scholarly journals Compliance of Diabetic Clients: Effect of Nurse-Led Home Care Interventions and Monitoring

2021 ◽  
Author(s):  
K C Leena ◽  
Irene Alvares ◽  
Sonia Karen Liz Sequeira ◽  
Priya Sweety Pereira ◽  
N C Deepika ◽  
...  
Keyword(s):  
Home Care ◽  
Registered Nurses ◽  
Health Care Providers ◽  
Rating Scale ◽  
Dietary Habits ◽  
Diabetes Management ◽  
Nursing Program ◽  
Care Providers ◽  
Glucose Levels ◽  
Significant Difference

Abstract Objectives Type 2 diabetes impacts greatly on quality of life. Health-care providers must focus on efforts to detect, treat, and manage clients through supportive educative approach. This study aims to measure effectiveness of nurse-led home care interventions. Materials and Methods This study among 103 diabetic subjects measured baseline blood pressure (BP), weight, and blood glucose levels. Information on compliance was obtained using a rating scale consisting of domains: dietary habits, exercise, rest, sleep, symptom management, prevention of complications, medication, and follow-up. Individualized comprehensive nursing interventions (education, testing, counselling) were provided, that were reinforced two times a week for 4 weeks, with minimum 7 home visits carried out by the researchers who are registered nurses and teaching faculty along with six interns of BSc nursing program. Post-tests were obtained at second and fourth weeks after start of intervention. Results Significant improvement in blood sugar (p < 0.05), systolic BP (p < 0.001), and diastolic BP (p < 0.001) was observed. There was no change in body mass index (BMI) (p > 0.05). Post-hoc analysis found significant difference between pre-, post1- and post2-measures. Significant association was found between dietary habits and BMI (p < 0.05) and diastolic BP (p < 0.05). Compliance improved from 29 (28.2%) to 47(45.6%), partially compliant from 55 (53.4%) to 45 (43.7%) and noncompliant 19 (18.4%) to 11 (10.7%), with a clear improvement in each of the domains of compliance. Conclusion Individualized comprehensive interventions delivered at the natural environment of families by registered nurses effectively improve compliance to diabetes management.

The Use of Mobile Apps to Improve Diabetes Self-Management: A Cross-Sectional Study (Preprint)

2021 ◽  
Author(s):  
Satoshi Inagaki ◽  
Kenji Kato ◽  
Kozue Abe ◽  
Takeshi Kawamoto ◽  
Hiroaki Takahashi ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Diabetes Management ◽  
The Self ◽  
Walking Distance ◽  
Self Management ◽  
Care Providers ◽  
Management Behavior ◽  
Cross Sectional ◽  
Significant Difference ◽  
Management Behaviors

BACKGROUND Background: Healthcare apps on smartphones are used to retrieve health information and manage health. A number of healthcare apps have been employed to support diabetes self-management, and evidence has accumulated on the outcomes of interventions using individual apps. However, only a small percentage of all healthcare apps have a proven effect on people with diabetes, and it is unclear which apps should be recommended in non-English-speaking countries. Verifying that the healthcare apps used by people with diabetes are useful for diabetes management behaviors will help healthcare providers know which apps to recommend. OBJECTIVE Objective: The purpose of this study was to clarify whether and how the use of healthcare apps affects the self-management behavior of people with diabetes. METHODS Methods: A cross-sectional questionnaire was given to patients with type 2 diabetes who were pre-registered with an Internet research company. The items on the questionnaire involved the use of smartphone healthcare apps, diabetes self-management behaviors (Japan Summary of Diabetes Self-Care Activities [J-SDSCA]), motivations for diabetes self-management (autonomous motivation and controlled motivation), and feelings of competence in self-management (Perceived Competence for Diabetes Scale). To examine whether a healthcare app had an effect on the self-management behavior score, a multiple regression analysis was conducted with the J-SDSCA score as the objective variable. RESULTS Results: Of the 253 participants, 61 (24.1%) indicated that they were currently using a healthcare app. Those using a healthcare app had a significantly higher J-SDSCA score than those not using one (beta =.15, 95% CI 0.60–3.54, P <.001). Regarding the frequency of exercise, the use of apps for steps and walking distance led to a significant difference (beta =.22, 95% CI 0.59–1.90, P <.001). For general diet, the use of any healthcare app had no significant effect (P =.22). CONCLUSIONS Conclusions: The use of healthcare apps was beneficial for diabetes self-management. Given that even non-specialized apps can improve diabetes self-management behaviors, health care providers should encourage patients to use apps that are tailored to their preferences and that are easy to use long-term. The use of healthcare apps was particularly associated with increased exercise regimen efforts. Recommending the use of healthcare apps, especially apps that include pedometers, could be useful when patients have problems with exercise.

scholarly journals Effects of COVID-19 lockdown on managing diabetes mellitus among Sudanese insulin pump users, A study from Sudan

2021 ◽  
Author(s):  
Esraa Hassan Salih ◽  
Khabab Abbasher Hussien Mohamed Ahmed ◽  
Mohammed Eltahier Abdalla Omer ◽  
Omer Osman Babiker ◽  
Malaz Tarig Abdalla Mohamed ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Health Care Providers ◽  
Dietary Habits ◽  
Diabetes Management ◽  
Insulin Pump ◽  
Average Duration ◽  
Healthcare Providers ◽  
Phone Call ◽  
Care Providers ◽  
Cross Sectional

Abstract Background: COVID-19 lockdown has affected diabetes management among the insulin pump users by changing their life style, affected their mental health, limited diabetes and insulin pump supplies and more difficult communication with the healthcare providersObjectives: The aim of this research is to study the effects of COVID-19 lockdown on managing diabetes mellitus among Sudanese insulin pump users, SudanMethods: This study was a descriptive cross-sectional study, Community based in Shimaa medical CO. LTD. A 26 insulin pump users were chosen by total coverage and the data was collected throughout phone call interviews. All statistical analyses were performed using IBM SPSS Statistics software, version 20.Results: The mean age of 22 participants was 25.3 ± 17.2 years, and the majority (63.6%) were females. The average duration of diabetes was 6.9 ± 3.9 years, and the average duration of insulin pump use was 3 ± 1 years. Of the 22 patients (90.9%) used glucometer for monitoring blood sugar. 9 (40.9%) were less subjective to depression, 9 (40.9%) had moderate susceptibility to have depression. Most of the patients have unchanged adherence to the insulin pump behaviours, carb counting (63.6%), boluswizard during mealtime (68.2%), and bolus wizard for hyperglycemia correction (68.2%), self-monitoring of blood glucose (40.9 %). (40.9%) of the patients had scheduled phone call appointments, 5 patients (22.7%) received virtual education (VE) from the insulin pump technician. 12 patients (54.5%) reported difficult obtaining at least one type of insulin pump supply.Conclusion: COVID-19 lock down has led to the decrease in physical activity with unchanged dietary habits. Getting the insulin pump supplies was difficult for most of the patient’s, and there was shortage and increase prices for diabetes care supplies. Telemedicine should be considered seriously to ease the communication between the patients and the health care providers.

scholarly journals Health-related quality of life of pharmacists in the pre-COVID-19 era

2020 ◽  
Author(s):  
Magdalena Kurnik-Łucka ◽  
Paweł Pasieka ◽  
Agnieszka Górecka-Mazur ◽  
Elżbieta Rząsa-Duran ◽  
Jakub Pękala ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care Providers ◽  
Health Survey ◽  
Dietary Habits ◽  
Short Form ◽  
Care Providers ◽  
Sf 36 ◽  
Significant Difference ◽  
Related Quality

Abstract Background pharmacists remain on the frontline of public health around the globe and their performance directly impacts patients’ safety. So far, to our knowledge, no European study has been dedicated to their heath-related quality of life (HQoL). Therefore, the primarily aim of our study was to evaluate HQoL of Polish pharmacists utilizing the SF-36 health survey with regard to anthropometric and lifestyle-related variables. Methods a total sample screened consisted of 1412 respondents, yet 765 pharmacists (mean age 40, 86.3% females) finally participated in the study. HQoL was assessed with the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36). Results the lowest median scores were noted for general health (GH, 50.0) and vitality (V, 60.0) domains. No gender differences regarding physical and mental summary scores were found. Significant difference of HQoL was found among the assessed age groups in several domains, especially physical functioning (PF) and GH (p < 0.001) scores, and especially in the group of 51-60-year-old-respondents. Correlations were found between PF (r=-0.29,p < 0.001), GH (r=-0.25,p < 0.001) and age as well PF (r=-0.27,p < 0.001), GH (r=-0.21,p < 0.001) and BMI. Self-assessed dietary habits were correlated with PF (r = 0.22,p < 0.001), mental health (r = 0.25,p < 0.001), GH (r = 0.27,p < 0.001) and V (r = 0.30, p < 0.001) scores. Conclusions our analysis indicates that pharmacists tend to have similar mental and physical burden according to SF-36, with age, BMI and dietary habits as predominant factors influencing their HQoL. The study presents unique values for future comparative analyses related, for instance, to the influence of the ongoing pandemic on HQoL of health-care providers.

scholarly journals A descriptive analysis of end-of-life discussions for high-grade glioma patients

2021 ◽  
Author(s):  
Ai Chikada ◽  
Sayaka Takenouchi ◽  
Yoshiki Arakawa ◽  
Kazuko Nin
Keyword(s):  
End Of Life ◽  
Health Care Providers ◽  
Patient Participation ◽  
High Grade Glioma ◽  
Team Approach ◽  
High Grade ◽  
Care Providers ◽  
Patient Goals ◽  
Significant Difference ◽  
Eol Care

Abstract Background End-of-life discussions (EOLDs) in patients with high-grade glioma (HGG) have not been well described. Therefore, this study examined the appropriateness of timing and the extent of patient involvement in EOLDs and their impact on HGG patients. Methods A cross-sectional survey was conducted among 105 bereaved families of HGG patients at a university hospital in Japan between July and August 2019. Fisher’s exact test and the Wilcoxon rank-sum test were used to assess the association between patient participation in EOLDs and their outcomes. Results In total, 77 questionnaires were returned (response rate 73%), of which 20 respondents replied with refusal documents. Overall, 31/57 (54%) participated in EOLDs at least once in acute hospital settings, and a significant difference was observed between participating and nonparticipating groups in communicating the patient’s wishes for EOL care to the family (48% vs 8%, P = .001). Moreover, &gt;80% of respondents indicated that the initiation of EOLDs during the early diagnosis period with patients and families was appropriate. Most EOLDs were provided by neurosurgeons (96%), and other health care providers rarely participated. Additionally, patient goals and priorities were discussed in only 28% of the EOLDs. Patient participation in EOLDs was not associated with the quality of EOL care and a good death. Conclusions Although participation in EOLDs is relatively challenging for HGG patients, this study showed that participation in EOLDs may enable patients to express their wishes regarding EOL care. It is important to initiate EOLDs early on through an interdisciplinary team approach while respecting patient goals and priorities.

scholarly journals The Role of Obesity in Predicting the Clinical Outcomes of COVID-19

Obesity Facts ◽  
2021 ◽  
pp. 1-9
Author(s):  
Serdar Sahin ◽  
Havva Sezer ◽  
Ebru Cicek ◽  
Yeliz Yagız Ozogul ◽  
Murat Yildirim ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Health Care Providers ◽  
Study Groups ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Care Providers ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Group D

<b><i>Introduction:</i></b> The aim of this was to describe the predictors of mortality related to COVID-19 infection and to evaluate the association between overweight, obesity, and clinical outcomes of COVID-19. <b><i>Methods:</i></b> We included the patients &#x3e;18 years of age, with at least one positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction. Patients were grouped according to body mass index values as normal weight &#x3c;25 kg/m<sup>2</sup> (Group A), overweight from 25 to &#x3c;30 kg/m<sup>2</sup> (Group B), Class I obesity 30 to &#x3c;35 kg/m<sup>2</sup> (Group C), and ≥35 kg/m<sup>2</sup> (Group D). Mortality, clinical outcomes, laboratory parameters, and comorbidities were compared among 4 groups. <b><i>Results:</i></b> There was no significant difference among study groups in terms of mortality. Noninvasive mechanical ventilation requirement was higher in group B and D than group A, while it was higher in Group D than Group C (Group B vs. Group A [<i>p</i> = 0.017], Group D vs. Group A [<i>p</i> = 0.001], and Group D vs. Group C [<i>p</i> = 0.016]). Lung involvement was less common in Group A, and presence of hypoxia was more common in Group D (Group B vs. Group A [<i>p</i> = 0.025], Group D vs. Group A [<i>p</i> &#x3c; 0.001], Group D vs. Group B [<i>p</i> = 0.006], and Group D vs. Group C [<i>p</i> = 0.014]). The hospitalization rate was lower in Group A than in the other groups; in addition, patients in Group D have the highest rate of hospitalization (Group B vs. Group A [<i>p</i> &#x3c; 0.001], Group C vs. Group A [<i>p</i> &#x3c; 0.001], Group D vs. Group A [<i>p</i> &#x3c; 0.001], Group D vs. Group B [<i>p</i> &#x3c; 0.001], and Group D vs. Group C [<i>p</i> = 0.010]). <b><i>Conclusion:</i></b> COVID-19 patients with overweight and obesity presented with more severe clinical findings. Health-care providers should take into account that people living with overweight and obesity are at higher risk for COVID-19 and its complications.

scholarly journals Care-seeking and managing diabetes in rural Bangladesh: a mixed methods study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hannah Maria Jennings ◽  
Joanna Morrison ◽  
Kohenour Akter ◽  
Hassan Haghparast-Bidgoli ◽  
Carina King ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Health Care Providers ◽  
Low Income ◽  
Diabetes Management ◽  
Local Health ◽  
Care Seeking ◽  
Care Providers ◽  
Structured Interviews ◽  
Rural Bangladesh

Abstract Background Type 2 diabetes mellitus poses a major health challenge worldwide and in low-income countries such as Bangladesh, however little is known about the care-seeking of people with diabetes. We sought to understand the factors that affect care-seeking and diabetes management in rural Bangladesh in order to make recommendations as to how care could be better delivered. Methods Survey data from a community-based random sample of 12,047 adults aged 30 years and above identified 292 individuals with a self-reported prior diagnosis of diabetes. Data on health seeking practices regarding testing, medical advice, medication and use of non-allopathic medicine were gathered from these 292 individuals. Qualitative semi-structured interviews and focus group discussions with people with diabetes and semi-structured interviews with health workers explored care-seeking behaviour, management of diabetes and perceptions on quality of care. We explore quality of care using the WHO model with the following domains: safe, effective, patient-centred, timely, equitable and efficient. Results People with diabetes who are aware of their diabetic status do seek care but access, particularly to specialist diabetes services, is hindered by costs, time, crowded conditions and distance. Locally available services, while more accessible, lack infrastructure and expertise. Women are less likely to be diagnosed with diabetes and attend specialist services. Furthermore costs of care and dissatisfaction with health care providers affect medication adherence. Conclusion People with diabetes often make a trade-off between seeking locally available accessible care and specialised care which is more difficult to access. It is vital that health services respond to the needs of patients by building the capacity of local health providers and consider practical ways of supporting diabetes care. Trial registration ISRCTN41083256. Registered on 30/03/2016.

scholarly journals A comparison of women’s expectations of labour and birth with the experiences in primiparas and multiparas with normal vaginal delivery

2016 ◽  
Vol 4 (1) ◽  
pp. 16-25 ◽  
Author(s):  
Manijeh Pirdil ◽  
Leila Pirdel
Keyword(s):  
Health Care ◽  
Vaginal Delivery ◽  
Health Care Providers ◽  
Normal Vaginal Delivery ◽  
Care Providers ◽  
Medical College ◽  
Childbirth Experience ◽  
Significant Difference ◽  
Negative Expectations

Background: Maternal childbirth expectations play an important role in determining a woman’s response to her childbirth experience. Women need to be helped to develop realistic and positive expectations and identify the factors that influence these expectations.Objective: The aim of this study was to compare woman’s expectations and experiences of childbirth.Methods: This descriptive-comparative study was carried out in Tabriz Alzahra Hospital from 2006 to 2007. For this purpose, a total of 600 primiparas and multiparas women who were candidates for vaginal delivery, were randomly selected and interviewed. The data were collected by questionnaire.Results: Comparison of the means of mothers expectation and experience of labor and birth between the two groups demonstrated a statistically significant difference (p<0.05). The findings indicated a number of differences exist between primiparas and multiparas women in relation to expectations and experiences of birth when compare two groups. The majority of women had negative expectations and experiences of childbirth.Conclusion: The evaluation and understanding of birth expectations and experiences as positive and negative is priority of maternity system. Antenatal educators need to ensure that pregnant women are appropriately prepared for what might actually happen to limit this expectation-experience gap. Health-care providers should improve the quality of antenatal care which can change negative childbirth expectations and experiences of womenJournal of Kathmandu Medical College, Vol. 4(1) 2015, 16-25

scholarly journals The Effect of "Pathway" to Diagnosis for Childhood ITP on Caregiver Quality of Life at Time of Diagnosis

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 2174-2174
Author(s):  
Michelle Neier ◽  
Michele P. Lambert ◽  
Rachael F. Grace ◽  
Kerry Hege ◽  
Stephanie Chiu ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Provider ◽  
Health Care Providers ◽  
Care Provider ◽  
Research Funding ◽  
Care Providers ◽  
Significant Difference ◽  
Time To Diagnosis ◽  
The Impact

Background: Immune thrombocytopenia (ITP) is an immune mediated bleeding disorder characterized by isolated thrombocytopenia. ITP can have a variety of presentations from asymptomatic to life threatening bleeding. Although childhood ITP is most often a self-resolving illness which can be closely observed without intervention, it can be associated with significant impact on quality of life (QoL). Prospective studies of QoL in ITP patients show that there is not always a correlation with treatment or disease severity. The pathway from initial presentation to final diagnosis varies and may include encounters with emergency room, primary care or specialty providers. There have been no published studies to date showing the impact of factors prior to the diagnosis of ITP on treatment decision making and QoL. Objective: To identify the role of physician-patient and physician-caregiver interactions on the QoL and emotional well-being of patients and their families. Ascertaining the impact of pre-diagnosis factors may provide an opportunity to improve access and quality of care provided. Methods: The ITP Consortium of North America (ICON) "Pathways" study was a multicenter observational prospective cohort study focused on the pathways to diagnosis of ITP. The study was supported by a Foundation for Morristown Medical Center Research Fund Grant. Subjects were included if they had presumed primary ITP and were age >12 months to <18 years. Subjects were excluded if they had secondary ITP, including Evans syndrome. Treatment was determined by the physician. Subjects were consented and presented with questionnaires to be completed at the conclusion of the initial hematology visit. The hematologist also completed survey data at that time. Survey data forms included demographic form, physician form, Peds QL Family Impact Questionnaire, Kids ITP tools (KIT) Parent Impact Report and parent proxy report, and child (patient) KIT self-report. There was a parent questionnaire which included a question about worry with a scale from 0 to 10. Study data were collected and managed using REDCap electronic data capture tools hosted at Atlantic Health System. Correlation between variables were calculated using Pearson coefficient or Spearman's rho depending on the distribution of the data variables. Results: Sixty subjects and caregivers were enrolled at 6 ICON centers; 52 were eligible for inclusion. The majority (40%) had Grade 1 bleeding. Most patients (82%) were seen in outpatient hematology clinic by the hematologist and had been referred by the emergency room (73%). The median time to consultation with a hematologist from onset of symptoms was 7 days (1-199) and the median time to diagnosis by hematologist from initial contact with a health care provider was 5 days (0-154). Most subjects had seen 2 health care providers prior to the hematologist. KIT proxy report cumulative scores were a mean of 76.03 (SD 14.72). There was no significant difference between the time to diagnosis or the time from initial encounter with health care provider to hematologist and initial level of worry (p=0.70 and 0.90, respectively). There was also no significant difference between the time to diagnosis or the time from initial encounter with health care provider to hematologist and KIT proxy scores (p=0.96 and 0.50, respectively). However, there was a significant decline in level of worry (scale 0-10) prior to the hematologist visit (median 8, range 1-10) to after the visit (median 4, range 1-10). The association between number of medical providers encountered prior to diagnosis and KIT proxy scores was not significant (p=0.45) (Table). Conclusions: In this study at 6 teaching institutions, we were unable to detect a significant difference in proxy-reported KIT scores relative to the number of health care providers seen or time from diagnosis until the first encounter with the hematologist. We were, however, able to detect a significant change in the level of caregiver worry pre- and post- visit with the pediatric hematologist, supporting a benefit of specialist care to the caregivers of children with ITP. This study was limited by its small sample size and retrospective design. ITP is considered a benign disease but is associated with a significant amount of worry and impact on QoL for patients and caregivers which warrants further investigation. Disclosures Lambert: CSL Behring: Consultancy; Amgen: Consultancy, Other; Bayer: Other: Ad boards; Novartis: Other: Ad boards, Research Funding; Shionogi: Consultancy; Kedrion: Consultancy; Sysmex: Consultancy; AstraZeneca: Research Funding; PDSA: Research Funding. Grace:Agios Pharmaceuticals, Inc: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Novartis: Research Funding.

scholarly journals Preclinical and clinical validation of a novel injected molded swab for molecular assay detection of SARS-CoV-2 virus

2021 ◽  
Author(s):  
Chiara Elia Ghezzi ◽  
Devon R Hartigan ◽  
Justin Hardick ◽  
Rebecca Gore ◽  
Miryam Adelfio ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Medical Devices ◽  
Clinical Studies ◽  
Nasal Swab ◽  
Cost Effective ◽  
Slight Reduction ◽  
Care Providers ◽  
Significant Difference ◽  
Injection Molded

During the COVID-19 public health emergency, many actions have been undertaken to help ensure that patients and health care providers had timely and continued access to high-quality medical devices to respond effectively. The development and validation of new testing supplies and equipment, including collection swab, help expand the availability and capability for various diagnostic, therapeutic, and protective medical devices in high demand during the COVID-19 emergency. Here, we report the validation of a new injection-molded anterior nasal swab, ClearTip™, that was experimentally validated in a laboratory setting as well as in independent clinical studies in comparison to gold standard flocked swabs. We have also developed an in vitro anterior nasal tissue model, that offers an efficient and clinically relevant validation tool to replicate with high fidelity the clinical swabbing workflow, while being accessible, safe, reproducible, time and cost effective. ClearTi™ displayed a greater efficiency of release of inactivated virus in the benchtop model, confirmed by greater ability to report positive samples in a clinical study in comparison to flocked swabs. We also quantified in multi-center pre-clinical and clinical studies the detection of biological materials, as proxy for viral material, that showed a statistically significant difference in one study and a slight reduction in performance in comparison to flocked swabs. Taken together these results underscore the compelling benefits of non-absorbent injected molded anterior nasal swab for COVID-19 detection, comparable to standard flocked swabs. Injection-molded swabs, as ClearTip™, could have the potential to support future swab shortage, due to its manufacturing advantages, while offering benefits in comparison to highly absorbent swabs in terms comfort, limited volume collection, and potential multiple usage.

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