Selected factors related to physical activity among persons with heart failure in a university-affiliated hospital, Bangkok, Thailand.

Background: Heart failure is a complex clinical syndrome that disturbs physical and psychological health and the quality of life of persons with heart failure and their families. Physical activity is one of the essential self-care in persons with heart failure, which can decrease the exacerbation of the heart failure symptoms, increase activity tolerance, ability to accomplish daily activities, and improve quality of life. Objectives: This research aimed to determine the physical activity level among persons with heart failure and explore the relationship between physical activity and its related factors based on the self-and family management framework, including motivation, functional ability, family support, and perceived quality of patient-provider relationships. Methods: A correlational cross-sectional study was conducted with a total of 70 participants who visited the Multidisciplinary Heart Failure Clinic of a university-affiliated hospital, Bangkok, Thailand, from December 2020 to May 2021. Participants were asked to complete five questionnaires that explored their physical activity and its related factors. Data were analyzed and reported using descriptive statistics and correlation coefficient, and the p-value of .05 was considered to be statistically significant. Results: The results showed most participants (78.50%) had a high physical activity level, and the other participants (21.50%) had a moderate physical activity level. Regarding the relationship between physical activity and its related factors, a total physical activity had a significant positive correlation with a functional ability (rs = .309, p < .05), and family support (r = .210, p < .05). While the physical activity had a positively non-significant correlation with motivation (r = .050, p > .05), and a negatively non-significant correlation with perceived quality of patient-provider relationships (r = -.049, p > .05). Conclusion: The research can be used to gain more understanding of physical activity among persons with heart failure. Nurses play an accountable role in promoting and providing appropriate interventions to constantly maintain and enhance physical activity as secondary prevention in persons with heart failure. Additionally, measuring physical activity using an objective measurement with the self-report should be considered for the favorable outcome.

Improving clinical outcomes of diabetic foot ulcers by the 3-month self- and family management support programs in Indonesia: A randomized controlled trial study.

BACKGROUND AND AIMS: Diabetic foot ulcers are the leading cause of lower extremity amputations, which require more effective prevention. Even though previous nursing studies on diabetic foot ulcers have been well performed, programs implementing self- and family management are limited and even underexplored. Therefore, the purpose of the study was to investigate the effect of 3-month self- and family management support programs on clinical outcomes among Indonesians with diabetic foot ulcers. METHOD: The randomized controlled trial design was used to answer the research question of the study. A total of 56 eligible participants were enrolled, with 27 in the experimental group and 29 in the control group. The experimental group received self- and family management support programs for three months. Meanwhile, the control group received usual care. Descriptive statistics, multivariate analysis of variance, and Generalized Estimating Equations were used to analyze the data. The significance level was considered at .05 for hypothesis testing. RESULTS: The study showed that there were statistically significant improvements in self-management, family supports, hemoglobin A1c, and wound size after implemented the programs for three months (p < .05). CONCLUSIONS: With regard to the result of the study, implementing the 3-month self- and family management support programs improves the patients' and families' abilities to perform diabetic foot ulcer care at home.

ADIE - Nursing Interventions of Diabetic Foot Ulcer: An Integrative Review of the Literature.

BACKGROUND AND AIMS: Diabetic foot ulcer is recognized as a consequence of peripheral neuropathy and peripheral arterial disease amid individuals with diabetes. As is well known, this situation still remains a crucial problem in nursing practice. Available studies describing an algorithm of inter- related nursing interventions concerned with diabetic foot ulcers are limited. Therefore, this integrative review was aimed to present evidence-based practice for overcoming the complications of diabetic foot ulcer as well as preventing lower extremity amputation. METHODS: This integrative review retrieved scientific literature from PubMed, CINAHL, ProQuest, SAGE Publishing and ScienceDirect databases as published from 2008 to 2017. Thirty-seven studies that met the inclusion criteria were included in this study. RESULTS: Our findings present that neurologic and circulatory assessments were considered as primary steps prior to conducting interventions. Formulating a diagnosis based upon the assessment results is a principal part to determine appropriate interventions. Multiple experimental studies displayed the effectiveness of certain interventions consist of applying wound cleansing, advanced modern wound dressing, topical therapy, offloading, intensive diabetes education and advanced treatment modalities. Hemoglobin A1c, high-density lipoprotein, procalcitonin, the potential of hydrogen of wound fluid, wound size, neurological and circulatory status were determined as the outcomes measurement which must be correctly evaluated. CONCLUSION: This review contributes an algorithm for intervening diabetic foot ulcer thereby generating the given name: ADIE (Assessment, Diagnosis, Interventions, and Evaluation). A collaborative care amid multidisciplinary diabetes team is needed for implementing along with evaluating the feasibility of the study findings. Moreover, active family participation also plays a crucial role to achieve successful management of diabetic foot ulcer at home.