Nursing staff members' intentions to use physical restraints with older people: testing the theory of reasoned action

AIM OF THE STUDY: To examine nursing staff members' attitudes, subjective norms, moral obligations and intentions to use physical restraints, using the Theory of Reasoned Action (TRA). RATIONALE: During the last two decades an extensive body of research has examined nurses' attitudes as one of the main factors affecting the decision to use or not to use physical restraints with older persons. However, no studies have examined empirically the antecedents to nurses' intentions to use physical restraints within a theoretically based framework. METHOD: A correlational design was used with 303 nursing staff members from an 800-bed elder care hospital in central Israel. Participants completed a questionnaire including questions based on the TRA as well as socio-demographic and professional characteristics. RESULTS: Regression analyses found attitudes, subjective norms and moral considerations to be significantly associated to intention to use physical restraints with older people. The TRA explained 48% of the variance in nurses' intentions. CONCLUSIONS: The TRA proved to be a useful framework for examining nurses' intentions to use physical restraints. Nurses' attitudes, beliefs and expectations of significant others should be examined before implementing educational programmes regarding the use of physical restraints.     

Gender differences in metabolic syndrome risk factors among patients with serious mental illness

The prevalence of metabolic syndrome and its components continue to increase among patients with serious mental illness. This cross‐sectional study investigated whether metabolic syndrome prevalence and risk factors differ between male and female patients with serious mental illness. In total, 260 eligible patients were recruited from two hospitals. The data on demographic characteristics, lifestyle behaviour factors, biochemistry, and anthropometry were collected. Analyses were performed using multivariate logistic regression. Metabolic syndrome prevalence was 40.8% (35.1% in men and 46.8% in women). Among patients aged 40–49 years, metabolic syndrome prevalence was higher in men; however, the trend was reversed among patients aged 50 years or older. Notably, gender‐specific metabolic syndrome risk factors were observed. In men, they included low education level, high body mass index (BMI), prolonged illness, comorbid physical illness, and diagnosis of bipolar disorder, whereas they included being married, old age, and high BMI in women. Our findings suggest that mental health professionals should consider the gender‐ and age‐based metabolic syndrome prevalence trend in patients with serious mental illness when designing interventions for the study population to minimize metabolic syndrome prevalence.     

Assessing telehealth interventions for physical activity and sedentary behavior self‐management in adults with type 2 diabetes mellitus: An integrative review

Type 2 diabetes is a chronic disease, requiring lifestyle management to prevent chronic complications. Increasing physical activity and reducing sedentary behavior are integral to maintaining glycemic control. The purpose of this study was to (1) appraise and synthesize the literature about physical activity and sedentary behavior intervention delivery via telehealth strategies in adults with type 2 diabetes mellitus and (2) to evaluate what is known about the effectiveness of such interventions on physical activity, sedentary behavior, and glycemic control. An integrative literature review was carried out, including the electronic databases PubMed, CINAHL, and PsychInfo, searching for articles published within the past 10 years, meeting specified inclusion and exclusion criteria, following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement guidelines. Seventeen studies were included. Significant improvements in physical activity and sedentary behavior were identified in web and mobile phone‐based interventions. Modest improvements in glycemic control were reported. Theoretical framework use and integration was limited, and intervention length and follow‐up varied greatly in the studies reviewed. Outcomes were measured using both self‐report and objective measures, but objective measures were used less frequently. Further, few studies have been conducted in the United States or in rural populations. Web and mobile phone‐based telehealth interventions to increase physical activity, reduce sedentary behaviors, and improve glycemic control have been supported by the literature. A need exists for future studies that are theory‐driven, include dose‐specific measures, self‐report and objective measures, and long‐term follow‐up. Examining intervention effects in rural populations is needed.     

Prevalence of sarcopenia and its association with diet and physical activity in older adults with type 2 diabetes: A cross-sectional study

This cross-sectional study explored the prevalence of sarcopenia in older adults with type 2 diabetes and investigated the effects of diet and physical activity on sarcopenia. In total, 577 older adults with diabetes were recruited from a teaching hospital in Taiwan. Diet and physical activity were assessed using self-rated questionnaires, including the Healthy Diet Inventory, the Mini Nutritional Assessment-Short Form, and the International Physical Activity Questionnaire-Short Form. Sarcopenia was defined in accordance with the Asian Working Group for Sarcopenia 2019 guidelines. In total, 51.12% of participants had either possible sarcopenia, sarcopenia, or severe sarcopenia. Participants who were female, old age, prolonged sedentary times, poor nutritional status, and lower level of moderate-to-vigorous physical activity were identified as risk factors for possible to severe sarcopenia. Older adults with diabetes and possible to severe sarcopenia had poor nutrition status and engaged in inadequate physical activity. The findings indicate that sarcopenia may be related to nutrition status and physical activity, especially in older adults with diabetes.     

Neighborhood environmental factors are related to health-enhancing physical activity and walking among community dwelling older adults in Nigeria

Introduction: Health promotion strategies grounded by evidence-based determinants of physical activity constitute an important focus of physiotherapy practice in the twenty-first century. This study investigated associations between neighborhood environmental factors and health-related moderate-to-vigorous physical activity (MVPA) and walking for transportation and recreation among community dwelling Nigerian older adults. Methods: A representative sample of 353 Nigerian older adults (age = 68.9 ± 9.13 years) in a cross-sectional survey provided self-reported min/week of MVPA and walking for transportation and recreation and perceived neighborhood environmental factors. Results: In multilevel linear regression analyses, proximity of destinations (β = 3.291; CI = 0.392, 6.191), access to services and places (β = 4.417; CI = 0.995, 7.838), esthetics (β = 3.603; CI = 0.617, 6.590), traffic safety (β = 5.685; CI = 3.334, 8.036), and safety from crime (β = 1.717; CI = 0.466, 2.968) were related to more MVPA. Also, proximity of destinations (β = 1.656; CI = 0.022, 3.291) and safety from crime (β = 2.205; CI = 0.018, 4.579) were related to more transport walking. Access to services and places (β = 2.086; CI = 0.713, 3.459) and walking infrastructure and safety (β = 1.741; CI = 0.199, 3.282) were related to more recreational walking. Conclusions: Six of eight supportive environmental factors were associated with more physical activity among community dwelling older Nigerian adults. Policy makers including physiotherapists in this role can use the evidence to inform community-based physical activity and health promotion programs for older adults in Nigeria.     

Evaluation of factors related to glycaemic control among South Korean patients with type 2 diabetes

Aims

To examine specific self‐care behaviours, depression, and diabetes‐related stress among South Korean patients with type 2 diabetes and to evaluate whether these factors are related to glycaemic control.

Methods

This cross‐sectional study included 171 patients with type 2 diabetes who visited an endocrinology clinic. A structured questionnaire and electronic medical records were used to collect data regarding self‐care behaviours, depression, diabetes‐related distress, and glycaemic control between May 2015 and July 2015.

Results

Compared with the group with good glycaemic control, the group with poor glycaemic control had significantly lower values for medication adherence and significantly greater values for regimen‐related distress. Depression was not significantly associated with glycaemic control. In logistic regression analysis, only medication adherence was independently associated with glycaemic control.

Conclusions

Medication adherence should be continuously emphasized and monitored in clinical practice to effectively manage glycaemic control among patients with type 2 diabetes. Furthermore, consideration of diabetes‐related distress may help improve glycaemic control among patients with type 2 diabetes.     

A critical review of the health belief model in relation to cigarette smoking behaviour

• ? There are a number of health behaviour models and theories available to nurses which have been developed to explain and predict health behaviour. Of particular interest to nurses in recent years is the ‘health belief model’ which has been the most widely used.
• ? Despite a wealth of evidence to support the model's value in predicting health behaviour, often it is evident that there are a substantial number of factors involved in health behaviour which are not health related and are therefore not easily predicted by the model. Cigarette smoking is one interesting example due to the many physiological and psychological factors involved that are not health related.
• ? Another model, the ‘theory of reasoned action’, may be useful in understanding such a complex behaviour as cigarette smoking as it relys not only on health beliefs but also takes into consideration personal factors which are seen as relevant by smokers such as social influence and the individuals positive or negative evaluation of giving up or continuing smoking and it is these factors according to the model, which underlie whether or not a person will intend to give up or continue to smoke.
• ? The theory of reasoned action may be a useful tool to both health educators and nurse researchers.

     

Health-related quality of life and physical activity in persons at high risk for type 2 diabetes

Purpose. The aim of this study was to compare the health-related quality of life (HRQOL) of persons at risk for type 2 diabetes to that of the Finnish general population. In addition, the associations between physical activity and HRQOL at-risk persons were studied.

Methods. One hundred thirty-two at-risk persons were recruited from health care centres in Central Finland. Participants filled out questionnaires including demographic characteristics, HRQOL (SF-36), frequency of vigorous physical activity (≤2 times a week, once a week, less than once a week) and comorbidities.

Results. HRQOL of at-risk persons differed significantly from that of the Finnish population in four of the eight dimensions of SF-36. Compared with reference values of the general population, the values of at-risk persons were worse for general health and pain, but better for mental health and role limitation (emotional) dimensions. Among at-risk persons those physically more active had less depressiveness and lower body weight. HRQOL decreased linearly with decreasing physical activity in all dimensions.

Conclusions. People with elevated risk for type 2 DM have reduced HRQOL in general health and body pain dimensions, but mental health and emotional role dimensions were better compared with that of the population. Among at-risk persons, the benefits of physical activity on HRQOL were seen in all HRQOL dimensions. Regular exercise and body weight control may improve subjective health and reduce risk for type 2 DM and its consequences.     

Gender differences in the relationship between physical functioning and depressive symptoms in low‐income older adults living alone

This study examined gender differences in the relationship between physical functioning and depressive symptoms in low‐income older adults living alone in Korea, and the variables influencing these symptoms. Data from a total of 317 older adults in the 2011 Korean National Survey were used. Upper limb mobility, lower limb mobility, activities of daily living, instrumental activities of daily living, and depressive symptoms were measured. Data were analyzed using multiple regression analysis. Low‐income older men and women living alone experienced depressive symptoms. Regression analysis showed that lower limb mobility and age together explained 35.4% of the variance in depressive symptoms in men. Subjective health status explained 16.7% of the same in women. These findings suggest that low‐income older adults living alone should be carefully monitored by public healthcare managers to improve their physical and mental health, considering gender‐specific elements.     

对2型糖尿病病人实施家庭管理提高自护能力的研究

目的探讨2型糖尿病病人的自护行为及实施家庭管理对其自护能力的影响。方法将100例2型糖尿病病人随机分为观察组与对照组,观察组实施家庭管理,对照组未作家庭干预。干预前和干预半年后分别对两组病人自护行为及生化指标进行比较。结果干预前两组病人自护行为及生化指标差异无统计学意义(P>0.05),经家庭管理干预后观察组病人自护行为(除遵医嘱服药和血糖监测外)及生化指标(除总胆固醇外)明显优于对照组(P<0.01或P<0.05)。结论对2型糖尿病病人实施家庭管理可提高其自护能力。     

A systematic review of the relationships among psychosocial factors and coping in adults with type 2 diabetes mellitus

Type 2 diabetes mellitus contributes to poor health outcomes including mortality, yet there is a gap in the literature when seeking to understand the influence of psychosocial factors on coping in this population. The paper presents a systematic review of quantitative studies that examined relationships among psychosocial determinants and coping in adults with type 2 diabetes. This review is the second layer of knowledge discovery for the concept, “Taking on a life-altering change is a rhythmical journey of experiencing ups and downs on the way to acceptance.” The life-altering change was determined to be a diagnosis of type 2 diabetes, the journey is the ups and downs of coping with the diagnosis as people work toward acceptance of type 2 diabetes. The review includes a synthesis of findings from 22 quantitative studies of psychosocial factors and coping in adults with type 2 diabetes. Anxiety, depression, stress, and diabetes distress were identified as key influential psychosocial factors. Increased social support was inversely related to emotional distress and coping styles were related to social well-being, psychological health, and physical health outcomes. The positive coping style of problem-focused coping was linked to improved psychological and physical health. Emotional responses to diagnosis were related to depression and anxiety. Negative coping styles of resignation, protest, or isolation were higher in women and linked to poorer quality of life, while avoidance was linked to increased diabetes-related distress and depressive symptoms.     

2型糖尿病患者发生视网膜病变相关危险因素调查

目的调查2型糖尿病患者发生视网膜病变危险因素,为减少2型糖尿病患者发生视网膜病变提供科学参考与依据。方法选取本院2017年3月至2019年3月125例2型糖尿病患者为研究对象,其中发生视网膜病变65例。对影响2型糖尿病患者发生视网膜病变的危险因素采用logistic回归分析。结果年龄、糖尿病家族史、高血压病史、有高血脂病史、吸烟是2型糖尿病患者发生视网膜病变的独立危险因素。结论针对2型糖尿病发生视网膜病变的危险因素应制定积极正确的干预措施,预防视网膜病变的发生。     

Impact of nurse‐led behavioural counselling to improve metabolic health and physical activity among adults with mental illness

The life expectancy of adults with mental illness is significantly less than that of the general population, and this is largely due to poor physical health. Behavioural counselling can improve physical health indicators among people with non‐communicable disease. This repeated‐measures, single‐group intervention trial evaluated the effects of a 19‐week behavioural counselling programme on metabolic health indicators and physical activity levels of outpatient adults with mental illness. Sixteen participants completed the intervention that comprised individual face‐to‐face counselling sessions with a registered nurse every 3 weeks, and progress reviews with a medical practitioner every 6 weeks. Assessment included self‐report and objective measurement of physical activity, and measures of blood pressure and anthropometry. Statistically‐significant changes were demonstrated between baseline and post intervention for participants’ waist circumference (P = 0.035) and waist‐to‐height ratio (P = 0.037). Non‐significant improvements were demonstrated in weight and physical activity. The findings indicated that adults with mental illness can engage in a nurse‐led behavioural counselling intervention, with improvements in some metabolic health measures after 19 weeks. It is recommended that behavioural counselling programmes for adults with mental illness be sustained over time and have an ‘open door’ policy to allow for attendance interruptions, such as hospitalization.     

健康体检中中年人2型糖尿病筛查相关指标的分析

目的探讨中年健康人群中空腹血糖水平与其他相关指标的关系。方法选择2004年1月～12月在我院体检中心进行体检的40～60岁的中年人1480例,测定空腹血糖、血清甘油三脂、总胆固醇、血尿酸、胰岛素、血压和BMI等指标,同时进行综合分析。结果中年健康人群中空腹血糖水平随年龄增长而升高,高血糖组人群的总胆固醇、血尿酸、血压和BMI高于正常血糖组。结论健康体检中血糖升高与体检者年龄、BMI、总胆固醇和舒张压有关联。     

Utilising the PRECEDE model to predict factors related to self-care behaviours in patients with rheumatoid arthritis in Yazd (Iran)

morowatisharifabad ma, nadrian h, mazloomy-mahmoodabad ss, soleimani-salehabadi h & asgarshahi m (2010)    Journal of Nursing and Healthcare of Chronic Illness 2 , 32–40
Utilising the PRECEDE model to predict factors related to self-care behaviours in patients with rheumatoid arthritis in Yazd (Iran)
Aim.  To explore the influences of predisposing, enabling and reinforcing factors on rheumatoid arthritis patients' self-care behaviour.
Design and methods.  A non-probability sample of 181 outpatients with rheumatoid arthritis, referring to a rheumatology clinic in the city of Yazd in central Iran, participated in the study. Appropriate instruments were designed to measure the variables of interest (predisposing, reinforcing and enabling factors along with self-care behaviours). Reliability and validity of the instruments were examined and approved.
Results.  Attitude and self-efficacy, as predisposing factors, were related to self-care behaviour of rheumatoid arthritis patients. Social support as a reinforcing factor and also enabling factors showed significant relationship with self-care behaviour. All of PRECEDE variables were statistically significant predictors of self-care behaviour and accounted for 44·3% of the variation.
Conclusions.  It was concluded that the PRECEDE model may be used in developing countries, like Iran, as a framework for planning intervention programmes in an attempt to improve the self-care behaviours of patients with rheumatoid arthritis.
Relevance to clinical practice.  In order to promote self-care behaviours of RA patients, it is worth focusing on predisposing and enabling factors by developing stage-specific intervention programmes based on the PRECEDE model.