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Medication literacy is the ability of individuals to access and understand medication information and then use that information to act and take their medication in a safe and appropriate way. The purpose of this study was to explore medication literacy in a group of Somali older adults and their families using qualitative secondary analysis. We conducted an analytic expansion of an existing qualitative study that explored the home healthcare perceptions of Somali older adults and their families. Qualitative data collected from 14 Somali families about home healthcare were reviewed and analyzed for material related to medication literacy. Data analysis revealed a number of important findings related to medication literacy and resulted in the discovery of four themes: Medication literacy is needed among Somali older adults and their families, Using home healthcare (HHC) to improve medication literacy, Better communication is essential to improving medication literacy, and Medication literacy is an intersecting family and social issue. The results of this study indicate that HHC has a role to play in improving the health and medication literacy of these families. They also highlight the need to further explore what techniques, tools, and/or supports HHC professionals need to care for non-English speaking populations. Future research needs to address how to meet the needs of diverse and vulnerable patients like Somali older adults, and how best to prepare HHC providers to do this.

Background: Urinary tract infection and blockage are serious and recurrent challenges for people with long-term indwelling catheters, and these catheter problems cause worry and anxiety when they disrupt normal daily activities., Objective: The goal was to determine whether urinary catheter-related self-management behaviors focusing on fluid intake would mediate fluid intake-related self-efficacy toward decreasing catheter-associated urinary tract infection (CAUTI) and/or catheter blockage., Methods: The sample involved data collected from 180 adult community-living, long-term indwelling urinary catheter users. The authors tested a model of fluid intake self-management related to fluid intake self-efficacy for key outcomes of CAUTI and blockage. To account for the large number of zeros in both outcomes, a zero-inflated negative binomial (ZINB) structural equation model was tested., Results: Structurally, fluid intake self-efficacy was positively associated with fluid intake self-management, suggesting that higher fluid intake self-efficacy predicts more (higher) fluid intake self-management; however, fluid intake self-management was not associated with either the frequency of CAUTIs or the presence or absence of CAUTI. Fluid intake self-efficacy was positively related to fluid intake self-management, and fluid intake self-management predicted less frequency of catheter blockage, but neither fluid intake self-efficacy nor fluid intake self-management predicted the presence or absence of blockage., Discussion: Further research is needed to better understand determinants of CAUTI in long-term catheter users and factors which might influence or prevent its occurrence. Increased confidence (self-efficacy) and self-management behaviors to promote fluid intake could be of value to long-term urinary catheter users to decrease catheter blockage.

Background: People using long-term indwelling urinary catheters experience multiple recurrent catheter problems. Self-management approaches are needed to avoid catheter-related problems., Objectives: The aim was to determine effectiveness of a self-management intervention in prevention of adverse outcomes (catheter-related urinary tract infection, blockage, and accidental dislodgement). Healthcare treatment associated with the adverse outcomes and catheter-related quality of life was also studied., Methods: A randomized clinical trial was conducted. The intervention involved learning catheter-related self-monitoring and self-management skills during home visits by a study nurse (twice during the first month and at 4 months-with a phone call at 2 months). The control group received usual care. Data were collected during an initial face-to-face home interview followed by bimonthly phone interviews. A total of 202 adult long-term urinary catheter users participated. Participants were randomized to treatment or control groups following collection of baseline data. Generalized estimating equations were used for the analysis of treatment effect., Results: In the intervention group, there was a significant decrease in reported blockage in the first 6 months (p = .02), but the effect did not persist. There were no significant effects for catheter-related urinary tract infection or dislodgment. Comparison of baseline rates of adverse outcomes with subsequent periods suggested that both groups improved over 12 months., Discussion: A simple-to-use catheter problems calendar and the bimonthly interviews might have functioned as a modest self-monitoring intervention for persons in both groups. A simplified intervention using a self-monitoring calendar is suggested-with optimal and consistent fluid intake likely to add value.

A long-term indwelling urinary catheter intervention was tested in a randomized trial that is described in this article. The perceived value of the intervention to the catheter users, one of the study's specific aims, was assessed at the end of their 12-month participation and is reported here. Study participants' responses, our findings, and implications for home healthcare are discussed.