Young Children's Self-care and Independence Tasks: Applying Self-Efficacy Theory

Social Psychologist, Albert Bandura, defines self-efficacy as the individual's belief in his or her own ability to perform a behavior. Self-efficacy for some self-care and independence tasks occurs in an early stage of young children's development. As caregivers take more responsibility for young children they must be aware of the child's need to become self-efficacious. Several self-care and independence tasks are discussed in relation to self-efficacy. Personal accomplishment is a key source of information for each child.     

Use of on-demand video to provide patient education on spinal cord injury

Background/objective

Persons with chronic spinal cord injury (SCI) have a high lifetime need for ongoing patient education to reduce the risk of serious and costly medical conditions. We have addressed this need through monthly in-person public education programs called SCI Forums. More recently, we began videotaping these programs for streaming on our website to reach a geographically diverse audience of patients, caregivers, and providers.

Design/methods

We compared information from the in-person forums to that of the same forums shown streaming on our website during a 1-year period.

Results

Both the in-person and Internet versions of the forums received high overall ratings from individuals who completed evaluation forms. Eighty-eight percent of online evaluators and 96% of in-person evaluators reported that they gained new information from the forum; 52 and 64% said they changed their attitude, and 61 and 68% said they would probably change their behavior or take some kind of action based on information they learned. Ninety-one percent of online evaluators reported that video is better than text for presenting this kind of information.

Conclusion

Online video is an accessible, effective, and well-accepted way to present ongoing SCI education and can reach a wider geographical audience than in-person presentations.     

慢性心力衰竭患者自我概念、抑郁和自我护理行为的路径分析

目的 探讨慢性心力衰竭患者自我概念、抑郁对自我护理行为的关系效应及影响路径.方法 采用Artinian心力衰竭自我护理行为量表、自我概念量表和综合性医院焦虑抑郁量表(HADS),对北京市某心血管病专科医院160例慢性心力衰竭住院患者进行测评.采用Amos 17.0进行路径分析.结果 体觉、理想自我、道德-伦理-精神自我、自我一致性对自我护理行为具有直接效应,其中前三者还通过抑郁对自我护理行为具有间接效应.体觉、自我一致性、理想自我、道德-伦理-精神自我、抑郁对自我护理行为的总体效应分别为0.09,0.15,0.31,0.09和-0.26.结论 慢性心力衰竭患者的自我护理行为受到自我概念和抑郁直接、间接影响,应从多途径多环节采取干预措施提高心力衰竭患者的自我护理.     

Improving self-care of patients with chronic disease using online personal health record

Background

Effective management of chronic diseases such as prostate cancer is important. Research suggests a tendency to use self-care treatment options such as over-the-counter (OTC) complementary medications among prostate cancer patients. The current trend in patient-driven recording of health data in an online Personal Health Record (PHR) presents an opportunity to develop new data-driven approaches for improving prostate cancer patient care. However, the ability of current online solutions to share patients’ data for better decision support is limited. An informatics approach may improve online sharing of self-care interventions among these patients. It can also provide better evidence to support decisions made during their self-managed care.

Aims

To identify requirements for an online system and describe a new case-based reasoning (CBR) method for improving self-care of advanced prostate cancer patients in an online PHR environment.

Method

A non-identifying online survey was conducted to understand self-care patterns among prostate cancer patients and to identify requirements for an online information system. The pilot study was carried out between August 2010 and December 2010. A case-base of 52 patients was developed.

Results

The data analysis showed self-care patterns among the prostate cancer patients. Selenium (55%) was the common complementary supplement used by the patients. Paracetamol (about 45%) was the commonly used OTC by the patients.

Conclusion

The results of this study specified requirements for an online case-based reasoning information system. The outcomes of this study are being incorporated in design of the proposed Artificial Intelligence (Al) driven patient journey browser system. A basic version of the proposed system is currently being considered for implementation.     

中文版糖尿病自护行为量表的信度和效度研究

目的 考察中文版糖尿病自护行为量表(SDSCA)的信度和效度,为我国2型糖尿病患者,自护行为评估提供有效、简便的工具.方法 翻译国外的糖尿病自护行为量表(SDSCA),形成中文版SDSCA,采用随机抽样方法,从内分泌门诊中选取20例2型糖尿病患者,进行中文版糖尿病自护行为量表的重测信度、量表内部一致性和结构效度研究.结果 中文版SDSCA各维度重测信度在0.763～1.000;量表各维度条目间相关系数,具体饮食最低(0.104),其余各维度条目间呈中度至高度相关0.555～0.933;主成分分析共抽取4个因子,解释变异量的67.483%.结论 中文版SDSCA的信效度理想,适合于2型糖尿病患者自护行为评价.

Abstract：

Objective To test the reliability and validity of the Chinese version Diabetea Self-Care Behavior(SDSCA)Questionnaire,and thus to provide an effective and convenient way of self-care behavior assessment for patients with type 2 diabetes.Methods The questionnaire based on the translation of SDSCA wag used in 20 cases of type 2 diabetes patients,in order to analyze the retest rehability,internal consistency and scale construct validity. Results The retest reliability of each dimension wag between 0.763 to 1.000;the scale correlation coeflicients between items in specific diet dimension Wag lowest(0.104),and the others were moderate to high degree of correlation between 0.555～0.933;exploratory factor analysis extracted 4 components,and the percentage of variance explained was 67.483% .Conclusions Chinese version SDSCA has a good reliability and validity,and is good for evaluating the self-care activities in type 2 diabetes patients.     

HIV Illness Representation as a Predictor of Self-care Management and Health Outcomes: A Multi-site, Cross-cultural Study

Research has shown that the perceptions that form the cognitive representation of an illness (illness representation) are fundamental to how persons cope with illness. This study examined the relationship of illness representation of HIV with self-care behavior and health outcomes. Data were collected at 16 sites in the United States, Taiwan, Norway, Puerto Rico and Colombia via survey. HIV seropositive participants (n = 1,217, 31% female, 38% African-American/Black, 10% Asian/Pacific Islander and 26% White/Anglo) completed measures of illness representation based on the commonly accepted five-component structure: identity, time-line, consequences, cause, and cure/controllability (Weinman et al. 1996, Psychology and Health, 11, 431–445). Linear regression analyses were conducted to investigate relationships among illness representation, self-care behaviors and quality-of-life outcomes. Components of illness representation were associated with self-care and health outcomes, indicating that the cognitive representation of HIV has consequences for effective illness management. For example, perception that there is little that can be done to control HIV was significantly associated with fewer and less effective self-care activities (F = 12.86, P < .001) and poorer health function in the domain of quality-of-life (F = 13.89, P < .001). The concept of illness representation provides a useful framework for understanding HIV symptom management and may be useful in directing development of effective patient-centered interventions.     

慢性牙周炎患者口腔自我照料的评估

目的根据口腔健康理论设计一份短问卷,用于临床调查,评估患者的口腔自我照料行为及观点。方法本研究是一项横断面调查。研究对象由72名慢性牙周炎患者组成,年龄范围在24～76岁,于初始牙周治疗前接受临床口腔检查和问卷调查,后者含14个问题项,内容涉及口腔卫生行为、口腔健康观点等。对调查资料和数据进行综合评估及关联性分析。结果人群菌斑控制水平不理想。大多数患者承认牙周病预防的重要性,但只有不到1/3的人坚持定期去医院接受检查,27%的人不愿意改变他们的日常生活习惯,34%的人怀疑个人行为对口腔卫生的影响力。对"刷牙次数"、"牙间隙清洁"、"定期牙科检查"、"依从自我照料建议"等因素与口腔卫生状况关系的分析表明,它们与菌斑评分均有显著关联性(P<0.05)。结论本问卷是采集牙周病患者多方面信息的简易工具;一些自我照料行为与口腔卫生水平的关联说明了牙周护理中以患者为中心的口腔健康评估的重要性。     

授权教育对PICC置管患者自我管理行为与自我效能的影响

目的 探讨授权教育方式进行健康指导对行PICC置管的患者自我管理行为、自我效能的影响.方法 选择肿瘤患者60例,随机分为授权教育组和传统教育组,每组30例,分别按照传统教育方法和授权教育方式进行健康教育.采用自我管理行为量表、自我效能问卷量表、PICC并发症发生率比较两组患者健康教育的效果.结果 出院1个月后对照组患者自我护理能力总分（89.61±8.19）分,实验组（103.06±16.2）分,两组比较差异有统计学意义（t=2.403,P＜0.05）;出院3个月后对照组患者自我效能评分（22.47±4.86）分,实验组（27.61±5.35）分,两组比较差异有统计学意义（t=4.116,P＜0.01）;出院1个月后对照组患者PICC并发症发生率50％,实验组10％,两组并发症发生率比较差异有统计学意义（x2 =4.414,P＜0.05）.结论 授权教育能够明显提高PICC患者的自我效能,提高患者对自身疾病的管理能力和信心,减少了并发症的发生,提高患者的生活质量.     

北京某三级甲等医院住院患者跌倒事件及影响因素调查

目的：分析住院患者跌倒的发生特点及相关因素,为采取针对性护理措施以降低跌倒的发生提供参考和依据。方法对2009-2012年上报的57例住院患者的跌倒事件及相关因素进行回顾性分析。结果跌倒患者平均（65．61±16．92）岁,64．9％的跌倒发生于夜班、中午或交接班时间段,71．4％的跌倒发生于节假日,77．2％的跌倒患者为二级护理,52．7％的跌倒患者有陪护,在跌倒发生时,62．1％的陪护不在场。结论多种因素如患者高龄、护士人力不足、巡视不够、陪护不力等都可引起跌倒的发生。提高护士人力配置,控制跌倒的危险因素,加强跌倒防范教育是减少住院患者跌倒的根本措施。     

妇科化学治疗患者自我管理效能感与焦虑抑郁的相关性分析

目的探讨妇科化学治疗（化疗）患者自我管理效能感与焦虑抑郁的关系。方法 2011年10月-2012年1月采用中文版癌症自我管理效能感量表和医院焦虑抑郁量表对110例妇科化疗患者进行问卷调查。结果共收回有效问卷106份。33例（31.70%）患者焦虑阳性,43例（41.30%）抑郁阳性,35例（33.70%）焦虑抑郁均为阳性;自我管理效能感得分为（86.31±27.06）分,并与焦虑呈负相关（r=0.793,P=0.000）,与抑郁呈负相关（r=0.753,P=0.000）。结论妇科化疗患者自我管理效能感与焦虑抑郁密切相关,在以后的护理工作中应该重视妇科肿瘤患者自我管理项目的构建,提高患者的自我效能,从而改善其心理状况。