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OBJECTIVE@#To investigate the mechanism of self-efficacy between self-management ability and self-management behavior and its differences among patients with different disease courses through mediation tests.@*METHODS@#In the study, 489 patients with type 2 diabetes who attended the endocrinology departments of four hospitals in Shanxi Province and Inner Mongolia Autonomous Region from July to September 2022 were enrolled as the study population. They were investigated by General Information Questionnaire, Diabetes Self-Management Scale, Chinese version of Diabetes Empowerment Simplified Scale, and Diabetes Self-Efficacy Scale. Mediation analyses were performed using the linear regression model, Sobel test, and Bootstrap test in the software Stata version 15.0 and divided the patients into different disease course groups for subgroup analysis according to whether the disease course was > 5 years.@*RESULTS@#In this study, the score of self-management behavior in the patients with type 2 diabetes was 6.16±1.41, the score of self-management ability was 3.99±0.74, and the score of self-efficacy was 7.05±1.90. The results of the study showed that self-efficacy was positively correlated with self-management ability (r=0.33) as well as self-management behavior (r=0.47) in the patients with type 2 diabetes (P < 0.01). The mediating effect of self-efficacy accounted for 38.28% of the total effect of self-management ability on self-management behaviors and was higher in the behaviors of blood glucose monitoring (43.45%) and diet control (52.63%). The mediating effect of self-efficacy accounted for approximately 40.99% of the total effect for the patients with disease course ≤ 5 years, while for the patients with disease course > 5 years, the mediating effect accounted for 39.20% of the total effect.@*CONCLUSION@#Self-efficacy enhanced the effect of self-management ability on the behavior of the patients with type 2 diabetes, and this positive effect was more significant for the patients with shorter disease course. Targeted health education should be carried out to enhance patients' self-efficacy and self-management ability according to their disease characteristics, to stimulate their inner action, to promote the development of their self-management behaviors, and to form a more stable and long-term mechanism for disease management.
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Humans , Diabetes Mellitus, Type 2/therapy , Self Efficacy , Self-Management , Blood Glucose Self-Monitoring , Blood Glucose , Self CareABSTRACT
Objective@#To evaluate the effect of Triangle hierarchical management among community patients with hypertension, so as to provide insights into the improvements of standardized hypertension management.@*Methods@#Patients with newly diagnosed hypertension from 2 community health service centers in Qiantang District of Hangzhou City by the end of 2020 were randomly assigned to the conventional group and the Triangle group. Patients in the conventional group were given health management services according to the requirements of basic public health service standard for one year, while patients in the Triangle group were given Triangle hierarchical management. The blood pressure, self-management behaviors, treatment compliance, smoking, alcohol consumption and exercise were collected using the self-management behavior scale, treatment compliance scale and self-designed questionnaires, and were compared before and after intervention with analysis of covariance and generalized estimation equations.@*Results@#Totally 200 patients with hypertension were recruited, including 100 patients in the conventional group and 100 patients in the Triangle group. There were no significant differences between the two groups before implementation of interventions in terms of gender, age, educational level or occupation (P>0.05). The reduction in blood pressure, increase in the score of treatment, diet, exercise and living habitat management and the total score of self-management behaviors, increase in the score of adherence to medication regimens, daily living management behaviors, smoking and alcohol consumption preference and the total score of treatment compliance, and increase in the number of patients with normal standard of quitting smoking, quitting alcohol consumption, exercise and blood pressure were significantly higher in the Triangle group than in the conventional group after intervention (P<0.05). @*Conclusions @#Triangle hierarchical management may increase the treatment compliance, improve the self-management behavior and facilitate hypertension control among hypertensive patients, which may be popularized for health management among community patients with hypertension.
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Objective:To investigate the effect of nurse-led stress inoculation training on fear of self-injecting and self-testing and self-management behaviors in elderly type 2 diabetic patients and provide reference for diabetes nursing care.Methods:A total of 110 elderly type 2 diabetic patients of Department of Endocrinology of Hainan People′s Hospital from January 2018 to January 2020 were divided into experimental group and control group according to odd and even numbers, with 55 patients in each group. The control group received routine nursing care, while the experimental group implemented nurse-led stress inoculation training for 4 weeks. The intervention effect was assessed by Diabetes Fear of Injecting and Self-testing Ouestionnaire (D-FISQ) and Diabetes self-management behaviors among older (DSMB-O), respectively.Results:In the study, one patient in the experimental group fell off, and finally included 54 cases in the experimental group and 55 cases in the control group. After intervention, the fear of self-injecting scores, fear of self-testing scores, and total D-FISQ scores were 13.15 ± 3.02, 15.67 ± 3.59 and 28.81 ± 5.08 in the experimental group, significantly lower than those in the control group (15.25 ± 3.18, 17.56 ± 3.92 and 32.82 ± 4.89), the difference was statistically significant ( t=3.55, 2.63, 4.19, P<0.05). Active exercises, current medication, blood glucose monitoring, dealing with problem, active response, reducing risks scores and total DSMB-O scores were 2.39 ± 0.49, 2.39 ± 0.49, 2.20 ± 0.81, 4.41 ± 0.92, 4.70 ± 1.13, 5.06 ± 0.79 and 25.28 ± 2.57 in the experimental group, significantly higher than those in the control group (3.95 ± 0.85, 2.11 ± 0.85, 1.51 ± 0.50, 3.95 ± 0.78, 4.13 ± 1.43, 4.38 ± 1.16 and 22.09 ± 2.24), the difference was statistically significant ( t values were 2.10-6.90, P<0.05). Conclusions:Nurse-led stress inoculation training can effectively alleviate fear of self-injecting and self-testing and promote self-management behaviors of elderly patients with type 2 diabetes.
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Objective:To investigate the resilience level and self-management status of patients with type 2 diabetes and analyze the mediating effect of mindfulness level between the resilience and self-management behavior.Methods:Totally 219 patients with type 2 diabetes from December 2019 to April 2020 were selected as the research subjects.The general information questionnaire, Mindful Attention Awareness Scale, Connor-Davidson Resilience Scale, and the Summary of Diabetes Self-Care Activities were used to investigate all patients.SPSS 22.0 was used for statistical analysis.Spearman correlation analysis was used to analyze the relationship among the variables, and multiple linear stepwise regression analysis was used to analyze the mediating effect.Results:The correlation analysis showed that resilience(45.0 (40.0, 50.0)) was positively related to self-management(14.0 (9.0, 22.0)) ( r=0.876, P<0.05), and mindfulness(46.0 (40.0, 57.0)) ( r=0.838, P<0.05). Mindfulness was positively related to self-management( r=0.821, P<0.05). The mediating effect test showed that mindfulness played a part of mediating role between resilience and self-management, with the mediation effect of 0.56, accounted for 69.80% of the total effect. Conclusion:The variables of mindfulness, mental resilience and self-management behavior in type 2 diabetic patients are positively correlated with each other.Mindfulness plays a partial mediating role between mental resilience and self-management behavior.
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Objective:To explore the effect of cognitive-behavioral therapy on fear of hypoglycemia and self-management behavior of patients with steroid diabetes mellitus.Methods:A total of 76 patients with steroid diabetes mellitus from August 2018 to October 2019 in the First Affilated Hospital of Nanjing Medical University were selected and divided into experimental group and control group according to the admission time, and each group contained 38 cases. The control group recieved routine therapy and nursing care, on the basis of this, the experimental group was given cognitive-behavioral therapy for 8 weeks. Before and after 8 weeks of intervention, the effects were assessed by Chinese version Hypoglycemia Fear Surgey-Worry Scale(CHFSⅡ-WS) and Sumary of Diabetes Self Care Activities (SDSCA), respectively.Results:There was no significant difference in the score of CHFS Ⅱ-WS, SDSCA before intervention between the two groups( P>0.05). After 8 weeks of intervention, the scores of worry & fear and total CHFS Ⅱ-WS scores were (6.61±1.66), (8.75±1.73) points in the experimental group and (7.60±1.44), (9.69±1.77) points in the control group, the differences were statistically significant ( t values were 2.678, 2.247, P<0.05); in addition, the scores of diet, exercise, blood sugar testing, medications in SDSCA were (20.36±1.91), (11.86±2.27), (7.19±1.56), (6.86±0.99) points in the experimental group, and (18.51±1.50), (9.89±2.29), (5.71±1.45), (5.31±1.18) points in the control group, the differences were statistically significant ( t values were 3.644-5.983, P<0.05). Conclusions:Cognitive-behavioral therapy can effectively alliviate fear of hypoglycemia and promote self-management behavior of steroid diabetes mellitus patients.
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Objective: To explore the effect of continuous nursing on self-management behavior and living quality of patients who received maintenance hemodialysis (MHD) in primary hospital. Methods: Sixty patients who received MHD were randomly divided into control group (n=30) and observation group (n=30). Patients of control group received routine health education, and that of observation group received the intervention of continuous nursing based on the routine method of control group. The self-management behavior and living quality of the two groups were scored at pre- and 6 month post- intervention so as to compare the self-management behavior and living quality between the two groups. Results: After 6 months, the self-management behavior of observation group was significantly higher than that of control group (t=1.712, P<0.05). The scores (51-60) of living quality of observation group was significantly higher than that of control group(x2=8.01, P<0.05). Conclusion: Continuous nursing is an effective way to improve the self-management behavior and living quality of patients received hemodialysis in primary hospital.
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Objective To explore the self-management behaviors of the patients with lumbar disc herniation. Methods Chronic disease self-management behavior measuring scale was used to investigate the self-management behaviors of 96 lumbar disc herniation patients. Results The score on self-management behaviors of the LDH patients was 20.42±7.52. 65.63%~84.38%of the patients took the wrong position at sitting, moving articles, and fetching articles from a low and high spot. 59.38%of them did not wear the waist supporter. 73.96%~95.83%of them did not follow the doctors' advice to sleep on hard bed, carry weights and keep the back warm. Conclusions The self-management behavior among LDH patients is dissatisfying. The nurses should provide patients with education on self-management behaviors, instructing them to take effective functional exercises, focusing on importance of cognitive symptom management in relieving pain and reducing negative emotion. Meanwhile, the nurses should advice patients to take right self-management behavior in daily life in order to promote the recovery of the function by patients' healthy behavior and life style.
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Objective To explore the self-management behaviors of the patients with lumbar disc herniation. Methods Chronic disease self-management behavior measuring scale was used to investigate the self-management behaviors of 96 lumbar disc herniation patients. Results The score on self-management behaviors of the LDH patients was 20.42±7.52. 65.63%~84.38%of the patients took the wrong position at sitting, moving articles, and fetching articles from a low and high spot. 59.38%of them did not wear the waist supporter. 73.96%~95.83%of them did not follow the doctors' advice to sleep on hard bed, carry weights and keep the back warm. Conclusions The self-management behavior among LDH patients is dissatisfying. The nurses should provide patients with education on self-management behaviors, instructing them to take effective functional exercises, focusing on importance of cognitive symptom management in relieving pain and reducing negative emotion. Meanwhile, the nurses should advice patients to take right self-management behavior in daily life in order to promote the recovery of the function by patients' healthy behavior and life style.
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Objective To explore the mediating effect of self-management behavior between nervous functional defects and health condition in patients with stroke.Methods A total of 100 patients with stroke chosen in Jianhu hospital affiliated to Nantong University from March to June 2015 were investigated using SSMBS,SSS and SRHMS through questionnaires after they left hospital for one year.The data was analyzed by stepwise regression analysis and Bootstrap procedure via SPSS13.0 and AMOS7.0.Results The total scores of SSS,SSMBS and SRHMS were (13.38±5.29),(162.59±21.43) and (278.13±51.48),respectively.Bivariate correlation analysis showed that there were correlations among self-management behavior,neurological impairment and self-rating health (r=-0.735,-0.568,0.693,P<0.01).The value of the mediating effect of self-management behavior was 0.137,accounting for 24.1% of the total effect.Bootstrap test showed 95% confidence interval of the direct mediating effect of self-management behavior was (0.006,0.208).Conclusions elf-management behavior has stronger mediating effect between nervous functional defects and health condition,it is a predictive factor of nervous functional defects and health condition.Medical workers should enhance the intervention of health self-management behavior for the patients with chronic diseases such as stroke.
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Objective To explore the effect of information-motivation-behavioral (IMB) skills model on self-management behavior and self perceived burden of elderly patients with permanent bladder fistula. Methods A total of 92 elderly patients with permanent urinary bladder fistula were randomly divided into experiment group and control group in our hospital from November 2015 to November 2016, 46 cases in each group. In the control group, taking classes, face-to-face education were done for a total of 6 months once a month, 60 minutes each time. In the experiment group, the IMB model was used for the nursing intervention for a total of 6 months once a month, 60 minutes each time. The two groups of patients were assessed by self management behavior scale and self perceived burden scale. Results After the intervention, the score on self-management ability of the experiment group was (76.32 ± 4.73), higher than (67.22 ± 3.14) of the control group (P<0.05). The score on the self perceived burden of the experiment group was significantly lower than that of the control group (10.32 ± 4.48 vs. 19.98± 6.63, P<0.05). Conclusion The implementation of IMB model can improve the self-management behavior of elderly male patients with bladder fistula, and reduce the burden of self perception.
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Objective To explore the effects of self-management strategies on self-efficacy and selfmanagement behavior in female college students with primary dysmenorrhea.Methods Implementing the plan that the interventional group (n=195) received self-management strategies,while the control group (n =196) did not received any intervention.Followed up six months,the self-efficacy and self-management behaviors and Visual Analogue Scale/Score (VAS) of dysmenorrhea pain were compared between two groups before and after the intervention.Results At the 6th month of observation period,the scores of self-efficacy in the intervention group (2.61 ±0.48) were significantly improved compared with the baseline (2.37 ± 0.36) and the control group(2.43±0.46) (both P＜0.05).Besides taking medicine to alleviate dysmenorrhea,other items in the self-management behaviors were significantly higher than baseline and control group (both P＜ 0.05).The mean of dysmenorrhea pain VAS of 6th menstrual period in the intervention group was lower than baseline and the control group (P＜0.05).Conclusion The self-management strategies can effectively improve the self-efficacy and self-management behaviors among female college students,and alleviate the degree of dysmenorrhea pain.
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Objective To describe the self-management behaviors and self-efficacy in patients with chronic low back pain (CLBP) and to explore the relationship between them. Methods The Chronic Disease Self-Management Study Measures and the Chronic Disease Self-Efficacy Scale were used to investigate a total of 113 patients with chronic low back pain. Results The average score of self-management behavior of CLBP patients was 21.42 ± 8.11. The average time for exercise was (168.72 ± 148.97) min/week;the average level of cognitive symptoms management practice and communication with physicians were 1.70 ± 0.74 and 2.10 ± 1.05 respectively. The self-efficacy was achieved the average level of 7.10 ± 1.88. There was a positive and significant correlation between the self-management behaviors and self-efficacy (P<0.05 or 0.01). Conclusions The self-management behaviors among patients with chronic low back pain was poor and was related with self-efficacy. Individualized health education was needed for improving self-efficacy, which would be benefit for self-management behaviors.
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Objective To prepare a primary dysmenorrhea self-management behavior scale used for female college students in China.Methods Based on Green health education model,a pool of 40 items was made through literature review as well as semistructured interviews on primary dysmenorrhea in female college sudent.In the following,a primary dysmenorrhea scale for female university students with 20 items was made by considering the advice from five obstetrists and gynecologists and employing a pre-test.Then the primary scale was used for an investigation among 100 female college students with dysmenorrheal and the items were screened by using by item analysis,and a scale with 19 items was decided.The revised scale was finalized by using it among 500 female students with dysmenorrheal in a college in Dalian for a formal investigation,with the reliability and validity tested by factor analysis and correlation analysis.Results The finalized scale was estabhshed containing four dimensions of 19 items.The scale internal consistency Cronbach's α coefficient was 0.91,the index on behaviour,gaining knowledge,treatment compliance and asking for help 0.77,0.88,0.86 and 0.84 respectively.The retest reliability was 0.92 and the index on each dimension was 0.76,0.84,0.83 and 0.77,respectively.The total content validity index of scale content validity index (S-CVI) was 0.93.The content validity index of each dimension,the item cotent validity (I-CVI)was 0.93,0.92,0.92 and 0.94,respectively.By exploratory factor analysis and screen plot,four factors were extracted,with a cumulative contribution rate of 62.90％.The correlation coefficients between the various dimensions were 0.12 to 0.35 and the correlation coefficients between the dimensions and total score were 0.49 to 0.78 (all P ＜0.05).Conclusions Primary dysmenorrhea self-management behavior scales for female college students has a good reliability and validity.It can be used as a tool to evaluate the self management behaviors of female college students in our country.
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Objective To explore the effects of empowerment education model on glycemic control and self-management behavior of community patients with diabetes. Method A total of 120 diabetics from 2 different communities were set as the observation group and control group. The control group was treated by routine medications and health education and the observation group was intervened with empowerment education model. After intervention for 6 months, the patients′blood glucose index and the diabetes self-management behavior were assessed and compared by scale of the diabetes self-care activities (SDSCA) between the two groups. Result By the end of the study, the glycemic index and SDSCA score in the former group were both significantly decreased than those in the control group (P<0.05), indicating the patients in the experiment group had better glycemic control and self-management behaviors compared with those in the control group. Conclusions Empowerment education model can arouse the internal motivation of patients to change their behaviors from passive to active acceptance in the health education. Empowerment education model can enhance diabetes patients′self-management conduct and the glycemic level.
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Objective To investigate the status of self-management behaviors and sense of coherence (SOC) in patients with type 2 diabetes as well as their correlation. Method A total of 348 patients with type 2 diabetes participated in the survey by way of the general demographic data form, diabetes self-care scale (2-DSCS) and sense of coherence scale (SOC-13). Results The total score on 2-DSCS was (65.61 ± 14.55), and 17.24%of them were scored fairly well. The total score on SOC-13 was (63.25 ± 11.46), with an average score of (4.87 ± 0.88) on every dimension of it. The total score on 2-DSCS together with its dimensions was positively correlated with the total score on SOC-13(P<0.05, P<0.01). Conclusions The SOC and self-management in patients with type 2 diabetes should be enhanced. In order to improve the level of self-management, nurses should take some individualized interventional measures based on the level of SOC in patients.
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Objective To explore the current situations in self-management of cancer patients over peripherally inserted central catheter (PICC) and the influencing factors. Method Self-designed general demographic data form, disease-related questionnaire and PICC self-management ability for cancer patients were used to investigate 98 tumor patients with PICC. Results The total score on self-management ability of the cancer patient with PICC was (150.85 ± 17.35). The influencing factors of their self-management of PICC included education level, economic condition, presence or absence of long-term caregivers and cognitive disorders, all contributive to the prediction of 28.60%total variance for the patients′self-management capability. Conclusions Cancer patients have a better ability in managing PICC, but a few patients failed to grasp self-management skills, which was resulted from many factors. Nurses should pay more attention to those with less education, under poorer economic conditions and without long-term caregivers, and provide them with more care and education so as to comprehensively improve their self-management skills.
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Objective To probe into the relationship of self-management behavior and hope level in patients with coronary heart disease after percutaneous coronary intervention (PCI).Methods The research instruments included three questionnaires:the Coronary Artery Disease Self-management Scale,the Herth Hope Scale and the demographic characteristics of respondents.Results Self-management behavior was in medium level and it was necessary to be improved.The total score of self-management behavior was positively correlated with hope level.Conclusions Medical workers should fully understand the status of selfmanagement behavior,and promote desirable self-management behavior through increase of hope level.