Purpose: The aims of this study were to (1) summarize the HF self-management interventions and (2) identify gaps and priorities for further investigation. Methods: A computer search of the literature over the past decade yielded 9 HF self-management studies. Six studies used non-experimental design; only 3 (33%) studies used quasi-experimental design which were included in this review. Results: The three pivotal HF self-management interventions studies were important because they highlight the positive effects of self-management compliance and other quality of life outcomes as well as discussing various issues. The informational booklet and telephone follow-up were the most common modalities in these interventions. The periodic telephone counseling offered in 2 studies effectively facilitated patient self-management compliance. There were some methodological flaws such as small sample sizes (range 8~21 in each group) and lack of experimental designs, long-term follow-up, and random group assignment. Additionally, the use of valid, reliable outcome measures is necessary to compare the effects of the interventions worldwide. Conclusion: More clinical evidence on HF self-management is needed using a larger sample size and the efficacy needs to be tested for various outcomes, including morbidity, mortality, and health care cost.
This study was conducted to identify the changes of the relationship among general characteristics, self-efficacy. and self-care of the hypertensives in rural area. For this purpose, self-regulation program was carried at two Community Health Practitioner Post located in the suburbs of Daejeon City from September to November. 1999. Data were analyzed with non-parametric statistics, t-test, pearson correlation. The results were as follows; 1. The level of self-care was significantly different according to sex, status of smoking, and the level of self-efficacy of non-smoker was significantly higher than smoker. 2. After self-regulation program, there were significant positive relationship among self-efficacy, self-care, internal locus control, and negative relationship between perceived barrier and self-care. From these results, it can be concluded that the self-regulation program is an effective nursing strategy to promote self-care performance of hypertensives in rural area, and this program can be recommended for the management of hypertensives.
Purpose: This study aimed to provide basic data to enhance self-nursing ability by investigating the symptoms of autonomic neuropathy and self-management activities in patients with diabetes accompanying hypertension. Methods: Subjects were 113 type-2 diabetic patients who were diagnosed as hypertensive in two primary medical institutions and taking anti-hypertensive treatments. The existence of postural hypotension was evaluated by blood pressure and pulse rate, and the subjective symptoms of autonomic neuropathy and self-management activities were checked by structured questionnaires. The collected data were analyzed by chi-square test, Fisher's exact test, t-test, Wilcoxon rank sum test and analysis of covariance. Results: Postural hypotension occurred in 4.4% of the subjects. Urinary frequency and dizziness during postural changes were the most frequent symptoms of autonomic neuropathy, and 57.5% of the subjects complained of symptoms in two or more domains. The group with autonomic neuropathy symptoms showed higher age, higher living stress, and fewer self-management activities in the diet and foot management domains as compared to the group without autonomic neuropathy symptoms. Conclusion: From these results, we learned that strengthening education on self-management for diet and foot management and customized interventions considering age and living stress are required through early identification of the symptoms of autonomic neuropathy in patients with diabetes accompanying hypertension.
Fahima, Khatun;Lee, Tae Wha;Ela, Rani;Gulshanara, Biswash;Pronita, Raha;Kim, Sue
여성건강간호학회지
/
제24권1호
/
pp.49-57
/
2018
Purpose: Postpartum fatigue can impact maternal well-being and has been associated with levels of perceived self-care. This study aimed to examine the relationship among fatigue, depressive mood, self-care agency, and self-care action among postpartum women in Bangladesh. Methods: A descriptive cross sectional survey was done with 124 first-time mothers from two tertiary hospitals in Dhaka, Bangladesh. The Modified Fatigue Symptoms checklist, Denyes' Self Care Instrument, the Edinburgh Postnatal Depression Scale, and items on sociodemographic and delivery-related characteristics, were used in Bengali via translation and back-translation process. Results: High fatigue levels were found in 18.5% (n=23) and 73.4% had possible depression (n=91). There was a significant negative relationship between fatigue and self-care agency (r=-.31, p<.001), and self-care action (r=-.21, p<.05). Fatigue differed by level of self-care agency (t=4.06, p<.001), self-care action (t=2.36, p=.023), newborn's APGAR score (t=-2.93, p=.004), parental preparation class participation (F=15.53, p<.001), and postpartum depressive mood (t=-4.64, p<.001). Conclusion: Findings suggest that high level of self-care efficacy and behaviors can contribute to fatigue management, and highlight the need for practical interventions to better prepare mothers for postpartum self-care, which may, in turn, alleviate postpartum fatigue.
The purpose of this study was to explore the relationship between self-rated health and Activity of Daily Living (ADL) and self-care behavior of rural elderly in Korea, focused on the difference among three distinctive living arrangements; living alone, living only with his/her spouse, and living with their married children. For this purpose, data were gathered from a nationwide survey, a total of 586 elderly aged 65 or older and living in rural area, using the structured questionnaire. Also, self-care behavior were categorized into 4 groups; life-style practice, medical self-care, adaption to functional limitation, and emotional management. The major findings are as follows; 1) Rural elderly perceived their health little and more 'bad' but their ADL capacity were 'not difficult', especially among elderly living with spouse. 2) The level of 20 items in self-care behavior ($1{\sim}5$score) was ranged from 2.51 to 3.81 score. The behavior level of regular exercise, setting up additional phone, taking a nutrient, and testing BP or pulse regularly were low but that of taking a medicine according to prescription, close contact with other people, and regular eating were proportionally high. 3) The majority of self-care behavior were correlated with subjective health positively but medical self-care behavior were correlated with subjective health or ADL negatively. Based on these results, policy implications are discussed.
Purpose: This study was done to assess the effects of a self-help intervention on clinical, lifestyle and psycho-social outcomes in patients with Type II diabetes. Methods: Eligible adults with Type II diabetes were randomly assigned to either the intervention group receiving the diabetes self-help or the control group receiving usual care. Of the 36 patients who completed the study, 15 were in the intervention group and 21 were in the control group. The self-help group consisted of six weekly sessions covering aspects of diabetes self-care and using continuing education, discussion, and structured social activities. Outcomes included changes in glycemic control, knowledge, self-management behaviors, diabetes-related self-efficacy, and health-related quality of life. Analysis of covariance was used to compare outcomes between the groups, adjusting for baseline measures. Results: After the six week intervention, significant improvements from the baseline were observed in the measurements of self-management behaviors, diabetes-related self-efficacy, and health-related quality of life for the intervention group. Conclusion: The findings provide preliminary evidence that a diabetes self-help group intervention can benefit diabetes patients in self-management behaviors, diabetes-related self-efficacy, and health-related quality of life. However, larger longitudinal studies are needed to determine the most efficacious self-management methods to sustain long-term glycemic control and psychological well-being.
Communal places for parents to take child-care are very important in activating cooperative child-care(CCC). Therefore, Jeju Special Self-Governing Province has been operating Cooperative-Childcare-Places(CCPs) since 2016. This study analyzed the operational status of the CCPs and presented the model type to provide data for the activation of CCC. Qualitative analyses were applied to the results of interviews with 10 staff members. The common task they considered difficult was recruitment, and there was a big difference in the operation of the regular program depending on the competence of the staff in charge. The lack of support systems, such as education and consulting, has made it difficult for the staff to do their work. Additionly, four models of CCPs were found, a resident self-governing type, a workplace type, an institutional type, and a rural complex type. In conclusion, CCP spaces should be planned and facilities created with a focus on the needs of child-care activities. Second, the role of staff in helping to organize the parents' self-governing committee is crucial. Third, it needs to establish a support system to strengthen the capacity of the staff members.
The purpose of this study is to examine the motive of participating in the care work, the overall cognition survey for the care work and the infant care practice areas required in the care work for the child care helpers who activate in the care work, and search for methods of specializing infant care and care experiences on the results. Results of study showed that firstly, middle- or the late middle-age women participated in the care worker recognized care work as productive labor to create economic value and that secondly, the child care helpers' recognition degree of self-development and job satisfaction through performance of care work was wholly high level and that there was will of participation in training for self-development but actual participation rate was low due to restrictions by general conditions. Thirdly, the infant care practice areas and their particular contents that the child care helpers recognized in the care work necessary were highly shown in the whole. The requested level of education for safety management, play guidance, humanity guidance for infant and child was high. Point to discuss is that occupation stability and occupation image must be raised through the public job-hunting system for the child care helpers. In addition, a tailor-made education support suitable for the child care helpers' career stage is needed. Education support by the performance of infant care practice area and the educational requirements must be provided to major rearers to ensure that they can function as behavioral and emotional supporters. Finally, a support system for continuous self-management.
The utilization of medical care services has been partly regionalized with the implementation of referral requirement by the government since July 1, 1989 when the health insurance coverage was extended to all the people. For the purpose of regionalization, the whole country has been primarily divided into tertiary care regions, and each of them again into secondary care regions. This study investigates the self-sufficiency for in-patient care services of secondary care regions focusing on why it varies among the regions. In doing so, analysis is performed to examine a model which embodies three sets of hypotheses as follows : 1) The regional self-sufficiency for medical care services would be subject to direct influences of regional characteristics, amount of available services and structural properties of regional medical care system ; 2) The regional characteristics would have indirect effects on the self-sufficiency which are mediated by medical care services ; and 3) The amount of available services would indirectly affect the self-sufficiency by influencing the structure of regional medical care system. The results of analysis were generally consistent with the model. The findings have some practical implications. The regional self-sufficiency for medical care services partly depends upon basic properties of each region which cannot be changed in a short period of time. Thus the self-sufficiency for medical care services can be improved mainly by health policy measures. In some of the regions the self-sufficiency for in-patient care services was much higher or lower than can be predicted from the bed-population ratio. Indication is that the allocation of health resources should be made considering a variety of factors bearing upon the supply of and demand for health care ; not on the basis of just a single criterion like the availability. The self-sufficiency of a certain region is related to not only its own characterstics but also the characteristics of neighboring regions. Therefore, attention should be also directed to the inter-regional relationships in health care when the needs for investment of health resources in a region are assessed. However, it should be noted that this study used the data collected before the referral requirement was imposed. A replication of this analysis using recent data would provide an evaluation of the impact on the self-sufficiency of the referral requirement as well as a confirmation of the findings of this study.
Purpose: The purpose of this study was to investigate the depression, anxiety, stress response and self-care, to analyze the correlation among depression, anxiety, stress response and self-care by gender, and to determine factors associated with self-care in diabetic patients. Method: The subjects of this study were 103 participants with diabetes mellitus. Data were analyzed by chi-square test, t-test, Pearson correlation coefficient and multiple regression analysis by using SAS program. Result: Items for self-care evaluation by gender were significant differences in hospital visit, hypoglycemia preparation, proper hygiene, taking a rest, foot injury check, drinking, and smoking. The female patients are more likely to have higher self-care score than the male patients. However, there were no differences in depression, anxiety and stress response by gender. In male patients, there were positive correlations between the degree of depression and stress response, the degree of anxiety and stress response. In female patients, there were positive correlations between the degree of depression and stress response, the degree of anxiety and stress response. In multiple regression analysis, gender and experienced admission is associated with self-care. Conclusion: We should consider integrated approaches for psychological problems in the management of diabetic patients.
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