A pilot study of self-monitoring urine flow in people with long-term urinary catheters

Self-monitoring of urine flow may be beneficial in preventing catheter-related problems. An intervention was pilot tested using a single group design with 11 individuals over 6 months. Feasibility of the intervention, performance of new measures (awareness, self-monitoring, and self- management of urine flow), and health outcomes were assessed. The intervention was well received by participants, none of whom withdrew voluntarily from the study. All data were collected at intake, and bimonthly at 2, 4, and 6 months. Nine of 11 participants reported that the intervention had helped them to pay attention to fluid intake. Episodes of UTI decreased over the course of the intervention, with the greatest drop between 2 and 4 months.     

Effectiveness of a self-efficacy program for persons with diabetes: a randomized controlled trial

The aim of this study was to examine the effects of a self-efficacy program for persons with type 2 diabetes in Taiwan. A randomized controlled trial was designed (n = 145), with 72 participants in the intervention group and 73 in the control group. The participants were pretested to establish a baseline and then post-tests were undertaken 3 and 6 months after the baseline data were collected. The participants in the intervention group received the standard diabetes education program and an additional self-efficacy program. The scores for efficacy expectations, outcome expectations, and self-care activities had significantly increased in the intervention group at the 3 and 6 month follow-ups, when compared to those of the control group. A smaller proportion of the participants in the intervention group had been hospitalized or had visited an emergency room than in the control group at the 6 month follow-up. This study revealed that a self-efficacy program for diabetes was acceptable and effective in the short term in the self-management of persons with type 2 diabetes.     

Changing Selves: a Grounded Theory Account of Belonging to a Self‐advocacy Group for People with Intellectual Disabilities1

Purpose To explore the experience of belonging to a self‐advocacy group for people with intellectual disabilities, and how membership of such a group impacts on individual members. Methods Eight people with intellectual disabilities, who belonged to a self‐advocacy group for at least 6 months, were interviewed about their experiences of membership. A grounded theory approach was used to generate and analyse the interview data. Results A model of the impact of belonging to a self‐advocacy group for people with intellectual disabilities on individual members' self‐concept is developed. The model proposes that participants' self‐concept changes as a result of group membership and that this process of change involves six key categories: joining the group; learning about and doing self‐advocacy; becoming aware of group aims and identity; experiencing a positive social environment; identifying positive change in self‐concept and seeing the future of self and group as interlinked. Conclusion Membership of a self‐advocacy group for people with intellectual disabilities changes the self‐concept of participants. The processes surrounding these changes have important implications for self‐advocacy groups both, in recruitment and in supporting group members.     

New measures of diabetes self‐care agency,diabetes self‐efficacy,and diabetes self‐management for insulin‐treated individuals with type 2 diabetes

Aims and objectives. To develop and refine three new scales that measure diabetes self‐care agency, diabetes self‐efficacy and diabetes self‐management to reflect the American Diabetes Association current standards of diabetes care and the American Association of Diabetes Educators self‐care behaviours. And, to establish the clarity, consistency and content validity of the scales. Background. There is a need to have valid and reliable instruments or scales to assess an individual’s diabetes self‐care agency, self‐efficacy and self‐management to plan appropriate interventions that can be effective in improving glycaemic control and delaying or preventing diabetes‐related complications. Design. A methodological design was used to conduct this study. Methods. Ten clinicians and 10 insulin‐treated individuals with type 2 diabetes (T2DM) from a diabetes care center in the southern USA participated in this study. Analysis consisted of inter‐rater agreement to determine clarity and consistency with standards of diabetes care and content validity of individual items on the scales (I‐CVI) and the overall scales (S‐CVI/Ave) to determine relevance for current diabetes care practice. Results. All I‐CVI and S‐CVI/Ave of the DSES exceeded the minimum acceptable criteria. All I‐CVI and the S‐CVI of the DSMS also exceeded the minimum accepted criteria, except for one item that had I‐CVI = 0·70. Evaluation of the items and the directions of the scales by the sample of insulin‐treated individuals with T2DM exceeded the minimum criteria of 80% inter‐rater agreement. Relevance to research and clinical practice. Further psychometric testing of the scales with samples of insulin‐treated individuals with diabetes is warranted and will lay the groundwork for further research and clinical practice to enhance the capability, confidence and actual performance of diabetes self‐management activities among insulin‐treated individuals with T2DM. Conclusions. The scales can be used by diabetes care providers to assess and follow‐up individuals with diabetes who need intense case management. They also can be the measures of choice to conduct future research to test the effects of interventions among insulin‐treated individuals with T2DM.     

Evaluation of a self‐efficacy enhancement program to prevent pressure ulcers in patients with a spinal cord injury

Aim

This study developed a self‐efficacy enhancement program and evaluated its effects on the self‐care behaviors, self‐care knowledge, and self‐efficacy regarding pressure ulcer prevention in patients with a spinal cord injury.

Methods

This was a multicenter randomized controlled trial. Six hospitals were invited to recruit patients with a spinal cord injury who were undergoing rehabilitation after receiving acute treatment. These hospitals were randomly allocated into experimental (three hospitals) or control (three hospitals) groups and 47 patients participated (24 in the experimental group and 23 in the control group). The experimental group was given an 8 week self‐efficacy enhancement program for pressure ulcer prevention. The self‐efficacy enhancement program consisted of small‐group face‐to‐face intervention (education and skills training), education with computer animation, phone counseling, face‐to‐face counseling, and self‐management records. The control group only received a pressure ulcer prevention information booklet. Self‐care knowledge, self‐efficacy, self‐care behaviors, and pressure ulcer incidence were measured at baseline and after the 8 week self‐efficacy enhancement program.

Results

The experimental group showed a significantly greater improvement in self‐care knowledge, self‐efficacy, and self‐care behaviors for pressure ulcer prevention than did the control group. One participant in the control group developed a pressure ulcer, while none of the participants in the experimental group developed a pressure ulcer; this difference was not statistically significant.

Conclusions

The self‐efficacy enhancement program enabled patients with a spinal cord injury to engage in continued self‐care behaviors and helped them to improve their knowledge and self‐efficacy concerning pressure ulcer prevention.

     

Training staff to promote self‐management in people with intellectual disabilities

Background

People with intellectual disabilities have increasing difficulties managing their daily affairs. This study examined the effectiveness of a staff training, which teaches staff to promote self‐management in people with intellectual disabilities.

Method

Effectiveness was assessed with questionnaires addressing clients’ (n = 26) independence and self‐reliance, support needs and challenging behaviour, using a pre–posttest control group design. Additionally, focus groups were conducted with trained staff members 6 months after the training.

Results

In the long term, the intervention group showed a significant increase in independence and self‐reliance, in contrast to the comparison group. No effect was found on support needs and challenging behaviour. Trained staff members reported limited benefits of the training, but had noticed changes in their attitude and method of working afterwards.

Conclusions

Further self‐management research is required to investigate how independence and self‐reliance can be promoted more effectively in this population. Future trainings should carefully consider their content, format, and implementation.