[Mediating effect of self-efficacy on self-management ability and self-management behavior in patients with type 2 diabetes mellitus]

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.

Influence of interactive analysis model-based peer support model on disease cognition, discriminated mentality, and self-management ability in young hepatitis B patients

BACKGROUND

This study used the interactive analysis model as the theoretical framework to carry out peer support for young hepatitis B patients, in order to improve their disease awareness, alleviate their discriminated mentality, reduce their burden of self-feeling, and enhance their self-management ability, so as to make them optimistic psychologically, face life positively, and follow scientific medical treatment.

AIM

To analyze the influence of interactive analysis model-based peer support model on disease cognition, discriminated mentality, and self-management ability in young hepatitis B patients, in order to expand new ideas for the nursing of clinical infectious diseases.

METHODS

Ninety-eight young hepatitis B patients treated at the Department of Infectious Diseases of our hospital from January 2019 to October 2020 were selected as the research subjects. They were divided into either a control group or an observation group according to the order of admission according to the 1:1 matching principle, with 49 cases in each group. Both groups received routine care, and the observation group additionally adopted an interactive analysis model-based peer support model. Disease cognition, self-perceived burden (SPBS), discriminated mentality, and self-management ability (AHSMSRS) before and after intervention were analyzed between the two groups.

RESULTS

After the intervention, the scores of all dimensions of disease awareness in the observation group were higher than those of the control group (P < 0.05), the scores of all dimensions of discriminated mentality in the observation group were lower than those of the control group (P < 0.05), the scores of all dimensions of SPBS in the observation group were lower than those of the control group (P < 0.05), and the scores of all dimensions of self-management ability in the observation group were higher than those of the control group (P < 0.05).

CONCLUSION

In the management of young hepatitis B patients, the peer support model based on the interactive analysis model can help improve the patients' awareness of the disease, reduce the psychological burden, and correct the psychology of discrimination, as well as enhance the patient's self-management ability, which has a positive effect on disease control.

Effect of narrative nursing model on self-management ability and quality of life of patients with advanced pancreatitis and diabetes

BACKGROUND

Pancreatic inflammation can cause the destruction and reduction of pancreatic islet β cells in patients, elicit stress-induced hyperglycemia, and induce complications such as diabetes, which not only prolongs the course of the disease, but also reduces the patient's quality of life. Therefore, strengthening nursing interventions during treatment to improve the quality of life of patients with advanced pancreatitis and diabetes is of great significance.

AIM

To evaluate the impact of narrative nursing mode on the self-management ability and quality of life of patients with advanced pancreatitis and diabetes.

METHODS

This study is a single-center, prospective, randomized controlled study. Forty-eight patients with advanced pancreatitis and diabetes who were admitted to our hospital from March 2019 to February 2021 were included in the study. The patients were numbered in sequence according to the time of admission. The digital table method was used to divide the patients randomly into a control group and an experimental group, each with 24 cases. Both groups received routine nursing, and the experimental group received a narrative nursing model on this basis. The two groups were compared for disease recovery, intestinal dysfunction, blood sugar control, healthy behavior ability, healthy lifestyle, mental flexibility, self-management ability, quality of life, and complications.

RESULTS

In the experimental group, urinary amylase returned to normal, abdominal pain and bloating subsided, body temperature returned to normal, and the time to the first defecation and hospitalization were shorter compared with the control group (P < 0.05). After nursing care, intestinal dysfunction and diabetes quality of life specific scale scores, fasting blood glucose, 2 h postprandial blood glucose, and glycosylated hemoglobin levels were significantly lower, and Self-rating Health Behavior Ability Scale, Health Promotion Lifestyle Scale II, and Psychological Resilience Scale scores were significantly higher in the experimental group than in the control group (P < 0.05). The incidence of complications in the experimental group was slightly lower than that in the control group (8.33% vs 16.67%), but the difference was not statistically significant (P < 0.05).

CONCLUSION

The implementation of narrative care mode for patients with advanced pancreatitis and diabetes has a significant effect, which helps to improve self-management ability and healthy behavior ability, relieve clinical symptoms and signs, control blood sugar level, improve health, and promote lifestyle and quality of life.

Influence of transitional nursing on the compliance behavior and disease knowledge of children with purpura nephritis

BACKGROUND

Purpura nephritis, also called Henoch-Schönlein purpura nephritis, is a systemic disease with small dead vasculitis as the main pathological change.

AIM

To observe the influence of transitional nursing activities on the compliance behaviors and disease knowledge of children with purpura nephritis.

METHODS

A total of 82 children with purpura nephritis were included and divided into a general nursing group (41 children) and transitional nursing group (41 children) using the envelope method. The general nursing group received routine nursing care, while the transitional nursing group received transitional nursing care. The behaviors, knowledge of the disease, and self-management ability of the two groups were evaluated after nursing care was provided.

RESULTS

The scores of four items (self-care ability, self-responsibility, health knowledge level, and self-concept) in the transitional nursing group were significantly higher than those in the general nursing group.

CONCLUSION

Transitional nursing can directly improve the disease knowledge level and self-management ability of children with purpura nephritis and effectively reduce complications.

Effect of comprehensive nursing intervention on self-management ability and quality of life in acute pancreatitis patients with diabetes mellitus

AIM

To explore if comprehensive nursing intervention can improve self-management ability and quality of life in patients with acute pancreatitis and diabetes mellitus (DM).

METHODS

One hundred and fourteen acute pancreatitis patients with DM were divided into a control group and a study group, with 57 cases in each group. All patients received the same treatments. The control group was given routine nursing intervention, and the study group received comprehensive nursing intervention. Fasting blood glucose (FBG), 2 h blood glucose (PG), and glycosylated hemoglobin (HbA1c) were measured before and after nursing intervention. The self-management ability and quality of life before and after intervention were compared between the two groups.

RESULTS

The levels of FBG, 2 h PG, and HbA1c at weeks 12 and 24 after nursing intervention in the study group were significantly lower than those at corresponding time points in the control group (P < 0.05). The levels of FBG, 2 h PG, and HbA1c were different among different time points in each group (P < 0.05). The scores of self-management ability and quality of life were significantly higher in the study group than in the control group (P < 0.05).

CONCLUSION

Comprehensive nursing intervention can effectively control blood sugar level in acute pancreatitis patients with DM, which is of great significance for improving patients' self-management ability and quality of life.

Influence of Orem's self-care theory based "one-to-one" health education on self-management ability and quality of life in patients with newly diagnosed type 2 diabetes

AIM

To evaluate the effect of Orem's self-care theory based "one-to-one" health education on the self-management ability and quality of life in patients with newly diagnosed type 2 diabetes mellitus (T2DM).

METHODS

A total of 106 patients with newly diagnosed T2DM admitted to the First People's Hospital of Wenling from February 2014 to August 2017 were divided into an observation group (n = 53) and a control group (n = 53) according to admission sequence. The control group was given routine health education, on the basis of which the observation group implemented Orem's self-care theory based "one-to-one" health education. The self-efficacy (GSES score), self-management ability (SDSCA score), blood glucose [fasting blood glucose (FPG), 2-h postprandial blood glucose (2h PG)], quality of life (SF-36 score), treatment compliance, and nursing satisfaction were compared between the two groups.

RESULTS

There was no significant difference in GSES or SDSCA score between the two groups before intervention. After intervention, the scores of GSES and SDSCA in both groups were higher than those before intervention (P < 0.05), and the GSES and SDSCA scores in the observation group were significantly higher than those of the control group (P < 0.05). The rate of treatment compliance was significantly higher in the observation group than in the control group [75.47% (48/53) vs 73.58% (39/53), P < 0.05]. There was no significant difference in FPG or 2h PG between the two groups before intervention (P > 0.05). After intervention, FPG and 2h PG were significantly lower than those before intervention (P < 0.05), and FPG and 2h PG in the observation group were significantly lower than those in the control group (P < 0.05). There was no significant difference in SF-36 scores between the two groups before intervention (P > 0.05). After intervention, the SF-36 scores in both groups were higher than those before intervention (P < 0.05), and the SF-36 score in the observation group was significantly higher than that in the control group (P < 0.05). The rate of nursing satisfaction was significantly higher in the observation group than in the control group [92.45% (49/53) vs 75.47% (40/53), P < 0.05].

CONCLUSION

The "one-to-one" health education based on Orem's self-care theory can effectively enhance the self-efficacy and self-management ability in patients with newly diagnosed T2DM, thereby improving the treatment compliance and promoting the decrease of blood sugar, which is conducive to improving the quality of life of patients and results in a high degree of nursing satisfaction.

Interventions based on self-management of well-being theory: pooling data to demonstrate mediation and ceiling effects, and to compare formats

OBJECTIVES

Interventions based on self-management of well-being (SMW) theory have shown positive effects, but additional questions remain: (1) Are improvements in well-being, as induced by the interventions, mediated by improved self-management ability (SMA)? (2) Do the interventions show ceiling effects? (3) Is a particular format of SMW intervention (individual, group, or self-help) more effective?

METHOD

Data of three randomized controlled trials were pooled. The greater part of the sample (N = 445) consisted of single older females. A bootstrap analysis was performed to test for mediation. Regression analyses with interaction effects were performed to test for ceiling effects. Controlled and transformed effect sizes (proportion of maximum change) were calculated to compare formats.

RESULTS

There was a full significant mediation of well-being by SMA. A significant interaction (ceiling) effect was found on well-being, but not on SMA. The controlled effect sizes of the raw scores were small to medium (.04-.49), and were small to large after transformation (.41-.73). None of the intervention formats was more effective.

CONCLUSION

Support for SMW theory was found, i.e. increasing self-management ability lead to improved well-being. Some ceiling effect was found. We conclude that various SMW interventions formats can improve self-management abilities and well-being with medium effects.

Sustaining program effectiveness after implementation: The case of the self-management of well-being group intervention for older adults

OBJECTIVE

The Self-Management of Well-being (SMW) group intervention for older women was implemented in health and social care. Our aim was to assess whether effects of the SMW intervention were comparable with the original randomized controlled trial (RCT). Furthermore, we investigated threats to effectiveness, such as participant adherence, group reached, and program fidelity.

METHODS

In the implementation study (IMP) 287 and RCT 142 women participated. We compared scores on self-management ability and well-being of the IMP and RCT. For adherence, drop-out rates and session attendance were compared. Regarding reach, we compared participants' baseline characteristics. Professionals completed questions regarding program fidelity.

RESULTS

No significant differences were found on effect outcomes and adherence between IMP and RCT (all p≥0.135). Intervention effect sizes were equal (0.47-0.59). IMP participants were significantly less lonely and more likely to be married, but had lower well-being. Most professionals followed the protocol, with only minimal deviations.

CONCLUSION

The effectiveness of the SMW group intervention was reproduced after implementation, with similar participant adherence, minimal changes in the group reached, and high program fidelity.

PRACTICE IMPLICATIONS

The SMW group intervention can be transferred to health and social care without loss of effectiveness. Implementation at a larger scale is warranted.

Do good self-managers have less physical and social resource deficits and more well-being in later life?

Proactive self-management is likely to be part of resource maintenance and well-being in later life, but empirical evidence is scarce. Therefore, we investigated (a) whether self-management ability (SMA) is associated with lower resource deficits, and (b) whether it is related directly and indirectly to life satisfaction (LS), positive affect (PA) and negative affect (NA). Regression and mediational analyses (N = 439, aged 65 years and older), showed that SMA related to resource deficits, and had direct associations with the three well-being indicators. Indirect associations-via lower resource deficits-were found for LS, whereas the association between SMA and PA was mostly a direct one, being mediated only to a small extent by physical resource deficits. The association between SMA and NA was mediated only by social resource deficits. It is concluded that better SMA seems to matter to resource maintenance and well-being, but future research needs to unravel the differential findings for physical and social resource deficits and for the separate well-being indicators.