Perceived Self-Efficacy and Associated Factors Among Adult Patients with Type 2 Diabetes Mellitus at Public Hospitals of Western Ethiopia, 2020

Knowledge, attitudes and practices among patients with end-stage kidney disease towards hyperkalaemia management in Shenzhen, China: a cross-sectional study

OBJECTIVES

To investigate the knowledge, attitudes and practices (KAP) among patients with end-stage kidney disease (ESKD) towards hyperkalaemia.

DESIGN

A cross-sectional study.

SETTING

This study was conducted between September and November 2023 at the Department of Nephrology, Shenzhen Third People's Hospital and the Second Affiliated Hospital of Southern University of Science and Technology.

PARTICIPANTS

The study included 568 patients with ESKD who were undergoing haemodialysis, peritoneal dialysis or both, recruited through convenience sampling.

PRIMARY AND SECONDARY OUTCOME MEASURES

This study was conducted using a self-administered questionnaire, which assessed participants' KAP towards hyperkalaemia management. The questionnaire comprised four sections: demographic information, knowledge (13 items), attitudes (9 items) and practices (9 items), with responses evaluated using a 5-point Likert scale. A cut-off value of 70% of the total score was applied, with thresholds for sufficient knowledge, favourable attitudes and proactive practices set at 6.3, 31.5 and 31.5 points, respectively. The higher the KAP scores, the better the levels of knowledge, attitude and practice. A structural equation model (SEM) was constructed to analyse the effects of demographic characteristics on KAP dimensions. Path coefficients (standardised estimates) were used to assess the strength of relationships between variables, with coefficients>0.2 generally considered moderate effects and >0.5 strong effects.

RESULTS

A total of 568 participants were enrolled in this study, including 369 (64.69%) males, and 249 (43.84%) have been diagnosed with ESKD for more than 5 years. The median (IQR) KAP scores of the participants were 9 (3-9) (possible range: 0-9), 34 (24-45) (possible range: 9-45) and 32 (10-45) (possible range: 9-45), respectively. SEM demonstrated that the frequency of dialysis had direct effects on knowledge (coefficient=0.113, p=0.039), education had direct effects on attitudes (coefficient=0.257, p<0.001), knowledge had direct effects on practices (coefficient=-0.130, p=0.016), attitudes had direct effects on practices (coefficient=0.549, p<0.001) and education had direct effects on practices (coefficient=0.112, p=0.007).

CONCLUSION

Patients with ESKD enrolled in this study have sufficient knowledge, favourable attitudes and proactive practices towards the hyperkalaemia. Nevertheless, it is still recommended to enhance clinical practice in hyperkalaemia management among patients with ESKD by tailoring education for those with lower education levels, emphasising the importance of regular dialysis and implementing strategies to bridge the knowledge-practice gap.

Psychosocial factors correlating self-care management among Jordanian adolescents with type 1 diabetes

PURPOSE

Few studies were conducted to examine the correlation between the anxiety symptoms, depressive symptoms, self-efficacy, and social support variables and type 1 diabetes in developing countries, including Jordan. Thus, this study was conducted to assess the correlation between these psychosocial factors and self-care management among Jordanian adolescents with type 1 diabetes.

DESIGN & METHODS

A cross-sectional, descriptive correlational design was used to perform a study among adolescents with type 1 diabetes (N = 351) aged 14-18 years who attended primary healthcare centers clinics, and diabetic clinics related to hospitals in Amman Governorate, Jordan. A convenience sampling method was used to recruit participants. The data were collected using self-reported questionnaire during the period from June to December 2023.

FINDINGS

The results revealed that around 61.0 % of the sample were males and 39 % female, and 74.9 % of the participants experienced type 1 diabetes for more than one year. Only, 4.3 % of the participants had the recommended HbA1c (< 7.5 %). The participants had high percentage anxiety and depressive symptoms, poor self-efficacy, moderate social support, and low self-care management. There was a correlation between self-efficacy, social support, and self-care management. Also, social support mediated the relationship between self-efficacy and self-care management. However, no relationship existed between anxiety and depressive symptoms and self-care management.

CONCLUSION

Screening for anxiety and depressive symptoms should be a significant element of care for adolescents with type 1 diabetes in outpatient clinics. Policymakers and healthcare professionals including pediatric nurses should develop strategies and education programs on self-care management to enhance self-care practices and management for adolescents with type 1 diabetes.

Patient-centered care model based on self-efficacy to improve self-care and quality of life of people with type 2 diabetes mellitus: A PLS-SEM approach

Background

The current model for managing type 2 diabetes mellitus (T2DM) is healthcare provider-centered rather than patient-centered. This approach may overlook individual patients' unique needs, potentially impacting the effectiveness of T2DM management goals.

Objective

This study aimed to develop a patient-centered care model based on self-efficacy to enhance self-care and improve the quality of life for individuals with T2DM.

Methods

The study employed a cross-sectional design with a sample size of 250 respondents recruited through multistage random sampling, Jember regency, East Java, Indonesia. The study variables included exogenous factors (people with T2DM, situational treatment, family, and healthcare services) and endogenous factors (self-efficacy, self-care, and quality of life). Data were collected from August to December 2022 using a questionnaire and analyzed descriptively and inferentially using SEM-PLS.

Results

The developed model was a good fit with strong predictive relevance (SRMR = 0.065; Q2 = 0.049). All exogenous factors-people with T2DM, situational treatment, family, and healthcare services-significantly affected self-efficacy (42.2%, 37%, 8.1%, and 17.3%; p <0.001). Self-efficacy had a 61.6% effect on self-care, and self-care had a 27.1% effect on quality of life (p <0.001). Only situational treatment factors had a direct effect on self-care (21.7%; p <0.001). All exogenous factors also influenced the quality of life through self-efficacy and self-care (7%, 6.2%, 1.3%, and 2.9%; p <0.05).

Conclusions

A patient-centered care model based on self-efficacy for managing T2DM can improve self-care behaviors and quality of life for individuals with T2DM. This model can be utilized by nurses in healthcare services to enhance the management of T2DM.

Self-efficacy of PLHIV for self-management at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: a cross-sectional study

BACKGROUND

Self-efficacy is the ability to execute, and it is a critical predictor of health-related outcomes among people living with human immunodeficiency virus (PLHIV). Self-efficacy directly determines treatment outcome. However, there is no evidence on the self-efficacy of PLHIV for self-management in Ethiopia. Currently, HIV is considered a manageable chronic disease. However, the burden remains high despite all the taken measures.

OBJECTIVES

This study aimed to assess the self-efficacy of PLHIV for self-management at the University of Gondar Comprehensive Specialized Hospital (UOGCSH), northwest Ethiopia, 2022.

METHODS

A cross-sectional study was conducted on PLHIV selected by a systematic random sampling technique using an interviewer-administered questionnaire at the UOGCSH from August 10 to September 30, 2022. The data was entered and analyzed using the Statically Package for Social Science version 25.0. Categorical variables were summarized as frequency (percentage) of the total. Both descriptive and inferential statistics, such as the Kruskal-Wallis H test and Mann-Whitney U test were performed to detect difference. P-value < 0.05 was considered to indicate statistically significance.

RESULTS

Overall, 405 PLHIV participated in the study, giving a 96% response rate. The overall median (Interquartile range) self-efficacy score of PLHIV for self-management was 22 (4) and 67.4% of the PLHIV self-efficacy score was above the median. A statistically significant difference was detected between the social support groups (χ2 (2) = 37.17, p < 0.0001), education background (U = 10,347, Z = 2.279, P = 0.023, r = 0.113), living conditions (U = 12,338, Z = 2.457, P = 0.014, r = 0.122) and medication adherence (U = 9516.5, Z = 3.699, P < 0.0001, r = 0.184).

CONCLUSION

Most participants' self-efficacy score was above the median. Statistically significant differences in self-efficacy were observed based on individual, environmental, and clinical factors. We suggest training and workshops for healthcare workers and the hospital and adherence support groups should work to improve the self-efficacy of PLHIV.

Assessment of the relationship between self-efficacy criteria and rate of lower limb amputation in diabetic patients; a cross-sectional study

Background

According to the high prevalence of diabetes Mellitus (DM), as a harmful metabolic disease, the adoption of self-care (SC) behaviors along with modern medications seems necessary for diabetes Mellitus patients (DMPs). Since self-efficacy (SE) affects the quality of SC behaviors in DMPs to prevent limb amputation as one of the most common DM-related complications, the present study aimed to investigate the probable relationship between the effect of the Diabetes Management Self-Efficacy (DMSE) with limb amputation rate in DMPs.

Methods

DMPs with ages of 18-65 years were selected and divided into two groups of the case (DMPs with experiences of DM ≥ 4 years and limb amputation, n = 300), and control (DMPs with no experience of limb amputation, n = 600). Data were collected through demographics, clinical checklists, and the DMSES tool, and were analyzed using SPSS (v.25).

Results

The mean age of DMPs was 55.2 ± 8.2 years, and 59.3% and 40.7% of patients had type I and type II DM, respectively. A significant relationship was found between the mean of DMSES in terms of groups of the case (Mean: 60.6) and control (mean 67.7) (P = 0.001), living place, education, family background in non-close relatives, underlying disease, high blood pressure, hyperlipidemia, and the type of DM. The odds ratio (OR) of amputation was also found higher in DMPs with a lower mean of DMSES OR = 1.03, CI 95%=1.01-1.04, P = 0.001).

Conclusion

In this study, DMSE had a significant relationship with reducing limb amputation rate in DMPs. Furthermore, The average self-efficacy score according to gender, place of residence, education, family history in non-close relatives, underlying disease, and type of diabetes was significantly difference. It is suggested, that self-efficacy would be enhanced through systematic education in diabetes clinics.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-023-01331-0.

The relationship between physical activity, self-efficacy and quality of life in colorectal cancer survivors: a multicenter cross-sectional study

PURPOSE

This study aimed to investigate the current situation and factors influencing physical activity, self-efficacy, and quality of life in Chinese colorectal cancer survivors. Additionally, this study explored the associations between physical activity, self-efficacy, and quality of life.

METHODS

A multicenter, cross-sectional study was conducted, involving 173 colorectal cancer survivors with a mean age of 59 years. Self-reported data on basic demographic characteristics, physical activity, self-efficacy, and quality of life were collected.

RESULTS

Among 173 colorectal cancer survivors, 90 (52.0%) were engaged in manual work. The self-efficacy score was found to be 25.99 ± 7.10, while the global health status score was 54.96 ± 21.56. Global health status was associated with sex, residence, chemoradiotherapy, and monthly income (p < 0.01). The self-efficacy score exhibited a significant positive correlation with quality of life, while demonstrating a negative correlation with symptom scores (p < 0.01). Recreational PA scores were positively associated with global health status (P < 0.05). Self-efficacy, recreational physical activity during winter, and whether the participants underwent chemoradiotherapy explained 29.3% of the variance in quality of life among colorectal cancer survivors.

CONCLUSIONS

Colorectal cancer survivors exhibited low levels of physical activity, self-efficacy, and quality of life. Their health is influenced by self-efficacy, recreational physical activity, and chemoradiotherapy. When developing intervention plans for colorectal cancer survivorship, it is crucial to consider survivors' self-efficacy and the type of physical activity in which they engage.

Perceptions of conflicting information about long-term medications: a qualitative in-depth interview study of patients with chronic diseases in the Swiss ambulatory care system

OBJECTIVE

Patients with multiple long-term conditions visit various healthcare professionals and are exposed to medication information from various sources causing an increased risk of patients perceiving contradictory medication information. The aims of this study are to: (1) characterise conflicting medication information perceived by patients with long-term conditions, (2) better understand the related impact on patients' medication self-management and healthcare system navigation and (3) explore ways in which such events could be prevented.

DESIGN

This study was conducted through qualitative semistructured interviews. Data were analysed using thematic analysis.

SETTING

Community pharmacies and medical centres in Geneva, Switzerland.

PARTICIPANTS

This study included outpatients from April 2019 to February 2020. Patients were included after participating in a quantitative survey of perceived conflicting information about medications for long-term diseases.

METHODS

Semistructured audiotaped interviews of 20 to 60 min following a pre-established interview guide to explore participants' perceptions of conflicting information. Interviews were transcribed verbatim, and a thematic analysis was conducted with inductive and deductive coding using MAXQDA (2018, Release 18.2.3).

RESULTS

Twenty-two patients were interviewed, until data saturation, mentioning indication or need for a medication as the main topic of conflicting information between two healthcare professionals. Perceived conflicting information often resulted from insufficient information provided and poor communication leading to confusion, doubts and medication non-adherence. Patients expected more information and more interprofessional communication on their medications. As a result of conflicting information, most participants learnt or were learning to take an active role and become partners of the healthcare providers.

CONCLUSION

The need to strengthen and improve communication and interprofessional collaborative practice among healthcare professionals and with the patient is emerging to increase the quality and consistency of information about medications, and consequently, to ensure better use and experience of medications.

Spanish version of the self-care self-efficacy scale: A validation study in community-dwelling older adults with chronic multimorbidity

OBJECTIVE

To test the psychometric properties of the Spanish version of the Self-Care Self-Efficacy Scale (SCSES-Sp) in community-dwelling older adults with chronic multimorbidity.

METHODS

A sample of 1013 community-dwelling older adults with chronic multimorbidity participated in an observational cross-sectional study that was carried out in 3 phases.

RESULTS

Confirmatory factor analysis showed that the SCSES-Sp has 4 dimensions: "self-efficacy in self-care behaviours based on clinical knowledge", "self-efficacy in self-care maintenance", "self-efficacy in self-care monitoring", and "self-efficacy in self-care management". A panel of independent experts considered the content of the SCSES-Sp valid. Convergent validity analysis showed moderate-strong correlations between all of the SCSES-Sp's dimensions and the reference criteria chosen. Reliability was good for the SCSES-Sp and all its dimensions. Test-retest reliability analysis showed that the SCSES-Sp was temporally stable.

CONCLUSIONS

The SCSES-Sp is a valid and reliable tool to assess self-efficacy in self-care in Spanish-speaking, community-dwelling older adults with chronic multimorbidity.

An Evaluation of Community Health Workers' Knowledge, Attitude and Personal Lifestyle Behaviour in Non-Communicable Disease Health Promotion and Their Association with Self-Efficacy and NCD-Risk Perception

Community health workers, also known as health extension workers (HEWs), play an important role in health promotion. This study evaluates HEWs' knowledge, attitude, and self-efficacy for non-communicable diseases (NCD) health promotion. HEWs (n = 203) completed a structured questionnaire on knowledge, attitude, behaviour, self-efficacy and NCD risk perception. Regression analysis was used to determine the association between self-efficacy and NCD risk perception with knowledge (high, medium, low), attitude (favourable/unfavourable) and physical activity (sufficient/insufficient). HEWs with higher self-efficacy were more likely to have high NCD knowledge (AOR: 2.21; 95% CI: 1.21. 4.07), favourable attitude towards NCD health promotion (AOR: 6.27; 95% CI: 3.11. 12.61) and were more physically active (AOR: 2.27; 95% CI: 1.08. 4.74) than those with lower self-efficacy. HEWs with higher NCD susceptibility (AOR: 1.89; 95% CI: 1.04. 3.47) and perceived severity (AOR: 2.69; 95% CI: 1.46, 4.93) had higher odds of NCD knowledge than their counterparts. Moreover, sufficient physical activity was influenced by HEWs' perceived NCD susceptibility and perceived benefits of lifestyle change. Therefore, HEWs need to adopt healthy lifestyle choices to become effective role models for the community. Our findings highlight the need to include a healthy lifestyle when training HEWs, which might increase self-efficacy for NCD health promotion.

Discriminating Low to High Adherent Type 2 Patients with Diabetes by Glycosylated Hemoglobin A1c, Eating Self-Efficacy and Other Psychosocial Determinants: Difference Between Patient and Physician Adherence Models

OBJECTIVE

Develop individual discriminant models using clinical and psychosocial variables for physicians and patients with diabetes based on their perceptions of patient adherence.

METHODS

This was a cross-sectional research design utilizing a discriminant analysis approach. Type 2 patients on treatment for diabetes for at least 2 years prior to research were selected. Clinical data were obtained from patient records, and psychosocial variables were collected by survey instruments filled out by patients. A final sample of 200 patients was recruited.

RESULTS

We found a positive correlation between patient and physician assessment of patient adherence behaviors. Greater adherence efforts were associated with lower HbA1c. Better quality of the patient-physician relationship was linked to better patient adherence. Increased HbA1c, longer therapy duration and higher BMI described low patient adherence for physicians. Lower HbA1c, female gender and fewer difficulties in marital adjustment characterized high adherence for patients. Dietary self-efficacy as well as emotional and social isolation discriminated mid-level adherers in both models.

CONCLUSION

This research confirmed that patients and physicians perceived and judged patients' adherence behaviors differently. Physicians and patients associated different clinical and psychological factors with low and high adherence. Further research is recommended to clarify how the quality of the physician-patient as well as the patient-spouse relationship affect dietary efficacy and patient adherence. A randomized, controlled clinical trial approach is recommended to establish the effectiveness of interventions aiming to improve dietary self-efficacy on adherence outcomes.

Assessment of the Health-Promoting Behaviors of Hospitalized Patients with Non-Communicable Diseases During the Second Wave of COVID-19

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has affected the health-related behaviors of patients with non-communicable diseases (NCDs). Thus, the factors predicting the health-promoting behaviors (HPBs) of hospitalized patients with NCDs during the second wave of COVID-19 should be examined.

OBJECTIVE

The aims of this study were to determine the relationships among the patients' characteristics, perceived self-efficacy, social support, perception of the benefits of and barriers, and HPBs, and to determine the predictive factors of HPBs among hospitalized patients with NCDs during the second wave of COVID-19.

PATIENTS AND METHODS

The study had a cross-sectional predictive correlational design and included 250 patients with NCDs 18 years of age or older hospitalized in a tertiary hospital in Thailand. Descriptive statistics, the chi-square test, the Pearson's correlation coefficient, and stepwise multiple linear regression were used for data analysis.

RESULTS

Most of the participants had a cardiovascular disease (34.0%). Followed by diabetes (28.8%), cancer (11.2%), hypertension (10.0%), heart disease (9.6%), or chronic obstructive pulmonary disease (6.4%) and had a moderate level of overall HPBs (M = 106.09; SD = 4.66). Among the six components of the HPBs, the participants achieved the moderate levels in nutrition, interpersonal relations, spiritual growth, and stress management, and low levels in physical-activity and health responsibility. The patients' perception of the benefits and barriers to the adoption of HPBs and perceived self-efficacy and social support were able to predict their HPBs, accounting for approximately 38.0% of the variance of such behaviors.

CONCLUSION

On the basis of our study's results, we suggest that researchers, multidisciplinary teams, the government, and policymakers establish effective interventions, guidelines, and policies for the development of HPBs to prevent and control the spread of COVID-19 particularly among patients with NCDs, and to improve their capacity for high-quality and continuing self-care.

Self-management support of adolescents with type 1 Diabetes Mellitus in the light of healthcare management

OBJECTIVES

to analyze the self-management support needs of adolescents with type 1 diabetes mellitus.

METHODS

this qualitative research was carried out between September and December 2017 with nine adolescents in the pediatric outpatient clinic of a university hospital and in their homes. The material collected through semi-structured interviews was interpreted by thematic inductive analysis in the light of the healthcare management concept.

RESULTS

adolescents' self-management support needs include longitudinal monitoring by health teams; family support in their training; support from the social network; and a careful look by government officials in the construction of guidelines for dispensing the essential inputs for treatment. However, these needs are not always met satisfactorily, resulting in gaps in this support.

FINAL CONSIDERATIONS

these gaps interfere in resolving health demands. Self-care with fragmented support affects the healthcare management dimensions, making it impossible to meet the uniqueness of adolescents in a comprehensive, expanded and ethical way.