Self-Care and Its Predictive Factors in Hemodialysis Patients

Introduction: Chronic kidney disease is a serious problem and patients need active self-care. This study focuses on the relationship between self-care and its predictive factors in hemodialysis (HD) patients. Methods: This multicenter correlational study was conducted on 201 HD patients referring to HD centers in the west of Tehran, Iran. A multi-stage sampling method was used to select the samples. Data were collected using self-care Scale, Paloutzian-Ellison Spiritual Well-Being Scale, and Connor Davidson Resilience Questionnaires. Data were analyzed using SPSS software version 13 and descriptive statistics and linear regression with stepwise method. Results: The mean (SD) scores of self-care, resilience, and spiritual well-being were 35.5 (5.69), 53.4 (12.94), and 97.4 (17.9), respectively. Univariate analysis showed that self-care had a statistically significant relationship with gender, occupation, education, being diabetic, and hyperlipidemia. Self-care positively correlated with the resilience and negatively correlated with age. Multivariate regression indicated that the resilience (β=0.78, P=0.001), being diabetic (β=-0.09, P=0.01), and age (β=-0.11, P=0.005) could be predictors of self-care. These variables accounted for 78% of variance in self-care in HD patients. Conclusion: Our results showed that resilience was positively correlated with self–care, but being diabetic and age were negatively correlated with self-care in HD patients. Therefore, the health care providers should pay more attention to HD patients who are diabetic and older, as they are at a higher risk of having impaired self-care.

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Flourishing Despite Migraines: A Nationally Representative Portrait of Resilience and Mental Health among Canadians

10.30756/ahmj.2021.05.02 ◽

2021 ◽

Author(s):

Esme Fuller-Thomson

Keyword(s):

Mental Health ◽

Health Care Providers ◽

Mental Health Problems ◽

Secondary Analysis ◽

Well Being ◽

Care Providers ◽

Physical And Mental Health ◽

History Of ◽

Nationally Representative ◽

The Relationship

Objective 1) To examine the relationship between migraine status and complete mental health (CMH) among a nationally representative sample of Canadians; 2) To identify significant correlates of CMH among those with migraine. Methods Secondary analysis of the nationally representative Canadian Community Health Survey – Mental Health (CCHS-MH) (N=21,108). Bivariate analyses and a series of logistic regression models were performed to identify the association between migraine status and CMH. Significant correlates of CMH were identified in the sample of those with migraine (N=2,186). Results Individuals without a history of migraine had 72% higher odds of being in CMH (OR=1.72; 95% CI=1.57, 1.89) when compared with those with a history of migraine. After accounting for physical health and mental health problems, the relationship between migraine status and CMH was reduced to non-significance, with both groups having an approximately equal likelihood of achieving CMH (OR=1.03; 05% CI=(0.92, 1.15). Among those with migraine, factors that were strongly associated with CMH were a lack of a history of depression, having a confidant, and having an income of $80,000 or more. Conclusion Clinicians and health care providers should also address co-occurring physical and mental health issues to support the overall well-being of migraineurs.

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Managing Cancer and Living Meaningfully (CALM) Therapy

Psycho-Oncology ◽

10.1093/med/9780190097653.003.0064 ◽

2021 ◽

pp. 502-508

Author(s):

Sarah Hales ◽

Gary Rodin

Keyword(s):

Health Care Providers ◽

Affect Regulation ◽

Symptom Management ◽

Quantitative Research ◽

Well Being ◽

Care Providers ◽

Safe Place ◽

The Future ◽

Spiritual Well Being ◽

Relational Attachment

Managing Cancer and Living Meaningfully (CALM) is a brief, semistructured individual intervention designed to alleviate distress and to promote psychological growth in individuals with advanced disease. This intervention emerged from a longitudinal program of research and from the theoretical traditions of relational, attachment, and existential theory. Through a process that supports affect regulation, attachment security, and reflective functioning, CALM focuses on four content domains: (1) symptom management and communication with health care providers; (2) changes in self and relations with close others; (3) spiritual well-being, sense of meaning, and purpose; and (4) preparing for the future, sustaining hope, and facing mortality. Caregivers are invited to one or more CALM sessions, during which communication, relational strengths and disruptions, and hopes and fears related to the present and to the future are addressed. Qualitative research has shown that the structure of CALM provides a safe place for cancer patients to explore their fears, to be seen in human terms, and to face the challenges and threats of advancing disease. Quantitative research has shown that compared to usual care, it leads to significantly greater reduction in and prevention of depressive symptoms and improvement in death preparation. Therapist skill in the delivery of CALM is developed through didactic and experiential workshops and by ongoing supervision.

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Moderation Effects of Substance Use on Physical and Mental Well-Being in Adults

Journal of the American Psychiatric Nurses Association ◽

10.1177/10783903211052089 ◽

2021 ◽

pp. 107839032110520

Author(s):

Mercy Ngosa Mumba ◽

Alexandria Nancarrow ◽

Jessica L. Jaiswal ◽

Erika Hocchaus ◽

Madelyn H. Campbell ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Substance Use ◽

Health Care Providers ◽

Mental Health Problems ◽

Well Being ◽

Health Problems ◽

Care Providers ◽

Mental Well Being ◽

The Relationship

BACKGROUND: Each year about one in five adults experiences mental illness. Although the independent physical and mental health consequences of alcohol misuse and cigarette smoking are well documented, little is known on how substance use moderates the relationship between physical and mental well-being. OBJECTIVE: The purpose of this study was to examine whether substance use moderates the relationship between physical activity and mental health in adults. METHODS: This was a secondary analysis of data provided by the Behavioral Risk Factor Surveillance System (BRFSS). RESULTS: Participants ( N = 450,016) were adults who completed the BRFSS in 2017. Those who did not drink alcohol had fewer mental health problems when they indicated greater amounts of time spent doing physical activities each week. Last, smokers’ number of mental health problems decreased as they engaged in more physical activity, whereas nonsmokers’ number of mental health problems increased as they engaged in more physical activity. CONCLUSIONS: The relationship between physical activity and mental health outcomes is well established and cannot be overemphasized. Nonetheless, substance abuse can moderate this relationship and should be routinely screened for by health care providers regardless of treatment setting.

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The Correlation Between Self-Care Behavior with Application of Eastern Wisdom and Resilience Among Village Health Volunteers: A Cross-Sectional Study in Southern Thailand

Journal of Population and Social Studies ◽

10.25133/jpssv302022.015 ◽

2022 ◽

Vol 30 ◽

pp. 240-250

Author(s):

Kenika Jiratchayaporn ◽

◽

Wilawan Christraksa ◽

Pattraporn Worrasirinara ◽

◽

...

Keyword(s):

Health Care Providers ◽

Demographic Data ◽

Self Care ◽

Care Providers ◽

Positive Correlation ◽

Southern Thailand ◽

Village Health Volunteers ◽

The Relationship ◽

Care Behavior ◽

Village Health

The job of village health volunteers (VHVs) is to coordinate between Thai government departments and the public. Such work can lead to boredom, discouragement, and physical and mental exhaustion. Therefore, strengthening the positive ability of VHVs can help them cope with fatigue. It is essential to continue supporting VHVs; consequently, it is necessary to incorporate Eastern wisdom into healthcare provided for village health volunteers. Purposive sampling was used in this descriptive research to study the relationship between self-care behaviors by applying Eastern wisdom to support and enhance the mental strength of the VHVs. The sample consisted of 77 VHVs in Southern Thailand. Demographic data questionnaire, self-care behavior questionnaire by applying Eastern wisdom, and resilience questionnaire were used to collect data. Pearson’s correlation was used to analyze data. The relationship between self-care behavior by applying Eastern wisdom and resilience was found to have a statistically significant positive correlation (r = .246, p < .05). The relationship between self-care behavior by applying Eastern wisdom and resilience in this study was weak, but there was a positive correlation. Thus, health care providers should promote and integrate Eastern wisdom into self-care activities with VHVs.

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Patient, Caregiver, and Provider Perspectives on Challenges and Solutions to Individualization of Care in Hemodialysis: A Qualitative Study

Canadian Journal of Kidney Health and Disease ◽

10.1177/2054358120970715 ◽

2020 ◽

Vol 7 ◽

pp. 205435812097071

Author(s):

Rachelle Sass ◽

Juli Finlay ◽

Krista Rossum ◽

Kaytlynn V. Soroka ◽

Michael McCormick ◽

...

Keyword(s):

Health Care ◽

Qualitative Study ◽

Focus Groups ◽

Health Care Providers ◽

Self Care ◽

Well Being ◽

Treatment Goals ◽

Care Providers ◽

Provider Perspectives ◽

Set Up

Background: Clinical settings often make it challenging for patients with kidney failure to receive individualized hemodialysis (HD) care. Individualization refers to care that reflects an individual’s specific circumstances, values, and preferences. Objective: This study aimed to describe patient, caregiver, and health care professional perspectives regarding challenges and solutions to individualization of care in people receiving in-center HD. Design: In this multicentre qualitative study, we conducted focus groups with individuals receiving in-center HD and their caregivers and semi-structured interviews with health care providers from May 2017 to August 2018. Setting: Hemodialysis programs in 5 cities: Calgary, Edmonton, Winnipeg, Ottawa, and Halifax. Participants: Individuals receiving in-center HD for more than 6 months, aged 18 years or older, and able to communicate in English were eligible to participate, as well as their caregivers. Health care providers with HD experience were recruited using a purposive approach and snowball sampling. Methods: Two sequential methods of qualitative data collection were undertaken: (1) focus groups and interviews with HD patients and caregivers, which informed (2) individual interviews with health care providers. A qualitative descriptive methodology guided focus groups and interviews. Data from all focus groups and interviews were analyzed using conventional content analysis. Results: Among 82 patients/caregivers and 31 health care providers, we identified 4 main themes: session set-up, transportation and parking, socioeconomic and emotional well-being, and HD treatment location and scheduling. Particular challenges faced were as follows: (1) session set-up: lack of preferred supplies, machine and HD access set-up, call buttons, bed/chair discomfort, needling options, privacy in the unit, and self-care; (2) transportation and parking: lack of reliable/punctual service, and high costs; (3) socioeconomic and emotional well-being: employment aid, finances, nutrition, lack of support programs, and individualization of treatment goals; and (4) HD treatment location and scheduling: patient displacement from their usual spot, short notice of changes to dialysis time and location, lack of flexibility, and shortages of HD spots. Limitations: Uncertain applicability to non-English speaking individuals, those receiving HD outside large urban centers, and those residing outside of Canada. Conclusions: Participants identified challenges to individualization of in-center HD care, primarily regarding patient comfort and safety during HD sessions, affordable and reliable transportation to and from HD sessions, increased financial burden as a result of changes in functional and employment status with HD, individualization of treatment goals, and flexibility in treatment schedule and self-care. These findings will inform future studies aimed at improving patient-centered HD care.

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Factors Predicting Spiritual Well-Being among Dependent Older People

Trends in Sciences ◽

10.48048/tis.2022.1718 ◽

2022 ◽

Vol 19 (1) ◽

pp. 1718

Author(s):

Doungmon Trapsinsaree ◽

Linchong Pothiban ◽

Rojanee Chintanawat ◽

Tipaporn Wonghongkul

Keyword(s):

Social Support ◽

Older People ◽

Health Care Providers ◽

Religious Belief ◽

Well Being ◽

Religious Practice ◽

Self Esteem ◽

Care Providers ◽

Study Results ◽

Spiritual Well Being

Spiritual well-being is a deep feeling within the mind that represents peacefulness and the inner strength of individuals, resulting from an understanding of the nature of life and acceptance of changes occurring to themselves. Spiritual well-being is; therefore, very important to dependent older people. The objectives of this study were to identify the levels of spiritual well-being of dependent older people, to examine the relationships between religious belief, religious practice, self-esteem, social support, depression, and spiritual well-being, and to examine the ability of those factors to predict spiritual well-being among dependent older people. The study sample were 395 of people aged 60 years and above who are dependent and live in three provinces in southern Thailand. Data were collected using questionnaires, including the Spiritual Well-Being Scale for Dependent Older People, Thai version of the Rosenberg Self-Esteem Scale, Thai version of the Multidimensional Scale of Perceived Social Support, Thai Geriatric Depression Scale, the Religious Practices Questionnaire, and the Buddhist Belief Questionnaire. Data were analyzed using descriptive statistics, Spearman’s rank correlation coefficient, and multiple regression analysis. The study results were as follows: 1) The spiritual well-being among dependent older people was at a moderate level (x̅ = 46.97, SD = 7.22). 2) Religious belief, religious practice, self-esteem, and social support significantly related positively to spiritual well-being (p < 0.01), while depression significantly related negatively to spiritual well-being (p < 0.01). 3) Religious belief, self-esteem, and social support together could explain 46.00 % of the variance in spiritual well-being. The results of this study can be used by nurses and health care providers to determine interventions for enhancing spiritual well-being in this particular group of older people. HIGHLIGHTS Spiritual well-being is one of the important dimensions of holistic care. Spiritual well-being has a positive effect on physical, mental and social health The conceptual framework is guided by the Buddhism Principles Religious belief, self-esteem, and social support together could explain 46.00 % of the variance in spiritual well-being

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Parity and Maternal Illness and the Incidence of Imminent Abortion

Jurnal Kesehatan Masyarakat ◽

10.15294/kemas.v14i1.11166 ◽

2018 ◽

Vol 14 (1) ◽

pp. 56-61

Author(s):

Layla Fadhilah Rangkuti ◽

Delfi Lutan ◽

Sri Rahayu Sanusi

Keyword(s):

Health Care Providers ◽

Univariate Analysis ◽

Case Control ◽

Bivariate Analysis ◽

Care Providers ◽

Chi Square ◽

Maternal Illness ◽

Chi Square Test ◽

Relationship Of ◽

The Relationship

Imminent abortion is the first stage abortion and a threat of abortion. Most of the studies stated that the incidence of abortion is 15-20% of all pregnancies. Complication in imminent abortion is bleeding or infection which can cause mortality. The objective of this research was to analyze the relationship of parity and maternal illness with the incidence of imminent abortion. The research used observational analytic study with case-control design. The samples were 100 participants. The data were analyzed by using univariate analysis and bivariate analysis with chi square test. The result of the bivariate analysis with chi square test showed that there was significant association of parity (p=0.0001) and maternal illness (p=0.0001) on the incidence of imminent abortion. It is recommended that health care providers can detect abortion earlier and also provide counseling for pregnant women about imminent abortion.

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Testing the Treatment Integrity of the Managing Cancer and Living Meaningfully Psychotherapeutic Intervention for Patients With Advanced Cancer

Frontiers in Psychology ◽

10.3389/fpsyg.2020.561997 ◽

2020 ◽

Vol 11 ◽

Author(s):

Susan Koranyi ◽

Rebecca Philipp ◽

Leonhard Quintero Garzón ◽

Katharina Scheffold ◽

Frank Schulz-Kindermann ◽

...

Keyword(s):

Health Care ◽

Advanced Cancer ◽

Health Care Providers ◽

Treatment Integrity ◽

Controlled Trial ◽

Well Being ◽

Care Providers ◽

Counseling Intervention ◽

Spiritual Well Being ◽

Progression Of Disease

IntroductionThe Managing Cancer and Living Meaningfully (CALM) therapy for patients with advanced cancer was tested against a supportive psycho-oncological counseling intervention (SPI) in a randomized controlled trial (RCT). We investigated whether CALM was delivered as intended (therapists’ adherence); whether CALM therapists with less experience in psycho-oncological care show higher adherence scores; and whether potential overlapping treatment elements between CALM and SPI can be identified (treatment differentiation).MethodsTwo trained and blinded raters assessed on 19 items four subscales of the Treatment Integrity Scale covering treatment domains of CALM (SC: Symptom Management and Communication with Health Care Providers; CSR: Changes in Self and Relationship with Others; SMP: Spiritual Well-being and Sense of Meaning and Purpose; FHM: Preparing for the Future, Sustaining Hope and Facing Mortality). A random sample of 150 audio recordings (75 CALM, 75 SPI) were rated on a three-point Likert scale with 1 = “adherent to some extent,” 2 = “adherent to a sufficient extent,” 3 = “very adherent.”ResultsAll 19 treatment elements were applied, but in various frequencies. CALM therapists most frequently explored symptoms and/or relationship to health care providers (SC_1: n_applied = 62; 83%) and allowed expression of sadness and anxiety about the progression of disease (FHM_2: n_applied = 62; 83%). The exploration of CALM treatment element SC_1 was most frequently implemented in a satisfactory or excellent manner (n_sufficient or very adherent = 34; 45%), whereas the treatment element SMP_4: Therapist promotes acknowledgment that some life goals may no longer be achievable (n_sufficient or very adherent = 0; 0%) was not implemented in a satisfactory manner. In terms of treatment differentiation, no treatment elements could be identified which were applied significantly more often by CALM therapists than by SPI therapists.ConclusionResults verify the application of CALM treatment domains. However, CALM therapists’ adherence scores indicated manual deviations. Furthermore, raters were not able to significantly distinguish CALM from SPI, implying that overlapping treatment elements were delivered to patients.

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