La teoría de las transiciones como paradigma de apoyo al automanejo en personas con condiciones crónicas / Transitions theory as a paradigm for supporting self-management in people with chronic conditions / A teoria das transições como paradigma para apoiar a autogestão em pessoas com condições crónicas

Resumen Introducción: La experiencia de vivir con una enfermedad crónica no es una tarea sencilla, se requiere de herramientas que permitan aumentar el grado de conciencia para enfrentar las necesidades y superar desafíos sobre el estado de salud y enfermedad. En los últimos años, se ha instaurado el apoyo al automanejo, con la finalidad de potenciar las habilidades en personas con este tipo de afecciones. Resulta trascendental considerar como desde enfermería se puede contribuir al logro de aquello. El objetivo del presente ensayo es reflexionar acerca de la teoría de las transiciones de Meléis como paradigma de apoyo al automanejo en personas con condiciones crónicas. Desarrollo: La teoría de las transiciones de Meléis establece que las personas están en constante cambio, tal como ocurre en el proceso de transición de salud-enfermedad. Recibir el diagnóstico de una enfermedad crónica, conlleva una serie de procesos complejos para la persona, debido a la multiplicidad de variables que ello implica. La teoría de Meléis entrega lineamientos para orientar a la persona profesional de enfermería sobre elementos claves e interrelacionados, como la concepción previa de la naturaleza de la transición y sus condiciones, lo que servirá para la planificación de modalidades de intervención congruentes con las experiencias de la persona y su evaluación en el transcurso del proceso de salud y enfermedad. Conclusión: El paradigma ofrecido por Meléis puede ser considerado un enfoque clave para emprender el proceso de cuidado de enfermería tendiente a apoyar a las personas con enfermedad crónica en el logro del automanejo.

Abstract Introduction: The experience of living with a chronic disease is not a simple task, since it requires tools that allow increasing the degree of awareness to face the needs and overcome challenges about the state of health and disease. In recent years, support for self-management has been established, with the aim of enhancing the skills of people with this type of condition. It is important to consider how the nursing discipline can contribute to achieve this. The aim of this paper is to reflect on Meléis' theory of transitions as a paradigm to support self-management in people with chronic conditions. Development: Meléis' theory of transitions establishes that people are in constant change, as occurs in the health-illness transition process. Receiving the diagnosis of a chronic disease involves a series of complex processes for the person, due to the multiplicity of variables involved. Meléis' theory provides guidelines to orient the nursing professional on key and interrelated elements, such as the previous conception of the nature of the transition and its conditions, which will serve for the planning of intervention modalities congruent with the person's experiences and their evaluation in the course of the health and disease process. Conclusion: The paradigm offered by Meléis can be considered a key approach to undertake the nursing care process aimed at supporting people with chronic illness in achieving self-management.

Resumo Introdução: A experiênca de viver com uma doença crônica não é uma tarefa simple, pois requer ferramentas que permitam aumentar o nível de consciência para enfrentar as necessidades e superar desafios relativos ao estado de saúde e doença. Nos últimos anos, foi estabelecido o apoio à autogestão, com o objetivo de melhorar as habilidades das pessoas com este tipo de condições. É transcendental considerar como a disciplina de Enfermagem pode contribuir para isso. O objetivo deste ensaio é refletir sobre a teoria das transições de Meleis como paradigma de apoio à autogestão em pessoas com condições crônicas. Desenvolvimento: A teoria das transições de Meléis estabelece que as pessoas estão em constante mudança, como acontece no processo de transição saúde-doença. Receber o diagnóstico de uma doença crónica implica uma série de processos complexos para a pessoa, devido à multiplicidade de variáveis envolvidas. A teoria de Meléis fornece directrizes para orientar o profissional de enfermagem sobre elementos-chave e inter-relacionados, como a conceção prévia da natureza da transição e das suas condições, que servirão para o planeamento de modalidades de intervenção congruentes com as experiências da pessoa e a sua avaliação no decurso do processo saúde-doença. Conclusão: O paradigma oferecido por Meleis pode ser considerado uma abordagem chave para empreender o processo de cuidado de enfermagem que visa apoiar as pessoas com doenças crônicas no alcance do autogerenciamento.

Autogestão ineficaz de linfedema em mulheres mastectomizadas: análise de conceito / Autogestión ineficaz de linfedema en mujeres mastectomizadas: análisis de concepto / Ineffective self-management of lymphedema in mastectomized women: concept analysis

Resumo Objetivo Analisar o conceito de "autogestão ineficaz do linfedema" em mulheres mastectomizadas. Métodos Trata-se de uma análise do conceito proposto por Walker e Avant operacionalizada por meio de uma revisão integrativa da literatura, organizada em oito etapas e baseada nas seguintes questões norteadoras: Qual é a definição de autogestão ineficaz em mulheres mastectomizadas? Quais os antecedentes, atributos e consequências da autogestão ineficaz em mulheres mastectomizadas? Como a autogestão ineficaz de linfedema tem sido definida no contexto de mulheres que passaram por mastectomia? A busca de artigos foi realizada em cinco bases de dados eletrônicas, sem limite de data, no período de julho de 2022 a fevereiro de 2023. Resultados Foram identificados 30 antecedentes e 19 consequentes; os mais frequentes entre eles foram respectivamente os seguintes: falta de apoio familiar/social e diminuição da qualidade de vida. Os atributos definidores mais frequentemente identificados foram os seguintes: edema, inchaço no braço, sensação de peso no membro, dor, dormência e diminuição da função do membro. Foram ainda elaborados os casos modelo e contrário para auxiliar na decisão sobre o uso do conceito. Conclusão Os conceitos resultantes da análise contribuem para clarificar os termos e o desenvolvimento da linguagem na enfermagem, devendo ser validados por juízes e prática clínica para melhor aplicação na oncologia clínica.

Resumen Objetivo Analizar el concepto de "autogestión ineficaz de linfedema" en mujeres mastectomizadas. Métodos Se trata de un análisis del concepto propuesto por Walker y Avant, realizado mediante una revisión integradora de la literatura, organizado en ocho etapas y basado en las siguientes preguntas orientadoras: ¿Cuál es la definición de autogestión ineficaz en mujeres mastectomizadas? ¿Cuáles son los antecedentes, atributos y consecuencias de la autogestión ineficaz en mujeres mastectomizadas? ¿Cómo se define la autogestión ineficaz de linfedema en el contexto de mujeres que pasaron por una mastectomía? La búsqueda de artículos fue realizada en cinco bases de datos electrónicas, sin límite de fecha, en el período de julio de 2022 a febrero de 2023. Resultados Se identificaron 30 antecedentes y 19 consecuentes. El antecedente más frecuente fue falta de apoyo familiar/social y el consecuente, reducción de la calidad de vida. Los atributos definidores identificados más frecuentemente fueron los siguientes: edema, hinchazón en el brazo, sensación de peso en el miembro, dolor, adormecimiento y reducción de la función del miembro. Además, se elaboraron los casos modelo y contrarios para ayudar en la decisión sobre el uso del concepto. Conclusión Los conceptos resultantes del análisis contribuyen a clarificar los términos y el desarrollo del lenguaje en enfermería y deben ser validados por jueces y práctica clínica para una mejor aplicación en la oncología clínica.

Abstract Objective To analyze the concept of "ineffective self-management of lymphedema" in mastectomized women. Methods This is an analysis of the concept proposed by Walker and Avant, operationalized through an integrative literature review, organized into eight stages, and based on the following guiding questions: What is the definition of ineffective self-management in mastectomized women? What are the antecedents, attributes, and consequences of ineffective self-management in mastectomized women? How has ineffective self-management of lymphedema been defined in the context of women who have undergone mastectomy? The search for articles was carried out in five electronic databases, with no date limit, from July 2022 to February 2023. Results Antecedents (30) and consequents (19) were identified. Among them, the most frequent were the following, respectively: lack of family and/or social support and decreased quality of life. The most frequently identified defining attributes were the following: edema, swelling in the arm, feeling of heaviness in the limb, pain, numbness, and reduced function of the limb. Model and contrary cases were also designed to help decide on the use of the concept. Conclusion The concepts resulting from the analysis contribute to clarifying the terms and development of language in nursing, and should be validated by judges and clinical practice for better application in clinical oncology.

Autogestão do diabetes na adolescência: experiência de jovens adultos e pais portugueses / Autogestión de la diabetes en la adolescencia: experiencias de jóvenes adultos y padres portugueses / Self-management of diabetes in adolescence: experience of Portuguese young adults and their parents

Resumo Objetivo Identificar os fatores que facilitam ou dificultam a construção da autonomia na adolescência através da experiência de jovens adultos com diabetes tipo 1 e seus pais. Métodos Estudo de natureza qualitativa, descritiva e exploratória. Foram realizadas duas entrevistas de grupo focal, uma com nove jovens adultos peritos na gestão de sua doença e outra com sete pais. Para análise dos dados, foram usados análise de conteúdo temática e categorial, com particularidades de entrevista de grupo focal, e recurso ao software NVIVO 12. Resultados Emergiram duas grandes categorias e dez subcategorias relativas aos fatores que facilitaram (sistemas de suporte, conhecimentos, alimentação, bomba de insulina, responsabilização precoce pela gestão da terapêutica, características dos jovens), e dificultaram (regime terapêutico, estigma, atitude dos profissionais de saúde, características dos jovens, conhecimento) o desenvolvimento da autonomia na gestão da doença. Conclusão A autonomia na gestão do diabetes envolve vários desafios aos adolescentes, o que requer adequação de atitudes e intervenções de profissionais. Além da gestão tradicional da condição de saúde, é essencial abordar temas relacionados com a socialização dos adolescentes, procurando estratégias inovadoras que promovam o coping e a qualidade de vida. Os resultados deste estudo possibilitam refletir sobre a relação terapêutica com os adolescentes, salientando a importância de individualizar cuidados e respostas inovadoras às suas necessidades específicas.

Resumen Objetivo Identificar los factores que facilitan o dificultan la construcción de la autonomía en la adolescencia a través de la experiencia de jóvenes adultos con diabetes tipo 1 y sus padres. Métodos: Estudio de naturaleza cualitativa, descriptiva y exploratoria. Se realizaron dos entrevistas de grupo focal, una con nueve jóvenes adultos expertos en la gestión de su enfermedad y otra con siete padres. Para el análisis de datos se utilizó el análisis de contenido temático y categorial, con particularidades de entrevista de grupo focal y recurso del software NVIVO 12. Resultados Surgieron dos grandes categorías y diez subcategorías relativas a los factores que facilitaron el desarrollo de la autonomía en la gestión de la enfermedad (sistemas de apoyo, conocimientos, alimentación, bomba de insulina, responsabilización temprana de la gestión de la terapéutica, características de los jóvenes) y los que la dificultaron (régimen terapéutico, estigma, actitudes de los profesionales de la salud, características de los jóvenes, conocimientos). Conclusión La autonomía en la gestión de la diabetes incluye muchos desafíos para los adolescentes, lo que requiere adaptación de actitudes e intervenciones de profesionales. Además de la gestión tradicional del estado de salud, es esencial abordar temas relacionados con la socialización de los adolescentes y buscar estrategias innovadoras que promuevan el coping y la calidad de vida. Los resultados de este estudio permiten reflexionar sobre la relación terapéutica con los adolescentes y destacar la importancia de individualizar los cuidados y las respuestas innovadoras para sus necesidades específicas.

Abstract Objective To identify the factors that facilitate or hinder the construction of autonomy in adolescence through the experience of young adults with type-1 diabetes and their parents. Methods This was a qualitative, descriptive, and exploratory study. Two focus group interviews were conducted: one with nine young adults who were experts in managing their illness and the other with seven parents. Thematic and categorical content analysis was used for data analysis, with particularities of a focus group interview and the use of the NVIVO 12 software. Results Two major categories and ten subcategories related to factors that facilitated (support systems, knowledge, diet, insulin pump, early responsibility for managing therapy, and characteristics of young people) and hindered (therapeutic regimen, stigma, attitude of health professionals, characteristics of young people, and knowledge) the development of autonomy in disease management emerged. Conclusion Autonomy in the management of diabetes involves several challenges for adolescents, which requires adaptation of attitudes and interventions by professionals. In addition to the traditional management of the health condition, addressing issues related to the socialization of adolescents is essential, looking for innovative strategies that promote coping and quality of life. The results of this study make it possible to reflect on the therapeutic relationship with adolescents, emphasizing the importance of individualizing care and innovative responses to their specific needs.

Educación en enfermería y cuidado de personas con condiciones crónicas: avances y desafíos / Nursing education and care for people with chronic conditions: advances and challenges

INTRODUCCIÓN: El escenario mundial actual de las enfermedades crónicas (EC) es preocupante. Representan el grueso de la carga de enfermedad, en una población envejecida y con alta prevalencia de factores de riesgo. Para mejorar los resultados de las personas con EC, una de las líneas de trabajo prioritarias es la incorporación del apoyo al automanejo, como parte del rol profesional de profesionales de la salud. La principal debilidad percibida hoy es la falta de formación teórico-práctica desde la formación de pregrado. OBJETIVO: evaluar la enseñanza acerca del cuidado en condiciones crónicas de salud, en la formación de pregrado de la Escuela de Enfermería. METODOLOGÍA: Estudio mixto que incluyó a) Análisis del plan de estudios de pregrado vigente 2) Exploración de la experiencia previa de la unidad en investigación y educación continua en cuidados crónicos; consulta con expertos, incluyendo miembros clínicos de equipos de salud que participan en la atención a crónicos. 3) Revisión de la literatura de modelos teóricos para los cuidados crónicos 4) Explorar, a través de las percepciones de los profesores, el grado de implementación de los cuidados de enfermería para las EC. RESULTADOS: Se detectó un bajo nivel de incorporación de la educación para el cuidado crónico en el currículum y ausencia de uso de conceptos claves relacionados con esto. Esto debe hacerse a lo largo de un proceso educativo que progresivamente aumenta el nivel de complejidad en la aplicación de los cuidados a las personas con EC y que se encuentra en implementación en un nuevo plan de estudio en ejecución desde el año 2022.

INTRODUCTION: The global current scenario in non-communicable diseases (NCD) is worrisome. In Chile these conditions represent the bulk of the disease burden, in an ageing population with a high prevalence of risk factors for NCDs. Thus, the training of health professionals in this field is paramount. PURPOSE: to share our experience at the school of nursing (SON) in designing and integrating chronic care and self-management support for people with chronic conditions in the undergraduate program. METHODOLOGY: a) Revision of the undergraduate curriculum 2) Exploring SON previous experience in research and continuing education in chronic care; consultation with experts including clinical members of health teams that participate in delivering chronic care. 3) Review of the literature to find theoretical models for chronic care 4) explore, through the lecturers' perceptions, the degree of implementation of nursing care for NCDs in clinical practice. RESULTS AND CONCLUSIONS: We found that there was a lack of incorporation of subjects and contents on chronic care in the curriculum and in clinical settings. It is important to incorporate chronic care and self-management support in nursing education at the theoretical and the clinical level. This should be done throughout an education process that increases progressively the level of complexity in the application of caring for people with NCDs. The SON will implement this approach in the new curricula starting on 2022.

Efectividad de un programa de automanejo para cuidadores familiares / Effectiveness of a self-management program for family caregivers

INTRODUCCIÓN: La carga de cuidado en los cuidadores familiares (CF), tiene un efecto en la salud física y mental, relaciones familiares, laborales y estado financiero, aumentando la necesidad de intervenciones efectivas para mejorar el automanejo de su condición y el cuidado al familiar en el hogar. OBJETIVO: evaluar la efectividad de un programa para promover el automanejo en CF. METODOLOGÍA: de diseño cuasi experimental con mediciones pre y post intervención, en una muestra no probabilística, intencionada de 19 CF de personas mayores con nivel de dependencia. El programa "Trabajando juntos en colaboración" (TJC), implementado por facilitadores entrenados y certificados, promueve el automanejo y habilidades para cuidar a su familiar en casa. Para evaluar el efecto de la intervención se aplicó pre y post-test el Instrumento de "Automanejo en Cuidadores Familiares", la prueba Shapiro-Wilks, el análisis de diferencias por la t-Student y test de Wilcoxon, se calculó el tamaño del efecto y la potencia estadística (1- ß). RESULTADOS: se encontró una diferencia estadísticamente significativa entre el pre y post intervención, observando un incremento en el resultado de la sumatoria global y en las tres dimensiones del automanejo. Estas diferencias muestran un efecto relevante a considerar (>,80) y una potencia alta (>,80). CONCLUSIÓN: El Programa TJC, muestra efectividad en mejorar el automanejo en CF, con una potencia adecuada que podría permitir generalizar resultados en poblaciones similares. Siendo este un programa genérico, podría ser aplicado en cualquier caso de CF, independiente a la enfermedad o condición de su familiar.

INTRODUCTION: The caregiving burden on family caregivers (FC) has an impact on physical and mental health, family relationships, work, and financial status, increasing the need for effective interventions to improve self-management of their condition and care for the family member at home. OBJECTIVE: to evaluate the effectiveness of a program to promote self-management in FC. METHODOLOGY: The study employed a quasi-experimental design with pre- and post-intervention measurements in a non-probabilistic, purposive sample of 19 FC of older individuals with a level of dependency. The "Trabajando Juntos en Colaboración" (TJC) program, implemented by trained and certified facilitators, promotes self-management and skills to care for their family member at home. To assess the intervention's effect, pre and post-tests were administered using the "Automanejo en Cuidadores Familiares" instrument, along with the Shapiro-Wilks test, t-Student analysis of differences, and Wilcoxon test. Effect size and statistical power (1- ß) were calculated. RESULTS: indicated statistically significant differences between the pre- and post-intervention periods, with an observed increase in the overall sum and in all three dimensions of self-management. These differences demonstrate a relevant effect (>0.80) and high statistical power (>0.80). CONCLUSION: the TJC program proves effective in enhancing self-management in CF, with sufficient power to potentially generalize results to similar populations. As a generic program, it could be applied in any FC case, regardless of the disease or condition of their family member.

Resultados de "Tomando Control de su Salud" online, en personas con enfermedades no transmisibles de México y Perú durante COVID-19 / Results of "Tomando Control de su Salud" online, in people with non-communicable diseases in Mexico and Peru during COVID-19

Las enfermedades no transmisibles (ENT) son una creciente preocupación global que afecta tanto a la atención médica como a la calidad de vida. Los programas de automanejo de enfermedades crónicas como el denominado "Tomando Control de su Salud" (TCS), se han vuelto estrategias efectivas para abordar este problema. OBJETIVO: Evaluar el resultado del programa TCS, versión en línea, en las variables automanejo y autoeficacia, en muestras de personas con ENT de México y Perú, durante la pandemia por COVID-19. METODOLOGÍA: El diseño del estudio fue cuasiexperimental con mediciones independientes (intervenidos y controles) y mediciones en línea, al inicio y término de la intervención; evaluadas con Partners in Health Scale y la Escala de Autoeficacia. Los cambios en el tiempo se examinaron mediante la prueba de Wilcoxon. RESULTADOS: De los 114 participantes, la mayoría eran mujeres (83.3%) con una edad promedio de 58.8 años. Antes de la intervención, los grupos fueron iguales en las variables de estudio. No se encontró ningún aumento significativo en las variables de estudio en el grupo control, sin embargo, hubo un aumento estadísticamente significativo en la autoeficacia y automanejo en el grupo intervenido. CONCLUSIONES: El programa TCS en línea contribuyó al aumento de la autoeficacia, el automanejo, el conocimiento de la enfermedad, la adherencia al tratamiento y el manejo de síntomas en participantes con ENT de México y Perú durante la pandemia de COVID-19. Esto respalda la evidencia de que el programa mejora la salud y la calidad de vida de quienes viven con estas enfermedades.

Non-communicable diseases (NCD) are a growing global concern that affects both healthcare and quality of life. Chronic disease self-management programs, such as "Tomando Control de su Salud" (TCS), have become effective strategies to address this problem. PURPOSE: To evaluate the results of the TCS program, online version, in the self-management and self-efficacy variables, in samples of people with NCD from Mexico and Peru, during the COVID-19 pandemic. METHODOLOGY: The study design was quasi-experimental with independent measurements (interventions and controls) and online measurements, at the beginning and end of the intervention; evaluated with the Partners in Health Scale and the Self-Efficacy Scale. Changes over time were examined using the Wilcoxon test. RESULTS: Out of the 114 participants, most were women (83.3%) with an average age of 58.8 years. Before the intervention, the groups were equal in the study variables. No significant increase in the study variables was found in the control group; however, there was a statistically significant increase in self-efficacy and self-management in the intervention group. CONCLUSIONS: The online TCS program contributed to increased self-efficacy, self-management, disease knowledge, treatment adherence, and symptom management in participants with NCD from Mexico and Peru during the COVID-19 pandemic. This supports evidence that the program improves the health and quality of life of those living with these illnesses.

Nivel de literacidad en salud en población chilena con enfermedades crónicas: análisis secundario de la Encuesta Nacional de Salud 2009 y 2016 / Health literacy level on chilean population with chronic diseases: secondary analysis of the 2009 and 2016 national health survey

INTRODUCCIÓN: Las enfermedades crónicas no transmisibles (ECNT) son consideradas una pandemia dada su alta prevalencia y morbimortalidad asociada. Se postula que el nivel de literacidad en salud (LS) de las personas con estas condiciones impactaría en su autocuidado. OBJETIVO: Conocer la prevalencia de bajo nivel de LS de la población chilena con ECNT según datos de la Encuesta Nacional de Salud (ENS) versión 2009 y 2016; además de identificar cómo su LS influiría sobre ciertos resultados en salud. METODOLOGÍA: Estudio transversal descriptivo-analítico. Se utiliza el ítem del módulo psicosocial de la ENS que evalúa autoeficacia literaria y se cruza con variables sociodemográficas y resultados intermedios de salud de interés. RESULTADOS Y DISCUSIÓN: La prevalencia de bajo nivel de LS en población con diabetes fue de 23,7% el 2009 y de 15,5%, el 2016. Para personas con hipertensión arterial, se obtuvo una prevalencia de 19,7% en el 2009 y de 17,5% en el 2016. Se observa diferencias por edad, sexo, nivel educacional y ruralidad. Se reporta mayor proporción de HbA1c descompensada, menor actividad física y peor estado de salud percibido en la población estudiada. CONCLUSIONES: El nivel de LS influye en cómo los individuos manejan su condición crónica. Contar con un diagnóstico previo del nivel de LS de las personas, permitiría diseñar intervenciones pertinentes a sus necesidades.

INTRODUCTION: Chronic non-communicable diseases (NCDs) are considered a pandemic given their high prevalence and associated morbidity and mortality. It is postulated that the level of health literacy (HL) of people with these conditions would impact their self-care. OBJECTIVE: To know the prevalence of low HL of the Chilean population with NCD according to data from the National Health Survey (ENS) version 2009 and 2016; in addition to identify how their HL would influence certain health outcomes. METHODOLOGY: Descriptive-analytical cross-sectional study. The ENS's item from the psychosocial module which evaluates literary self-efficacy is used and crossed with sociodemographic variables and intermediate health outcomes of interest. RESULTS AND DISCUSSION: The prevalence of low HL in the population with diabetes was 23.7% in 2009 and 15.5% in 2016. For people with arterial hypertension, a prevalence of 19.7% was obtained in the 2009 and 17.5% in 2016. Differences are observed by age, sex, educational level, and rurality. A higher proportion of uncompensated HbA1c, lower physical activity and worse perceived health status are reported in the population studied. CONCLUSIONS: The HL level influences how individuals manage their chronic condition. Having a prior diagnosis of people's HL would allow the design of interventions to be relevant to their needs.

El Modelo Transteórico y la Teoría del Automanejo Individual y Familiar como paradigma para comprender el cambio de comportamiento y el automanejo en personas con enfermedades crónicas / The Transtheoretical Model and the Individual and Family Self-Management Theory as a paradigm to understand behavior change and self-management in people with chronic diseases

INTRODUCCIÓN: El automanejo y el cambio de conducta siguen siendo retos para quienes padecen enfermedades crónicas. Para su abordaje existen modelos y estrategias que orientan a alcanzar mejores resultados en salud. OBJETIVO: Analizar la Teoría del Automanejo Individual y Familiar junto con el Modelo Transteórico como paradigmas para comprender los desafíos e identificar factores involucrados en el cambio conductual y el automanejo de personas con enfermedades crónicas. DESARROLLO: El Modelo Transteórico comprende cinco etapas que explican el proceso cíclico de cambio. Por otro lado, la Teoría del Automanejo Individual y Familiar se distingue por tres dimensiones: contexto, proceso y resultados. Al interrelacionar ambos modelos, se observa que el contexto dado por la Teoría del Automanejo Individual y Familiar puede determinar la etapa del cambio. Los procesos, como la autoeficacia, la facilitación social o la autorregulación, son implementados de formas distintas según la etapa del cambio en la que la persona se encuentre. CONCLUSIÓN: La integración de ambos modelos potencia la comprensión acerca del cambio de conducta en personas con enfermedades crónicas. Esta articulación favorece enfoques más personalizados, lo que permitiría que los profesionales de enfermería reconocer la etapa de cambio en la que se encuentra la persona y, con base en la Teoría del Automanejo, atender las necesidades del individuo y familia, propiciando un cuidado integral.

INTRODUCTION: Self-management and behavioral change continue to be challenges for those suffering from chronic diseases. There are models and strategies for approaching them that aim to achieve better health outcomes. OBJECTIVE: Analyze the Individual and Family Self-Management Theory together with the Transtheoretical Model as paradigms to understand the challenges and identify factors involved in behavioral change and self-management of people with chronic diseases. DEVELOPMENT: The Transtheoretical Model comprises five stages that explain the cyclical process of change. On the other hand, the Individual and Family Self-Management Theory is distinguished by three dimensions: context, process and outcomes. By interrelating both models, it is observed that the context given by the Individual and Family Self-Management Theory can determine the stage of change. Processes, such as self-efficacy, social facilitation or self-regulation, are implemented in different ways depending on the stage of change the person is in. Finally, outcomes, such as self-management, emerge from the effective joint application of both models. CONCLUSION: The integration of both models enhances the understanding of behavior change in people with chronic diseases. This articulation favors more personalized approaches, which would allow nursing professionals to recognize the stage of change in which the person is and, based on the Self-Management Theory, address the needs of the individual and family, promoting comprehensive care.

Trajectory, Perceived Causes and Efforts in Diabetes Selfmanagement: A Qualitative Study Among Young People With Type 2 Diabetes Mellitus and Caregivers

@#Introduction: Previous studies have suggested that young individuals with type 2 diabetes mellitus (T2DM) face challenges in achieving optimal diabetes self-management, leading to difficulties in attaining the recommended glycaemic target. The reasons behind these suboptimal practices remain unclear due to the limited number of studies conducted in Malaysia that focused on diabetes self-management among young people. This qualitative study aimed to understand the lived experience of young people with T2DM on self-management in Malaysia. Methods: Young people at the age of 10 to 24 years, who had been diagnosed with T2DM and the caregivers who managing young people with T2DM were interviewed. Data were thematically analysed with the aid of QSR NVivo version 12. Results: Sixteen young informants and eleven caregivers participated in this study. Three major themes conceptualised the lived experience of diabetes self-management: (1) the trajectory to T2DM diagnosis; (2) perceived causes of T2DM; (3) the efforts in diabetes self-management. The route of diagnosis and experiential knowledge about T2DM might determine their efforts in the self-management among the young people. Healthy eating, medication taking and physical activity were perceived as important tasks in diabetes self-management. The involvement of the caregivers in diabetes self-management evolved over time. Conclusion: The study highlighted the experience of young people and caregivers since the beginning of the diagnosis and their strategies in diabetes self-management. More understanding of the lived experiences of patients and caregivers in disease management within the socio-ecological context could help to improve health-care services and intervention for this population.

Impact of a Tailored Self-Management Education Programme for Older Adults with Knee Osteoarthritis in a Multi-Ethnic Country / Jurnal Sains Kesihatan Malaysia

@#Self-management education program (SMEP) is essential in the knee osteoarthritis (OA) management. While the benefits of tailored SMEP have been highlighted in the literature, evidence on the effects of tailored knee OA SMEP for multiethnic populations, such as in Malaysia, remains limited. Therefore, the aim of this study was to conduct an intervention study on a tailored SMEP among Malaysian older adults who aged 60 years and above with knee OA. Participants aged 60 years and over with a diagnosis of knee OA were recruited. The intervention comprised four weekly structured group SMEP which was developed specifically for the multicultural population in Malaysia. Symptom’s severity and functional performance were assessed at baseline and six-week follow-up using the Knee Injury and Osteoarthritis Outcome Score questionnaire (KOOS), 30 seconds sit to stand (30sST), time up and go (TUG), chair sit and reach (CSR), back stretch (BS), handgrip strength (HGS) and two-minute walk (2MW) tests. Of the 32 individuals recruited, 30 participants, mean age of 66.77 (±6.42) years, completed the post-intervention assessment. Improvements in mean KOOS domains scores were observed by between 1.3% - 8.6% from baseline to follow-up. Significant differences between baseline and followup scores were identified for 30sST (p < 0.05), TUG ( p < 0.001) and 2MW (p < 0.001) tests. A 4-week tailored SMEP delivered face to face by a physiotherapist, improved lower limb muscle strength, mobility, balance and endurance. Larger randomized controlled trials regarding the long-term effects of SMEP for older adults with OA is warranted.

Establishment of pharmaceutical care model for lower extremity artery disease based on patients’disease self-management ability / 中国药房

OBJECTIVE To construct the integrated pharmaceutical care model of in-hospital pharmaceutical care+out-hospital pharmacy outpatient service for patients with lower extremity artery disease （LEAD）， so as to improve patients’ disease self- management ability， and the efficacy and safety of therapy. METHODS The in-hospital pharmaceutical care and out-hospital pharmacy outpatient service model was constructed for LEAD patients， including pharmaceutical evaluation， self-management ability education， and pharmacy follow-up， to perform long-term management of patients. Totally 65 LEAD patients admitted to the vascular surgery department of our hospital， receiving pharmacist management， from September， 2021 to December， 2022 were selected as the study objects， and pharmacists conducted in-hospital pharmaceutical care+continuous out-patient management. The efficacy indicators， safety indicators， and patients’s disease self-management ability indicators were compared before and after 3 months of pharmacist management. RESULTS After 3 months of pharmacists’ participation in the management of 65 patients， Fontaine stage decreased in 55 patients， there was the significant difference in Fontaine stage before and after management （P＜ 0.001）. The proportion of patients who completely followed the guidelines for medication increased from 63.1% to 96.9%； the incidence of small bleeding was reduced by 7.7% after pharmacists’ management. The scores of Morisky medication compliance and patients’ disease self-management ability were higher than 3 months ago （P＜0.001）. Patient proportion with “good” medical satisfaction increased by 18.4%. CONCLUSIONS The in-hospital pharmaceutical care and out-hospital pharmacy outpatient service model of LEAD patients can effectively improve patients’ disease self-management ability， and improve the efficacy and safety of therapy.

Autocuidado digital en el manejo de los trastornos musculoesqueléticos de columna: revisión sistemática y metanálisis / Digital self-care in the management of spine musculoskeletal disorders: A systematic review and meta-analysis / Autocuidado digital no manejo de distúrbios musculoesqueléticos de coluna: revisão sistemática e metanálise

Objetivo: analizar la efectividad del autocuidado digital en el manejo del dolor y la discapacidad funcional en personas con trastornos musculoesqueléticos espinales. Método: revisión sistemática de la literatura, desarrollada con la checklist PRISMA, de ensayos clínicos aleatorizados sobre personas con trastornos musculoesqueléticos de columna e intervenciones digitales a las que se accede por computadora, smartphones u otro dispositivo portátil. Bases de datos consultadas: National Library of Medicine, Excerpta Médica dataBASE, SciVerse Scopus, Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Science Citation Indexes, Cummulative Index to Nursing and Allied Health Literature y Physiotherapy Evidence Database. Síntesis de resultados descriptiva y por metanálisis (modelo de efectos fijos) realizada con el software Review Manager. Calidad metodológica evaluada mediante la escala Physiotherapy Evidence Database. Resultados: se seleccionaron 25 ensayos (5142 participantes) que mostraron mejoras estadísticamente significativas (p<0,05) del 54% (12/22) en los niveles de dolor y del 47% (10/21) en la discapacidad funcional en el grupo intervención. Los metanálisis mostraron efectos moderados sobre la intensidad del dolor y efectos pequeños sobre la discapacidad funcional. Predominaron los estudios de calidad media. Conclusión: las intervenciones de atención digital demostraron resultados beneficiosos para la intensidad del dolor y la discapacidad funcional, principalmente para el dolor lumbar crónico. Se ha demostrado que la atención digital es promisoria para favorecer el automanejo de las afecciones musculoesqueléticas de columna. Registro PROSPERO CRD42021282102.

Objective: to analyze the effectiveness of digital self-care in the management of pain and functional disability among people with spine musculoskeletal disorders. Method: a systematic literature review, developed with the PRISMA checklist, of randomized clinical trials of people with spine musculoskeletal disorders and digital interventions accessed by means of computers, smartphones or other portable devices. Databases researched: National Library of Medicine, Excerpta Médica dataBASE, SciVerse Scopus, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Science Citation Indexes, Cumulative Index to Nursing and Allied Health Literature and Physiotherapy Evidence Database. The descriptive synthesis of the results and by means of meta-analyses (fixed-effects model) was performed with the Review Manager software. The methodological quality was evaluated with the Physiotherapy Evidence Database scale. Results: a total of 25 trials were selected (5,142 participants), which showed statistically significant improvements (p <0.05) in 54% (12/22) in the pain levels and 47% (10/21) in functional disability in the Intervention Group. The meta-analyses showed moderate effects on pain intensity and small effects on functional disability. There was a predominance of medium quality studies. Conclusion: the digital care interventions showed a beneficial result in pain intensity and in functional disability, mainly for chronic low back pain. Digital care emerges as promising to support self-management of the spine musculoskeletal conditions. PROSPERO registry number CRD42021282102.

Objetivo: analisar a efetividade do autocuidado digital no manejo da dor e incapacidade funcional em pessoas com distúrbios musculoesqueléticos de coluna. Método: revisão sistemática da literatura, desenvolvida com o checklist PRISMA, de ensaios clínicos randomizados de pessoas com distúrbios musculoesqueléticos de coluna e intervenções digitais acessadas por computador, smartphones ou outro dispositivo portátil. Bases pesquisadas: National Library of Medicine, Excerpta Médica dataBASE, SciVerse Scopus, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Science Citation Indexes, Cummulative Index to Nursing and Allied Health Literature e Physiotherapy Evidence Database. Síntese dos resultados descritiva e por metanálises (modelo de efeitos fixos) com o software Review Manager. Qualidade metodológica avaliada pela escala Physiotherapy Evidence Database. Resultados: selecionaram-se 25 ensaios (5142 participantes) que revelaram melhoras estatisticamente significativas (p<0,05) em 54% (12/22) nos níveis de dor e 47% (10/21) na incapacidade funcional no grupo intervenção. As metanálises mostraram efeitos moderados na intensidade da dor e pequenos na incapacidade funcional. Houve predominância de estudos de média qualidade. Conclusão: intervenções de cuidados digitais mostraram resultado benéfico na intensidade da dor e na incapacidade funcional principalmente para dor lombar crônica. Evidenciam-se os cuidados digitais como promissores para apoiar o autogerenciamento das condições musculoesqueléticas de coluna. Registro PROSPERO CRD42021282102.

Atención de enfermería en salud mental a personas con diabetes mellitus: revisión integrativa / Mental health nursing care for people with diabetes mellitus: An integrative review / Cuidados de enfermagem em saúde mental para pessoas com diabetes mellitus: revisão integrativa

Objetivo: evaluar las evidencias disponibles en la literatura sobre la atención de enfermería en salud mental a personas con diabetes mellitus en los diferentes niveles de atención de salud. Método: revisión integrativa de la literatura. Búsqueda en cinco bases de datos. Muestra de 14 estudios, exportados al gerenciador EndNote®. Los datos se organizaron en planilla de Microsoft Excel®. La calidad metodológica de los estudios fue evaluada mediante herramientas propuestas por el Joanna Briggs Institute. Las etapas de muestreo, categorización, evaluación, interpretación de resultados y síntesis de los estudios incluidos fueron realizadas por dos revisores de manera independiente y ciega. El análisis descriptivo de resultados está presentado en tres categorías. Resultados: recomendaciones para autocuidado reforzado por la red de apoyo social, incluyendo herramientas y estrategias de los ámbitos físico y psíquico; estrategias de comunicación terapéutica y psicoterapia, haciendo foco en la psicoterapia y la comunicación terapéutica; e intervenciones de autogestión/autogerenciamiento, abordando el autocuidado en base a teorías conductuales. Conclusión: la síntesis de conocimientos reveló que las pautas de autocuidado reforzadas por la red de apoyo social, las estrategias de comunicación terapéutica y psicoterapia y las intervenciones de autogestión/autogerenciamiento son intervenciones positivas que ayudan a las personas con diabetes mellitus y trastornos mentales a prevenir complicaciones.

Objective: evaluate the evidence available on mental health nursing care for people with diabetes mellitus at different levels of health care. Method: integrative literature review. The search was conducted in five databases. The sample consisted of 14 studies. The studies were exported to the EndNote manager and their data to a Microsoft Excel spreadsheet. The methodological quality of the studies was evaluated using tools proposed by the Joanna Briggs Institute. Sampling, categorization, evaluation, interpretation of the results, and synthesis of the included studies were carried out by two reviewers independently. The descriptive analysis of the results is presented in three categories. Results: self-care guidelines enhanced by the social support network, encompassing physical and psychological tools and strategies; therapeutic communication and psychotherapy strategies, focusing on psychotherapy and therapeutic communication; and self-management interventions, addressing self-care based on behavioral theories. Conclusion: the synthesis of knowledge revealed that guidelines for self-care enhanced by the social support network, psychotherapy and therapeutic communication strategies, and self-management interventions are positive interventions that contribute to people with mental disorders and diabetes mellitus in the prevention of diseases.

Objetivo: avaliar as evidências disponíveis sobre os cuidados de enfermagem em saúde mental para pessoas com diabetes mellitus nos diferentes níveis de atenção à saúde. Método: revisão integrativa da literatura. Busca realizada em cinco bases de dados. Amostra composta por 14 estudos. Os estudos foram exportados para o gerenciador EndNote, e seus dados, para uma planilha desenvolvida pelo Microsoft Excel. A qualidade metodológica dos estudos foi avaliada por meio de ferramentas propostas pelo Joanna Briggs Institute. Etapas de amostragem, categorização, avaliação, interpretação dos resultados e síntese dos estudos incluídos foram realizadas por dois revisores de forma independente e mascarada. A análise descritiva dos resultados é apresentada em três categorias. Resultados: orientações para o autocuidado potencializadas pela rede de suporte social, englobando ferramentas e estratégias no âmbito físico e psíquico; estratégias de comunicação terapêutica e psicoterapia, focalizando a psicoterapia e a comunicação terapêutica; e intervenções de autogestão/ autogerenciamento, abordando o autocuidado com base em teorias comportamentais. Conclusão: a síntese do conhecimento revelou que as orientações para o autocuidado potencializadas pela rede de suporte social, estratégias de comunicação terapêutica e psicoterapia e intervenções de autogestão/autogerenciamento são intervenções positivas que auxiliam as pessoas com transtornos mentais e diabetes mellitus na prevenção de agravos.

Knowledge of physiological aspects, clinical management, and nutrition among patients with type 2 diabetes mellitus

Objective: To evaluate the knowledge about physiological aspects, clinical management, and nutrition of primary care patients with type 2 diabetes mellitus by sociodemographic, economic, and clinical variables. Material and methods: We conducted an observational cross-sectional study in 22 Family Health Strategy units in the city of Montes Claros, Minas Gerais, in 2015 among 353 patients registered with type 2 diabetes mellitus. A structured questionnaire was used to assess sociodemographic and clinical characteristics. Knowledge was assessed using the diabetes knowledge scale questionnaire. Data were presented with absolute frequencies and percentages and analyzed using Poisson regression. Results: Most respondents demonstrated satisfactory knowledge in the field of physiology (60.30%) and unsatisfactory knowledge in clinical management (67.7%) and nutrition (61.5%). Schooling was associated with knowledge in the areas of physiology, clinical management and nutrition, and treatment associated with clinical management. Conclusion: Knowledge about type 2 diabetes mellitus was related to sociodemographic characteristics and treatment. The importance of health education for coping with this chronic condition is evident.

Objetivo: Evaluar los conocimientos sobre aspectos fisiológicos, manejo clínico y nutrición de usuarios con diabetes mellitus tipo 2 registrados en unidades de Atención Primaria y su análisis según variables sociodemográficas, económicas y clínicas. Métodos: Se trata de un estudio observacional y transversal realizado en 22 unidades de la Estrategia Salud de la Familia de la ciudad de Montes Claros, Minas Gerais, en 2015 con 353 pacientes registrados con diabetes mellitus tipo 2. Se utilizó un cuestionario estructurado para evaluar las características sociodemográficas y clínicas. El conocimiento se evaluó mediante el cuestionario de la escala de conocimiento de la diabetes. Los datos se presentaron en frecuencias absolutas y porcentajes. El análisis de datos utilizó la regresión de Poisson. Resultados: La mayoría de los encuestados demostró conocimientos satisfactorios en el campo de fisiología (60,30%) y conocimientos insatisfactorios en manejo clínico (67,7%) y nutrición (61,5%). La escolaridad se asoció con conocimientos en las áreas de Fisiología, Manejo Clínico y Nutrición e treatment con Manejo Clínico. Conclusión: El conocimiento sobre la diabetes mellitus tipo 2 está relacionado con las características sociodemográficas y el. tratamento. La importancia de la educación en salud para el enfrentamiento de esta condición crónica es evidente.

Aplicativos para autogestão do diabetes tipo 1 em usuários de sistema de infusão contínua de insulina / Applications for self-management of type 1 diabetes in users of continuous insulin infusion system / Aplicaciones para el autocontrol de la diabetes tipo 1 en personas usuarias del sistema de infusión continua de insulina

Objetivo: Identificar e descrever as características dos aplicativos móveis para autogestão do diabetes mellitus tipo 1 em usuários de sistema de infusão contínua de insulina. Método: Revisão integrativa, com buscas efetuadas no mês de junho de 2020, a partir dos artigos publicados PUBMED, CINAHL, Cochrane Library, Web of Science e Scopus. Considerou-se como critério de elegibilidade estudos que abordavam sobre aplicativos móveis para autogestão do DM1 em usuários de Sistema de Infusão Contínua de Insulina, sem restrição temporal. Foram excluídos apenas estudos indisponíveis. Resultados: Após a análise de duas revisoras independentes foram incluídos na análise final 14 estudos e identificados 11 aplicativos móveis para smartphones que podem auxiliar no autogerenciamento do DM1, nomeados como iDECIDE, Sugar Sleuth, VoiceDiab, Blip, GoCARB, Nightscout, Gerenciamento Inteligente de Diabetes, Calculadora móvel de troca de Alimentos, Insulin Pump, DiaMob e Diário Interativo sobre Diabetes. Conclusão: Os aplicativos móveis foram desenvolvidos para promover mudanças de comportamento e ajustes no tratamento de maneira positiva, tanto em resultados clínicos quanto na qualidade de vida e autogestão do diabetes em pessoas com DM1. Aplicativos móveis para smartphones podem auxiliar no autogerenciamento do DM1, por possibilitar auxílio na decisão de aplicação de insulina, controle glicêmico, análise na necessidade de insulina nas refeições, gestão alimentar, cálculo dos componentes alimentares nas refeições, monitoramento contínuo da glicose e cálculo automático de bolus de carboidratos e insulina.

Objetivo: Identificar y comprender las características de las aplicaciones móviles para el autocontrol de la diabetes mellitus tipo 1 (DM1) en personas usuarias de sistemas de infusión continua de insulina. Método: Revisión integradora, con búsquedas realizadas en el mes de junio de 2020, de artículos publicados en las bases de datos PUBMED, CINAHL, Cochrane Library, Web of Science y Scopus. Los criterios de elegibilidad considerados para los estudios fueron que abordaran aplicaciones móviles para el autocuidado de DM1 en personas usuarias del sistema de infusión continua de insulina, sin restricción de tiempo. Solo se excluyeron los estudios no disponibles. Resultados: Después del análisis de dos revisores independientes, se incluyeron 14 estudios en el análisis final y se identificaron 11 aplicaciones móviles para teléfonos inteligentes que pueden ayudar en la autogestión de DM1, denominadas iDECIDE, Sugar Sleuth, VoiceDiab, Blip, GoCARB, Nightscout, Intelligent Manejo de la diabetes, Calculadora móvil de intercambio de alimentos, Bomba de insulina, DiaMob y Diario interactivo sobre diabetes. Conclusión: En los estudios analizados, se desarrollaron aplicaciones móviles para promover cambios de comportamiento y ajustes de tratamiento de forma positiva, tanto en los resultados clínicos como en la calidad de vida y el autocontrol de la diabetes en personas con DM1. Las aplicaciones móviles para teléfonos inteligentes pueden ayudar en el autocontrol de DM1, al permitir la asistencia en la decisión de aplicar insulina, control glucémico, análisis de la necesidad de insulina en las comidas, manejo de alimentos, cálculo de los componentes de los alimentos en las comidas, monitoreo continuo de glucosa y cálculo automático del bolo de carbohidratos e insulina.

Objetive: To identify and understand the characteristics of mobile applications for self-management of type 1 mellitus diabetes in users of continuous insulin infusion systems. Method: integrative review with searches carried out in the month of June 2020, based on the articles published in PUBMED, CINAHL, Cochrane Library, Web of Science and Scopus. The eligibility criteria were based to consider those studies that addressed mobile applications for self-management of DM1 in users of Continuous Infusion System of Insulin without time restriction. Only unavailable studies were excluded. Results: After the analysis of two independent reviewers, 14 studies were included in the final analysis, and 11 mobile applications for smartphones that can assist in self-management of DM1 were identified; these were named as iDECIDE, Sugar Sleuth, VoiceDiab, Blip, GoCARB, Nightscout, Intelligent Diabetes Management, Calculator Food exchange mobile, Insulin Pump, DiaMob and Interactive Diary on Diabetes. Conclusion: Mobile applications were developed to promote behavioral changes and treatment adjustments in a positive way, both in clinical results and in the quality of life and self-management of diabetes in people with DM1. Mobile apps for smartphones can assist in self-management of DM1 by enabling assistance in the decision to apply insulin, glycemic control, analysis of the need for insulin in meals, food management, calculation of food components in meals, continuous glucose monitoring and automatic calculation of bolus of carbohydrates and insulin.

Homo zappiens: nômades digitais e as subjetividades no âmbito da autogestão lazer-trabalho / Homo zappiens: digital nomads and subjectivities within leisure-work self-management

Este estudo, de natureza qualitativa, teve por objetivo investigar os conteúdos informacionais disseminados no site Movimento Nômades Digitais, buscando compreender os processos de autogestão de lazer-trabalho nesse estilo de viver. A pesquisa do tipo exploratória foi pautada em análise documental e estudo de caso. Os resultados apontam alguns paradoxos no equilíbrio entre as formas de concepção da autogestão do trabalho e as possíveis ressonâncias na autogestão do lazer. Essas mudanças no estilo do trabalho podem não representar, igualmente, mais flexibilidade de tempo e possibilidades de vivências de experiências significativas no lazer, sobretudo, pelos aspectos econômicos, políticos, culturais e organizacionais envolvidos. A autogestão do lazer parece não poder ser diretamente associada à autogestão do trabalho dos nômades digitais, já que outros elementos entram em cena, para além da opção pessoal em si.

This qualitative study aimed to investigate the informational content disseminated on the Movimento Nômades Digitais website, seeking to understand the leisure-work self-management processes in this lifestyle. Exploratory research was based on document analysis and case study. Results point to some paradoxes in the balance between the forms of conception of work self-management and the possible resonances in leisure self-management. These changes in the style of work may not represent, equally, more flexibility of time and possibilities of living meaningful experiences in leisure, due to the economic, political, cultural and organizational aspects involved. The self-management of leisure does not seem to be directly associated with the self-management of work by digital nomads, since other elements come into play, in addition to the personal option itself.

Socio-Economic Status As An Associate Of Emotional Competence Of Secondary School Students

The study aims to find out the association between socio-economic status (SES) of the family and emotional competence (EC) of secondary school students by taking the construct as a whole and in terms of of its component factors. The cross- sectional study collected data from a stratified random sample of 866 students from the secondary schools of Ernakulam and Thrissur districts (Kerala, India), representing the population of adolescents in the age range 13-15, studying in the secondary classes (Std. VIII to X) of schools affiliated to the Board of Public Examinations, Govt. of Kerala. Data were collected by administering the Emotional Competence Scale for Secondary School Pupils (Rekha & Salim Kumar, 2015) and the Socio-Economic Status Scale (Usha & Vijayan, 2014). Chi-square test of association was employed to analyse the data inferentially. The result revealed the presence of significant association between SES of the family and emotional competence in total and two of the constituent factors of EC, viz., self-awareness and relationship management

Melhorando a autogestão do diabetes durante a pandemia de COVID-19: uma revisão de escopo / Improving diabetes self-management during the COVID-19 pandemic: a scoping review

OBJETIVO: Sintetizar evidências disponíveis sobre ações de enfermagem para melhorar a autogestão do diabetes durante a pandemia de COVID-19. MÉTODO: Revisão de escopo usando a metodologia Joanna Briggs Institute (JBI) e o Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Identificaram-se estudos acadêmicos e literatura cinzenta de sete bases de dados primárias e seis secundárias. Dois revisores avaliaram os estudos e os dados foram analisados ​​descritivamente. RESULTADOS: Foram identificados 1.322 títulos, dos quais 31 estudos foram incluídos. Os estudos foram publicados em 2020, principalmente em inglês. A teleconsulta foi uma estratégia relevante para ajudar os pacientes a controlar o diabetes e sua saúde. CONCLUSÃO: A revisão indica que ações de enfermagem realizadas durante a pandemia para melhorar a autogestão do diabetes não foram diferentes do que está consolidado, mas algumas adaptações foram realizadas. A necessidade de autocuidado, apoio social e uma abordagem centrada no paciente é reforçada.

OBJECTIVE: To synthesize the available evidence on nursing-based actions to improve diabetes self-management during the COVID-19 pandemic. METHOD: Scoping review using the Joanna Briggs Institute methodology (JBI) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The research covered academic studies and gray literature from seven primary and six secondary databases. Two independent reviewers assessed the studies, and the data were analyzed descriptively. RESULTS: A total of 1,322 titles were identified, of which 31 studies were included. All studies were published in 2020, mainly in English. Teleconsultation was a relevant strategy to help patients manage diabetes and their general health. CONCLUSION: The review indicates that the nursing-based actions carried out during the COVID-19 pandemic to improve diabetes self-management are not different from what has been consolidated, but some adaptations have been undertaken. The need for self-care, social support, and a collaborative and patient-centered approach is reinforced.

Smartphone and application use in self-management of chronic kidney disease: a cross-sectional feasibility study

ABSTRACT INTRODUCTION: Smartphone and application use can improve communication and monitoring of chronic diseases, including chronic kidney disease, through self-management and increased adherence to treatment. OBJECTIVE: To assess smartphone use in patients with chronic kidney disease on dialysis and their willingness to use mobile applications as a disease self-management strategy. DESIGN AND SETTING: This was a cross-sectional study of chronic kidney disease patients on hemodialysis in the São Francisco Valley in the Northeast Region, Brazil. METHODS: The questionnaire developed by the authors was administered between April and June 2021. Cronbach's alpha coefficient for the construct was 0.69. Associations between the dependent and independent variables were determined using univariate analysis. Multivariate analysis with logistic regression analysis was also performed. RESULTS: A total of 381 patients were included, of whom 64% had a smartphone, although only 3.1% knew of a kidney disease-related application. However, 59.3% believed that using an application could help them manage their disease. Having a smartphone was associated with treatment adherence, higher educational attainment, and higher per capita income. Educational attainment remained an independent factor in multivariate analysis. CONCLUSION: More than 64% of patients had a smartphone, although few knew of applications developed for kidney disease. More than half of the population believed that technology use could benefit chronic kidney disease treatment. Smartphone ownership was more common among the younger population, with higher educational attainment and income, and was associated with greater adherence to hemodialysis sessions.

Mobile health applications designed for self-management of chronic pulmonary diseases in children and adolescents: a systematic mapping review / Aplicativos de saúde móvel projetados para a autogestão de doenças pulmonares crônicas em crianças e adolescentes: revisão sistemática de mapeamento

ABSTRACT Objective: Mobile health (mHealth) applications are scarce for children and adolescents with chronic pulmonary diseases (CPDs). This study aimed to map and describe the contents of the mHealth apps available for use in children and adolescents with CPDs. Methods: We performed a systematic mapping review of published scientific literature in PubMed, Scopus, and Cochrane Library by February of 2023, using relevant keywords. Inclusion criteria were as follows: children aged < 18 years with CPDs; and studies published in English on mHealth apps. Results: A total number of 353 studies were found, 9 of which met the inclusion criteria. These studies described seven mHealth apps for Android and iOS, designed either for asthma (n = 5) or for cystic fibrosis (n = 2). Five content areas were identified: education/information; pharmacological treatment; emergency; support; and non-pharmacological treatment. The studies (4, 2, and 3, respectively) showed consistent findings using qualitative, quantitative, and mixed methodologies. Conclusions: This mapping review provided a guided selection of the most appropriate mHealth apps for use in children and adolescents with CPDs based on the needs of each target population. However, these mHealth apps have limited capabilities to reinforce disease self-management and provide information related to treatment compliance.

RESUMO Objetivo: Aplicativos de saúde móvel (mHealth, do inglês mobile health) para crianças e adolescentes com doenças pulmonares crônicas (DPC) são escassos. Este estudo teve como objetivo mapear e descrever o conteúdo dos aplicativos de mHealth disponíveis para uso em crianças e adolescentes com DPC. Métodos: Realizamos uma revisão sistemática de mapeamento da literatura científica publicada nos bancos de dados PubMed, Scopus e Cochrane Library até fevereiro de 2023, utilizando descritores relevantes. Os critérios de inclusão foram os seguintes: crianças menores de 18 anos com DPC e estudos publicados em inglês sobre aplicativos de mHealth. Resultados: Foram encontrados 353 estudos, dos quais 9 atenderam aos critérios de inclusão. Esses estudos descreveram sete aplicativos de mHealth para Android e iOS projetados para asma (n = 5) ou para fibrose cística (n = 2). Foram identificadas cinco áreas de conteúdo: educação/informação, tratamento farmacológico, emergência, suporte e tratamento não farmacológico. Os estudos (4, 2 e 3, respectivamente) apresentaram achados consistentes utilizando metodologias qualitativas, quantitativas e mistas. Conclusões: Esta revisão de mapeamento forneceu uma seleção guiada dos aplicativos de mHealth mais adequados para uso em crianças e adolescentes com DPC com base nas necessidades de cada população-alvo. No entanto, esses aplicativos de mHealth têm capacidades limitadas para reforçar a autogestão da doença e fornecer informações relacionadas à adesão ao tratamento.