opinions, views and perceptions of malaria and of its treatments. These groups were followed by 15 in-depth interviews of participants with a recent malaria experience to allow for an in-depth exploration of their self-care practices. The analysis followed principles of grounded theory and was conducted using Nvivo 9 qualitative data management software. Results The self-treatment of malaria at home was found to be a common practice among the study participants. The majority of the participants practiced self-medication with a painkiller as an initial response. The persistence and the worsening of the disease symptoms prompted participants to consider other self-care options. Perceptions that many malaria symptoms are suggestive of other conditions motivated participants to self-refer for malaria test. The accessibility of private laboratory facilities and drug shops motivated their use for malaria tests and for obtaining anti-malarial medicines, respectively. Self-treatment with anti-malarial monotherapy was common, motivated by their perceived effectiveness and availability. The perceived barriers to using the recommended combination treatment, artemether-lumefantrine, were related to the possible side-effects and to uncertainty about their effectiveness, and these doubts motivated some participants to consider self-medication with local herbs. Several factors were mentioned as motivating people for self-care practices. These included poor patient provider relationship, unavailability of medicine and the costs associated with accessing

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

    PubMed Central

    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.

    2006-01-01

    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. PMID:17332865

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

    PubMed

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

    2010-01-01

    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.

  1. Design and Evaluation of a Self-Care Educational Activity as a Student Learning Experience

    PubMed Central

    Skoy, Elizabeth T.; Eukel, Heidi N.

    2014-01-01

    Objective. To design an educational activity and evaluate its effectiveness on increasing third-year pharmacy students’ knowledge and confidence to recommend self-care products to patients. Design. Faculty members created a self-care activity, the Amazing Self-Care Race, for educational use in a pharmaceutical care laboratory course. Student teams worked competitively to complete 15 stations focused on self-care. A complex, real-world case was presented at each station. Student recommendations were presented to a facilitator. Prior to and following the activity, students were invited to complete an online anonymous survey instrument. Assessment. Eighty-six students completed presurvey and postsurvey instruments to assess their knowledge and perceived confidence to recommend a self-care product to a patient prior to and following participation in the Amazing Self-Care Race. Students demonstrated a significant increase in their ability and confidence to recommend self-care products following the activity (p<0.001). Conclusion. The Amazing Self-Care Race is an effective educational activity that increases student knowledge and confidence in self-care therapeutics. The activity helped students to develop self-care skills, enabled them to learn through doing, encouraged them to synthesize information while making self-care recommendations, and helped them to develop confidence by thinking on their feet. PMID:24558280

  2. The Holistic, Interactive and Persuasive Model to Facilitate Self-care of Patients with Diabetes

    NASA Astrophysics Data System (ADS)

    Vargas-Lombard, Miguel; Jipsion, Armando; Vejarano, Rafael; Camargo, Ismael; Álvarez, Humberto; Mora, Elena Villalba; Menasalva Ruíz, Ernestina

    The patient, in his multiple facets of citizen and user of services of health, needs to acquire during, and later in his majority of age, favorable conditions of health to accentuate his quality of life and it is the responsibility of the health organizations to initiate the process of support for that patient during the process of mature life. The provision of services of health and the relation doctor-patient are undergoing important changes in the entire world, forced to a large extent by the indefensibility of the system itself. Nevertheless decision making requires previous information and, what more the necessity itself of being informed requires having a “culture” of health that generates pro activity and the capacity of searching for instruments that facilitate the awareness of the suffering and the self-care of the same. Therefore it is necessary to put into effect a ICT model (hiPAPD) that has the objective of causing Interaction, Motivation and Persuasion towards the surroundings of the diabetic Patient facilitating his self-care. As a result the patient himself individually manages his services through devices and AmI Systems (Ambient Intelligent).

  3. Self-care and Subjectivity among Mexican Diabetes Patients in the United States.

    PubMed

    Seligman, Rebecca; Mendenhall, Emily; Valdovinos, Maria D; Fernandez, Alicia; Jacobs, Elizabeth A

    2015-03-01

    Type 2 diabetes is considered a public health crisis, particularly among people of Mexican descent in the United States. Clinical approaches to diabetes management increasingly emphasize self-care, which places responsibility for illness on individuals and mandates self-regulation. Using narrative and free-list data from a two-phase study of low-income first- and second-generation Mexican immigrants living with diabetes, we present evidence that self-care among our participants involves emotion regulation as well as maintenance of and care for family. These findings suggest, in turn, that the ideology of selfhood on which these practices are based does not correspond with the ideology of selfhood cultivated in the U.S. clinical sphere. Divergence between these ideologies may lead to self-conflict for patients and the experience of moral blame. We argue that our participants use their explanations of diabetes causality and control as a form of self-making, which both resists such blame and asserts an alternative form of selfhood that may align more closely with the values held by our Mexican-American participants.

  4. Contingency Management to Increase Grade Point Average among Fraternity Members: A Feasibility Study

    ERIC Educational Resources Information Center

    Van Patten, Ryan A.; Irons, Jessica G.; Apple, Kevin J.

    2015-01-01

    Contingency management is an incentive-based intervention strategy that has been demonstrated to be effective for inducing behavior change among a variety of populations and for a variety of behaviors. The current study examined whether contingency management techniques can help students change behaviors in an effort to raise their grade point…

  5. [Adherence to oral hygiene and dental self-care].

    PubMed

    Poplinger, A

    2010-04-01

    illustrates, through a comprehensive literature review of theories, models and researches, the contemporary methods for promoting adherence to oral hygiene, dental Self-Care and treatment. Using the combination of a survey from a select sample of specialists in the field of Dentistry, and the conclusions inferred from studies reviewed, I was able to determine how investment in the Bio-Psycho-Social approach would improve patient satisfaction from their doctors and outcomes of the treatment, shorten the duration of treatment, consume only little resources, improve dental health of patients and prevent repetitive visits to the dentists clinics. At the same time, despite the fact that dentistry practitioners acknowledge the importance of patient's adherence and take active measures such as talks, praises, guidance and providing information, most of them don't seem to comprehend interfusion of family members or friends as an integral part of the treatment. Moreover, their overall feeling is of incompetence when regarding dealing with un-adherent patients. Therefore, maybe there is room for providing dentists and staff with seminars, conventions etc. about the latest novelties on the subject. In conclusion, enhancing dental patient's adherence to health behavior is a domain mainly under the responsibility of the dentist, but also of his staff. As elaborated in the article, the measures for doing so are: 1. Information- the dentist should guide patients about the different methods for maintaining oral hygiene, explain how proper adherence benefits positive treatment outcome, and provide a broad and informative picture of the patient's specific problem. 2. Positive rapport - the need for establishing a good relationship between the doctor and his patients is crucial for attaining effective and satisfactory treatment outcomes. No doubt that this matter depends upon the personality and character of both the doctor and the patient, but using positive verbal reinforcements, symbolic

  6. Long-term conditions. 2: supporting and enabling self-care.

    PubMed

    Wilson, Patricia M; Mayor, Vina

    2006-01-01

    This article is the second of a series focusing on long-term conditions. It explores supported self-care identifying that this is the most appropriate approach to managing long-term conditions in 70-80% of patients with a chronic illness. The paper focuses on the Department of Health for England and Wales flagship initiative; the Expert Patient Programme. This lay-led self-management programme for people affected by a physical long-term condition is currently being rolled out by PCTs throughout the NHS and is seen as a key mechanism for empowering individuals and reducing resource demand in long-term conditions. The history, content, current and future models of the Expert Patient Programme will be described and the paper concludes by discussing future challenges for the programme as illuminated by two external evaluations.

  7. Self care and health-seeking behavior of migrant farmworkers.

    PubMed

    Anthony, Maureen J; Martin, Evan G; Avery, Ann M; Williams, Judith M

    2010-10-01

    There are an estimated three million migrant and seasonal farmworkers (MSFW) in the United States. In addition to the inherent dangers of farm work, numerous factors place MSFW at even greater risk for work-related injuries. Little is known about how MSFW care for work-related injuries, and how the decision to seek professional care is made. A prospective survey using face-to-face structured interviews was used to explore the type and frequency of occupational injuries as well as self-care and health-care seeking practices of MSFW. Musculoskeletal injuries were the most commonly reported injuries, followed by injuries of the skin and chemical exposure. Self care with over-the-counter remedies was the predominant method of dealing with injuries, and, with the exception of chemical exposure, was found to be for the most part, appropriate. The reported use of alternative medicine or herbal remedies was low. Future research efforts should focus on ergonomic modifications and farmworker education to reduce or prevent musculoskeletal injuries. The number of reported chemical exposures and inappropriate treatment draw attention to the need for continued efforts for both primary prevention of exposure and optimal treatment once exposure occurs.

  8. Self-Care Behaviors and Glycemic Control in Low-Income Adults in México With Type 2 Diabetes Mellitus May Have Implications for Patients of Mexican Heritage Living in the United States.

    PubMed

    Compeán Ortiz, Lidia G; Del Ángel Pérez, Beatriz; Reséndiz González, Eunice; Piñones Martínez, Socorro; González Quirarte, Nora H; Berry, Diane C

    2016-04-01

    This study examined self-care behaviors and their relationship to glycemic control in low-income Mexican adults with type 2 diabetes in Southeastern Tamaulipas, México. A total of 135 patients were enrolled from 17 community health centers. The most frequent self-care behavior was medication management (80%), and the least frequent self-care behavior was self blood glucose monitoring (7%). All the patients demonstrated poor glycemic control, with glycated hemoglobin > 7%. Self-care behaviors were associated with fasting blood glucose (rs = .223, p = .005). Medication management was influenced by cognitive performance, F(1, 130) = 4.49, p = .036, and depression, F(1, 130) = 8.22, p = .005. Dietary behaviors were influenced by previous diabetes education, F(1, 130) = 6.73, p = .011. These findings indicate that education and cognitive behavioral interventions in Spanish for Mexican adults with type 2 diabetes are urgently needed.

  9. Effect of home blood pressure telemonitoring with self-care support on uncontrolled systolic hypertension in diabetics.

    PubMed

    Logan, Alexander G; Irvine, M Jane; McIsaac, Warren J; Tisler, Andras; Rossos, Peter G; Easty, Anthony; Feig, Denice S; Cafazzo, Joseph A

    2012-07-01

    Lowering blood pressure reduces cardiovascular risk, yet hypertension is poorly controlled in diabetic patients. In a pilot study we demonstrated that a home blood pressure telemonitoring system, which provided self-care messages on the smartphone of hypertensive diabetic patients immediately after each reading, improved blood pressure control. Messages were based on care paths defined by running averages of transmitted readings. The present study tests the system's effectiveness in a randomized, controlled trial in diabetic patients with uncontrolled systolic hypertension. Of 244 subjects screened for eligibility, 110 (45%) were randomly allocated to the intervention (n = 55) or control (n = 55) group, and 105 (95.5%) completed the 1-year outcome visit. In the intention-to-treat analysis, mean daytime ambulatory systolic blood pressure, the primary end point, decreased significantly only in the intervention group by 9.1 ± 15.6 mmHg (SD; P < 0.0001), and the mean between-group difference was 7.1 ± 2.3 mmHg (SE; P < 0.005). Furthermore, 51% of intervention subjects achieved the guideline recommended target of <130/80 mmHg compared with 31% of control subjects (P < 0.05). These improvements were obtained without the use of more or different antihypertensive medications or additional clinic visits to physicians. Providing self-care support did not affect anxiety but worsened depression on the Hospital Anxiety and Depression Scale (baseline, 4.1 ± 3.76; exit, 5.2 ± 4.30; P = 0.014). This study demonstrated that home blood pressure telemonitoring combined with automated self-care support reduced the blood pressure of diabetic patients with uncontrolled systolic hypertension and improved hypertension control. Home blood pressure monitoring alone had no effect on blood pressure. Promoting patient self-care may have negative psychological effects.

  10. Student Perceptions of and Confidence in Self-Care Course Concepts Using Team-based Learning.

    PubMed

    Frame, Tracy R; Gryka, Rebecca; Kiersma, Mary E; Todt, Abby L; Cailor, Stephanie M; Chen, Aleda M H

    2016-04-25

    Objective. To evaluate changes in student perceptions of and confidence in self-care concepts after completing a team-based learning (TBL) self-care course. Methods. Team-based learning was used at two universities in first professional year, semester-long self-care courses. Two instruments were created and administered before and after the semester. The instruments were designed to assess changes in student perceptions of self-care using the theory of planned behavior (TPB) domains and confidence in learning self-care concepts using Bandura's Social Cognitive Theory. Wilcoxon signed rank tests were used to evaluate pre/post changes, and Mann Whitney U tests were used to evaluate university differences. Results. Fifty-three Cedarville University and 58 Manchester University students completed both instruments (100% and 92% response rates, respectively). Student self-care perceptions with TPB decreased significantly on nine of 13 items for Cedarville and decreased for one of 13 items for Manchester. Student confidence in self-care concepts improved significantly on all questions for both universities. Conclusion. Data indicate TBL self-care courses were effective in improving student confidence about self-care concepts. Establishing students' skill sets prior to entering the profession is beneficial because pharmacists will use self-directed learning to expand their knowledge and adapt to problem-solving situations.

  11. Re-designing Orem's Self-care Theory for Patients with Chronic Hepatitis

    PubMed Central

    Hasanpour-Dehkordi, Ali; Mohammadi, Nooredin; Nikbakht-Nasrabadi, Alireza

    2016-01-01

    Background: Hepatitis is an inflammatory disease which has many adverse effects on patients’ life because of its chronic nature. Since Orem's theory of self-care is a grounded theory, the concepts and applications of this theory in patients with chronic hepatitis who have special needs may lead to some challenges. The purpose of this study was to explore self-care in patients with chronic hepatitis. Methods/Design: A directed content analysis was used in this qualitative study. Participants were recruited from a metropolitan area. Data were collected through semi-structured interviews. The verbatim transcripts of the participants’ interviews were analyzed according to directed content analysis. Results: In this study, four themes, suggested by Orem, were drawn from the data according to directed content analysis. The codes generated from the data were classified into concepts and then the concepts were assigned into these four themes. These themes were needs in the matrix of time and place, self-care agency, need for change in self-care and consequences of hepatitis. Conclusion: The use of Orem's self-care theory cannot meet the need for self-care in hepatitis patients because these patients have vital sexual, respect and belonging, physical, economical, and psychological-behavioral needs, and lack adequate knowledge about self-care. Consequently, the specific self-care model developed in this study helps health professionals identify self-care activities in patients with chronic hepatitis. PMID:27803560

  12. Student Perceptions of and Confidence in Self-Care Course Concepts Using Team-based Learning.

    PubMed

    Frame, Tracy R; Gryka, Rebecca; Kiersma, Mary E; Todt, Abby L; Cailor, Stephanie M; Chen, Aleda M H

    2016-04-25

    Objective. To evaluate changes in student perceptions of and confidence in self-care concepts after completing a team-based learning (TBL) self-care course. Methods. Team-based learning was used at two universities in first professional year, semester-long self-care courses. Two instruments were created and administered before and after the semester. The instruments were designed to assess changes in student perceptions of self-care using the theory of planned behavior (TPB) domains and confidence in learning self-care concepts using Bandura's Social Cognitive Theory. Wilcoxon signed rank tests were used to evaluate pre/post changes, and Mann Whitney U tests were used to evaluate university differences. Results. Fifty-three Cedarville University and 58 Manchester University students completed both instruments (100% and 92% response rates, respectively). Student self-care perceptions with TPB decreased significantly on nine of 13 items for Cedarville and decreased for one of 13 items for Manchester. Student confidence in self-care concepts improved significantly on all questions for both universities. Conclusion. Data indicate TBL self-care courses were effective in improving student confidence about self-care concepts. Establishing students' skill sets prior to entering the profession is beneficial because pharmacists will use self-directed learning to expand their knowledge and adapt to problem-solving situations. PMID:27170817

  13. Student Perceptions of and Confidence in Self-Care Course Concepts Using Team-based Learning

    PubMed Central

    Gryka, Rebecca; Kiersma, Mary E.; Todt, Abby L.; Cailor, Stephanie M.; Chen, Aleda M. H.

    2016-01-01

    Objective. To evaluate changes in student perceptions of and confidence in self-care concepts after completing a team-based learning (TBL) self-care course. Methods. Team-based learning was used at two universities in first professional year, semester-long self-care courses. Two instruments were created and administered before and after the semester. The instruments were designed to assess changes in student perceptions of self-care using the theory of planned behavior (TPB) domains and confidence in learning self-care concepts using Bandura’s Social Cognitive Theory. Wilcoxon signed rank tests were used to evaluate pre/post changes, and Mann Whitney U tests were used to evaluate university differences. Results. Fifty-three Cedarville University and 58 Manchester University students completed both instruments (100% and 92% response rates, respectively). Student self-care perceptions with TPB decreased significantly on nine of 13 items for Cedarville and decreased for one of 13 items for Manchester. Student confidence in self-care concepts improved significantly on all questions for both universities. Conclusion. Data indicate TBL self-care courses were effective in improving student confidence about self-care concepts. Establishing students’ skill sets prior to entering the profession is beneficial because pharmacists will use self-directed learning to expand their knowledge and adapt to problem-solving situations. PMID:27170817

  14. Construction and validation of a scale of assessment of self-care behaviors with arteriovenous fistula in hemodialysis.

    PubMed

    Sousa, Clemente Neves; Apóstolo, João Luís Alves; Figueiredo, Maria Henriqueta Jesus Silva; Dias, Vanessa Filipa Ferreira; Teles, Paulo; Martins, Maria Manuela

    2015-04-01

    Several guidelines recommend the importance of educating the patient about the care of vascular access. Nurses have a key role in promoting the development of self-care behaviors by providing the necessary knowledge to patients, so that they develop the necessary skills to take care of the arteriovenous fistula (AVF). This article describes the process of building a scale of assessment of self-care behaviors with arteriovenous fistula in hemodialysis (ASBHD-AVF). This is a cross-sectional study in which the development, construction, and validation process followed the directions of the authors Streiner and Norman. This is a convenience sample, sequential, and nonprobabilistic constituted by 218 patients. The study was conducted in two stages during 2012-2014. The first phase corresponds to the scale construction process, 64 patients participated, while the second corresponds to the evaluation of metric properties and 154 patients participated. The principal component analysis revealed a two-factor structure, with factorial weights between 0.805 and 0.511 and between 0.700 and 0.369, respectively, explaining 39.12% of the total variance of the responses. The Cronbach's alpha of the subscale management of signs and symptoms is 0.797 and from the subscale prevention of complications is 0.722. The ASBHD-AVF revealed properties that allow its use to assess the self-care behaviors in the maintenance and conservation of the AVF.

  15. Do Perceptions of Empowerment Affect Glycemic Control and Self-Care Among Adults with Type 2 Diabetes?

    PubMed Central

    D’Souza, Melba Sheila; Karkada, Subrahmanya Nairy; Hanrahan, Nancy P.; Venkatesaperumal, Ramesh; Amirtharaj, Anandhi

    2015-01-01

    Background: The Arab adult with T2DM is understudied with less known facts about the perception of empowerment and its relationship with self-care and glycemic control. Purpose: The purpose of this study was to determine the extent to which perception of empowerment by Arab adults living with Type 2 Diabetes Mellitus (T2DM) was associated with better glycemic control and self-care management. Methods: A cross-sectional descriptive study was led among 300 Arab adults living in Oman with T2DM in an outpatient diabetes clinic. The Diabetes Empowerment Scale (DES), glycosylated haemaglobin (HbA1c) and Body mass index was assessed. The DES was found to be valid and reliable for the population. ANOVA, Regression analysis, and Structural equation modeling was used for analysis. Results: The composite score and three subscales of DES were a significant and strong predictor of good glycemic control among Omani adults with T2DM (p<0.001). Age, education, duration of DM, prior DM education program and medications were significantly associated with DES. Conclusion: Diabetes nurse educators engaged in the care of adults with T2DM should assess self-empowerment and tailor interventions to increase empowerment for better glycemic control. Patient empowerment plays an essential role in maintaining self-care behaviours and HbA1c. PMID:26156908

  16. [Self-care, adherence and uncertainty: biomedical treatments and patients' experiences regarding chronic migraine pain].

    PubMed

    Del Monaco, Romina

    2013-04-01

    Based in the social sciences, this text explores and analyzes the particularities of migraine treatments using a relational approach, articulating the statements of professionals with the experiences and practices of patients in health services and their everyday care trajectories to manage pain. This qualitative research study utilized semi-structured interviews with neurologists and patients in a public hospital in the Autonomous City of Buenos Aires. A number of processes were observed by which biomedicine assigns part of the responsibility for the course of the disease to the patient through the logic of self-care. Patients must make changes in their ways of life in order to prevent headaches from appearing. Nevertheless, as the efficacy of these modifications is unclear, daily life is filled with uncertainty and charged with the mandate to follow care guidelines, which are valued not only professionally but also socially.

  17. Elective Self-Care Course Emphasizing Critical Reasoning Principles

    PubMed Central

    2011-01-01

    Objectives. To create, implement, and assess a self-directed online course based on 3 critical reasoning principles to develop pharmacy students’ skills in literature appraisal, content, metacognition, and assessment. Design. Students completed 3 assignments for the course: compile a literature appraisal on a healthcare topic; plan learning objectives and meta-cognitive skills for a learning module; and create a case-based online lesson with multi-structured feedback. Assessment. An online exit survey evaluated students’ perceptions regarding development of ACE (agency, collaboration, expertise) principles and preparation for competency. Students reported acquisition of ACE principles and noted improvements in their learning approaches, sense of responsibility for individual and community learning, skills, and confidence. Conclusions. An online elective course in self-care addressed practice standards for patient safety, maintenance of competency, and interprofessional education by emphasizing critical reasoning skills. PMID:22171110

  18. Measurement properties of instruments evaluating self-care and related concepts in people with chronic obstructive pulmonary disease: A systematic review.

    PubMed

    Clari, Marco; Matarese, Maria; Alvaro, Rosaria; Piredda, Michela; De Marinis, Maria Grazia

    2016-01-01

    The use of valid and reliable instruments for assessing self-care is crucial for the evaluation of chronic obstructive pulmonary disease (COPD) management programs. The aim of this review is to evaluate the measurement properties and theoretical foundations of instruments for assessing self-care and related concepts in people with COPD. A systematic review was conducted of articles describing the development and validation of self-care instruments. The methodological quality of the measurement properties was assessed using the COSMIN checklist. Ten studies were included evaluating five instruments: three for assessing self-care and self-management and two for assessing self-efficacy. The COPD Self-Efficacy Scale was the most studied instrument, but due to poor study methodological quality, evidence about its measurement properties is inconclusive. Evidence from the COPD Self-Management Scale is more promising, but only one study tested its properties. Due to inconclusive evidence of their measurement properties, no instrument can be recommended for clinical use.

  19. Periodontal self-care: evidence-based support.

    PubMed

    Drisko, Connie L

    2013-06-01

    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.

  20. [Adherence to oral hygiene and dental self-care].

    PubMed

    Poplinger, A

    2010-04-01

    illustrates, through a comprehensive literature review of theories, models and researches, the contemporary methods for promoting adherence to oral hygiene, dental Self-Care and treatment. Using the combination of a survey from a select sample of specialists in the field of Dentistry, and the conclusions inferred from studies reviewed, I was able to determine how investment in the Bio-Psycho-Social approach would improve patient satisfaction from their doctors and outcomes of the treatment, shorten the duration of treatment, consume only little resources, improve dental health of patients and prevent repetitive visits to the dentists clinics. At the same time, despite the fact that dentistry practitioners acknowledge the importance of patient's adherence and take active measures such as talks, praises, guidance and providing information, most of them don't seem to comprehend interfusion of family members or friends as an integral part of the treatment. Moreover, their overall feeling is of incompetence when regarding dealing with un-adherent patients. Therefore, maybe there is room for providing dentists and staff with seminars, conventions etc. about the latest novelties on the subject. In conclusion, enhancing dental patient's adherence to health behavior is a domain mainly under the responsibility of the dentist, but also of his staff. As elaborated in the article, the measures for doing so are: 1. Information- the dentist should guide patients about the different methods for maintaining oral hygiene, explain how proper adherence benefits positive treatment outcome, and provide a broad and informative picture of the patient's specific problem. 2. Positive rapport - the need for establishing a good relationship between the doctor and his patients is crucial for attaining effective and satisfactory treatment outcomes. No doubt that this matter depends upon the personality and character of both the doctor and the patient, but using positive verbal reinforcements, symbolic

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

    SciTech Connect

    Hanucharurnkul, S.

    1988-01-01

    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.

  2. Social Work Students and Self-Care: A Model Assignment for Teaching

    ERIC Educational Resources Information Center

    Moore, Sharon E.; Bledsoe, Linda K.; Perry, Armon R.; Robinson, Michael A.

    2011-01-01

    The literature reveals scant research on self-care practices among social work students; yet self-care is vital as students prepare to be practitioners who are not only effective in working with all aspects of the clients' total selves, but who are themselves healthy. They are not prepared to be good practitioners unless they have first learned to…

  3. Student Interest in a Protocol-based System for Self-Care Decision Making.

    ERIC Educational Resources Information Center

    Coons, Stephen Joel

    1989-01-01

    Self-care programs and information sources should serve as a catalyst to facilitate appropriate care seeking behavior in college students and improve communication with health professionals. Health professionals in self-care provide proper encouragement, skills, and resources to enable individuals to involve themselves in appropriate self-care…

  4. The Effects of Self-Care Instruction on Locus of Control in Children.

    ERIC Educational Resources Information Center

    Blazek, Brodie; McClellan, Muriel S.

    1983-01-01

    A study focused on whether self-care instruction in health education can affect locus of control in fifth-grade students. Individual responsibility for self-care was encouraged. Results indicate that the instruction did increase the extent to which the children viewed health as the result of their own actions. (Author/PP)

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

    ERIC Educational Resources Information Center

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

    2011-01-01

    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 interviews…

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

    ERIC Educational Resources Information Center

    DePalma, Valerie; Wheeler, Marci

    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…

  7. Impact of Health Literacy, Self-efficacy, and Outcome Expectations on Adherence to Self-care Behaviors in Iranians with Type 2 Diabetes

    PubMed Central

    Reisi, Mahnoush; Mostafavi, Firoozeh; Javadzade, Homamodin; Mahaki, Behzad; Tavassoli, Elahe; Sharifirad, Gholamreza

    2016-01-01

    Objectives Diabetic patients with higher health literacy (HL) may feel more confident in their ability to perform self-care behaviors and may have strong beliefs that diabetes-related behaviors will lead to specific outcomes. Our study aimed to document the relationships between HL, self-efficacy, outcome expectations, and diabetes self-care of patients with type 2 diabetes mellitus (T2DM) in Iran. Methods We conducted a cross-sectional observational study of 187 patients with T2DM. Participants completed the Functional Communicative and Critical Health Literacy scale, the Summary of Diabetes Self-Care Activities, the Diabetes Management Self-Efficacy Scale, Outcome Expectations Questionnaire, and a demographic questionnaire. Results Participants who received diabetes education (t = 5.79, p<0.001) and were married (F = 3.04, p<0.050) had better diabetes self-care behavior. There was a significant positive correlation between self-care behaviors and communicative HL (r = 0.455, p<0.010), critical HL (r = 0.297, p<0.010), self-efficacy (r = 0.512, p<0.010) and outcome expectations (r = 0.387, p<0.010). Diabetes education and marital status accounted for 16.9% of the variance in diabetes self-care. Self-efficacy, outcome expectations, communicative, and critical HL explained 28.0%, 1.5%, 3.7%, and 1.4% of the variance, respectively. Conclusions This study revealed that the potential impact of self-efficacy, outcome expectations, communicative, and critical HL should be considered in the education program for patients with diabetes. We found self-efficacy to be the most important predictor of diabetes self-care. Therefore, the use of self-efficacy theory when designing patient education interventions could enhance diabetes self-care. It is essential that health care providers assess patient’s HL levels to tailor health-related information specific to a domain of HL. This would fully inform patients and promote empowerment rather than simple compliance. PMID:26813680

  8. A literature review on self-care of chronic illness: definition, assessment and related outcomes.

    PubMed

    Ausili, Davide; Masotto, Matteo; Dall'Ora, Chiara; Salvini, Lorena; Di Mauro, Stefania

    2014-01-01

    INTRODUZIONE. L’assistenza alle persone con malattie croniche rappresenta una sfida per il benessere della popolazione e per la futura sostenibilità dei sistemi sanitari. La promozione del self-care è considerata un aspetto chiave dell’assistenza ai malati cronici. Lo scopo di questa revisione della letteratura è stato quello di esplorare: come il self-care nelle malattie croniche è stato definito dal punto di vista teorico; come il self-care può essere valutato nella pratica clinica e nella ricerca; quali associazioni esistono tra il livello di self-care e i risultati di salute dei pazienti con malattie croniche. RISULTATI. In letteratura si è riscontrata un’ampia gamma di definizioni e terminologie connesse con il self-care nelle malattie croniche. Sebbene nei diversi approcci siano stati identificati alcuni elementi comuni utili a spiegare il concetto di self-care, le variabili fisiche, cognitive, emotive e socioculturali sottese al self-care nelle malattie croniche risultano controverse e scarsamente definite. Un crescente numero di studi ha sviluppato o impiegato strumenti di valutazione del self-care validi ed affidabili per una specifica malattia cronica; tuttavia molti autori riportano la mancanza di utilizzo di strumenti di valutazione nella pratica clinica standard. Un numero limitato di studi ha mostrato delle correlazioni significative tra il self-care nelle malattie croniche e alcune misure di risultato come lo stato generale di salute, la qualità di vita e i costi dell’assistenza sanitaria. CONCLUSIONI. Favorire lo sviluppo del self-care è riconosciuto come un aspetto cruciale dell’assistenza ai malati cronici. Un’analisi più approfondita delle variabili e dei processi che influenzano il self-care potrebbe contribuire ad una più completa descrizione di questo fenomeno. La valutazione sistematica del self-care nella pratica clinica dei professionisti sanitari è fortemente raccomandata. Lo sviluppo di strumenti generali e non

  9. The evidence base for professional and self-care prevention - caries, erosion and sensitivity

    PubMed Central

    2015-01-01

    Background The aim of this conference paper was to examine the evidence base for primary and secondary prevention of dental caries, erosions and dentin hypersensitivity through professional and self-care measures. Methods A mapping of systematic reviews (SR) of literature was carried out in PubMed and the Cochrane library through April 2014 using established MeSH-terms and disease-related search words in various combinations. The search was restricted to SR's published in English or Scandinavian and all age groups were considered. The reference lists of the selected papers were hand-searched for additional review articles of potential interest. Meta-analyses, guidelines and treatment recommendations were considered only when SR's were lacking. In the event of updates or multiple systematic reviews covering the same topic, only the most recent article was included. No quality assessment of the systematic reviews was carried out. The quality of evidence was rated in four levels according to the GRADE scale. Results In total, 39 SR were included. For primary caries prevention, the quality of evidence was high for the use of fluoride toothpaste (with and without triclosan) and moderate for fluoride varnish and fissure sealants. The quality of evidence for fluoride gel, fluoride mouth rinse, xylitol gums and silver diamine fluoride (SDF) was rated as low. For secondary caries prevention and caries arrest, only fluoride interventions and SDF proved consistent benefits, although the quality of evidence was low. Likewise, the GRADE score for preventing erosions located in the enamel with fluoride supplements was low. The quality of evidence for various professional and self-care methods to prevent and manage dentine hypersensitivity was very low. Conclusions There are knowledge gaps in many domains of cariology and preventive dentistry that must be addressed and bridged through clinical research of good quality. PMID:26392204

  10. Validation of a New Instrument for Self-care in Spanish Palliative Care Professionals Nationwide.

    PubMed

    Galiana, Laura; Oliver, Amparo; Sansó, Noemí; Benito, Enric

    2015-09-14

    Self-care is a cornerstone issue for those who deal with stressful events, as it is the case of palliative care professionals. It has been related to awareness, coping with death and quality of life, among others, but no measurement instruments have been used in palliative care professionals. This research presents and validates a brief new measure with clinical and psychometric good properties, called Professional Self-Care Scale (PSCS). The PSCS assesses professionals' self-care in three areas: physical self-care, inner self-care, and social self-care. Data come from a cross-sectional survey in a sample of 385 professionals of palliative care. The Mindful Attention Awareness Scale, the Coping with Death Scale, and the Professional's Quality of Life measure were also used. Results of the CFA showed adequate fit (χ2(24, N = 385) = 140.66, p < .01; CFI = .91; GFI = .93; SRMR = .09; and RMSEA = .10). Evidence pointed better reliability indices for the 3-item physical and inner factors of self-care than for the social dimension (Rho and GLB of .64, .90, and .57, respectively). Evidence regarding validity was consistent with previous literature. When levels of self-care were examined, women showed higher levels of inner and social self-care (F(3, 371) = 3.19, p = .02, η2 = .03, as also did psychologists when compared to doctors and nurses (F(9, 1074) = 2.00, p = .04, η2 = .02. The PSCS has shown adequate psychometric properties, and thus it could be used as diagnostic instrument when studying professionals' health.

  11. Self-Care in the Classroom for Children with Chronic Illness: A Case Study of a Student with Cystic Fibrosis.

    ERIC Educational Resources Information Center

    Cox, Julie Elizabeth Jonson

    1994-01-01

    Describes the essential self-care of an eight-year old second-grade student. This study illustrates a school counselor's use of a multimodal, behavioral intervention to increase the level of self-care in the classroom. Relevant reinforcements, individual and group counseling, and peer support, resulted in improved self-care. (RJM)

  12. Quality of Recipient-Caregiver Relationship and Psychological Distress are Correlates of Self-Care Agency after Lung Transplantation

    PubMed Central

    Dabbs, Annette DeVito; Terhorst, Lauren; Song, Mi-Kyung; Shellmer, Diana A.; Aubrecht, Jill; Connolly, Mary; Dew, Mary Amanda

    2012-01-01

    Self-care behaviors are crucial for following the complex regimen after lung transplantation, yet little is known about recipients’ levels of self-care agency (the capability and willingness to engage in self-care behaviors) and its correlates. We examined levels of self-care agency and recipient characteristics (socio-demographics, psychological distress, quality of relationship with primary lay caregiver, and health locus of control) in 111 recipients. Based on Perceived Self-Care Agency scores, recipients were assigned to either the low or high self-care agency comparison group. Characteristics were compared between groups to identify characteristics likely to be associated with lower self-care agency. Mean (S.D.) score for self-care agency (scale range 53–265) was 223.02 (22.46). Recipients with lowest self-care agency scores reported significantly poorer quality of caregiver relationships (p < .001) and greater psychological distress (p < .001). After controlling for psychological distress, the quality of the recipient-caregiver relationship remained significantly associated with self-care agency. Every one-point decrease in the quality of caregiver relationship increased the risk of low self-care agency by 12%. Recipients with poorer caregiver relationships and greater psychological distress may need additional support to perform the self-care behaviors expected after lung transplantation. PMID:23004565

  13. Self-care project for faculty and staff of future health care professionals: Case report.

    PubMed

    MacRae, Nancy; Strout, Kelley

    2015-01-01

    Self-care among health care providers is an important component of their ability to provide quality health care to patients. Health care institutions have programs in place for students that emphasize health and wellness, but few programs are available for faculty and staff. To address this gap and facilitate modeling health and wellness strategies for students, a New England institution that educates health care practitioners began a pilot self-care project for faculty and staff. Both quantitative and qualitative data were collected. The template used for this project could be used as a stepping-stone for future wellness self-care program in higher education for faculty, staff, and students.

  14. Family caregiver versus nursing assessments of elderly self-care abilities.

    PubMed

    Biggs, A J

    1990-08-01

    An assessment guide to be used by family caregivers would provide positive reinforcement oriented to what elderly family members can do in caring for themselves. Findings from this study indicate that there is an acceptable level of agreement between assessments of elderly self-care by family caregivers of dependent elderly and nursing assessments of the same self-care abilities. By actively involving family caregivers in the assessment of self-care abilities of their dependent elderly, family integrity and functioning may also be enhanced and families may feel more competent and less burdened as they provide assistance to elderly family members.

  15. African-Americans' perceptions of health care provider cultural competence that promote HIV medical self-care and antiretroviral medication adherence.

    PubMed

    Gaston, Gina B

    2013-01-01

    Most studies of cultural competence in healthcare examine healthcare providers' definitions of cultural competence practices. This study is unique in that it examines the relationship between African-American patients' perceptions of the cultural competence of their HIV healthcare providers and the adherence of these patients to medical self-care and antiretroviral therapy (ART). This cross-sectional, exploratory, descriptive study was conducted at the Ruth Rothstein CORE Center in Chicago, Illinois. The sample consisted of 202 HIV-positive African-Americans who completed surveys during clinic visits. Multiple measures were used, including the Patient Assessments of Cultural Competency survey instrument developed by the Department of Health and Human Services Agency for Healthcare Research and Quality. Medical self-care was measured using the advice and instructions scale and the self-care symptom management for people living with HIV/AIDS categorical scale. ART adherence was measured using the Adherence Behaviors Self-Report and Adherence Self-Report scales. The data revealed many significant correlations between variables. The more patients believed that providers should integrate culture in HIV treatment; the better their reported health (F1,138=0.151, P=0.05) and the more they followed their provider's advice and instructions (medical self-care; F1,138=0.029, P=0.05). Participants who trusted their providers engaged in more medical self-care (F1,138=0.280, P=0.01). More shared treatment decisions were reported among participants who had higher levels of education (F1,127=0.337, P=0.05). Findings of this study indicate the need for increased attention to the role of cultural competence in HIV/AIDS care. Understanding patient perceptions of provider cultural competence has the potential to improve HIV treatment adherence and health outcomes.

  16. Examining the Effects of Remote Monitoring Systems on Activation, Self-care, and Quality of Life in Older Patients With Chronic Heart Failure

    PubMed Central

    Evangelista, Lorraine S.; Lee, Jung-Ah; Moore, Alison A.; Motie, Marjan; Ghasemzadeh, Hassan; Sarrafzadeh, Majid; Mangione, Carol M.

    2015-01-01

    Background The use of remote monitoring systems (RMSs) in healthcare has grown exponentially and has improved the accessibility to and ability of patients to engage in treatment intensification. However, research describing the effects of RMSs on activation, self-care, and quality of life (QOL) in older patients with heart failure (HF) is limited. Objective The aim of this study was to compare the effects of a 3-month RMS intervention on activation, self-care, and QOL of older patients versus a reference group matched on age, gender, race, and functional status (ie, New York Heart Association classification) who received standard discharge instructions after an acute episode of HF exacerbation requiring hospitalization. Methods A total of 21 patients (mean age, 72.7 ± 8.9 years; range, 58–83 years; 52.4% women) provided consent and were trained to measure their weight, blood pressure, and heart rate at home with an RMS device and transmit this information every day for 3 months to a centralized information system. The system gathered all data and dispatched alerts when certain clinical conditions were met. Results The baseline sociodemographic and clinical characteristics of the 2 groups were comparable. Over time, participants in the RMS group showed greater improvements in activation, self-care, and QOL compared with their counterparts. Data showed moderately strong associations between increased activation, self-care, and QOL. Conclusion Our preliminary data show that the use of an RMS is feasible and effective in promoting activation, self-care, and QOL. A larger-scale randomized clinical trial is warranted to show that the RMS is a new and effective method for improving clinical management of older adults with chronic HF. PMID:24365871

  17. The weight of the self: care and compassion in Guatemalan dietary choices.

    PubMed

    Yates-Doerr, Emily

    2012-03-01

    The Public Health Nutrition (PHN) community categorizes dietary-related chronic illnesses as "noncommunicable," fixing these afflictions within individual bodies where they are best managed by individual choices. Yet within clinical encounters in Guatemala, nutritionists and patients treat eating and dieting as relational, transmissible practices. Patients actively seek nutritionists' care, asserting their self-care attempts have failed and they need support from others; nutritionists meanwhile develop treatment plans that situate "personal choice" as lying outside the control of a solitary individual. This article moves between international policy-pedagogy and patient-nutritionist interactions to examine forms of personhood, responsibility, and rationalities of choice present in body weight-management practices in Guatemala. Although nutrition discourses might appear to exemplify how institutional (bio)power manifests through internalized self-monitoring and preoccupation for one's own self, I argue that within the lived experiences of "nutrition-in-action," the self-body of the patient becomes broadly conceived to include the nutritionist, the family, and the broader community. PMID:22574395

  18. Psychometric Properties of a Moroccan Version of the Summary of Diabetes Self-Care Activities Measure

    PubMed Central

    Adarmouch, Latifa; Sebbani, Majda; Elyacoubi, Abdelhadi; Amine, Mohamed

    2016-01-01

    Background. The Summary of Diabetes Self-Care Activities (SDSCA) is a widely used self-report measure for diabetes self-management. It is an interesting tool for practice and research. Objectives. To translate and culturally adapt the SDSCA to the Moroccan context and to assess psychometric properties of the adapted version among type 2 diabetic patients. Methods. The Moroccan version was obtained following forward and backward translations. An expert panel issued a final version. The adapted version was administered to patients aged 30 years and older who have type 2 diabetes. Psychometric evaluation consisted of assessing validity through internal consistency (Cronbach's alpha, item-to-scale and interitem correlations) and exploratory factor analysis and reproducibility (test-retest reliability). Results. Seventy-five participants were included. Cronbach's alpha ranged from 0.20 (diet) to 0.99 (exercise). Moderate to good interitem and item-to-scale correlations were found. Factor analysis resulted in a Moroccan SDSCA version consisting of 8 items, organized in four subscales that explained 89.6% of the variance: diet, exercise, blood sugar testing, and foot-care. Intraclass correlations ranged from 0.27 to 0.52 for subscales. Conclusion. This study provides preliminary evidence for suitability of use of the Moroccan SDSCA among type 2 diabetic patients in order to assess diabetes self-management. PMID:27019853

  19. Mobile Health Apps to Facilitate Self-Care: A Qualitative Study of User Experiences

    PubMed Central

    Anderson, Kevin; Burford, Oksana; Emmerton, Lynne

    2016-01-01

    Objective Consumers are living longer, creating more pressure on the health system and increasing their requirement for self-care of chronic conditions. Despite rapidly-increasing numbers of mobile health applications (‘apps’) for consumers’ self-care, there is a paucity of research into consumer engagement with electronic self-monitoring. This paper presents a qualitative exploration of how health consumers use apps for health monitoring, their perceived benefits from use of health apps, and suggestions for improvement of health apps. Materials and Methods ‘Health app’ was defined as any commercially-available health or fitness app with capacity for self-monitoring. English-speaking consumers aged 18 years and older using any health app for self-monitoring were recruited for interview from the metropolitan area of Perth, Australia. The semi-structured interview guide comprised questions based on the Technology Acceptance Model, Health Information Technology Acceptance Model, and the Mobile Application Rating Scale, and is the only study to do so. These models also facilitated deductive thematic analysis of interview transcripts. Implicit and explicit responses not aligned to these models were analyzed inductively. Results Twenty-two consumers (15 female, seven male) participated, 13 of whom were aged 26–35 years. Eighteen participants reported on apps used on iPhones. Apps were used to monitor diabetes, asthma, depression, celiac disease, blood pressure, chronic migraine, pain management, menstrual cycle irregularity, and fitness. Most were used approximately weekly for several minutes per session, and prior to meeting initial milestones, with significantly decreased usage thereafter. Deductive and inductive thematic analysis reduced the data to four dominant themes: engagement in use of the app; technical functionality of the app; ease of use and design features; and management of consumers’ data. Conclusions The semi-structured interviews provided

  20. Science: In Sickness and in Health: A Self-Care Curriculum.

    ERIC Educational Resources Information Center

    Ferguson, Tom

    1979-01-01

    A physician presents teachers with some classroom activities in medical self-care, including anatomy, measuring pulse, relaxation, biofeedback, yoga, and throat examinations. For a related article by the same author, see pages 66-72 of this issue. (SJL)

  1. Self-care of young people with long-term physical and mental health conditions.

    PubMed

    Kirk, Susan; Pryjmachuk, Steven

    2016-09-12

    This article examines the evidence about 'what works' in supporting self-care in relation to children or young people with physical and mental health conditions. It is based on two systematic reviews and on research evaluating different self-care support programmes that have been developed in the UK. The authors identify four components for an effective and acceptable self-care programme that nurses can include when developing and providing such support for children and young people with long-term physical and mental health conditions. These are: providing a sense of community, developing knowledge and skills, building independence and confidence, engaging children and young people. The authors highlight the increasingly important role that children's and mental health nurses can play in supporting young people's self-care.

  2. Self-care of young people with long-term physical and mental health conditions.

    PubMed

    Kirk, Susan; Pryjmachuk, Steven

    2016-09-12

    This article examines the evidence about 'what works' in supporting self-care in relation to children or young people with physical and mental health conditions. It is based on two systematic reviews and on research evaluating different self-care support programmes that have been developed in the UK. The authors identify four components for an effective and acceptable self-care programme that nurses can include when developing and providing such support for children and young people with long-term physical and mental health conditions. These are: providing a sense of community, developing knowledge and skills, building independence and confidence, engaging children and young people. The authors highlight the increasingly important role that children's and mental health nurses can play in supporting young people's self-care. PMID:27615584

  3. Unsupervised self-care predicts conduct problems: The moderating roles of hostile aggression and gender.

    PubMed

    Atherton, Olivia E; Schofield, Thomas J; Sitka, Angela; Conger, Rand D; Robins, Richard W

    2016-04-01

    Despite widespread speculation about the detrimental effect of unsupervised self-care on adolescent outcomes, little is known about which children are particularly prone to problem behaviors when left at home without adult supervision. The present research used data from a longitudinal study of 674 Mexican-origin children residing in the United States to examine the prospective effect of unsupervised self-care on conduct problems, and the moderating roles of hostile aggression and gender. Results showed that unsupervised self-care was related to increases over time in conduct problems such as lying, stealing, and bullying. However, unsupervised self-care only led to conduct problems for boys and for children with an aggressive temperament. The main and interactive effects held for both mother-reported and observational-rated hostile aggression and after controlling for potential confounds. PMID:26820648

  4. Relationship among patients' perceived capacity for communication, health literacy, and diabetes self-care.

    PubMed

    Leung, Angela Yee Man; Cheung, Mike Kwun Ting; Chi, Iris

    2014-01-01

    The mechanisms underlying the relations among health literacy, perceived capacity for communication, diabetes knowledge, and diabetes self-care are unclear. This study tested this relation using structural equation modeling with a sample of 137 Chinese patients 65 years of age or older with type 2 diabetes. The model showed that health literacy, knowledge, communication capacity, and diabetes self-care formed complex relations. After adjusting for age, education, and Chinese cultural influence, health literacy affected diabetes self-care indirectly through perceived capacity for communication (standardized estimate coefficient=.641, p<.001) but not diabetes knowledge. To enhance self-care, interventions should be tailored to increase patient health literacy and perceived capacity for communication with health care providers. Training should be provided to patients to enhance their communication abilities.

  5. Potential Benefits of Companion Animals for Self-Care Children. Reviews of Research.

    ERIC Educational Resources Information Center

    Heath, D. Terry; McKenry, Patrick C.

    1989-01-01

    Discusses the potential benefits of having pets for self-care children. Researchers suggest that companion animals can lower blood pressure, show up high on a list of children's helpers and indirectly increase feelings of safety. (RJC)

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

    PubMed

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

    2002-01-01

    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.

  7. Competing Demands for Time and Self-Care Behaviors, Processes of Care, and Intermediate Outcomes Among People With Diabetes

    PubMed Central

    McEwen, Laura N.; Kim, Catherine; Ettner, Susan L.; Herman, William H.; Karter, Andrew J.; Beckles, Gloria L.; Brown, Arleen F.

    2011-01-01

    OBJECTIVE To determine whether competing demands for time affect diabetes self-care behaviors, processes of care, and intermediate outcomes. RESEARCH DESIGN AND METHODS We used survey and medical record data from 5,478 participants in Translating Research Into Action for Diabetes (TRIAD) and hierarchical regression models to examine the cross-sectional associations between competing demands for time and diabetes outcomes, including self-management, processes of care, and intermediate health outcomes. RESULTS Fifty-two percent of participants reported no competing demands, 7% reported caregiving responsibilities only, 36% reported employment responsibilities only, and 6% reported both caregiving and employment responsibilities. For both women and men, employment responsibilities (with or without caregiving responsibilities) were associated with lower rates of diabetes self-care behaviors, worse processes of care, and, in men, worse HbA1c. CONCLUSIONS Accommodations for competing demands for time may promote self-management and improve the processes and outcomes of care for employed adults with diabetes. PMID:21464464

  8. Premenstrual Distress Among Japanese High School Students: Self-Care Strategies and Associated Physical and Psychosocial Factors.

    PubMed

    Otsuka-Ono, Hiroko; Sato, Iori; Ikeda, Mari; Kamibeppu, Kiyoko

    2015-01-01

    This study aimed to identify self-care strategies and assess physical and psychosocial factors associated with premenstrual distress among high school students. A cross-sectional survey of 217 adolescent girls aged 15 to 18 years was conducted in October 2009. Most (84.3 percent) had at least one or more symptoms of premenstrual distress. Premenstrual distress interfered with normal school activity in 51.2 percent. Most participants (57.1 percent) did not perform any self-care strategies for premenstrual distress. A hierarchical multiple linear regression analysis was conducted. Comprehension of one's own physical and mental states during premenstrual phases mediated the relationship between neuroticism and premenstrual distress. Activity restrictions due to menstrual distress mediated the relationship between the family's understanding of one's behavior during premenstrual phases and premenstrual distress. Findings suggest that, even if girls have neuroticism, it will be important to teach them to address the comprehension of one's own physical and mental states so that perceptions of both premenstruation and menstruation become more positive. Findings also suggest that the family's understanding was associated with alleviation of premenstrual distress. This study suggests the need for education to help adolescent girls and their families manage premenstrual distress and increase awareness of the benefit of managing its associated symptoms.

  9. Effect of healing touch training on self-care awareness in nurses

    NASA Astrophysics Data System (ADS)

    Black, Pegi

    Nursing focuses on supporting clients' health and health behaviors; however, they tend to exhibit unproductive behaviors when it comes to caring for themselves. As nurses' self-neglect can undermine client care, supporting nurses' self-care practices are expected to translate into clients' self-care. Healing Touch (HT) is one option for supporting nurses' self-care, as it is an accepted nursing practice and studies suggest that HT may have beneficial effects for those delivering it. This study examined the impact of a 2-day HT training on awareness of the need for self-care in nurses. HT training was offered as continuing education for 45 nurses at a Veteran's Administration hospital in Long Beach, CA. This mixed-methods study used a pre/post-test design to measure the effects of HT Level 1 training on nurses' self-care self-awareness. Independent samples t-tests and analyses of variance were used to detect whether any significant differences emerged based on participant demographic data. Data were analyzed using paired t-tests to determine whether participants' self-awareness changed over the study period. Effect size for any differences were calculated using Cohen's d. Open-ended responses were reviewed and common themes were identified related to what participants believed they learned and how it affected their care for themselves and their clients. Two increases were found to be significant and of sufficient power when comparing pre- to delayed post-test scores: physical self-care awareness (mean difference = 0.956, t(44) = 5.085, p = .000, r = .61) and professional self-care awareness (mean difference = .955, t(43) = 5.277, p = .000, r = .63). Qualitative findings suggested that changes in their awareness, self-directed practices, and patient care practices are anticipated, evident, and sustained based upon themes across the three tests. Nurses are advised to take a course that teaches specific self-care techniques and strategies and continue practicing

  10. Effectiveness of a School- and Community-based Academic Asthma Health Education Program on Use of Effective Asthma Self-care Behaviors in Older School-age Students

    PubMed Central

    Kintner, Eileen K.; Cook, Gwendolyn; Marti, C. Nathan; Allen, April; Stoddard, Debbie; Harmon, Phyllis; Gomes, Melissa; Meeder, Linda; Van Egeren, Laurie A.

    2014-01-01

    Purpose The purpose was to evaluate the effectiveness of SHARP, an academic asthma health education and counseling program, on fostering use of effective asthma self-care behaviors. Design and Methods This was a phase III, two-group, cluster randomized, single-blinded, longitudinal design guided the study. Caregivers of 205 fourth- and fifth-grade students completed the asthma health behaviors survey at pre-intervention and 1, 12, and 24 months post-intervention. Analysis involved multilevel modeling. Results All students demonstrated improvement in episode management, risk-reduction/prevention, and health promotion behaviors; SHARP students demonstrated increased improvement in episode management and risk-reduction/prevention behaviors. Practice Implications Working with schoolteachers, nurses can improve use of effective asthma self-care behaviors. PMID:25443867

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

    PubMed Central

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

    2013-01-01

    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. PMID:23807843

  12. Self-care of patients with diabetes mellitus cared for at an emergency service in Mexico.

    PubMed

    Baquedano, Irasema Romero; dos Santos, Manoel Antônio; Martins, Tatiane Aparecida; Zanetti, Maria Lúcia

    2010-01-01

    This study examines the self-care ability of type 2 diabetes mellitus patients and relates it to sociodemographic and clinical variables. The study included 251 patients who were cared for by an emergency service in Mexico, in 2007. Data were obtained through structured interviews held at participants' households, through a form, a questionnaire and the Self-Care Ability Scale. Descriptive and correlation statistics were used for data analysis. The results show that 83 (33.5%) individuals displayed good self-care ability and 168 (66.5%) individuals displayed regular ability. A directly proportional correlation was found between self-care ability and schooling (r=0.124; p<0.05), as well as a negative correlation for religion (rs=-0.435; p<0.05) and duration of disease evolution (r=-0.667; p<0.05). The conclusion is that most of the individuals with type 2 diabetes mellitus displayed regular ability for self-care. Self-care ability is related to multiple variables that should be taken into account by health professionals when suggesting educational programs.

  13. Quaternion Averaging

    NASA Technical Reports Server (NTRS)

    Markley, F. Landis; Cheng, Yang; Crassidis, John L.; Oshman, Yaakov

    2007-01-01

    Many applications require an algorithm that averages quaternions in an optimal manner. For example, when combining the quaternion outputs of multiple star trackers having this output capability, it is desirable to properly average the quaternions without recomputing the attitude from the the raw star tracker data. Other applications requiring some sort of optimal quaternion averaging include particle filtering and multiple-model adaptive estimation, where weighted quaternions are used to determine the quaternion estimate. For spacecraft attitude estimation applications, derives an optimal averaging scheme to compute the average of a set of weighted attitude matrices using the singular value decomposition method. Focusing on a 4-dimensional quaternion Gaussian distribution on the unit hypersphere, provides an approach to computing the average quaternion by minimizing a quaternion cost function that is equivalent to the attitude matrix cost function Motivated by and extending its results, this Note derives an algorithm that deterniines an optimal average quaternion from a set of scalar- or matrix-weighted quaternions. Rirthermore, a sufficient condition for the uniqueness of the average quaternion, and the equivalence of the mininiization problem, stated herein, to maximum likelihood estimation, are shown.

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

    PubMed

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

    2008-01-01

    (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.

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

    PubMed Central

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

    2010-01-01

    (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. PMID:22844654

  16. Holistic self-care for rehabilitation experienced by thai buddhist trauma patients in areas of political and social unrest.

    PubMed

    Songwathana, Praneed; Watanasiriwanich, Wachiraya; Kitrungrote, Luppana

    2013-01-01

    This study describes the meaning and practice of holistic self-care for rehabilitation among Thai Buddhist trauma patients living in areas of political unrest where acts of terrorism occur. Eleven Thai Buddhist trauma patients were selected as specified. The data were collected by in-depth interviews between November 2011 and April 2012, and analyzed using the Van Manen method.Those interviewed described "holistic self-care for rehabilitation" as learning (1) to acquire a new life and (2) to bear the increased demands of care as a chronic disease. Health care responses fell into 3 categories: (1) improving physical self-sufficiency and rehabilitation by increasing muscle strength, pain management, and pressure sores; (2) improving psychological well-being by applying positive thinking, making an effort to live independently, and following a set of religious practices; and (3) finding harmony in life through caution and a willingness to adjust one's lifestyle. Although the participants seemed to adapt well to their new lifestyles, extensive support from health care professionals was necessary. This study promotes better understanding of the holistic health care experiences the survivors of trauma have as a result of an unstable political situation that includes aspects of social unrest and terrorism.

  17. Holistic self-care for rehabilitation experienced by thai buddhist trauma patients in areas of political and social unrest.

    PubMed

    Songwathana, Praneed; Watanasiriwanich, Wachiraya; Kitrungrote, Luppana

    2013-01-01

    This study describes the meaning and practice of holistic self-care for rehabilitation among Thai Buddhist trauma patients living in areas of political unrest where acts of terrorism occur. Eleven Thai Buddhist trauma patients were selected as specified. The data were collected by in-depth interviews between November 2011 and April 2012, and analyzed using the Van Manen method.Those interviewed described "holistic self-care for rehabilitation" as learning (1) to acquire a new life and (2) to bear the increased demands of care as a chronic disease. Health care responses fell into 3 categories: (1) improving physical self-sufficiency and rehabilitation by increasing muscle strength, pain management, and pressure sores; (2) improving psychological well-being by applying positive thinking, making an effort to live independently, and following a set of religious practices; and (3) finding harmony in life through caution and a willingness to adjust one's lifestyle. Although the participants seemed to adapt well to their new lifestyles, extensive support from health care professionals was necessary. This study promotes better understanding of the holistic health care experiences the survivors of trauma have as a result of an unstable political situation that includes aspects of social unrest and terrorism. PMID:24305082

  18. Unhealthy Substance Use Behaviors as Symptom-Related Self-Care in HIV/AIDS

    PubMed Central

    Brion, John M.; Rose, Carol Dawson; Nicholas, Patrice K.; Sloane, Rick; Voss, Joachim G.; Corless, Inge B.; Lindgren, Teri G.; Wantland, Dean J.; Kemppainen, Jeanne K.; Sefcik, Elizabeth F.; Nokes, Kathleen M.; Kirksey, Kenn M.; Eller, Lucille Sanzero; Hamilton, Mary Jane; Holzemer, William L.; Portillo, Carmen J.; Mendez, Marta Rivero; Robinson, Linda M.; Moezzi, Shanaz; Rosa, Maria; Human, Sarie; Maryland, Mary; Arudo, John; Ros, Ana Viamonte; Nicholas, Thomas P.; Cuca, Yvette; Huang, Emily; Bain, Catherine; Tyer-Viola, Lynda; Zang, Sheryl M.; Shannon, Maureen; Peters-Lewis, Angelleen

    2014-01-01

    The prevalence of symptoms in HIV disease can be associated with HIV disease itself, comorbid illness, and/or antiretroviral therapy. Unhealthy substance use behaviors, particularly substance-use behaviors including heavy alcohol intake, marijuana use, other illicit drug use, and cigarette smoking, are engaged in by many HIV-positive individuals, often as a way to manage disease-related symptoms. This study is a secondary data analysis of baseline data from a larger randomized-controlled trial of an HIV/AIDS Symptom Management Manual. In the present study, the prevalence and characteristics of unhealthy substance use behaviors in relation to HIV/AIDS symptoms are examined. Subjects were recruited from a variety of settings which provide HIV/AIDS care and treatment. The mean age of the sample (n=775) was 42.8 years (SD=9.6) and nearly thirty-nine percent (38.5%) of the sample was female. The racial demographics of the sample were: 28% African American, 28% Hispanic, 21% White/Caucasian, 16% African from Kenya or South Africa, 1% Asian, and 5% self-described as “Other.” The mean number of years living with HIV was reported to be 9.1 years (SD=6.6).Specific self-reported unhealthy substance-use behaviors were use of marijuana (n= 111; 14.3%), cigarette smoking (n=355; 45.8%), heavy alcohol use (n= 66; 8.5%), and illicit drugs (n= 98; 12.6%). A subset of individuals who identified high levels of specific symptoms also reported significantly higher substance use behaviors including amphetamine and injection drug use in addition to heavy alcohol use, cigarette smoking, and marijuana use. Implications for clinical practice include assessment of self-care behaviors, screening for substance abuse, and education of persons related to self-management across the trajectory of HIV disease. PMID:21352430

  19. Evaluation of Internet-Based Technology for Supporting Self-Care: Problems Encountered by Patients and Caregivers When Using Self-Care Applications

    PubMed Central

    van Gemert-Pijnen, Julia; Boer, Henk; Steehouder, Michaël F; Seydel, Erwin R

    2008-01-01

    Background Prior studies have shown that many patients are interested in Internet-based technology that enables them to control their own care. As a result, innovative eHealth services are evolving rapidly, including self-assessment tools and secure patient-caregiver email communication. It is interesting to explore how these technologies can be used for supporting self-care. Objective The aim of this study was to determine user-centered criteria for successful application of Internet-based technology used in primary care for supporting self-care. Methods We conducted scenario-based tests combined with in-depth interviews among 14 caregivers and 14 patients/consumers to describe the use of various self-care applications and the accompanying user problems. We focused on the user-friendliness of the applications, the quality of care provided by the applications, and the implementation of the applications in practice. Results Problems with the user-friendliness of the self-care applications concerned inadequate navigation structures and search options and lack of feedback features. Patients want to retrieve health information with as little effort as possible; however, the navigation and search functionalities of the applications appeared incapable of handling patients’ health complaints efficiently. Among caregivers, the lack of feedback and documentation possibilities caused inconvenience. Caregivers wanted to know how patients acted on their advice, but the applications did not offer an adequate feedback feature. Quality of care problems were mainly related to insufficient tailoring of information to patients’ needs and to efficiency problems. Patients expected personalized advice to control their state of health, but the applications failed to deliver this. Language (semantics) also appeared as an obstacle to providing appropriate and useful self-care advice. Caregivers doubted the reliability of the computer-generated information and the efficiency and

  20. A preliminary study of a cloud-computing model for chronic illness self-care support in an underdeveloped country

    PubMed Central

    Piette, John D.; Mendoza-Avelares, Milton O.; Ganser, Martha; Mohamed, Muhima; Marinec, Nicolle; Krishnan, Sheila

    2013-01-01

    Background Although interactive voice response (IVR) calls can be an effective tool for chronic disease management, many regions of the world lack the infrastructure to provide these services. Objective This study evaluated the feasibility and potential impact of an IVR program using a cloud-computing model to improve diabetes management in Honduras. Methods A single group, pre-post study was conducted between June and August 2010. The telecommunications infrastructure was maintained on a U.S. server, and calls were directed to patients’ cell phones using VoIP. Eighty-five diabetes patients in Honduras received weekly IVR disease management calls for six weeks, with automated follow-up emails to clinicians, and voicemail reports to family caregivers. Patients completed interviews at enrollment and a six week follow-up. Other measures included patients’ glycemic control (A1c) and data from the IVR calling system. Results 55% of participants completed the majority of their IVR calls and 33% completed 80% or more. Higher baseline blood pressures, greater diabetes burden, greater distance from the clinic, and better adherence were related to higher call completion rates. Nearly all participants (98%) reported that because of the program, they improved in aspects of diabetes management such as glycemic control (56%) or foot care (89%). Mean A1c’s decreased from 10.0% at baseline to 8.9% at follow-up (p<.01). Most participants (92%) said that if the service were available in their clinic they would use it again. Conclusions Cloud computing is a feasible strategy for providing IVR services globally. IVR self-care support may improve self-care and glycemic control for patients in under-developed countries. PMID:21565655

  1. Self-care practices and experiences of people living with HIV not receiving antiretroviral therapy in an urban community of Lusaka, Zambia: implications for HIV treatment programmes

    PubMed Central

    2013-01-01

    Background Despite the increasingly wider availability of antiretroviral therapy (ART), some people living with HIV (PLHIV) and eligible for treatment have opted to adopt self-care practices thereby risking early AIDS-related mortality. Methods A qualitative study was conducted in urban Zambia to gain insights into PLHIV self-care practices and experiences and explore the implications for successful delivery of ART care. Between March 2010 and September 2011, in-depth interviews were conducted with PLHIV who had dropped out of treatment (n=25) and those that had opted not to initiate medication (n=37). Data was entered into and managed using Atlas ti, and analysed inductively using latent content analysis. Results PHIV used therapeutic and physical health maintenance, psychological well-being and healthy lifestyle self-care practices to maintain physical health and mitigate HIV-related symptoms. Herbal remedies, faith healing and self-prescription of antibiotics and other conventional medicines to treat HIV-related ailments were used for therapeutic and physical health maintenance purposes. Psychological well-being self-care practices used were religiosity/spirituality and positive attitudes towards HIV infection. These practices were modulated by close social network relationships with other PLHIV, family members and peers, who acted as sources of emotional, material and financial support. Cessations of sexual relationships, adoption of safe sex to avoid re-infections and uptake of nutritional supplements were the commonly used risk reduction and healthy lifestyle practices respectively. Conclusions While these self-care practices may promote physical and psychosocial well-being and mitigate AIDS-related symptoms, at least in the short term, they however undermine PLHIV access to ART care thereby putting PLHIV at risk of early AIDS-related mortality. The use of scientifically unproven herbal remedies raises health and safety concerns; faith healing may create

  2. Self-care behaviors and health indicators in adults with type 2 diabetes.

    PubMed

    Compeán Ortiz, Lidia Guadalupe; Gallegos Cabriales, Esther Carlota; González González, José Gerardo; Gómez Meza, Marco Vinicio

    2010-01-01

    This descriptive correlational study aimed to analyze self-care behaviors and their relationship with health indicators represented by glycemic control, lipid profile, Body Mass Index [BMI], waist circumference and body fat percentage in a sample of 98 adults with type 2 diabetes in an area of Nuevo Leon, Mexico (August 2005/May 2006). The results showed a low self-care behaviors index (X = 36.94, SD=15.14). A significant relationship was found between self-care behaviors and glycosilated hemoglobin [HbA1c] (r s=-.379, p<.001), triglycerides (r s=-.208, p=.040), BMI (r s=-.248, p=.014) and body fat percentage (r s=-.221, p=.029). Multivariate analysis revealed the influence of self-care behaviors on HbA1c, BMI and body fat percentage with explained variances of 9 to 41% (p < .05). From all self-care dimensions, diet was the most predictive for health indicators, moderated by gender and understanding of diabetes contents (p< .05).

  3. The interpretation of self-care: a difference in outlook between clients and home-nurses.

    PubMed

    van Agthoven, W M; Plomp, H N

    1989-01-01

    In this article, the client's interpretation of self-care and that of home-nurses are compared [1. Agthoven W. M. van and Zorg op Maat. Het afstemmingsproces tussen wijkverpleging, kliënt en informele zorgverlener. Instituut voor Sociale Geneeskunde, Vrije Universiteit (The process of directing self-care, informal and formal assistance). Department of Social Medicine, Free University, Amsterdam, 1985.] Self-care is defined, by two components: the decision (as to) what to do and the execution of the care. In estimating the client's capacity for self-care a limited number of discrepancies play a role on the physical level and many more on the psychosocial level. It is particularly in psychosocial care that a severe distortion occurs if the professional helper makes an estimate of the client's capacity to cope with the psychological and social aspects of care. The client finds himself much more capable, in this respect, than the home-nurse. Moreover, the client estimates the role of this professional helper in providing advice and guidance much lower than the helper in providing advice and guidance much lower than the helper indicates. Various discrepancies in outlook of client and home-nurse concerning self-care were indicated in the study and discussed in relation to Freidsons concept 'social construction of illness' and Scheff's ideas about 'negotiating responsibility'. PMID:2749305

  4. Predicator of Pregnant Women’s Self-care Behavior against Air Pollution: An explanation based on the Extended Parallel Process Model (EPPM)

    PubMed Central

    Jasemzadeh, Mehrnoosh; Jaafarzadeh, Nematallah; Khafaie, Morteza Abdullatif; Malehi, Amal Saki; Araban, Marzieh

    2016-01-01

    Introduction Air pollution is one of the most important problems of metropolitan cities. The level of air pollution in the city of Ahvaz is so much higher than the standard level, that it can create risks, particularly for pregnant women in the area. The aim of the study was to examine the predictors of self-care behavior of pregnant women against air pollution according to Extended Parallel Process Model (EPPM) in Ahvaz. Methods In this cross-sectional study, 330 pregnant women who were referred to health care centers in western Ahvaz in 2015 were examined. The data collection tool was a reliable and valid researcher-made questionnaire consisting of three parts: The first part was demographic information, the second part according to the extended parallel process model, included perceived susceptibility, perceived severity, response efficacy, and self-efficacy. The third part examined self-care behavior. Then, the collected data was analyzed by using the software SPSS 16. Data analysis was done by using Spearman’s correlation coefficient and linear regression. Results The average age of study subjects was 26.07 ± 2.3 years, and most (45.5%) were in the second trimester of pregnancy. These findings showed that self-efficacy constructs (β = 0.41) and response efficacy (β= 0.15) have predictive power of self-care behavior (p < 0.05). Conclusion The findings showed that self-efficacy and response efficacy, are important factors to predict air pollution self-care behavior. Therefore, to develop a theory-based behavioral modification program for pregnant women, more emphasis on these constructs is recommended. PMID:27790338

  5. A F.A.M.I.L.Y. Approach to Self-Care: Creating a Healthy Balance.

    ERIC Educational Resources Information Center

    Eckstein, Donna

    2001-01-01

    The F.A.M.I.L.Y. Approach to Self-Care introduces a systematic approach for couples and individuals in identifying personal perceptions of health toward balancing current strengths and weaknesses with self-care behaviors. Health factors within the acronym F.A.M.I.L.Y are identified as a model for self-care. A model, "Caring for Self," is also…

  6. Evaluation of a hand-held, computer-based intervention to promote early self-care behaviors after lung transplant

    PubMed Central

    Dabbs, Annette DeVito; Dew, Mary Amanda; Myers, Brad; Begey, Alex; Hawkins, Robert; Ren, Dianxu; Dunbar-Jacob, Jacqueline; Oconnell, Erin; McCurry, Kenneth R.

    2011-01-01

    Background Lung transplant recipients are expected to perform self-care behaviors to maximize transplant-related health outcomes. Despite high non-adherence rates in performing these self-care behaviors, and the dire clinical consequences of such non-adherence, interventions are lacking. Pocket Personal Assistant for Tracking Health (Pocket PATH) is a hand-held device developed for patients to record health data, review data trends, and report condition changes to the transplant team. Methods A pilot trial was conducted to compare self-care agency, self-care behaviors, and health-related quality of life (HRQOL) between recipients randomized to use Pocket PATH (n = 15) vs. standard care (n = 15) for the first two months following hospital discharge after lung transplantation. Results Baseline characteristics were equivalent across groups. Patients in the Pocket PATH group showed significantly higher ratings of self-care agency, performed self-care behaviors at significantly higher rates, and reported significantly better HRQOL than standard care controls. Conclusion Pocket PATH is more efficacious than standard care in promoting early self-care agency, self-care behaviors, and HRQOL in lung recipients. A large-scale randomized controlled trial is needed to test the impact of Pocket PATH on long-term self-care behaviors. PMID:19473201

  7. Determinants of dietary self-care behaviours among Taiwanese patients with type 2 diabetes.

    PubMed

    Ouyang, Chung-Mei; Dwyer, Johanna T; Jacques, Paul F; Chuang, Lee-Ming; Haas, Catherine F; Weinger, Katie

    2015-01-01

    The effects of patient characteristics on reported adherence to dietary self-care behaviours in 184 Taiwanese outpatients 40 years or older with type 2 diabetes was assessed. Patient characteristics included the presence of predisposing factors affecting diabetes adherence (knowledge and attitudes about the disease, self-efficacy, and the absence of psychological problems), enabling factors (understanding of diabetes and environmental factors affecting it), and reinforcing factors (presence of medical and social support) which were evaluated using a 72 item self-administered questionnaire with 8 subscales. Adherence was assessed by patients' reports of carrying out 7 self-care behaviours (following a diabetic meal plan, following the diabetes exchange system, eating meals providing the same amount of carbohydrate every day, counting carbohydrates, reducing dietary fat, consuming high fiber foods, and keeping a daily food record). Reported adherence ranged from 17% to 74%. No single predisposing, enabling, or reinforcing factor predicted adherence to all of the dietary self-care behaviours. However, more self-efficacy, better understanding, and a better attitude toward diabetes were associated with performing five or more of the dietary self-care behaviours examined. With respect to specific self-care behaviours, women were more likely than men to count carbohydrates (OR=5.75) and reduce fat in their diets (OR=2.57). Patients who attended more nutrition education sessions were more likely to follow diabetes meal plans (OR=2.11) and the diabetes exchange system (OR=3.07). Efforts are needed to encourage providers to teach diabetes self-care behaviours to patients and to capitalize upon demographic and psychosocial characteristics that can enhance patient adherence. PMID:26420183

  8. Glycemic control, quality of life and self-care behavior among adolescents with type 1 diabetes who attended a diabetes camp.

    PubMed

    Santiprabhob, Jeerunda; Kiattisakthavee, Pornpimol; Likitmaskul, Supawadee; Chaichanwattanakul, Katharee; Wekawanich, Jirapa; Dumrongphol, Hattaya; Sriwijitkamol, Apiradee; Peerapatdit, Thavatchai; Nitiyanant, Wannee

    2012-01-01

    A prospective study was conducted at the tenth Siriraj diabetes camp with the objectives of evaluating the effectiveness of diabetes camp on 1) glycemic control, 2) knowledge, 3) quality of life, and 4) self-care behavior of adolescents with type 1 diabetes (T1D) who participated in the diabetes camp. During the 5-day camp, twenty-seven participants (mean age 15.6 +/- 2.1 years, mean duration 6.3 +/- 3.0 years) were taught diabetes self-management education (DSME) and engaged in psychosocial support sessions. Post-camp activities were held every 3 months and participants were followed for 12 months post-camp. Glycemic control was assessed prior to the camp, then every 3 months. Knowledge level was assessed prior to the camp, at the end of the camp, and every 3 months. Diabetes self-care behavior and quality of life were evaluated prior to the camp, at 3 months and 12 months after the camp. After attending the camp, participants had improvement in knowledge but there were no changes in HbA1c levels or quality of life scores. Quality of life was not consistently associated with HbA1c. In general, participants did not perceive their quality of life was poor or feel having diabetes affected their social life. The issue participants worried about most was whether they would develop complications from diabetes. There were several weak points found among participant self-care behavior, particularly in diet-related matters. Despite no improvement in glycemic control, participants gained knowledge from attending the camp. Diet related self-care behavior is difficult for teenagers with T1D to be compliant.

  9. Being old and living alone in urban areas: the meaning of self-care and health on the perception of life situation and identity

    PubMed Central

    Sundsli, Kari; Espnes, Geir Arild; Söderhamn, Olle

    2013-01-01

    Background Living alone in urban areas when getting old is an important and necessary field for research as the growth of the urban population worldwide increases, and due to the fact that people live longer. How older people manage their self-care and health, and how this might influence their identity and life situation may be very important to understand when planning for a new, upcoming older generation. The aim of this study was to elucidate the meaning of self-care and health for the perception of life situation and identity among single-living older individuals in urban areas in southern Norway. Methods A phenomenological–hermeneutic approach inspired by Ricoeur was applied. Nine single-living older persons in urban areas, 70–82 years of age, and identified to be in good health were interviewed. The interviews were audiotaped, transcribed verbatim, and analyzed using a phenomenological–hermeneutic method. Results Strength and a time dimension characterized the meaning of self-care and health for the perception of life situation and identity as narrated by the group of single-living older individuals in urban areas in southern Norway. The informants were, as older individuals, caring, autonomous, and robust characters, who had gone through difficult times in life, and in a resilient way moved towards a new future. They valued and were grateful for what they had learned in their lives and could go forward and still experience and explore. Conclusion Self-care is significant in the perception of life situation and identity among single urban older people in this study, and characterized by strength, temporality, gratitude, autonomy, and natality. Society needs to acknowledge the strengths and capabilities of older people to a greater extent. PMID:23847434

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

    PubMed

    Aish, A E; Isenberg, M

    1996-06-01

    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 following hospital discharge, was effective in supporting healthy low-fat eating behavior. Nursing care influenced patients' self-care agency but lacked impact on self-efficacy for healthy eating. PMID:8736471

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

    PubMed

    Aish, A E; Isenberg, M

    1996-06-01

    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 following hospital discharge, was effective in supporting healthy low-fat eating behavior. Nursing care influenced patients' self-care agency but lacked impact on self-efficacy for healthy eating.

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

    PubMed

    Berbiglia, Violeta A

    2011-04-01

    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

  13. Self-care and yoga-academic-practice collaboration for occupational health.

    PubMed

    Alexander, Gina

    2013-12-01

    High rates of stress and burnout among nurses and other health care providers justify the exploration of innovative interventions designed to reduce stress and promote self-care among this population. A growing body of evidence supports the physical and psychosocial benefits of yoga and suggests the potential for yoga to support self-care and reduce stress among health care providers. This article describes the formation of an academic-practice collaboration to use yoga as a model for occupational health and wellness among nurses employed at a tax-supported urban health system. In addition, recommendations for program sustainability over time are discussed. PMID:24328918

  14. Medicine reclassification processes and regulations for proper use of over-the-counter self-care medicines in Japan

    PubMed Central

    Nomura, Kaori; Kitagawa, Yuki; Yuda, Yasukatsu; Takano-Ohmuro, Hiromi

    2016-01-01

    Objectives Japan has actively reclassified substances ranging from prescription drugs to over-the-counter (OTC) drugs in recent years. The sale of most OTC drugs was deregulated several times and pharmacists’ supervision was deemed no longer mandatory. Japan established a new OTC evaluation system in 2015 to hear opinions from various stakeholders regarding medicine types to be reclassified. This study aimed to examine the new framework to identify candidate substances for reclassification. Moreover, we examined how to manage the safe, self-care use of OTC drugs in Japan. Methods The necessary regulatory information on OTC approvals as of January 2015 was collected using an Internet search and relevant databases. To highlight the characteristics of OTC drugs in Japan, the UK was selected as a comparison country because it too was actively promoting the reclassification of medicines from prescription to nonprescription status, and because of economic similarity. Results Japan and the UK have a risk-based classification for nonprescription medicines. Japan has made OTC drugs available with mandatory pharmacists’ supervision, face-to-face with pharmacists, or online instruction, which is similar to the “pharmacy medicine” practiced in the UK. Japan recently reformed the reclassification process to involve physicians and the public in the process; some interactions were back to “prescription-only medicine” in the UK. Conclusion It is expected that the opinion of marketers, medical professionals, and the public will improve the discussion that will greatly contribute to the safe use of drugs. Monitoring the new system will be noteworthy to ensure that OTC drug users are managing their self-care properly and visiting a doctor only when necessary. The supply methods are similar in Japan and the UK; however, the expected growth in the Japanese OTC market by the Cabinet and the industry is still uncertain. PMID:27555801

  15. Impact of neuropathy on the adherence to diabetes-related self-care activities: a cross-sectional study

    PubMed Central

    Timar, Bogdan; Timar, Romulus; Schiller, Adalbert; Oancea, Cristian; Roman, Deiana; Vlad, Mihaela; Balinisteanu, Bogdan; Mazilu, Octavian

    2016-01-01

    Purpose The purpose of this study was to evaluate the impact of the presence and severity of neuropathy and depression on the patient’s adherence to diabetes-related self-care activities (DRSCA) in a cohort of patients with type 2 diabetes mellitus (T2DM). Patients and methods In this cross-sectional, noninterventional study, 198 patients with T2DM were enrolled according to a population-based, consecutive-case enrollment principle. In all patients, the adherence to DRSCA was evaluated using the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire; a higher SDSCA score is associated with a better adherence. The presence and severity of neuropathy was assessed using the Michigan Neuropathy Screening Instrument (MNSI) and the severity of depression using the Patient Health Questionnaire-9 (PHQ-9). Results The presence of neuropathy was associated with a decreased SDSCA score (26 points vs 37 points; P<0.001), an increased severe depression prevalence (24.7% vs 4.3%; P<0.001), and an increased PHQ-9 score (12 points vs 7 points; P<0.001). The MNSI score was reverse correlated with SDSCA score (r=−0.527; P<0.001) and positively correlated with PHQ-9 score (r=0.495; P<0.001). The reverse correlation between MNSI score and SDSCA score was present for all the subcomponents of SDSCA questionnaire (diet, exercise, glycemic monitoring, and foot care). Conclusion The presence of neuropathy is associated with decreases in the quality of adherence to DRSCA in patients with T2DM and with increases in the symptomatology of depression. The significant, negative association between the severity of T2DM and the quality of disease self-management points to a possible loop-type relationship between these two components, being possible a reciprocal augmentation with negative consequences on the global management of the disease. PMID:27445464

  16. Use of Traditional and Complementary Medicine as Self-Care Strategies in Community Health Centers

    PubMed Central

    Chung, Vincent C.H.; Wong, Samuel Y.S.; Wang, Harry H.X.; Wong, Martin C.S.; Wei, Xiaolin; Wang, Jiaji; Liu, Siya; Ho, Robin S.T.; Yu, Ellen L.M.; Griffiths, Sian M.

    2016-01-01

    Abstract In China, Community Health Centers (CHCs) are major providers of primary care services, but their potential in empowering patients’ self-management capacity has not been assessed. This study aims to describe self-care practice patterns amongst CHC attendees in urban China. In this cross-sectional quantitative study, 3360 CHC patients from 6 cities within the Pearl Delta Region were sampled using multistage cluster sampling. Thirty-seven per cent had used with over-the-counter Chinese herbal medicines (OTC CHMs) in the past year and majority of respondents found OTC CHMs effective. OTC CHMs were more popular amongst those who needed to pay out of pocket for CHC services. Less than 10% used vitamins and minerals, and those with a lower socioeconomic background have a higher propensity to consume. Although doubts on their usefulness are expressed, their use by the vulnerable population may reflect barriers to access to conventional health care, cultural affinity, or a defense against negative consequences of illnesses. About 25% performed physical exercise, but the prevalence is lower amongst women and older people. Taiji seems to be an alternative for these populations with promising effectiveness, but overall only 6% of CHC attendees participated. These results suggest that CHCs should start initiatives in fostering appropriate use of OTC CHM, vitamins, and minerals. Engaging community pharmacists in guiding safe and effective use of OTC CHM amongst the uninsured is essential given their low accessibility to CHC services. Prescription of Taiji instead of physical exercises to women and older people could be more culturally appropriate, and the possibility of including this as part of the CHC services worth further exploration. PMID:27281074

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

    ERIC Educational Resources Information Center

    Eastwood, Callum D.; Ecklund, Kathryn

    2008-01-01

    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…

  18. Symptom monitoring, alleviation, and self-care among Mexican Americans during cancer treatment.

    PubMed

    Williams, Phoebe D; Lantican, Leticia S; Bader, Julia O; Lerma, Daniela

    2014-10-01

    Monitoring the occurrence and severity of symptoms among Mexican American adults undergoing cancer treatments, along with their self-care to alleviate symptoms, are understudied; the current study aimed to fill this gap in the literature. A total of 67 Mexican Americans receiving outpatient oncology treatments in the southwestern United States participated. Instruments included a patient-report checklist, the Therapy-Related Symptom Checklist (TRSC), the Symptom Alleviation: Self-Care Methods tool, and a demographic and health information form. At least 40% of participants reported the occurrence of 12 symptoms: hair loss, feeling sluggish, nausea, taste change, loss of appetite, depression, difficulty sleeping, weight loss, difficulty concentrating, constipation, skin changes, and numb fingers and toes. More than a third also reported pain, vomiting, decreased interest in sexual activity, cough, and sore throat. The helpful self-care strategies reported included diet and nutrition changes; lifestyle changes; and mind, body control, and spiritual activities. Patient report of symptoms during cancer treatments was facilitated by the use of the TRSC. Patients use symptom alleviation strategies to help relieve symptoms during their cancer treatment. The ability to perform appropriate, effective self-care methods to alleviate the symptoms may influence adherence to the treatment regimen. PMID:25253108

  19. Self-Care and Self-Help Groups for the Elderly: A Directory.

    ERIC Educational Resources Information Center

    National Inst. on Aging (DHHS/PHS), Bethesda, MD.

    This document notes that, as health care costs continue to rise, the elderly are monitoring themselves as a means of cost containment, and as a way of enhancing their sense of well-being and their ability to lead active lives. It points out that more and more organizations are sponsoring health programs that promote the concept of self-care and…

  20. Young Cancer Patients' Perceptions of a Video Game Used to Promote Self Care

    ERIC Educational Resources Information Center

    Beale, Ivan L.; Marin-Bowling, Veronica M.; Guthrie, Nicole: Kato, Pamela M.

    2006-01-01

    A video game called "Re-Mission" has recently been investigated with adolescent and young adult cancer patients enrolled in a multi-site randomized controlled evaluation of the game as a psycho-educational intervention. The main focus of the trial was to determine effects of the game on self-care and other health-related outcomes. It was also…

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

    ERIC Educational Resources Information Center

    Evans, Yvonne A.; Payne, Monica A.

    2008-01-01

    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…

  2. Four Popular Stereotypes about Children in Self-Care: Implications for Family Life Educators

    ERIC Educational Resources Information Center

    Riley, Dave; Steinberg, Jill

    2004-01-01

    Books of advice for parents on the perils of "latchkey" children were published before researchers began to investigate the topic. We argue that the early "how to" books for parents created some overgeneralizations that require rethinking. Four popular assumptions about children in self-care are examined against current theory and research…

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

    ERIC Educational Resources Information Center

    Rager, Kathleen B.

    2005-01-01

    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…

  4. Adherence to Self-Care Interventions for Depression or Anxiety: A Systematic Review

    ERIC Educational Resources Information Center

    Simco, Russell; McCusker, Jane; Sewitch, Maida

    2014-01-01

    Objective: The objective of this study was to synthesise and describe adherence to intervention in published studies of supported self-care for depression or anxiety, and to identify participant characteristics associated with higher adherence. Methods: We searched the databases EMBASE, MEDLINE, CINAHL, and PSYCINFO for the period from January…

  5. Self-Efficacy, Planning and Action Control in an Oral Self-Care Intervention

    ERIC Educational Resources Information Center

    Zhou, Guangyu; Sun, Caiyun; Knoll, Nina; Hamilton, Kyra; Schwarzer, Ralf

    2015-01-01

    To evaluate a theory-guided intervention on oral self-care and examine the possible mechanisms among self-regulatory factors, two brief intervention arms were compared, an information-based education treatment and a self-regulation treatment focusing on planning and action control. Young adults (N = 284; aged 18-29 years) were assessed at baseline…

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

    ERIC Educational Resources Information Center

    Swartz, Ann L.

    2012-01-01

    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…

  7. Differences in foot self-care and lifestyle between men and women with diabetes mellitus 1

    PubMed Central

    Rossaneis, Mariana Angela; Haddad, Maria do Carmo Fernandez Lourenço; Mathias, Thaís Aidar de Freitas; Marcon, Sonia Silva

    2016-01-01

    ABSTRACT Objective: to investigate differences with regard to foot self-care and lifestyle between men and women with diabetes mellitus. Method: cross-sectional study conducted in a sample of 1,515 individuals with diabetes mellitus aged 40 years old or older. Poisson regression models were used to identity differences in foot self-care deficit and lifestyle between sexes, adjusting for socioeconomic and clinical characteristics, smoking and alcohol consumption. Results: foot self-care deficit, characterized by not regularly drying between toes; not regularly checking feet; walking barefoot; poor hygiene and inappropriately trimmed nails, was significantly higher among men, though men presented a lower prevalence of feet scaling and use of inappropriate shoes when compared to women. With regard to lifestyle, men presented less healthy habits, such as not adhering to a proper diet and taking laboratory exams to check for lipid profile at the frequency recommended. Conclusion: the nursing team should take into account gender differences concerning foot self-care and lifestyle when implementing educational activities and interventions intended to decrease risk factors for foot ulceration. PMID:27533270

  8. Reflexivity and Self-Care for Creative Facilitators: Stepping outside the Circle

    ERIC Educational Resources Information Center

    Moffatt, Amanda; Ryan, Mary; Barton, Georgina

    2016-01-01

    Those who work with others to explore new and creative ways of thinking about community and organizational participation, ways of engaging with others, individual well-being and creative solutions to problems, have a significant role in a cohesive society. Creative forms of learning can stimulate reflexive practices of self-care and lead to…

  9. Symptom monitoring, alleviation, and self-care among Mexican Americans during cancer treatment.

    PubMed

    Williams, Phoebe D; Lantican, Leticia S; Bader, Julia O; Lerma, Daniela

    2014-10-01

    Monitoring the occurrence and severity of symptoms among Mexican American adults undergoing cancer treatments, along with their self-care to alleviate symptoms, are understudied; the current study aimed to fill this gap in the literature. A total of 67 Mexican Americans receiving outpatient oncology treatments in the southwestern United States participated. Instruments included a patient-report checklist, the Therapy-Related Symptom Checklist (TRSC), the Symptom Alleviation: Self-Care Methods tool, and a demographic and health information form. At least 40% of participants reported the occurrence of 12 symptoms: hair loss, feeling sluggish, nausea, taste change, loss of appetite, depression, difficulty sleeping, weight loss, difficulty concentrating, constipation, skin changes, and numb fingers and toes. More than a third also reported pain, vomiting, decreased interest in sexual activity, cough, and sore throat. The helpful self-care strategies reported included diet and nutrition changes; lifestyle changes; and mind, body control, and spiritual activities. Patient report of symptoms during cancer treatments was facilitated by the use of the TRSC. Patients use symptom alleviation strategies to help relieve symptoms during their cancer treatment. The ability to perform appropriate, effective self-care methods to alleviate the symptoms may influence adherence to the treatment regimen.

  10. [Factors related to self-care in diabetes mellitus patients attended at emergency service in Mexico].

    PubMed

    Baquedano, Irasema Romero; dos Santos, Manoel Antônio; Teixeira, Carla Regina de Souza; Martins, Tatiane Aparecida; Zanetti, Maria Lúcia

    2010-12-01

    This cross-sectional study aimed to determine the self-care ability of individuals with type 2 diabetes mellitus and to relate this capacity with some sociodemographic and clinical variables. Participants were 251 patients who attended the Emergency Service at the Mérida Regional Hospital in Yucatán, Mexico, in 2006. Data were obtained through directed home interviews, using a form, a questionnaire and the Self-Care Capacity Scale. Descriptive and correlation statistics were used for data analysis. The results showed 83 (33.5%) subjects with good and 168 (66.5%) subjects with regular ability. A directly proportional correlation was found between self-care ability and years of study (r = 0.124; p < 0.05), as well as a negative correlation for religion (rs = -0.435; p < 0.05) and evolution time of the disease (r = -0.667; p < 0.05). These variables should be taken into account to promote self-care for diabetes patients, and further research needs to be developed with a focus on other variables involved in the behavior adopted to benefit their health.

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

    ERIC Educational Resources Information Center

    McClaran, Diane M.; Breakey, Robin Sarris

    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.…

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

    ERIC Educational Resources Information Center

    Ireland, Penelope; Johnston, Leanne M.

    2012-01-01

    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…

  13. The relationships among self-care, dispositional mindfulness, and psychological distress in medical students

    PubMed Central

    Slonim, Jessica; Kienhuis, Mandy; Di Benedetto, Mirella; Reece, John

    2015-01-01

    Background Past research suggests that medical students experience high levels of psychological distress. Objective The aim of the current study was to investigate the relationships among engagement in self-care behaviours, dispositional mindfulness, and psychological distress. Methods The sample consisted of 139 female and 68 male Australian medical students (N=207) aged 17–41 years (M=21.82, SD=3.62) across the 5 years of the Monash University medical course. Participants completed an online survey comprising a demographics questionnaire, the Five Facet Mindfulness Questionnaire, the Health-Promoting Lifestyle Profile II, and the Depression, Anxiety, and Stress Scales. Results Results revealed significant and interpretable multivariate correlations between distress and both mindfulness and self-care. Furthermore, the dispositional mindfulness observation subscale was found to be a significant moderator of the relationship between several dimensions of self-care and psychological distress. Conclusions The present study points to the potential of self-care and mindfulness to decrease medical student distress and enhance well-being. PMID:26112354

  14. Reduction of Multiple Aberrant Behaviors and Concurrent Development of Self-Care Skills with Differential Reinforcement.

    ERIC Educational Resources Information Center

    Vollmer, Timothy R.; And Others

    1992-01-01

    A modified functional analysis was used to assess the behavioral function of a profoundly retarded man's self-injurious behavior (SIB). Differential reinforcement of alternative behavior effectively reduced SIB and related behavior problems, while compliance of a self-care acquisition task increased markedly. (Author/DB)

  15. What Kind of Self-Care Strategies Do People Report Using and Is There an Association with Well-Being?

    ERIC Educational Resources Information Center

    Hansson, Anna; Hilleras, Pernilla; Forsell, Yvonne

    2005-01-01

    Objectives: The aim of this study was to describe what kind of self-care strategies people report using to improve or maintain their well-being. Furthermore, we also wanted to investigate whether reports of using self-care strategies were associated with well-being. Methods: A selected sample (n = 871), aged between 20 and 64 years, living in…

  16. Patient Education for Self-Care: The Role of Nurses. Current Bibliographies in Medicine. January 1983 through November 1990.

    ERIC Educational Resources Information Center

    Tillman, Peggie S., Comp.

    This bibliography contains 468 citations to journal articles and monographs on the role of the nurse in educating the patient or care provider for more involved self-care. Self-care is defined as the deliberate, voluntary practice of activities by individuals in the interest of health maintenance and promotion. A variety of National Library of…

  17. Lived experiences of self-care among older physically active urban-living individuals

    PubMed Central

    Sundsli, Kari; Espnes, Geir Arild; Söderhamn, Olle

    2013-01-01

    Background Promoting physical activity is a public health priority in most industrial countries, and physical function is an important factor when taking into consideration older people’s self-care and health. Despite the increasing challenges associated with urbanization and the aging population, urban life appears to be positive in many ways for urban dwellers. However, the manner in which older people live in urban settings and how this influences their ability to take care of themselves should be considered important knowledge for health professionals and politicians to acquire. 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 urban home-dwelling individuals who are physically active. Methods Ten subjects, three women and seven men, who were aged 65–82 years and identified to be physically active, were interviewed. The interviews were recorded, transcribed verbatim, and analyzed according to the descriptive phenomenological method devised by Giorgi. Results Our findings showed beneficial self-care. The participants lived active everyday lives and were frequently physically active. They were part of a supportive, inclusive, and promoting fellowship, and they had the opportunity to travel. They utilized their competence and experienced making themselves useful. It was a privilege to be part of a family life as a husband, wife, parent, and/or a grandparent. They acknowledged physical and mental limitations, yet they felt they were in good health. Conclusion Health professionals and politicians should identify places where fellowship and relationships can be built, as well as encourage older people to use their competence by engagement in volunteering. These interventions are important to support older people’s self-care and health. This may also be a way to reduce ageism in Western societies. PMID:23390363

  18. Factors that affect self-care behaviour of female high school students with dysmenorrhoea: a cluster sampling study.

    PubMed

    Chang, Shu-Fang; Chuang, Mei-hua

    2012-04-01

    The purpose of this study was to identify factors that affect the self-care behaviour of female high school students with dysmenorrhoea. This cross-sectional study utilized a questionnaire-based survey to understand the self-care behaviour of female high school students dysmenorrhoeal, along with the factors that affect this behaviour. A cluster random sampling method was adopted and questionnaires were used for data collection. Study participants experienced a moderate level of discomfort from dysmenorrhoea, and perceived dysmenorrhoea as serious. This investigation finds that cues to action raised perceived susceptibility to dysmenorrhoea and the perceived effectiveness of self-care behaviour and, therefore, increased the adoption of self-care behaviour. Hence, school nurses should offer female high school students numerous resources to apply correct self-care behaviour.

  19. Barriers and facilitators to self-care in chronic heart failure: a meta-synthesis of qualitative studies.

    PubMed

    Siabani, Soraya; Leeder, Stephen R; Davidson, Patricia M

    2013-01-01

    Chronic heart failure (CHF) is a costly condition that places large demands on self-care. Failure to adhere with self-care recommendations is common and associated with frequent hospitalization. Understanding the factors that enable or inhibit self-care is essential in developing effective health care interventions. This qualitative review was conducted to address the research question, "What are the barriers and facilitators to self-care among patients with CHF?" Electronic databases including Medline, EMBASE, CINAHL, Web of Science, Scopus and Google scholar were searched. Articles were included if they were peer reviewed (1995 to 2012), in English language and investigated at least one contextual or individual factor impacting on self-care in CHF patients > 18years. The criteria defined by Kuper et al. including clarity and appropriateness of sampling, data collection and data analysis were used to appraise the quality of articles. Twenty-three articles met the inclusion criteria. Factors impacting on self-care were included factors related to symptoms of CHF and the self-care process; factors related to personal characteristics; and factors related to environment and self-care system. Important factors such as socioeconomic situation and education level have not been explored extensively and there were minimal data on the influence of age, gender, self-confidence and duration of disease. Although there is an emerging literature, further research is required to address the barriers and facilitators to self-care in patients with CHF in order to provide an appropriate guide for intervention strategies to improve self-care in CHF. PMID:23961394

  20. A cross-sectional study of depression and self-care in patients with type 2 diabetes with and without foot ulcers.

    PubMed

    Coelho, Camila Ribeiro; Zantut-Wittmann, Denise Engelbrecht; Parisi, Maria Cândida Ribeiro

    2014-02-01

    Depression has been recognized as a risk factor for foot ulceration in persons with diabetes mellitus. Using convenience sampling methods, a cross-sectional study was conducted among persons with type 2 diabetes treated in a diabetic foot clinic in Sao Paulo, Brazil between February 2010 and December 2011. One hundred (100) patients (average age 62 years, range 38 to 83 years), 50 with a foot ulcer and 50 at risk for developing a foot ulcer, participated. Symptoms of depression were assessed using the Beck Depression Inventory (BDI), where scores increase with severity; and patients were interviewed about foot self-care behaviors. Average BDI scores among patients with an ulcer were higher (mean 20.37; range 1 to 42) than those of patients that had not developed a foot ulcer (mean 15.70; range 2 to 49) (P = 0.030). Self-care behavior was not significantly different between the two groups. Severe depression (P = 0.049, OR= 6.56 95% CI 1.01-42.58) and male gender (P <0.001, OR=14.87 95% CI 3.83-57.82) were associated with the presence of a foot ulcer. Despite reported adequate self-care behaviors, patients with an ulcer had more symptoms of depression than patients who were at risk for developing a foot ulcer. Studies examining cause-and-effect relationships between these observations and the potential role of depression interventions are needed. The results of this and other studies suggest depression screening is important in patients with diabetes mellitus and foot ulcers.

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

    PubMed Central

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

    2013-01-01

    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 over-the-counter (OTC) medications and home remedies self-care; professional health care is typically sought when self-care is not effective. However, relative to men, women were more knowledgeable about different approaches to self-care, especially home remedies, they used a wider range of self-care activities, and they placed greater priority on self-care over professional health care. Discussion The structure of older women’s and men’s self-care domain of health lifestyle is similar. However, there are subtle differences in health lifestyle that are likely embedded in gendered role behavior and may contribute to women’s greater health complaints. PMID:21632439

  2. Symptomatology and Coping Resources Predict Self-Care Behaviors in Middle to Older Age Patients with Heart Failure

    PubMed Central

    Graven, Lucinda J.; Grant, Joan S.; Gordon, Glenna

    2015-01-01

    Background. Symptoms of heart failure (HF) and coping resources, such as social support and social problem-solving, may influence self-care behaviors. Research regarding the influence of HF symptomatology characteristics and components of social support and social problem-solving on self-care is limited. Objective. To identify predictors of HF self-care behaviors using characteristics of HF symptomatology, components of social support and social problem-solving, and demographic and clinical factors. Methods. Using a cross-sectional, correlational predictive design, a convenience sample (N = 201) of outpatients with HF answered self-report surveys. Multiple linear regression with stepwise variable selection was conducted. Results. Six predictors of HF self-care were identified: race, symptom frequency, symptom-related interference with enjoyment of life, New York Heart Association Class HF, rational problem-solving style, and social network (β = 34.265, R2 = 0.19, P = 0.001). Conclusions. Assessing the influence of race on self-care behaviors in middle to older age patients with HF is important. Clinical assessment that focuses on symptom frequency, symptom-related interference with enjoyment of life, and HF Class might also impact self-care behaviors in this population. Rational problem-solving skills used and evaluation of the size of and satisfaction with one's social network may be appropriate when assessing self-care. PMID:26618000

  3. Symptomatology and Coping Resources Predict Self-Care Behaviors in Middle to Older Age Patients with Heart Failure.

    PubMed

    Graven, Lucinda J; Grant, Joan S; Gordon, Glenna

    2015-01-01

    Background. Symptoms of heart failure (HF) and coping resources, such as social support and social problem-solving, may influence self-care behaviors. Research regarding the influence of HF symptomatology characteristics and components of social support and social problem-solving on self-care is limited. Objective. To identify predictors of HF self-care behaviors using characteristics of HF symptomatology, components of social support and social problem-solving, and demographic and clinical factors. Methods. Using a cross-sectional, correlational predictive design, a convenience sample (N = 201) of outpatients with HF answered self-report surveys. Multiple linear regression with stepwise variable selection was conducted. Results. Six predictors of HF self-care were identified: race, symptom frequency, symptom-related interference with enjoyment of life, New York Heart Association Class HF, rational problem-solving style, and social network (β = 34.265, R (2) = 0.19, P = 0.001). Conclusions. Assessing the influence of race on self-care behaviors in middle to older age patients with HF is important. Clinical assessment that focuses on symptom frequency, symptom-related interference with enjoyment of life, and HF Class might also impact self-care behaviors in this population. Rational problem-solving skills used and evaluation of the size of and satisfaction with one's social network may be appropriate when assessing self-care.

  4. ASSOCIATION BETWEEN SELF-CARE BEHAVIORS AND SELF-ESTEEM OF RURAL ELDERLIES; NECESSITY OF HEALTH PROMOTION

    PubMed Central

    Bagheri-Nesami, Masoumeh; Goudarzian, Amir Hossein; Mirani, Hesam; Jouybari, Sina Sabourian; Nasiri, Davoud

    2016-01-01

    Introduction: Changes in the modern medical science caused significant reduction of mortality and every day increase of the elderly in the world. According to prevalence of physical and mental problems in elderly, it is necessary to take some actions. Self care in one of the best way to improve elderly health and life satisfaction that seems have a relation to self-esteem. Methods: This descriptive and analytical study was performed on 180 elderly in rural areas of the Sari city. Elderly selected by multi-stage randomize sampling method. Data were gathered by using standard questionnaires of self-care and Rosenberg self-esteem. Data were analyzed by Spearman and Pearson’s correlation using SPSS software (V16). Findings: The mean±SD of the ages of the elderly were 66.85±7.661. The score of self-care varies between 99 to 155 and most of them (66.7%) had good level of self-care. Also, most of elderly (52.2%) had high level of self-esteem. Also there was a significant relationship, between self-care and self-esteem (P<0.001, r=0.426). Conclusion: According to significant relationship between self-care and self-esteem of elderly, by the planning for improving the self care of elderly, can increase their health and significantly reduce from physical and mental complications. PMID:27047266

  5. Unhealthy substance-use behaviors as symptom-related self-care in persons with HIV/AIDS.

    PubMed

    Brion, John M; Rose, Carol Dawson; Nicholas, Patrice K; Sloane, Rick; Corless, Inge B; Lindgren, Teri G; Wantland, Dean J; Kemppainen, Jeanne K; Sefcik, Elizabeth F; Nokes, Kathleen M; Kirksey, Kenn M; Eller, Lucille; Hamilton, Mary Jane; Holzemer, William L; Portillo, Carmen J; Mendez, Marta Rivero; Robinson, Linda M; Moezzi, Shahnaz; Rosa, Maria; Human, Sarie; Maryland, Mary; Arudo, John; Ros, Ana Viamonte; Nicholas, Thomas P; Cuca, Yvette; Huang, Emily; Bain, Catherine; Tyer-Viola, Lynda; Zang, Sheryl M; Shannon, Maureen; Peters-Lewis, Angelleen; Willard, Suzanne

    2011-03-01

    Unhealthy substance-use behaviors, including a heavy alcohol intake, illicit drug use, and cigarette smoking, are engaged in by many HIV-positive individuals, often as a way to manage their disease-related symptoms. This study, based on data from a larger randomized controlled trial of an HIV/AIDS symptom management manual, examines the prevalence and characteristics of unhealthy behaviors in relation to HIV/AIDS symptoms. The mean age of the sample (n = 775) was 42.8 years and 38.5% of the sample was female. The mean number of years living with HIV was 9.1 years. The specific self-reported unhealthy substance-use behaviors were the use of marijuana, cigarettes, a large amount of alcohol, and illicit drugs. A subset of individuals who identified high levels of specific symptoms also reported significantly higher substance-use behaviors, including amphetamine and injection drug use, heavy alcohol use, cigarette smoking, and marijuana use. The implications for clinical practice include the assessment of self-care behaviors, screening for substance abuse, and education of persons regarding the self-management of HIV. PMID:21352430

  6. Self-care and home dialysis-role of social work.

    PubMed

    Hickerson, M

    1978-01-01

    Social work intervention in Self-Care involves evaluation, preparation, crisis-intervention and ongoing assessment and support. Early introduction of this modality is considered vital and factors of age, education, socio-economic level, sensory and environmental conditions are considered in the evaluation process. The social work relationship with patients is described within the context of family and community supports. Experience has demonstrated that patients with pre-existing adaptation problems may require more concentrated social work counseling. The goals of independence and rehabilitation are shown to be effected by patient motivation and economic restrictions. The social worker participating in the team approach is described as contributing to the patients opportunity for self-determination through patient advocacy, supportive services and social action. Self-Care patients are considered as having high potential for achievement and satisfaction.

  7. The self-care motivation model: theory and practice in healthy human development.

    PubMed

    Horowitz, L G

    1985-02-01

    Effective health education and behavior motivation programs are needed to promote the compliance of children and young adults with preventive health care practices. Health promotion and primary prevention programs must consider the entire individual as well as his or her environment if positive behavior changes are to be maintained. This paper introduces an innovative model for self-care motivation curriculum development. The model prescribes the use of value clarification, enhanced physical/cognitive/affective awareness, positive lifestyle choices, and self-reinforcement skills training whereby individuals learn to become self-motivated and reinforcing agents for their own primary preventive health practices. It is theorized that by developing self-care and self-regulation skills, students will achieve and maintain higher levels of wellness, thus improving the quality of their lives and ensuring healthy human development.

  8. Reduction of multiple aberrant behaviors and concurrent development of self-care skills with differential reinforcement.

    PubMed

    Vollmer, T R; Iwata, B A; Smith, R G; Rodgers, T A

    1992-01-01

    A modified functional analysis was used to assess the behavioral function of a profoundly retarded man's self-injurious behavior (SIB). Results of that analysis showed that the behavior was most likely to occur in a demand context (self-care instructions) but was maintained by positive reinforcement in the form of attention and physical contact. The results of the functional analysis also prescribed a treatment involving differential reinforcement of alternative behavior (DRA). Further investigation showed that other aberrant behaviors, such as aggression and disruption, were members of the same functional response class as SIB. The differential reinforcement of alternative behavior (DRA) procedure effectively reduced those behaviors while compliance to a self-care acquisition task increased markedly. The results are discussed in terms of the importance of determining behavioral function prior to treatment.

  9. Role of the Lebanese family caregivers in cardiac self-care: a collective approach

    PubMed Central

    Dumit, Nuhad Y; Abboud, Sarah; Massouh, Angela; Magilvy, Joan K

    2015-01-01

    Aims and objectives The purpose of this study was to explore perceptions of cardiac self-care among Lebanese family caregivers of cardiac patients. The specific aims were to describe the cultural context of cardiac care-giving in Lebanon and to explore the roles of family caregivers in enhancing self-care practices in patients with cardiac diseases. Background The role of family caregivers in Lebanon, a country in the Middle East, is assumed to extend beyond care-giving to making decisions on behalf of the patient and assuming responsibility for patient care. To date, there has been no study done to empirically validate this impression. Design The design of the study is qualitative descriptive that used semi-structured individual interviews with family caregivers of Lebanese cardiac patients. Method Thirteen family caregivers of cardiac patients were recruited from a referral medical centre in Lebanon. The participants were designated by their patients and interviewed in a place of their choice. Results One overarching and three themes emerged from data analysis describing roles of family care givers in cardiac self-care. The overarching theme was: Family caregivers of Lebanese cardiac patients were unfamiliar with the term, concept and meaning of Self-Care. The moral and emotional duty to care for the family member stemmed from obligation and responsibility towards patients (theme I). Interdependent care (theme II) between cardiac patients and their families emerged as a significant cultural role. Family members play multiple supportive roles in care-giving namely emotional, informational and instrumental role (theme III). Conclusion In this study, family caregiver role is shown to be based in the sense of obligation and duty towards the sick family member who collectively provide different types of supportive care. Relevance to clinical practice Nurses have to give significant importance to the family caregiver role as an integral part of any culturally sensitive

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

    PubMed

    Smith, Pratsani; Phillips, Kenneth D

    2013-04-01

    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, χ(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

  11. A feasibility study of a telephone-supported self-care intervention for depression among adults with a comorbid chronic physical illness in primary care

    PubMed Central

    2012-01-01

    Objective We assessed the feasibility and acceptability to patients of a telephone-supported self-care intervention for depression among adults aged 40 years or over with one of six targeted chronic physical illnesses and comorbid depressive symptoms in family practice settings. Methods An open, uncontrolled trial (feasibility study) was conducted among patients treated in Montreal family practices. Eligible patients were aged 40 years or over, had one or more of the targeted chronic physical illnesses for at least 6 months (arthritis, hypertension, diabetes, heart disease, asthma and chronic obstructive pulmonary disease) and were evaluated as having at least mild depressive symptoms (a score of ≥ 5 on the 9-item Patient Health Questionnaire, PHQ-9). Participants received a package of six self-care tools (information booklet, video, Internet programme, action plan, workbook and mood-monitoring tool) with telephone support by a lay coach for up to 6 months. Results In total, 63 eligible patients provided written consent and completed the baseline interview; 57 (90%) and 55 (87%) patients completed 2-month and 6-month follow-up interviews, respectively. The mean number of telephone calls made by coaches to participants was 10.5 (SD 4.0), and the average length of these calls was 10.6 minutes. At the 6-month follow-up, 83.6% of the participants reported that one or more of the tools were helpful. Clinically significant improvements were seen in depressive symptoms (as assessed by the PHQ-9) at 6 months, with an effect size of 0.88 (95% CI, 0.55, 1.14). Conclusion A telephone-supported self-care intervention for depression was feasible, was acceptable to patients, and was associated with a significant 6-month improvement in depressive symptoms. A randomised trial of this intervention is justified. PMID:24294301

  12. Developing an appropriate model for self-care of hypertensive patients: first experience from EMRO

    PubMed Central

    Sadeghi, Masoumeh; Shiri, Mansoor; Roohafza, Hamidreza; Rakhshani, Fatemeh; Sepanlou, Sadaf; Sarrafzadegan, Nizal

    2013-01-01

    BACKGROUND Cardiovascular diseases (CVDs) constitute 53% of deaths above the age of 30; 54% of these deaths are attributed to high blood pressure. Coronary artery disease (CAD) is the main cause of mortality in the world. Hypertension accounts for 13% of mortalities and 6% of morbidities and is one of the main risk factors that cause loss of healthy life years. Blood pressure is not optimally controlled even among those who are aware of their disease. Previous studies showed that apart from pharmacological treatment, lifestyle improvement can also play a significant role in the prevention of high blood pressure CVDs. Self-care among them has been addressed in several previous studies. There are few self-care programs in Iran, but no study has been conducted on blood pressure. METHODS In this study the primary model is designed and then revised, and in the pilot study the feasibility of the project was approved and the final model presented. RESULTS The current project proposes a model for self-care of hypertensive patients and their families, and is based on education of health care providers and patients in such a way that patients can control their illness. CONCLUSION The model can be implemented at a national scale. PMID:23970918

  13. Accessibility of mHealth Self-Care Apps for Individuals with Spina Bifida.

    PubMed

    Yu, Daihua X; Parmanto, Bambang; Dicianno, Brad E; Pramana, Gede

    2015-01-01

    As the smartphone becomes ubiquitous, mobile health is becoming a viable technology to empower individuals to engage in preventive self-care. An innovative mobile health system called iMHere (Internet Mobile Health and Rehabilitation) has been developed at the University of Pittsburgh to support self-care and adherence to self-care regimens for individuals with spina bifida and other complex conditions who are vulnerable to secondary complications. The goal of this study was to explore the accessibility of iMHere apps for individuals with spina bifida. Six participants were asked to perform tasks in a lab environment. Though all of the participants were satisfied with the iMHere apps and would use them again in the future, their needs and preferences to access and use iMHere apps differed. Personalization that provides the ability for a participant to modify the appearance of content, such as the size of the icons and the color of text, could be an ideal solution to address potential issues and barriers to accessibility. The importance of personalization--and potential strategies--for accessibility are discussed. PMID:26755902

  14. Nurses’ Empowerment in Self-Care Education to Stroke Patients: An Action Research Study

    PubMed Central

    Aslani, Zahra; Alimohammadi, Nasrollah; Taleghani, Fariba; Khorasani, Parvaneh

    2016-01-01

    ABSTRACT Background: Self-care needs are major problems among stroke patients. Nurses can support them through interventions such as education, a change in their attitude and emphasis on their remaining abilities. However, research has shown some weak points in the quality of care given to these patients. So the aim of this study was to improve the nurses’ practice in self-care education to stroke patients. Methods: The findings of evaluation phase showed that during action research, approaching the nurses’ empowerment in self-care education to stroke patients has been set in motion. The nursing practice improvement, knowledge based practice, nurses’ attitude change, ability to respond against routinization, and motivation promotion emphasize the success of change process. Facilitators and barriers of educating patients are acknowledged by the participants as a factor influencing the continuation of change. Results: The lack of nurses’ educating performance skills was overcome using action research and changes were made to improve the performance of nurses. Conclusions: The lack of nurses’ educating performance skills was overcome using action research and changes were made to improve the performance of nurses. PMID:27713896

  15. Managing the rate of increase in average co-ancestry in a rolling front tree breeding strategy.

    PubMed

    Kerr, R J; McRae, T A; Dutkowski, G W; Tier, B

    2015-04-01

    In breeding forest trees, as for livestock, the goal is to capture as much genetic gain as possible for the breeding objective, while limiting long- and short-term inbreeding. The Southern Tree Breeding Association (STBA) is responsible for breeding Australia's two main commercial forest tree species and has adopted algorithms and methods commonly used in animal breeding to achieve this balance. Discrete generation breeding is the norm for most tree breeding programmes. However, the STBA uses an overlapping generation strategy, with a new stream of breeding initiated each year. A feature of the species bred by the STBA (Pinus radiata and Eucalyptus globulus) is the long interval (up to 7 years) between when an individual is mated and when its progeny is first assessed in field trials and performance data included in the national performance database. Mate selection methods must therefore recognize the large pool of unmeasured progeny generated over recent years of crossing. In addition, the substantial delay between when an individual is selected in a field trial and when it is clonally copied into a mating facility (breeding arboretum) means that selection and mating must occur as a two-step process. In this article, we describe modifications to preselection and mate selection algorithms that allow unmeasured progeny (juveniles) to be recognized. We also demonstrate that the addition of hypothetical new progeny to the juvenile pool is important for computing the increase in average co-ancestry in the population. Methods outlined in this article may have relevance to animal breeding programmes where between mating and progeny measurement, new rounds of mating are initiated. PMID:25823837

  16. Managing the rate of increase in average co-ancestry in a rolling front tree breeding strategy.

    PubMed

    Kerr, R J; McRae, T A; Dutkowski, G W; Tier, B

    2015-04-01

    In breeding forest trees, as for livestock, the goal is to capture as much genetic gain as possible for the breeding objective, while limiting long- and short-term inbreeding. The Southern Tree Breeding Association (STBA) is responsible for breeding Australia's two main commercial forest tree species and has adopted algorithms and methods commonly used in animal breeding to achieve this balance. Discrete generation breeding is the norm for most tree breeding programmes. However, the STBA uses an overlapping generation strategy, with a new stream of breeding initiated each year. A feature of the species bred by the STBA (Pinus radiata and Eucalyptus globulus) is the long interval (up to 7 years) between when an individual is mated and when its progeny is first assessed in field trials and performance data included in the national performance database. Mate selection methods must therefore recognize the large pool of unmeasured progeny generated over recent years of crossing. In addition, the substantial delay between when an individual is selected in a field trial and when it is clonally copied into a mating facility (breeding arboretum) means that selection and mating must occur as a two-step process. In this article, we describe modifications to preselection and mate selection algorithms that allow unmeasured progeny (juveniles) to be recognized. We also demonstrate that the addition of hypothetical new progeny to the juvenile pool is important for computing the increase in average co-ancestry in the population. Methods outlined in this article may have relevance to animal breeding programmes where between mating and progeny measurement, new rounds of mating are initiated.

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

    PubMed Central

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

    2012-01-01

    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

  18. Incorporating Natural Products, Pharmaceutical Drugs, Self-Care and Digital/Mobile Health Technologies into Molecular-Behavioral Combination Therapies for Chronic Diseases.

    PubMed

    Bulaj, Grzegorz; Ahern, Margaret M; Kuhn, Alexis; Judkins, Zachary S; Bowen, Randy C; Chen, Yizhe

    2016-01-01

    Merging pharmaceutical and digital (mobile health, mHealth) ingredients to create new therapies for chronic diseases offers unique opportunities for natural products such as omega-3 polyunsaturated fatty acids (n-3 PUFA), curcumin, resveratrol, theanine, or α-lipoic acid. These compounds, when combined with pharmaceutical drugs, show improved efficacy and safety in preclinical and clinical studies of epilepsy, neuropathic pain, osteoarthritis, depression, schizophrenia, diabetes and cancer. Their additional clinical benefits include reducing levels of TNFα and other inflammatory cytokines. We describe how pleiotropic natural products can be developed as bioactive incentives within the network pharmacology together with pharmaceutical drugs and self-care interventions. Since approximately 50% of chronically-ill patients do not take pharmaceutical drugs as prescribed, psychobehavioral incentives may appeal to patients at risk for medication non-adherence. For epilepsy, the incentive-based network therapy comprises anticonvulsant drugs, antiseizure natural products (n-3 PUFA, curcumin or/and resveratrol) coupled with disease-specific behavioral interventions delivered by mobile medical apps. The add-on combination of antiseizure natural products and mHealth supports patient empowerment and intrinsic motivation by having a choice in self-care behaviors. The incentivized therapies offer opportunities: (1) to improve clinical efficacy and safety of existing drugs, (2) to catalyze patient-centered, disease self-management and behavior-changing habits, also improving health-related quality-of-life after reaching remission, and (3) merging copyrighted mHealth software with natural products, thus establishing an intellectual property protection of medical treatments comprising the natural products existing in public domain and currently promoted as dietary supplements. Taken together, clinical research on synergies between existing drugs and pleiotropic natural products

  19. Incorporating Natural Products, Pharmaceutical Drugs, Self-Care and Digital/Mobile Health Technologies into Molecular-Behavioral Combination Therapies for Chronic Diseases

    PubMed Central

    Bulaj, Grzegorz; Ahern, Margaret M.; Kuhn, Alexis; Judkins, Zachary S.; Bowen, Randy C.; Chen, Yizhe

    2016-01-01

    Merging pharmaceutical and digital (mobile health, mHealth) ingredients to create new therapies for chronic diseases offers unique opportunities for natural products such as omega-3 polyunsaturated fatty acids (n-3 PUFA), curcumin, resveratrol, theanine, or α-lipoic acid. These compounds, when combined with pharmaceutical drugs, show improved efficacy and safety in preclinical and clinical studies of epilepsy, neuropathic pain, osteoarthritis, depression, schizophrenia, diabetes and cancer. Their additional clinical benefits include reducing levels of TNFα and other inflammatory cytokines. We describe how pleiotropic natural products can be developed as bioactive incentives within the network pharmacology together with pharmaceutical drugs and self-care interventions. Since approximately 50% of chronically-ill patients do not take pharmaceutical drugs as prescribed, psychobehavioral incentives may appeal to patients at risk for medication non-adherence. For epilepsy, the incentive-based network therapy comprises anticonvulsant drugs, antiseizure natural products (n-3 PUFA, curcumin or/and resveratrol) coupled with disease-specific behavioral interventions delivered by mobile medical apps. The add-on combination of antiseizure natural products and mHealth supports patient empowerment and intrinsic motivation by having a choice in self-care behaviors. The incentivized therapies offer opportunities: (1) to improve clinical efficacy and safety of existing drugs, (2) to catalyze patient-centered, disease self-management and behavior-changing habits, also improving health-related quality-of-life after reaching remission, and (3) merging copyrighted mHealth software with natural products, thus establishing an intellectual property protection of medical treatments comprising the natural products existing in public domain and currently promoted as dietary supplements. Taken together, clinical research on synergies between existing drugs and pleiotropic natural products

  20. Does Telephone Follow-Up and Education Affect Self-Care and Metabolic Control in Diabetic Patients?

    PubMed

    Aytekin Kanadli, Keriman; Ovayolu, Nimet; Ovayolu, Özlem

    2016-01-01

    The major goal of diabetes control is to assist patients to perform self-care and metabolic control. One possible way to achieve this goal is education and regular monitoring of patients by telephone. Thus, the present study was conducted with the aim of investigating the impact of education and telephone follow-up on self-care and metabolic control in diabetic patients. This experimental study was conducted at a hospital in the Central Anatolia region of Turkey, with 88 diabetic patients including 44 intervention subjects and 44 control subjects. After an initial discussion, patients in the intervention group received education and telephone follow-up for 3 months. Required approvals were obtained before initiation of the study. Data were collected using a questionnaire form and the Diabetes Self-Care Scale. The Diabetes Self-Care Scale scores ranged between 140 and 210, where higher scores indicated increased self-care activities of patients. At the end of the study, the self-care score was found to increase from 61.3 ± 10.9 to 89.9 ± 12.3 in the intervention group (P < .005), but it showed a reduction from 56.5 ± 7.6 to 54.7 ± 9.3 after 3-month period in the control group. Education and telephone follow-up was also found to reduce the values of several variables of metabolic control including hemoglobin A1c, total cholesterol, triglycerides, low-density lipoprotein cholesterol, and systolic blood pressure. In conclusion, education and telephone follow-up of diabetic patients led to increased self-care scores and had a positive impact on metabolic control variables. In light of these findings, we suggest that education and tele-health home monitoring may be provided on a continuous basis to help patients sustain self-care behaviors that they have adopted during the study period.

  1. Effect of public health nurses’ educational intervention on self-care of the patients with type 2 diabetes

    PubMed Central

    Zandiyeh, Zahra; Hedayati, Batool; Zare, Elahe

    2015-01-01

    Background: Diabetes is the most common metabolic disease and the sixth cause of mortality in the world. Most of the conducted studies show that the only way to control this disease and prevent its disabling complications is constant administration of self-care. Aim: This study was conducted with the goal of determining the effect of public health nurses’ educational intervention on the self-care of the patients with type 2 diabetes who referred to Hazrat Ali clinic in Isfahan. Materials and Methods: This is a two-group two-step clinical trial with a before–after intervention design in which 50 patients with type 2 diabetes and with a mean age of 40–70 years were selected and assigned to study (n = 25) and control (n = 25) groups by allotting them even and add numbers. Educational intervention was conducted in the study group through seven educational sessions. Mean scores of self-care before and after interventions were compared by Toobert and Glasgow brief self-care activities questionnaire. Results: Results showed no significant difference in the self-care scores before intervention in the two groups (P = 0.67, z = 0.43), but the mean score of self-care showed a significant increase after intervention in the study group, compared to the control group (P = 0.002, z = 3.14). Conclusion: Based on the obtained results, it is suggested to provide constant education of self-care for diabetic patients in health care centers, with more emphasis on a change in self-care skills and behavior. PMID:27462630

  2. Students' Attitudes, Academic Performance and Preferences for Content Delivery in a Very Large Self-Care Course Redesign.

    PubMed

    Camiel, Lana Dvorkin; Mistry, Amee; Schnee, David; Tataronis, Gary; Taglieri, Catherine; Zaiken, Kathy; Patel, Dhiren; Nigro, Stefanie; Jacobson, Susan; Goldman, Jennifer

    2016-05-25

    Objective. To evaluate students' performance/attitudes toward a flipped team-based learning (TBL) format in a "very large" self-care course based on student content delivery preference. Design. Third-year students enrolled in the course were surveyed regarding elements of redesign and homework completion. Additionally, their performance and incoming grade point average were evaluated. Assessment. A survey was completed by 286 of 305 students. Nineteen percent of respondents preferred traditional content delivery, whereas 30% preferred flipped TBL, 48% preferred a mixed format, and 3% had no preference. The grades achieved in the course were: A (49%), B (48%), C (3%) and D (0%). The majority completed "all" or "most" of the homework, appreciated attributes of course redesign, felt home preparation and in-class activities engaged them, and reported improved communication/evaluation skills. Content delivery preference significantly affected attitudes. Conclusion. Students positively received a flipped team-based learning classroom format, especially those who preferred flipped TBL or mixed content delivery. A minority with preference for traditional teaching style did not enjoy the new format; however, their academic performance did not differ significantly from those who did. PMID:27293234

  3. Students' Attitudes, Academic Performance and Preferences for Content Delivery in a Very Large Self-Care Course Redesign.

    PubMed

    Camiel, Lana Dvorkin; Mistry, Amee; Schnee, David; Tataronis, Gary; Taglieri, Catherine; Zaiken, Kathy; Patel, Dhiren; Nigro, Stefanie; Jacobson, Susan; Goldman, Jennifer

    2016-05-25

    Objective. To evaluate students' performance/attitudes toward a flipped team-based learning (TBL) format in a "very large" self-care course based on student content delivery preference. Design. Third-year students enrolled in the course were surveyed regarding elements of redesign and homework completion. Additionally, their performance and incoming grade point average were evaluated. Assessment. A survey was completed by 286 of 305 students. Nineteen percent of respondents preferred traditional content delivery, whereas 30% preferred flipped TBL, 48% preferred a mixed format, and 3% had no preference. The grades achieved in the course were: A (49%), B (48%), C (3%) and D (0%). The majority completed "all" or "most" of the homework, appreciated attributes of course redesign, felt home preparation and in-class activities engaged them, and reported improved communication/evaluation skills. Content delivery preference significantly affected attitudes. Conclusion. Students positively received a flipped team-based learning classroom format, especially those who preferred flipped TBL or mixed content delivery. A minority with preference for traditional teaching style did not enjoy the new format; however, their academic performance did not differ significantly from those who did.

  4. Students’ Attitudes, Academic Performance and Preferences for Content Delivery in a Very Large Self-Care Course Redesign

    PubMed Central

    Mistry, Amee; Schnee, David; Tataronis, Gary; Taglieri, Catherine; Zaiken, Kathy; Patel, Dhiren; Nigro, Stefanie; Jacobson, Susan; Goldman, Jennifer

    2016-01-01

    Objective. To evaluate students’ performance/attitudes toward a flipped team-based learning (TBL) format in a “very large” self-care course based on student content delivery preference. Design. Third-year students enrolled in the course were surveyed regarding elements of redesign and homework completion. Additionally, their performance and incoming grade point average were evaluated. Assessment. A survey was completed by 286 of 305 students. Nineteen percent of respondents preferred traditional content delivery, whereas 30% preferred flipped TBL, 48% preferred a mixed format, and 3% had no preference. The grades achieved in the course were: A (49%), B (48%), C (3%) and D (0%). The majority completed “all” or “most” of the homework, appreciated attributes of course redesign, felt home preparation and in-class activities engaged them, and reported improved communication/evaluation skills. Content delivery preference significantly affected attitudes. Conclusion. Students positively received a flipped team-based learning classroom format, especially those who preferred flipped TBL or mixed content delivery. A minority with preference for traditional teaching style did not enjoy the new format; however, their academic performance did not differ significantly from those who did. PMID:27293234

  5. Do health literacy and patient empowerment affect self-care behaviour? A survey study among Turkish patients with diabetes

    PubMed Central

    Eyüboğlu, Ezgi; Schulz, Peter J

    2016-01-01

    Objective This study aimed to assess the impact of health literacy and patient empowerment on diabetes self-care behaviour in patients in metropolitan Turkish diabetes centres. The conceptual background is provided by the psychological health empowerment model, which holds that health literacy without patient empowerment comes down to wasting health resources, while empowerment without health literacy can lead to dangerous or suboptimal health behaviour. Design, setting and participants A cross-sectional study was conducted with 167 patients over the age of 18 from one of two diabetes clinics in a major Turkish City. Self-administered questionnaires were distributed to eligible outpatients who had an appointment in one of the clinics. Health literacy was measured by a newly translated Turkish version of the Short Test of Functional Health Literacy in Adults (S-TOFHLA) and the Chew self-report scale. Patient empowerment was measured by a 12-item scale based on Spreitzer's conceptualisation of psychological empowerment in the workplace. Self-care behaviour was measured by the Self-care behaviours were measured by the Summary of Diabetes Self-Care Activities Measure (SDSCA). Level of diabetes knowledge was measured by Diabetes Knowledge Test. Results Two subscales of empowerment, impact and self-determination, predicted self-reported frequency of self-care behaviours. Neither health literacy nor diabetes knowledge had an effect on self-care behaviours. Conclusions Health literacy might be more effective in clinical decisions while empowerment might exert a stronger influence on habitual health behaviours. PMID:26975936

  6. Symptom-related self-care of Mexican Americans with type 2 diabetes: preliminary findings of the Starr County Diabetes Education Study.

    PubMed

    Brown, S A; Upchurch, S L; Garcia, A A; Barton, S A; Hanis, C L

    1998-01-01

    Starr County, Texas, a Texas-Mexico border community, was the site of a study involving culturally-appropriate education and group support for Mexican Americans with type 2 diabetes. Data were collected from 63 subjects on frequency of diabetes-related symptoms during the previous month and on self-care symptom treatments. On average, subjects were 57-year-old females, diagnosed with diabetes for 10 years, and exhibiting HbA1c levels of 12.5%. Almost 50% experienced excessive urination, excessive thirst, shakiness/nervousness, and numbness and/or tingling in their extremities. More than 50% of those who experienced symptoms did not view them as serious. Only one subject checked blood sugar levels when symptoms occurred. Significantly higher mean glycosylated hemoglobin levels were found for individuals who experienced dizziness and/or chest pain compared with those who did not. A variety of self-care treatments were employed, including over-the-counter medications and home remedies. PMID:9677951

  7. Association of Online Health Information–Seeking Behavior and Self-Care Activities Among Type 2 Diabetic Patients in Saudi Arabia

    PubMed Central

    AlHumud, Ahmed; Al-Duhyyim, Abdulaziz; Alrashed, Mohammed; Bin Shabr, Faisal; Alteraif, Alwalid; Almuziri, Abdullah; Househ, Mowafa; Qureshi, Riaz

    2015-01-01

    , familial history of the disease, unemployment, and not seeking diabetes education were the most common barriers for online health-related information–seeking behavior. Younger age, female, marital status, higher education, higher income, and longer duration of Internet usage were associated with more online health-related information–seeking behaviors. Most (89/96, 93%) online health-related information seekers reported positive change in their behaviors after seeking online health information. Overall odds ratio (OR 1.56, 95% CI 0.63-3.28) for all self-care responses demonstrated that there was no statistically significant difference between those seeking health-related information online and non–health-related information seekers. However, health-related information seekers were better in testing their blood glucose regularly, taking proper action for hyperglycemia, and adopting nonpharmacological management. Conclusions Physicians and television are still the primary sources of health-related information for adult diabetic patients in Saudi Arabia whether they seek health-related information online or not. This study demonstrates that participants seeking online health-related information are more conscious about their diabetes self-care compared to non–health-related information seekers in some aspects more than the others. PMID:26268425

  8. Pre-chirping management of a self-similar Yb-fiber amplifier towards 80 W average power with sub-40 fs pulse generation.

    PubMed

    Zhao, Jian; Li, Wenxue; Wang, Chao; Liu, Yang; Zeng, Heping

    2014-12-29

    We report on the generation of 80-W average power 38-fs laser pulse from a 2-m polarization-maintaining large-mode-area photonic crystal fiber amplifier with high pump absorption coefficient. The pre-chirping management was demonstrated to play a key role on the self-similar amplification. The achieved spectral bandwidth and compressed pulse duration were determined by the interplay between self-phase modulation and finite gain bandwidth. The power scaling in the self-similar fiber amplifier system was eventually limited by the onset of stimulated Raman scattering. PMID:25607187

  9. Sore throat: effective communication delivers improved diagnosis, enhanced self-care and more rational use of antibiotics.

    PubMed

    van der Velden, A W; Bell, J; Sessa, A; Duerden, M; Altiner, A

    2013-11-01

    confidence in self-care and encourage them to accept the self-limiting character of the illness - important steps towards improving antibiotic stewardship in acute throat infections.

  10. Health Status and Self-care Outcomes Following an Education-Support Intervention for People with Chronic Heart Failure

    PubMed Central

    Clark, Angela P.; McDougall, Graham; Riegel, Barbara; Joiner-Rogers, Glenda; Innerarity, Sheri; Meraviglia, Martha; Delville, Carol; Davila, Ashley

    2014-01-01

    Background The rising cost of hospitalizations for heart failure (HF) care mandates intervention models to address education for self-care success. The effectiveness of memory enhancement strategies to improve self-care and learning needs further examination. Objective The objective of this study was to examine the effects of an education-support intervention delivered in the home setting, using strategies to improve health status and self-care in adults/older adults with class I-III HF. Our secondary purpose was to explore participants’ subjective perceptions of the intervention. Methods This study used a randomized, 2 group design. Fifty people were enrolled for 9 months and tested at 4 time points—baseline; following a 3-month education-support intervention; at 6 months, following 3-months of telephone/email support; and 9 months, following a 3-month period of no contact. Advanced practice registered nurses (APRNs) delivered the intervention. Memory enhancement methods were built into the teaching materials and delivery of the intervention. We measured the intervention’s effectiveness on health status outcomes (functional status, self-efficacy, quality of life, emotional state/depressive symptoms, and metamemory) and self-care outcomes (knowledge/knowledge retention, self-care ability). Subjects evaluated the usefulness of the intervention at the end of the study. Results The mean age of the sample was 62.4 years, with a slight majority of female participants. Participants were well educated and had other concomitant diseases, including diabetes (48%), and an unexpected degree of obesity. The intervention group showed significant improvements in functional status, self-efficacy and quality of life (Kansas City Cardiomyopathy Questionnaire-KCCQ); metamemory Change and Capacity subscales (Metamemory in Adulthood Questionnaire-MIA); self-care knowledge (HF Knowledge Test-HFKT); and self-care (Self-Care in Heart Failure Index—SCHFI). Participants in both

  11. Self-care Decontamination within a Chemical Exposure Mass-casualty Incident.

    PubMed

    Monteith, Raymond G; Pearce, Laurie D R

    2015-06-01

    Growing awareness and concern for the increasing frequency of incidents involving hazardous materials (HazMat) across a broad spectrum of contaminants from chemical, biological, radiological, and nuclear (CBRN) sources indicates a clear need to refine the capability to respond successfully to mass-casualty contamination incidents. Best results for decontamination from a chemical agent will be achieved if done within minutes following exposure, and delays in decontamination will increase the length of time a casualty is in contact with the contaminate. The findings presented in this report indicate that casualties involved in a HazMat/CBRN mass-casualty incident (MCI) in a typical community would not receive sufficient on-scene care because of operational delays that are integral to a standard HazMat/CBRN first response. This delay in response will mean that casualty care will shift away from the incident scene into already over-tasked health care facilities as casualties seek aid on their own. The self-care decontamination protocols recommended here present a viable option to ensure decontamination is completed in the field, at the incident scene, and that casualties are cared for more quickly and less traumatically than they would be otherwise. Introducing self-care decontamination procedures as a standard first response within the response community will improve the level of care significantly and provide essential, self-care decontamination to casualties. The process involves three distinct stages which should not be delayed; these are summarized by the acronym MADE: Move/Assist, Disrobe/Decontaminate, Evaluate/Evacuate.

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

    PubMed Central

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

    2008-01-01

    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, η2 = .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, η2 = .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. PMID:18088556

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

    PubMed Central

    Shea, Kimberly; Chamoff, Breanna

    2012-01-01

    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

  14. Assessment on self-care, mobility and social function of children with spina bifida in Turkey

    PubMed Central

    Sirzai, Hulya; Dogu, Beril; Demir, Selamet; Yilmaz, Figen; Kuran, Banu

    2014-01-01

    The aim of the study was to investigate the functional performance in children with spina bifida, using the Pediatric Evaluation of Disability Inventory (PEDI) to look into capacity of twenty-eight children with spina bifida with lesions at different levels in different dimensions of self-care, mobility and social function. Mean age of the patients was 3.5 ± 2.3 (1–10) years. In the muscle test carried out, 13 patients (44.8%) had no movements including pelvic elevation in lower extremity muscles and they were at level 5. Sixteen patients (54%) were non-ambulatory according to the Hoofer ambulation classification. Raw and scale scores in the self-care, mobility and social function domains both in the functional skill scale and in the caregiver scale were found to be lower compared to the data of the normal population. A statistically significant correlation was observed in the self-care values of the Functional Skills Scales and the Caregiver Assistance Scale measurements, which was positive for age and negative for Functional Ambulation Scale and muscle test (P < 0.05). A positive relation was found between the Functional Skills Scales-mobility area and age while a negative relation was observed between Functional Ambulation Scale and muscle test (P < 0.005). A negative relation was also found between Caregiver Assistance Scale-mobility and Functional Ambulation Scale and muscle test (P < 0.005). In our study, the functional performance of the children was found to be low. Low-level lesions, encouraging muscular strength and independence in mobility are all very important factors for functional independence. PMID:25206788

  15. Socio-economic inequalities in health, habits and self-care during pregnancy in Spain.

    PubMed

    Larrañaga, Isabel; Santa-Marina, Loreto; Begiristain, Haizea; Machón, Mónica; Vrijheid, Martine; Casas, Maribel; Tardón, Adonina; Fernández-Somoano, Ana; Llop, Sabrina; Rodriguez-Bernal, Clara L; Fernandez, Mariana F

    2013-09-01

    Socioeconomic disadvantage can be harmful for mother's health and can influence child's health long term. The aim of this study is to analyse social inequalities between pregnant women from four INMA (INfancia y Medio Ambiente) cohorts. The analysis included 2,607 pregnant women recruited between 2004 and 2008 from four INMA cohorts. Data on maternal characteristics were collected through two questionnaires completed in the first and third trimester of pregnancy. The relationship between socioeconomic status (SES) and maternal health, dietary intake, lifestyle habits and self-care related variables was modelled using logistic regression analysis. 33.5 % of women had a university level of education and 47 % had high occupational class. Women with higher SES reported healthier habits, fewer complications during pregnancy, better weight gain control and attended more prenatal appointments than women with lower SES. The risk of sedentary behaviour and passive smoking was higher among women with a lower level of education (OR = 1.7, 95 % CI 1.3-2.2 and OR = 1.6, 95 % CI 1.2-2.3, respectively) and with less skilled occupations (OR = 1.7, 95 % CI 1.4-2.0 and OR = 1.2, 95 % CI 1.0-1.5, respectively). Although both SES indicators-occupation and education-act as social determinants of diet, occupation was a more powerful determinant than education. For other lifestyle and self-caring variables, education was a more powerful predictor than occupation. Social inequalities were observed in health, habits and self-care during pregnancy. Proper care during pregnancy requires the control of common clinical variables and the knowledge of socioeconomic conditions of the pregnant women.

  16. Self-care Decontamination within a Chemical Exposure Mass-casualty Incident.

    PubMed

    Monteith, Raymond G; Pearce, Laurie D R

    2015-06-01

    Growing awareness and concern for the increasing frequency of incidents involving hazardous materials (HazMat) across a broad spectrum of contaminants from chemical, biological, radiological, and nuclear (CBRN) sources indicates a clear need to refine the capability to respond successfully to mass-casualty contamination incidents. Best results for decontamination from a chemical agent will be achieved if done within minutes following exposure, and delays in decontamination will increase the length of time a casualty is in contact with the contaminate. The findings presented in this report indicate that casualties involved in a HazMat/CBRN mass-casualty incident (MCI) in a typical community would not receive sufficient on-scene care because of operational delays that are integral to a standard HazMat/CBRN first response. This delay in response will mean that casualty care will shift away from the incident scene into already over-tasked health care facilities as casualties seek aid on their own. The self-care decontamination protocols recommended here present a viable option to ensure decontamination is completed in the field, at the incident scene, and that casualties are cared for more quickly and less traumatically than they would be otherwise. Introducing self-care decontamination procedures as a standard first response within the response community will improve the level of care significantly and provide essential, self-care decontamination to casualties. The process involves three distinct stages which should not be delayed; these are summarized by the acronym MADE: Move/Assist, Disrobe/Decontaminate, Evaluate/Evacuate. PMID:25915603

  17. An Economic Evaluation of a Self-Care Intervention in Persons with Heart Failure and Diabetes

    PubMed Central

    Reilly, Carolyn Miller; Butler, Javed; Culler, Steven D.; Gary, Rebecca A.; Higgins, Melinda; Schindler, Peter; Butts, Brittany; Dunbar, Sandra B.

    2015-01-01

    Background Persons with concomitant heart failure (HF) and diabetes mellitus are a growing population whose quality of life is encumbered with worse clinical outcomes as well as high health resource use (HRU) and costs. Methods and Results Extensive data on HRU and costs were collected as part of a prospective cost effectiveness analysis of a self-care intervention to improve outcomes in persons with both HF and diabetes. HRU costs were assigned from a Medicare reimbursement perspective. Patients (n=134) randomized to the self-care intervention and those receiving usual care/attention control were followed for 6 months, revealing significant differences in the number of hospitalization days and associated costs between groups. The mean number of inpatient days (d) was 3d with bootstrapped bias corrected (BCa) confidence intervals (CI) of 1.8d – 4.4d) for intervention group and 7.3d (BCa CI 4.1d – 10.9d) in the control group; p= .044. Total direct HRU costs per participant were an estimated $9,065 (BCa CI $6,496 to $11,936) in the intervention and $16,712 (BCa CI 8,200 to $26,621) in the control group, for a mean difference of −$7,647 (BCa CI −$17,588 to $809, p= .21) in favor of the intervention, including intervention costs estimated to be $130.67 per patient. Conclusions The self-care intervention demonstrated dominance in lowering costs without sacrificing Quality Adjusted Life Years. Clinical Trial Registration– http://www.clinicaltrials.gov: NCT01606085 PMID:26164214

  18. Regulatory focus and adherence to self-care behaviors among adults with type 2 diabetes.

    PubMed

    Avraham, Rinat; Van Dijk, Dina; Simon-Tuval, Tzahit

    2016-09-01

    The aims of this study were, first, to test the association between regulatory focus of adults with type 2 diabetes and their adherence to two types of self-care behaviors - lifestyle change (e.g. physical activity and diet) and medical care regimens (blood-glucose monitoring, foot care and medication usage). Second, to explore whether a fit between the message framing and patients' regulatory focus would improve their intentions to adhere specifically when the type of behavior fits the patients' regulatory focus as well. A cross-sectional study was conducted among 130 adults with type 2 diabetes who were hospitalized in an academic medical center. The patients completed a set of questionnaires that included their diabetes self-care activities, regulatory focus, self-esteem and demographic, socioeconomic and clinical data. In addition, participants were exposed to either a gain-framed or a loss-framed message, and were then asked to indicate their intention to improve adherence to self-care behaviors. A multivariable linear regression model revealed that promoters reported higher adherence to lifestyle change behaviors than preventers did (B = .60, p = .028). However, no effect of regulatory focus on adherence to medical care regimens was found (B = .46, p = .114). In addition, preventers reported higher intentions to adhere to medical care behaviors when the message framing was congruent with prevention focus (B = 1.16, p = .023). However, promoters did not report higher intentions to adhere to lifestyle behaviors when the message framing was congruent with promotion focus (B = -.16, p = .765). These findings justify the need to develop tailor-made interventions that are adjusted to both patients' regulatory focus and type of health behavior. PMID:26576471

  19. Assessment of Activities of Daily Living, Self-Care, and Independence.

    PubMed

    Mlinac, Michelle E; Feng, Michelle C

    2016-09-01

    Activities of daily living (ADL) comprise the basic actions that involve caring for one's self and body, including personal care, mobility, and eating. In this review article, we (1) review useful clinical tools including a discussion on ways to approach ADL assessment across settings, (2) highlight relevant literature evaluating the relationship between cognitive functioning and ADLs, (3) discuss other biopsychosocial factors affecting ADL performance, (4) provide clinical recommendations for enhancing ADL capacity with an emphasis on self-care tasks (eating, grooming, dressing, bathing and toileting), and (5) identify interventions that treatment providers can implement to reduce the burden of ADL care. PMID:27475282

  20. [Home care for the chronically ill: a self-care health system].

    PubMed

    Silva, Leticia Robles

    2004-01-01

    This article focuses on home care for chronically ill adults and seniors. According to our thesis, home care should be understood as a self-care system, and its aim is to guarantee the individual's social and bodily survival. Home care consists of three areas, related to illness, the home, and to life history. Caregiving, usually under women's responsibility, is present throughout the history of the illness and the health-seeking process. The article analyzes these issues in light of the ageing process, the epidemiological changes occurring worldwide, and the urgency to incorporate this analysis into the heath care research agenda. PMID:15073644

  1. Patients' and Spouses' Contribution Toward Adherence to Self-Care Behaviors in Type 2 Diabetes.

    PubMed

    Pereira, M Graça; Costa, Vera; Oliveira, Daniela; Ferreira, Gabriela; Pedras, Susana; Sousa, Maria Rui; Machado, José C

    2015-01-01

    This article focuses on patients' and partners' variables regarding adherence to self-care, in recently diagnosed patients with Type 2 diabetes. One hundred four patients and partners were included. Instruments answered were Family Inventory of Life Events and Changes (family stress), Family Crisis Oriented Personal Evaluation Scales (family coping), Revised Dyadic Adjustment Scale (dyadic adjustment), Multidimensional Diabetes Questionnaire (partner support) and Hospital Anxiety and Depression Scale (psychological morbidity). Results showed adherence to diet to be positively predicted by patient dyadic adjustment and patient positive support and negatively by partner depression and partner negative support. Adherence to exercise was predicted by patient's family stress and negatively by partner anxiety. Adherence to glucose monitoring was predicted by partner positive support. Psychological variables were not associated with adherence to foot care. Finally, positive partner support moderated the relationship between family stress and dyadic adjustment in patients. The results emphasize the need to treat the patient in the context of the dyad. Future research should focus on partners' specific instrumental behaviors that promote patients' self-care behaviors.

  2. Experiences with establishing the first self-care hemodialysis program in a hospital in mainland China.

    PubMed

    Yang, Wen-Ling; Zhang, Feng; He, Lian; Zhang, Ai-Hua; Wang, Tao; Suzie, Burford; Yang, Li-Jie; Lai, Chi

    2013-01-01

    There has never been a home hemodialysis (HHD) program or self-care hemodialysis (SC-HD) program in Mainland China, and it may be plausible starting from an SC-HD program. This study describes the systems for, and the initial results of, starting an SC-HD program. A program for SC-HD was instituted at the Peking University Third Hospital. A working group had designed the patient education program and water quality assurance. The patient's education program was established, which consisted of a handbook and a video for training. In May 2009, two patients were recruited and trained for HD. They were adequately dialyzed with satisfactory Kt/V, both the patients could perform all of the self-care procedures after training for 12 weeks. More difficult procedures, such as the self-cannulation, were successfully handled. Significant improvement was found in six of the eight short form (SF)-36 health scales after 6 months for SC-HD treatment. For the past year, there were no severe complications resulting from SC-HD. In summary, our first SC-HD program in Mainland China is feasible and safe. It promotes rehabilitation, increases self-esteem, and improves health-related quality of life. It is also a first attempt for starting an HHD program. PMID:23228242

  3. Knowledge, Awareness and Self-Care Practices of Hypertension among Cardiac Hypertensive Patients

    PubMed Central

    Bilal, Muhammad; Haseeb, Abdul; Lashkerwala, Sehan Siraj; Zahid, Ibrahim; Siddiq, Khadijah; Saad, Muhammad; Dar, Mudassir Iqbal; Arshad, Mohammad Hussham; Shahnawaz, Waqas; Ahmed, Bilal; Yaqub, Aimen

    2016-01-01

    Introduction: The most prevalent form of hypertension is systolic blood pressure (SBP) and it is considered to be predisposing risk factor for cardiovascular disease. The objective of the study was to assess self-care practices, knowledge and awareness of hypertension, especially related to SBP among cardiac hypertensive patients. Methodology: A Cross sectional study was conducted on 664 cardiac hypertensive patients, which were selected by non-probability convenience sampling from cardiology outpatient department of three tertiary care hospitals. Face to face interviews were conducted using a pre designed questionnaire. Data was entered and analyzed by SPSS (V17). Results: 81.8%, did not know that hypertension is defined as high blood pressure. 97.1% of the sample population did not know that top measurement of blood pressure was referred to as systolic and only 25.0% correctly recognized normal systolic blood pressure to be less than 140mmHg. 7.4% of the patients consulted their doctor for hypertension once or twice in a month. Risk factor for high blood pressure most commonly identified by the participants was too much salt intake Conclusions: The results state that there is an inadequate general knowledge of hypertension among cardiac patients and they do not recognise the significance of elevated SBP levels. There is a need to initiate programs that create community awareness regarding long term complications of uncontrolled hypertension, particularly elevated SBP levels so that there is an improvement in self-care practices of the cardiacpatients. PMID:26383212

  4. An Active Learning Complementary and Alternative Medicine Session in a Self-Care Therapeutics Class

    PubMed Central

    Nemec, Eric C.

    2014-01-01

    Objective. To provide an interactive, non-supplement based complementary and alternative medicine (CAM) session in a self-care therapeutics class and to evaluate the effect of the session on pharmacy students’ perceptions and knowledge of CAM. Design. Second professional year pharmacy students enrolled in a required 3-credit course titled Self-Care Therapeutics participated in an active learning session on CAM. Students physically engaged in 5 separate active learning CAM sessions including massage therapy, Tai Chi, yoga, progressive muscle relaxation, and Reiki. Assessment. Students were assessed on both knowledge and perception of CAM. Concept mastery was assessed using a written examination and individual readiness assurance tests (iRAT) and team readiness assurance tests (tRAT). Perception of CAM was measured using both a presession and a postsession survey. Conclusion. Participating in an intensive, active learning CAM session provided an opportunity to increase students’ knowledge of CAM and an effective strategy for providing the learner with the experience to better envision incorporation into patient therapies. PMID:25258446

  5. Diabetes self-care behaviours and clinical outcomes among Taiwanese patients with type 2 diabetes.

    PubMed

    Ouyang, Chung-Mei; Dwyer, Johanna T; Jacques, Paul F; Chuang, Lee-Ming; Haas, Catherine F; Weinger, Katie

    2015-01-01

    We examined the influences of patients' background characteristics on the frequency of performing five diabetes self-care behaviours that 185 Taiwanese outpatients reported. All patients had type 2 diabetes diagnosed for more than a year and attended an outpatient clinic at a large university hospital where they had received at least one dietitian-led individual nutrition education session and one nurse-led diabetes education session during the course of their care. Seventy nine percent of the patients regularly (defined as responses often or always on the questionnaire) took their medications and over half followed recommended meal plans and exercised, but fewer performed foot care (38%) or checked their blood glucose levels (20%) regularly. The associations between patients' demographics and disease-related characteristics and their performance of self-care behaviours were assessed with logistic regression. Although checking blood glucose levels and performing diabetes foot care were unrelated to any clinical outcome examined, patients who took their diabetes medications had lower hemoglobin A1c levels and fewer chronic complications than those who did not. Furthermore, patients who followed a diabetes meal plan also had lower hemoglobin A1c levels, and those who exercised regularly had healthier body mass indices (BMI) than those who did not. PMID:26420184

  6. Evaluation of two self-care treatments for prevention of vaginal candidiasis in women with HIV.

    PubMed

    Williams, A B; Yu, C; Tashima, K; Burgess, J; Danvers, K

    2001-01-01

    Vaginal candidiasis (VC) is a common concern for women living with HIV infection. The authors evaluated the effectiveness of two self-care approaches to prophylaxis of VC among HIV-infected women, weekly intravaginal application of Lactobacillus acidophilus or weekly intravaginal application of clotrimazole tablets, in a randomized, double-blind, placebo-controlled trial. VC was defined as a vaginal swab positive for Candida species in the presence of signs/symptoms of vaginitis and the absence of a diagnosis of Trichomonas vaginalis or bacterial vaginosis. Thirty-four episodes of VC occurred among 164 women followed for a median of 21 months. The relative risk of experiencing an episode of VC was 0.4 (95% CI = 0.2, 0.9) in the clotrimazole arm and 0.5 (95% CI = 0.2, 1.1) in the Lactobacillus acidophilus arm. The estimated median time to first episode VC was longer for clotrimazole (p = .03, log rank test) and Lactobacillus acidophilus (p = .09, log rank test) compared with placebo. Vaginal yeast infections can be prevented with local therapy. Education about self-care for prophylaxis of VC should be offered to HIV-infected women.

  7. Evaluation of the telephone intervention in the promotion of diabetes self-care: a randomized clinical trial 1

    PubMed Central

    Fernandes, Bárbara Sgarbi Morgan; Reis, Ilka Afonso; Torres, Heloisa de Carvalho

    2016-01-01

    ABSTRACT Objective: to evaluate the effectiveness of the telephone intervention for promoting self-care related to physical activity and following a diet plan in users with diabetes, compared to conventional monitoring of users over a six-month period. Method: this was a randomized clinical trial, which included 210 users with diabetes, linked to eight Primary Health Units of Belo Horizonte, Minas Gerais. The experimental group (104 members) received six telephone interventions over the six-month monitoring; the control group (106 members) received conventional monitoring. To evaluate the self-care practices related to physical activity and following a healthy eating plan, in both groups, the self-care questionnaire was applied before the intervention and at three and six months after its start. Results: the mean effect of self-care scores in the experimental group was 1.03 to 1.78 higher than the control group, with progressive and significant improvement (p<0.001). Conclusion: the results indicate that the telephone intervention had a beneficial effect on diabetes self-care. The primary identifier of the clinical trials registry was: RBR-8wx7qb. PMID:27579926

  8. Chronic Illness Self-care and the Family Lives of Older Adults: A Synthetic Review Across Four Ethnic Groups

    PubMed Central

    Gallant, Mary P.; Spitze, Glenna; Grove, Joshua G.

    2010-01-01

    The purpose of this paper is to integrate the literature on family and social ties among older ethnic minority men and women with the literature on chronic illness self-care among elders in these groups, in order to increase understanding of social influences on self-care behavior, raise questions for future research, and inform culturally appropriate interventions to maximize the health-promoting potential of social relationships. The paper presents demographic and chronic illness prevalence information, and then summarizes literature about patterns of chronic illness self-care behaviors for older African-Americans, Latinos, Asian-Americans, and American Indians in the U.S. For each group, the sociological literature about residential, cultural, and socioeconomic patterns, family lives, and other social ties is then reviewed, and the self-care literature that has accounted for these patterns is discussed. Finally, six themes are outlined and related questions are identified to further illuminate the social context of older adults’ chronic illness self-care. PMID:20177963

  9. The effects of mirror therapy with tasks on upper extremity function and self-care in stroke patients

    PubMed Central

    Park, Youngju; Chang, Moonyoung; Kim, Kyeong-Mi; An, Duk-Hyun

    2015-01-01

    [Purpose] The purpose of this study was to determine the effects of mirror therapy with tasks on upper extremity unction and self-care in stroke patients. [Subjects] Thirty participants were randomly assigned to either an experimental group (n=15) or a control group (n=15). [Methods] Subjects in the experimental group received mirror therapy with tasks, and those in the control group received a sham therapy; both therapies were administered, five times per week for six weeks. The main outcome measures were the Manual Function Test for the paralyzed upper limb and the Functional Independence Measure for self-care performance. [Results] The experimental group had more significant gains in change scores compared with the control group after the intervention. [Conclusion] We consider mirror therapy with tasks to be an effective form of intervention for upper extremity function and self-care in stroke patients. PMID:26157249

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

    PubMed Central

    2011-01-01

    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. PMID:22132687

  11. Standardized Discharge Information After Short-Stay Hysterectomy and Relationships With Self-Care Confidence, Perceived Recovery, and Satisfaction.

    PubMed

    Lynch, Kate M; LeFort, Sandra M

    2016-01-01

    We report on the development and investigation of standardized, nurse-delivered discharge information to women after same-day hysterectomy, including the relationships among discharge information, self-care confidence, perceived recovery, and satisfaction. Fifty-one women reported high levels of self-care confidence and various levels of perceived recovery 48 to 72 hours after surgery. They were satisfied to highly satisfied with their experiences and with the discharge information provided. The important role of standardized patient discharge information is highlighted.

  12. Telephone call-in services for children in self-care.

    PubMed

    Williams, R L; Fosarelli, P D

    1987-09-01

    An estimated 8 to 10 million American children younger than 18 years of age are in self-care before or after school. Telephone call-in services to provide adult contact for these children when telephone contact with their parents is impossible or not feasible have been developed in more than 100 cities throughout the country. This study describes 2082 calls received by Tucson's KIDLINE and 2208 calls received by Baltimore's KIDSLINE. The mean age of the callers was 9.7 years, with twice as many girls as boys calling. Loneliness or boredom accounted for 68% of the calls, with fewer calls for help with homework (8%), interpersonal problems (6%), medical problems (3%), and fears (2%). Medical calls were mostly for minor infectious illness; there were no calls for life-threatening emergencies. We discuss the possible implications for pediatric practice. PMID:3618572

  13. Using Essential Oils to Enhance Nursing Practice and for Self-Care.

    PubMed

    Allard, Melissa E; Katseres, Julie

    2016-02-01

    With the growing popularity of integrative medicine, essential oils have found their way back into health care. Essential oils provide a simple way to alleviate certain physical symptoms, promote emotional well-being, and provide comfort. This article, the last in a five-part series on holistic nursing, discusses the administration and common uses of essential oils; their reported benefits, potential risks, and contraindications; and the current state of associated research. The authors focus specifically on the inhalation, both direct and by diffusion, as well as the topical application of essential oils, providing guidance for their use in acute care, self-care, community nursing, and long-term care that will enable readers to incorporate this modality into nursing practice.

  14. Health and self-care among garbage collectors: work experiences in a recyclable garbage cooperative.

    PubMed

    Dall'Agnol, Clarice Maria; Fernandes, Fernanda dos Santos

    2007-01-01

    Study performed with garbage pickers who organized a cooperative to sort recyclable garbage in Porto Alegre, Brazil, in a shed loaned by the city administration. This activity, which has attracted an increasing number of people excluded from the formal job market, presents peculiar health risks and patterns of disease. The study aimed to learn about the participants' concepts and self-care actions, proposing discussions and jointly reflection on their problems. It focuses on the working environment and on attitudes towards health risks. Through the focal group technique with ten female subjects, the expression of capacity of situational analysis of those involved was privileged, giving rise to three main themes. Each theme discussed was followed by the construction of a plan of action in order to meet compatibly the more pressing needs according to the operational feasibility of the solutions proposed. PMID:17934577

  15. Health and self-care among garbage collectors: work experiences in a recyclable garbage cooperative.

    PubMed

    Dall'Agnol, Clarice Maria; Fernandes, Fernanda dos Santos

    2007-01-01

    Study performed with garbage pickers who organized a cooperative to sort recyclable garbage in Porto Alegre, Brazil, in a shed loaned by the city administration. This activity, which has attracted an increasing number of people excluded from the formal job market, presents peculiar health risks and patterns of disease. The study aimed to learn about the participants' concepts and self-care actions, proposing discussions and jointly reflection on their problems. It focuses on the working environment and on attitudes towards health risks. Through the focal group technique with ten female subjects, the expression of capacity of situational analysis of those involved was privileged, giving rise to three main themes. Each theme discussed was followed by the construction of a plan of action in order to meet compatibly the more pressing needs according to the operational feasibility of the solutions proposed.

  16. Perceived autonomy and self-care resources among senior center users.

    PubMed

    Matsui, Miho; Capezuti, Elizabeth

    2008-01-01

    Personal autonomy-the ability to make freely self-directed choices in one's life-is considered critical to an older person's quality of life. Informed by model and role-modeling nursing theory, this descriptive, correlational study examined the relationship of perceived enactment of autonomy to self-care resources, both internal (age, race, functional ability) and external (social support, living arrangements, community-based service utilization, and service satisfaction) among 120 older adults from 6 Manhattan senior centers. Participants demonstrated positive perceived autonomy. Study participants used a variety of community-based services, and their satisfaction with the services was significantly linked to autonomy. Using multiple linear regression model, the only significant predictors of perceived autonomy were race (white > nonwhite), service satisfaction, and social support. Nursing strategies such as providing information that promotes informed decision making and encouraging independence, as well as working collaboratively with members of an older persons' social network, can enhance an older persons' autonomy. PMID:18394515

  17. 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

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

    2006-01-01

    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. PMID:16930489

  18. A model for demand management in a managed care environment.

    PubMed

    McGraw, E; Barthel, H; Arrington, M

    2000-04-01

    Downsizing of personnel and budgets demands effective means of managing patients' demand for care to ensure that care assets are appropriately utilized. Preliminary data indicate that the Central Triage concept of demand management is effective, efficient, and satisfactory to patients. As a centralized portal to care for individuals presenting without appointments, registered nurses screen and triage via protocol. The nurses send patients to the Emergency Center, make same-day appointments, or provide self-care education as indicated. During the first 9 months of operation, Central Triage inprocessed 35,231 patients. Twenty-three percent were determined to have self-care deficits and received education to assist them in meeting their current self-care demands. Follow-up of 10% of the patients receiving self-care education revealed that 88% improved without further intervention and 95% were satisfied with the care they received. Central Triage has demonstrated an annual cost avoidance exceeding $2,500,000. PMID:10803007

  19. Do employee health management programs work?

    PubMed

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

    2009-01-01

    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.

  20. Self-Care Practices of Female Peer Support Specialists with Co-Occurring Mood and Substance Use Disorders

    ERIC Educational Resources Information Center

    Wohlert, Beverly A.

    2014-01-01

    The purpose of this study was to better understand the self-care practices of female peer support specialists (PSS) with co-occurring mood and substance use disorders. The researcher took a qualitative grounded theory approach conducting in-depth semi-structured interviews with ten women employed at peer-run agencies in Maricopa County, Arizona.…

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

    ERIC Educational Resources Information Center

    Savundranayagam, Marie Y.; Brintnall-Peterson, Mary

    2010-01-01

    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…

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

    ERIC Educational Resources Information Center

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

    2012-01-01

    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…

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

    ERIC Educational Resources Information Center

    Cavkaytar, Atilla; Pollard, Elena

    2009-01-01

    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…

  4. A Competency-Based Approach to Teaching Professional Self-Care: An Ethical Consideration for Social Work Educators

    ERIC Educational Resources Information Center

    Newell, Jason M.; Nelson-Gardell, Debra

    2014-01-01

    Incorporating material on professional self-care into social work course content is valuable to the education of neophyte social work practitioners. This article presents a review of the literature on professional burnout, secondary traumatic stress, and compassion fatigue, including the risk factors associated with the experience of these…

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

    ERIC Educational Resources Information Center

    Burns, Margaret A.

    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…

  6. The Development of an ICF-Oriented, Adaptive Physician Assessment Instrument of Mobility, Self-care, and Domestic Life

    ERIC Educational Resources Information Center

    Farin, Erik; Fleitz, Annette

    2009-01-01

    The objective of this study was development and psychometric testing of an adaptive, International Classification of Functioning, Disability, and Health (ICF)-oriented questionnaire to be processed by the rehabilitation physician that aids in assessing mobility, self-care, and domestic life (Moses-Physician). The intent is to develop a physician…

  7. Nurturing each other on the front lines of caring: self-care in the aftermath of hurricane Sandy.

    PubMed

    Resnicoff, Marci

    2013-10-01

    Holistic nurses are equipped with a strong set of core values and holistic principles that guide our practice. This includes understanding and upholding the value of self-care. Even on the front lines in highly stressful situations, holistic nurses value the importance of nurturing self and colleagues.

  8. Usability of an Adaptive Computer Assistant that Improves Self-care and Health Literacy of Older Adults

    PubMed Central

    Blanson Henkemans, O. A.; Rogers, W. A.; Fisk, A. D.; Neerincx, M. A.; Lindenberg, J.; van der Mast, C. A. P. G.

    2014-01-01

    Summary Objectives We developed an adaptive computer assistant for the supervision of diabetics’ self-care, to support limiting illness and need for acute treatment, and improve health literacy. This assistant monitors self-care activities logged in the patient’s electronic diary. Accordingly, it provides context-aware feedback. The objective was to evaluate whether older adults in general can make use of the computer assistant and to compare an adaptive computer assistant with a fixed one, concerning its usability and contribution to health literacy. Methods We conducted a laboratory experiment in the Georgia Tech Aware Home wherein 28 older adults participated in a usability evaluation of the computer assistant, while engaged in scenarios reflecting normal and health-critical situations. We evaluated the assistant on effectiveness, efficiency, satisfaction, and educational value. Finally, we studied the moderating effects of the subjects’ personal characteristics. Results Logging self-care tasks and receiving feedback from the computer assistant enhanced the subjects’ knowledge of diabetes. The adaptive assistant was more effective in dealing with normal and health-critical situations, and, generally, it led to more time efficiency. Subjects’ personal characteristics had substantial effects on the effectiveness and efficiency of the two computer assistants. Conclusions Older adults were able to use the adaptive computer assistant. In addition, it had a positive effect on the development of health literacy. The assistant has the potential to support older diabetics’ self care while maintaining quality of life. PMID:18213433

  9. More Than Needles: The Importance of Explanations and Self-Care Advice in Treating Primary Dysmenorrhea with Acupuncture.

    PubMed

    Armour, Michael; Dahlen, Hannah G; Smith, Caroline A

    2016-01-01

    Background. Primary dysmenorrhea is a common gynaecological condition. Traditional Chinese medicine (TCM) acupuncturists commonly treat primary dysmenorrhea and dispense specific self-care advice for this condition. The impact of self-care advice on primary dysmenorrhea is unknown. Methods. 19 TCM acupuncture practitioners from New Zealand or Australia and 12 New Zealand women who had recently undergone acupuncture treatment for primary dysmenorrhea as part of a randomised controlled trial participated in this qualitative, pragmatic study. Focus groups and semistructured interviews were used to collect data. These were recorded, transcribed, and analysed using thematic analysis. Results. The overarching theme was that an acupuncture treatment consisted of "more than needles" for both practitioners and participants. Practitioners and participants both discussed the partnership they engaged in during treatment, based on openness and trust. Women felt that the TCM self-care advice was related to positive outcomes for their dysmenorrhea and increased their feelings of control over their menstrual symptoms. Conclusions. Most of the women in this study found improved symptom control and reduced pain. A contributing factor for these improvements may be an increased internal health locus of control and an increase in self-efficacy resulting from the self-care advice given during the clinical trial. PMID:27242909

  10. More Than Needles: The Importance of Explanations and Self-Care Advice in Treating Primary Dysmenorrhea with Acupuncture

    PubMed Central

    2016-01-01

    Background. Primary dysmenorrhea is a common gynaecological condition. Traditional Chinese medicine (TCM) acupuncturists commonly treat primary dysmenorrhea and dispense specific self-care advice for this condition. The impact of self-care advice on primary dysmenorrhea is unknown. Methods. 19 TCM acupuncture practitioners from New Zealand or Australia and 12 New Zealand women who had recently undergone acupuncture treatment for primary dysmenorrhea as part of a randomised controlled trial participated in this qualitative, pragmatic study. Focus groups and semistructured interviews were used to collect data. These were recorded, transcribed, and analysed using thematic analysis. Results. The overarching theme was that an acupuncture treatment consisted of “more than needles” for both practitioners and participants. Practitioners and participants both discussed the partnership they engaged in during treatment, based on openness and trust. Women felt that the TCM self-care advice was related to positive outcomes for their dysmenorrhea and increased their feelings of control over their menstrual symptoms. Conclusions. Most of the women in this study found improved symptom control and reduced pain. A contributing factor for these improvements may be an increased internal health locus of control and an increase in self-efficacy resulting from the self-care advice given during the clinical trial. PMID:27242909

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

    ERIC Educational Resources Information Center

    Mays, Nicole McGaha; Heflin, L. Juane

    2011-01-01

    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…

  12. Questions and Answers about School-Age Children in Self-Care: A Sloan Work and Family Research Network Fact Sheet

    ERIC Educational Resources Information Center

    Sloan Work and Family Research Network, 2009

    2009-01-01

    The Sloan Work and Family Research Network has prepared Fact Sheets that provide statistical answers to some important questions about work-family and work-life issues. This Fact Sheet includes statistics about Children in Self-Care, and answers the following questions about school-age children in self-care: (1) How many school-age children are in…

  13. Lived experiences of self-care among older, home-dwelling individuals identified to be at risk of undernutrition

    PubMed Central

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

    2012-01-01

    Introduction In a society where most older people live in their own homes, it may be expected of older individuals to exercise their potential to take care of themselves in daily life. Nutrition is a central aspect of self-care, and groups of older, home-dwelling people are at risk of undernutrition. Aim The aim of this study was to describe the lived experiences of self-care and features that influence health and self-care among older, home-dwelling individuals identified to be at risk of undernutrition. Methods Qualitative interviews were performed with eleven home-dwelling individuals who had been identified as being at risk of undernutrition. The interviews were recorded, transcribed verbatim, and analyzed with a descriptive phenomenological method. Findings Self-care as a lived experience among older, home-dwelling individuals identified to be at risk of undernutrition is about being aware of food choices and making decisions about taking healthy steps or not. In the presence of health problems, the appetite often decreases. Being able to take care of oneself in daily life is important, as is receiving help when needing it. Working at being physically and socially active and engaged may stimulate the appetite. Having company at meals is important and missed when living alone. Being present and taking each day by day, as well as considering oneself in the light of past time and previous experiences and looking ahead, is central, even when having fears for the future and the end of life. Conclusion Health care professionals should be aware of these findings in order to support self-care in older people, and they should pay attention to the social aspects at meals. PMID:23271914

  14. Nutritional self-care among a group of older home-living people in rural Southern Norway

    PubMed Central

    Dale, Bjørg; Söderhamn, Ulrika

    2015-01-01

    Background Older home-living people are an at-risk group for undernutrition, particularly those who are living alone. Lack of knowledge about healthy dietary habits, altered taste sensation, and declined health status are shown to be some of the factors related to undernutrition. The aims of this study were to explore how a small group of older people in Southern Norway perceived their nutritional self-care. Methods An exploratory qualitative approach, combined with a simple self-report questionnaire, was used. Five persons living in rural areas in Southern Norway, who in a former study were screened and found to be at risk for undernutrition, participated. Qualitative data assessed by means of individual self-care talks in the persons’ own homes were analyzed using directed content analysis. A simple self-report questionnaire containing demographic variables, two health-related questions, and the Nutritional Form For the Elderly (NUFFE-NO) instrument was filled out at baseline and 6 months after the self-care talks. Results The qualitative data showed that the participants had adequate knowledge about healthy and nutritious diets. They were aware of and motivated to adapt their diet to their current state of health and to perform the necessary actions to maintain an optimal nutritional status and nutritional self-care. Conclusion Older people living at home are a diverse group. However, this study showed that they may have sufficient knowledge, willingness, and ability to perform nutritional self-care, even if they live alone and have several chronic illnesses and impaired health. PMID:25670905

  15. Vulnerable Women’s Self-Care Needs in Knowledge, Attitude and Practice Concerning Sexually Transmitted Diseases

    PubMed Central

    Alimohammadi, Nasrollah; Baghersad, Zahra; Boroumandfar, Zahra

    2016-01-01

    Background: Vulnerable women are prone to sexually transmitted diseases (STD) due to their special conditions and poor knowledge about these diseases in the society. Therefore, the present study aimed to determine the vulnerable women’s self-care needs in knowledge, attitude and practice concerning STD. Methods: This is a cross-sectional-descriptive study conducted in 2014. The data collection was carried out using a self-administered structured questionnaire. 120 vulnerable women referring to centers affiliated to health and well-being center in Isfahan participated in this study. They were selected through proportional rationing sampling and filled out a researcher developed questionnaire containing information on personal characteristics, self-care knowledge, attitude, and practice needs toward the STD. The data were analyzed using statistical methods including Spearman & Pearson correlation co-efficient, independent t-test and ANOVA. All analyses were carried out using SPSS, 20. Results: Based on the results, most of the subjects mentioned that their priorities of self-care needs in domains of knowledge, attitude and practice were “familiarization with the types and contamination ways of sexually transmitted diseases” (57.9%); “diagnosis of STD only makes us anxious” (24.8), and “the method of washing the genital area before and after intercourse” 41.3%), respectively. There was a significant association among marital status, education, history of addiction, and self-care needs in domains of knowledge, attitude and practice (P<0.05). Conclusion: Results showed that vulnerable women not only knew their need about STD, but also paid attention to their attitude and practice needs toward STD. Therefore, educational programs should be designed and administrated by the experts, based on vulnerable women’s self-care needs concerning their knowledge, attitude and practice to prevent and control STD in vulnerable individuals. PMID:27382588

  16. Managing tension headaches at home

    MedlinePlus

    Tension-type headache - self-care; Muscle contraction headache - self-care; Headache - benign - self-care; Headache - tension- self-care; Chronic headaches - tension - self-care; Rebound headaches - ...

  17. Self-care telephone talks as a health-promotion intervention in urban home-living persons 75+ years of age: a randomized controlled study

    PubMed Central

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

    2014-01-01

    Aim The aim of this study was to evaluate the effects of a telephone-based self-care intervention among urban living individuals 75+ years of age by comparing self-reported perceived health, mental health, sense of coherence, self-care ability, and self-care agency before and after the intervention. Materials and methods In a randomized controlled study, 15 persons answered a questionnaire about perceived health, mental health, sense of coherence, self-care ability, and self-care agency. In a sex- and age-matched control group (n=15), the same questions were answered. Data were collected before and after intervention. An open-ended question about experiences of the intervention was included in the last questionnaire. The intervention consisted of a first meeting with health professionals and additional five self-care telephone calls. The control group did not receive any intervention or attention except for the questionnaires. Descriptive statistics were used to describe the study group. To compare the intervention group and control group on nominal and ordinal levels, the McNemar test and the Wilcoxon signed-rank test, respectively, were chosen. Results Thirty individuals (14 females and 16 males) participated in the study, ranging in age between 75 and 93 years. A significant difference was obtained in the intervention group regarding mental health. Mental health improved significantly in the intervention group (P=0.037). In the control group, mental health, sense of coherence, self-care ability, and self-care agency showed worse outcome results after the intervention (19 weeks). Conclusion Self-care telephone talks improved mental health significantly in our sample, and mental health focus could be understood as a possible condition for health promotion to take place. Structured self-care telephone talks have proved to be successful and a relevant method to use in practice. PMID:24421638

  18. [HIV-AIDS medicine, antiretroviral treatment, adherence: a discussion about self-care].

    PubMed

    Margulies, Susana

    2012-01-01

    We propose a reflection on the role of biomedical and clinical action in the organization, promotion and legitimating of discourses and practices of self-care and control in the experience of HIV-AIDS disease. We analyze the conditions and requirements of the so-called "adherence" to antiretroviral treatment, which is of central importance in medical and health actions. Since medical intervention tends to associate viral progression to patient adherence, the "meeting of requirements" implies not only the certainty about medical indication but the very possibility of salvation. Through corporeal monitoring and the control of the interactions and practices of those affected, this medicalizing process directs their behavior, sets forms of discipline and imposes a responsible way to care for themselves. Thus, the power of biomedical institution is not only its ability to define a physical condition through diagnosis but also helps to establish the parameters of illness experience, reconfiguring the ways in which subjects understand and relate to themselves and others, producing new forms of identity, belongings and social relations.

  19. Sustainable Reduction of Sleepiness through Salutogenic Self-Care Procedure in Lunch Breaks: A Pilot Study.

    PubMed

    Schnieder, Sebastian; Stappert, Sarah; Takahashi, Masaya; Fricchione, Gregory L; Esch, Tobias; Krajewski, Jarek

    2013-01-01

    The aim of the study was to elucidate the immediate, intermediate, and anticipatory sleepiness reducing effects of a salutogenic self-care procedure called progressive muscle relaxation (PMR), during lunch breaks. The second exploratory aim deals with determining the onset and long-term time course of sleepiness changes. In order to evaluate the intraday range and interday change of the proposed relaxation effects, 14 call center agents were assigned to either a daily 20-minute self-administered PMR or a small talk (ST) group during a period of seven months. Participants' levels of sleepiness were analyzed in a controlled trial using anticipatory, postlunchtime, and afternoon changes of sleepiness as indicated by continuously determined objective reaction time measures (16,464 measurements) and self-reports administered five times per day, once per month (490 measurements). Results indicate that, in comparison to ST, the PMR break (a) induces immediate, intermediate, and anticipatory reductions in sleepiness; (b) these significant effects remarkably show up after one month, and sleepiness continues to decrease for at least another five months. Although further research is required referring to the specific responsible mediating variables, our results suggest that relaxation based lunch breaks are both accepted by employees and provide a sustainable impact on sleepiness. PMID:24381633

  20. Patient Compliance in Home-Based Self-Care Telehealth Projects.

    PubMed

    Maeder, Anthony; Poultney, Nathan; Morgan, Gary; Lippiatt, Robert

    2015-12-01

    This paper presents the findings of a literature review on patient compliance in home-based self-care telehealth monitoring situations, intended to establish a knowledge base for this aspect which is often neglected alongside more conventional clinical, economic and service evaluations. A systematic search strategy led to 72 peer-reviewed published scientific papers being selected as most relevant to the topic, 58 of which appeared in the last 10 years. Patient conditions in which most evidence for compliance was found were blood pressure, heart failure and stroke, diabetes, asthma, chronic obstructive pulmonary disease and other respiratory diseases. In general, good compliance at the start of a study was found to drop off over time, most rapidly in the period immediately after the start. Success factors identified in the study included the extent of patient health education, telehealth system implementation style, user training and competence in system usage, active human support from the healthcare provider and maintaining strong participant motivation. PMID:26556057

  1. Self-care practices and the need for influenza vaccination in healthy individuals.

    PubMed

    Bodkin, Candice; Klopper, Hester C

    2003-12-01

    The purpose of this research was to determine whether self-care practices in healthy individuals reduce the need for trivalent influenza vaccination and whether naturopathic influenza prevention reduces rate, duration and severity of influenza, absenteeism from work due to influenza and side-effects, as compared to trivalent influenza vaccination. A survey design was followed using exploratory, descriptive and comparative methods. The method of study was an open-label, two-group, parallel study. The data collection tool was a self-administered questionnaire. A two-group sample was obtained through non-probability, purposeful sampling. Data was analysed by means of descriptive and inferential statistics at the 0.05 level of significance. Results indicated that there was no significant difference between the rates of influenza infection of the naturopathic group as compared with the trivalent vaccination group but there was a marginal reduction in the duration of febrile illness in the former group. The naturopathic group were less likely to visit a medical practitioner in order to resolve the influenza, however, they were as likely as the trivalent vaccinated group to commence a new treatment plan. Neither method of influenza prevention resulted in a significant reduction in absenteeism from work. The trivalent vaccinated group had significantly more side-effects than the naturopathic group.

  2. Sustainable Reduction of Sleepiness through Salutogenic Self-Care Procedure in Lunch Breaks: A Pilot Study

    PubMed Central

    Stappert, Sarah; Takahashi, Masaya; Fricchione, Gregory L.

    2013-01-01

    The aim of the study was to elucidate the immediate, intermediate, and anticipatory sleepiness reducing effects of a salutogenic self-care procedure called progressive muscle relaxation (PMR), during lunch breaks. The second exploratory aim deals with determining the onset and long-term time course of sleepiness changes. In order to evaluate the intraday range and interday change of the proposed relaxation effects, 14 call center agents were assigned to either a daily 20-minute self-administered PMR or a small talk (ST) group during a period of seven months. Participants' levels of sleepiness were analyzed in a controlled trial using anticipatory, postlunchtime, and afternoon changes of sleepiness as indicated by continuously determined objective reaction time measures (16,464 measurements) and self-reports administered five times per day, once per month (490 measurements). Results indicate that, in comparison to ST, the PMR break (a) induces immediate, intermediate, and anticipatory reductions in sleepiness; (b) these significant effects remarkably show up after one month, and sleepiness continues to decrease for at least another five months. Although further research is required referring to the specific responsible mediating variables, our results suggest that relaxation based lunch breaks are both accepted by employees and provide a sustainable impact on sleepiness. PMID:24381633

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

    PubMed

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

    2011-09-01

    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

  4. The impact of Multimedia Software Support on the Knowledge and Self-Care Behaviors of Patients with Type 2 Diabetes: a Randomized Clinical Trial

    PubMed Central

    Farmahini Farahani, Moloud; Purfarzad, Zahra; Ghorbani, Mojtaba; Ghamari Zare, Zohre; Ghorbani, Fateme

    2016-01-01

    Introduction: Education is the most effective and economical part of diabetes treatment. The purpose of this study was to investigate the effect of a training program with multimedia software on the knowledge and self-care behaviors of patients with type 2 diabetes. Methods: This study was a randomized controlled clinical trial in which 60 patients referred to diabetes clinic at Arak city were divided randomly into experimental (n=30) and control (n=30) groups. The instruments for collecting data were "Summary of Diabetes self-care activities questionnaire" and "knowledge of self-care in patients with diabetes". Data were collected before and 2 months after the intervention in the both groups. Educational program with equal content was applied for both experimental group (self-care program with multimedia software support) & control group (lecture and presentation with PowerPoint). Data analysis was done using SPSS Ver.13. Results: Implementation of the self-care program with multimedia software support resulted in improvements in patients’ self-care behaviors in the experimental group, whereas these behaviors had not significant changes in the control group after eight weeks. There was a significant difference in the mean score of knowledge in both the experiment and control groups before and after the intervention. Conclusion: Considering beneficial effects of training program with multimedia software support on the knowledge and self-care behaviors and the importance of this issue, suggested that the patients preferably provide terms of use of educational software for themselves. PMID:27354975

  5. Type 2 diabetes–related foot care knowledge and foot self-care practice interventions in the United States: a systematic review of the literature

    PubMed Central

    Bonner, Timethia; Foster, Margaret; Spears-Lanoix, Erica

    2016-01-01

    Introduction The purpose of this systematic literature review is to review published studies on foot care knowledge and foot care practice interventions as part of diabetic foot care self-management interventions. Methods Medline, CINAHL, CENTRAL, and Cochrane Central Register of Controlled Trials databases were searched. References from the included studies were reviewed to identify any missing studies that could be included. Only foot care knowledge and foot care practice intervention studies that focused on the person living with type 2 diabetes were included in this review. Author, study design, sample, intervention, and results were extracted. Results Thirty studies met the inclusion criteria and were classified according to randomized controlled trial (n=9), survey design (n=13), cohort studies (n=4), cross-sectional studies (n=2), qualitative studies (n=2), and case series (n=1). Improving lower extremity complications associated with type 2 diabetes can be done through effective foot care interventions that include foot care knowledge and foot care practices. Conclusion Preventing these complications, understanding the risk factors, and having the ability to manage complications outside of the clinical encounter is an important part of a diabetes foot self-care management program. Interventions and research studies that aim to reduce lower extremity complications are still lacking. Further research is needed to test foot care interventions across multiple populations and geographic locations. PMID:26899439

  6. Self-Care Practices for Common Colds by Primary Care Patients: Study Protocol of a European Multicenter Survey—The COCO Study

    PubMed Central

    Weltermann, Birgitta M.; Gerasimovska-Kitanovska, Biljana; Thielmann, Anika; Chambe, Juliette; Lingner, Heidrun; Pirrotta, Enzo; Buczkowski, Krzysztof; Tekiner, Selda; Czachowski, Slawomir; Edirne, Tamer; Zielinski, Andrzej; Yikilkan, Hülya; Koskela, Tuomas; Petrazzuoli, Ferdinando; Hoffman, Robert D.; Petek Šter, Marija; Guede Fernández, Clara; Uludağ, Ayşegül; Hoffmann, Kathryn; Mevsim, Vildan; Kreitmayer Pestic, Sanda

    2015-01-01

    Background. Self-care for common colds is frequent, yet little is known about the spectrum, regional differences, and potential risks of self-care practices in patients from various European regions. Methods/Design. We describe the study protocol for a cross-sectional survey in 27 primary care centers from 14 European countries. At all sites, 120 consecutive adult patients, who visit their general practitioner for any reason, filled in a self-administered 27-item questionnaire. This addresses patients' self-care practices for common colds. Separately, the subjective level of discomfort when having a common cold, knowing about the diseases' self-limited nature, and medical and sociodemographic data are requested. Additionally, physicians are surveyed on their use of and recommendations for self-care practices. We are interested in investigating which self-care practices for common colds are used, whether the number of self-care practices used is influenced by knowledge about the self-limited nature of the disease, and the subjective level of discomfort when having a cold and to identify potential adverse interactions with chronic physician-prescribed medications. Further factors that will be considered are, for example, demographic characteristics, chronic conditions, and sources of information for self-care practices. All descriptive and analytical statistics will be performed on the pooled dataset and stratified by country and site. Discussion. To our knowledge, COCO is the first European survey on the use of self-care practices for common colds. The study will provide new insight into patients' and general practitioners' self-care measures for common colds across Europe. PMID:26421048

  7. Self-Care Practices for Common Colds by Primary Care Patients: Study Protocol of a European Multicenter Survey-The COCO Study.

    PubMed

    Weltermann, Birgitta M; Gerasimovska-Kitanovska, Biljana; Thielmann, Anika; Chambe, Juliette; Lingner, Heidrun; Pirrotta, Enzo; Buczkowski, Krzysztof; Tekiner, Selda; Czachowski, Slawomir; Edirne, Tamer; Zielinski, Andrzej; Yikilkan, Hülya; Koskela, Tuomas; Petrazzuoli, Ferdinando; Hoffman, Robert D; Petek Šter, Marija; Guede Fernández, Clara; Uludağ, Ayşegül; Hoffmann, Kathryn; Mevsim, Vildan; Kreitmayer Pestic, Sanda

    2015-01-01

    Background. Self-care for common colds is frequent, yet little is known about the spectrum, regional differences, and potential risks of self-care practices in patients from various European regions. Methods/Design. We describe the study protocol for a cross-sectional survey in 27 primary care centers from 14 European countries. At all sites, 120 consecutive adult patients, who visit their general practitioner for any reason, filled in a self-administered 27-item questionnaire. This addresses patients' self-care practices for common colds. Separately, the subjective level of discomfort when having a common cold, knowing about the diseases' self-limited nature, and medical and sociodemographic data are requested. Additionally, physicians are surveyed on their use of and recommendations for self-care practices. We are interested in investigating which self-care practices for common colds are used, whether the number of self-care practices used is influenced by knowledge about the self-limited nature of the disease, and the subjective level of discomfort when having a cold and to identify potential adverse interactions with chronic physician-prescribed medications. Further factors that will be considered are, for example, demographic characteristics, chronic conditions, and sources of information for self-care practices. All descriptive and analytical statistics will be performed on the pooled dataset and stratified by country and site. Discussion. To our knowledge, COCO is the first European survey on the use of self-care practices for common colds. The study will provide new insight into patients' and general practitioners' self-care measures for common colds across Europe.

  8. Incorporating positive body image into the treatment of eating disorders: A model for attunement and mindful self-care.

    PubMed

    Cook-Cottone, Catherine P

    2015-06-01

    This article provides a model for understanding the role positive body image can play in the treatment of eating disorders and methods for guiding patients away from symptoms and toward flourishing. The Attuned Representational Model of Self (Cook-Cottone, 2006) and a conceptual model detailing flourishing in the context of body image and eating behavior (Cook-Cottone et al., 2013) are discussed. The flourishing inherent in positive body image comes hand-in-hand with two critical ways of being: (a) having healthy, embodied awareness of the internal and external aspects of self (i.e., attunement) and (b) engaging in mindful self-care. Attunement and mindful self-care thus are considered as potential targets of actionable therapeutic work in the cultivation of positive body image among those with disordered eating. For context, best-practices in eating disorder treatment are also reviewed. Limitations in current research are detailed and directions for future research are explicated. PMID:25886712

  9. Incorporating positive body image into the treatment of eating disorders: A model for attunement and mindful self-care.

    PubMed

    Cook-Cottone, Catherine P

    2015-06-01

    This article provides a model for understanding the role positive body image can play in the treatment of eating disorders and methods for guiding patients away from symptoms and toward flourishing. The Attuned Representational Model of Self (Cook-Cottone, 2006) and a conceptual model detailing flourishing in the context of body image and eating behavior (Cook-Cottone et al., 2013) are discussed. The flourishing inherent in positive body image comes hand-in-hand with two critical ways of being: (a) having healthy, embodied awareness of the internal and external aspects of self (i.e., attunement) and (b) engaging in mindful self-care. Attunement and mindful self-care thus are considered as potential targets of actionable therapeutic work in the cultivation of positive body image among those with disordered eating. For context, best-practices in eating disorder treatment are also reviewed. Limitations in current research are detailed and directions for future research are explicated.

  10. Evaluating capacity to live independently and safely in the community: Performance Assessment of Self-care Skills.

    PubMed

    Chisholm, Denise; Toto, Pamela; Raina, Ketki; Holm, Margo; Rogers, Joan

    2014-02-01

    To determine clients' capacity for community living, occupational therapists must use measures that capture the person-task-environment transaction and compare clients' task performance to a performance standard. The Performance Assessment of Self-care Skills, a performance-based, criterion-referenced, observational tool, fulfills this purpose. In this practice analysis, using data from this tool from multiple clinical studies (N = 941), the authors describe tasks that clients from various diagnostic populations could and could not perform independently and safely. For clinicians, the Performance Assessment of Self-care Skills can be used to identify which daily tasks are compromised and the point of task breakdown, as well as to provide guidance about potential interventions.

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

    PubMed Central

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

    2013-01-01

    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. PMID:23983734

  12. Effects of gender, age, and diabetes duration on dietary self-care in adolescents with type 1 diabetes: a Self-Determination Theory perspective.

    PubMed

    Austin, Stéphanie; Senécal, Caroline; Guay, Frédéric; Nouwen, Arie

    2011-09-01

    This study tests a model derived from Self-Determination Theory (SDT) (Deci and Ryan, 2000) to explain the mechanisms by which non-modifiable factors influence dietary self-care in adolescents with type 1 diabetes (n = 289). SEM analyses adjusted for HbA1c levels revealed that longer diabetes duration and female gender were indicative of poorer dietary self-care. This effect was mediated by contextual and motivational factors as posited by SDT. Poorer autonomy support from practitioners was predominant in girls with longer diabetes duration. Perceived autonomous motivation and self-efficacy were indicative of greater autonomy support, and led to better dietary self-care.

  13. Impact of chronic disease self-management programs on type 2 diabetes management in primary care

    PubMed Central

    Forjuoh, Samuel N; Ory, Marcia G; Jiang, Luohua; Vuong, Ann M; Bolin, Jane N

    2014-01-01

    AIM: To assess the effectiveness of the Chronic Disease Self-Management Program (CDSMP) on glycated hemoglobin A1c (HbA1c) and selected self-reported measures. METHODS: We compared patients who received a diabetes self-care behavioral intervention, the CDSMP developed at the Stanford University, with controls who received usual care on their HbA1c and selected self-reported measures, including diabetes self-care activities, health-related quality of life (HRQOL), pain and fatigue. The subjects were a subset of participants enrolled in a randomized controlled trial that took place at seven regional clinics of a university-affiliated integrated healthcare system of a multi-specialty group practice between January 2009 and June 2011. The primary outcome was change in HbA1c from randomization to 12 mo. Data were analyzed using multilevel statistical models and linear mixed models to provide unbiased estimates of intervention effects. RESULTS: Demographic and baseline clinical characteristics were generally comparable between the two groups. The average baseline HbA1c values in the CDSMP and control groups were 9.4% and 9.2%, respectively. Significant reductions in HbA1c were seen at 12 mo for the two groups, with adjusted changes around 0.6% (P < 0.0001), but the reductions did not differ significantly between the two groups (P = 0.885). Few significant differences were observed in participants’ diabetes self-care activities. No significant differences were observed in the participants’ HRQOL, pain, or fatigue measures. CONCLUSION: The CDSMP intervention may not lower HbA1c any better than good routine care in an integrated healthcare system. More research is needed to understand the benefits of self-management programs in primary care in different settings and populations. PMID:24936263

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

    PubMed Central

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

    2012-01-01

    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. PMID:22025101

  15. Neutron resonance averaging

    SciTech Connect

    Chrien, R.E.

    1986-10-01

    The principles of resonance averaging as applied to neutron capture reactions are described. Several illustrations of resonance averaging to problems of nuclear structure and the distribution of radiative strength in nuclei are provided. 30 refs., 12 figs.

  16. Paradoxes in Averages.

    ERIC Educational Resources Information Center

    Mitchem, John

    1989-01-01

    Examples used to illustrate Simpson's paradox for secondary students include probabilities, university admissions, batting averages, student-faculty ratios, and average and expected class sizes. Each result is explained. (DC)

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

    PubMed

    Damásio, Bruno Figueiredo; Koller, Silvia Helena

    2013-10-01

    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

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

    PubMed

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

    2012-06-01

    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

  19. Health Literacy, Physician Trust, and Diabetes-related Self-care Activities in Hispanics with Limited Resources

    PubMed Central

    White, Richard O.; Osborn, Chandra Y.; Gebretsadik, Tebeb; Kripalani, Sunil; Rothman, Russell L.

    2014-01-01

    Background Hispanics with diabetes often have deficits in health literacy (HL). We examined the association among HL, psychosocial factors, and diabetes-related self-care activities. Methods Cross-sectional analysis of 149 patients. Data included patient demographics and validated measures of HL, physician trust, self-efficacy, acculturation, self-care behaviors, and A1c. Results Participants (N=60) with limited HL were older and less educated, and had more years with diabetes compared with adequate HL participants (N=89). Limited HL participants reported greater trust in their physician, greater self-efficacy, and better diet, foot care, and medication adherence. Health literacy status was not associated with acculturation or A1c. In adjusted analyses, HL status remained associated with physician trust, and we observed a notable but nonsignificant trend between HL status and medication adherence. Discussion Lower HL was associated with greater physician trust and better medication adherence. Further research is warranted to clarify the role of HL and physician trust in optimizing self-care for Hispanics. PMID:24185168

  20. Long-term Urinary Catheter Users Self-Care Practices and Problems

    PubMed Central

    Wilde, Mary; McDonald, Margaret V.; Brasch, Judith; McMahon, James M.; Fairbanks, Eileen; Shah, Shivani; Tang, Wan; Scheid, Eileen

    2013-01-01

    Aims The aims were to characterize a sample of 202 adult community-living long-term indwelling urinary catheter users, to describe self-care practices and catheter problems, and to explore relationships among demographics, catheter practices, and problems. Background Long-term urinary catheter users have not been well studied, and persons using the device indefinitely for persistent urinary retention are likely to have different patterns of catheter practices and problems. Design The study was a cross-sectional descriptive and exploratory analysis. Methods Home interviews were conducted with catheter users who provided information by self-reported recall over the previous two months. Data were analyzed by descriptive statistics and tests of association between demographics, catheter practices, and catheter problems. Results The sample was widely diverse in age (19–96 years), race, and medical diagnosis. Urethral catheters were used slightly more often (56%) than suprapubic (44%), for a mean of 6 yrs. (SD 7 yrs.). Many persons were highly disabled, with 60% having difficulty in bathing, dressing, toileting, and getting out of the bed; 19% also required assistance in eating. A high percentage of catheter problems were reported with: 43% experiencing leakage (bypassing of urine), 31% having had a urinary tract infection, 24% blockage of the catheter, 23% catheter-associated pain, and 12% accidental dislodgment of the catheter. Treatments of catheter-related problems contributed to additional health care utilization including extra nurse or clinic visits, trips to the emergency department, or hospitalization. Symptoms of catheter associated urinary tract infections were most often related to changes in the color or character of urine or generalized symptoms. Conclusions Catheter related problems contribute to excess morbidity and health care utilization and costs. Relevance to clinical practice More research is needed in how to minimize catheter associated problems

  1. Enhancing Diabetes Self-care Among Rural African Americans With Diabetes

    PubMed Central

    Williams, Ishan C.; Utz, Sharon W.; Hinton, Ivora; Yan, Guofen; Jones, Randy; Reid, Kathryn

    2015-01-01

    Purpose The purpose of this study is to test the feasibility of conducting a community-based randomized controlled trial evaluating a culturally tailored community-based group diabetes self-management education (DSME) program among rural African Americans. Methods Thirty-two African American rural adults with type 2 diabetes were recruited and 25 adults were retained and participated in an interventional study designed to test the effectiveness of the “Taking Care of Sugar” DSME program for the 2-year follow-up. Participants were selected from rural central Virginia. Primary outcomes variables included average blood sugar levels, cardiovascular risk factors, and general physical and mental health. These outcomes were assessed at baseline, 3 months, 6 months, and 12 months post baseline. Results From baseline to 3-month follow-up assessment, participants exhibited significant improvement on several physiological and behavioral measures. Given the small sample size, hypothesis testing was limited. Results show change from baseline over time, illustrating that the primary outcome of A1C decreased, although not significant. Additionally, participants reported more knowledge about diabetes self-management and personal care skills (ie, exercise and foot care) that persisted over time. The feasibility of the culturally tailored DSME was established, and participation with the program was high. Conclusions A community-based group DSME program using storytelling is feasible. This research will help to inform clinicians and health policymakers as to the types of interventions that are feasible in a larger rural population. If such a program is carried out, we can improve knowledge, reduce complications, and improve quality of life among rural African Americans. PMID:24478047

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

    PubMed Central

    2013-01-01

    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

  3. Self-Care for Common Colds by Primary Care Patients: A European Multicenter Survey on the Prevalence and Patterns of Practices—The COCO Study

    PubMed Central

    Thielmann, Anika; Gerasimovska-Kitanovska, Biljana; Koskela, Tuomas H.; Mevsim, Vildan; Petrazzuoli, Ferdinando; Petek-Šter, Marija; Lingner, Heidrun; Hoffman, Robert D.; Tekiner, Selda; Chambe, Juliette; Edirne, Tamer; Hoffmann, Kathryn; Pirrotta, Enzo; Uludağ, Ayşegül; Kreitmayer Pestic, Sanda; Zielinski, Andrzej; Guede Fernández, Clara

    2016-01-01

    Background. Patients use self-care to relieve symptoms of common colds, yet little is known about the prevalence and patterns across Europe. Methods/Design. In a cross-sectional study 27 primary care practices from 14 countries distributed 120 questionnaires to consecutive patients (≥18 years, any reason for consultation). A 27-item questionnaire asked for patients' self-care for their last common cold. Results. 3,074 patients from 27 European sites participated. Their mean age was 46.7 years, and 62.5% were females. 99% of the participants used ≥1 self-care practice. In total, 527 different practices were reported; the age-standardized mean was 11.5 (±SD 6.0) per participant. The most frequent self-care categories were foodstuffs (95%), extras at home (81%), preparations for intestinal absorption (81%), and intranasal applications (53%). Patterns were similar across all sites, while the number of practices varied between and within countries. The most frequent single practices were water (43%), honey (42%), paracetamol (38%), oranges/orange juice (38%), and staying in bed (38%). Participants used 9 times more nonpharmaceutical items than pharmaceutical items. The majority (69%) combined self-care with and without proof of evidence, while ≤1% used only evidence-based items. Discussion. This first cross-national study on self-care for common colds showed a similar pattern across sites but quantitative differences. PMID:27738443

  4. Networks of knowledge or just old wives' tales?: A diary-based analysis of women's self-care practices and everyday lay expertise.

    PubMed

    Broom, Alex; Meurk, Carla; Adams, Jon; Sibbritt, David

    2014-07-01

    Complementary and alternative medicine is increasingly popular in Australia and particularly among women. While existing research provides some understanding of women's engagement with complementary and alternative medicine and biomedicine, there has been comparatively little examination of the day-to-day character of their experiences. In this study, we utilise solicited diaries with women aged 60-65 years drawn from the 1946-1951 cohort of the Australian Longitudinal Study on Women's Health to capture the temporal dimension of their therapeutic engagement. Focusing on 30 active complementary and alternative medicine users, we explore women's experiences of managing their health, illness and well-being over a 1-month period. The themes that emerge from their diaries illustrate the day-to-day enactment of lay expertise through informal knowledge networks, practices of self-trialling and experimentation and the moralities underpinning self-care. The diaries provide unprecedented temporal insight into the (often problematic) enactment of lay expertise at the nexus of complementary and alternative medicine and biomedicine. They also point to the value of longitudinal techniques of data collection for augmenting more traditional sociological ways of exploring therapeutic pluralism.

  5. Relationships of illness representation, diabetes knowledge, and self-care behaviour to glycemic control in incarcerated persons with diabetes.

    PubMed

    Reagan, Louise A; Walsh, Stephen J; Shelton, Deborah

    2016-09-12

    Purpose The purpose of this paper is to examine relationships of self-care behavior, illness representation and diabetes knowledge with A1C (level of glycemic control) in 124 incarcerated persons. Design/methodology/approach Using a cross-sectional design, summary scores and items from the self-care inventory revised, brief illness perception questionnaire and the spoken knowledge for low literacy in diabetes were evaluated using linear regression to assess their relationship to A1C. Findings Metabolic control was suboptimal for the majority of inmates with diabetes. The final regression model was statistically significant ( F (3, 120)=9.51, p=0.001, R(2)=19.2 percent). Higher log10 HbA1C (A1C) was associated with lower personal control beliefs ( B=-0.007, t (122)=-2.42, p=<0.02), higher self-report of diabetes understanding ( B=0.009, t (122)=3.12, p=0.00) and using insulin ( B=0.062, t (122)=2.45, p=0.02). Research limitations/implications Similar to findings with community dwelling participants, enhancing diabetes personal control beliefs among inmates may lead to lower A1C. Social implications Highly structured environments with limited options for self-care, personal choices and readily available health care may give some incarcerated persons with diabetes no motivation to improve diabetes control even if they have an understanding of what to do. Originality/value While there is abundant research in the community describing how these factors influence A1C levels, research of this nature with incarcerated persons with diabetes is limited. Findings will inform diabetes programming during incarceration to better prepare inmates for reentry. PMID:27548018

  6. The Effects of a Self-Care Program on the Severity of Symptoms and Quality of Life of Patients With Irritable Bowel Syndrome.

    PubMed

    Ghiyasvandian, Shahrzad; Ghorbani, Mojtaba; Zakerimoghadam, Masoumeh; Purfarzad, Zahra; Kazemnejad, Anoshirvan

    2016-01-01

    Irritable bowel syndrome (IBS) is a chronic disease that needs special self-care strategies. The current study aimed at determining the effects of a self-care program on the severity of symptoms and quality of life of patients with IBS. In this randomized controlled clinical trial, 119 patients were randomly assigned to the experimental (n = 60) and control (n = 59) groups. Patients in both groups received the usual treatment of IBS by a gastroenterologist. The control group did not receive any intervention, whereas the experimental group was trained in the self-care program. The process of implementing the self-care program included designing and determining the content validity of the self-care training package, individual training, the first follow-up call, group training, and the second follow-up call. The instruments for collecting data were IBS-Quality of Life and IBS-Symptom Severity Scale. Two sets of evaluations (before and 2 months after the intervention) were done for both groups. The data were analyzed using SPSS software, Version 16. The results showed that there was not a significant difference between the two groups in the severity of symptoms and quality of life before the intervention (p > .05); however, the 2 groups were significantly different after the intervention (p < .0001). Implementation of the self-care program resulted in the improvement of quality of life and reduction in the symptom severity in the experimental group after the intervention (p < .0001), whereas no significant changes were observed in the control group (p > .05). Hence, the data supports that self-care program was effective in improving the quality of life and reducing the severity of symptoms in patients with IBS. PMID:27684634

  7. Optimism and adaptation to chronic disease: The role of optimism in relation to self-care options of type 1 diabetes mellitus, rheumatoid arthritis and multiple sclerosis.

    PubMed

    Fournier, Marijda; De Ridder, Denise; Bensing, Jozien

    2002-11-01

    OBJECTIVES: To determine the role of optimistic beliefs in adaptation processes of three chronic diseases different in controllability by self-care. It was expected that optimism towards the future would relate to adaptation independently of the controllability of disease. Optimism regarding one's coping ability should be beneficial in controllable diseases. Unrealistic optimism was expected to be beneficial in uncontrollable disease. DESIGN: The cross-sectional design involved 104 patients with type 1 diabetes, 95 patients with rheumatoid arthritis and 98 patients with multiple sclerosis, recruited via their physician at the out-patient department of five hospitals. METHOD: Confirmatory Factor Analysis (LISREL) was employed to confirm a three-dimensional approach of optimism: outcome expectancies, efficacy expectancies and unrealistic thinking. Multi-sample analysis by path modelling was used to examine whether the relationship of the three optimistic beliefs with coping (CISS-21), depression and anxiety (HADS), and physical functioning (SF-36) differs with the controllability based on the self-care options of chronic disease. RESULTS: These show that when chronic disease must be controlled by self-care, physical health depends more strongly on positive efficacy expectancies. In contrast, when self-care options for controlling chronic disease are limited, physical health depends more strongly on positive unrealistic thinking and relates negatively to positive efficacy expectancies. The impact of the three optimistic beliefs on mental health is independent of the controllability by self-care. CONCLUSION: Optimistic beliefs are differently beneficial for physical health dependent on the controllability of chronic disease. Unrealistic beliefs are helpful when patients are confronted with moderately to largely uncontrollable disease where self-care options are limited, in contrast to positive efficacy expectancies that are helpful when patients deal with largely

  8. The Effect of Orem’s Self-Care Model on Fatigue in Patients With Multiple Sclerosis: A Single Blind Randomized Clinical Trial Study

    PubMed Central

    Afrasiabifar, Ardashir; Mehri, Zahra; Javad Sadat, Saied; Ghaffarian Shirazi, Hamid Reza

    2016-01-01

    Background Orem’s self-care model is a nursing model that was introduced with the purpose of improving the self-care of individuals, especially patients suffering from chronic diseases. Objectives To determining the effect of Orem’s self-care model on fatigue in multiple sclerosis patients. Patients and Methods This research involved a clinical trial. Sixty-three multiple sclerosis patients at the vice-chancellor in treatment affairs of Yasuj University of Medical Sciences were selected based on nonrandom sampling, but they were allocated to the two groups based on random allocation. In the intervention group, Orem’s model was applied during six sessions of 45 - 60 minutes in length, and the process continued for 1 month. The data were collected 1 week before and 7 weeks after the end of the intervention using the Orem’s self-care model-based assessment form and fatigue severity scale, the validity and reliability of which have been Results Before the intervention, 11.11% of the participants had a good knowledge of self-care. In addition, self-care willingness and skills were observed in 76.19% and 4.76% of participants, respectively. The mean difference in fatigue reduced significantly in the intervention group after the intervention (P < 0.05). After the intervention, a statistically significant difference was observed in the mean difference of fatigue between the two groups (P < 0.05). Conclusions Orem’s self-care model is significantly effective in reducing the fatigue of multiple sclerosis patients. PMID:27781119

  9. The average enzyme principle.

    PubMed

    Reznik, Ed; Chaudhary, Osman; Segrè, Daniel

    2013-09-01

    The Michaelis-Menten equation for an irreversible enzymatic reaction depends linearly on the enzyme concentration. Even if the enzyme concentration changes in time, this linearity implies that the amount of substrate depleted during a given time interval depends only on the average enzyme concentration. Here, we use a time re-scaling approach to generalize this result to a broad category of multi-reaction systems, whose constituent enzymes have the same dependence on time, e.g. they belong to the same regulon. This "average enzyme principle" provides a natural methodology for jointly studying metabolism and its regulation.

  10. The Role of Narrative and Other-Referencing in Attenuating Psychological Reactance to Diabetes Self-Care Messages.

    PubMed

    Gardner, Liz; Leshner, Glenn

    2016-01-01

    This study charts pathways through message resistance to enhance the persuasiveness of diabetes self-care messages. A 2 (narrative) × 2 (other-referencing) × 2 (message) × 4 (order) experiment with adult diabetics (N = 58) tested whether packaging overt recommendations as a story rather than an informational argument (i.e., narrative structure) and highlighting the impact of health decisions on family and friends rather than the individual (i.e., other-referencing) can effectively attenuate psychological reactance to messages encouraging healthy diet and physical activity. Narrative and other-referencing each led to lower perceived threat to choice, less state anger and counterarguing, less negative cognitive responses, more positive attitudes toward the ad and the behaviors promoted, and greater intended compliance with message recommendations. Findings illustrate two strategies that communicators may employ in order to benefit from clear, direct health messages while avoiding the reactance they may provoke. Moreover, findings inform message design for diabetes self-care education. PMID:26528578

  11. Popular medicine and self-care in a Mexican migrant community: toward an explanation of an epidemiological paradox.

    PubMed

    Waldstein, Anna

    2010-01-01

    While Hispanics are among the most economically disadvantaged groups in the United States, immigrants from Latin America have health profiles equal to or better than Americans of European descent. Research on this epidemiological paradox suggests that aspects of Hispanic culture prevent negative health outcomes associated with poverty, poor education, and barriers to professional care. However, little attention has been given to the ethnomedical beliefs and practices of any Hispanic subgroup. Here I present an ethnographic study of women's popular medicine in a Mexican migrant community in Athens, Georgia. Migrant women promote healthy behaviors, diagnose sick family members, and prescribe home remedies. These practices stem from long traditions of self-medication and family care, which have experienced less disruption by the biomedical profession than have other North American popular medical systems. Examining Mexican popular medicine within the context of scientific literature suggests that these self-care practices protect health and should be considered by investigators of the "Hispanic health paradox." The study also suggests that directing more attention to self-care will be fruitful for medical anthropology. PMID:20391159

  12. Torrenting values, feelings, and thoughts—Cyber nursing and virtual self-care in a breast augmentation forum

    PubMed Central

    Martin Salzmann-Erikson, R.N.; Henrik Eriksson, R.N.T.

    2011-01-01

    Earlier research shows that breast augmentation is positively correlated with positive psychological states. The aim of this study was to explore the shared values, feelings, and thoughts within the culture of breast enlargement among women visiting Internet-based forums when considering and/or undergoing esthetic plastic surgery. The study used a netnographic method for gathering and analyzing data. The findings show that the women used the Internet forum to provide emotional support to other women. Through electronic postings, they cared for and nursed each others’ anxiety and feelings throughout the whole process. Apart from the process, another central issue was that the women's relationships were frequently discussed; specifically their relationship to themselves, their environment, and with the surgeons. The findings suggest that Internet forums represent a channel through which posters can share values, feelings, and thoughts from the position of an agent of action as well as from a position as the object of action. These dual positions and the medium endow the women with a virtual nursing competence that would otherwise be unavailable. By introducing the concept of torrenting as a means of sharing important self-care information, the authors provide a concept that can be further explored in relation to post modern self-care strategies within contemporary nursing theories and practice. PMID:22053162

  13. A single blinded randomised controlled pilot trial of prism adaptation for improving self-care in stroke patients with neglect.

    PubMed

    Turton, Ailie J; O'Leary, Kelly; Gabb, Judith; Woodward, Rebecca; Gilchrist, Iain D

    2010-04-01

    Prism adaptation has been shown to alleviate the symptoms of unilateral spatial neglect following stroke in single case and small group studies. The purposes of this single blinded pilot randomised controlled trial were to determine the feasibility of delivering prism adaptation treatment in a clinically valid sample and to assess its impact on self-care. Thirty seven right hemisphere stroke patients with unilateral spatial neglect were randomised into either prism adaptation (using 10 dioptre, 6 degree prisms) or sham treatment (using plain glasses) groups. Treatment was delivered each weekday for two weeks. Pointing accuracy, without vision of the finger, was recorded each day before treatment. Outcome was measured, by blinded assessors, four days and eight weeks after the end of treatment using the Catherine Bergego Scale (CBS) and the conventional neuropsychological tests from the Behavioural Inattention Test (BIT). Thirty four patients received treatment: 16 with prisms, 18 sham. Mean compliance was 99% and 97%, respectively. Over the treatment days only the prism treated group showed increased leftward bias in open loop pointing to targets on a touch screen. However, despite the group level changes in pointing behaviour no overall effect of the treatment on self-care or BIT were found.

  14. Effectiveness of Self-Care Education on the Enhancement of the Self-Esteem of Patients Undergoing Hemodialysis

    PubMed Central

    Poorgholami, Farzad; Javadpour, Shohreh; Saadatmand, Vahid; Jahromi, Marzieh Kargar

    2016-01-01

    Introduction and Aim: The assessment of self-esteem in hemodialysis people is becoming increasingly important and necessary. Low self-esteem as a problem in patients undergoing hemodialysis decreases adherence to treatment. The researcher intends to carry out a study in order to investigate the effect of self-care education on enhancement of the self-esteem of patients undergoing hemodialysis in Iran. Method and material: This is a quasi-experimental study. The subjects of the study who were selected based on purposive sampling method consisted of 50 patients with advanced chronic renal disease treated with hemodialysis. Before the intervention, two questionnaires were completed by patients. There was no intervention in the control group and the patients received only routine care in the hospital. In the experimental group, the hemodialysis patients received 5 consecutive one-hour training sessions by the researcher. Then the Rosenberg scale was filled out by the patients 2 month later. Result: According to the results, Paired t-test showed a significant difference between the mean self-esteem score in both groups before and after intervention. Conclusion: Increasing the knowledge and awareness of hemodialysis patients must constitute a cornerstone of therapy and an integral part of nursing responsibilities. Nurses should educate the patients about self-care behaviors and remind them of the dangerous complications of abandoning these. PMID:26383201

  15. Popular medicine and self-care in a Mexican migrant community: toward an explanation of an epidemiological paradox.

    PubMed

    Waldstein, Anna

    2010-01-01

    While Hispanics are among the most economically disadvantaged groups in the United States, immigrants from Latin America have health profiles equal to or better than Americans of European descent. Research on this epidemiological paradox suggests that aspects of Hispanic culture prevent negative health outcomes associated with poverty, poor education, and barriers to professional care. However, little attention has been given to the ethnomedical beliefs and practices of any Hispanic subgroup. Here I present an ethnographic study of women's popular medicine in a Mexican migrant community in Athens, Georgia. Migrant women promote healthy behaviors, diagnose sick family members, and prescribe home remedies. These practices stem from long traditions of self-medication and family care, which have experienced less disruption by the biomedical profession than have other North American popular medical systems. Examining Mexican popular medicine within the context of scientific literature suggests that these self-care practices protect health and should be considered by investigators of the "Hispanic health paradox." The study also suggests that directing more attention to self-care will be fruitful for medical anthropology.

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

    PubMed

    Thomas, Jody R; Clark, Alexander M

    2011-01-01

    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

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

    PubMed

    Thomas, Jody R; Clark, Alexander M

    2011-03-06

    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.

  18. Comparison of the role of self-efficacy and illness representations in relation to dietary self-care and diabetes distress in adolescents with type 1 diabetes.

    PubMed

    Nouwen, Arie; Urquhart Law, G; Hussain, Shakir; McGovern, Steven; Napier, Heidi

    2009-11-01

    This cross-sectional study examined the joint effects of self-efficacy and illness representations on dietary self-care and diabetes distress in adolescents with type 1 diabetes by comparing two theoretical models: the Self-regulation Model (Leventhal, H., Meyer, D., & Nerenz, D. (1980). The common-sense representations of illness danger. In S. Rachman (Ed.), Medical Psychology (Vol. 2, pp. 7-30). New York: Pergamon.) and Social Cognitive Theory (Bandura, A. (1997). Self efficacy: The exercise of control. New York: W.H. Freeman.). One hundred and fifty-one adolescents with type 1 diabetes completed self-report measures of dietary self-efficacy, illness representations, dietary self-care and diabetes distress. Data were analysed using structural equation modelling. The model best supported by the data (Leventhal's Self-regulation Model) showed that dietary self-efficacy, perceived consequences and treatment effectiveness had direct and independent effects on both dietary self-care and diabetes distress. Together with dietary self-efficacy, perceived short-term treatment effectiveness was a significant predictor of dietary self-care. Age was found to be a negative predictor of short-term treatment effectiveness beliefs. Diabetes distress was best predicted by self-efficacy and perceived consequences. It can be concluded that to target effectively dietary self-care and distress, clinicians should focus on key illness representation variables (perceived short-term treatment effectiveness and perceived consequences) in conjunction with self-efficacy.

  19. Average density in cosmology

    SciTech Connect

    Bonnor, W.B.

    1987-05-01

    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.

  20. "You teach us to listen,… but you don't teach us about suffering": self-care and resilience strategies in medical school curricula.

    PubMed

    Outram, Sue; Kelly, Brian

    2014-11-01

    This article examines the pre-vocational preparation of doctors to cope with the demands of clinical practice, drawing on literature from across a number of domains: mental health, psychological stress among medical students and medical practitioners; and self-care strategies in medicine curricula. High rates of psychological distress in medical students and medical practitioners were consistently reported. A number of questions remain pertinent to medical education: how does the experience of medical education impact on this level of distress, and possibly exacerbate pre-existing student vulnerabilities? What will help future doctors respond to, and cope with, suffering in their patients? Can the formal curriculum build resilience? Medical schools and educators have a responsibility to address these questions and to provide effective self-care curricula. In this review promising interventions such as mindfulness training are reported, frameworks to guide self-awareness in medical students are suggested, and recommendations for a self-care curriculum are made.

  1. "When it's just me at home, it hits me that I'm completely alone": an online survey of adolescents in self-care.

    PubMed

    Ruiz-Casares, Mónica

    2012-01-01

    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 and self-care to feelings of loneliness and rejection of time by themselves. Adolescents reporting loneliness were significantly less likely to enjoy being home alone during the day and at night (p < or = .001). Also, gender, age, and emotions such as fear, boredom, and separation anxiety are associated with loneliness among adolescents in self-care. Interventions to increase connectedness and combat loneliness during out-of-school hours are recommended. PMID:22303617

  2. "You teach us to listen,… but you don't teach us about suffering": self-care and resilience strategies in medical school curricula.

    PubMed

    Outram, Sue; Kelly, Brian

    2014-11-01

    This article examines the pre-vocational preparation of doctors to cope with the demands of clinical practice, drawing on literature from across a number of domains: mental health, psychological stress among medical students and medical practitioners; and self-care strategies in medicine curricula. High rates of psychological distress in medical students and medical practitioners were consistently reported. A number of questions remain pertinent to medical education: how does the experience of medical education impact on this level of distress, and possibly exacerbate pre-existing student vulnerabilities? What will help future doctors respond to, and cope with, suffering in their patients? Can the formal curriculum build resilience? Medical schools and educators have a responsibility to address these questions and to provide effective self-care curricula. In this review promising interventions such as mindfulness training are reported, frameworks to guide self-awareness in medical students are suggested, and recommendations for a self-care curriculum are made. PMID:25395229

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

    PubMed Central

    Jansà, Margarida; Vidal, Mercè; Giménez, Marga; Conget, Ignacio; Galindo, Mercedes; Roca, Daria; Colungo, Cristina; Esmatjes, Enric; Salamero, Manel

    2013-01-01

    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 α: 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

  4. The association of family social support, depression, anxiety and self-efficacy with specific hypertension self-care behaviours in Chinese local community.

    PubMed

    Hu, H H; Li, G; Arao, T

    2015-03-01

    This study aimed to test the role of family social support, depression, anxiety and self-efficacy on specific self-care behaviours. In a local community health center, 318 patients with hypertension completed a questionnaire assessing self-care, family social support, depression, anxiety and self-efficacy in 2012. Each self-care behaviour was separately analyzed with logistic regression models. The mean score of perceived family social support for hypertension treatment was 20.91 (maximum=60). Adult children were identified as the primary support source. Approximately 22.3% and 15.4% of participants reported symptoms of anxiety and depression, respectively. Participants had moderately positive levels of confidence performing self-care (42.1±13.3 out of 60). After adjusting for demographic and health variables, a 10-unit increase in family social support increased the odds ratio (OR) of taking medication by 1.39 (95% confidence interval (CI) 1.03-1.87) and increased the OR for measuring blood pressure (BP) regularly by 1.33 (95% CI 1.02-1.74). Depression and anxiety were not associated with any self-care behaviours. A10-unit increase in self-efficacy increased the adjusted OR for performing physical exercise to 1.25 (95% CI 1.04-1.49). In conclusion, family social support was positively associated with medication adherence and regular BP measurement. Strategies to improve family social support should be developed for hypertension control, yet further prospective studies are needed to understand the effects of family social support, depression, anxiety and self-efficacy on self-care behaviours.

  5. The Effect of Educating Health Promotion Strategies on Self-Care Self-Efficacy in Patients Undergoing Kidney Transplantation: A Double Blind Randomized Trial

    PubMed Central

    Soltannezhad, Fateme; Farsi, Zahra; Jabari Moroei, Masoud

    2013-01-01

    Background: Self-care self-efficacy in patients with end stage renal disease, waiting for kidney transplantation, probably decreases due to facing new conditions and side effects of treatment. Objectives: The current study was conducted to investigate the effect of educating health promotion strategies on self-care self-efficacy in patients undergoing kidney transplantation. Patients and Methods: A double blind randomized clinical trial was conducted on 52 patients undergoing kidney transplantation in Baqiyatallah Hospital in 2012. Patients were randomly assigned into intervention and control groups. The questionnaire of Strategies Used by People to Promote Health (SUPPH) was employed to measure self-care self-efficacy. At first, the two groups filled the questionnaire. Then, the intervention group was trained regarding health promotion strategies within 4 sessions before the transplantation. The control group was trained according to routine protocol of the transplantation unit. Then, the two groups were followed up for two months, and reassessed at the end of the first and second months after the transplantation. The data were analyzed by descriptive and analytic statistics including independent samples T test, Chi square and repeated measures ANOVA. Results: In the intervention group, the mean of total self-care self-efficacy was 106.96 ± 25.1 at first, and changed to 135.81 ± 9.65 and 111.19 ± 12.45 after the first and second post-test respectively (P = 0.001). In the control group, the mean of total self-care self-efficacy was 112.73 ± 14.33 at first, and changed to 118.58 ± 17.59 and 108.73 ± 15.93 after the first and second post-test respectively (P = 0.001). Significant differences were observed between the two groups in the first post-test regarding total score of self-care self-efficacy (P = 0.001) and dimensions of reduction of stress (P = 0.001), enjoying life (P = 0.01), and coping (P = 0.001). The mean scores of the intervention group were

  6. A self-care educational intervention to improve knowledge of dietary phosphorus control in patients requiring hemodialysis: a pilot study.

    PubMed

    Brogdon, Rhonda M

    2013-01-01

    The purpose of this pilot study was to improve knowledge of dietary phosphorus control in patients requiring hemodialysis. The evidence-based literature suggests that nonadherence to phosphorous control in diets is a major health concern for patients who require hemodialysis because they have limited kidney function. Phosphorus tends to accumulate rather than be excreted. A self-care educational intervention was used in a pilot study (N = 10) to increase patients' knowledge about low phosphorous diets to promote dietary adherence. The outcome of this study was evaluated by a pre-test/post-test of patients' knowledge about phosphorus in the diet. A positive gain in knowledge was realized related to the intervention.

  7. A Small Group Assignment Gives Students a Novel Opportunity to Demonstrate Current Clinical Controversies in a Self-Care Course

    PubMed Central

    2014-01-01

    Objective. To design and implement a small-group assignment on current event, nonprescription drug therapy questions in a self-care course, and to evaluate student performance in predefined areas. Design. Students self-identified a current clinical question in nonprescription therapy, searched primary literature, and presented their findings to peers in class. Assessment. Students were evaluated using a grading rubric on communication skills, ability to retrieve and analyze biomedical literature, and ability to formulate and defend an evidence-based recommendation. Overall, students performed well in all competencies, with grades ranging from 84% to 100% (median=92%). Faculty members completing a postassignment survey gave positive feedback regarding the educational value of the assignment and the ease of use of the designed rubric. Conclusion. A course assignment that involved peer-to-peer presentations and dealt exclusively with applicable, relevant, clinical questions regarding nonprescription drug therapy gave students a novel opportunity to practice drug information skills. PMID:25657380

  8. Correlates of perceived self-care activities and diabetes control among Dutch type 1 and type 2 diabetics.

    PubMed

    Raaijmakers, Lieke G M; Martens, Marloes K; Bagchus, Charlotte; de Weerdt, Inge; de Vries, Nanne K; Kremers, Stef P J

    2015-06-01

    This study examined how Dutch type 1 and type 2 diabetes patients' perceived autonomy support, as well as their perceived competence and treatment self-regulation, are associated with their diabetes self-care activities (healthy diet, physical activity, monitoring blood glucose, medication use) and general diabetes control. A cross-sectional questionnaire study was conducted among 143 type 1 diabetics and 384 type 2 diabetics. Overall, participants felt competent, supported in their autonomy, and perceived to autonomously self-regulate their diabetes. Our results underline the importance of perceived competence in type 1 and 2 diabetics, as this was strongly associated with adhering to a healthy diet and general diabetes control. Our findings also emphasize the need for autonomy supportive health care professionals in diabetes care. Interestingly, perceived competence partially mediated the influence of autonomy support on general diabetes control. PMID:25627667

  9. Longitudinal Associations between Sex, Diabetes Self-Care, and Health-Related Quality of Life Among Youth with Type 1 or Type 2 Diabetes Mellitus

    PubMed Central

    Naughton, Michelle J.; Yi-Frazier, Joyce P.; Morgan, Timothy M.; Seid, Michael; Lawrence, Jean M.; Klingensmith, Georgeanna J.; Waitzfelder, Beth; Standiford, Debra A.; Loots, Beth

    2015-01-01

    Objective To examine the longitudinal associations between sex, diabetes self-care and the health-related quality of life (HRQL) of children and adolescents with Type 1 or Type 2 diabetes. Study design The sample included 910 Type 1 and 241 Type 2 participants, ages 10–22 at baseline, from SEARCH for Diabetes in Youth, a longitudinal observational study. The primary outcome measure was the Pediatric Quality of Life Inventory (PedsQL). Repeated measures, mixed model regression analysis was conducted using data from baseline and at least one follow-up assessment, spanning approximately 4 years. Results HRQL was higher among those with Type 1 versus Type 2 diabetes. Among Type 1 participants, higher (better) PedsQL total scores over time were related to higher parent education (p=0.0007), lower HbA1c values (p<.0001), and greater physical activity during the past 7 days (p=0.0001). There was a significant interaction between sex and age (p<0.0001); girls’ HRQL remained stable or decreased over time, whereas males’ HRQL increased. For participants with Type 2 diabetes, there was no significant interaction by age and sex, but lower total HRQL was related to being female (p=0.011) and higher BMI-z scores (p=0.014). Conclusions HRQL in this cohort varied by diabetes type. The interaction between sex and age for Type 1 participants, coupled with poorer HRQL among females than males with Type 2 diabetes, suggests the impacts of diabetes on HRQL differ by sex and should be considered in clinical management. Encouraging physical activity and weight control continue to be important in improving HRQL. PMID:24582483

  10. Use of Traditional and Complementary Medicine as Self-Care Strategies in Community Health Centers: Cross-Sectional Study in Urban Pearl River Delta Region of China.

    PubMed

    Chung, Vincent C H; Wong, Samuel Y S; Wang, Harry H X; Wong, Martin C S; Wei, Xiaolin; Wang, Jiaji; Liu, Siya; Ho, Robin S T; Yu, Ellen L M; Griffiths, Sian M

    2016-06-01

    In China, Community Health Centers (CHCs) are major providers of primary care services, but their potential in empowering patients' self-management capacity has not been assessed. This study aims to describe self-care practice patterns amongst CHC attendees in urban China.In this cross-sectional quantitative study, 3360 CHC patients from 6 cities within the Pearl Delta Region were sampled using multistage cluster sampling.Thirty-seven per cent had used with over-the-counter Chinese herbal medicines (OTC CHMs) in the past year and majority of respondents found OTC CHMs effective. OTC CHMs were more popular amongst those who needed to pay out of pocket for CHC services. Less than 10% used vitamins and minerals, and those with a lower socioeconomic background have a higher propensity to consume. Although doubts on their usefulness are expressed, their use by the vulnerable population may reflect barriers to access to conventional health care, cultural affinity, or a defense against negative consequences of illnesses. About 25% performed physical exercise, but the prevalence is lower amongst women and older people. Taiji seems to be an alternative for these populations with promising effectiveness, but overall only 6% of CHC attendees participated.These results suggest that CHCs should start initiatives in fostering appropriate use of OTC CHM, vitamins, and minerals. Engaging community pharmacists in guiding safe and effective use of OTC CHM amongst the uninsured is essential given their low accessibility to CHC services. Prescription of Taiji instead of physical exercises to women and older people could be more culturally appropriate, and the possibility of including this as part of the CHC services worth further exploration. PMID:27281074

  11. Americans' Average Radiation Exposure

    SciTech Connect

    NA

    2000-08-11

    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.

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

    ERIC Educational Resources Information Center

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

    2010-01-01

    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…

  13. Using a Web-Based Approach to Assess Test-Retest Reliability of the "Hypertension Self-Care Profile" Tool in an Asian Population: A Validation Study.

    PubMed

    Koh, Yi Ling Eileen; Lua, Yi Hui Adela; Hong, Liyue; Bong, Huey Shin Shirley; Yeo, Ling Sui Jocelyn; Tsang, Li Ping Marianne; Ong, Kai Zhi; Wong, Sook Wai Samantha; Tan, Ngiap Chuan

    2016-03-01

    Essential hypertension often requires affected patients to self-manage their condition most of the time. Besides seeking regular medical review of their life-long condition to detect vascular complications, patients have to maintain healthy lifestyles in between physician consultations via diet and physical activity, and to take their medications according to their prescriptions. Their self-management ability is influenced by their self-efficacy capacity, which can be assessed using questionnaire-based tools. The "Hypertension Self-Care Profile" (HTN-SCP) is 1 such questionnaire assessing self-efficacy in the domains of "behavior," "motivation," and "self-efficacy." This study aims to determine the test-retest reliability of HTN-SCP in an English-literate Asian population using a web-based approach. Multiethnic Asian patients, aged 40 years and older, with essential hypertension were recruited from a typical public primary care clinic in Singapore. The investigators guided the patients to fill up the web-based 60-item HTN-SCP in English using a tablet or smartphone on the first visit and refilled the instrument 2 weeks later in the retest. Internal consistency and test-retest reliability were evaluated using Cronbach's Alpha and intraclass correlation coefficients (ICC), respectively. The t test was used to determine the relationship between the overall HTN-SCP scores of the patients and their self-reported self-management activities. A total of 160 patients completed the HTN-SCP during the initial test, from which 71 test-retest responses were completed. No floor or ceiling effect was found for the scores for the 3 subscales. Cronbach's Alpha coefficients were 0.857, 0.948, and 0.931 for "behavior," "motivation," and "self-efficacy" domains respectively, indicating high internal consistency. The item-total correlation ranges for the 3 scales were from 0.105 to 0.656 for Behavior, 0.401 to 0.808 for Motivation, 0.349 to 0.789 for Self-efficacy. The corresponding

  14. Using a Web-Based Approach to Assess Test-Retest Reliability of the "Hypertension Self-Care Profile" Tool in an Asian Population: A Validation Study.

    PubMed

    Koh, Yi Ling Eileen; Lua, Yi Hui Adela; Hong, Liyue; Bong, Huey Shin Shirley; Yeo, Ling Sui Jocelyn; Tsang, Li Ping Marianne; Ong, Kai Zhi; Wong, Sook Wai Samantha; Tan, Ngiap Chuan

    2016-03-01

    Essential hypertension often requires affected patients to self-manage their condition most of the time. Besides seeking regular medical review of their life-long condition to detect vascular complications, patients have to maintain healthy lifestyles in between physician consultations via diet and physical activity, and to take their medications according to their prescriptions. Their self-management ability is influenced by their self-efficacy capacity, which can be assessed using questionnaire-based tools. The "Hypertension Self-Care Profile" (HTN-SCP) is 1 such questionnaire assessing self-efficacy in the domains of "behavior," "motivation," and "self-efficacy." This study aims to determine the test-retest reliability of HTN-SCP in an English-literate Asian population using a web-based approach. Multiethnic Asian patients, aged 40 years and older, with essential hypertension were recruited from a typical public primary care clinic in Singapore. The investigators guided the patients to fill up the web-based 60-item HTN-SCP in English using a tablet or smartphone on the first visit and refilled the instrument 2 weeks later in the retest. Internal consistency and test-retest reliability were evaluated using Cronbach's Alpha and intraclass correlation coefficients (ICC), respectively. The t test was used to determine the relationship between the overall HTN-SCP scores of the patients and their self-reported self-management activities. A total of 160 patients completed the HTN-SCP during the initial test, from which 71 test-retest responses were completed. No floor or ceiling effect was found for the scores for the 3 subscales. Cronbach's Alpha coefficients were 0.857, 0.948, and 0.931 for "behavior," "motivation," and "self-efficacy" domains respectively, indicating high internal consistency. The item-total correlation ranges for the 3 scales were from 0.105 to 0.656 for Behavior, 0.401 to 0.808 for Motivation, 0.349 to 0.789 for Self-efficacy. The corresponding

  15. The context of empowerment and self-care within the field of diabetes.

    PubMed

    Scambler, Sasha; Newton, Paul; Asimakopoulou, Koula

    2014-11-01

    There is a growing emphasis within the diabetes literature on the importance of empowerment as a way of encouraging people to take control of and responsibility for the successful management of their disease. Patients are actively encouraged to become active participants in their care, and there is an expectation that health-care professionals will facilitate this process. This article uses Bourdieu's concept of field, as a bounded social space in which actors conduct their lives day-to-day, to explore the context within which issues of empowerment are addressed and negotiated. The practice of empowerment within the biologically defined and biomedically 'policed' field of diabetes is explored using empirical data from a study of diabetes health-care professionals' understanding and practices around empowerment. It is concluded that rather than promoting active self-management and empowerment, the nature of the field of diabetes, and in particular its privileging of the biomedical, can mitigate against people with diabetes negotiating the field effectively and taking control of the disease and its management. PMID:24695383

  16. The context of empowerment and self-care within the field of diabetes.

    PubMed

    Scambler, Sasha; Newton, Paul; Asimakopoulou, Koula

    2014-11-01

    There is a growing emphasis within the diabetes literature on the importance of empowerment as a way of encouraging people to take control of and responsibility for the successful management of their disease. Patients are actively encouraged to become active participants in their care, and there is an expectation that health-care professionals will facilitate this process. This article uses Bourdieu's concept of field, as a bounded social space in which actors conduct their lives day-to-day, to explore the context within which issues of empowerment are addressed and negotiated. The practice of empowerment within the biologically defined and biomedically 'policed' field of diabetes is explored using empirical data from a study of diabetes health-care professionals' understanding and practices around empowerment. It is concluded that rather than promoting active self-management and empowerment, the nature of the field of diabetes, and in particular its privileging of the biomedical, can mitigate against people with diabetes negotiating the field effectively and taking control of the disease and its management.

  17. Using Qualitative Methods to Explore Lay Explanatory Models, Health-Seeking Behaviours and Self-Care Practices of Podoconiosis Patients in North-West Ethiopia

    PubMed Central

    Banks, Harrison S.; Tsegay, Girmay; Wubie, Moges; Tamiru, Abreham; Davey, Gail; Cooper, Max

    2016-01-01

    Background Podoconiosis (endemic non-filarial elephantiasis) is a chronic, non-infectious disease resulting from exposure of bare feet to red-clay soil in tropical highlands. This study examined lay beliefs about three under-researched aspects of podoconiosis patients’ care: explanatory models, health-seeking behaviours and self-care. Methods In-depth interviews and focus group discussions were undertaken with 34 participants (19 male, 15 female) between April-May 2015 at podoconiosis treatment centres across East and West Gojjam regions in north-west Ethiopia. Results Explanatory models for podoconiosis included contamination from blood, magic, soil or affected individuals. Belief in heredity or divine punishment often delayed clinic attendance. All participants had tried holy water treatment and some, holy soil. Herbal treatments were considered ineffectual, costly and appeared to promote fluid escape. Motivators for clinic attendance were failure of traditional treatments and severe or disabling symptoms. Patients did not report self-treatment with antibiotics. Self-care was hindered by water being unavailable or expensive and patient fatigue. Conclusion A pluralistic approach to podoconiosis self-treatment was discovered. Holy water is widely valued, though some patients prefer holy soil. Priests and traditional healers could help promote self-care and “signpost” patients to clinics. Change in behaviour and improving water access is key to self-care. PMID:27536772

  18. Turkish Parents as Teachers: Teaching Parents How to Teach Self-Care and Domestic Skills to Their Children with Mental Retardation

    ERIC Educational Resources Information Center

    Cavkaytar, Atilla

    2007-01-01

    The purpose of this study was to determine the effectiveness of a parent training program teaching self-care and domestic skills to children with mental retardation. The study was conducted with three mothers, their children and classroom teachers. Multiple probe across behaviors design was used. Experimental procedure consisted of three meetings…

  19. Gender-Specific Factors Influencing Diabetes Self-Care Behaviors and Health-Related Quality of Life Among Older Adults With Type 2 Diabetes in South Korea.

    PubMed

    Choi, Jeong Sil; Kim, Bo Hwan; Chang, Sun Ju

    2015-01-01

    The purpose of the current study was to identify gender-specific factors influencing diabetes self-care behaviors and health-related quality of life among older adults with type 2 diabetes in South Korea. This is a secondary analysis using data from 278 older adults (77 women, 201 men) with type 2 diabetes. An independent t test and hierarchical multiple regression analyses were used to analyze the data. No significant mean differences in diabetes self-care behaviors and health-related quality of life were observed according to gender. Regarding predictors by gender, the number of diabetes-related complications was a unique predictor of diabetes self-care behaviors in older men, whereas duration of diabetes and barriers were unique predictors in older women. Depression was a significant common predictor of health-related quality of life in older men and women. Nurses should be aware of and consider gender specificity when developing intervention programs for promoting self-care behaviors and health-related quality of life.

  20. The Relationship between Self-Care Practices, Burnout, Compassion Fatigue, and Compassion Satisfaction among Professional Counselors and Counselors-in-Training

    ERIC Educational Resources Information Center

    Star, Katharina L.

    2013-01-01

    The present study examined the relationship between compassion fatigue, burnout, compassion satisfaction, and self-care among counselors and counselors-in-training. Additionally, the current study investigated if recent life changes, age, sex, race, years of experience, education level, and work/internship setting impacted counselors' and…

  1. 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

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

    2011-01-01

    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…

  2. Medical assistant coaching to support diabetes self-care among low-income racial/ethnic minority populations: Randomized controlled trial

    PubMed Central

    Ruggiero, Laurie; Riley, Barth B.; Hernandez, Rosalba; Quinn, Lauretta T.; Gerber, Ben S.; Castillo, Amparo; Day, Joseph; Ingram, Diana; Wang, Yamin; Butler, Paula

    2014-01-01

    Innovative, culturally tailored strategies are needed to extend diabetes education and support efforts in low-resourced primary care practices serving racial/ethnic minority groups. A randomized controlled trial examined the effect of a diabetes self-care coaching intervention delivered by medical assistants and the joint effect of intervention and ethnicity over time. The randomized repeated-measures design included 270 low-income African American and Hispanic/Latino patients with type 2 diabetes. The one-year clinic- and telephone-based medical assistant coaching intervention was culturally tailored and guided by theoretical frameworks. A1C was obtained, and a self-care measure was completed at baseline, 6 months, and 12 months. Data were analyzed using mixed-effects models with and without adjustment for covariates. There was significant overall improvement in mean self-care scores across time, but no intervention effect. Results revealed differences in self-care patterns across racial/ethnic subgroups. No differences were found for A1C levels across time or group. PMID:24569698

  3. “Any Movement at All Is Exercise”: A Focused Ethnography of Rural Community-Dwelling Older Adults' Perceptions and Experiences of Exercise as Self-Care

    PubMed Central

    Connelly, Denise M.

    2013-01-01

    ABSTRACT Purpose: To understand rural community-dwelling older adult participants' shared values, beliefs, and behaviours related to exercise as self-care. Methods: We conducted a constructivist-focused ethnography involving semi-structured interviews and participant observation with 17 individuals 65 years and older. Interviews were transcribed and inductively coded to develop themes related to exercise, self-care, and exercise as self-care. Field notes were triangulated with follow-up interviews and dialogue between authors to enhance interpretation. Results: Participants described exercise broadly as movement and not as a central self-care behaviour. However, awareness of the importance and health-related benefits of exercise increased after a significant personal health-related event. Participants preferred exercise that was enjoyable and previously experienced. Conclusions: Prescribing exercise for older adults may be particularly effective if the focus is on enjoyable and previously experienced physical activity and if it incorporates interpretation of exercise guidelines and training principles in relation to chronic conditions and potential health benefits. PMID:24396160

  4. Social Participation of Diabetes and Ex-Leprosy Patients in the Netherlands and Patient Preference for Combined Self-Care Groups

    PubMed Central

    de Vries, Henry J. C.; de Groot, Roos; van Brakel, Wim H.

    2014-01-01

    Introduction: Earlier, we showed that neuropathic complications limit social participation of ex-leprosy patients, even in a non-endemic leprosy setting like the Netherlands. Self-care groups for ex-leprosy patients can strengthen self-worth of participants, prevent further handicap, and enable the exchange of coping strategies. For non-endemic leprosy settings with a very low rate of leprosy patients, a self-care group exclusively for (ex)leprosy patients is not likely to be feasible. A combined group with patients facing comparable morbidity would be more efficient than disease-specific self-care groups. Here, we studied the comparability in social constraints of diabetic patients and ex-leprosy patients. Moreover, we investigated if combined self-care groups for ex-leprosy patients and diabetic patients would be desirable and acceptable for possible participants. Methods: Social participation was studied based on in-depth interviews and Participation Scale information collected from 41 diabetic patients and compared with the data of 31 ex-leprosy patients from a prior study. Moreover, we made an inventory of potential strengths and limitations and attitudes toward combined self-care groups for diabetic patients with neuropathy. Results: The following themes emerged among diabetic patients: disease confrontation, dependency, conflict with partner or relatives, feelings of inferiority, stigma, abandoning social activities, fear of the future, lack of information, and hiding the disease. These themes were very similar to those voiced by the previously interviewed ex-leprosy patients. The latter more often mentioned stigma and disease ignorance among Dutch health care workers. Whereas ex-leprosy patients perceived stigma on multiple fronts, diabetic patients only mentioned feeling inferior. Diabetic patients experienced some form of participation restriction in 39% of the cases as opposed to 71% of the ex-leprosy patients. Diabetic patients did acknowledge the

  5. The effects of an interventional program based on self-care model on health-related quality of life outcomes in hemodialysis patients

    PubMed Central

    Bahadori, Mohammadkarim; Ghavidel, Fatemeh; Mohammadzadeh, Shahla; Ravangard, Ramin

    2014-01-01

    Background: Hemodialysis patients have lower quality of life and one of the ways to improve their quality of life is providing self-care education to them using some models including self-care model. This study aimed to determine and evaluate the effects of using self-care model on health and quality of life outcomes in hemodialysis patients. Materials and Methods: This was a quasi-experimental study conducted in 2012 on the patients who were referred to a military hospital in Tehran, Iran to be treated with hemodialysis. All 32 patients referred to this hospital in 2012 were selected and studied. Required data were collected using the Short Form-36 (SF-36) standard questionnaire and a researcher-made questionnaire. The educational intervention was implemented using self-care model. Collected data were analyzed using SPSS for Windows version 18.0 and some statistical tests including paired samples t-test, Wilcoxon and McNemar tests. Results: The results showed that the mean and standard deviation (SD) of patients’ parameters including weight and blood pressure improved significantly after the educational intervention compared to before the intervention (P < 0.001). Also, all dimensions of the quality of life of hemodialysis patients, including physical function, role physical, bodily pain, general health, vitality, social function, mental health, and role emotional improved compared to those before the intervention (P < 0.001). Conclusion: Implementing the self-care model increased the quality of life of hemodialysis patients. Therefore, the use of this model in hemodialysis patients is recommended. PMID:25540783

  6. A randomized clinical trial comparing advanced pneumatic truncal, chest, and arm treatment to arm treatment only in self-care of arm lymphedema.

    PubMed

    Ridner, Sheila H; Murphy, Barbara; Deng, Jie; Kidd, Nancy; Galford, Emily; Bonner, Candace; Bond, Stewart M; Dietrich, Mary S

    2012-01-01

    Treatment of the truncal lymphatics prior to treatment of the lymphedematous arm is an accepted, although not empirically tested, therapeutic intervention delivered during decongestive lymphatic therapy (DLT). Breast cancer survivors with arm lymphedema are encouraged to use these techniques when performing simple lymphatic drainage as part of their life-long lymphedema self-care. Self-massage is at times difficult and pneumatic compression devices are used by many patients to assist with self-care. One such device, the Flexitouch(®) System, replicates the techniques used during DLT; however, the need for application of pneumatic compression in unaffected truncal areas to improve self-care outcomes in arm only lymphedema is not established. The objective of this study was to compare the therapeutic benefit of truncal/chest/arm advanced pneumatic compression therapy (experimental group) verses arm only pneumatic compression (control group) in self-care for arm lymphedema without truncal involvement using the Flexitouch(®) System. Outcomes of interest were self-reported symptoms, function, arm impedance ratios, circumference, volume, and trunk circumference. Forty-two breast cancer survivors, (21 per group), with Stage II lymphedema completed 30 days of home self-care using the Flexitouch(®) System. Findings revealed a statistically significant reduction in both the number of symptoms and overall symptom burden within each group; however, there were no statistically significant differences in these outcomes between the groups. There was no statistically significant overall change or differential pattern of change between the groups in function. A statistically significant reduction in bioelectrical impedance and arm circumference within both of the groups was achieved; however, there was no statistically significant difference in reduction between groups. These findings indicate that both configurations are effective, but that there may be no added benefit to

  7. Cross-cultural adaptation and reliability testing of Polish adaptation of the European Heart Failure Self-care Behavior Scale (EHFScBS)

    PubMed Central

    Uchmanowicz, Izabella; Łoboz-Rudnicka, Maria; Jaarsma, Tiny; Łoboz-Grudzień, Krystyna

    2014-01-01

    Background Development of simple instruments for determination of self-care levels in heart failure (HF) patients is a subject of ongoing research. One such instrument, gaining growing popularity worldwide, is the European Heart Failure Self-care Behavior Scale (EHFScBS). The aim of this study was to adapt and to test reliability of the Polish version of EHFScBS. Method A standard guideline was used for translation and cultural adaptation of the English version of EHFScBS into Polish. The study included 100 Polish HF patients aged between 24 and 91 years, among them 67 men and 33 women. Cronbach’s alpha was used for analysis of the internal consistency of EHFScBS. Results Mean total self-care score in the study group was 34.2±8.1 points. Good or satisfactory level of self-care were documented in four out of 12 analyzed EHFScBS domains. Cronbach’s alpha for the entire questionnaire was 0.64. The value of Cronbach’s alpha after deletion of specific items ranged from 0.55 to 0.65. Conclusion Polish HF patients present significant deficits of self-care, which are to a large extent associated with inefficacy of the public health care system. Apart from cultural characteristics, the socioeconomic context of the target population should be considered during language adaptation of EHFScBS, as well as during interpretation of data obtained with this instrument. A number of self-care–related behaviors may be optimized as a result of appropriate educational activities, also those offered by nursing personnel. PMID:25382973

  8. Effect of Orem’s Self-Care Model on Self-Esteem of Adolescents with Asthma Referred to an Asthma and Allergy Clinic in Isfahan

    PubMed Central

    Hemati, Zeinab; Mosaviasl, Fatemeh Sadat; Abasi, Samira; Ghazavi, Zohre

    2015-01-01

    Introduction: Acquisition of chronic diseases such as asthma leads to psychological, mental and physical complications in adolescents, and hence their self-esteem may be compromised. Therefore, the present study was conducted to assess the effect of Orem’s self-care model on self-esteem of adolescents with asthma. Materials and Methods: This semi-experimental study enrolled 64 asthmatic adolescents referred to Shariati Hospital, Isfahan. Subjects were assigned to two groups of control and intervention consecutively. Then, the self-care training program was conducted according to Orem’s self-care model in eight two-hour sessions based on self-care needs, and self-esteem was measured in the two groups prior to and two months after the last training session. The data were collected by a questionnaire of demographic characteristics and the Coopersmith Self-Esteem Inventories (CSEI) and analyzed by SPSS version 20. Results: Independent t-test showed a significant difference in the mean score of self-esteem between the intervention and control groups after the training (P<0.05), but the difference was not statistically significant prior to the intervention. Paired t-test showed a significant difference in the mean score of self-esteem before and after the training in the intervention group (P<0.01), but this difference was not statistically significant in the control group (P>0.05). Conclusion: Regarding the effect of Orem’s self-care model on self-esteem of adolescents with asthma, we recommend the use of this model as a care intervention in healthcare centers to promote adolescents’ health. PMID:27114724

  9. Authoritative parenting, parenting stress, and self-care in pre-adolescents with type 1 diabetes.

    PubMed

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

    2012-09-01

    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.

  10. Living with joint hypermobility syndrome: patient experiences of diagnosis, referral and self-care

    PubMed Central

    Terry, Rohini H; Rimes, Katharine A; Clark, Carol J; Simmonds, Jane V; Horwood, Jeremy P

    2015-01-01

    Background. Musculoskeletal problems are common reasons for seeking primary health care. It has been suggested that many people with ‘everyday’ non-inflammatory musculoskeletal problems may have undiagnosed joint hypermobility syndrome (JHS), a complex multi-systemic condition. JHS is characterized by joint laxity, pain, fatigue and a wide range of other symptoms. Physiotherapy is usually the preferred treatment option for JHS, although diagnosis can be difficult. The lived experience of those with JHS requires investigation. Objective. The aim of the study was to examine patients’ lived experience of JHS, their views and experiences of JHS diagnosis and management. Methods. Focus groups in four locations in the UK were convened, involving 25 participants with a prior diagnosis of JHS. The focus groups were audio recorded, fully transcribed and analysed using the constant comparative method to inductively derive a thematic account of the data. Results. Pain, fatigue, proprioception difficulties and repeated cycles of injury were among the most challenging features of living with JHS. Participants perceived a lack of awareness of JHS from health professionals and more widely in society and described how diagnosis and access to appropriate health-care services was often slow and convoluted. Education for patients and health professionals was considered to be essential. Conclusions. Timely diagnosis, raising awareness and access to health professionals who understand JHS may be particularly instrumental in helping to ameliorate symptoms and help patients to self-manage their condition. Physiotherapists and other health professionals should receive training to provide biopsychosocial support for people with this condition. PMID:25911504

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

    PubMed Central

    2010-01-01

    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

  12. Dissociating Averageness and Attractiveness: Attractive Faces Are Not Always Average

    ERIC Educational Resources Information Center

    DeBruine, Lisa M.; Jones, Benedict C.; Unger, Layla; Little, Anthony C.; Feinberg, David R.

    2007-01-01

    Although the averageness hypothesis of facial attractiveness proposes that the attractiveness of faces is mostly a consequence of their averageness, 1 study has shown that caricaturing highly attractive faces makes them mathematically less average but more attractive. Here the authors systematically test the averageness hypothesis in 5 experiments…

  13. Toward a Middle-Range Theory of Weight Management.

    PubMed

    Pickett, Stephanie; Peters, Rosalind M; Jarosz, Patricia A

    2014-06-19

    The authors of this paper present the middle-range theory of weight management that focuses on cultural, environmental, and psychosocial factors that influence behaviors needed for weight control. The theory of weight management was developed deductively from Orem's theory of self-care, a constituent theory within the broader self-care deficit nursing theory and from research literature. Linkages between the conceptual and middle-range theory concepts are illustrated using a substruction model. The development of the theory of weight management serves to build nursing science by integrating extant nursing theory and empirical knowledge. This theory may help predict weight management in populations at risk for obesity-related disorders.

  14. Managing menopause at home

    MedlinePlus

    Perimenopause - self-care; Hormone replacement therapy - self-care; HRT- self-care ... surgeries to remove your ovaries, chemotherapy, or certain hormone treatments for breast cancer. Hot flashes and sweats ...

  15. Real-time support of pediatric diabetes self-care by a transport team.

    PubMed

    Franklin, Brandi E; Crisler, S Crile; Shappley, Rebekah; Armour, Meri M; McCommon, Dana T; Ferry, Robert J

    2014-01-01

    OBJECTIVE The study seeks to improve access for underserved patients via novel integration of Pedi-Flite (a critical care transport team) and to validate whether this safely enhances diabetes care and effectively expands the endocrine workforce. RESEARCH DESIGN AND METHODS The study retrospectively analyzed pager service use in a cohort of established diabetic patients (n = 979) after inception of Pedi-Flite support. Outcomes included incidence and severity of recurrent diabetic ketoacidosis (DKA) and cost savings generated from reduced referrals to the emergency department (ED) and on-call endocrinologist. We generated descriptive statistics to characterize the study population and ED visits for DKA and constructed logistic regression models to examine associations of pager use and likelihood of ED visitation and nonelective inpatient admission from an ED for DKA. RESULTS Pager users comprised 30% of the patient population. They were younger but had more established diabetes than nonusers. While pager users were 2.75 times more likely than nonusers to visit the ED for DKA (P < 0.0001), their visits were less likely to lead to inpatient admissions (odds ratio 0.58; P < 0.02). More than half (n = 587) of all calls to the pager were resolved without need for further referral. Estimates suggest that 439 ED visits and 115 admissions were avoided at a potential cost savings exceeding 760,000 USD. CONCLUSIONS Integration of a transport service provides a novel, cost-effective approach to reduce disparities in diabetes care. Advantages include scalability, applicability to other disease areas and settings, and low added costs. These findings enrich an emerging evidence base for telephonic care-management models supported by allied health personnel. PMID:23959568

  16. Navigating the poverty of heroin addiction treatment and recovery opportunity in Kenya: access work, self-care and rationed expectations.

    PubMed

    Rhodes, Tim; Ndimbii, James; Guise, Andy; Cullen, Lucy; Ayon, Sylvia

    2015-01-01

    Drawing on the analyses of qualitative interview accounts of people who inject heroin in Kenya, we describe the narration of addiction treatment access and recovery desire in conditions characterised by a 'poverty of drug treatment opportunity'. We observe the performance of addiction recovery narrative in the face of heavy social constraints limiting access to care. Fee-based residential rehabilitation ('rehab') is the only treatment locally available and inaccessible to most. Its recovery potential is doubted, given normative expectations of relapse. Treating drug use is a product of tightly bounded agency. Individuals enact strategies to maximise their slim chances of treatment access ('access work'), develop self-care alternatives when these fail to materialise and ration their care expectations. The use of rehab as a primary means of respite and harm reduction rather than recovery and the individuation of care in the absence of an enabling recovery environment are key characteristics of drug treatment experience. The recent incorporation of 'harm reduction' into policy discourses may trouble the primacy of recovery narrative in addiction treatment and in how treatment desires are voiced. The diversification of drug treatments in combination with social interventions enabling their access are fundamental. PMID:26089184

  17. Navigating the poverty of heroin addiction treatment and recovery opportunity in Kenya: access work, self-care and rationed expectations.

    PubMed

    Rhodes, Tim; Ndimbii, James; Guise, Andy; Cullen, Lucy; Ayon, Sylvia

    2015-01-01

    Drawing on the analyses of qualitative interview accounts of people who inject heroin in Kenya, we describe the narration of addiction treatment access and recovery desire in conditions characterised by a 'poverty of drug treatment opportunity'. We observe the performance of addiction recovery narrative in the face of heavy social constraints limiting access to care. Fee-based residential rehabilitation ('rehab') is the only treatment locally available and inaccessible to most. Its recovery potential is doubted, given normative expectations of relapse. Treating drug use is a product of tightly bounded agency. Individuals enact strategies to maximise their slim chances of treatment access ('access work'), develop self-care alternatives when these fail to materialise and ration their care expectations. The use of rehab as a primary means of respite and harm reduction rather than recovery and the individuation of care in the absence of an enabling recovery environment are key characteristics of drug treatment experience. The recent incorporation of 'harm reduction' into policy discourses may trouble the primacy of recovery narrative in addiction treatment and in how treatment desires are voiced. The diversification of drug treatments in combination with social interventions enabling their access are fundamental.

  18. Health-Seeking Behaviors and Self-Care Practices of People with Filarial Lymphoedema in Nepal: A Qualitative Study

    PubMed Central

    Adhikari, Ram Kumar; Sherchand, Jeevan Bahadur; Mishra, Shiva Raj; Ranabhat, Kamal; Pokharel, Amrit; Devkota, Pramila; Mishra, Durga; Ghimire, Yadu Chandra; Gelal, Khageshwor; Paudel, Rajan; Wagle, Rajendra Raj

    2015-01-01

    Background. Lymphatic filariasis is endemic in Nepal. This study aimed to investigate health-seeking behaviors and self-care practices of people with filarial Lymphoedema in Nepal. Methods. A cross-sectional study was conducted using qualitative methods in three endemic districts. Twenty-three patients with current Lymphoedema were recruited in the study. Results. Hydrocele was found to be a well-known condition and a major health problem in the studied communities. People with Lymphoedema primarily sought health care from traditional healers, whereas sometimes home-based care was their first treatment. Later Ayurvedic and allopathic hospital-based care were sought. Respondents reported various psychological problems such as difficulty in engaging in sexual intercourse, anxiety, worry and stress, depression, low self-esteem, feeling weak, fear of being abandoned, and fear of transmitting disease to the children. Standard foot care practices except washing were largely absent. Conclusions. Lymphoedema in the limbs and hydrocele were found to be major health problems. The traditional health care providers were the first contact of care for the majority of respondents. Only a few patients had been practicing standard foot care practices. PMID:25694785

  19. After-school supervision and adolescent cigarette smoking: contributions of the setting and intensity of after-school self-care.

    PubMed

    Mott, J A; Crowe, P A; Richardson, J; Flay, B

    1999-02-01

    This paper looks at the independent contributions of the setting and the intensity of after-school self-care to the cigarette smoking behaviors of 2352 ninth graders. We controlled for a variety of correlates of adolescent cigarette smoking that have not been accounted for in existing research. Results indicated that the intensity of the self-care experience was significantly associated with adolescent smoking behavior irrespective of the typical setting of the adolescents' after-school activities. Our findings also indicated that a nonpermissive parenting style, family rule-setting about cigarettes, and especially, in absentia parental monitoring may reduce the likelihood of cigarette smoking among latchkey and nonlatchkey adolescents alike. However, latchkey youth were not any more sensitive to these aspects of parenting than other adolescents. This is consistent with the notion that targeting these aspects of the home lives of all adolescents has the potential to reduce smoking behaviors among latchkey as well as nonlatchkey children.

  20. Moving toward comprehensive acute heart failure risk assessment in the emergency department: the importance of self-care and shared decision making.

    PubMed

    Collins, Sean P; Storrow, Alan B

    2013-08-01

    Nearly 700,000 emergency department (ED) visits were due to acute heart failure (AHF) in 2009. Most visits result in a hospital admission and account for the largest proportion of a projected $70 billion to be spent on heart failure care by 2030. ED-based risk prediction tools in AHF rarely impact disposition decision making. This is a major factor contributing to the 80% admission rate for ED patients with AHF, which has remained unchanged over the last several years. Self-care behaviors such as symptom monitoring, medication taking, dietary adherence, and exercise have been associated with decreased hospital readmissions, yet self-care remains largely unaddressed in ED patients with AHF and thus represents a significant lost opportunity to improve patient care and decrease ED visits and hospitalizations. Furthermore, shared decision making encourages collaborative interaction between patients, caregivers, and providers to drive a care path based on mutual agreement. The observation that “difficult decisions now will simplify difficult decisions later” has particular relevance to the ED, given this is the venue for many such issues. We hypothesize patients as complex and heterogeneous as ED patients with AHF may need both an objective evaluation of physiologic risk as well as an evaluation of barriers to ideal self-care, along with strategies to overcome these barriers. Combining physician gestalt, physiologic risk prediction instruments, an evaluation of self-care, and an information exchange between patient and provider using shared decision making may provide the critical inertia necessary to discharge patients home after a brief ED evaluation. PMID:24159563

  1. Moving toward comprehensive acute heart failure risk assessment in the emergency department: the importance of self-care and shared decision making.

    PubMed

    Collins, Sean P; Storrow, Alan B

    2013-08-01

    Nearly 700,000 emergency department (ED) visits were due to acute heart failure (AHF) in 2009. Most visits result in a hospital admission and account for the largest proportion of a projected $70 billion to be spent on heart failure care by 2030. ED-based risk prediction tools in AHF rarely impact disposition decision making. This is a major factor contributing to the 80% admission rate for ED patients with AHF, which has remained unchanged over the last several years. Self-care behaviors such as symptom monitoring, medication taking, dietary adherence, and exercise have been associated with decreased hospital readmissions, yet self-care remains largely unaddressed in ED patients with AHF and thus represents a significant lost opportunity to improve patient care and decrease ED visits and hospitalizations. Furthermore, shared decision making encourages collaborative interaction between patients, caregivers, and providers to drive a care path based on mutual agreement. The observation that “difficult decisions now will simplify difficult decisions later” has particular relevance to the ED, given this is the venue for many such issues. We hypothesize patients as complex and heterogeneous as ED patients with AHF may need both an objective evaluation of physiologic risk as well as an evaluation of barriers to ideal self-care, along with strategies to overcome these barriers. Combining physician gestalt, physiologic risk prediction instruments, an evaluation of self-care, and an information exchange between patient and provider using shared decision making may provide the critical inertia necessary to discharge patients home after a brief ED evaluation.

  2. The Counseling, Self-Care, Adherence Approach to Person-Centered Care and Shared Decision Making: Moral Psychology, Executive Autonomy, and Ethics in Multi-Dimensional Care Decisions.

    PubMed

    Herlitz, Anders; Munthe, Christian; Törner, Marianne; Forsander, Gun

    2016-08-01

    This article argues that standard models of person-centred care (PCC) and shared decision making (SDM) rely on simplistic, often unrealistic assumptions of patient capacities that entail that PCC/SDM might have detrimental effects in many applications. We suggest a complementary PCC/SDM approach to ensure that patients are able to execute rational decisions taken jointly with care professionals when performing self-care. Illustrated by concrete examples from a study of adolescent diabetes care, we suggest a combination of moral and psychological considerations to support the claim that standard PCC/SDM threatens to systematically undermine its own goals. This threat is due to a tension between the ethical requirements of SDM in ideal circumstances and more long-term needs actualized by the context of self-care handled by patients with limited capacities for taking responsibility and adhere to their own rational decisions. To improve this situation, we suggest a counseling, self-care, adherence approach to PCC/SDM, where more attention is given to how treatment goals are internalized by patients, how patients perceive choice situations, and what emotional feedback patients are given. This focus may involve less of a concentration on autonomous and rational clinical decision making otherwise stressed in standard PCC/SDM advocacy.

  3. The Counseling, Self-Care, Adherence Approach to Person-Centered Care and Shared Decision Making: Moral Psychology, Executive Autonomy, and Ethics in Multi-Dimensional Care Decisions.

    PubMed

    Herlitz, Anders; Munthe, Christian; Törner, Marianne; Forsander, Gun

    2016-08-01

    This article argues that standard models of person-centred care (PCC) and shared decision making (SDM) rely on simplistic, often unrealistic assumptions of patient capacities that entail that PCC/SDM might have detrimental effects in many applications. We suggest a complementary PCC/SDM approach to ensure that patients are able to execute rational decisions taken jointly with care professionals when performing self-care. Illustrated by concrete examples from a study of adolescent diabetes care, we suggest a combination of moral and psychological considerations to support the claim that standard PCC/SDM threatens to systematically undermine its own goals. This threat is due to a tension between the ethical requirements of SDM in ideal circumstances and more long-term needs actualized by the context of self-care handled by patients with limited capacities for taking responsibility and adhere to their own rational decisions. To improve this situation, we suggest a counseling, self-care, adherence approach to PCC/SDM, where more attention is given to how treatment goals are internalized by patients, how patients perceive choice situations, and what emotional feedback patients are given. This focus may involve less of a concentration on autonomous and rational clinical decision making otherwise stressed in standard PCC/SDM advocacy. PMID:26756477

  4. Attributing discrimination to weight: associations with well-being, self-care, and disease status in patients with type 2 diabetes mellitus.

    PubMed

    Potter, Lindsey; Wallston, Kenneth; Trief, Paula; Ulbrecht, Jan; Juth, Vanessa; Smyth, Joshua

    2015-12-01

    This study examined the association between attributing self-reported discrimination to weight and diabetes outcomes (glycemic control, diabetes-related distress, and diabetes self-care). A community dwelling sample of 185 adults (mean age 55.4; 80 % White/Caucasian 65 % female) with poorly controlled type 2 diabetes (HbA1c level ≥ 7.5 %) provided demographic and several self-report measures (including diabetes-related distress, diabetes self-care activities, discrimination, and attributions of discrimination), and had height, weight, and glycated hemoglobin (HbA1c) assessed by trained research staff as part of a larger research study. Individuals who attributed self-reported discrimination to weight had significantly higher HbA1c levels, higher levels of diabetes-related distress, and worse diabetes-related self-care behaviors (general diet, exercise, and glucose testing). These relationships persisted even when controlling for BMI, overall discrimination, depressive symptoms, and demographic characteristics. Results indicate that the perception of weight stigma among individuals with type 2 diabetes is strongly associated with a range of poor diabetes outcomes. Efforts to reduce exposure to and/or teach adaptive coping for weight stigma may benefit patients with type 2 diabetes.

  5. The perinatal self-care index: development of an evidence-based assessment tool for use with child sexual abuse survivors.

    PubMed

    Roller, Cyndi Gale

    2012-01-01

    Every ninth woman presenting for prenatal care reports having experienced childhood sexual abuse. Many develop mental health disorders, including posttraumatic stress disorder (PTSD). In response to PTSD, pregnant women survivors of childhood sexual abuse engage in negative perinatal self-care behaviors that can lead to adverse perinatal outcomes. Currently, promotion of perinatal self-care does not consider childhood sexual abuse or PTSD. This study aimed to develop a Perinatal Self-Care Index, determine sensitivity of the index to differences in behaviors of childhood sexual abuse survivors (PTSD-affected and PTSD-resilient), and validate usefulness in relation to birth weight. Secondary analysis was conducted using data from a prospective cohort study of the effects of PTSD on pregnancy outcomes. The index explained 6.5% of variance in birth weight. Prediction improved to 9.4% once PTSD and socioeconomic status were considered. The index is sensitive to differences in PTSD-affected versus PTSD-resilient survivors of childhood sexual abuse and a useful predictor of birth weight in this analysis. PMID:23111720

  6. Predictors of adherence with self-care guidelines among persons with type 2 diabetes: results from a logistic regression tree analysis.

    PubMed

    Yamashita, Takashi; Kart, Cary S; Noe, Douglas A

    2012-12-01

    Type 2 diabetes is known to contribute to health disparities in the U.S. and failure to adhere to recommended self-care behaviors is a contributing factor. Intervention programs face difficulties as a result of patient diversity and limited resources. With data from the 2005 Behavioral Risk Factor Surveillance System, this study employs a logistic regression tree algorithm to identify characteristics of sub-populations with type 2 diabetes according to their reported frequency of adherence to four recommended diabetes self-care behaviors including blood glucose monitoring, foot examination, eye examination and HbA1c testing. Using Andersen's health behavior model, need factors appear to dominate the definition of which sub-groups were at greatest risk for low as well as high adherence. Findings demonstrate the utility of easily interpreted tree diagrams to design specific culturally appropriate intervention programs targeting sub-populations of diabetes patients who need to improve their self-care behaviors. Limitations and contributions of the study are discussed.

  7. Using a Web-Based Approach to Assess Test–Retest Reliability of the “Hypertension Self-Care Profile” Tool in an Asian Population

    PubMed Central

    Koh, Yi Ling Eileen; Lua, Yi Hui Adela; Hong, Liyue; Bong, Huey Shin Shirley; Yeo, Ling Sui Jocelyn; Tsang, Li Ping Marianne; Ong, Kai Zhi; Wong, Sook Wai Samantha; Tan, Ngiap Chuan

    2016-01-01

    Abstract Essential hypertension often requires affected patients to self-manage their condition most of the time. Besides seeking regular medical review of their life-long condition to detect vascular complications, patients have to maintain healthy lifestyles in between physician consultations via diet and physical activity, and to take their medications according to their prescriptions. Their self-management ability is influenced by their self-efficacy capacity, which can be assessed using questionnaire-based tools. The “Hypertension Self-Care Profile” (HTN-SCP) is 1 such questionnaire assessing self-efficacy in the domains of “behavior,” “motivation,” and “self-efficacy.” This study aims to determine the test–retest reliability of HTN-SCP in an English-literate Asian population using a web-based approach. Multiethnic Asian patients, aged 40 years and older, with essential hypertension were recruited from a typical public primary care clinic in Singapore. The investigators guided the patients to fill up the web-based 60-item HTN-SCP in English using a tablet or smartphone on the first visit and refilled the instrument 2 weeks later in the retest. Internal consistency and test–retest reliability were evaluated using Cronbach's Alpha and intraclass correlation coefficients (ICC), respectively. The t test was used to determine the relationship between the overall HTN-SCP scores of the patients and their self-reported self-management activities. A total of 160 patients completed the HTN-SCP during the initial test, from which 71 test–retest responses were completed. No floor or ceiling effect was found for the scores for the 3 subscales. Cronbach's Alpha coefficients were 0.857, 0.948, and 0.931 for “behavior,” “motivation,” and “self-efficacy” domains respectively, indicating high internal consistency. The item-total correlation ranges for the 3 scales were from 0.105 to 0.656 for Behavior, 0.401 to 0.808 for Motivation, 0.349 to 0

  8. Constipation - self-care

    MedlinePlus

    ... fast foods, such as white breads, pastries, doughnuts, sausage, fast-food burgers, potato chips, and French fries. ... before talking with your provider. This includes mineral oil. Some people get a rash, nausea, or a ...

  9. Lymphedema - self-care

    MedlinePlus

    ... any changes. Protect your skin from injuries, even small ones: Use only an electric razor for shaving underarms or legs. Wear gardening gloves and cooking gloves. Wear gloves when doing work around the house. Use a thimble when you sew. Be careful ...

  10. Hemodialysis access - self care

    MedlinePlus

    Kidney failure - chronic-hemodialysis access; Renal failure - chronic-hemodialysis access; Chronic renal insufficiency - hemodialysis access; Chronic kidney failure - hemodialysis access; Chronic renal failure - hemodialysis access; dialysis - hemodialysis access

  11. Self Care for Educators

    ERIC Educational Resources Information Center

    National Child Traumatic Stress Network, 2008

    2008-01-01

    Trauma takes a toll on children, families, schools, and communities. Trauma can also take a toll on school professionals. Any educator who works directly with traumatized children and adolescents is vulnerable to the effects of trauma--referred to as "compassion fatigue" or "secondary traumatic stress"--being physically, mentally, or emotionally…

  12. Tremor - self-care

    MedlinePlus

    ... your provider about how you can change your sleep habits if you have problems sleeping. Stress and anxiety can also make your tremor worse. These things may lower your stress level: Meditation, deep relaxation, or breathing exercises Reducing your caffeine ...

  13. Breastfeeding - self-care

    MedlinePlus

    ... of fruit: 1/2 cup (120 milliliters) fruit juice Apples Apricots Peaches 1/2 cup (70 grams) cut up fruit, such as watermelon or cantaloupe 1/4 cup (50 grams) dried ... vegetable juice Eat about 6 servings of grains like bread, ...

  14. Acne - self-care

    MedlinePlus

    ... It may help to use a wash with salicylic acid or benzoyl if your skin is oily and prone to acne. Remove all ... products may contain benzoyl peroxide, sulfur, resorcinol, or ... bacteria, drying up skin oils, or causing the top layer of your ...

  15. Averaging Models: Parameters Estimation with the R-Average Procedure

    ERIC Educational Resources Information Center

    Vidotto, G.; Massidda, D.; Noventa, S.

    2010-01-01

    The Functional Measurement approach, proposed within the theoretical framework of Information Integration Theory (Anderson, 1981, 1982), can be a useful multi-attribute analysis tool. Compared to the majority of statistical models, the averaging model can account for interaction effects without adding complexity. The R-Average method (Vidotto &…

  16. Averaging Internal Consistency Reliability Coefficients

    ERIC Educational Resources Information Center

    Feldt, Leonard S.; Charter, Richard A.

    2006-01-01

    Seven approaches to averaging reliability coefficients are presented. Each approach starts with a unique definition of the concept of "average," and no approach is more correct than the others. Six of the approaches are applicable to internal consistency coefficients. The seventh approach is specific to alternate-forms coefficients. Although the…

  17. The Average of Rates and the Average Rate.

    ERIC Educational Resources Information Center

    Lindstrom, Peter

    1988-01-01

    Defines arithmetic, harmonic, and weighted harmonic means, and discusses their properties. Describes the application of these properties in problems involving fuel economy estimates and average rates of motion. Gives example problems and solutions. (CW)

  18. A Modified User-Oriented Heuristic Evaluation of a Mobile Health System for Diabetes Self-management Support

    PubMed Central

    Georgsson, Mattias; Staggers, Nancy; Weir, Charlene

    2016-01-01

    Mobile health platforms offer significant opportunities for improving diabetic self-care, but only if adequate usability exists. Expert evaluations such as heuristic evaluation can provide distinct usability information about systems. The purpose of this study was to complete a usability evaluation of a mobile health system for diabetes patients using a modified heuristic evaluation technique of (1) dual-domain experts (healthcare professionals, usability experts), (2) validated scenarios and user tasks related to patients’ self-care, and (3) in-depth severity factor ratings. Experts identified 129 usability problems with 274 heuristic violations for the system. The categories Consistency and Standards dominated at 24.1% (n = 66), followed by Match Between System and Real World at 22.3% (n = 61). Average severity ratings across system views were 2.8 (of 4), with 9.3% (n = 12) rated as catastrophic and 53.5% (n = 69) as major. The large volume of violations with severe ratings indicated clear priorities for redesign. The modified heuristic approach allowed evaluators to identify unique and important issues, including ones related to self-management and patient safety. This article provides a template for one type of expert evaluation adding to the informaticists’ toolbox when needing to conduct a fast, resource-efficient and user-oriented heuristic evaluation. PMID:26657618

  19. A Modified User-Oriented Heuristic Evaluation of a Mobile Health System for Diabetes Self-management Support.

    PubMed

    Georgsson, Mattias; Staggers, Nancy; Weir, Charlene

    2016-02-01

    Mobile health platforms offer significant opportunities for improving diabetic self-care, but only if adequate usability exists. Expert evaluations such as heuristic evaluation can provide distinct usability information about systems. The purpose of this study was to complete a usability evaluation of a mobile health system for diabetes patients using a modified heuristic evaluation technique of (1) dual-domain experts (healthcare professionals, usability experts), (2) validated scenarios and user tasks related to patients' self-care, and (3) in-depth severity factor ratings. Experts identified 129 usability problems with 274 heuristic violations for the system. The categories Consistency and Standards dominated at 24.1% (n = 66), followed by Match Between System and Real World at 22.3% (n = 61). Average severity ratings across system views were 2.8 (of 4), with 9.3% (n = 12) rated as catastrophic and 53.5% (n = 69) as major. The large volume of violations with severe ratings indicated clear priorities for redesign. The modified heuristic approach allowed evaluators to identify unique and important issues, including ones related to self-management and patient safety. This article provides a template for one type of expert evaluation adding to the informaticists' toolbox when needing to conduct a fast, resource-efficient and user-oriented heuristic evaluation. PMID:26657618

  20. How does gender influence the recognition of cardiovascular risk and adherence to self-care recommendations?: a study in polish primary care

    PubMed Central

    2013-01-01

    Background Studies have shown a correlation between gender and an ability to change lifestyle to reduce the risk of disease. However, the results of these studies are ambiguous, especially where a healthy lifestyle is concerned. Additionally, health behaviors are strongly modified by culture and the environment. Psychological factors also substantially affect engagement with disease-related lifestyle interventions. This study aimed to examine whether there are differences between men and women in the frequency of health care behavior for the purpose of reducing cardiovascular risk (CVR), as well as cognitive appraisal of this type of risk. We also aimed to identify the psychological predictors of engaging in recommended behavior for reducing the risk of cardiovascular disease after providing information about this risk in men and women. Methods A total of 134 consecutive eligible patients in a family practice entered a longitudinal study. At initial consultation, the individual’s CVR and associated health burden was examined, and preventive measures were recommended by the physician. Self-care behavior, cognitive appraisal of risk, and coping styles were then assessed using psychological questionnaires. Six months after the initial data collection, the frequency of subjects’ self-care behavior was examined. Results We found an increase in health care behavior after providing information regarding the rate of CVR in both sexes; this increase was greater for women than for men. Women followed self-care guidelines more often than men, particularly for preventive measures and dietary advice. Women were more inclined to recognize their CVR as a challenge. Coping style, cognitive appraisal, age, level of health behaviors at baseline and CVR values accounted for 48% of the variance in adherence to self-care guidelines in women and it was 52% in men. In women, total risk of CVD values were most important, while in men, cognitive appraisal of harm/loss was most

  1. High average power pockels cell

    DOEpatents

    Daly, Thomas P.

    1991-01-01

    A high average power pockels cell is disclosed which reduces the effect of thermally induced strains in high average power laser technology. The pockels cell includes an elongated, substantially rectangular crystalline structure formed from a KDP-type material to eliminate shear strains. The X- and Y-axes are oriented substantially perpendicular to the edges of the crystal cross-section and to the C-axis direction of propagation to eliminate shear strains.

  2. Supporting Self-Care for Families of Children With Eczema With a Web-Based Intervention Plus Health Care Professional Support: Pilot Randomized Controlled Trial

    PubMed Central

    Muller, Ingrid; Yardley, Lucy; Burgess, Hana; Selinger, Hannah; Stuart, Beth L; Little, Paul

    2014-01-01

    Background Childhood eczema, or childhood atopic dermatitis, causes significant distress to children and their families through sleep disturbance and itch. The main cause of treatment failure is nonuse of prescribed treatments. Objective The objective of this study was to develop and test a Web-based intervention to support families of children with eczema, and to explore whether support from a health care professional (HCP) is necessary to engage participants with the intervention. Methods We followed the PRECEDE-PROCEED model: regular emollient use was the target behavior we were seeking to promote and we identified potential techniques to influence this. LifeGuide software was used to write the intervention website. Carers of children with eczema were invited through primary care mail-out and randomized to 3 groups: (1) website only, (2) website plus HCP support, or (3) usual care. Patient-Oriented Eczema Measure (POEM) scores were measured online by carer report at baseline and at 12 weeks. Qualitative interviews were carried out with 13 HCPs (primarily practice nurses) and 26 participants to explore their experiences of taking part in the study. Results A total of 143 carers were recruited through 31 practices. We found a decrease of ≥2 in follow-up compared with baseline POEM score in 23 of 42 (55%) participants in the website only group, 16 of 49 (33%) in the usual care group, and 18 of 47 (38%) in the website plus HCP group. Website use data showed that 75 of 93 (81%) participants allocated to the website groups completed the core modules, but less than half used other key components (videos: 35%; regular text reminders: 39%). There were no consistent differences in website use between the website only or the website plus HCP groups. Qualitative feedback showed that most HCPs had initial concerns about providing support for eczema self-care because this was not a condition that they felt expert in. However, HCPs reported productive consultations and that

  3. Determining GPS average performance metrics

    NASA Technical Reports Server (NTRS)

    Moore, G. V.

    1995-01-01

    Analytic and semi-analytic methods are used to show that users of the GPS constellation can expect performance variations based on their location. Specifically, performance is shown to be a function of both altitude and latitude. These results stem from the fact that the GPS constellation is itself non-uniform. For example, GPS satellites are over four times as likely to be directly over Tierra del Fuego than over Hawaii or Singapore. Inevitable performance variations due to user location occur for ground, sea, air and space GPS users. These performance variations can be studied in an average relative sense. A semi-analytic tool which symmetrically allocates GPS satellite latitude belt dwell times among longitude points is used to compute average performance metrics. These metrics include average number of GPS vehicles visible, relative average accuracies in the radial, intrack and crosstrack (or radial, north/south, east/west) directions, and relative average PDOP or GDOP. The tool can be quickly changed to incorporate various user antenna obscuration models and various GPS constellation designs. Among other applications, tool results can be used in studies to: predict locations and geometries of best/worst case performance, design GPS constellations, determine optimal user antenna location and understand performance trends among various users.

  4. Vocal attractiveness increases by averaging.

    PubMed

    Bruckert, Laetitia; Bestelmeyer, Patricia; Latinus, Marianne; Rouger, Julien; Charest, Ian; Rousselet, Guillaume A; Kawahara, Hideki; Belin, Pascal

    2010-01-26

    Vocal attractiveness has a profound influence on listeners-a bias known as the "what sounds beautiful is good" vocal attractiveness stereotype [1]-with tangible impact on a voice owner's success at mating, job applications, and/or elections. The prevailing view holds that attractive voices are those that signal desirable attributes in a potential mate [2-4]-e.g., lower pitch in male voices. However, this account does not explain our preferences in more general social contexts in which voices of both genders are evaluated. Here we show that averaging voices via auditory morphing [5] results in more attractive voices, irrespective of the speaker's or listener's gender. Moreover, we show that this phenomenon is largely explained by two independent by-products of averaging: a smoother voice texture (reduced aperiodicities) and a greater similarity in pitch and timbre with the average of all voices (reduced "distance to mean"). These results provide the first evidence for a phenomenon of vocal attractiveness increases by averaging, analogous to a well-established effect of facial averaging [6, 7]. They highlight prototype-based coding [8] as a central feature of voice perception, emphasizing the similarity in the mechanisms of face and voice perception.

  5. Vocal attractiveness increases by averaging.

    PubMed

    Bruckert, Laetitia; Bestelmeyer, Patricia; Latinus, Marianne; Rouger, Julien; Charest, Ian; Rousselet, Guillaume A; Kawahara, Hideki; Belin, Pascal

    2010-01-26

    Vocal attractiveness has a profound influence on listeners-a bias known as the "what sounds beautiful is good" vocal attractiveness stereotype [1]-with tangible impact on a voice owner's success at mating, job applications, and/or elections. The prevailing view holds that attractive voices are those that signal desirable attributes in a potential mate [2-4]-e.g., lower pitch in male voices. However, this account does not explain our preferences in more general social contexts in which voices of both genders are evaluated. Here we show that averaging voices via auditory morphing [5] results in more attractive voices, irrespective of the speaker's or listener's gender. Moreover, we show that this phenomenon is largely explained by two independent by-products of averaging: a smoother voice texture (reduced aperiodicities) and a greater similarity in pitch and timbre with the average of all voices (reduced "distance to mean"). These results provide the first evidence for a phenomenon of vocal attractiveness increases by averaging, analogous to a well-established effect of facial averaging [6, 7]. They highlight prototype-based coding [8] as a central feature of voice perception, emphasizing the similarity in the mechanisms of face and voice perception. PMID:20129047

  6. Vibrational averages along thermal lines

    NASA Astrophysics Data System (ADS)

    Monserrat, Bartomeu

    2016-01-01

    A method is proposed for the calculation of vibrational quantum and thermal expectation values of physical properties from first principles. Thermal lines are introduced: these are lines in configuration space parametrized by temperature, such that the value of any physical property along them is approximately equal to the vibrational average of that property. The number of sampling points needed to explore the vibrational phase space is reduced by up to an order of magnitude when the full vibrational density is replaced by thermal lines. Calculations of the vibrational averages of several properties and systems are reported, namely, the internal energy and the electronic band gap of diamond and silicon, and the chemical shielding tensor of L-alanine. Thermal lines pave the way for complex calculations of vibrational averages, including large systems and methods beyond semilocal density functional theory.

  7. Averaging of globally coupled oscillators

    NASA Astrophysics Data System (ADS)

    Swift, James W.; Strogatz, Steven H.; Wiesenfeld, Kurt

    1992-03-01

    We study a specific system of symmetrically coupled oscillators using the method of averaging. The equations describe a series array of Josephson junctions. We concentrate on the dynamics near the splay-phase state (also known as the antiphase state, ponies on a merry-go-round, or rotating wave). We calculate the Floquet exponents of the splay-phase periodic orbit in the weak-coupling limit, and find that all of the Floquet exponents are purely imaginary; in fact, all the Floquet exponents are zero except for a single complex conjugate pair. Thus, nested two-tori of doubly periodic solutions surround the splay-phase state in the linearized averaged equations. We numerically integrate the original system, and find startling agreement with the averaging results on two counts: The observed ratio of frequencies is very close to the prediction, and the solutions of the full equations appear to be either periodic or doubly periodic, as they are in the averaged equations. Such behavior is quite surprising from the point of view of generic dynamical systems theory-one expects higher-dimensional tori and chaotic solutions. We show that the functional form of the equations, and not just their symmetry, is responsible for this nongeneric behavior.

  8. Averaging inhomogeneous cosmologies - a dialogue.

    NASA Astrophysics Data System (ADS)

    Buchert, T.

    The averaging problem for inhomogeneous cosmologies is discussed in the form of a disputation between two cosmologists, one of them (RED) advocating the standard model, the other (GREEN) advancing some arguments against it. Technical explanations of these arguments as well as the conclusions of this debate are given by BLUE.

  9. Averaging inhomogenous cosmologies - a dialogue

    NASA Astrophysics Data System (ADS)

    Buchert, T.

    The averaging problem for inhomogeneous cosmologies is discussed in the form of a disputation between two cosmologists, one of them (RED) advocating the standard model, the other (GREEN) advancing some arguments against it. Technical explanations of these arguments as well as the conclusions of this debate are given by BLUE.

  10. Polyhedral Painting with Group Averaging

    ERIC Educational Resources Information Center

    Farris, Frank A.; Tsao, Ryan

    2016-01-01

    The technique of "group-averaging" produces colorings of a sphere that have the symmetries of various polyhedra. The concepts are accessible at the undergraduate level, without being well-known in typical courses on algebra or geometry. The material makes an excellent discovery project, especially for students with some background in…

  11. Averaging Robertson-Walker cosmologies

    NASA Astrophysics Data System (ADS)

    Brown, Iain A.; Robbers, Georg; Behrend, Juliane

    2009-04-01

    The cosmological backreaction arises when one directly averages the Einstein equations to recover an effective Robertson-Walker cosmology, rather than assuming a background a priori. While usually discussed in the context of dark energy, strictly speaking any cosmological model should be recovered from such a procedure. We apply the scalar spatial averaging formalism for the first time to linear Robertson-Walker universes containing matter, radiation and dark energy. The formalism employed is general and incorporates systems of multiple fluids with ease, allowing us to consider quantitatively the universe from deep radiation domination up to the present day in a natural, unified manner. Employing modified Boltzmann codes we evaluate numerically the discrepancies between the assumed and the averaged behaviour arising from the quadratic terms, finding the largest deviations for an Einstein-de Sitter universe, increasing rapidly with Hubble rate to a 0.01% effect for h = 0.701. For the ΛCDM concordance model, the backreaction is of the order of Ωeff0 approx 4 × 10-6, with those for dark energy models being within a factor of two or three. The impacts at recombination are of the order of 10-8 and those in deep radiation domination asymptote to a constant value. While the effective equations of state of the backreactions in Einstein-de Sitter, concordance and quintessence models are generally dust-like, a backreaction with an equation of state weff < -1/3 can be found for strongly phantom models.

  12. Managing venous leg ulcers and oedema using compression hosiery.

    PubMed

    Tickle, Joy

    2015-10-21

    Increasing demand for services and rising costs in the NHS have resulted in reduced consultation times and resources for clinicians when treating patients with compression therapy. This article emphasises the importance of considering alternative treatment approaches, while encouraging patient choice, independence and self-care. One alternative treatment is the use of compression hosiery kits for the management of venous leg ulceration and oedema.

  13. Chronic disease management for patients with respiratory disease.

    PubMed

    Bryant, Elizabeth

    National and international awareness of the heavy burden of chronic disease has led to the development of new strategies for managing care. Elisabeth Bryant explains how self-care, education and support for more patients with complex needs should be built into planned care delivery, and emphasises that the patient is the key member of the care team.

  14. Model averaging in linkage analysis.

    PubMed

    Matthysse, Steven

    2006-06-01

    Methods for genetic linkage analysis are traditionally divided into "model-dependent" and "model-independent," but there may be a useful place for an intermediate class, in which a broad range of possible models is considered as a parametric family. It is possible to average over model space with an empirical Bayes prior that weights models according to their goodness of fit to epidemiologic data, such as the frequency of the disease in the population and in first-degree relatives (and correlations with other traits in the pleiotropic case). For averaging over high-dimensional spaces, Markov chain Monte Carlo (MCMC) has great appeal, but it has a near-fatal flaw: it is not possible, in most cases, to provide rigorous sufficient conditions to permit the user safely to conclude that the chain has converged. A way of overcoming the convergence problem, if not of solving it, rests on a simple application of the principle of detailed balance. If the starting point of the chain has the equilibrium distribution, so will every subsequent point. The first point is chosen according to the target distribution by rejection sampling, and subsequent points by an MCMC process that has the target distribution as its equilibrium distribution. Model averaging with an empirical Bayes prior requires rapid estimation of likelihoods at many points in parameter space. Symbolic polynomials are constructed before the random walk over parameter space begins, to make the actual likelihood computations at each step of the random walk very fast. Power analysis in an illustrative case is described. (c) 2006 Wiley-Liss, Inc. PMID:16652369

  15. Ensemble averaging of acoustic data

    NASA Technical Reports Server (NTRS)

    Stefanski, P. K.

    1982-01-01

    A computer program called Ensemble Averaging of Acoustic Data is documented. The program samples analog data, analyzes the data, and displays them in the time and frequency domains. Hard copies of the displays are the program's output. The documentation includes a description of the program and detailed user instructions for the program. This software was developed for use on the Ames 40- by 80-Foot Wind Tunnel's Dynamic Analysis System consisting of a PDP-11/45 computer, two RK05 disk drives, a tektronix 611 keyboard/display terminal, and FPE-4 Fourier Processing Element, and an analog-to-digital converter.

  16. Stimulating Healthy Aging with a Model Nurse-Managed Free Clinic in a Senior Center.

    ERIC Educational Resources Information Center

    Franklin, Ruth H.

    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…

  17. Integrating patient voices into health information for self-care and patient-clinician partnerships: Veterans Affairs design recommendations for patient-generated data applications.

    PubMed

    Woods, Susan S; Evans, Neil C; Frisbee, Kathleen L

    2016-05-01

    Electronic health record content is created by clinicians and is driven largely by intermittent and brief encounters with patients. Collecting data directly from patients in the form of patient-generated data (PGD) provides an unprecedented opportunity to capture personal, contextual patient information that can supplement clinical data and enhance patients' self-care. The US Department of Veterans Affairs (VA) is striving to implement the enterprise-wide capability to collect and use PGD in order to partner with patients in their care, improve the patient healthcare experience, and promote shared decision making. Through knowledge gained from Veterans' and healthcare teams' perspectives, VA created a taxonomy and an evolving framework on which to design and develop applications that capture and help physicians utilize PGD. Ten recommendations for effectively collecting and integrating PGD into patient care are discussed, addressing health system culture, data value, architecture, policy, data standards, clinical workflow, data visualization, and analytics and population reach.

  18. Home visits in brain tumor patient: how nurse and family members cooperate in tumor patient’s family self-care

    PubMed Central

    Yan, Zhiyue

    2013-01-01

    Purposes We reported the roles and functions of nurses in home visits for brain tumor patients using the family health assessment guide in the study. Methods One patient of brain glioma was chosen as the case illustration. The nurses assessed the patients’ situation, their families and living environment individually. All these factors were analyzed together. Results The nurses then implemented their knowledge and skills to adopt different measures in different conditions, investigated the patients’ health problems and carried out personalized effective actions. Conclusions Nurses should put effort into community nursing to allow patients to live in a safe environment, to satisfy the health needs of human being and their needs for health knowledge, and enhance their self-care abilities. PMID:24385701

  19. The patient work system: An analysis of self-care performance barriers among elderly heart failure patients and their informal caregivers

    PubMed Central

    Holden, Richard J.; Schubert, Christiane C.; Mickelson, Robin S.

    2014-01-01

    Human factors and ergonomics approaches have been successfully applied to study and improve the work performance of healthcare professionals. However, there has been relatively little work in “patient-engaged human factors,” or the application of human factors to the health-related work of patients and other nonprofessionals. This study applied a foundational human factors tool, the systems model, to investigate the barriers to self-care performance among chronically ill elderly patients and their informal (family) caregivers. A Patient Work System model was developed to guide the collection and analysis of interviews, surveys, and observations of patients with heart failure (n=30) and their informal caregivers (n=14). Iterative analyses revealed the nature and prevalence of self-care barriers across components of the Patient Work System. Person-related barriers were common and stemmed from patients’ biomedical conditions, limitations, knowledge deficits, preferences, and perceptions as well as the characteristics of informal caregivers and healthcare professionals. Task barriers were also highly prevalent and included task difficulty, timing, complexity, ambiguity, conflict, and undesirable consequences. Tool barriers were related to both availability and access of tools and technologies and their design, usability, and impact. Context barriers were found across three domains—physical-spatial, social-cultural, and organizational—and multiple “spaces” such as “at home,” “on the go,” and “in the community.” Barriers often stemmed not from single factors but from the interaction of several work system components. Study findings suggest the need to further explore multiple actors, context, and interactions in the patient work system during research and intervention design, as well as the need to develop new models and measures for studying patient and family work. PMID:25479983

  20. Intergenerational Transmission of Chronic Illness Self-Care: Results from the Caring for Hypertension in African American Families Study

    ERIC Educational Resources Information Center

    Warren-Findlow, Jan; Seymour, Rachel B.; Shenk, Dena

    2011-01-01

    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…

  1. Flexible time domain averaging technique

    NASA Astrophysics Data System (ADS)

    Zhao, Ming; Lin, Jing; Lei, Yaguo; Wang, Xiufeng

    2013-09-01

    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.

  2. KinoHaptics: An Automated, Wearable, Haptic Assisted, Physio-therapeutic System for Post-surgery Rehabilitation and Self-care.

    PubMed

    Rajanna, Vijay; Vo, Patrick; Barth, Jerry; Mjelde, Matthew; Grey, Trevor; Oduola, Cassandra; Hammond, Tracy

    2016-03-01

    A carefully planned, structured, and supervised physiotherapy program, following a surgery, is crucial for the successful diagnosis of physical injuries. Nearly 50 % of the surgeries fail due to unsupervised, and erroneous physiotherapy. The demand for a physiotherapist for an extended period is expensive to afford, and sometimes inaccessible. Researchers have tried to leverage the advancements in wearable sensors and motion tracking by building affordable, automated, physio-therapeutic systems that direct a physiotherapy session by providing audio-visual feedback on patient's performance. There are many aspects of automated physiotherapy program which are yet to be addressed by the existing systems: a wide classification of patients' physiological conditions to be diagnosed, multiple demographics of the patients (blind, deaf, etc.), and the need to pursue patients to adopt the system for an extended period for self-care. In our research, we have tried to address these aspects by building a health behavior change support system called KinoHaptics, for post-surgery rehabilitation. KinoHaptics is an automated, wearable, haptic assisted, physio-therapeutic system that can be used by a wide variety of demographics and for various physiological conditions of the patients. The system provides rich and accurate vibro-haptic feedback that can be felt by the user, irrespective of the physiological limitations. KinoHaptics is built to ensure that no injuries are induced during the rehabilitation period. The persuasive nature of the system allows for personal goal-setting, progress tracking, and most importantly life-style compatibility. The system was evaluated under laboratory conditions, involving 14 users. Results show that KinoHaptics is highly convenient to use, and the vibro-haptic feedback is intuitive, accurate, and has shown to prevent accidental injuries. Also, results show that KinoHaptics is persuasive in nature as it supports behavior change and habit building

  3. Effect of Orem’s Self-Care Model on Perceived Stress in Adolescents with Asthma Referring the Asthma and Allergy Clinic, Isfahan, 2014

    PubMed Central

    Hemati, Zeinab; Abasi, Samira; Mosaviasl, Fatemehsadat; Shakerian, Behzad; Kiani, Davood

    2016-01-01

    Background: Incidence of asthma in adolescents leads to variations in family status, roles and interaction with peers for them, which could be a source of stress and psychological tensions in them. Therefore, the present study was conducted to investigate the effect of Orem’s self-care model on perceived stress in adolescents with asthma. Methods: In this semi-experimental study conducted from April 2013 to February 2014, 64 asthmatic adolescents referring Shariati Hospital, Isfahan were enrolled by simple random sampling and the patients were assigned to two groups of control and intervention. Then, Orem’s self-care model-based training was implemented throughout eight sessions of two hours each and the Cohen Perceived Stress Scale was administered to both groups prior to and two months after the completion of the training. The data were analyzed by descriptive and analytical statistics consisting of paired t-test, independent t-test, Chi-square and Mann-Whitney using SPSS Version 20. Results: Mean age of the participants was 14.15±3.12 years in the intervention group and 15.21±3.09 years in the control groups. 68.8% and 59.4% of the participants were male in the intervention and control groups, respectively. Independent t-test indicated a significant difference in the mean scores of perceived stress in the intervention (25.46±5.31) and control groups (28.90±5.27) after the training. Also, the result of paired t-test indicated a significant difference in the mean score of perceived stress between before (29.18±5.27) and after (25.46±5.31) training. Conclusion: As the training based on Orem’s model had a positive effect on declining perceived stress in asthmatic adolescents, continuation of using these training interventions could contribute to ultimately achieving positive outcomes in health functions of these patients. PMID:27382591

  4. Towards a Personal Health Management Assistant.

    PubMed

    Ferguson, G; Quinn, J; Horwitz, C; Swift, M; Allen, J; Galescu, L

    2010-10-01

    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

  5. Strategies for self-management of HIV-related anxiety.

    PubMed

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

    2006-08-01

    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 and effectiveness for each self-care activity were also included. Praying received the highest overall rating of effectiveness of any self-management strategies included in this study at 8.10 (scale 1 to 10), followed by meditation (7.37), exercising (7.32), using relaxation techniques (7.22), cooking (6.98), and walking (6.90). An analysis of effectiveness scores for each self-care strategy by country reflected a wide variation. The three most effective anxiety self-care strategies reported by participants from Norway included exercise (7.31), walking (6.96), and reading (6.44). Highest ratings of effectiveness by participants from Taiwan included talking with others with HIV (6.0), attending support groups (6.0), and exercising (6.0). US participants allocated highest ratings of effectiveness to complementary/alternative therapies, including praying (8.10), meditating (7.43), and using relaxation techniques (7.35). Regardless of the country, watching television and talking with family and friends were the two most frequently reported strategies. These strategies for self-management of HIV-related anxiety are important for clinicians to be aware of in the care of persons with HIV/AIDS.

  6. Developmental issues in managing children with diabetes.

    PubMed

    Savinetti-Rose, B

    1994-01-01

    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

  7. Social recovery and the move beyond deficit models of depression: a feminist analysis of mid-life women's self-care practices.

    PubMed

    Fullagar, Simone; O'Brien, Wendy

    2014-09-01

    In Australia, like other advanced liberal democracies, the adoption of a recovery orientation was hailed as a major leap forward in mental health policy and service provision. We argue that this shift in thinking about the meaning of recovery requires further analysis of the gendered dimension of self-identity and relationships with the social world. In this article we focus on how mid-life women constructed meaning about recovery through their everyday practices of self-care within the gendered context of depression. Findings from our qualitative research with 31 mid-life women identified how the recovery process was complicated by relapses into depression, with many women critically questioning the limitations of biomedical treatment options for a more relational understanding of recovery. Participant stories revealed important tacit knowledge about recovery that emphasised the process of realising and recognising capacities and self-knowledge. We identify two central themes through which women's tacit knowledge of this changing relation to self in recovery is made explicit: the disciplined self of normalised recovery, redefining recovery and depression. The findings point to the need to reconsider how both recovery discourses and gendered expectations can complicate women's experiences of moving through depression. We argue for a different conceptualisation of recovery as a social practice through which women realise opportunities to embody different 'beings and doings'. A gendered understanding of what women themselves identify is important to their well-being, can contribute to more effective recovery oriented policies based on capability rather than deficit. PMID:25063967

  8. 40 CFR 91.1304 - Averaging.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Averaging. 91.1304 Section 91.1304... Averaging. (a) A manufacturer may use averaging across engine families to demonstrate a zero or positive credit balance for a model year. Positive credits to be used in averaging may be obtained from...

  9. 40 CFR 91.1304 - Averaging.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 21 2012-07-01 2012-07-01 false Averaging. 91.1304 Section 91.1304... Averaging. (a) A manufacturer may use averaging across engine families to demonstrate a zero or positive credit balance for a model year. Positive credits to be used in averaging may be obtained from...

  10. 40 CFR 91.1304 - Averaging.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 21 2013-07-01 2013-07-01 false Averaging. 91.1304 Section 91.1304... Averaging. (a) A manufacturer may use averaging across engine families to demonstrate a zero or positive credit balance for a model year. Positive credits to be used in averaging may be obtained from...

  11. Culturally Competent Diabetes Self-Management Education for Mexican Americans: The Starr County Border Health Initiative.

    ERIC Educational Resources Information Center

    Brown, Sharon A.; Garcia, Alexandra A.; Kouzekanani, Kamiar; Hanis, Craig L.

    2002-01-01

    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…

  12. Are Self-Management Interventions Suitable for All? Comparing Obese Versus Nonobese Type 2 Diabetes Patients

    ERIC Educational Resources Information Center

    Kroese, Floor M.; Adriaanse, Marieke A.; De Ridder, Denise T. D.

    2013-01-01

    Objective: The aim of the current study was to compare obese and nonobese type 2 diabetes patients at baseline and after participating in an existing self-management intervention (i.e., "Beyond Good Intentions") on cognitive, self-care, and behavioral measures to examine whether both groups are equally prepared and able to adopt…

  13. Below-Average, Average, and Above-Average Readers Engage Different and Similar Brain Regions while Reading

    ERIC Educational Resources Information Center

    Molfese, Dennis L.; Key, Alexandra Fonaryova; Kelly, Spencer; Cunningham, Natalie; Terrell, Shona; Ferguson, Melissa; Molfese, Victoria J.; Bonebright, Terri

    2006-01-01

    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…

  14. 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

    Mańko, Grzegorz; Ziółkowski, Artur; Mirski, Andrzej; Kłosiński, Michał

    2013-01-01

    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. PMID:24036691

  15. 40 CFR 76.11 - Emissions averaging.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) ACID RAIN NITROGEN OXIDES EMISSION REDUCTION PROGRAM § 76.11 Emissions averaging. (a) General... averaging plan is in compliance with the Acid Rain emission limitation for NOX under the plan only if...

  16. 40 CFR 76.11 - Emissions averaging.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) ACID RAIN NITROGEN OXIDES EMISSION REDUCTION PROGRAM § 76.11 Emissions averaging. (a) General... averaging plan is in compliance with the Acid Rain emission limitation for NOX under the plan only if...

  17. Parvalbumin Cell Ablation of NMDA-R1 Causes Increased Resting Network Excitability with Associated Social and Self-Care Deficits

    PubMed Central

    Billingslea, Eddie N; Tatard-Leitman, Valerie M; Anguiano, Jaynie; Jutzeler, Catherine R; Suh, Jimmy; Saunders, John A; Morita, Susumu; Featherstone, Robert E; Ortinski, Pavel I; Gandal, Michael J; Lin, Robert; Liang, Yuling; Gur, Raquel E; Carlson, Gregory C; Hahn, Chang-Gyu; Siegel, Steven J

    2014-01-01

    NMDA-receptor (NMDAR) hypofunction is strongly implicated in the pathophysiology of schizophrenia. Several convergent lines of evidence suggest that net excitation propagated by impaired NMDAR signaling on GABAergic interneurons may be of particular interest in mediating several aspects of schizophrenia. However, it is unclear which behavioral domains are governed by a net increase of excitation and whether modulating downstream GABAergic signaling can reverse neural and thus behavioral deficits. The current study determines the selective contributions of NMDAR dysfunction on PV-containing interneurons to electrophysiological, cognitive, and negative-symptom-related behavioral phenotypes of schizophrenia using mice with a PVcre-NR1flox-driven ablation of NR1 on PV-containing interneurons. In addition, we assessed the efficacy of one agent that directly modulates GABAergic signaling (baclofen) and one agent that indirectly modifies NMDAR-mediated signaling through antagonism of mGluR5 receptors (2-methyl-6-(phenylethynyl) pyridine (MPEP)). The data indicate that loss of NMDAR function on PV interneurons impairs self-care and sociability while increasing N1 latency and baseline gamma power, and reducing induction and maintenance of long-term potentiation. Baclofen normalized baseline gamma power without corresponding effects on behavior. MPEP further increased N1 latency and reduced social behavior in PVcre/NR1+/+ mice. These two indices were negatively correlated before and following MPEP such that as N1 latency increases, sociability decreases. This finding suggests a predictive role for N1 latency with respect to social function. Although previous data suggest that MPEP may be beneficial for core features of autism spectrum disorders, current data suggest that such effects require intact function of NMDAR on PV interneurons. PMID:24525709

  18. Using the teach-back and Orem's Self-care Deficit Nursing theory to increase childhood immunization communication among low-income mothers.

    PubMed

    Wilson, Feleta L; Baker, Lynda M; Nordstrom, Cheryl K; Legwand, Carol

    2008-01-01

    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.

  19. 40 CFR 89.204 - Averaging.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... are defined as follows: (1) Eligible engines rated at or above 19 kW, other than marine diesel engines, constitute an averaging set. (2) Eligible engines rated under 19 kW, other than marine diesel engines, constitute an averaging set. (3) Marine diesel engines rated at or above 19 kW constitute an averaging...

  20. 40 CFR 89.204 - Averaging.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... are defined as follows: (1) Eligible engines rated at or above 19 kW, other than marine diesel engines, constitute an averaging set. (2) Eligible engines rated under 19 kW, other than marine diesel engines, constitute an averaging set. (3) Marine diesel engines rated at or above 19 kW constitute an averaging...

  1. 40 CFR 89.204 - Averaging.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... are defined as follows: (1) Eligible engines rated at or above 19 kW, other than marine diesel engines, constitute an averaging set. (2) Eligible engines rated under 19 kW, other than marine diesel engines, constitute an averaging set. (3) Marine diesel engines rated at or above 19 kW constitute an averaging...

  2. 40 CFR 89.204 - Averaging.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... are defined as follows: (1) Eligible engines rated at or above 19 kW, other than marine diesel engines, constitute an averaging set. (2) Eligible engines rated under 19 kW, other than marine diesel engines, constitute an averaging set. (3) Marine diesel engines rated at or above 19 kW constitute an averaging...

  3. 40 CFR 89.204 - Averaging.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... are defined as follows: (1) Eligible engines rated at or above 19 kW, other than marine diesel engines, constitute an averaging set. (2) Eligible engines rated under 19 kW, other than marine diesel engines, constitute an averaging set. (3) Marine diesel engines rated at or above 19 kW constitute an averaging...

  4. Spectral averaging techniques for Jacobi matrices

    SciTech Connect

    Rio, Rafael del; Martinez, Carmen; Schulz-Baldes, Hermann

    2008-02-15

    Spectral averaging techniques for one-dimensional discrete Schroedinger operators are revisited and extended. In particular, simultaneous averaging over several parameters is discussed. Special focus is put on proving lower bounds on the density of the averaged spectral measures. These Wegner-type estimates are used to analyze stability properties for the spectral types of Jacobi matrices under local perturbations.

  5. Averaging and Adding in Children's Worth Judgements

    ERIC Educational Resources Information Center

    Schlottmann, Anne; Harman, Rachel M.; Paine, Julie

    2012-01-01

    Under the normative Expected Value (EV) model, multiple outcomes are additive, but in everyday worth judgement intuitive averaging prevails. Young children also use averaging in EV judgements, leading to a disordinal, crossover violation of utility when children average the part worths of simple gambles involving independent events (Schlottmann,…

  6. Engagement with Automated Patient Monitoring and Self-Management Support Calls: Experience with a Thousand Chronically-Ill Patients

    PubMed Central

    Piette, John D.; Rosland, Ann-Marie; Marinec, Nicolle Stec; Striplin, Dana; Bernstein, Steven J.; Silveira, Maria J.

    2013-01-01

    Background Patient self-care support via Interactive Voice Response (IVR) can improve disease management. However little is known about the factors affecting program engagement. Methods We compiled data on IVR program engagement for 1,173 patients with: heart failure, depression, diabetes, and cancer who were followed for 28,962 person-weeks. Patients in programs for diabetes or depression (N=727) had the option of participating along with an informal caregiver who received electronic feedback based on the patient’s IVR assessments. Analyses focused on factors associated with completing weekly IVR calls. Results Patients were on average 61 years old, 37% had at most a high school education, and 48% reported incomes < $30,000. Among patients given the option of participating with an informal caregiver, 65% chose to do so. Patients completed 83% of attempted IVR assessments, with rates higher for heart failure (90%) and cancer programs (90%) than for the diabetes (81%) or depression programs (71%) (p<0.001). Among patients in diabetes or depression programs, those opting to have feedback provided to an informal caregiver were more likely to complete assessments (adjusted odds ratio: 1.36; 95% CI: 1.06, 1.75). Older patients had higher call completion rates, even among patients > 75 years of age. Missed clinic appointments, prior hospitalizations, depression program participation, and poorer mental health were associated with lower completion rates. Conclusions Patients with a variety of chronic conditions will complete IVR self-care support calls regularly. Risk factors for missed IVR calls overlap with those for missed appointments. Involvement of informal caregivers may significantly increase engagement. PMID:23222527

  7. Going Mobile With Diabetes Support: A Randomized Study of a Text Message–Based Personalized Behavioral Intervention for Type 2 Diabetes Self-Care

    PubMed Central

    Woolsey, Sarah; Georgsson, Mattias; Black, Jeff; Bello, Nelly; Lence, Clare; Oostema, Steve; North, Christie

    2015-01-01

    Objective. Patients with type 2 diabetes often fail to achieve self-management goals. This study tested the impact on glycemic control of a two-way text messaging program that provided behavioral coaching, education, and testing reminders to enrolled individuals with type 2 diabetes in the context of a clinic-based quality improvement initiative. The secondary aim examined patient interaction and satisfaction with the program. Methods. Ninety-three adult patients with poorly controlled type 2 diabetes (A1C >8%) were recruited from 18 primary care clinics in three counties for a 6-month study. Patients were randomized by a computer to one of two arms. Patients in both groups continued with their usual care; patients assigned to the intervention arm also received from one to seven diabetes-related text messages per day depending on the choices they made at enrollment. At 90 and 180 days, A1C data were obtained from the electronic health record and analyzed to determine changes from baseline for both groups. An exit survey was used to assess satisfaction. Enrollment behavior and interaction data were pulled from a Web-based administrative portal maintained by the technology vendor. Results. Patients used the program in a variety of ways. Twenty-nine percent of program users demonstrated frequent engagement (texting responses at least three times per week) for a period of ≥90 days. Survey results indicate very high satisfaction with the program. Both groups’ average A1C decreased from baseline, possibly reflecting a broader quality improvement effort underway in participating clinics. At 90 and 180 days, there was no statistically significant difference between the intervention and control groups in terms of change in A1C (P >0.05). Conclusions. This study demonstrated a practical approach to implementing and monitoring a mobile health intervention for self-management support across a wide range of independent clinic practices. PMID:25987806

  8. Going mobile with diabetes support: a randomized study of a text message-based personalized behavioral intervention for type 2 diabetes self-care.

    PubMed

    Capozza, Korey; Woolsey, Sarah; Georgsson, Mattias; Black, Jeff; Bello, Nelly; Lence, Clare; Oostema, Steve; North, Christie

    2015-05-01

    Objective. Patients with type 2 diabetes often fail to achieve self-management goals. This study tested the impact on glycemic control of a two-way text messaging program that provided behavioral coaching, education, and testing reminders to enrolled individuals with type 2 diabetes in the context of a clinic-based quality improvement initiative. The secondary aim examined patient interaction and satisfaction with the program. Methods. Ninety-three adult patients with poorly controlled type 2 diabetes (A1C >8%) were recruited from 18 primary care clinics in three counties for a 6-month study. Patients were randomized by a computer to one of two arms. Patients in both groups continued with their usual care; patients assigned to the intervention arm also received from one to seven diabetes-related text messages per day depending on the choices they made at enrollment. At 90 and 180 days, A1C data were obtained from the electronic health record and analyzed to determine changes from baseline for both groups. An exit survey was used to assess satisfaction. Enrollment behavior and interaction data were pulled from a Web-based administrative portal maintained by the technology vendor. Results. Patients used the program in a variety of ways. Twenty-nine percent of program users demonstrated frequent engagement (texting responses at least three times per week) for a period of ≥90 days. Survey results indicate very high satisfaction with the program. Both groups' average A1C decreased from baseline, possibly reflecting a broader quality improvement effort underway in participating clinics. At 90 and 180 days, there was no statistically significant difference between the intervention and control groups in terms of change in A1C (P >0.05). Conclusions. This study demonstrated a practical approach to implementing and monitoring a mobile health intervention for self-management support across a wide range of independent clinic practices.

  9. Gestational diabetes - self-care

    MedlinePlus

    ... control your blood sugar levels, you may need oral medicine (taken by mouth) or insulin therapy (shots). ... is doing well If you need insulin or oral medicine to control your blood sugar, you may need ...

  10. Dry skin - self-care

    MedlinePlus

    ... frequently Washing your hands often Some soaps and detergents Skin conditions, such as eczema and psoriasis Certain ... Avoid rough fabrics like wool. Wash clothes with detergents that are free of dyes or fragrances. Drink ...

  11. Menopause, a Self Care Manual.

    ERIC Educational Resources Information Center

    Lopez, Maria Cristina; And Others

    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…

  12. Oral mucositis - self-care

    MedlinePlus

    Cancer treatment - mucositis; Cancer treatment - mouth pain; Cancer treatment - mouth sores; Chemotherapy - mucositis; Chemotherapy - mouth pain; Chemotherapy - mouth sores; Radiation therapy - mucositis; Radiation therapy - mouth pain; Radiation therapy - mouth ...

  13. Anal itching - self-care

    MedlinePlus

    ... foods and beverages Scents or dyes in toilet paper or soap Diarrhea Hemorrhoids , which are swollen veins ... wipes, a wet washcloth, or wet unscented toilet paper. Avoid soaps with dyes or fragrances. Pat dry ...

  14. Atopic dermatitis - self-care

    MedlinePlus

    ... MO: Elsevier Saunders; 2016:chap 5. James WD, Berger TG, Elston DM. Atopic dermatitis, eczema, and noninfectious immunodeficiency disordersIn: James WD, Berger TG, Elston DM, eds. Andrews' Diseases of the ...

  15. Kegel exercises - self-care

    MedlinePlus

    ... men and women who have problems with urine leakage or bowel control. You may have these problems: ... nerve disorders may also have problems with urine leakage or bowel control. Kegel exercises can be done ...

  16. Prostatitis- bacterial - self-care

    MedlinePlus

    ... chance of the condition returning. Antibiotics may cause side effects. These include nausea or vomiting, diarrhea, and other symptoms. Report these to your doctor. DO NOT just stop taking your pills.

  17. Shin splints - self-care

    MedlinePlus

    ... pain is gone. Do stretching exercises. Take ibuprofen, naproxen, or aspirin to decrease swelling and to help with pain. Know these medicines have side effects and can cause ulcers and bleeding. Talk to ...

  18. Rotator cuff - self-care

    MedlinePlus

    ... rotator cuff is a group of muscles and tendons that attach to the bones of the shoulder ... problems include: Tendinitis , which is irritation of the tendons and inflammation of the bursa (a normally smooth ...

  19. Ischemic ulcers - self-care

    MedlinePlus

    ... Saunders; 2014:chap 120. Leong M, Phillips LG. Wound healing. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern ... V. Wound care and irrigations. In: Perry AG, Potter PA, ...

  20. Venous ulcers - self-care

    MedlinePlus

    ... Saunders; 2014:chap 120. Leong M, Phillips LG. Wound healing. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern ... V. Wound care and irrigations. In: Perry AG, Potter PA, ...

  1. Global Average Brightness Temperature for April 2003

    NASA Technical Reports Server (NTRS)

    2003-01-01

    [figure removed for brevity, see original site] Figure 1

    This image shows average temperatures in April, 2003, observed by AIRS at an infrared wavelength that senses either the Earth's surface or any intervening cloud. Similar to a photograph of the planet taken with the camera shutter held open for a month, stationary features are captured while those obscured by moving clouds are blurred. Many continental features stand out boldly, such as our planet's vast deserts, and India, now at the end of its long, clear dry season. Also obvious are the high, cold Tibetan plateau to the north of India, and the mountains of North America. The band of yellow encircling the planet's equator is the Intertropical Convergence Zone (ITCZ), a region of persistent thunderstorms and associated high, cold clouds. The ITCZ merges with the monsoon systems of Africa and South America. Higher latitudes are increasingly obscured by clouds, though some features like the Great Lakes, the British Isles and Korea are apparent. The highest latitudes of Europe and Eurasia are completely obscured by clouds, while Antarctica stands out cold and clear at the bottom of the image.

    The Atmospheric Infrared Sounder Experiment, with its visible, infrared, and microwave detectors, provides a three-dimensional look at Earth's weather. Working in tandem, the three instruments can make simultaneous observations all the way down to the Earth's surface, even in the presence of heavy clouds. With more than 2,000 channels sensing different regions of the atmosphere, the system creates a global, 3-D map of atmospheric temperature and humidity and provides information on clouds, greenhouse gases, and many other atmospheric phenomena. The AIRS Infrared Sounder Experiment flies onboard NASA's Aqua spacecraft and is managed by NASA's Jet Propulsion Laboratory, Pasadena, Calif., under contract to NASA. JPL is a division of the California Institute of Technology in Pasadena.

  2. Average-cost based robust structural control

    NASA Technical Reports Server (NTRS)

    Hagood, Nesbitt W.

    1993-01-01

    A method is presented for the synthesis of robust controllers for linear time invariant structural systems with parameterized uncertainty. The method involves minimizing quantities related to the quadratic cost (H2-norm) averaged over a set of systems described by real parameters such as natural frequencies and modal residues. Bounded average cost is shown to imply stability over the set of systems. Approximations for the exact average are derived and proposed as cost functionals. The properties of these approximate average cost functionals are established. The exact average and approximate average cost functionals are used to derive dynamic controllers which can provide stability robustness. The robustness properties of these controllers are demonstrated in illustrative numerical examples and tested in a simple SISO experiment on the MIT multi-point alignment testbed.

  3. Spatial limitations in averaging social cues

    PubMed Central

    Florey, Joseph; Clifford, Colin W. G.; Dakin, Steven; Mareschal, Isabelle

    2016-01-01

    The direction of social attention from groups provides stronger cueing than from an individual. It has previously been shown that both basic visual features such as size or orientation and more complex features such as face emotion and identity can be averaged across multiple elements. Here we used an equivalent noise procedure to compare observers’ ability to average social cues with their averaging of a non-social cue. Estimates of observers’ internal noise (uncertainty associated with processing any individual) and sample-size (the effective number of gaze-directions pooled) were derived by fitting equivalent noise functions to discrimination thresholds. We also used reverse correlation analysis to estimate the spatial distribution of samples used by participants. Averaging of head-rotation and cone-rotation was less noisy and more efficient than averaging of gaze direction, though presenting only the eye region of faces at a larger size improved gaze averaging performance. The reverse correlation analysis revealed greater sampling areas for head rotation compared to gaze. We attribute these differences in averaging between gaze and head cues to poorer visual processing of faces in the periphery. The similarity between head and cone averaging are examined within the framework of a general mechanism for averaging of object rotation. PMID:27573589

  4. Cosmological ensemble and directional averages of observables

    SciTech Connect

    Bonvin, Camille; Clarkson, Chris; Durrer, Ruth; Maartens, Roy; Umeh, Obinna E-mail: chris.clarkson@gmail.com E-mail: roy.maartens@gmail.com

    2015-07-01

    We show that at second order, ensemble averages of observables and directional averages do not commute due to gravitational lensing—observing the same thing in many directions over the sky is not the same as taking an ensemble average. In principle this non-commutativity is significant for a variety of quantities that we often use as observables and can lead to a bias in parameter estimation. We derive the relation between the ensemble average and the directional average of an observable, at second order in perturbation theory. We discuss the relevance of these two types of averages for making predictions of cosmological observables, focusing on observables related to distances and magnitudes. In particular, we show that the ensemble average of the distance in a given observed direction is increased by gravitational lensing, whereas the directional average of the distance is decreased. For a generic observable, there exists a particular function of the observable that is not affected by second-order lensing perturbations. We also show that standard areas have an advantage over standard rulers, and we discuss the subtleties involved in averaging in the case of supernova observations.

  5. Spectral and parametric averaging for integrable systems

    NASA Astrophysics Data System (ADS)

    Ma, Tao; Serota, R. A.

    2015-05-01

    We analyze two theoretical approaches to ensemble averaging for integrable systems in quantum chaos, spectral averaging (SA) and parametric averaging (PA). For SA, we introduce a new procedure, namely, rescaled spectral averaging (RSA). Unlike traditional SA, it can describe the correlation function of spectral staircase (CFSS) and produce persistent oscillations of the interval level number variance (IV). PA while not as accurate as RSA for the CFSS and IV, can also produce persistent oscillations of the global level number variance (GV) and better describes saturation level rigidity as a function of the running energy. Overall, it is the most reliable method for a wide range of statistics.

  6. Spatial limitations in averaging social cues.

    PubMed

    Florey, Joseph; Clifford, Colin W G; Dakin, Steven; Mareschal, Isabelle

    2016-01-01

    The direction of social attention from groups provides stronger cueing than from an individual. It has previously been shown that both basic visual features such as size or orientation and more complex features such as face emotion and identity can be averaged across multiple elements. Here we used an equivalent noise procedure to compare observers' ability to average social cues with their averaging of a non-social cue. Estimates of observers' internal noise (uncertainty associated with processing any individual) and sample-size (the effective number of gaze-directions pooled) were derived by fitting equivalent noise functions to discrimination thresholds. We also used reverse correlation analysis to estimate the spatial distribution of samples used by participants. Averaging of head-rotation and cone-rotation was less noisy and more efficient than averaging of gaze direction, though presenting only the eye region of faces at a larger size improved gaze averaging performance. The reverse correlation analysis revealed greater sampling areas for head rotation compared to gaze. We attribute these differences in averaging between gaze and head cues to poorer visual processing of faces in the periphery. The similarity between head and cone averaging are examined within the framework of a general mechanism for averaging of object rotation. PMID:27573589

  7. Improvement of pain-related self-management for cancer patients through a modular transitional nursing intervention: a cluster-randomized multicenter trial.

    PubMed

    Jahn, Patrick; Kuss, Oliver; Schmidt, Heike; Bauer, Alexander; Kitzmantel, Maria; Jordan, Karin; Krasemann, Susann; Landenberger, Margarete

    2014-04-01

    Patients' self-management skills are affected by their knowledge, activities, and attitudes toward pain management. This trial aimed to test the Self Care Improvement through Oncology Nursing (SCION)-PAIN program, a multimodular structured intervention to reduce patients' barriers to self-management of cancer pain. Two hundred sixty-three patients with diagnosed malignancy, pain>3 days, and average pain > or = 3/10 participated in a cluster-randomized trial on 18 wards in 2 German university hospitals. Patients on the intervention wards received, in addition to standard pain treatment, the SCION-PAIN program consisting of 3 modules: pharmacologic, nonpharmacologic pain management, and discharge management. The intervention was conducted by specially trained cancer nurses and included components of patient education, skills training, and counseling. Starting with admission, patients received booster sessions every third day and one follow-up telephone counseling session within 2 to 3 days after discharge. Patients in the control group received standard care. Primary end point was the group difference in patient-related barriers to self-management of cancer pain (Barriers Questionnaire-BQ II) 7 days after discharge. The SCION-PAIN program resulted in a significant reduction of patient-related barriers to pain management 1 week after discharge from the hospital: mean difference on BQ II was -0.49 points (95% confidence interval -0.87 points to -0.12 points; P=0.02). Furthermore, patients showed improved adherence to pain medication; odds ratio 8.58 (95% confidence interval 1.66-44.40; P=0.02). A post hoc analysis indicated reduced average and worst pain intensity as well as improved quality of life. This trial reveals the positive impact of a nursing intervention to improve patients' self-management of cancer pain.

  8. Dynamic Multiscale Averaging (DMA) of Turbulent Flow

    SciTech Connect

    Richard W. Johnson

    2012-09-01

    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

  9. Contrasting patient and practitioner perspectives in type 2 diabetes management.

    PubMed

    Hunt, L M; Arar, N H; Larme, A C

    1998-12-01

    Studies of self-care behaviors in the management of type 2 diabetes often focus on patient knowledge and motivation, without considering the role of practitioner orientations. Using an exploratory descriptive design, we conducted open-ended interviews with 51 type 2 diabetes patients and 35 practitioners from clinics in San Antonio and Laredo, Texas. We found critical differences between patient and practitioner goals, evaluations, and strategies in diabetes management, especially regarding such key concepts as "control" and "taking care of self". Practitioners' perspectives are rooted in a clinical context, emphasizing technical considerations, whereas patients' perspectives exist within a life-world context and foreground practical and experiential considerations. These result in very different approaches to treatment. Practitioners, presuming failed treatment indicates uncooperativeness, try to inform and motivate patients. The patients we interviewed, however, understood and were committed to type 2 diabetes self-care, but lacked full access to behavioral options due to their poverty and limited social power. PMID:9842286

  10. 40 CFR 1037.710 - Averaging.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 34 2012-07-01 2012-07-01 false Averaging. 1037.710 Section 1037.710 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR POLLUTION CONTROLS CONTROL OF EMISSIONS FROM NEW HEAVY-DUTY MOTOR VEHICLES Averaging, Banking, and Trading for Certification §...

  11. Average Transmission Probability of a Random Stack

    ERIC Educational Resources Information Center

    Lu, Yin; Miniatura, Christian; Englert, Berthold-Georg

    2010-01-01

    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…

  12. Whatever Happened to the Average Student?

    ERIC Educational Resources Information Center

    Krause, Tom

    2005-01-01

    Mandated state testing, college entrance exams and their perceived need for higher and higher grade point averages have raised the anxiety levels felt by many of the average students. Too much focus is placed on state test scores and college entrance standards with not enough focus on the true level of the students. The author contends that…

  13. Determinants of College Grade Point Averages

    ERIC Educational Resources Information Center

    Bailey, Paul Dean

    2012-01-01

    Chapter 2: The Role of Class Difficulty in College Grade Point Averages. Grade Point Averages (GPAs) are widely used as a measure of college students' ability. Low GPAs can remove a students from eligibility for scholarships, and even continued enrollment at a university. However, GPAs are determined not only by student ability but also by…

  14. 40 CFR 86.449 - Averaging provisions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...: Class Tier Model year FEL cap(g/km) HC+NOX Class I or II Tier 1 2006 and later 5.0 Class III Tier 1 2006... States. (c) To use the averaging program, do the following things: (1) Certify each vehicle to a family... to the nearest tenth of a g/km. Use consistent units throughout the calculation. The averaging...

  15. 40 CFR 86.449 - Averaging provisions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...: Class Tier Model year FEL cap(g/km) HC+NOX Class I or II Tier 1 2006 and later 5.0 Class III Tier 1 2006... States. (c) To use the averaging program, do the following things: (1) Certify each vehicle to a family... to the nearest tenth of a g/km. Use consistent units throughout the calculation. The averaging...

  16. 40 CFR 86.449 - Averaging provisions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...: Class Tier Model year FEL cap(g/km) HC+NOX Class I or II Tier 1 2006 and later 5.0 Class III Tier 1 2006... States. (c) To use the averaging program, do the following things: (1) Certify each vehicle to a family... to the nearest tenth of a g/km. Use consistent units throughout the calculation. The averaging...

  17. 40 CFR 86.449 - Averaging provisions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...: Class Tier Model year FEL cap(g/km) HC+NOX Class I or II Tier 1 2006 and later 5.0 Class III Tier 1 2006... States. (c) To use the averaging program, do the following things: (1) Certify each vehicle to a family... to the nearest tenth of a g/km. Use consistent units throughout the calculation. The averaging...

  18. 40 CFR 86.449 - Averaging provisions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...: Class Tier Model year FEL cap(g/km) HC+NOX Class I or II Tier 1 2006 and later 5.0 Class III Tier 1 2006... States. (c) To use the averaging program, do the following things: (1) Certify each vehicle to a family... to the nearest tenth of a g/km. Use consistent units throughout the calculation. The averaging...

  19. 40 CFR 63.846 - Emission averaging.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... operator may average TF emissions from potlines and demonstrate compliance with the limits in Table 1 of... operator also may average POM emissions from potlines and demonstrate compliance with the limits in Table 2... limit in Table 1 of this subpart (for TF emissions) and/or Table 2 of this subpart (for POM...

  20. 40 CFR 63.846 - Emission averaging.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... operator may average TF emissions from potlines and demonstrate compliance with the limits in Table 1 of... operator also may average POM emissions from potlines and demonstrate compliance with the limits in Table 2... limit in Table 1 of this subpart (for TF emissions) and/or Table 2 of this subpart (for POM...

  1. 40 CFR 63.846 - Emission averaging.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... operator may average TF emissions from potlines and demonstrate compliance with the limits in Table 1 of... operator also may average POM emissions from potlines and demonstrate compliance with the limits in Table 2... limit in Table 1 of this subpart (for TF emissions) and/or Table 2 of this subpart (for POM...

  2. 40 CFR 63.846 - Emission averaging.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... averaging. (a) General. The owner or operator of an existing potline or anode bake furnace in a State that... by total aluminum production. (c) Anode bake furnaces. The owner or operator may average TF emissions from anode bake furnaces and demonstrate compliance with the limits in Table 3 of this subpart...

  3. 40 CFR 63.846 - Emission averaging.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... averaging. (a) General. The owner or operator of an existing potline or anode bake furnace in a State that... by total aluminum production. (c) Anode bake furnaces. The owner or operator may average TF emissions from anode bake furnaces and demonstrate compliance with the limits in Table 3 of this subpart...

  4. Averaged equations for distributed Josephson junction arrays

    NASA Astrophysics Data System (ADS)

    Bennett, Matthew; Wiesenfeld, Kurt

    2004-06-01

    We use an averaging method to study the dynamics of a transmission line studded by Josephson junctions. The averaged system is used as a springboard for studying experimental strategies which rely on spatial non-uniformity to achieve enhanced synchronization. A reduced model for the near resonant case elucidates in physical terms the key to achieving stable synchronized dynamics.

  5. New results on averaging theory and applications

    NASA Astrophysics Data System (ADS)

    Cândido, Murilo R.; Llibre, Jaume

    2016-08-01

    The usual averaging theory reduces the computation of some periodic solutions of a system of ordinary differential equations, to find the simple zeros of an associated averaged function. When one of these zeros is not simple, i.e., the Jacobian of the averaged function in it is zero, the classical averaging theory does not provide information about the periodic solution associated to a non-simple zero. Here we provide sufficient conditions in order that the averaging theory can be applied also to non-simple zeros for studying their associated periodic solutions. Additionally, we do two applications of this new result for studying the zero-Hopf bifurcation in the Lorenz system and in the Fitzhugh-Nagumo system.

  6. The Hubble rate in averaged cosmology

    SciTech Connect

    Umeh, Obinna; Larena, Julien; Clarkson, Chris E-mail: julien.larena@gmail.com

    2011-03-01

    The calculation of the averaged Hubble expansion rate in an averaged perturbed Friedmann-Lemaître-Robertson-Walker cosmology leads to small corrections to the background value of the expansion rate, which could be important for measuring the Hubble constant from local observations. It also predicts an intrinsic variance associated with the finite scale of any measurement of H{sub 0}, the Hubble rate today. Both the mean Hubble rate and its variance depend on both the definition of the Hubble rate and the spatial surface on which the average is performed. We quantitatively study different definitions of the averaged Hubble rate encountered in the literature by consistently calculating the backreaction effect at second order in perturbation theory, and compare the results. We employ for the first time a recently developed gauge-invariant definition of an averaged scalar. We also discuss the variance of the Hubble rate for the different definitions.

  7. 44 CFR 353.5 - Average cost per FEMA professional staff-hour.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... STATE AND LOCAL GOVERNMENT OR LICENSEE RADIOLOGICAL EMERGENCY PLANS AND PREPAREDNESS § 353.5 Average... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Average cost per FEMA professional staff-hour. 353.5 Section 353.5 Emergency Management and Assistance FEDERAL EMERGENCY...

  8. 44 CFR 353.5 - Average cost per FEMA professional staff-hour.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... STATE AND LOCAL GOVERNMENT OR LICENSEE RADIOLOGICAL EMERGENCY PLANS AND PREPAREDNESS § 353.5 Average... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Average cost per FEMA professional staff-hour. 353.5 Section 353.5 Emergency Management and Assistance FEDERAL EMERGENCY...

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

    PubMed

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

    2009-03-01

    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 with usual-care controls, examining changes in proximal outcomes (intentions, self-efficacy and proactive coping), self-care behaviour (diet, physical activity and medication) and weight over time (0, 3 and 12 months). Subsequently, the contribution of proactive coping in predicting maintenance of behavioural change was analysed using stepwise hierarchical regression analyses, controlling for baseline self-care behaviour, patient characteristics, and intentions and self-efficacy as measured after the course. The intervention was effective in improving proximal outcomes and behaviour with regard to diet and physical activity, resulting in significant weight loss at 12 months. Furthermore, proactive coping was a better predictor of long-term self-management than either intentions or self-efficacy. Proactive coping thus offers new insights into behavioural maintenance theory and can be used to develop effective self-management interventions. PMID:20204991

  10. Clarifying the Relationship between Average Excesses and Average Effects of Allele Substitutions.

    PubMed

    Alvarez-Castro, José M; Yang, Rong-Cai

    2012-01-01

    Fisher's concepts of average effects and average excesses are at the core of the quantitative genetics theory. Their meaning and relationship have regularly been discussed and clarified. Here we develop a generalized set of one locus two-allele orthogonal contrasts for average excesses and average effects, based on the concept of the effective gene content of alleles. Our developments help understand the average excesses of alleles for the biallelic case. We dissect how average excesses relate to the average effects and to the decomposition of the genetic variance. PMID:22509178

  11. Light propagation in the averaged universe

    SciTech Connect

    Bagheri, Samae; Schwarz, Dominik J. E-mail: dschwarz@physik.uni-bielefeld.de

    2014-10-01

    Cosmic structures determine how light propagates through the Universe and consequently must be taken into account in the interpretation of observations. In the standard cosmological model at the largest scales, such structures are either ignored or treated as small perturbations to an isotropic and homogeneous Universe. This isotropic and homogeneous model is commonly assumed to emerge from some averaging process at the largest scales. We assume that there exists an averaging procedure that preserves the causal structure of space-time. Based on that assumption, we study the effects of averaging the geometry of space-time and derive an averaged version of the null geodesic equation of motion. For the averaged geometry we then assume a flat Friedmann-Lemaître (FL) model and find that light propagation in this averaged FL model is not given by null geodesics of that model, but rather by a modified light propagation equation that contains an effective Hubble expansion rate, which differs from the Hubble rate of the averaged space-time.

  12. Effect of Orem Self-Care Program on the Life Quality of Burn Patients Referred to Ghotb-al-Din-e-Shirazi Burn Center, Shiraz, Iran: A Randomized Controlled Trial

    PubMed Central

    Hashemi, Fatemeh; Rahimi Dolatabad, Fatemeh; Yektatalab, Shahrzad; Ayaz, Mehdi; Zare, Najaf; Mansouri, Parisa

    2014-01-01

    Background: Advances in treatment and critical care have largely improved the survival following burns; therefore, the importance of quality of life in burn patients is an issue beyond question. The aim of this study was to determine the effects of Orem self-care program on Quality of Life of burn patients. Methods: A randomized clinical trial study was conducted on 110 eligible burn patients who were selected using easy sampling method and allocated randomly into two groups of experiment and control. The instrument for data collection was a questionnaire, containing demographic and burn information and burn-specific health scale–brief (BSHS-B) questionnaire. For the experiment group, 5 sessions of theoretical training and 75-90 minutes of practical training were accomplished. The quality of life of the patients with burns was assessed in three phases by the BSHS-B questionnaire. The data were analyzed in SPSS-17 using Chi-square test, Fisher’s exact test, Independent t-test and repeated measurement multivariate test. Results: After one month and two months of the use of self-care model, the quality of life of the cases improved from 73.33% to 83.78% and 98.12%, respectively (P<0.001). But the changes in the quality of life of the patients in the control group were not statistically significant (P>0.05). Conclusion: Based on the obtained results of this study, designing and implementing a self-care program based on Orem’s model and the needs of burn patients will improve their quality of life. Therefore, it is recommended that this program should be considered as a part of treatment program for these patients. Trial Registration Number: 2013042112129N1 PMID:25349844

  13. Averaging of Backscatter Intensities in Compounds

    PubMed Central

    Donovan, John J.; Pingitore, Nicholas E.; Westphal, Andrew J.

    2002-01-01

    Low uncertainty measurements on pure element stable isotope pairs demonstrate that mass has no influence on the backscattering of electrons at typical electron microprobe energies. The traditional prediction of average backscatter intensities in compounds using elemental mass fractions is improperly grounded in mass and thus has no physical basis. We propose an alternative model to mass fraction averaging, based of the number of electrons or protons, termed “electron fraction,” which predicts backscatter yield better than mass fraction averaging. PMID:27446752

  14. Average shape of transport-limited aggregates.

    PubMed

    Davidovitch, Benny; Choi, Jaehyuk; Bazant, Martin Z

    2005-08-12

    We study the relation between stochastic and continuous transport-limited growth models. We derive a nonlinear integro-differential equation for the average shape of stochastic aggregates, whose mean-field approximation is the corresponding continuous equation. Focusing on the advection-diffusion-limited aggregation (ADLA) model, we show that the average shape of the stochastic growth is similar, but not identical, to the corresponding continuous dynamics. Similar results should apply to DLA, thus explaining the known discrepancies between average DLA shapes and viscous fingers in a channel geometry. PMID:16196793

  15. Average Shape of Transport-Limited Aggregates

    NASA Astrophysics Data System (ADS)

    Davidovitch, Benny; Choi, Jaehyuk; Bazant, Martin Z.

    2005-08-01

    We study the relation between stochastic and continuous transport-limited growth models. We derive a nonlinear integro-differential equation for the average shape of stochastic aggregates, whose mean-field approximation is the corresponding continuous equation. Focusing on the advection-diffusion-limited aggregation (ADLA) model, we show that the average shape of the stochastic growth is similar, but not identical, to the corresponding continuous dynamics. Similar results should apply to DLA, thus explaining the known discrepancies between average DLA shapes and viscous fingers in a channel geometry.

  16. Average-passage flow model development

    NASA Technical Reports Server (NTRS)

    Adamczyk, John J.; Celestina, Mark L.; Beach, Tim A.; Kirtley, Kevin; Barnett, Mark

    1989-01-01

    A 3-D model was developed for simulating multistage turbomachinery flows using supercomputers. This average passage flow model described the time averaged flow field within a typical passage of a bladed wheel within a multistage configuration. To date, a number of inviscid simulations were executed to assess the resolution capabilities of the model. Recently, the viscous terms associated with the average passage model were incorporated into the inviscid computer code along with an algebraic turbulence model. A simulation of a stage-and-one-half, low speed turbine was executed. The results of this simulation, including a comparison with experimental data, is discussed.

  17. 40 CFR 76.11 - Emissions averaging.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) ACID RAIN NITROGEN OXIDES EMISSION REDUCTION PROGRAM § 76.11 Emissions averaging. (a) General... compliance with the Acid Rain emission limitation for NOX under the plan only if the following...

  18. 40 CFR 76.11 - Emissions averaging.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) ACID RAIN NITROGEN OXIDES EMISSION REDUCTION PROGRAM § 76.11 Emissions averaging. (a) General... compliance with the Acid Rain emission limitation for NOX under the plan only if the following...

  19. 40 CFR 76.11 - Emissions averaging.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) ACID RAIN NITROGEN OXIDES EMISSION REDUCTION PROGRAM § 76.11 Emissions averaging. (a) General... compliance with the Acid Rain emission limitation for NOX under the plan only if the following...

  20. Total pressure averaging in pulsating flows

    NASA Technical Reports Server (NTRS)

    Krause, L. N.; Dudzinski, T. J.; Johnson, R. C.

    1972-01-01

    A number of total-pressure tubes were tested in a non-steady flow generator in which the fraction of period that pressure is a maximum is approximately 0.8, thereby simulating turbomachine-type flow conditions. Most of the tubes indicated a pressure which was higher than the true average. Organ-pipe resonance which further increased the indicated pressure was encountered within the tubes at discrete frequencies. There was no obvious combination of tube diameter, length, and/or geometry variation used in the tests which resulted in negligible averaging error. A pneumatic-type probe was found to measure true average pressure, and is suggested as a comparison instrument to determine whether nonlinear averaging effects are serious in unknown pulsation profiles. The experiments were performed at a pressure level of 1 bar, for Mach number up to near 1, and frequencies up to 3 kHz.