Negative emotions, self-care activities on glycemic control in adults with type 2 diabetes: a cross-sectional study

Glycemic control has become a focus of concern among diabetic patients. However, only 26.71% of patients achieved better glycemic control in China. Given the complexity of glycemic control, it is worth investigating the potential mechanisms between negative emotions and glycemic control. A total of 428 participants were recruited from a tertiary hospital (the number of hospital beds>500). They completed questionnaires consisting of demographics, Zung Self-Assessed Anxiety Scale(SAS), Zung Self-Assessed Depression Scale(SDS), and the Summary of Diabetes Self-Care Activities (SDSCA). HbA1 c was used to measure glycemic control. Descriptive analysis, Pearson correlation analysis, and Bootstrap analysis were conducted to analyze data. A total of 428 questionnaires were distributed, with 28 invalid questionnaires (93.46% were valid). Depression and self-care activities (exercise, medication) were associated with glycemic control. At the same time, the Bootstrap analysis revealed that self-care activities (exercise: standardized coefficient β = 0.0181, p < 0.05, medication: standardized coefficient β = 0.0211, p < 0.05) mediated the relationship between depression and glycemic control.

Symptom Perception and Influencing Factors in Chinese Patients with Heart Failure: A Preliminary Exploration

A growing body of evidence supports the fact that optimal health-related quality of life is largely dependent on patient competence in symptom perception. However, many studies have reported poor symptom perception in patients with heart failure. In China, there has been no previous research on assessing the symptom perception ability of patients with heart failure. This study aimed to describe how Chinese patients with heart failure perceive their symptoms, as well as to explore their influencing factors. A theory-based, descriptive, correlational cross-sectional design was used in this study. Data on symptom perception and factors related to symptom perception were collected via structured interviews and medical records. A convenience sample of 208 hospitalized patients was enrolled. The degree of symptom perception in this study was at a high level. The results showed that the level of depression, the New York Heart Association functional class, the left ventricular ejection fraction, and educational background were identified as independent factors of symptom perception in Chinese patients with heart failure. The degree of symptom perception of patients with heart failure was affected by personal, psychological, and physiological factors. Health policy and healthcare providers should pay more attention and deepen the understanding to Chinese patients with heart failure to provide better healthcare.

Symptom perception in heart failure: a scoping review on definition, factors and instruments

Background:

Symptom perception in heart failure has been identified as crucial for effective self-care that is a modifiable factor related to decreased hospital readmission and improved survival.

Aims:

To review systematically the heart failure symptom perception literature and synthesise knowledge on definition, description, factors and instruments.

Methods:

We conducted a scoping review including studies reporting patient-reported symptom perception in adults with heart failure. Structured searches were conducted in Medline, PubMed, Embase, CINAHL, PsychINFO, Web of Science, Cochrane, JBI and grey literature. Two authors independently reviewed references for eligibility. Data were charted in tables and results narratively summarised.

Results:

The search yielded 3057 references, of which 106 were included. The definition of heart failure symptom perception comprised body listening, monitoring signs, recognising, interpreting and labelling symptoms, and furthermore awareness of and assigning meaning to the change. Symptom monitoring, recognition and interpretation were identified as challenging. Symptom perception facilitators include prior heart failure hospitalisation, heart failure self-care maintenance, symptom perception confidence, illness uncertainty and social support. Barriers include knowledge deficits, symptom clusters and lack of tools/materials. Factors with inconsistent impact on symptom perception include age, sex, education, experiences of living with heart failure, comorbidities, cognitive impairment, depression and symptom progression. One instrument measuring all dimensions of heart failure symptom perception was identified.

Conclusion:

Heart failure symptom perception definition and description have been elucidated. Several factors facilitating or hampering symptom perception are known. Further research is needed to determine a risk profile for poor symptom perception – which can then be taken into consideration when supporting heart failure self-care.