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

OBJECTIVE: To investigate the current status of self-management ability in patients with systemic lupus erythematosus (SLE), and to analyze the related factors affecting the self-management ability of SLE patients. METHODS: A total of 180 SLE patients who were selected from the outpatient department and ward of the Department of Rheumatology and Immunology of a Tertiary Hospital in Beijing from January 2024 to March 2024. General information questionnaire, SLE self-management ability assessment scale, general self-efficacy scale (GSES) and family concern index questionnaire (APGAR) were used for questionnaire investigation, so as to investigate the current status and related influencing factors of self-management ability in patients with SLE. RESULTS: A total of 170 questionnaires were effectively collected, and the total score of self-management ability was (90.94±14.26) points, of which 103 patients were 89-110 points, accounting for 60.6%; 60 patients were 67-88 points, accounting for 35.3%; 7 patients were 0-66 points, accounting for 4.1%; The results of univariate analysis showed that personal monthly income, follow-up frequency, family caring index, self-efficacy and SLE self-management ability score had statistical significance (P < 0.05). Spearman rank correlation analysis showed that family caring index, self-efficacy scores were positively correlated with the scores of various dimensions and the total score of SLE self-management scores (P < 0.001). Multivariate Logistic regression analysis showed that family caring index (OR=1.503, 95%CI=1.186-1.906), self-efficacy (OR=1.103, 95%CI=1.038-1.172), personal monthly income of 5 000-8 000 yuan/month (OR=0.120, 95%CI=0.022-0.645) and 1-2 weeks return frequency (OR=0.044, 95%CI=0.003-0.575) were significant influencing factors for SLE patients' self-management ability. CONCLUSION The results of this study indicate that patients with SLE have a good level of self-management ability. In the process of chronic disease management, medical staff should formulate detailed and layered intervention measures to further improve self-management ability with SLE patients, and at the same time, help SLE patients establish good family caring index and patient self-efficacy, which is conducive to improving self-management ability of SLE patients, so as to effectively promote disease management and improve the quality of life.
Humans ; Lupus Erythematosus, Systemic/psychology* ; Self-Management ; Self Efficacy ; Surveys and Questionnaires ; Female ; Male ; Income ; Self Care

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

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: 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

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: 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: We aim to introduce the predictive value of a quantitatively described formula model in a multicenter prospective analysis using the EuroQol-5 dimensions (EQ-5D) health scale to anticipate postoperative improvement in patients with degenerative lumbar spine disease (DLSD). MATERIALS AND METHODS: Quality of life was evaluated in 376 patients from 17 tertiary hospitals before and after spinal decompression and fusion surgery. The five items of the EQ-5D, mobility (M), self-care (S), usual activities (A), pain/discomfort (P), and anxiety/depression (D), were checked as level 1, 2, or 3, with 3 being the worst. A minimal significant change in the calculated EQ-5D (cEQ-5D) was set as 0.05. Logistic regression analysis was performed to predict the highest successful outcome (cEQ-5D improvement after operation >0.05) with the given sets of 5 items of the EQ-5D. RESULTS: In the cEQ-5D analysis, among patients with a formula score of S+A+2×P+D≤8, 18/68 (27%) showed significant improvement in the cEQ-5D at 1 year postoperatively (p<0.05). However, in patients with a formula score of ≥9, 265/308 (86%) demonstrated significant improvements in the cEQ-5D at 1 year postoperatively (p<0.05). CONCLUSION: We suggest that S+A+2×P+D≥9 in the EQ-5D can quantitatively describe the better surgical outcome predictors for DLSD. With a definite DLSD lesion confirmed by an imaging study, patients who meet the formula scores of 9 or over and have refractory symptoms to non-operative treatment could be better surgical candidates resulting in satisfactory surgical outcomes of over 86%, than those who scored 8 or lower.
Aged ; Aged, 80 and over ; Decompression, Surgical/adverse effects ; Female ; *Health ; Humans ; Lumbar Vertebrae/*surgery ; Male ; Middle Aged ; Postoperative Complications/etiology/psychology ; Postoperative Period ; Prognosis ; Prospective Studies ; *Quality of Life ; Self Care ; Spinal Diseases/diagnosis/*surgery ; Surveys and Questionnaires ; Treatment Outcome

PURPOSE: Health literacy has been attracting increasing attention because low health literacy is considered an important predictor of adverse health outcomes in many chronic conditions, including diabetes. However, it is unclear how health literacy is associated with health outcomes. The purpose of this study was to formulate a hypothetical structural equation model linking health literacy to self-efficacy, self-care activities, and health-related quality of life (HRQOL) in patients with type 2 diabetes. METHODS: cross-sectional survey design was employed, and 459 patients with type 2 diabetes were recruited from outpatient clinics in two university hospitals. The patients completed a pack of questionnaires. The hypothetical model was tested using structural equation modeling analysis. RESULTS: The values of multiple fit indices indicated that the proposed model provided a good fit to the data. Health literacy exerted not only a direct effect on self-care activities, but also an indirect effect on self-care activities via self-efficacy. However, health literacy exerted only an indirect effect on HRQOL. This structural model was invariant across hemoglobin-A1c-controlled and hemoglobin-A1c-uncontrolled groups. Based on R2 values, the final model accounted for 20.0% of the variance in selfefficacy, 61.0% of the variance in self-care activities, and 16.0% of the variance in HRQOL. CONCLUSIONS: This study suggests that self-care activities are crucial to the link between health literacy and HRQOL. Both health literacy and self-efficacy need to be considered in clinical practice for enhancing self-care activities in patients with type 2 diabetes. This approach may ultimately improve HRQOL in these patients.
Adult ; Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/*nursing/*psychology ; Female ; *Health Knowledge, Attitudes, Practice ; *Health Literacy ; Humans ; Male ; Middle Aged ; Models, Theoretical ; Quality of Life/*psychology ; Republic of Korea ; Self Care/*psychology ; *Self Efficacy ; Surveys and Questionnaires ; Young Adult