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Contrast-enhanced ultrasonography (CEUS) has revolutionized diagnostic imaging by significantly improving the accuracy and capabilities of ultrasound technology. By utilizing contrast agents, CEUS offers enhanced visualization of blood flow, superior detection of vascular diseases, and delineation of pathological from healthy tissues. Real-time imaging capabilities afforded by CEUS have been shown to be instrumental in guiding interventions and assessing treatment efficacy, thereby contributing to personalized patient care and improved clinical outcomes. This document provides a comprehensive review of the current benefits, limitations, and future directions of contrast-enhanced ultrasonography. It acknowledges the potential for allergic reactions, the necessity for specialized training, high costs, and the occurrence of image artifacts as drawbacks, while also anticipating advancements in targeted agents and imaging techniques. Moreover, the document emphasizes the need for ongoing research to evaluate the long-term safety and efficacy of contrast agents and their impact across various medical disciplines. Despite the challenges, the integration of CEUS into clinical practice holds enormous potential to further refine diagnostic processes and enhance patient management. [ABSTRACT FROM AUTHOR]

Background: Effective self-care practices are crucial for maintaining health and well-being, as inadequate self-care can lead to increased health risks and decreased overall quality of life. To address these issues, one promising approach involves leveraging progressive web app (PWA) platforms to educate and empower individuals with necessary self-care services. This study aims to design, implement, and evaluate a national self-care PWA platform, aiming to enhance accessibility and effectiveness in promoting health and self-care practices. The platform designed to improve self-care processes can be utilized by mothers, children, adolescents, youth, adults, and patients with emotional and mental disorders. Methods: This study was conducted in three phases. In the first phase, during 35 meetings with 19 health care providers including physicians and another group of professionals, the most common illnesses and conditions that require self-care were identified. Platform capabilities were then assessed based on stakeholder opinions. Subsequently, during 15 meetings 19 health care providers identified a comprehensive list of conditions benefiting from dedicated decision aids to enhance individuals' self-care processes. In the second phase, a progressive web app platform was designed based on these common illnesses and conditions and capabilities and subsequently evaluated. To usability evaluation the platform, 26 evaluators utilized the system for two weeks. The QUIS 5.5 questionnaire was employed for evaluation, and the results were analyzed using SPSS 23. In the final phase, the system was implemented at the Smart University of Medical Sciences (SMUMS), affiliated with the Ministry of Health and Medical Education in Iran. Results: Based on the most common illnesses and conditions (n = 87) and identified capabilities, the national self-care platform was designed with eight sections catering to 'Maternal and child health services,' 'Mothers,' 'Infants,' 'Teenagers,' 'Adults,' 'Elderly,' 'Health of All Age Groups,' 'Patients with Mental and Emotional Health Disorders,' and 'General Information' for user education. Furthermore, the platform features 54 decision aids (DA), teleconsultation services, and a self-care magazine (Access link: https://khodmoragheb.ir/). These features were integrated to provide comprehensive support and resources for self-care. A mean exceeding 7 was attained across all evaluated dimensions, indicating that evaluators generally agreed the platform performed well. Conclusion: The designed national self-care platform offers a promising solution for managing healthcare challenges. This innovative approach addresses the specific needs of individuals and extends its reach to Persian-speaking patients worldwide, fostering a global impact. By embracing self-care practices on an international scale, this platform contributes to a more inclusive and accessible healthcare landscape for individuals in Iran, Afghanistan, Tajikistan, and beyond. [ABSTRACT FROM AUTHOR]

Background: As South Africa's population rapidly ages, the burden of non-communicable diseases and the challenges of performing daily care activities among older individuals are increasing. This study investigates trends in self-reported difficulties with daily care activities among older adults in South Africa and examines the association between these difficulties, sociodemographic factors, and chronic conditions. Methods: The study used cross-sectional data from ten rounds of South Africa General Household Survey (2012–2021). Sample population included 26,362 men and 42,400 women aged 60 years and above. The outcome measure was assessed by self-reported difficulty in performing basic care activities such as washing or dressing. Results: Between 2012 and 2021, the percentage of participants reporting "A lot of difficulty" increased by 79.75%, "Some difficulty" increased by 112.11%, while "Unable to do" decreased by 8.97%. The risk of self-care difficulties was higher for men (RR = 1.11, 95% CI = 1.02, 1.20) and increased with age: RR = 1.24 (95% CI = 1.08, 1.42) for ages 65–69; RR = 2.27 (95% CI = 2.00, 2.58) for ages 70–74; and RR = 5.65 (95% CI = 5.08, 6.28) for ages 75+. Not being currently married (RR = 1.65, 95% CI = 1.51, 1.79), being of African/Black (RR = 1.21, 95% CI = 1.06, 1.38) or Coloured race (RR = 1.41, 95% CI = 1.21, 1.65), and having diabetes (RR = 1.44, 95% CI = 1.34, 1.55), hypertension (RR = 1.35, 95% CI = 1.26, 1.45), or asthma (RR = 1.30, 95% CI = 1.14, 1.48) were also associated with a higher risk of self-care difficulties. Conclusion: There was a notable increase in the proportion of participants reporting significant difficulty and some difficulty in performing self-care tasks, while a decrease was observed in the category of participants unable to do such tasks. Health policies should prioritize the specific needs of vulnerable sociodemographic and health groups, considering their increased risk of self-care difficulties. [ABSTRACT FROM AUTHOR]

Introduction: Globally, hypertension is a significant public health concern and a leading cause of premature death. Since this disease is incurable, it is necessary to promote patients' self-care behaviors to control it. The goal of this research was to identify the elements that influence self-care actions in individuals with hypertension, utilizing the Protection Motivation Theory (PMT) framework. Methods: A study was carried out in Omidiyeh, located in southern Iran, using a cross-sectional design, involving 397 adults with hypertension (198 females and 199 males) who were selected from comprehensive health centers using a stratified random sampling technique. Data was gathered through a demographic data collection form and a questionnaire created by the researcher, which was based on the PMT. Data were assessed utilizing SPSS 25 and AMOS 24 software, and various statistical tests including one-way ANOVA, Pearson correlation, multiple regression, independent t-test, and structural equation modeling were conducted. Findings: The variables of intrinsic reward (r = 0.182), extrinsic reward (r = 0.288), and response cost (r = 0.126) showed a significant negative correlation with self-care behaviors. On the other hand, perceived susceptibility (r = 0.212), perceived severity (r = 0.110), self-efficacy (r = 0.555), and response efficacy (r = 0.424) demonstrated a significant positive correlation with self-care behaviors. Specifically, self-efficacy and response efficacy were the most powerful predictors of self-care behaviors, respectively. Conclusion: The results showed that several factors can forecast self-care behaviors in patients with hypertension. Researchers are recommended to incorporate PMT in educational interventions and concentrate on self-efficacy and response efficacy constructs. [ABSTRACT FROM AUTHOR]

Educational inequalities in sports participation remain a public health issue in the Netherlands. Combining structurally based resources from Pierre Bourdieu's theory of capital with Amartya Sen's conceptualization of individual agency may offer new insights into the complex mechanisms that drive these inequalities. Specifically, we posited that the way individuals are able to exercise their agency within the structurally based economic, social, and cultural resources they have access to may help explain educational inequalities in sports participation. Data from two waves of the GLOBE study (2014, 2021) were used to test whether two sequential mediators, structurally based resources followed by individual agency, help explain the relationship between educational level and sports participation. Adults aged 25 and older residing in Eindhoven, the Netherlands self-reported highest attained educational level, structurally based resources (economic, social, and embodied cultural capital), individual agency (self-control, perceived choice, and reflexivity), and sports participation. A sequential mediation analysis using structural equation modelling was used to test the direct effect of education on sports participation, the sequential indirect effect through both mediators, and partial indirect effects through each mediator individually. Educational level was positively associated with sports participation. The hypothesized sequential mediation pathway was not supported; educational level was positively associated with structurally based resources and structurally based resources were positively associated with individual agency, but individual agency was not related to sports participation. Though not through individual agency, structurally based resources helped explain educational inequalities in sports participation. Having access to more economic, social, and cultural resources may empower individuals by increasing their agency. This increased agency was not associated with sports participation, which could be because sports participation is not universally valued as a goal. The conceptualization and operationalization of individual agency in the context of sports participation warrants more research. We found that structurally based resources helped explain a substantial portion of educational inequalities in sport, so we propose that policies alleviating more than just economic barriers to sports participation, but also social and cultural barriers, may help reduce educational inequalities in sports participation in the Netherlands. [ABSTRACT FROM AUTHOR]

Background: Animation has promise for teaching complex health content through smartphone applications. However, smartphones have had limited use in Thailand for health literacy improvement among adults with chronic diseases. This study aims to explore the perceptions of adults with diabetes and/or hypertension resulting from 2D short animated videos for literacy against chronic disease that are available via smartphones. Methods: Four animated videos were initially developed based on clinical practice guidelines and nursing experience. Physicians, an expert in health education, and an animation team developed and revised scripts and storyboards of the animated videos. Lastly, videos were validated by physicians and health educators for content breadth and depth and by media experts for motion graphics and illustration. Each video presents a different situation in diabetes, hypertension, missing appointments, and obesity, ranging from 2.18 to 4.14 min in duration. The inclusion criteria were adults 35–70 years old with diabetes or hypertension who received care from primary care units. Thematic analysis was performed on the extracted data. Results: Twenty participants with a mean age of 58.4 years (SD 6.7; ranged 41–68) were focus-group interviewed. Three animation elements were assessed, including presentation, impacts, and suggestions. Participants had positive responses regarding the presentation (suitability of images and smooth motion graphics, short length of videos, simple language, understandable content, and clear sound) and impacts (recalling information, enhancing engagement, and motivating health awareness and behavior change). Suggested improvements were for a bigger font size for subtitles and considering the use of spoken text instead of on-screen text for recommendations at the end of the animations. Conclusions: Animated videos are acceptable for delivering health information. Pilot testing animated videos for promoting literacy against chronic diseases in adults with diabetes and hypertension is needed for optimal utility. [ABSTRACT FROM AUTHOR]

Introduction: Stroke is a major cause of disability in adults and the elderly worldwide. Post-stroke rehabilitation success largely depends on consistent participation in treatment sessions and adherence to prescribed physical exercises; however, factors such as individual belief about their health status often affect motivation, slowing recovery. Addressing these influences is essential for improving health-related quality of life and optimizing recovery outcomes. Methods: This study employed a cross-sectional and correlational design with convenience sampling. The aim was to explore the relationship between recovery locus of control (RLOC) and health-related quality of life (HRQoL) among chronic stroke survivors. The Recovery Locus of Control scale and the EuroQol 5D-5L scale were utilized for assessment. Results: A total of 69 participants were included in this survey. The mean RLOC score was 34.91, with internal RLOC at 21.16 and external RLOC at 13.77 and the total EQ5D index was 0.659. Age was a significant grouping factor, with the 30–39 age group showing a significant positive relationship (r = 1.000, p = 0.002), pain and anxiety/depression (p =.045), mobility and anxiety/depression (p =.009), anxiety/depression and self-care (p =.047), IRLOC and ERLOC (p =.013). Conclusion: The study found that while respondents exhibited high RLOC scores, there was no significant relationship between RLOC scores and the EQ5D-5L index score, suggesting that other factors may play a more critical role in influencing HRQoL among chronic stroke survivors. [ABSTRACT FROM AUTHOR]

Objectives: This study evaluated the impact of self-management interventions based on the COM-B model on peri-implant conditions in older adults with periodontitis. Materials and methods: The patients were randomly divided into two groups: Group 1 (control group) received only an oral health education (OHE) pamphlet. Group 2 (test group) performed a self-management intervention based on the COM-B model. Each patient was examined for the most inflammatory implant. The measurement parameters included self-efficacy, self-management ability, and clinical indicators such as probing depth (PD), bleeding on probing (BOP), modified gingival index (mGI), modified plaque index (mPI), and peri-implant mucositis severity score (PMSS). The data was collected at baseline, 4, 8, and 12 weeks. Results: 42 patients underwent testing for 3 months. After 12 weeks, the improvement of self-efficacy, self-management ability, and the reduction of BOP, mPI, and PMSS in the test group was significantly higher than in the control group. Conclusion: The study suggests that self-management interventions based on the COM-B model can enhance the self-management ability of older adults with periodontitis and reduce peri-implant inflammation. This method is more effective than distributing OHE pamphlets. Trial registration: The randomized controlled clinical trial was registered on Chinese Clinical Trial Registry (No. ChiCTR2400082660, Date: 03/04/2024). [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes is a rising health problem, especially in older adults. Health literacy and the degree of diabetes knowledge are among the factors that may influence diabetes self-care activities. The aim of this study was to assess factors affecting self-care activities among older adults living with type 2 diabetes in Alexandria, Egypt. Methods: A cross-sectional study included 400 older adults over the age of 60 with type 2 diabetes, recruited from diabetes outpatient clinics affiliated to the health insurance organization in Alexandria, Egypt. A predesigned, structured interview questionnaire was used to assess sociodemographic factors, personal habits, medical history, and drug history. The All Aspects of Health Literacy Scale (AAHLS) and the numeracy section of the Short Test of Functional Health Literacy in Adults (STOFHLA) were used to assess the level of health literacy. Diabetes Knowledge Test 2 (DKT2) was used to assess diabetes knowledge and Summary of Diabetes Self-care Activities scale was used to assess self-care activities. Multiple logistic regression analysis was used to examine the relationship between health literacy and self-care. Results: The mean age of the participants was 65.75 ± 5.15 years, and 56.2% of them were males. The mean duration of diabetes was 10.61 ± 5.28 years, 14.3% were illiterate, and 37.2% were university graduates. Positive correlations were found between health literacy, diabetes knowledge, and diabetes self-care activities (p < 0.001). Health literacy and diabetes knowledge were found to be significant predictors of diabetes self-care activities in older adults (aOR = 1.132; 95% CI:1.062–1.207, p < 0.001 and aOR = 1.313; 95% CI: 1.178–1.464, p < 0.001; respectively). Conclusions: Health literacy and diabetes knowledge were found to be predictors of good self-care activities in older adults living with diabetes. Health educators and health care professionals should focus on health education and the enhancement of diabetes knowledge to improve self-care activities and eventually glycemic control in older adults living with diabetes. [ABSTRACT FROM AUTHOR]

Objective: Diabetes is an incapacitating condition affecting millions of people in South Africa. Maintaining optimal glycaemic control is crucial in preventing diabetes complications, highlighting the importance of diabetes self-care. This study examined how Social Determinants of Health (SDoH) are associated with self-care management practices in individuals with diabetes in South Africa using the framework developed by the Healthy People 2020 initiative. Methods: This study utilised cross-sectional Project Mind baseline data collected in 2017. Self-care management was coded on a scale from '0' (never) to '7' (daily adherence). For analysis, this scale was dichotomised into two categories: low self-care (scores 0–5) and high self-care (scores 6–7). Furthermore, adherence with these daily self-care activities was categorised into three levels: no adherence, partial adherence (inconsistent or partial adherence to activities), and full adherence (consistent adherence to all self-care activities). Results: The analytical sample (n = 539) was predominantly female (76%), with a mean age of 54 years, urban residents (60%), unemployed (70%), and attained secondary education (11.3%). In determining the attainment of a higher scale of self-care, age (AOR = 1.02, CI=[0.99,1.05]) and secondary education (AOR = 1.13, CI=[1.02, 2.03]) were associated with an increase in the scale of self-care. Conversely, urban residency (AOR = 0.50, CI=[0.29,0.88]) and being obese (AOR = 0.43, CI=[0.19,1.00]) were associated with a lower scale of self-care. Although not statistically robust, food insecurity decreased while being a woman and having a stable house showed an increased association. Travelling longer distances to access healthcare was positively associated with no adherence, and urban residency has a negative association with full adherence relative to partial adherence. Conclusions: The associations between SDoH and diabetes self-care management within a South African context highlight the need for a more holistic understanding and approach to interventions. Future endeavours should examine these determinants more broadly and formulate integrative strategies to ameliorate diabetes self-care. [ABSTRACT FROM AUTHOR]

Objective: This qualitative study sought to explore patient experiences with technologies used in the Community Health in a Virtual Environment (Co-HIVE) pilot trial. Technology is becoming increasingly prevalent in mental healthcare, and user acceptance is critical for successful adoption and therefore clinical impact. The Co-HIVE pilot trialled a model of care whereby community-dwelling patients with symptoms of depression utilised virtual appointments and remote monitoring for the assessment and management of their condition, as an adjunct to routine care. Methods: Using a qualitative descriptive design, participants for this study were patients with symptoms of moderate to severe depression (based on the 9-item Patient Health Questionnaire, PHQ-9), who had completed the Co-HIVE pilot. Data was collected via semi-structured interviews that were audio-recorded, transcribed clean-verbatim, and thematically analysed using the Framework Method. Results: Ten participants completed the semi-structured interviews. Participants reported experiencing more personalised care, improved health knowledge and understanding, and greater self-care, enabled by the remote monitoring technology. Additionally, participants reported virtual appointments supported the clinician–patient relationship and improved access to mental health services. Conclusions: This experience of participants with the Co-HIVE pilot indicates there is a degree of acceptance of health technologies for use with community mental healthcare. This acceptance demonstrates opportunities to innovate existing mental health services by leveraging technology. [ABSTRACT FROM AUTHOR]

Background/Objectives: Empathy and emotional regulation (susceptibility and resistance) play an important role in a nurse's well-being and the provision of high-quality care. This phenomenon has not yet been studied in the context of nurses working in neuroscience. This study aimed to explore the perceptions related to empathy among nurses working in neuroscience contexts. Methods: Employing a mixed-methods approach, we conducted an online quantitative survey with 211 nurses working in various neuroscience settings using the Balanced Emotional Empathy Scale (BEES) and 15 online semistructured qualitative interviews to delve deeper into empathetic experiences. The mean and measures of dispersion, such as standard deviation, were used to analyze the quantitative data. Thematic analysis investigated qualitative data, and data triangulation was performed. Results: The quantitative findings revealed no significant differences in empathy or emotional regulation across the different neuroscience settings but highlighted an increase in susceptibility related to young age (under 29) and years of service (first 5 years). The interviews brought to light the challenges nurses face in highly emotional situations and the strategies they employ to manage empathy and maintain professional detachment, such as self-care strategies, awareness development, and team support. One hindering factor is managers. Conclusions: The findings of this study underscore the essential role of empathetic capability in nursing care in neuroscience. The experience of younger nurses and the first 5 years of employment are elements to be considered by managers for burnout risk. Nurses demonstrate susceptibility and resistance and maintain a balance in dealing with high-emotional-stress situations. The implications of these findings are significant and should guide future research and practice in the field of neuroscience nursing. [ABSTRACT FROM AUTHOR]

Background/Objectives: Caregivers of patients with heart disease may often feel physically, emotionally, and psychologically overwhelmed by their role. The analysis of cardiac rehabilitation (CR) components and caregivers' needs suggests that some interventions may benefit them. Therefore, this study aimed to identify a consensus on the CR components targeting caregivers of patients with heart disease. Methods: A three-round international e-Delphi study with experts on CR was conducted. In round 1, experts provided an electronic level of agreement on a set of initial recommendations originating from a previous scoping review. In round 2, experts were asked to re-rate the same items after feedback and summary data were provided from round 1. In round 3, the same experts were asked to re-rate items that did not reach a consensus from round 2. Results: A total of 57 experts were contacted via e-mail to participate in the Delphi panel, and 43 participated. The final version presents seven recommendations for caregivers of patients with heart disease in CR programs. Conclusions: These recommendations are an overview of the evidence and represent a tool for professionals to adapt to their context in the different stages of CR, integrating the caregiver as a care focus and as support for their sick family members. By identifying the components/interventions, there is potential to benchmark the development of a cardiac rehabilitation strategy to be used and tested by the healthcare team for optimizing the health and role of these caregivers. [ABSTRACT FROM AUTHOR]

Background: Developing and cultivating mindfulness exerts a positive effect on psychological and cognitive performance. Sharpening the skill requires continuous mindfulness-based training (MT), which can be challenging for people leading busy lives. Therefore, the current study examined whether trait mindfulness can be improved by a flexible and brief MT program of self-breathing using a pre–post intervention design. Methods: Trait mindfulness was assessed using the Japanese version of the Five Facet Mindfulness Questionnaire (FFMQ) before the intervention (pre), after 2 weeks (during), and 4 weeks after the intervention started (post). Data were analyzed using the Friedman test followed by the Dunn–Bonferroni correction. Results: The study sample consisted of 22 healthy participants aged from 20 to 60 years with no previous experience with yoga or meditation equivalent to MT. The mean number of days of MT practice was 26.4, and 11 participants had interruptions. The median values of pre-, during-, and post-total FFMQ scores were 115.5, 123, and 129, respectively. Significant differences were observed in the total pre and post (p < 0.001) and during and post (p = 0.002) FFMQ scores, though a medium effect was found (r = 0.30) only between the pre and post scores. Of the five sub-scales of FFMQ, significant differences were observed only between pre and post Observing (p = 0.01), Nonreactivity (p < 0.001), and Describing (p = 0.01), and during and post Nonjudging (p = 0.016), and Nonreactivity (p = 0.025). Conclusions: Our findings suggest that the simple, brief, and flexible self-breathing method employed in this study has a substantial effect on fostering trait mindfulness and, therefore, can be adopted by people with hectic daily schedules. [ABSTRACT FROM AUTHOR]

Background: Many parturients have poor self-care ability, strong dependence on others, and lack mother-infant related nursing skills and health care knowledge. Due to their lack of pregnancy experience, many primiparas lack the relevant skills and knowledge, which can affect maternal and infant health and maternal quality of life. Purpose: The study aimed to investigate the effects of the PRECEDE-PROCEDE model on self-care ability and quality of life among primipara during puerperium. Methods: This quasi-clinical study selected eligible primaparas from those who gave birth at a Grade A hospital in Hengyang, China between April and July 2019. Eighty puerperium primiparas were divided into a control group receiving standard care and an intervention group following the PRECEDE-PROCEDE model. Comparison of self-care ability and quality of life scores was conducted between the two groups pre-intervention, at 3 weeks, and at 6 weeks postpartum. Statistical analysis using SPSS 18.0 included mean and standard deviation for measurement data, and frequency and constituent ratio for counting data. Tests such as t-test, Chi-squared test, rank-sum test, and repeated measure analysis of variance were applied. Findings: The control group's self-care ability scores were (150.8 ± 9.9), (150.9 ± 9.3), and (152.0 ± 10.2) before intervention, at 3 weeks postpartum, and at 6 weeks postpartum, respectively. For the intervention group, the corresponding scores were (151.1 ± 15.1), (157.8 ± 8.5), and (162.4 ± 7.2). Quality of life scores for the control group were (54.7 ± 8.6), (54.8 ± 7.7), and (55.1 ± 7.7) before intervention, at 3 weeks postpartum, and at 6 weeks postpartum, respectively. At the same time points, while the intervention group saw increases from (55.6 ± 7.6) to (59.2 ± 5.9) and (61.0 ± 5.3). There were statistically significant differences in the time effect and inter-group effect of the total score of self-care ability during puerperium, total score of quality of life, and the score of each dimension between the two groups (P < 0.05), and we also found an interaction effect between grouping and time factors (P < 0.05). After intervention, the incidence of common puerperium health problems except neonatal constipation and diarrhea in the intervention group was lower than that in the control group (P < 0.05). Conclusion: PRECEDE-PROCEDE model may improve self-care ability, reduce the occurrence of common health problems, and improve the quality of life of primiparas during puerperium. [ABSTRACT FROM AUTHOR]

Background: Coronary artery disease is one of the leading causes of death and disability worldwide. Coronary angiography is a diagnostic procedure used to detect atherosclerosis. Patients typically experience anxiety and stress before and during the angiography procedure. Furthermore, self-care ability is crucial following angiography. Aim: This study aims to describe the design and evaluation of a mobile application focusing on stress, anxiety, and self-care abilities in patients undergoing coronary angiography. Method: The researchers developed a mobile application for patients undergoing angiography. The application provides information about angiography and tips for enhancing self-care following the procedure. An interventional study was conducted on 70 patients admitted to the angiography ward in hospitals in Kerman, Iran, between 2022 and 2023. The participants were randomly divided into two groups: control and intervention. The interventional group received the intervention application the night before angiography. Two groups completed the Anxiety and Stress Questionnaire (DAS) and Kearney-Flescher Self-Care Survey before the intervention. The researchers used questionnaires that had been prepared and previously utilized in other studies. The two groups completed the anxiety and stress questionnaire within three to six hours and the self-care questionnaire one month after angiography. SPSS 15 software was used for data analysis, with a significance level set at 0.05. Results: The study found that the majority of participants were women. Before the study, there was no significant difference between the two groups in terms of anxiety, stress, and self-care scores. However, after the study, the intervention group showed a significant decrease in average anxiety and stress scores (p < 0.001). Additionally, compared to the control group, the intervention group demonstrated significant improvement in average self-care score (p < 0.001). Conclusion: According to this study, AP can be effective in influencing the anxiety, stress levels, and self-care ability of patients who undergo coronary angiography. It can help to reduce stress and anxiety while increasing self-care. Instructive software is user-friendly, cost-effective, and can be recommended by nurses and doctors. [ABSTRACT FROM AUTHOR]

Pressure on healthcare systems to address growing population needs is forcing services to adapt, which includes supporting acute patients in the community. One emerging service in the United Kingdom that offers this level of treatment is "Hospital at Home" (HaH). Self‐management support is an area of particular importance in this context considering that acute treatment is provided in a community setting with limited input and monitoring by healthcare professionals. There is currently limited understanding about the range of formal and informal support and resources needed and accessed by patients in such circumstances, and whether and how HaH professionals engage with the everyday contexts and the network members of patients. Semistructured interviews were conducted with nurses (n = 9) from a single Hospital at Home site to further understand their experiences of providing acute treatments in the context of patients' homes; and how self‐management and social network support roles are perceived. Thematic analysis was used and four themes were identified: The value of prioritising illness work at home within a discourse of person-centered care; the work involved in the "naturally" therapeutic environment of the home; partners as key members of the informal care team; limited awareness and engagement with (in)formal networks. Findings demonstrate tensions between discourses where nurses idealise the value of the home and a holistic service provision, while in practice prioritising illness (over relational, emotional, and practical) work and delivering a service that is routinised, and time‐ and cost‐efficient. Nurses recognise the positive role of network members for illness management in the context of people's everyday life, but awareness and engagement are limited to partners and the formal services that HaH staffs are familiar with. Developing a better understanding of the role of social networks (SNs) in supporting people with acute needs at home can help improve patient experiences and care and HaH services, especially for people who are vulnerable, with complex needs, living alone, and with limited access to resources. [ABSTRACT FROM AUTHOR]

Mental health issues have increased substantially since the onset of the COVID-19 pandemic. However, health policymakers do not have adequate data and tools to predict mental health demand, especially amid a crisis. Using time-series data collected in Singapore, this study examines if and how algorithmically measured emotion indicators from Twitter posts can help forecast emergency mental health needs. We measured the mental health needs during 549 days from 1 July 2020 to 31 December 2021 using the public's daily visits to the emergency room of the country's largest psychiatric hospital and the number of users with "crisis" state assessed through a government-initiated online mental health self-help portal. Pairwise Granger-causality tests covering lag length from 1 day to 5 days indicated that forecast models using Twitter joy, anger and sadness emotions as predictors perform significantly better than baseline models using past mental health needs data alone (e.g., Joy Intensity on IMH Visits, χ2 = 14·9, P < ·001***; Sadness Count on Mindline Crisis, χ2 = 4·6, P = ·031*, with a one-day lag length). The findings highlight the potential of new early indicators for tracking emerging public mental health needs. [ABSTRACT FROM AUTHOR]

Diabetes self-care activities are essential for achieving optimal glycemic control. However, little investigation has been conducted in Ethiopia to evaluate the relationship between the rate glycemic controland self-care activities among patients with type 2 diabetes mellitus (T2DM). Therefore, this study was conducted to assess self -care activities and their association with glycemic control among patients with T2DM in Northwest Ethiopia general hospitals. This multicenter cross-sectional study was conducted in Northwest Ethiopia general hospitals diabetic clinics. Diabetes self-care activities were measured using the Amharic version of the Summary of Diabetes Self-Care Activities (SDSCA-Amharic). Glycated hemoglobin (HbA1c) were used to assess the rate of glycemic control. A linear regression model was used to identify predictors of self-care activities and glycemic control. P-value of < 0.05 at 95% confidence interval (CI) was considerd as statistically significant. Of 413 participants included in the final analysis, two-thirds (66.3%) had poor glycemic control, with a mean HbA1c of 7.94% (SD = 1.75). Blood glucose testing was the most important self-care activity domain for predicting better glycemic control [β=-0.36, 95% CI (-0.48, -0.24); P = 0.0001] followed by diet [β=-0.29, 95% CI (-0.39, -0.083); P = 0.0001], foot-care [β=-0.28, 95% CI (-0.3, -0.061); P = 0.003], and physical activity [β=-0.27, 95% CI (-0.29, -0.056); P = 0.004], respectively. Moreover, unable to read and write [β = 0.72, 95% CI (0.57, 3.8); P = 0.037], overweight [β = 0.32, 95% CI (0.011, 0.62); P = 0.042], obesity [β = 0.67, 95% CI (0.39, 0.94); P = 0.0001], and low level of medication adherence [β = 0.7, 95% CI (0.39, 1.1); P = 0.0001] were significant predictors of poor glycemic control. Previous diabetes education [β=-0.88, 95% CI (-1.2, -0.57); P=0.0001] was a significant predictor of good glycemic control. The prevalence of poor glycemic control and poor self-care activities were high among patients with T2DM. Self-care activities were independent predictors of glycemic control among patients with T2DM. Therefore, management interventions for patients with T2DM should focus on improving self-care activities and other predictor variables. [ABSTRACT FROM AUTHOR]

Background: Following acute coronary syndrome (ACS), up to 40% of patients report elevated depressive symptoms which is associated with a two-fold increase in mortality risk due to behavioral and biological mechanisms. Mindfulness-Based Cognitive Therapy (MBCT) delivered via synchronous group videoconferencing could help reduce depressive symptoms. Objective: To guide MBCT adaptation for ACS patients for a future clinical trial, this qualitative study aimed to explore ACS patients' (1) symptoms after ACS, (2) needs for behavioral health treatment, (3) perspectives on mindfulness intervention and group videoconference delivery, and (4) willingness to self-collect dried blood spots in a research study. Methods: We compared ACS patients with and without depressive symptoms to highlight particularly relevant treatment topics for patients developing depression following ACS experience. From 2/2019-11/2019, we conducted semi-structured individual telephone interviews with N = 23 patients after ACS (N = 13 with and N = 10 without elevated depressive symptoms; 63.4 (SD = 8.5) years, 87% male, 96% non-Hispanic white, 7.1 (SD = 7.5) years since ACS). In qualitative content analyses, four independent coders coded each interview. Results: Participants with depressive symptoms experienced emotional, physical, social, and health behavior problems, while those without depressive symptoms made positive health behavior changes and struggled with anxiety symptoms. Both groups were interested in a behavioral health treatment for emotional and social support. Most were willing to participate in a mindfulness group via videoconferencing; some preferred in-person, but accessibility and convenience outweighed these cons. Almost all were willing to self-collect dried blood spots and some were already familiar with this technique. Conclusion: ACS patients, especially those with depressive symptoms, need help managing a multitude of quality of life concerns that can be targeted with an adapted MBCT approach. A videoconference-delivered MBCT approach is of interest. Suggestions for adapting MBCT to target the needs of ACS patients are discussed. [ABSTRACT FROM AUTHOR]

The global rise in chronic kidney disease (CKD) necessitates a re-evaluation of healthcare practices. This review explores the shift from paternalistic to collaborative model, focusing on patient empowerment. This article aims to elucidate the foundational concept of patient empowerment, describe the goals of patient-centered care (PCC), identify barriers to PCC implementation, and propose strategies to enhance PCC. The ultimate aim is to empower CKD patients in self-care. The article explores multifaceted strategies of PCC, highlights the pivotal role of shared decision-making, and underscores the necessity of a collaborative clinician-patient partnership. It emphasizes the significance of patient-centered education, benefits of PCC in CKD care, and the role of artificial intelligence in improving healthcare outcomes. This review concludes by summarizing insights into the transformative shift toward patient-centered approaches in CKD management. It emphasizes the positive impact of this paradigm shift on both the healthcare system and CKD patients. The findings highlight the positive effects of PCC on both the health-care system and CKD patients. [ABSTRACT FROM AUTHOR]

Serotonin (5-hydroxytryptamine: 5-HT), a neurotransmitter that regulates mood in the brain and signaling in the gut, has receptors throughout the body that serve various functions, especially in the gut and brain. Selective serotonin reuptake inhibitors (SSRIs) are used to treat depression, but their efficacy is uncertain. Depression is often associated with early gastrointestinal symptoms. Gut disorders such as functional dyspepsia (FD), irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), are linked to elevated serotonin levels. In this review, we would like to discuss the approach of using serotonin as a biomarker for gut–brain, and body-wide organ communication may lead to the development of preventive and innovative treatments for gut–brain disorders, offering improved visibility and therapeutic monitoring. It could also be used to gauge stress intensity for self-care and mental health improvement. [ABSTRACT FROM AUTHOR]

Background: The hospital discharge process poses significant safety risks for older patients due to complexities in communication and coordination among stakeholders, leading to potential drug‐related problems post‐discharge. Adopting a person‐centred care (PCC) approach in medication communication by healthcare professionals (HCPs) is crucial to ensure positive health outcomes. This study aimed to explore the practice of PCC in medication communication between older patients and HCPs during the hospital discharge process. Methods: We conducted a qualitative study using non‐participatory direct observations of patient–HCP consultations during hospital discharge, followed by semi‐structured interviews with observed patients and, when applicable, their informal caregivers. Data collection occurred from October 2020 to May 2021 at two Swedish hospitals. We gathered data using an observational form and audio‐recorded all consultations and interviews. The data were analysed thematically using the systematic text condensation method. Results: Twenty patients were included (median age: 81 years [range: 65–94]; 9 female) in observations and 13 of them participated in interviews. Two patients were accompanied by an informal caregiver during the interviews. Three main themes were identified: (1) The impact of traditional authoritarian structures, depicts power dynamics between patients and their HCPs, showing how traditional structures influence the practice of PCC in medication communication during hospital discharge; (2) Consultation timing and mode not on patients' terms, describes suboptimal times and settings for consultations, along with the use of complex language that hinders effective communication; and (3) Discrepancy in expectations of self‐care ability, illustrates a mismatch between the self‐care guidance provided by HCPs during hospital discharge and the actual needs and preferences of patients and informal caregivers. Conclusion: Medication communication between older patients and HCPs during hospital discharge is frequently inconsistent with the practice of PCC. Not only must HCPs improve their communication strategies, but patients and their informal caregivers should also be better prepared for discharge communication and encouraged to participate in their care. This involvement would give them relevant knowledge and tailor communication to their individual needs, preventing problems in managing their medications after discharge. Patient or Public Contribution: An advisory group of six patients and/or informal caregiver contributors provided input on the study design, edited the consent forms, and helped develop the interview guide. [ABSTRACT FROM AUTHOR]

Background: General practitioners (GPs) are key to the frontline assessment and treatment of young people after self‐harm. Young people value GP‐led self‐harm care, but little is known about how GPs manage young people after self‐harm. Aim: This study aimed to understand the approaches of GPs to self‐harm in young people and explore their perspectives on ways they might help young people avoid repeat self‐harm. Methods: We conducted semi‐structured interviews with GPs from the National Health Service in England in 2021. GPs were recruited from four geographically spread clinical research networks and a professional special interest group. Data were analysed using reflexive thematic analysis. The study's patient and public involvement and community of practice groups supported participant recruitment and data analysis. Results: Fifteen interviews were undertaken with a mean age of participants being 41 years and a breadth of experience in practice ranging from 1 to 22 years. Four themes were generated: GPs' understanding of self‐harm; approaches to managing self‐harm; impact of COVID‐19 on consultations about self‐harm; and ways to avoid future self‐harm. Conclusion: Negative attitudes towards self‐harm within clinical settings are well documented, but GPs said they took self‐harm seriously, listened to young people, sought specialist support when concerned and described appropriate ways to help young people avoid self‐harm. GPs felt that relationship‐based care is an important element of self‐harm care but feared remote consultations for self‐harm may impede on this. There is a need for brief GP‐led interventions to reduce repeat self‐harm in young people. Patient and Public Contribution: A study advisory group consisting of young people aged 16–25 years with personal experience of self‐harm and parents and carers of young people who have self‐harmed designed the recruitment poster of this study, informed its topic guide and contributed to its findings. [ABSTRACT FROM AUTHOR]

eHealth literacy (eHL) is directly linked to disease prevention, health promotion, and improved healthcare outcomes. The objectives of this study are to assess undergraduate university students' knowledge and perceived skills of finding, appraising, and applying electronic health information to health-related problems, as well as to assess the association of eHL with physical, psychological, and emotional self-care. Methods: The measurement model, comprising four correlated factors based on the 28 valid items from two reliable and valid tests, the 'eHealth literacy scale (eHEALS)' and 'the self-care assessment tool (SCAT)', was estimated using confirmatory factor analysis (CFA) among a sample of 1557 undergraduate university students in Pakistan. Results: The mean value of the eHEALS ranges between 2.90 and 3.33, indicating that the majority of the respondents had moderate levels of eHL skills. Female respondents and respondents from urban areas have greater levels of perceived eHL skills compared with their male and rural counterparts. The CFA model fit indices show that the goodness of fit values are acceptable: x2 = 7.727, p = 0.000; RMSEA = 0.065; TLI = 0.930, CFI = 0.936, IFI = 0.936, GFI = 0.890, NFI = 0.928, RFI = 0.920, PGFI = 0.754. Conclusion: Electronic health (eHealth) literacy has a strong positive association with physical, psychological, and emotional self-care. However, perceived eHL skills among undergraduate university students are moderate, making them potentially susceptible to health risks. Implications: Our study has several practical implications. Its findings can be used to devise eHealth literacy programs for developing relevant skills among undergraduate university students based on their identified needs. [ABSTRACT FROM AUTHOR]

Background: Self-care is becoming increasingly popular due to rising medical costs, isolation from family, and rising hospital infections. Therefore, the current research aimed to investigate the impact of psychological intervention training based on the protection motivation theory (PMT) on the self-care of patients with myocardial infarction (Ml). Methods: The current study utilized both qualitative and quantitative approaches. The quantitative section was quasi-experimental, with pre-test and post-test design and control group. In 2021, 106 patients with Ml were selected for statistical analysis at Ibn Al-Bitar Specialized Hospital for Cardiac Surgery in Baghdad, Iraq. Using SPSS software, the Shapiro-Wilk test was used to examine the normality of the distribution of the variables, Levene's test was utilized to investigate the equality of variances, and analysis of covariance (ANCOVA) was utilized to evaluate the study. Results: The results of a one-way ANCOVA indicated that the subscales, including proper diet (F = 42.53, P < 0.001), non-smoking (F = 7.81, P < 0.001), physical activity (F = 55.96, P < 0.001), adherence to prescribed medication regimen (F = 91.65, P < 0.001), and adjusting the effect of stressful variables (F = 27.74, P < 0.001) improved significantly. Conclusion: PMT, by improving various aspects and subscales of self-care in patients with Ml, can be used as an effective educational intervention to help improve these patients' lifestyles and return them as quickly as possible to normal life. [ABSTRACT FROM AUTHOR]

Background: Atrial fibrillation (AF), a frequently occurring heart rhythm disorder, is linked to a higher likelihood of mortality, heart failure, and stroke. Patients with AF often have poor illness perceptions and suboptimal self-care behaviors, leading to adverse health outcomes. This research has aimed to evaluate the impact of a psychoeducational intervention on illness perceptions and self-care behaviors in patients with AF. Methods: A randomized controlled trial (RCT) was conducted between March 2023 and March 2024 at three tertiary care hospitals in Baghdad, Iraq. Participants were recruited using purposive sampling from March 2023 to June 2023. The 6-week psychoeducational intervention was delivered from July 2023 to August 2023. Illness perceptions were assessed employing the Brief Illness Perception Questionnaire (B-IPQ; Broadbent et al., 2006), and self-care behaviors were measured using the European Heart Rhythm Association (EHRA) Self-Care Questionnaire (Hendriks et al., 2014). SPSS software (version 26.0) was employed to analyze the data, using mixed-design analysis of variance (ANOVA) and analysis of covariance (ANCOVA). Statistical significance was set at P < 0.05. Results: The mixed-design ANOVA revealed a significant interaction effect between time and group for illness perceptions (F(3, 456) = 29.7, P < 0.001, partial μ = 0.163) and selfcare behaviors (F(3, 456) = 41.2, P < 0.001, partial q2 = 0.213). The intervention group showed a 31.1% improvement in illness perception scores and a 40.5% improvement in self-care behavior scores from baseline to post-intervention (P < 0.001). These improvements were sustained at the 3- and 6-month follow-ups (P < 0.001). Conclusion: The psychoeducational intervention significantly improved illness perceptions and self-care behaviors among patients with AF in Iraq. These improvements were sustained at the 3- and 6-month follow-ups. Healthcare providers should consider incorporating psychoeducational interventions into standard AF management to promote better patient outcomes. Policymakers should support the implementation of similar interventions to reduce the burden of this chronic condition. [ABSTRACT FROM AUTHOR]

Background: Most people with a stoma worry about leakage, and a quarter experience leakage of stomal effluent outside the baseplate on a monthly basis. Leakage has additional physical and psychosocial consequences, for instance, peristomal skin complications, feeling unable to cope, and self-isolation. Method: An interventional, single-arm, multi-centre study was undertaken in the United Kingdom to evaluate a novel digital leakage notification system for ostomy care, including a support service (=test product) for 12 weeks in patients with a recent stoma formation (≤9 months). Patients completed questionnaires at baseline and after 4, 6, 8, 10, and 12 weeks, evaluating leakage episodes, Ostomy Leak Impact (tool containing three domains), and patient self-management (by PAM-13). Additionally, mental well-being (by WHO-5) and health-related quality of life (QoL) (by EQ-5D-5L) were assessed. Outcomes between baseline and final evaluation were compared by generalised linear and linear mixed models. Results: 92 patients (ITT population) with a mean age of 49.4 years (range 18–81 years) were recruited. Of these, 80% had an ileostomy, and 53% were female. After 12 weeks of using the test product, a significant decrease in mean episodes of leakage outside the baseplate (1.57 versus 0.93, p < 0.046) was observed. Ostomy Leak Impact scores improved across all three domains (p < 0.001), indicating less embarrassment, increased engagement in social activities, and increased control. Patient self-management also improved significantly (PAM-13 score: ∆6.6, p < 0.001), as did the WHO-5 well-being index (∆8.0, p < 0.001). Lastly, EQ-5D-5L profile scores tended to improve (p = 0.075). Conclusions: A new digital leakage notification system demonstrated strong improvements to patients' stoma self-care, mental well-being, and QoL. Registration number on ClinicalTrials.gov: NCT05135754. [ABSTRACT FROM AUTHOR]

In an increasingly globalized world, the accessibility of healthcare and medication has expanded beyond local healthcare systems and national borders. This study aims to investigate the transnational health and self-care experiences of 11 Japanese women who have resided in South Korea for a minimum of six months and have utilized oral contraceptives, including those that were acquired over-the-counter (OTC). Data were gathered through semi-structured interviews and analyzed by utilizing the NVivo software. The analysis yielded three significant thematic categories, namely (1) experiences and perceptions of obtaining and utilizing contraceptive pills, including OTC access; (2) individual and social perceptions of pills and their accessibility in Japan, insights from actual users; and (3) enhancing pill accessibility, transnational health and self-care experiences and perspectives. Participants acknowledged that oral contraceptives are a global product and experienced communication challenges with healthcare providers as a result of differing understandings of these medications. Additionally, this study identified transnational strategies, such as purchasing an adequate supply of pills just before departure and seeking pills from local families or acquaintances. This study not only highlights the implications of clinical care for transnational patients but also underscores their critical global perspectives on access to oral contraceptives. Furthermore, it proposes two models for improving accessibility within the Japanese healthcare system, even in prescription-only contexts, by introducing OTC options. [ABSTRACT FROM AUTHOR]

Background: Because of the importance of nursing surveillance, there is a need to develop a scale to measure nursing surveillance that reflects the roles of nurses in South Korea. This study aimed to develop a scale to measure surveillance by Korean nurses and to test its reliability and validity. Methods: In the development phase, a literature review was conducted to verify the attributes of nursing surveillance, and preliminary items were developed based on the surveillance activities in the Nursing Intervention Classification (NIC) and the interviews of Korean nurses and modified through content validation and a pilot study. In the psychometric testing phase, two surveys were conducted with Korean nurses working in acute hospitals, using the preliminary scale in exploratory factor analysis (EFA, n = 220) and confirmatory factor analysis (CFA, n = 219). Data were analyzed through EFA, CFA, correlation, and reliability analyses to verify convergent validity, discriminant validity, criterion validity, and reliability. To verify the validity of the preliminary scale, the exploratory factor analysis and confirmatory factor analysis convergent validity, discriminant validity, criterion validity, and reliability were performed. Results: In the EFA, 16 items were grouped into four factors, accounting for 70.1% of the cumulative variance. In the CFA, the model exceeded the criteria for all fit indices (χ2 = 155.62 [df = 94, p <.001], CMIN = 1.65, SRMR =.048, RMSEA =.055, GFI =.921, NFI =.916, TLI =.955, CFI =.964) and was acceptable. The convergent validity, discriminant validity, criterion validity, and reliability were verified. The final Korean nursing surveillance scale consists of four factors: 'anticipation of problems and decision-making' with six items; 'systematic assessment' with five items; 'recognition of patterns' with three items; and 'identification of the patient's self-care and coping strategies' with two items. Conclusion: The Korean nursing surveillance scale developed in this study comprised questions that included NIC's surveillance activities and empirical data from Korean nurses; based on the attributes of nursing monitoring derived from concept analysis, its validity and reliability were verified. This study can provide precedent to motivate the development of nursing surveillance scales in other countries, and ultimately stimulate studies on nursing surveillance, which is essential for patient safety. [ABSTRACT FROM AUTHOR]

Based on the signaling hypothesis of blood glucose (BG), a rise in BG levels signals a positive energy budget for healthy individuals but cellular starvation for individuals with type 1 diabetes. We examined this novel prediction and its intervention implications in the context of delay discounting, the degree to which delayed rewards are discounted, and the regulatory effects of insulin ingestion. We recruited 44 adults with type 1 diabetes (mean age 30.8 years, diabetes duration 15.4 years) and recorded their BG levels. The delay discounting rate was measured using the intertemporal choice task, where participants were required to choose between sets of smaller-and-sooner (SS) and larger-and-later (LL) rewards. In addition, 82 age-matched healthy participants were recruited to provide a baseline comparison on delay discounting. Random forest analysis showed that among many diagnostic factors, delay discounting was most dominating in differentiating the individuals with type 1 diabetes from the control participants. A hierarchical linear mixed model revealed that participants with type 1 diabetes had a stronger preference for SS rewards (p <.001) after controlling for covariates. Participants who had insulin delivered before the last meal exhibited a stronger preference for LL rewards compared to after-meal delivery. In contrast, subjective measures (e.g., self-reported hunger) failed to predict the participants' actual BG levels and delay discounting rates. In sum, individuals with type 1 diabetes tend to discount future rewards excessively compared to the control participants. Pre-meal insulin ingestion was associated with a higher LL preference for future rewards. [ABSTRACT FROM AUTHOR]

Suboptimal management of leg ulcers is a growing burden on NHS nursing and financial resources (Guest et al, 2015; 2017; 2020). Compression therapy plays a crucial role in leg ulcer management by improving outcomes and reducing the burden of disease, however it is not routinely applied in practice and knowledge and confidence between bandage types and application styles often varies greatly (Guest et al, 2017; Hopkins, 2023). This article focuses on the importance of compression therapy in the management of leg ulceration and how to select the appropriate compression therapy based on the patient's presenting symptoms. It identifies possible barriers to application and offers potential strategies and suggestions to support the use of compression options in the community. [ABSTRACT FROM AUTHOR]

Objective Strokes are among the most destructive health problems. They can especially have detrimental effects on the occupational performance of sufferers. The experiences of patients suffering from stroke regarding the impact of the disease on their occupational performance, especially the barriers and facilitators of this performance, can help understand this phenomenon better and design client-centered interventions in this field. Nevertheless, a limited body of literature has investigated the encounters of these individuals and their familial caretakers within this domain. Therefore, the objective of this research is to synthesize the available research evidence regarding the experiences of stroke survivors and their family caregivers regarding barriers and facilitators of occupational performance after stroke. Materials & Methods All published articles were searched from 4 databases without a time limit according to the determined keywords. Among the 70 articles found, only 22 were included in the study and analyzed based on the quality indicators. Results The analysis of extractive studies led to the emergence of two categories of barriers to occupational performance with subcategories of individual obstacles, contextual barriers, and rehabilitation barriers and facilitators of occupational performance with subcategories of educational strategies, development of environmental support, and strengthening of individual strategy. Conclusion Clients with stroke have many barriers in their occupational performance, and the barriers that are related to the context of rehabilitation are significant. In addition to these important barriers, the existence of supportive and educational facilitators can help improve the client's occupational performance. A better understanding of the factors related to the occupational performance of patients suffering from stroke requires more studies, especially in the relationship between the context and professional issues of occupational therapy and clients' occupational performance. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes self-care among diabetic patients is crucial as it determines how patients care for their illness in their daily routine for better diabetes control. This study aims to calculate the average score for diabetes self-care among patients with type 2 diabetes mellitus and chronic kidney disease and to identify factors that are associated with this score. Materials and Methods: This cross-sectional study enrols patients over 18 years old with type 2 diabetes mellitus and chronic renal disease with an eGFR of less than 60 mL/min/1.73 m2 in a tertiary hospital in Malaysia. The Malay version of the Summary of Diabetic Self-Care Activities (SDSCA) was used to assess diabetes self-care, the Malay version of the diabetes-related distress questionnaire (DDS-17) was used to assess diabetes distress, and the Malay version of the Patient Health Questionnaire-9 (PHQ-9) was used to assess depression. Data analysis was performed using both simple and multiple linear regression models to determine the associations between variables. Result: One hundred and seventy-six eligible patients were recruited for this study. The mean score for diabetes self-care is 3.62. The eGFR (p = 0.002) and diabetes distress (p = 0.004) are the significant associated factors for diabetes self-care among type 2 diabetes mellitus patients with chronic kidney disease. Conclusion: The mean score for diabetes self-care indicated a moderate level of self-care. The eGFR level and diabetes distress were important factors influencing diabetes self-care practices. [ABSTRACT FROM AUTHOR]

Background/Objectives: The use of eHealth as a monitoring system in people with heart failure (HF) has been shown to be effective in promoting self-care and reducing re-admissions and mortality. The present study develops and evaluates the accessibility and usability of the web app iCardioMonitor HF monitoring system. Methods: This study consisted of two stages. The first stage (co-design) comprised two phases: (1) analysis of the scientific literature and expert opinions and (2) co-design of the iCardioMonitor (web app plus a knowledge-base algorithm) and definition of alert criteria. The second stage (cross-sectional descriptive study) analyzed system accessibility (% of people using the iCardioMonitor and % of parameters recorded) and usability, employing the Spanish version of the System Usability Scale for the Assessment of Electronic Tools. Results: The iCardioMonitor was configured by a web app and an algorithm with the capacity to detect decompensated HF automatically. A total of 45 patients with an average age of 55.8 years (standard deviation [SD] = 10.582) and an average time since diagnosis of 7.1 years (SD = 7.471) participated in the second stage. The percentage of iCardioMonitor use was 83.2%. The average usability score was 77.2 points (SD = 21.828), higher in women than men (89.2; SD = 1.443–76.0; SD = 1.443) (p = 0.004). The usability score was higher the shorter the time since diagnosis (r = 0.402; p = 0.025) and the higher the number of responses (r = 0.377; p = 0.031). Conclusions: The results obtained show that iCardioMonitor is a tool accepted by patients and has obtained a remarkable score on the usability scale. iCardioMonitor was configured by a web app and an algorithm with the capacity to detect decompensated HF automatically. [ABSTRACT FROM AUTHOR]

Background: The focus of this qualitative research was to interview current and retired Gaelic games athletes to ascertain how athletes viewed concussion recognition and management. Methods: A grounded theory methodology design was utilised to investigate concussion recognition and management experiences of a cohort of Gaelic games athletes (n = 22). Data for the study were collected using a semi-structured interview format. Results: Two major themes were identified: (1) an inconsistent identification of concussion as an injury and the absence of standardised procedures for removal from play, and (2) the impact of athlete-driven decision making on concussion management. Concussions were experienced by all the participants on multiple occasions while playing Gaelic games. However, concussion recognition and removal rarely occurred, as many athletes chose not to disclose their injuries or self-managed their concussions. Conclusions: The recognition and management of concussions in Gaelic games are currently inadequate, and they may be posing significant risks to athletes' long-term health. This research highlights the need for more stringent protocols for concussion recognition and removal at pitch side. In addition, Gaelic games require a more objective injury management plan during acute and chronic concussion recovery. [ABSTRACT FROM AUTHOR]

Background and Objectives: Behavior management as a set of clinical techniques to induce desirable clinical treatment and subsequent compliance behaviors in children and families varies internationally based on professional training, access to care, health literacy, and societal norms. This report proposes non-typical diagnostic considerations of additional inherent behavioral conditions and familial and social qualifiers that may help predict success both at the chairside and in compliance with home self-care behaviors to reduce caries susceptibility. Methods: A review of the medical and dental literature provides ample support for the consideration of changing characteristics of both the patient and the environment. Results: The current recommendations for choice of behavior guidance in direct clinical care, as used in the USA, often fall short of efficacy for a variety of reasons including the provider limitations, the extent and difficulty of treatment, and most recently appreciated, the complexity of negative childhood experiences, subclinical behavioral disorders, and immutable negative determinants of health outside the dental setting affecting interaction with health professionals. These same factors, such as family dysfunction and societal stresses, also impact compliance with out-of-clinic preventive efforts that many oral health care providers rely upon to help mitigate treatment limitations in reaching children. There are also behavioral elements of compliance and attitudes toward health that dentists need to recognize. Conclusions: A broader, more inclusive concept of behavior guidance to include factors beyond those typically associated with a dental patient affecting treatment and compliance with preventive behaviors may be beneficial. Every population and patient will have differing characteristics and require individualized care. [ABSTRACT FROM AUTHOR]

Background: The recent substantial increase in the incidence of stroke cases has resulted in high medical expenses. Stroke necessitates ongoing care, emphasizing the importance of consistent self-management. The occurrence of stroke impacts healthcare costs and has far-reaching effects on social services, encompassing disability, unemployment, and other related concerns beyond individuals and families. This study aimed to assess the impact of mobile health literacy, stroke-related health knowledge, health beliefs, and self-efficacy on self-care behaviors of patients with stroke to plan tailored self-care interventions for this patient population. Methods: This descriptive survey included 99 stroke patients from three hospitals, which provided treatment equivalent to or better than general hospitals, in City C and was conducted between 7 July 2023 and 30 May 2024. The data collected from hospitalized stroke patients were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, and multiple linear regression. Results: The self-care behavior of patients with stroke who participated in the study was 73.01 ± 12.24 points. Stroke self-efficacy was identified as a significant factor influencing stroke self-care behaviors and eating habits. Mobile health literacy and stroke self-efficacy also influenced medication and self-care behavior, whereas hypertension and stroke self-efficacy affected lifestyle self-care behaviors. Conclusions: Strengthening stroke self-efficacy, improving mobile health literacy, and addressing comorbidities such as hypertension are important for promoting self-care behavior in stroke patients. [ABSTRACT FROM AUTHOR]

Thailand is a country with a high proportion of methamphetamine substance abuse users, and the trend is increasing. Methamphetamine is a highly addictive stimulant affecting the central nervous system. Amphetamine addicts are mostly male. Amphetamine addiction is a serious problem often caused by poor attachment in childhood, leading to stress and anxiety, and therefore requires special therapy. A psychotherapy program using mentalization-based group therapy was undertaken in our quasi-experimental study. Programs like this have met with success in several countries. We aimed to test the effectiveness of mentalization-based group therapy on the sense of coherence and self-care behavior among males undergoing recovery from amphetamine dependence at two substance rehabilitation hospitals in southern Thailand. One hospital was the experimental setting, and the other was the control setting. The participants from the two settings were purposively selected and matched by age. The experimental group (n = 32) received the program, and the control group (n = 32) received only usual care. Instruments used for the data collection were a Demographic Data Form, the Sense of Coherence Scale, and the Self-care Behavior Scale. The data were analyzed using descriptive statistics, Chi-square statistics, paired t-tests, and MANCOVA. Results revealed that after receiving the program, the mean scores in the experimental group's sense of coherence and self-care behaviors were significantly higher than before the program and those of the control group. Advanced practice nurses with special training can apply this program among males with amphetamine dependence. However, comparing the changes in the sense of coherence and self-care behaviors with a longer follow-up is recommended for further study. [ABSTRACT FROM AUTHOR]

Acute coronary syndrome is a chronic illness that influences physical and psychological health and well-being and requires continuous treatment and effective self-care. This two-group quasi-experimental study investigated the effectiveness of the Self-Care Support Program for People with Acute Coronary Syndrome. Sixty participants were purposively recruited from medical wards of a university-affiliated hospital in Bangkok, Thailand. A Self-Care Support Program based on Orem's self-care theory was integrated with a motivational interviewing approach. The experimental group (n = 30) received the 4-week intervention program with the usual care, while the comparison group (n = 30) received only usual care. Instruments for data collection included a Demographic and Health Data Form, the Self-Care Behavior for Acute Coronary Syndrome Questionnaire, the Veterans Specific Activity Questionnaire, and the Rehospitalization Record Form. Data analysis was performed using descriptive statistics, Chi-square test, Fisher's exact test, and two-way repeated measures analysis of variance. Results revealed that the experimental group had significantly improved self-care behavior and functional ability immediately and four weeks after program completion (week 8), compared to the comparison group. There was no difference in rehospitalization between the two groups. Nurses with advanced skills in motivational training can use this program to promote effective self-care practices, improve functional ability, and reduce rehospitalization. Further study using randomized controlled trials and other settings is needed before it can be widely used. [ABSTRACT FROM AUTHOR]

Veterans experience higher risks of suicide and mental health disorders due to the traumas of military service, disabilities, and the difficulties of reassimilation into civilian life. Therapeutic interventions using humananimal interactions have shown promising results in reducing many risk factors affecting veterans' quality of life. This quality improvement project sought to consider if veterans participating in a recreational therapy program focused on beekeeping and administered by the Department of Veteran Affairs would experience quality of life improvements using a standardized EQ-5D-5L assessment. Our results indicate significant changes in mobility, anxiety/depression, and overall health for veterans participating in beekeeping as a recreational therapy. Implications for practice and future research are presented. [ABSTRACT FROM AUTHOR]

Methods: Web of Science, Cochrane library and PubMed were systematically searched up to January 2024 to identify studies examining the impact of financial incentives on diabetes management in patients. Studies were evaluated based on the robustness of their methodology, participant numbers, and quality scores. The Cochrane risk-of-bias tool was applied for randomized controlled trials, while the Newcastle–Ottawa Scale was used for non-randomized controlled trials to assess study quality. Due to the heterogeneity of the included studies, a narrative synthesis approach was utilized. Results: In the study, we included 12 published research studies. Five studies investigated the influence of financial incentives on patient behavior, all demonstrating a significant positive impact on behaviors such as blood glucose monitoring, medication adherence, and physical activity. 10 studies analyzed the impact of financial incentives on HbA1c levels in diabetes patients. Among them, 5 studies reported that financial incentives could improve HbA1c levels through longitudinal historical comparisons. The other 5 studies did not find significant improvements compared to the control group. Three studies explored long-term effects, two studies targeting the adolescent population had no impact, and one study targeting adults had a positive impact. Conclusions: In summary, this review found that financial incentives can positively influence patient behavior and enhance compliance, but their impact on HbA1c levels is inconsistent. Financial incentives may help adult patients maintain behavior even after the withdrawal of incentives. [ABSTRACT FROM AUTHOR]

Background: Journeying with patients throughout their cancer trajectory and caring for them at the end of life can lead to emotional and moral distress in oncologists, negatively impacting their personal and professional identities. A better understanding of how transitions in care goals affect oncologists can shed light on the challenges faced and the support required. This study explored the impact of care transitions on oncologists' professional identity formation (PIF). Methods: From September to December 2023, semi-structured interviews were conducted with oncologists in a palliative care center in Singapore. The Ring Theory of Personhood (RToP) was used as a framework to capture the effects of experiences with patients transitioning from curative to palliative care on the oncologists' sense of self and identity. Data were analyzed using both inductive and deductive qualitative analysis. Results: Participants included six female and six male physicians, aged 30 to 53 years (mean 38 years), with an average of 9.75 years of experience as oncologists. The main domains identified were 1) challenges faced in transitioning patients to palliative care, 2) the impact of dealing with dying patients on oncologists, and 3) coping mechanisms. Conclusion: Oncologists experience self-doubt and moral distress as they manage transitions in care. The PIF of oncologists can be supported through reflection and introspection, peer support, and interventions to promote self-care — ultimately enabling them to make meaning of their experiences, renew family ties, and reaffirm their commitment to the profession. [ABSTRACT FROM AUTHOR]

Purpose: This study explored potential categories of dyadic disease appraisal differences among patients hospitalized with chronic heart failure (CHF) in China and analyzed the main factors influencing these categories. Methods: A survey was conducted using various tools and scales, including the Chinese version of the Memorial Heart Failure Symptom Appraisal Scale, Heart failure self-care index scale, Social Support Rating Scale, Zarit burden interview, and Self-rating anxiety scale. The data was collected from patients who were hospitalized with CHF in the cardiology department of one of two tertiary hospitals in Nanchong City, China. The dyadic disease appraisal categories were identified using latent profile analysis (LPA). Multiple logistic regression analysis was also employed to analyze the factors influencing the formation of potential categories of differences in dyadic disease appraisal in CHF patients. Results: A total of 262 pairs of hospitalized CHF patients and their caregivers participated in this study. The dyadic disease appraisal of CHF patients was potentially categorized as the "negative difference group" (28 individuals, 10.7%) and the "positive or convergence group" (234 persons, 89.3%). The results showed that the factors influencing the categorization of dyadic disease appraisal differences included the patient's social support, disease progression, and Caregivers anxiety level, burden, gender, educational attainment, and age (p < 0.05). Conclusion: The study findings demonstrated heterogeneity between the two groups of CHF patients in the dyadic disease appraisal. Therefore, it is necessary to focus on patients who have a brief duration of illness and limited social support. Specifically, it is important to prioritize support for female caregivers who are 65 years or older, have lower levels of educational attainment, and experience a significant burden and anxiety. Regular implementation of support person-bilateral co-management strategies can effectively reduce differences in how the disease is perceived and enhance the overall well-being of both caregivers and patients. [ABSTRACT FROM AUTHOR]

Posterior spinal instrumented fusion (PSIF) is a treatment option for adolescent spinal deformity. PSIF leads to loss of spinal segment motion. It is unclear the extent to which spinal stiffness is perceived by adolescent patients after fusion. Focus groups of adolescents between ages 11 and 21 years who underwent PSIF for spinal deformity were performed. Focus groups were evaluated for common themes, and a 36-question survey was designed. Survey responses were analyzed relative to last instrumented vertebra (LIV) and Scoliosis Research Society-22 (SRS-22) scores. Five focus groups were held with 18 patients in total. Three main themes were identified by participants: 56% identified difficulty bending forward, 44% identified difficulty hunching while sitting, and 56% identified difficulty with twisting motions. Patients with more distal LIV reported significant more difficulty with self-care/grooming (P =.014) and chores (P <.001). SRS-22 function/activity scores correlated well with survey categories in self-care/grooming (r =.61; P =.049) and recreation (r =.69; P =.019). Focus groups suggest that spinal stiffness is frequently perceived and leads to alteration in daily tasks in adolescents after spinal fusion. [ABSTRACT FROM AUTHOR]

Background: Although quality of life (QOL) is an outcome of postoperative cardiac rehabilitation (CR), its course and related factors from postoperative hospitalization to the post-discharge period have not been adequately investigated. Additionally, the EuroQol-5Dimension-5Level (EQ-5D-5L) index score has not been characterized over the same period. We aimed to characterize QOL changes assessed by the EQ-5D-5L, over the period from hospitalization to 1 year post-discharge, in patients post-cardiac and thoracic aortic surgery, and investigate the factors associated with these temporal changes. Methodology: This prospective, single-center study included 117 patients who underwent open cardiovascular surgery (median age, 72 years; men, 69%). Patients were assessed for QOL status when transferred to the general ward; at discharge; and at 6 and 12 months after discharge, using the EQ-5D-5L index score and a generalized linear mixed model with random intercepts. Patients were classified into two groups based on score changes post-discharge. Logistic regression analysis evaluated factors associated with QOL decrease post-discharge. Results: The EQ-5D-5L index score significantly increased over time, except between 6 and 12 months post-discharge; "Common activities" was the most common dimension showing score improvement. In 25 patients (21%), the EQ-5D-5L index scores were lower after discharge compared to their scores at discharge. In the logistic regression analysis, Barthel Index pre-admission, preoperative hemoglobin level, and Mini-Mental State Examination-Japanese scores pre-discharge were significantly associated with QOL decline after adjusting for the European System for Cardiac Operative Risk Evaluation II score. Conclusions: Most patients post-cardiac or thoracic aortic surgery experienced improved QOL from postoperative hospital stay to 1 year post-discharge. However, in patients with pre-operative basic activities of daily living, hemoglobin and post-operative cognitive decline may require ongoing comprehensive CR because of reduced QOL. Given the potential selection bias introduced by the relatively small sample size in this study, future research involving larger populations is necessary. [ABSTRACT FROM AUTHOR]

Background: In the last two decades, the use of oral anticancer agents (OAAs) has increased in cancer patients. Despite this, patients and their caregivers face some challenging issues (side effects, drug-to-drug interactions, etc.) related to OAA administration. The three dimensions of self-care by Riegel et al., self-care maintenance (i.e., stability of patient condition), self-care monitoring (i.e., detection of side effects), and self-care management (i.e., management of side effects), may be implemented to avoid negative outcomes. However, knowledge of self-care determinants is necessary to recognise people at risk of poor self-care behaviours. Aims: Determine which are the predictors of self-care maintenance, self-care monitoring and self-care management in patients with cancer taking OAA. Methods: A systematic review with narrative synthesis was conducted. We included studies on adult patients with cancer using any kind of oral anticancer agent and describing a predictor of self-care. The search was performed on PubMed, CINAHL/PsycINFO, and Web of Science. Results: Of 3,061 records, 45 studies were included in this review. Forty-six predictors organised into 14 categories were identified. In general, all studies focused only on adherence, considered as a self-care maintenance component, and none of them focused on other dimensions of self-care. The predictors of OAA adherence most reported were age, side effects, and socioeconomic factors (e.g., insurance status, and annual income). Conclusions: This systematic review highlighted the literature gap on the analysis of determinants of self-care behaviours in patients taking OAAs. This element could be a starting point for future research that can provide elements to support the oncology nursing research agenda, aimed at recognising patients at risk of poor self-care. [ABSTRACT FROM AUTHOR]

Background. Many individuals with serious mental illness live in supported accommodation. Decisions regarding type of supported accommodation required and level of support to meet individual's needs are crucial for continuing rehabilitation and recovery following admission to hospital. This study aimed to identify personal and contextual predictive factors for (1) discharge from hospital to different levels of supported accommodation and (2) self‐directed support needs of individuals with serious mental illness once they are in supported accommodation in Scotland. Method. Linked data from the Scottish Morbidity Record‐Scottish Mental Health and Inpatient Day Case Section and the Scottish Government Social Care Survey were analysed using multinomial regression and multivariable logistic regression to identify personal and contextual factors associated with accommodation destination at the time of discharge and four self‐directed support needs: personal care; domestic care; healthcare; and social, educational, and recreational. Results. Personal factors (age and having a diagnosis of schizophrenia, schizotypal, or delusional disorder) were associated with individuals moving to supported accommodation with higher levels of support. One contextual factor, compulsory detention when admitted to hospital, decreased the likelihood of moving to any type of supported accommodation. The personal and contextual factors associated with identified self‐directed support needs varied by need. Support provided by the local authority was associated with all self‐directed support needs, with having a diagnosis of schizophrenia, schizotypal, or delusional disorder associated with identifying domestic care, healthcare, and social, educational, and recreational needs, while living in the most deprived areas was associated with identifying healthcare needs. Advancing age and being compulsorily detained decreased the likelihood of identifying social, educational, and recreational needs. Conclusion. The study highlights that older men with a diagnosis of schizophrenia, schizotypal, or delusional disorder require higher levels of support upon discharge from hospital. When living in supported accommodation, having this diagnosis increases the likelihood of identifying support with looking after the home, looking after their health, and social and recreational activities; however, being older decreases the likelihood of identifying support with social and recreational activities. [ABSTRACT FROM AUTHOR]

Dyadic conditions of patients with heart failure and their caregivers may affect both patient self-care and caregiver contribution to patient self-care (CCPS). The purpose of this study was to examine the relationships of patient-caregiver physical function and depressive symptoms to the patient self-care (maintenance and management) and CCPS. Data from 55 were analyzed using an Actor–Partner Interdependence Model to address the aim through AMOS. Patient self-care was very poor. Better patient physical function was related to better patient self-care management (actor effect) and poorer CCPS maintenance (partner effect). Better caregiver physical function was related to CCPS management (actor effect). Severer patient depressive symptoms were related to poorer patient self-care maintenance (actor effect) and poorer CCPS management (partner effect). Physical function and depressive symptoms in patient-caregiver dyads were related to patient self-care and CCPS. To improve patient self-care and CCPS, dyadic support for physical function and depressive symptoms is needed. [ABSTRACT FROM AUTHOR]

Our objective was to understand how empathy and self-awareness content, alongside traditional deescalation training, might impact ambulatory clinic staff responses to patient and family escalation events. Verbal and physical workplace violence is escalating across healthcare organizations, including ambulatory clinics. Deescalation content is often developed with acute care, psychiatric, or emergency care in mind. There is a need for relevant and empathic deescalation training for ambulatory clinic staff to address their specific needs. We developed empathic and self-reflective deescalation training which was interactive and relevant to ambulatory clinic staff. Staff were trained using both in-person and virtual modalities. Participant self-reflection pre- and postintervention questionnaires indicated increases in understanding and application of deescalation methodologies. Multiple ambulatory clinics where staff participated saw a decrease in patient complaints and grievances. Participating ambulatory clinics also saw an improvement in the likelihood to recommend practice. However, participating ambulatory clinics did not see a reduction in reported patient-involved workplace violence events. Ensuring both empathy and self-awareness content in deescalation training, along with relevant ambulatory clinic scenarios, support ambulatory staff to respond effectively and appropriately to escalation events, helps reduce patient complaints, and improves patient satisfaction. [ABSTRACT FROM AUTHOR]