INTRODUCTION: The rising rate of adolescent suicide, and the burden of self-harm and mental health disorders, pose significant threats to Singapore's future health outcomes and human potential. This study sought to examine the risk profile and healthcare utilisation patterns of Singaporean adolescents who presented to the emergency department (ED) for suicidal or self-harm behaviour. METHOD: A retrospective review of medical records for patients aged 10 to 19 years who visited Singapore's KK Women's and Children's Hospital ED for suicidal or self-harm attempts from January to December 2021 was conducted. RESULTS: A total of 221 patients were identified, with a predominance of female patients (85.5%) over males (14.5%). The mean age was 14.2 ± 1.4 years. Intentional drug overdose (52.0%) was the most commonly used method. Significantly more females presented for intentional paracetamol overdose (46.6% versus [vs] 28.1%, P=0.049), whereas jumping from a height was more common among males (18.8% vs 5.8%, P=0.022). The most frequently observed mental health challenges were stress-related and emotional coping difficulties (50.7%), followed by mood and anxiety symptoms (53.4%). A history of self-harm and suicidal behaviours were the most common psychosocial risk factors. Within the year prior to their ED presentation, 15.4% had accessed healthcare services for mild medical ailments, 19.5% for medically unexplained symptoms, and 17.2% for previous self-harm or suicide attempts. CONCLUSION Most cases involved psychosocial and emotional regulation difficulties, some of which displayed sex-specific patterns, rather than complex psychiatric disorders. The identified predictive factors can help inform Singapore's National Mental Health and Well-being Strategy, to guide targeted and transdiagnostic interventions in schools and community settings.
Humans ; Adolescent ; Singapore/epidemiology* ; Female ; Male ; Suicide, Attempted/psychology* ; Emergency Service, Hospital/statistics & numerical data* ; Self-Injurious Behavior/psychology* ; Retrospective Studies ; Child ; Young Adult ; Drug Overdose/epidemiology* ; Risk Factors ; Acetaminophen/poisoning* ; Patient Acceptance of Health Care/statistics & numerical data* ; Sex Factors

Public health crises, such as the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) since Dec. 2019, are widely acknowledged as severe traumatic events that impose threats not only because of physical concerns but also because of the psychological distress of infected patients. We designed an internet-based integrated intervention and evaluated its efficacy on depression and anxiety symptoms in patients infected by SARS-CoV-2.
Adult ; Anxiety ; therapy ; Betacoronavirus ; Cell Phone ; China ; Coronavirus Infections ; psychology ; Depression ; therapy ; Female ; Humans ; Internet ; Male ; Middle Aged ; Mindfulness ; Pandemics ; Pneumonia, Viral ; psychology ; Prospective Studies ; Psychological Distress ; Relaxation Therapy ; Self Care ; methods

OBJECTIVES: This study aimed to investigate the effect of counseling on quality of life (QOL) in postmenopausal women conducted in Hamadan, Iran in 2015. METHODS: In this quasi-experimental study, 80 postmenopausal women were randomly selected and allocated to case and control groups (40 per group). Data collection tool included questionnaires of demographic information and QOL during menopause, which were completed by the samples before the intervention. In the case group, training program was run during four sessions in the form of weekly consulting sessions for 45 to 60 minutes. Training program included familiarity with menopause symptoms, confrontation and self-care during this period. The control group, only received routine cares. Three months after intervention, information were collected in both groups. Data were analyzed using SPSS for Windows. RESULTS: Before the intervention, mean ± standard deviation for QOL in case group was 101.2 ± 31.4 and it was significantly decreased to 96.9 ± 27.0 after intervention (P < 0.05). While no significant change was observed in the control group (from 98.9 ± 35.5 to 102.3 ± 35.0, P = 0.443). Symptoms of physical (P = 0.033) and sexual (P < 0.001) dimensions significantly decreased in the case group. While significant increase was observed in terms of psychosocial (P = 0.049) and sexual symptoms in control group. CONCLUSIONS: Findings suggested impact of consulting on improvement of QOL during menopause. Supportive consulting can be a suitable approach for improving women's health, reducing problems and enhancing QOL in menopause period.
Counseling* ; Data Collection ; Education ; Female ; Humans ; Iran* ; Menopause ; Non-Randomized Controlled Trials as Topic ; Quality of Life* ; Recognition (Psychology) ; Referral and Consultation ; Self Care ; Women's Health

PURPOSE: This study was conducted to develop an Empowerment Education Program (EEP) for kidney transplant patients and to test the program's effects on uncertainty, self-care ability, and compliance. METHODS: The research was conducted using a nonequivalent control group with a pretest-posttest design. The participants were 53 outpatients (experimental group: 25, control group: 28) who were receiving hospital treatment after kidney transplants. After the pre-test, patients in the experimental group underwent a weekly EEP for six weeks. The post-test was conducted immediately after, and four weeks after the program's completion in the same manner as the pre-test. For the control group, we conducted a post-test six and ten weeks after the pre-test, without and program intervention. A repeated measure ANOVA was performed to compare the change scores on main outcomes. RESULTS: Uncertainty was significantly lower in the experimental group than in the control group, both immediately after (t=-3.84, p=<.001) and 4 weeks after (t=-4.51 p=<.001) the program, whereas self-care ability (t=5.81, p=<.001), (t=5.84, p=<.001) and compliance (t=5.07, p=<.001), (t=5.45, p=<.001) were significantly higher. CONCLUSION: Kidney transplant patients who underwent an EEP showed a decrease in uncertainty and an improvement in self-care ability and compliance. Thus, our findings confirmed that an EEP can be an independent intervention method for improving and maintaining the health of kidney transplant patients.
Compliance ; Education* ; Humans ; Kidney Transplantation* ; Kidney* ; Methods ; Outpatients ; Patient Compliance ; Power (Psychology)* ; Self Care ; Uncertainty

PURPOSE: The purpose of this review was to identify the current status of nursing studies on heart failure (HF) patients in South Korea and to suggest future study direction. METHODS: A literature review of databases such as KoreaMed, KERIS and nursing and allied health journal were searched with key terms ‘heart failure’ and ‘nursing’ for the period from January 2000 to February 2017. A total of 35 studies including 28 articles and 7 theses met the inclusion criteria. RESULTS: Twenty-seven out of 35 studies were observational studies on outpatients and most of the studies did not mention the ejection fraction and New York Heart Association functional classification class (NYHA class) in the inclusion criteria. Self-care and health-related quality of life as psychological factors, and physical activity as a biological factor, were used as main variables. However, we found it difficult to understand how much score indicates better quality of life because of an inconsistent and wide score. In quality assessment, 8 intervention studies had no serious flaws. CONCLUSION: Further studies should consider more biological and social factors influencing HF. The quality assessment with respect to nursing intervention studies in HF showed that randomized and double-blind trials are needed.
Biological Factors ; Classification ; Heart Failure* ; Heart* ; Humans ; Korea* ; Motor Activity ; Nursing* ; Outpatients ; Psychology ; Quality of Life ; Self Care

Little is known about the risk factors for the fear of falling in elderly Korean individuals. Thus, the present study aimed to investigate the risk factors for fear of falling in a representative elderly population of over 10,000 individuals aged 65 years and older. A multivariate multinomial analysis revealed that the risk factors associated with a severe fear of falling were being female [odds ratio (OR)=4.396], older age (OR=5.550 for those aged ≥85 years), lower level of education (OR=0.719 for those with ≥13 years of schooling), chronic illness (OR=2.788 for those with more than three chronic illnesses), poor subjective health (OR=6.268), functional impairments (OR=2.340), a history of falling (OR=7.062), and depression (OR=1.774). The ORs for each of these risk factors were particularly high in participants with a severe fear of falling. Particularly, a history of falling and/or poor subjective health status had strong independent associations with the fear of falling. The present findings may help health care professionals identify individuals that would benefit from interventions aimed at reducing the fear of falling.
Accidental Falls* ; Aged* ; Chronic Disease ; Delivery of Health Care ; Depression ; Diagnostic Self Evaluation ; Education ; Female ; Humans ; Korea* ; Psychology* ; Risk Factors*

PURPOSE: The purpose of the study was to analyze the effects of self-care behavior, empowerment, and social support on glycosylated hemoglobin in patients with type 2 diabetes. METHODS: The data were collected during the period of July 1 to July 31, 2016. In total, 172 participants were recruited from outpatients who had been diagnosed with type 2 diabetes at a health care center, a health promotion center at National Health Insurance Corporation, and a tertiary hospital. Statistical data were analyzed with SPSS 20.0 using frequency analysis, t-test, ANOVA, Scheffé test, Pearson's correlation coefficients, and hierarchical regression analysis. RESULTS: The study results showed that self-care behavior (β=−.34, p<.001), empowerment (β=−.34, p<.001), and social support (β=−.20, p=.018) were found to be influential factors affecting glycosylated hemoglobin, with an overall descriptive power of 69%. CONCLUSION: Self-care behavior, empowerment, and social support are considered to be important factors in blood glucose management for the patients with type 2 diabetes. Therefore, self-caring blood glucose programs and internal synchronizing education through social support and empowerment need to be improved.
Blood Glucose ; Delivery of Health Care ; Diabetes Mellitus ; Education ; Health Promotion ; Hemoglobin A ; Hemoglobin A, Glycosylated* ; Humans ; National Health Programs ; Outpatients ; Power (Psychology)* ; Self Care* ; Tertiary Care Centers

PURPOSE: The project was to test a structural equation model in which self-efficacy, self-care health behaviors, and modifiable risk factors predict the quality of life (QOL) of individuals with coronary artery disease. METHODS: The data set from the intervention study with 130 patients with coronary artery disease before the intervention was included in the secondary analysis for this study. The following parameters were measured: self-efficacy, self-care health behaviors with the subscales of health responsibility, exercise, consumption of a healthy diet, stress management, and smoking cessation; modifiable risk score; and QOL (assessed using the 36-item Short-Form Health Survey instrument). RESULTS: The mean age of the participants was 66.1 years. The following evaluation parameters indicated that the proposed model provided a good fit to the data: comparative fit index at .87, goodness of fit index at .91, adjusted goodness of fit index at .84, standardized root mean square residual at .06, root mean square error of estimation at .09, and confidence interval at 0.06-0.13. Self-efficacy, self-care health behaviors, and modifiable risk factors had significant effects on QOL and explained 64.0% of the variance, with modifiable risk factors mediating between self-care health behaviors and QOL. CONCLUSIONS: The findings indicate that self-efficacy, self-care health behaviors, and modifiable risk factors play an important role in QOL in adults with coronary artery disease. Patients could be more confident in performing self-care health behaviors, leading to a better QOL, by more effectively managing their cardiovascular risk factors. Nursing strategies to improve QOL in this population should include motivating them to perform self-care health behaviors.
Adult ; Aged ; Cardiovascular Diseases/etiology ; Coronary Artery Disease/psychology/*therapy ; Cross-Sectional Studies ; Female ; *Health Behavior ; Humans ; Male ; Middle Aged ; Models, Theoretical ; *Quality of Life ; Risk Factors ; Self Care/*methods/psychology ; Self Efficacy

PURPOSE: Myocardial infarction can occur due to known risk factors and lifestyle choices. The difficulties that patients experience after discharge can lead to readmission and nonadherence to lifestyle change. The purpose of this study was to analyze the difficulties experienced by patients after hospitalization due to myocardial infarction and to identify the predictors of readmission and unchanged lifestyles. METHODS: The study used a mixed-methods design across 106 patients who had experienced a first episode of acute myocardial infarction. The data were collected from two patient interviews and the patients' medical records. A logistic regression was used to predict unchanged lifestyle and readmission. RESULTS: In the first interview, 74.5% of the patients reported receiving information prior to discharge. Six months after discharge, 80.2% mentioned that they had changed their lifestyles, but only 59.4% reported that their health had improved, and 75.5% continued to have concerns regarding their health. Patients described difficulties with regard to psychological problems, family dynamics, professional issues, problems with managing cardiovascular symptoms, and complications associated with hospital interventions. A follow-up assessment revealed that 12.3% of patients had been readmitted for cardiovascular disease. CONCLUSIONS: The analysis revealed significant predictors of readmission amongst patients with hypertension and three-vessel disease. Specifically, the number of people in the household, per capita income, and a lack of information/education provided at discharge as well as problems related to mental health after discharge predicted unchanged lifestyle. An educational program might be advantageous to clarify doubts and involve patients in their own disease management.
Activities of Daily Living ; Adult ; Attitude to Health/ethnology ; Female ; Follow-Up Studies ; Health Education/methods ; Healthy Lifestyle ; Humans ; Male ; Middle Aged ; Myocardial Infarction/ethnology/psychology/*therapy ; Patient Readmission/statistics & numerical data ; Portugal/ethnology ; Risk Factors ; Self Care

PURPOSE: This research was conducted to reveal Japanese mothers' changing perceptions towards their technology-dependent children in the home care setting. METHODS: Fourteen Japanese mothers participated in semi-structured interviews, which were analyzed using a grounded theory approach. RESULTS: "Degree of preoccupation with the child" emerged as the category representing the mothers' perceptions towards their child. Three categories emerged that represented the progression of maternal perceptions over time: "accepting the child's conditions", "mastering the management of care in various conditions", and "considering social participation for the child". CONCLUSIONS: First, mothers gradually accepted the conditions of their child after his/her disease and disability were known. Second, others managed technology-required care and concurrently considered the social participation of their child through daily care at home. Third, the level of preoccupation with the child was affected by the mothers' management of care and their attitude towards the social participation of their child in home care. In this study, as is widely alleged in historical recognition of Japan, mothers provided daily care almost without help from other family members. Additionally, they thought it natural and good for their children. Above all, especially in Japan, professional support for mothers are necessary so that they can take breaks from care.
Adaptation, Psychological ; Adolescent ; Adult ; *Attitude to Health ; Biomedical Technology ; Caregivers ; Child ; Child Advocacy ; Disabled Children/*psychology ; Female ; Home Care Services ; Humans ; Japan ; Male ; Middle Aged ; Mother-Child Relations ; Mothers/*psychology ; Perception ; Personal Autonomy ; Self-Help Devices ; Young Adult