Repeatability and reliability of the diabetic foot self-care questionnaire in Arabic patients: A transcultural adaptation

PurposeThe diabetic foot self-care questionnaire is considered a self-care evaluation tool with 16 questions for assessing diabetic foot health disorders. To date, the DFSQ has been validated in different languages, but an Arabic version was lacking. Consequently, the purpose of this study was to translate and validate the Arabic version of the DFSQ (DFSQ-AR).MethodA suitable method was developed for the translation protocol and cross-cultural validation from Spanish to Arabic. Regarding the total marks from each sub-scale, agreement degrees and confidence were analyzed using Cronbach's α and intraclass correlation coefficient (ICC), respectively. In addition, the mean ± standard deviation differences between pre and post-tests were calculated and completed using Bland-Altman distribution plots.ResultsExcellent agreement between the two versions was demonstrated based on Cronbach's α. Three sub-scales consisting of knowledge of foot hygiene, the appropriate use of footwear and socks, and podiatric self-care were added together to obtain the total score. Excellent retest reliability was shown for the total score. Test/retest reliability was excellent for the self-care and shoe and socks sub-scales. There were no significant differences among any domains (p > 0.05). There were no statistically significant differences (P = 0.000) for the mean ± standard deviations (SD) between pre- and post-tests (98.09 ± 15.42) [93.75–102.43] and 97.96 ± 13.88 [94.5–101.86] points, respectively). Bland-Altman plots or clinically pertinent variations were not statistically significantly different.ConclusionsThe DFSQ-AR is considered a strong and valid questionnaire with adequate repeatability in the Arabic language population.     

经皮冠状动脉支架植入术后个性化健康教育对提高患者自我管理能力的影响

目的：观察个性化健康教育模式应用于经皮冠状动脉支架植入术( PCI)后患者中对改善其自我管理能力的作用，总结其临床可行性。方法选择在我院2014年6月至2015年6月期间行PCI治疗后的患者60例，分别对其一般资料、疾病资料及健康知识进行调查，收集调查结果进行分类，给予个性化健康教育，观察护理前后患者自我管理能力评分的变化。结果所有患者在实施个性化健康教育后，对该疾病的健康知识认知水平及自我管理能力各维度得分对比干预前，均都有不同程度的改善，(P<0．05)，差异具有统计学意义。结论个性化健康教育模式应用在PCI术后患者中可以明显提高患者对疾病的认知程度，从而提高术后自我管理能力，有重要的临床使用价值。     

自我管理在产后抑郁症高危产妇中的应用及疗效评价

目的针对高危产妇且在产后出现抑郁症的患者展开自我管理培训,旨在优化临床护理与管理模式,减少高危产妇在产后由于抑郁引发的危险。方法 选取花都区人民医院在2011年10月至2013年10月这2年内收治的高危产妇共126例,选取的患者均存在产后抑郁情况。将患者随机分为对照组(63例)及观察组(63例)。对照组采用常规临床管理方式,观察组采用自我管理干预方式,帮助产妇进行自我管理。对比两组患者精神状况在管理前后变化情况,了解让患者自我管理相对于常规管理模式在患者精神状态优化方面的效果。结果观察组患者产后抑郁症状减轻效果明显优于对照组患者,在SSRS量表以及SCL-90量表评定上分数更低,说明精神状况更好。两组患者管理效果存在显著差异性(P<0.05),具有统计学意义。结论帮助患者进行自我管理能够有效让患者自行控制情绪,减少产后抑郁程度,并降低抑郁情绪对产后恢复造成的不良影响。因此在临床护理与管理中使用自我管理存在推广价值。     

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

ObjectiveThe 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.MethodsIn 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.ResultsNo 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.ConclusionThe 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 implicationsThe SMW group intervention can be transferred to health and social care without loss of effectiveness. Implementation at a larger scale is warranted.     

Evaluation of the “Take Five School”: An education programme for people with Type 2 Diabetes in the Western Cape,South Africa

AimTo evaluate the Take Five School (TFS) group education programme for patients with Type 2 Diabetes in South Africa.MethodsQuestionnaires, administered before and after 4 sessions of an hour each of group education, measured the effect on self-care activities in 84 patients from 6 different clinics. Individual interviews with health care workers (HCWs) and focus group interviews (FGI's) with patients explored attitudes.ResultsA significant improvement in adherence to a diabetic diet, physical activity, foot care and the perceived ability to teach others was seen. There was no significant change in smoking or adherence to medication. Qualitative data revealed that comprehensive education was appreciated, that the group process was deemed supportive, that HCWs doubt the effect of education in general and that a combination of group and individual sessions was seen as an option worth exploring. Strengths, weaknesses, opportunities and threats to the TFS are identified. Recommendations are made to improve the programme and its environment.ConclusionSignificant self-reported improvements in self-care activities after a group-education programme support the view that introducing structured group education for Type 2 Diabetics in a South African public sector primary care context holds promise. Group education for diabetics, especially in resource limited settings, should be sustained and further research should focus on clinical outcomes.     

自我管理对院外抗病毒治疗HIV感染者生活质量的影响

目的探讨自我管理对院外抗病毒治疗的艾滋病(HIV)感染者生活质量的影响。方法将在我院艾滋病咨询处定点抗病毒治疗的40例艾滋病患者随机分为对照组和试验组,每组20例。对照组采用常规健康教育,试验组开始使用抗病毒药物同时,实施自我管理教育。分别在实施自我管理教育前和实施自我管理教育12个月后对两组患者进行自我管理能力、生活质量评价。结果实施自我管理教育前,两组患者自我管理能力、生活质量指数,差异无统计学意义(P>0.05);实施自我管理教育后,试验组自我管理能力、生活质量指数均显著提高(均P<0.05)。结论自我管理教育能提高院外抗病毒治疗HIV感染者的自我管理能力,改善患者生活质量。