Impact of a transtheoretical model on the psychosocial factors affecting exercise among workers

The purpose of this study was to investigate the effects of exercise intervention on improvement of perceived exercise benefit, perceived exercise barrier, and exercise self-efficacy. A quasi- experimental design was utilized and purposive sampling was conducted at a telecom worksite in southern Taiwan. One hundred and ninety-three subjects were assigned to an experimental and a control group. The experimental group, which consisted of 133 subjects, participated in a program of exercise intervention. The intervention program applied a transtheoretical model to aid subjects in developing effective approaches within different stages of the exercise change. It included written materials and teaching activities for the different stages of exercise. The control group, which consisted of 60 subjects, had no treatment. All subjects completed a structured questionnaire, including perceived exercise benefits, perceived exercise barriers, exercise self-efficacy, and stages of exercise, pre-test and post-test. Statistical analyses included Chi-square test, paired t-test, analysis of covariance, one-way ANOVA, and Scheffe's post hoc comparison. After the exercise intervention, the results post-test of the experimental group showed that (1) perceived exercise benefit, perceived exercise barriers, and exercise self-efficacy improved significantly, and (2) perceived exercise benefit and exercise self-efficacy were significantly higher than those of the control group post-test while perceived exercise barriers were significantly lower than those of the control group post-test.     

Effectiveness of an educational intervention on improving knowledge level of Chinese registered nurses on prevention of falls in hospitalized older people--a randomized controlled trial

Falls are highly prevalent in hospitalized older people. Although many factors contribute to this, registered nurses (RNs) lack of knowledge about how to prevent hospitalized older people falls was identified as one of the major factors. This study explored the effects of an educational intervention on improving knowledge level of RNs on prevention of falls in hospitalized older people. It was a randomized controlled trial. 374 RNs from 4 acute care hospitals in ChongQing were recruited to the study. Data were collected before the intervention and at the 3-month follow-up. After the intervention, knowledge scores increased significantly from baseline in the intervention group and significant differences were detected between the scores of the two groups at the 3-month follow-up. The results reflected that the educational intervention was an effective strategy for improving knowledge level of RNs on prevention of falls in hospitalized older people.     

智能药物管理系统在老年慢性病患者住院-居家过渡期的应用

目的 研发智能药物管理系统,并探讨该系统在老年慢性病患者住院-居家过渡期中的应用效果。方法 基于协同设计理论,结合前期需求调研,于2021年6-9月,选取某公立医院的老年慢性病住院患者作为研究对象,采用随机数字法进行分组,干预组49例,对照组45例。对照组采用口服药的常规管理模式,干预组采用智能药物管理系统进行用药管理。干预前后调查2组的用药依从性、用药知识和合理用药自我效能得分,干预后收集干预组对系统的评价量表。结果 干预组患者的用药依从性、合理用药自我效能得分及均高于对照组（P<0.05）;是否使用微信小程序对用药知识得分及差值比较差异无统计学意义（P>0.05）;92%的患者对智能药物管理系统具有较高的满意度。结论 智能药物管理系统能有效提高老年慢性病患者的用药依从性及合理用药自我效能,且具有较好的适老性和可行性,拓展了用药安全管理的服务范畴,值得进一步推广。     

基于PRECEDE-PROCEED模式的护理在社区2型糖尿病患者中的应用

目的对社区2型糖尿病患者实施基于PRECEDE-PROCEED模式构建的干预方案,探讨其对患者糖尿病知识和自我效能的干预效果。方法采取便利抽样方法选取2014年5—10月杭州市某街道社区卫生服务中心的86例2型糖尿病患者作为研究对象,采用随机数字表法将其分为干预组和对照组,各43例。干预组采用为期6个月的PRECEDE-PROCEED模式干预,同期对照组接受常规的社区健康教育课程1次。评价两组患者干预前和干预3、6个月后的糖尿病知识水平和自我效能得分。最终干预组40例、对照组42例患者完成研究。结果重复测量方差分析结果显示,两组患者糖尿病知识、自我效能得分存在时间、组间及时间和组间的交互效应(P<0.05)。组间两两比较结果显示,干预前两组糖尿病知识、自我效能得分差异均无统计学意义(P>0.05);干预3、6个月后,两组糖尿病知识、自我效能得分差异均有统计学意义(P<0.05)。结论应用PRECEDE-PROCEED模式对社区2型糖尿病患者进行干预能够有效改善患者的糖尿病知识水平和自我效能,值得推广应用。     

Promoting Fall Self-Efficacy and Fall Risk Awareness in Older Adults

ABSTRACT

Introduction: This study examined whether participation in a modified version of the “Stepping On” program was effective in increasing fall self-efficacy, static and dynamic balance, and awareness of fall risks in older adults. Design: A mixed methods, one-group, nonexperimental, pretest-posttest design. Participants: Nineteen women aged 65 and older residing in a senior living facility. Intervention: Participants attended a 7-week fall prevention education program focused on group exercises, home hazards, community safety and footwear, and vision and medication management. The program met for 2 h weekly for 7 weeks. Participants were assessed pre- and postintervention using the Modified Falls-Efficacy Scale, Get Up and Go Test, and Romberg Balance Test. In addition, a focus group was facilitated postintervention to determine participants’ awareness of fall risks. Results: While the Modified Falls-Efficacy Scale (MFES) postintervention results were not statistically significant, they did indicate a decreased level of confidence in participants’ ability to avoid a fall postintervention. “Get Up and Go” completion time also increased postintervention, but was not statistically significant. No change in static balance was noted in Romberg Balance Test results. Participants did report an overall increase in awareness of fall risks postintervention. Conclusion: Although results did not support the hypotheses regarding increased fall self-efficacy and static and dynamic balance, participation in the modified “Stepping On” program did lead to an overall increase in awareness of fall risks. Modifying the evidence-based program made it feasible to test in a new community and may have empowered older adults with the knowledge to prevent future falls.     

智能药物管理系统在养老机构老年人中的应用

目的 探讨智能药物管理系统对养老机构老年人用药情况的干预效果。方法 2019年11月—2020年1月采用便利抽样法选取94例居住于重庆市2所养老机构的老年人作为研究对象,采用随机数字表法将其随机分为试验组及对照组,两组各47例,试验组应用由药物感应终端、web管理后台和微信小程序组成的智能药物管理系统进行干预,对照组采用常规用药管理模式,干预时间为3个月。于干预前及干预3个月时分别收集两组的用药依从性量表、用药知识问卷及合理用药自我效能量表得分,并在干预3个月时收集试验组的智能药物管理系统效果评价量表得分。结果 试验组用药依从性量表得分及合理用药自我效能量表得分干预前后差值显著高于对照组（P<0.05）;试验组中,使用微信小程序的老年人的用药知识得分干预前后差值显著高于未使用微信小程序的老年人（P<0.05）;95.7%的老年人对该系统整体感到满意。结论 智能药物管理系统能提高养老机构老年人用药依从性及合理用药自我效能,保障其用药安全。     

A preliminary study on the effects of the Peer-Led Self-Management (PLSM) program on self-efficacy,self-management,and physiological measures in older adults with diabetes: A block randomized controlled trial

This study explored the effects and feasibility of the peer-led self-management (PLSM) program for older adults with diabetes. Twenty-eight participants from 10 communities in southern Taiwan were randomly allocated to experimental and control groups. Those in the experimental group were enrolled in a 4-week PLSM program; those in the control group received a self-management manual and continued their usual clinical care. Improvement in outcomes (self-efficacy, self-management, physiological measures) over time in both groups were evaluated. After PLSM intervention, self-efficacy and self-management had improved; body weight and body mass index measures of the experimental group at post-test 1 and post-test 2 were significantly lower than those of the control group (p < .001); HbA1c, total cholesterol, and triglycerides at post-test 2 were also significantly better (p < .001; p = .03; p = .02). We discuss preliminary benefits and feasibility of the PLSM program.     

Effects of psycho-educational interventions on sexual health risks and psycho-social adaptation in young adults with genital herpes

The purpose of this study was to test the outcomes of group psycho-educational intervention (PEI) led by nurses on sexual health risks (knowledge, behaviour, disease burden) and psycho-social adaptation (depression, mood states, self-efficacy) in young adults with the chronic disease, genital herpes. Two hundred and fifty-two young adults with symptomatic genital herpes participated in a randomized controlled trial (RCT). The intervention was participation in a three-session group PEI facilitated by a nurse in the community. Participants completed questionnaires measuring sexual health risks (herpes knowledge, sexual risk behaviour, disease burden of patterns of recurrences of outbreaks of the disease), and psycho-social adaptation (depression using the Beck Depression Inventory [BDI], mood states using the Profile of Mood States [POMS], and feelings of self-efficacy for protection from sexually transmitted diseases [PSTD]) at induction into the study, and at 3 and 6 months. Participants were mainly employed, Caucasian, single women in their twenties (X = 27.1 years, SD = 4.3), with some college education; 23% of the sample were men. After controlling for baseline knowledge about genital herpes, the experimental group had significantly more knowledge than the control group at 3 and 6 months' post-intervention. They also reported using condoms and spermicides to prevent the spread of genital herpes more often than did the control group. The implications for nurses in the community include the following: (a) PEI is an intervention that can be used by nurses in the community with a high-risk population; (b) group intervention is a viable treatment for people with a highly stigmatized, chronic sexually transmitted disease (STD); and (c) further testing of the use of PEI by nurses in the community with other high-risk populations is needed.     

A comparison of motivational intervention and knowledge-supplied intervention for weight control in female students living alone: focus on self-efficacy]

The purpose of this study was: 1) to verify if motivational intervention enhances self-efficacy and desire for weight control; and 2) to compare the performance of weight control, desire, and self-efficacy among subjects in the motivational intervention group with those in the knowledge-supplied intervention group. Subjects included twenty-two female students living alone. The participants were divided into two groups of motivational-intervention (experimental group) and knowledge-supplied intervention (control group), consisting of eleven subjects in each group selected at random. A pre-test/post-test control design was used. Intervention in the experimental group consisted of a confirmation of individual reasons for weight control, connecting weight control with a life worth living for, and self-monitoring. Intervention in the control group however, involved instructions, on physiological and biochemical basis of proper weight control. As the result, these are suggested that the motivational intervention associated with enhancement of self-efficacy in weight control and dietary behavior. Compared to knowledge-based intervention, motivational intervention was associated with higher chewing method performance ratios, longer terms of continuing the chewing method, self-efficacy of weight control, self-efficacy of dietary behavior, and desire to weight control.     

医院-社区-家庭延续护理模式在老年骨质疏松患者中的应用

目的：探讨医院-社区-家庭延续护理模式在老年骨质疏松患者中的应用效果。方法：采用便利抽样的方法,选取2016年1月至6月于天津医科大学总医院保健医疗部住院或门诊治疗的老年骨质疏松患者113例,随机分为观察组57例,对照组56例。对照组采取常规护理方法,观察组在常规护理基础上实施医院-社区-家庭延续护理模式,3个月后比较两组骨质疏松知识得分、健康信念、自我效能、服药依从性水平。结果：干预后观察组骨质疏松症知识得分,健康信念量表得分及自我效能得分与对照组比较差异有统计学意义 (P＜0.05);观察组干预前后服药依从性差异有统计学意义（P＜0.05）;对照组干预前后服药依从性差异无统计学意义（P＞0.05）。结论：老年骨质疏松患者医院-社区-家庭延续护理干预可有效提高老年骨质疏松症患者的知识水平,健康信念,自我效能及其服药依从性。     

Implementation of a community pharmacy-based falls prevention program

Background

Falls are the leading cause of fatal and nonfatal unintentional injury among older adults in the United States. Multifaceted falls prevention programs, which have been reported to reduce the risk for falls among older adults, usually include a medication review and modification component. Based on a literature search, no randomized trials that have examined the effectiveness of this component have been published.

Objective

The aim of this article was to report on a retrospective process evaluation of data from a randomized, controlled trial conducted to examine the effectiveness of a medication review intervention, delivered through community pharmacies, on the rate of falls among community-dwelling older adults.

Methods

Patients were recruited through 32 pharmacies in North Carolina. Participants were community-dwelling older adults at high risk for falls based on age (≥65 years), number of concurrent medications (≥4), and medication classes (emphasis on CNS-active agents). The process evaluation measured the recruitment of patients into the study, the process through which the intervention was delivered, the extent to which patients implemented the recommendations for intervention, and the acceptance of pharmacists' recommendations by prescribing physicians.

Results

Of the 7793 patients contacted for study participation, 981 (12.6%) responded to the initial inquiry. A total of 801 (81.7%) participated in an eligibility interview, of whom 342 (42.7%) were eligible. Baseline data collection was completed in 186 of eligible patients (54.4%), who were randomly assigned to the intervention group (n = 93) or the control group (n = 93). Pharmacists delivered a medication review to 73 of the patients (78.5%) in the intervention group, with 41 recommendations for changes in medication, of which 10 (24.4%) were implemented. Of the 31 prescribing physicians contacted with pharmacists' recommendations, 14 (45.2%) responded, and 10 (32.3%) authorized the changes.

Conclusions

Based on the findings from the present study, coordination of care between community pharmacists and prescribers needs to be improved for the realization of potential beneficial effects of medication management on falls prevention.     

Effects of board game play on nursing students’ medication knowledge: A randomized controlled trial

AimThis study aimed to examine the effectiveness of an educational board game in improving nursing students’ medication knowledge.BackgroundMaintaining patient safety is a core practice for nurses. Medication management is a central principle of patient safety. Nurses acquire pharmacology knowledge and medication safety skills in the classroom training. Thus, solidifying and strengthening nursing students’ medication knowledge are crucial tasks for nursing faculty members. In recent years, board games, which offer both entertainment and competitive play, have been employed to educate students in a variety of disciplines and settings. Through board game play, students can learn in an enjoyable and fun atmosphere.DesignA randomized controlled trial design.MethodsA convenience sample of 69 nursing students was obtained from a university in Taiwan. Participants were randomly assigned either to an experimental (board game) group (n = 35) or a comparison group (n = 34) using block randomization. The experimental group engaged in board game play to learn about medications, whereas the comparison group attended a one-hour didactic lecture. Using questionnaires, data were collected before the intervention, immediately post intervention and one month post intervention.ResultsFollowing the intervention, regardless of the learning method, both groups showed significant improvements in their immediate recall of medication information. However, when retested after one month, the experimental group obtained significantly higher scores than the comparison group. Moreover, students in the experimental group reported more satisfaction with the learning method than those in the comparison group.ConclusionsThe study results suggest that learning through board games could enhance nursing students’ retention of knowledge. Students reported favorable reactions to using a board game learning method for increasing knowledge of medication. With respect to this finding, faculty members may consider employing board games as teaching tools in nursing and other health science courses. Moreover, the findings of this study can also provide additional information for nursing managers in hospital wards or long-term care facilities where nurses are trained to familiarize themselves with frequently administered medications.Tweetable abstractBoard game play can enhance nursing students’ retention of knowledge; students reported positive reactions to game-based learning for medication training.     

The Impacts of using community health volunteers to coach medication safety behaviors among rural elders with chronic illnesses

It is a challenge for rural health professionals to promote medication safety among older adults taking multiple medications. A volunteer coaching program to promote medication safety among rural elders with chronic illnesses was designed and evaluated. A community-based interventional study randomly assigned 62 rural elders with at least two chronic illnesses to routine care plus volunteer coaching or routine care alone. The volunteer coaching group received a medication safety program, including a coach and reminders by well-trained volunteers, as well as three home visits and five telephone calls over a two-month period. All the subjects received routine medication safety instructions for their chronic illnesses. The program was evaluated using pre- and post-tests of knowledge, attitude and behaviors with regard to medication safety. Results show the volunteer coaching group improved their knowledge of medication safety, but there was no change in attitude after the two-month study period. Moreover, the group demonstrated three improved medication safety behaviors compared to the routine care group. The volunteer coaching program and instructions with pictorial aids can provide a reference for community health professionals who wish to improve the medication safety of chronically ill elders.     

Effects of a self-management course for patients with systemic lupus erythematosus

BACKGROUND: For people living with systemic lupus erythematosus, the disease's potential variety and severity of manifestations and unpredictable course present challenges and repercussions in all arenas of life. AIM: A quasi-experimental study was conducted to examine the effects of a systemic lupus erythematosus self-management course for Korean patients on fatigue, coping skills, self-efficacy, depression, pain and disease activity. METHODS: In a two-group pre- and post-test design, a total of 41 participants were assigned to the experimental group (21 participants) and to the control group (20 participants). The experimental group received six weekly 2-hour sessions for groups of 10-15 literate adults of all ages, while the control group did not receive any intervention. Outcome measures included fatigue, coping skills, self-efficacy, depression, pain and disease activity. RESULTS: Patients who participated in the self-management course showed significant improvement in fatigue (P = 0.049), coping skills (P = 0.007), self-efficacy (P = 0.001), and depression (P = 0.025). There were no significant changes in pain and disease activity after the intervention. CONCLUSIONS: The systemic lupus erythematosus self-management course had effects in reducing fatigue and depression and improving coping skills and self-efficacy. This course is potentially a good nursing intervention that can be offered in community settings.     

The effectiveness of an intervention program to promote physical activity among female adolescents in a vocational nursing school

The purpose of this research was to explore the impact of a physical activity program on exercise knowledge, exercise attitude, exercise self-efficacy, exercise behavior, and cardiorespiratory fitness among female students. A vocational nursing school was selected by purposeful sampling. The experimental group (n=88) and control group (n=89) each contained two classes which were randomly selected from 11th grade classes in the vocational nursing school. All participants completed a structured questionnaire, including an exercise knowledge scale, an exercise attitude scale, an exercise self-efficacy scale, and a cardiorespiratory fitness activities scale at both the pre-test and the post-test stages. An 800-meter running test was used to test the cardiorespiratory fitness of participants. One week after the pre-test, the experimental group received a 12-week physical activity program, while the control group did not receive any intervention. The statistical analysis included percentage, mean, one-way ANOVA, pair-t test and repeated-measures two-way ANOVA. The results showed that improvements in exercise attitude, exercise self-efficacy, exercise knowledge and 800-meter running among the experimental group were significantly higher than among the control group. However, there was no significant effect on the score for cardiorespiratory fitness activities. The results of this research could be used as a reference for school health professionals to promote physical activities for female adolescents.     

Arbi Care application increases preschool children’s hand-washing self-efficacy among preschool children

Objective

This research aimed to examine the effectiveness of an Android mobile game application called Arbi Care as a means to prevent diarrhea and build self-efficacy in hand washing among preschool children.

社区中危以上跌倒风险老年人护理干预效果的评价

目的探讨护理干预在预防社区中危以上跌倒风险老年人跌倒中的应用方法及效果。方法 2015年1-12月,采用便利抽样法选取上海市南码头街道某居委中危以上跌倒风险的老年人100例为研究对象,实施入户跌倒危险因素分析与个性化护理干预措施,采用老年人跌倒风险评估量表、跌倒预防知-信-行问卷及跌倒居家环境危险因素评估表对干预效果进行调查。结果干预后,社区中危以上跌倒风险老年人的跌倒发生率及跌倒风险评分低于干预前、跌倒预防知-信-行评分高于干预前、跌倒环境危险因素评分低于干预前,差异均有统计学意义(均P0.05)。结论个性化的跌倒危险因素分析与护理干预可以提高社区中危以上跌倒风险老年人的跌倒预防知-信-行,减少环境危险因素,有效预防跌倒的发生。     

The effects of short-term exercise intervention on falls self-efficacy and the relationship between changes in physical function and falls self-efficacy in Japanese older people: a randomized controlled trial

OBJECTIVE: To evaluate the effects of short-term exercise intervention on falls self-efficacy and to evaluate the relationships between baseline falls self-efficacy and changes in physical function in older people. DESIGN: Single-blinded randomized controlled trial. The participants were 171 subjects aged 65 and older. They were randomly assigned into an exercise intervention group or a health education group. The subjects in the exercise intervention group performed an exercise program for 3 mos. Falls self-efficacy was measured using the falls efficacy scale (FES). The measurements of physical function included static and dynamic balance, walking velocity, flexibility, and strength. RESULTS: There was no significant improvement of FES in either group. But there were significant negative correlations between baseline FES score and the change in maximum walking velocity (r = -0.29, P < 0.018) and knee extensor strength (r = -0.25, P < 0.040. Linear regression analysis showed that the change in static balance was related to baseline FES. CONCLUSIONS: The results suggest that a short-term exercise intervention had no effect, possibly because of the high baseline FES scores of the participants, on the confidence of community-dwelling older persons. However, the negative association between FES score and increases in some measures of function suggest that short-term exercise may be beneficial to a subset of older persons with lower FES scores.