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: 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 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: Chronic kidney disease (CKD) is a condition characterized by the gradual loss of kidney function over time. Self-management programs have been widely applied to chronic disease education programs, which are designed to delay deteriorating kidney functions, preclude depression, and improve quality of life. This study aims to analyze effectiveness of self-management programs in bettering CKD patients' eGFR, mitigating depression symptoms and improving quality of life in randomized control or clinical trials. METHODS: Using key terms, a search was conducted in English-language, peer-reviewed journals on CKD that were published between 2002 and 2014 on databases including CINAHL, Cochrane Library, MEDLINE. The measurable variables included CKD patients' eGFR, depression, and quality of life. Random and fixed effects meta analysis were applied with standard error and correlation based measure of effect size. RESULTS: Eight studies met the inclusion criteria. A self-management program significantly impacted CKD patients' depression and mental quality-of-life dimensions, with an effect size of .29 [95% confidence interval (CI) (0.07, 0.53)] and −.42 [95% CI (−0.75, −0.10)]. However, the intervention of a self-management program had no significant effect on patients' eGFR as well as physical quality-of-life dimensions, with effect sizes of .06 [95% CI (−0.69, 0.81)] and −.16 [95% CI (−0.81, 0.50)]. CONCLUSIONS: Self-management programs of patients with chronic kidney disease can improve the depression and mental quality of life. Aside from providing more objective evidence-based results, this study provides a reference for clinical health care personnel who tend to patients with CKD.
Cognitive Therapy/methods ; Depressive Disorder/*etiology/therapy ; Glomerular Filtration Rate/*physiology ; Humans ; *Quality of Life ; Randomized Controlled Trials as Topic ; Renal Insufficiency, Chronic/physiopathology/psychology/*therapy ; Self Care/*methods

PURPOSE: The purpose of this study was to evaluate the effects of a risk factoretailored small group education on anxiety and depressive symptoms, self-efficacy and self-care compliance in patients with first-time acute coronary syndrome (ACS) for 12-month follow-up. METHODS: A quasi-experimental pretest and post-test design was used. Patients were recruited from a national university hospital from 2010 to 2011 in Korea. The group education consisted of a 60-minute long video developed using multimedia contents including voice-recorded texts, flash animation, and video clips, with nurses' dialogue. The intervention group (n = 34) participated in group education using the multimedia video in a small group of patients with similar risk factors, and received periodic telephone counseling and text messages. The control group (n = 40) received usual care and counseling upon request. RESULTS: Depressive symptoms decreased, and self-efficacy and self-care compliance in the areas of medication, exercise, and healthy diet practice significantly increased in patients in the intervention group, compared with those in the control group. CONCLUSIONS: Risk factoretailored small group education and periodic text message were an effective strategy for decreasing depression, and increasing self-efficacy and long-term compliance with lifestyle changes in patients with first-time ACS. We suggested that risk factoretailored small group education need to be given for first-time ACS patients for psychological support and behavioral change in clinical practice. It is also comparable to individual approach to encourage psychological and behavioral change.
Acute Coronary Syndrome/*nursing/*psychology ; Adaptation, Psychological ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; *Multimedia ; *Patient Education as Topic ; Patient-Centered Care/methods ; Republic of Korea ; Risk Factors ; Self Care/*methods ; Self Efficacy ; Stress, Psychological/*nursing ; Teaching/*methods

PURPOSE: The purpose of this study was to develop a multi-disciplinary self-management intervention based on empowerment theory and to evaluate the effectiveness of the intervention for older adults with chronic illness. METHODS: A randomized controlled trial design was used with 43 Korean older adults with chronic illness (Experimental group=22, Control group=21). The intervention consisted of two phases: (1) 8-week multi-disciplinary, team guided, group-based health education, exercise session, and individual empowerment counseling, (2) 16-week self-help group activities including weekly exercise and group discussion to maintain acquired self-management skills and problem-solving skills. Baseline, 8-week, and 24-week assessments measured health empowerment, exercise self-efficacy, physical activity, and physical function. RESULTS: Health empowerment, physical activity, and physical function in the experimental group increased significantly compared to the control group over time. Exercise self-efficacy significantly increased in experimental group over time but there was no significant difference between the two groups. CONCLUSION: The self-management program based on empowerment theory improved health empowerment, physical activity, and physical function in older adults. The study finding suggests that a health empowerment strategy may be an effective approach for older adults with multiple chronic illnesses in terms of achieving a sense of control over their chronic illness and actively engaging self-management.
Aged ; Aged, 80 and over ; Chronic Disease ; Exercise ; Female ; Health Education ; Humans ; Male ; Motor Activity ; *Power (Psychology) ; *Program Evaluation ; Self Care/*methods ; Self Efficacy

Deliberate self-harm refers to an intentional act of causing physical injury to oneself without wanting to die. It is frequently encountered in adolescents who have mental health problems. Primary care physicians play an important role in the early detection and timely intervention of deliberate self-harm in adolescents. This article aims to outline the associated risk factors and possible aetiologies of deliberate self-harm in adolescents, as well as provide suggestions for clinical assessment and appropriate management within the primary care setting.
Adolescent ; Adolescent Behavior ; Adolescent Medicine ; methods ; Empathy ; Female ; Humans ; Primary Health Care ; methods ; Referral and Consultation ; Risk Factors ; Self-Injurious Behavior ; diagnosis ; psychology ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to investigate if pain mediates or moderates the relationship between cognitive impairment and aggressive behaviors in nursing home residents with dementia based on the Need-driven Dementia-compromised Behavior model. METHODS: This was a secondary analysis of the Minimum Data Set assessment data on long-term care from the state of Florida during calendar year 2009. The data used in this study was the first comprehensive assessment data from residents with dementia (N = 56,577) in Medicare-certified or Medicaid-certified nursing homes. Path analysis using a series of hierarchical regression analyses and two-way analysis of variance was used to evaluate the mediating and moderating effect of pain on the relationship between the level of cognitive impairment and aggression. RESULTS: Results indicated that pain did not mediate the relationship between cognition and aggressive behaviors, but there was evidence of a significant moderating effect of pain only for residents with severe cognitive impairment. Only among the residents with severe cognitive impairment, those with pain had significantly more frequent aggressive behaviors than those without pain. CONCLUSION: A change in the frequency of aggressive behaviors in severely cognitively impaired residents should signal the possibility that the person is experiencing pain. Accurate but simple pain assessment in this population including these behavioral changes should be developed further, and pain should be well controlled to reduce these problematic behaviors.
Aged ; Aged, 80 and over ; *Aggression ; Cognition Disorders/*complications/psychology ; Dementia/*complications/psychology ; Female ; Florida ; Humans ; Long-Term Care ; Male ; Nursing Homes ; Pain/*complications/psychology ; Pain Measurement/methods ; Self Report ; *Social Behavior

OBJECTIVE: To investigate the self-management behaviors of patients with type 2 diabetes mellitus (DM) in a community and to explore the relationship between self-management behaviors and the glycemic control. METHODS: A total of 211 type 2 DM patients in a community were selected by stratified random sampling. Patients were grouped according to the scores of self-management behaviors. The fasting plasma glucose (FPG), 2 h postprandial plasma glucose (2hPG) and glycated hemoglobin (HbA1C) level were tested. The differences between groups and relationship between self-management behaviors and glycemic control were analyzed. RESULTS: Self-management behaviors of most patients were not effective, and 2hPG and HbA1C were affected by different levels of the self-management behaviors (P<0.05). The self-management behaviors were negatively related to FPG (r=-0.277, P=0.015), 2hPG (r=-0.453, P=0.001), and HbA1C (r=-0.435, P=0.001). Glycemic control of the patients whose course of disease was over 5 years was significantly different due to different self-management behaviors. FPG level of the patients was positively related to alimentary control. The 2hPG level of the patients was positively related to alimentary control, medication persistence, and blood glucose self-monitoring. The HbA1C level of the patients was positively related to alimentary control and medication persistence. The times the patients received DM education, the way to use insulin, and the disease course of the patients were important factors to affect self-management behaviors of type 2 DM in the community. CONCLUSION Self-management behaviors of type 2 DM patients in the community are not effective. Satisfactory self-management behaviors, specially the control of 2hPG and HbA1C are beneficial to glycemic control. We can improve the self-management behaviors in type 2 DM patients by paying attention to the disease course, the treatment method, and the contents and effect of DM education.
Adult ; Aged ; Aged, 80 and over ; Attitude to Health ; Blood Glucose ; metabolism ; Blood Glucose Self-Monitoring ; statistics & numerical data ; China ; Community Networks ; Diabetes Mellitus, Type 2 ; blood ; psychology ; therapy ; Diet, Diabetic ; methods ; psychology ; Female ; Glycated Hemoglobin A ; analysis ; Humans ; Male ; Middle Aged ; Patient Education as Topic ; Self Care ; methods ; psychology ; Surveys and Questionnaires ; Young Adult