Experiences of Facilitators and Inhibitors to Treatment Adherence in Patients with Heart Failure.

Treatment adherence is a fundamental aspect of heart failure (HF) management. This study aimed to explore the experiences of facilitators and inhibitors of treatment adherence in patients with HF. This descriptive qualitative study was conducted from May 2020 to June 2021. Participants including people with HF, their family caregivers and physicians, and nurses were selected purposefully, with the aim of obtaining sufficient information power. Semi-structured interviews were used to collect data. Data were analyzed using thematic analysis. Two main themes "the driving forces behind treatment adherence" and "the deterrent forces behind treatment adherence" emerged from the analysis. The first theme contained the following subthemes: "supportive family," "positive personality characteristics," and "having health literacy." The second theme consisted of "negligence," "psychological problems," "cultural, social, and economic problems," "physical limitations," and "lack of self-care management knowledge." Nurses can consider facilitators and inhibitors of treatment adherence in designing educational and care programs for patients with HF.

[Narratives on changes in health-related behaviours during lockdown in Spain according to gender]. / Narrativas sobre cambios de conductas en salud durante el confinamiento en España según género.

OBJECTIVE: To explore experiences related to health-oriented behaviours during lockdown in the Spanish resident population from a gender perspective. METHOD: Qualitative research with a critical and feminist approach. Twenty-nine semi-structured interviews (17 women and 12 men) were conducted between June and July 2020 via telephone with people who had previously answered an online survey. The interviews were transcribed and a thematic content analysis was carried out, differentiating between the experiences of women and men. The data were triangulated by the research team. RESULTS: Among women, greater diversity emerged in terms of health behaviours. Among them, the difficult experiences related to COVID-19, the complexity of living together and doing unpaid care work, as well as the importance of support networks, stood out. Among men, there were different attitudes towards sport, self-care and having time for healthy eating were positively valued, and there was a good assessment of coexistence and organisation in household chores. In both men and women, work overload and economic problems were related to emotional distress and difficulties in carrying out healthy activities. CONCLUSIONS: Health-oriented behaviours during lockdown differed according to gender. They were mostly limited to COVID-19 experiences, socio-economic conditions and burden of care. It is essential to tailor public health and primary care programmes according to people's life moments, taking into account their social context and questioning traditional gender roles.

Dietary self-care and associated factors among diabetic patients in Jimma University Medical Centre, South West Ethiopia; A path analysis.

BACKGROUND: Diabetes Mellitus (DM), a chronic metabolic disorder that caused about 4.2 million deaths and at least 760 billion dollars' expenditure in 2019, has been targeted for action by leaders of WHO member countries. In Ethiopia deaths, due to DM reached 34,262 in 2013. Studies show effective lifestyle interventions; particularly medical nutrition therapy reduces HbA1c by 0.5 to 2%. However, practicing recommended diet is reported to be difficult. Not only Knowledge and practice but also perception studies are therefore necessary to design future health programs. OBJECTIVE: To assess diabetic self-care, dietary practice and associated factors among diabetes patients. METHOD: Institution-basedbased cross-sectional study design was employed from february15-May15, 2020 in Jimma university medical Centre (JUMC). Systematic sampling of every other patient (K = 2.7) was employed to interview 371 participants. A previously validated tool was used to collect data through a face-to-face interview. A path analysis was used to fit the structural model and tests the hypothesized Health Belief Model (HBM) relationships. RESULT: Response rate was 95.4% (354). Around 52% of the participants were male and 76.8% follow diabetic education at least some times. 42.4% and 48% of respondents have good dietary and general self-care practices respectively. With unstandardized coefficient (standard error) self-efficacy0.10 (0.01) being the strongest cues to action0.10 (0.02), perceived threat0.02 (0.01), and perceived barrier-0.08(0.01) constructs of HBM have a significant effect on dietary practice. Knowledge, social support and diabetes distress exert a significant indirect effect on dietary practice through health belief constructs with unstandardized path coefficient (standard error) of 0.22(0.03), 0.02(0.01), and -0.03(0.004) respectively. CONCLUSION: In this study, the proportion of good practice is found to be lower for both dietary as well as general self-care. HBM can best fit to explain variability in dietary self-care practice; therefore, future interventions should be designed to address the vast perception and psychosocial factors influencing dietary self-care practices.

Developing Resilience: Strategies to Adapt Within an Interprofessional Team.

Resilience can be defined as sustaining well-being in the face of adversity by harnessing internal and/or external resources. Many of the strategies that promote highly effective teams, such as regulating emotions, self-reflection, and inclusion, may also contribute to team resilience. Nurse leaders can facilitate social connections, optimism, self-care, mindfulness practices, and meaningful recognition as strategies to promote nurse resilience. Resilience may mitigate many of the harmful effects for nurses working in the high demanding health care work environment.

Spiritual Health First Aid for Self-Care: Nursing During COVID-19.

ABSTRACT: Nurses who provided care to patients with coronavirus (COVID-19) and supported patients in their transition from life to death in the absence of patients' families have been especially needful of spiritual self-care. A spiritual first aid kit can help nurses cope with these difficult times. Spiritual self-care is vital for all nurses to renew and preserve the psychological, spiritual, and physical self.

Association between Fear of COVID-19 with Self-care Behaviors in Elderly: A Cross- Sectional Study.

This study aims to determine the association between fear of COVID-19 with self-care in the elderly. This is a cross-sectional study, in which data were collected using the online survey method with three questionnaires: social demographic characteristics, fear of COVID-19, and elderly self-care. The 350 elderly people were selected by multi-stage sampling from the list of households registered in the integrated health system. According to the result, the mean (SD) age of participants was 69.91 (5.19) and two-thirds of them were married, also the majority of the participants (55%) had an education level less than a diploma. A direct and statistically significant correlation was observed between fear of COVID-19 and self-care. Linear regression analysis showed that the self-care rate decreases with increasing of the COVID-19 fear (B = -0.395, SE = 0.001, R2 = 0.154). The lowest scores were related to self-care which can be due to the restrictions applied and limited family relations during the COVID-19 epidemic. Therefore, it is recommended that purposeful training programs and appropriate psychological support interventions are developed to help overcome COVID-19 fear and help elderly people use preventative behaviors.

COVID-19 lockdown disrupts support networks integral to maintaining foot health: a mixed-methods study.

BACKGROUND: In response to the COVID-19 pandemic, populations were advised to remain at home to control viral spread. Government-mandated restrictions on free movement affected individuals' engagement with physical activity, with reported increases leading to biopsychosocial health benefits and conversely increased sedentary behaviour leading to poorer health. Good foot health is key to enabling physical activity and maximal participation in activities of occupation and daily living. METHODS: A population-based cross-sectional study was performed, using a web-based platform. Quantitative and qualitative data were captured through responses to closed and open survey questions. Anybody with a foot health condition was eligible to participate in the online survey. Links were sent through professional networks, support groups and charities, using a snowball strategy to maximise participation. RESULTS: Two hundred fifty-five respondents completed the survey. Most (n = 193, 75.69%) reported an ongoing foot pain or problem that had been present for 4 weeks or longer, whilst 49 respondents (19.22%) noted a new pain or problem. Pain was the most frequently reported symptom (n = 139, 54.51%), whilst change in appearance of the foot was also commonly reported (n = 122, 47.84%), often alongside the observable presence of swelling. Musculoskeletal foot symptoms were frequently reported (n = 123, 48%), and were significantly associated with reported reduced physical activity (X2 = 6.61, p = 0.010). Following qualitative analysis five themes and 11 subthemes emerged, informed by 49 independent codes. A central theme of lockdown disrupting support networks, both formal (healthcare providers) and informal (friends or family members) emerged. The 5 sub-themes were: 1. foot pain is a constant companion, 2. self-care, 3. 'cope or crumble' scenarios, 4. future intent to access healthcare and 5. reduced ability to undertake physical activity. CONCLUSIONS: Pain was the most frequently reported foot problem during COVID-19 lockdown restriction. Lockdown restrictions disrupted support networks integral to maintaining foot health. Poor foot health impacted people's ability to remain physically active. Complaints previously considered relatively 'minor' such as support for skin and nail care, were found to be exacerbated by restricted support networks, leading to greater negative impact.

Experiences and Views of Domestic Summer Travelers During the COVID-19 Pandemic: Findings from a National Survey.

Domestic travel creates a serious risk of spreading COVID-19, including novel strains of the virus. Motivating potential travelers to take precautions is critical, especially for those at higher risk for severe illness. To provide an evidence base for communication efforts, we examined the experiences and views of travelers during the summer of 2020 through a telephone survey of 1,968 US adults, conducted in English and Spanish, July 2 through July 16, 2020. The survey found that more than one-quarter (28%) of adults had traveled domestically in the prior 30 days, most commonly for "vacation" (43%), and less than half wore masks (46%) or practiced social distancing (47%) "all of the time." Although high-risk adults were significantly less likely to travel than non-high-risk adults (23% vs 31%; P < .001), they were no more likely to take precautions. Many travelers did not wear a mask or practice social distancing because they felt such actions were unnecessary (eg, they were outside or with friends and family). Although a substantial share of travelers (43% to 53%) trusted public health agencies "a great deal" for information about reducing risks while traveling, more travelers (73%) trusted their own healthcare providers. Findings suggest that outreach may be improved by partnering with providers to emphasize the benefits of layering precautions and provide targeted education to high-risk individuals. Messages that are empathetic to the need to reduce stress and convey how precautions can protect loved ones may be particularly resonant after more than a year of pandemic-related restrictions.

Communicating bad news in the context of COVID-19.

Communicating bad news is one of the most frequent activities in hospitals, for which some recommendations have been adapted to the needs within the coronavirus-2 disease (COVID-19) context. This document presents nine steps to deliver bad news (face to face or remotely) adapted to the COVID-19 context from two international protocols (SPIKES and GRIEV_ING). The importance of promoting physical and emotional self-care skills in health personnel is also described, as well as psychological first aid strategies to address the emotional response of the family member who receives the news. Finally, the limitations and advantages of the proposal should be considered.

La comunicación de malas noticias es una de las actividades más frecuentes en los hospitales dentro del contexto de la COVID-19. A pesar de su alta frecuencia, existen pocas recomendaciones adaptadas a las necesidades que el contexto de la COVID-19 demanda. Debido a lo anterior, en el presente escrito se presentan nueve pasos para dar malas noticias (cara a cara o por vía remota) de dos protocolos internacionales (SPIKES y GRIEV_ING) adaptados a las necesidades de transmisión de información de la COVID-19. Se describe también la importancia de promover habilidades de autocuidado físico y emocional en el personal de salud, así como estrategias de primeros auxilios psicológicos para el abordaje de la respuesta emocional del familiar que recibe la noticia. Finalmente, se deben considerar las limitaciones y ventajas de la propuesta.

Case Management in a Time of Uncertainties.

The year 2020 was a time of uncertainties and unpredictability. In this issue of Professional Case Management Journal, 2 articles discuss the issues of prolonged grief, complicated grief, and self-care.

Self-care among healthcare social workers: The impact of COVID-19.

For social work practitioners in healthcare settings, self-care can be an integral tool to assuaging stressors associated with COVID-19. However, research that examines the impact of public health crises, such as COVID-19, is nominal, at best. This exploratory study investigated the impact of COVID-19 on the self-care practices of self-identified healthcare social workers (N = 2,460) in one southeastern state. Primary data were collected via an electronic survey and assessed via a retrospective pre/post design. Analyses compared practices before and after COVID-19 was declared a pandemic. Overall, data suggest that participants experienced significant pre/post decreases in self-care practices across multiple domains. As well, findings indicate that participants who identified as married, financially stable, and working non-remotely, and in good physical/mental health engaged in significantly more self-care practices than other participants, at post. This study underscores the need to foster supportive professional cultures that include developing self-care practice skills, particularly during large-scale crisis, such as COVID-19.

COVID-19 precautionary behavior among Israeli breast cancer patients.

OBJECTIVE: Cumulative knowledge indicates that cancer patients, among them breast cancer patients, are more susceptible to COVID-19 than individuals without cancer. Therefore, these patients need to take additional precautions against the COVID-19 outbreak. This study aimed to examine factors associated with precautionary behavior among Israeli breast cancer patients during the COVID-19 pandemic. METHODS: A cross-sectional study was conducted among 151 women with breast cancer. Participants completed measures of knowledge about COVID-19, perceived threat, sense of mastery, social support, precautionary behavior, and socio-demographic questionnaires. A multivariate regression model was calculated with precautionary behavior as the dependent variable. RESULTS: The mean of precautionary behavior score was relatively high. Participants perceived their health as relatively good, had relatively high knowledge about COVID-19, and moderate perceived threat. Sense of mastery was relatively moderate and perceived social support was relatively high. In the multivariate regression analysis, after controlling for the background variables, knowledge about COVID-19 (F(2,149) = 8.68, p < 0.001; beta = 0.36) was significantly associated with precautionary behavior. This variable explained 15.4% of the precautionary behavior variance. CONCLUSION: Findings suggest that in order to enhance precautionary behavior among women with breast cancer during a pandemic outbreak, it is recommended to pay attention their knowledge about the virus.

Validity and reliability of the Self-Care Activities Screening Scale (SASS-14) during COVID-19 lockdown.

BACKGROUND: In a context where there is no treatment for the current COVID-19 virus, the combination of self-care behaviours together with confinement, are strategies to decrease the risk of contagion and remain healthy. However, there are no self-care measures to screen self-care activities in general population and which, could be briefly in a lockdown situation. This research aims to build and validate a psychometric tool to screen self-care activities in general population. METHODS: Firstly, an exploratory factor analysis was performed in a sample of 226 participants to discover the underlying factorial structure and to reduce the number of items in the original tool into a significant pool of items related to self-care. Later a confirmatory factor analyses were performed in a new sample of 261 participants to test for the fit and goodness of factor solutions. Internal validity, reliability, and convergent validity between its score with perceived stress and psychological well-being measures were examined on this sample. RESULTS: The exploratory analyses suggested a four-factor solution, corresponding to health consciousness, nutrition and physical activity, sleep, and intra-personal and inter-personal coping skills (14 items). Then, the four-factor structure was confirmed as the best model fit for self-care activities. The tool demonstrated good reliability, predictive validity of individuals' perception of coping with COVID-19 lockdown, and convergent validity with well-being and perceived stress. CONCLUSIONS: This screening tool could be helpful to address future evaluations and interventions to promote healthy behaviours. Likewise, this tool can be targeted to specific population self-care's needs during a scalable situation.

Supports for people with intellectual and developmental disabilities during the COVID-19 pandemic from their own perspective.

BACKGROUND: Individuals with intellectual and developmental disabilities (IDD) represent a particularly vulnerable group to the threats posed by COVID-19. However, they have not yet been given a voice on how their living conditions have been affected by COVID-19. AIMS: This study aims to report the impact on people with IDD of COVID-19 and the response measures applied in Spain during the lockdown. METHOD: Data on 582 individuals with IDD were collected through a survey. Seven open questions were included to capture the perspectives of people with IDD on COVID-19 and its consequences. Content analysis was performed to identify themes and categories across participant responses. Chi-square tests were used to analyze the relationship between reporting a specific category and participants' characteristics. RESULTS: Supports have been conditioned by the living context. People living in specific settings had fewer natural supports, while those living with their family relied heavily on it. Participants also lacked supports considered necessary. It is worth stressing that persons with IDD have also provided support to others. CONCLUSIONS: Although people with IDD have generally received the assistance they need during the lockdown, it must be ensured that appropriate supports are provided regardless of the context in which they live.

Gesundheitsverhalten und Bedürfnisse von Menschen mit COPD während der COVID-19-Pandemie - Eine Dokumentenanalyse.

Health behaviours and needs of people with COPD during COVID-19 pandemic: a document analysis Abstract. Background: The government's guidelines affected people with COPD on different levels during the COVID-19 pandemic. In addition to belonging to a group of particularly vulnerable persons, they had to adapt their health behaviours, in particular physical activity, to recommendations provided in order to prevent negative effects on disease progression. There is little knowledge regarding how this group of patients coped with these challenges during the COVID-19 pandemic. OBJECTIVE: To describe the health behaviours and needs people with COPD convey during nursing phone consultations and which nursing interventions have been carried out. METHODS: A document analysis of 50 nursing phone consultations was performed. The data were summarised descriptively and analysed thematically. RESULTS: The main topics were the adaptation of physical activity, the implementation of the recommendations to the individual life situation, the detection of a COVID-19 infection and questions concerning the planning of medical appointments. CONCLUSION: The COVID-19 pandemic poses additional challenges to the disease management of people with COPD. The increased need for care brought on by the pandemic was able to be met by the knowledge provided in the nursing phone consultations. What remains to be established is what role the consultations play in a sustainable change in behaviour and in dealing with negative emotions.

Psychiatric Manifestations of COVID-19 and Their Social Significance.

Alterations in complex behavioral patterns during the extended period of the COVID-19 pandemic are predicted to promote a variety of psychiatric disease symptoms due to enforced social isolation and self-quarantine. Accordingly, multifaceted mental health problems will continue to increase, thereby creating a challenge for society and the health care system in general. Recent studies show that COVID-19 can directly or indirectly influence the central nervous system, potentially causing neurological pathologies such as Alzheimer disease and Parkinson disease. Thus, chronic COVID-19-related disease processes have the potential to cause serious mental illnesses, including depression, anxiety, and sleep disorders. Importantly, mental health problems can foster systemic changes in functionally-linked neuroendocrine conditions that heighten a person's susceptibility to COVID-19 infection. These altered defense mechanisms may include compromised "self-control" and "self-care", as well as a "lack of insight" into the danger posed by the virus. These consequences may have serious social impacts on the future of COVID-19 survivors. Compounding the functionally related issues of altered mental health parameters and viral susceptibility are the potential effects of compromised immunity on the establishment of functional herd immunity. Within this context, mental health takes on added importance, particularly in terms of the need to increase support for mental health research and community-based initiatives. Thus, COVID-19 infections continue to reveal mental health targets, a process we must now be prepared to deal with.

Self care practices and psychological distress among diabetic patients in Manipur during COVID-19: A scenario from the North East.

BACKGROUND AND AIM: Uncontrolled diabetes has emerged as one of the major risk factors for mortality in patients with coronavirus disease (COVID-19). Physical inactivity, alterations in dietary habits, and inability to seek guidance from the physician are some of the contributing factors. This study aims to assess the self-care practices and psychological distress during the pandemic among diabetic patients visiting the institute's out patient department. METHOD: A convenient sampling method was used to recruit subjects from a representative clinical sample using validated scales like the Summary of Diabetes Self-Care Activities (SDSCA) and Kessler Psychological Distress Scale (K10). RESULT: The study enrolled a total of 108 subjects with the mean age being 56.3 years. The everyday healthy eating plan was followed by 76.85% (N = 83) subjects and daily physical activity for at least 30 min performed by 50% (54) subjects. Only 12.04% (13) subjects tested their blood sugar and 6.48% (7) respondents checked their feet daily. There was no significant difference found between the SDSCA and psychological distress based on socio-demographic variables. CONCLUSION: Participants in this study typically reported a good level of self-care behavior particularly for diet followed by exercise whereas the self-care behavior was not adequate for foot care and blood-glucose testing. People were not too anxious about COVID-19. This study highlighted the fact that people with diabetes should monitor their blood sugar levels more often along with their foot care.