Development and psychometric testing of a Scale for Evaluating Self-management Needs of Knee Osteoarthritis (SMNKOA) in Taiwan

2016 ◽  
Vol 33 (S1) ◽  
pp. S614-S614
Author(s):  
M.H. Kao ◽  
Y.F. Tsai

IntroductionKnee OA is a chronic and multifactorial disease; self-management needs are complex, which requires a multidimensional management plan. There is a need for healthcare providers to provide patients with knowledge of knee OA and how to effectively manage the disease.ObjectiveSelf-management-needs scales are one means of determining the management requirements of an individual patient. There is no suitable instrument available for assessing self-management needs of adult patients with knee OA in Taiwan. This study developed an instrument that could assess the self-management needs of knee OA patients using Orem's self-care theory as a theoretical framework.AimsThis study developed and psychometrically tested a new instrument for measuring adult patients’ self-management needs of knee OA (SMNKOA).MethodsDevelopment of the instrument involved three phases: item generation and scale development; content and face validity of the initial instrument; and evaluation of validity and reliability of the new instrument. Participants (n = 372) were purposively sampled from orthopaedic clinics at medical centres in Taiwan.ResultsThe self-care theory guided the development of the 35-item SMNKOA scale. The content validity index was 0.83. Principal components analysis identified a 3-factor solution, accounting for 53.19% of the variance. The divergent validity was –0.67; convergent validity was –0.51. Cronbach's α was 0.95, Pearson correlation coefficient was 0.88, and the intraclass correlation coefficient was 0.95.ConclusionsThe SMNKOA scale can measure and identify the individual self-management needs of knee OA patients. It will help healthcare providers better evaluate strategies that can help these patients cope with this chronic disease.Disclosure of interestThe authors have not supplied their declaration of competing interest.

2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Fereidoun Jahangir ◽  
Esmaeil Kavi ◽  
Behnam Masmouei ◽  
Mohammad-Rafi Bazrafshan ◽  
Hamed Delam ◽  
...  

Background: Diabetes is a global epidemic with serious complication and there is a clear need for paying special attention to self-management as the cornerstone to optimal control of the disease. Objectives: This study aimed to assess the self-management status and its correlation to disease control indicators in people with diabetes. Methods: In a descriptive cross-sectional study, 220 patients were selected from the list of the referred patients available in Lamerd public health network from December 2014 to June 2015. In the first step, data about demographic information and disease control were collected from the patients’ records. In the second step, the self-management status of each patient was assessed by the Diabetes Self-Management Questionnaire developed by Schmitt et al. To analyze the data, independent sample t-test and Pearson correlation coefficient were used. Results: The mean age of the male and female participants was 56.43 ± 13.50 and 56.46 ± 10.49 years old, respectively. The mean duration of the disease was 6.67 ± 4.72 years for men and 7.07 ± 5.30 years for women. Twenty-one (25.9%) men and 60 (43.7%) women had a history of smoking. The results of the Pearson correlation coefficient showed that there was an inverse and statistically significant relationship between diabetes self-management status and weight, body mass index (BMI), waist circumference, glucose tolerance test (GTT), LDL, and cholesterol. The results of the t-test did not show significant differences between the level of HbA1C (HbA1C7) and self-management scores of the patients (P > 0.05). Conclusions: Patients with better self-management status were in a better disease control condition with respect to weight, BMI, waist circumference, GTT, LDL, and cholesterol levels. Special attention to the control and management of LDL, cholesterol, HbA1C, BMI, and blood pressure levels is recommended in planning for these patients.


2016 ◽  
Vol 26 (3) ◽  
pp. 354-372 ◽  
Author(s):  
Mei-Hua Kao ◽  
Yun-Fang Tsai

Self-management of osteoarthritis (OA) of the knee is important for treating this chronic disease. This study developed and psychometrically tested a new instrument for measuring adult patients’ self-management needs of knee osteoarthritis (SMNKOA). The theoretical framework of self-care guided the development of the 35-item SMNKOA scale. Participants ( N = 372) were purposively sampled from orthopedic clinics at medical centers in Taiwan. The content validity index was 0.83. Principal components analysis identified a three-factor solution, accounting for 53.19% of the variance. The divergent validity was −0.67; convergent validity was −0.51. Cronbach’s alpha was .95, Pearson’s correlation coefficient was .88, and the intraclass correlation coefficient was .95. The scale’s reliability and validity supports the SMNKOA, as a tool to measure self-management needs of adults with knee OA. Nurses and other health care providers can use this instrument to evaluate knee OA patients and identify strategies for improving health-related outcomes and patient education.


Author(s):  
Massy Mutumba ◽  
Henry Mugerwa ◽  
Victor Musiime ◽  
Anudeeta Gautam ◽  
Hellen Nakyambadde ◽  
...  

The heightened vulnerability of adolescents to poor HIV care outcomes underscores the need for interventions that create and promote HIV self-management behavioral skills. Adolescents living with HIV (ALHIV) experience a complex array of physical, emotional, and social challenges that constrain their self-care, but the majority of existing psychosocial programs focus primarily on medication adherence. Understanding adolescents’ self-care needs, challenges, and preferences is necessary for developing effective culturally relevant interventions. The involvement of caregivers and stakeholders is also critical to realizing positive self-care outcomes. This article presents the findings from focus group discussions with ALHIV, caregivers, and healthcare providers on self-care. The data were collected as part of formative research in the development of a self-management intervention for Ugandan ALHIV. Participants’ discussions on self-care strategies and intervention approaches provide valuable insights to guide the development of interventions to promote positive HIV care outcomes among Ugandan ALHIV.


2020 ◽  
Author(s):  
Garuth Chalfont ◽  
Céu Mateus ◽  
Sandra Varey ◽  
Christine Milligan

Abstract Background and Objectives Although telehealth research among the general population is voluminous, the quality of studies is low and results are mixed. Little is known specifically concerning older people and their self-efficacy to engage with and benefit from such technologies. This article reviews the evidence for which self-care telehealth technology supports the self-efficacy of older people with long-term conditions (LTCs) living at home. Research Design and Methods Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA) guidelines, this overview of systematic reviews focused on four LTCs and the concept of “self-efficacy.” Quality was appraised using R-AMSTAR and study evaluation was guided by the PRISMS taxonomy for reporting of self-management support. Heterogeneous data evidencing technology-enhanced self-efficacy were narratively synthesized. Results Five included articles contained 74 primary studies involving 9,004 participants with chronic obstructive pulmonary disease, hypertension, heart failure, or dementia. Evidence for self-care telehealth technology supporting the self-efficacy of older people with LTCs living at home was limited. Self-efficacy was rarely an outcome, also attrition and dropout rates and mediators of support or education. The pathway from telehealth to self-efficacy depended on telehealth modes and techniques promoting healthy lifestyles. Increased self-care and self-monitoring empowered self-efficacy, patient activation, or mastery. Discussion and Implications Future research needs to focus on the process by which the intervention works and the effects of mediating variables and mechanisms through which self-management is achieved. Self-efficacy, patient activation, and motivation are critical components to telehealth’s adoption by the patient and hence to the success of self-care in self-management of LTCs. Their invisibility as outcomes is a limitation.


2021 ◽  
Author(s):  
Abhijeet Prasad Sinha ◽  
Manmohan Singhal ◽  
Mansi Gupta ◽  
Ashish Joshi

BACKGROUND Diabetes represents an important public health challenge in India and Globally. It affects quality of life and is one of the leading causes of death and disability. The burden on global health is huge and about 463 million adults are currently living with diabetes. 77 million people in India in the age group of 20-79 years are affected by this pandemic and total cost to health expenditure is 8 billion US dollars, therefore huge burden, and great economic cost on Public health. The self-management of diabetes, the research priorities include exploring the concept of diabetes self-management and major research questions would comprise of asking what affects self-management in persons with diabetes and how do m-health application and interventions can impact on the self-management behaviors in development, utility of the m-health app in self-management of person with diabetes. Therefore, this project research is of great significance and would bring an integrative approach on self-care management OBJECTIVE To design, develop and evaluate the impact of m-health enabled nutrition informatics intervention for home based self-management of type 2 diabetes in an Indian setting. METHODS A mixed research study will be conducted between January 2022 and January 2023. A sample of approximately 250 individuals will be recruited and enrolled using a nonprobability complete enumeration sampling method from selected urban settings of Delhi inclusion and exclusion criteria with age20-79 years male and female with Type 2 diabetes and have access to Smart phone Data will be collected using which questionnaires. The collected data will be used to assess use and utility of mobile health application developed. The knowledge, attitudes, practices, and beliefs regarding Diabetes self-care management. Lastly, the study questionnaire system usability survey(SUS) will be used to assess the usability of mobile applications on selfcare management of Diabetes RESULTS A pilot of 250 individuals has been conducted to pretest the DBMS questionnaire. The data collection will be initiated from January 2022, and the initial results are planned for publication by October 2022.Descriptive analysis of the gathered data will be performed using SPSS V11, and reporting of the results will be done at 95% CIs and P=.0.05. CONCLUSIONS The findings of the study would inform the elements essential for the development of m-health intervention to improve self-care management of diabetes at home settings. The usefulness and acceptance of the proposed intervention will be conducted. CLINICALTRIAL DITU/UREC/2021/07/10


2021 ◽  
Vol 11 (2) ◽  
pp. 177-186
Author(s):  
Made Rini Damayanti ◽  
Gusti Ayu Ary Antari ◽  
Ni Luh Putu Nopriani

Background: Diabetes mellitus is a chronic disease that may pose serious complications if poorly managed. The application of mobile technology (m-health) ranging from simple to more complex programs in diabetes management has the potential to foster patients’ active involvement in their care. However, the evidence of m-health effectiveness on the self-management of type-2 diabetes patients in low- and middle-income countries is still mixed.Purpose: To evaluate the effect of a ten-week short message system (SMS)-based intervention (Tweek SMSDM) on self-management of type-2 diabetes patients.Methods: A quasi-experimental study was performed in two groups. The intervention group (n=30) received additional daily automated messages to enhance their diabetic self-care practice, while the control group (n=30) continued to follow the standard program only. Pre- and post-intervention data were measured in both groups using the Indonesian version of the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire. T-test, Mann-Whitney, Wilcoxon Signed-Ranks, McNemar and Fisher exact tests were carried out to analyze the data.Results: After ten weeks, the intervention group showed significant mean changes in the domains of general diet (0.42±1.08; p=0.034), specific diet (1.75±1.42; p=0.0001), exercise (1.02±1.85; p=0.005), blood-glucose testing (0.53±1.67; p=0.009), and foot care (4.75±2.51; p=0.001) before and after the intervention, while the control group did not. This study also found significant differences in the mean scores for each domain of the SDSCA between the intervention and the control groups (p<0.05).Conclusion: The Tweek SMSDM program can improve the self-management of type-2 diabetes patients and positively affect each domain in the SDSCA. The findings of this study recommend that nurses integrate the program into patient treatment regimes in primary healthcare centers; therefore, patients and their significant others can play more proactive roles in their diabetic care.


2017 ◽  
Vol 12 (1) ◽  
pp. 13
Author(s):  
Alif Farkhanan Nur Laili

Indonesia is the country with the third highest number of leprosy with 16131 patients in 2014 in disability prevalence rate of 6,82 per 1 million inhabitants (MoH RI,2014). East Java is the province with the most cases of leprosy in Indonesia (Ministry of Health, 2014). Pasuruan is one of the areas withhigh leprosy burden with the number of cases reached 175 cases and 16.57% of them have disabilities level 2 (DHO Pasuruan, 2015). Prevention of disability can be done with self-care measures. Factors that support the successful self-care of leprosy patients including the support of family and knowledge of leprosy patients. The purpose of this study to determine the relationship between family support and knowledge with self-care of lepers. This study using cross sectional study design. The sampling technique using simple random sampling and obtained a sample of 46 people. Data were collected by interview. Data analysis using Pearson correlation test. Showed no relationship between family supportwith self-care of leprosy patients with p value of 0.00 < 0.5 with correlation coefficient 0.690. There is a relationship between knowledge and self-care with a 0.00 p value < 0.05 with correlation coefficient 0.691. The need for an optimization program based self-care group families to improve family support,especially in terms of information support.Keywords: self-care of leprosy, family support, knowledge


2022 ◽  
Vol 32 (1) ◽  
Author(s):  
Katelyn R. Smalley ◽  
Lisa Aufegger ◽  
Kelsey Flott ◽  
Erik K. Mayer ◽  
Ara Darzi

AbstractBronchiectasis is an increasingly common chronic respiratory disease which requires a high level of patient engagement in self-management. Whilst the need for self-management has been recognised, the knowledge and skills needed to do so— and the extent to which patients possess these—has not been well-specified. On one hand, understanding the gaps in people’s knowledge and skills can enable better targeting of self-management supports. On the other, clarity about what they do know can increase patients’ confidence to self-manage. This study aims to develop an assessment of patients’ ability to self-manage effectively, through a consensus-building process with patients, clinicians and policymakers. The study employs a modified, online three-round Delphi to solicit the opinions of patients, clinicians, and policymakers (N = 30) with experience of bronchiectasis. The first round seeks consensus on the content domains for an assessment of bronchiectasis self-management ability. Subsequent rounds propose and refine multiple-choice assessment items to address the agreed domains. A group of ten clinicians, ten patients and ten policymakers provide both qualitative and quantitative feedback. Consensus is determined using content validity ratios. Qualitative feedback is analysed using the summative content analysis method. Overarching domains are General Health Knowledge, Bronchiectasis-Specific Knowledge, Symptom Management, Communication, and Addressing Deterioration, each with two sub-domains. A final assessment tool of 20 items contains two items addressing each sub-domain. This study establishes that there is broad consensus about the knowledge and skills required to self-manage bronchiectasis effectively, across stakeholder groups. The output of the study is an assessment tool that can be used by patients and their healthcare providers to guide the provision of self-management education, opportunities, and support.


JMIR Aging ◽  
10.2196/17142 ◽  
2020 ◽  
Vol 3 (1) ◽  
pp. e17142 ◽  
Author(s):  
Sue P Heiney ◽  
Sara B Donevant ◽  
Swann Arp Adams ◽  
Pearman D Parker ◽  
Hongtu Chen ◽  
...  

Background Mobile health (mHealth) apps are dramatically changing how patients and providers manage and monitor chronic health conditions, especially in the area of self-monitoring. African Americans have higher mortality rates from heart failure than other racial groups in the United States. Therefore, self-management of heart failure may improve health outcomes for African American patients. Objective The aim of the present study was to determine the feasibility of using an mHealth app, and explore the outcomes of quality of life, including self-care maintenance, management, and confidence, among African American patients managing their condition after discharge with a diagnosis of heart failure. Methods Prior to development of the app, we conducted qualitative interviews with 7 African American patients diagnosed with heart failure, 3 African American patients diagnosed with cardiovascular disease, and 6 health care providers (cardiologists, nurse practitioners, and a geriatrician) who worked with heart failure patients. In addition, we asked 6 hospital chaplains to provide positive spiritual messages for the patients, since spirituality is an important coping method for many African Americans. These formative data were then used for creating a prototype of the app, named Healthy Heart. Specifically, the Healthy Heart app incorporated the following evidence-based features to promote self-management: one-way messages, journaling (ie, weight and symptoms), graphical display of data, and customized feedback (ie, clinical decision support) based on daily or weekly weight. The educational messages about heart failure self-management were derived from the teaching materials provided to the patients diagnosed with heart failure, and included information on diet, sleep, stress, and medication adherence. The information was condensed and simplified to be appropriate for text messages and to meet health literacy standards. Other messages were derived from interviews conducted during the formative stage of app development, including interviews with African American chaplains. Usability testing was conducted over a series of meetings between nurses, social workers, and computer engineers. A pilot one-group pretest-posttest design was employed with participants using the mHealth app for 4 weeks. Descriptive statistics were computed for each of the demographic variables, overall and subscales for Health Related Quality of Life Scale 14 (HQOL14) and subscales for the Self-Care of Heart Failure Index (SCHFI) Version 6 using frequencies for categorical measures and means with standard deviations for continuous measures. Baseline and postintervention comparisons were computed using the Fisher exact test for overall health and paired t tests for HQOL14 and SCHFI questionnaire subscales. Results A total of 12 African American participants (7 men, 5 women; aged 51-69 years) diagnosed with heart failure were recruited for the study. There was no significant increase in quality of life (P=.15), but clinically relevant changes in self-care maintenance, management, and confidence were observed. Conclusions An mHealth app to assist with the self-management of heart failure is feasible in patients with low literacy, low health literacy, and limited smartphone experience. Based on the clinically relevant changes observed in this feasibility study of the Healthy Heart app, further research should explore effectiveness in this vulnerable population.


2010 ◽  
Vol 13 (2) ◽  
pp. 87-97
Author(s):  
Herni Susanti

AbstrakDefisit perawatan diri pada klien skizofrenia tidak boleh dipandang remeh. Perawat yang terlibat dalam upaya rehabilitasi psikososial perlu memberikan pelayanan kepada klien skizofrenia dengan masalah defisit perawatan diri secara profesional. Salah satu caranya dengan memberikan asuhan keperawatan berdasarkan kerangka teori yang dikembangkan oleh ahli-ahli di bidang keperawatan. Teori self-care (perawatan diri) oleh Orem memiliki penjelasan yang lengkap tentang konsep perawatan diri, defisit perawatan diri, serta tindakan keperawatan untuk mengatasi masalah yang muncul. Dalam konteks rehabilitasi, teori Orem sangat sesuai dengan tujuan rehabilitasi yaitu membantu klien untuk memandirikan klien seoptimal mungkin. AbstractMental health nurses should professionally address the self-care deficit problem in schizophrenic patients, especially in the psychosocial rehabilitation phase. The nursing intervention of the self-care deficit patients can be delivered based on the nursing theoretical framework. The Orem’s self-care theory elucidates the concept of self-care, self-care deficit, and its nursing care. In the rehabilitation context, the Orem’s theory is relevant to the aim of rehabilitation – optimalizing the client’s own daily functional capacities.


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