Factors related to self-management behavior among persons with mild-to-moderate chronic obstructive pulmonary disease in Wenzhou,China

Objective:To describe the self-management(SM)behavior among persons with mild-to-moderate chronic obstructive pulmonary disease(COPD),and it examines the correlation between COPD knowledge,self-efficacy,perceived social support,and SM behavior among persons with mild-to-moderate COPD in Wenzhou,China.Methods:A simple random sampling technique was used to recruit 121 persons with mild-to-moderate COPD who visited the respiratory outpatient department of the First Affiliated Hospital of Wenzhou Medical University in Wenzhou,China.Research instruments include a demographic data questionnaire,COPD SM scale,COPD knowledge questionnaire,6-item chronic disease self-efficacy scale,and perceived social suppor t scale.Descriptive statistics and Pearson's Correlation were used for data analysis.Results:The findings show that the mean score of COPD SM scale was 2.70(SD=0.45).The Pearson correlation analysis revealed that the COPD knowledge(r=0.47,P<0.001),self-efficacy(r=0.28,P=0.001),and perceived social support(r=0.48,P<0.001)were positively correlated to the COPD SM behavior among persons with mild-to-moderate COPD in Wenzhou,China.Conclusions:The findings indicate that disease knowledge,self-efficacy,and perceived social support were related to SM behavior in persons with mild-to-moderate COPD,which provides a theoretical basis for developing SM interventions for persons with mildto-moderate COPD and improving this population's SM behavior.

Relationship between Moral Elevation and Prosocial Behavior among College Students: The Mediating Role of Perceived Social Support and Moderating Role of Moral Identity

Objectives:The present study examined the relationship between college students’moral elevation and prosocial behavior.As well as the mediating role of perceived social support and the moderating role of moral identity.Methods:A sample of 489 college students were recruited for the study.They were asked to complete a series of questionnaires,including Moral Elevation Scale(MES),Perceived Social Support Scale(PSSS),Moral Identity Scale(MIS)and Prosocial Tendency Measure(PTM).As part of the data analysis,we used correlation analysis and the method of constructing latent variable structural equation model to explore the mechanism of action among variables.Results:After controlling for gender,discipline,the research found that:(1)Moral elevation positively predicted the prosocial behavior among the college students;(2)Perceived social support mediated the relationship between moral elevation and prosocial behavior;(3)Moral identity moderated the second half of the model(i.e.,the link between perceived social support and prosocial behavior).Specifically,the mediating effect of perceived social support was stronger for college students with high-level moral identity compared to those with low-level moral identity.Conclusions:Moral identity significantly moderates the mediating effect of perceived social support,and the mediating model with moderated is established.

The status quo and influence of self-management behaviors in convalescent stroke patients

Objective： The aims of this study were to investigate the status quo of self-management behaviors in stroke patients at the recovery stage and to explore its influencing factors.Methods： A total of 440 hospitalized convalescent stroke patients were recruited and investigated using the Basic Situation Questionnaire, Self-management Behavior Scale of Stroke, Stroke Prevention Knowledge Questionnaire and Social Support Rating Scale.Results： The mean self-management behavior score was （151.95±23.58）, and dimensions in descending order were as follows： dietary management, drug safety management, social function and interpersonal relationships, life management, emotion management, rehabilitation exercise management and disease management. Five regional self-management behavior scores were statistically significant, and the scores from Minnan and Minzhong of the Fujian province, China, were higher than the others. Gender, age, family income and self-management behavior were significantly correlated （P〈0.05）; educational level, stroke knowledge level, social support level and self-management behavior were positively correlated, and the difference was statistically significant （P〈0.01）. Conclusions： The overall self-management level of convalescent stroke patients should be improved to strengthen health education; focus on the educational level, which is relatively low; strengthen the social support system of patients; stimulate the enthusiasm and initiative of self-management disease patients to promote disease rehabilitation and improve the quality of life.

Self-Management Behaviors of Patients with Hypertension in Daily Life

Background: In a rapidly aging Japanese society, the number of patients with hypertension has seen a steady increase. The basic treatments for hypertension are maintaining blood pressure through medication and preventing complications. It is important for patients with hypertension to perform self-management. This improves their lifestyle while controlling their blood pressure to prevent complications and maintain good health. Purpose: This study aimed to examine the actual self-management behavior ability of patients with hypertension and to clarify the factors involved in their self-management behavior. Methods: A total of 150 patients with hypertension were included in this study. The following data were obtained from the patients as background information: sex, age, years with disease, whether they are receiving antihypertensive agents, type of antihypertensive agent, blood test data, heart thoracic ratio, left ventricular ejection fraction, pulse wave, pulse wave velocity, and height. The levels of self-management skills of the patients were also assessed using the “Instrument to Measure the Self-care of patients with Hypertension” developed by Tsuboi et al. Results: The associations among self-management behaviors in daily life, such as diet, exercise, stress, medication, alcohol intake, and smoking, were analyzed in patients with hypertension. The subjects were classified into the following three groups: aged 65 years or below (Group A), early stage elderly individuals (Group B), and late-stage elderly individuals aged 75 years or over (Group C). The results showed that the subjects in Group C had higher self-management scores for diet, exercise, stress, medication, and drinking than the subjects in the other two groups. The scores of smoking and self-management of the subjects in Group A were high but their other self-management scores were low. All the subjects were taking between 1 to 3 types of oral antihypertensive drugs. The rate of achievement of the target blood pressure was 50% or more in all the three groups. However, the pulse wave velocity was high in all the three groups. Conclusion: The results indicate that the risk of developing disorders of the brain and cardiovascular system is high in all the three groups, owing to the high degree of arteriosclerosis. Therefore, increasing the number of nursing interventions is expected to reduce blood pressure, maintain and promote self-management behavior in daily life, and prevent the onset of complications. The results suggest that nursing interventions involving lifestyle guidance for improving the self-management skills of patients are urgently needed by patients under 65 years of age.

Awareness, self-management behaviors, health literacy and kidney function relationships in specialty practice

AIM To determine the relationship between chronic kidney disease(CKD) awareness(CKD-A), self-management behaviors(CKD-SMB) knowledge, performance of CKDSMBs, health literacy(HL) and kidney function. METHODS Participants were eligible patients attending an outpatient nephrology clinic. Participants were administered: Newest Vital Sign to measure HL, CKD self-managementknowledge tool(CKD-SMKT) to assess knowledge, past performance of CKD-SMB, CKD-A. Estimated GFR(e GFR) was determined using the MDRD-4 equation. Duration of clinic participation and CKD cause were extracted from medical charts. RESULTS One-hundred-fifty patients participated in the study. e GFRs ranged from 17-152 m L/min per 1.73 m2. Majority(83%) of respondents had stage 3 or 4 CKD, low HL(63%), and were CKD aware(88%). Approximately 40%(10/25) of patients in stages 1 and 2 and 6.4%(8/125) in stages 3 and 4 were unaware of their CKD. CKD-A differed with stage(P < 0.001) but not by HL level, duration of clinic participation, or CKD cause. Majority of respondents(≥ 90%) correctly answered one or more CKD-SMKT items. Knowledge of one behavior, "controlling blood pressure" differed significantly by CKD-A. CKD-A was associated with past performance of two CKD-SMBs, "controlling blood pressure"(P = 0.02), and "keeping healthy body weight"(P = 0.01). Adjusted multivariate analyses between CKD-A and:(1) HL; and(2) CKD-SMB knowledge were nonsignificant. However, there was a significant relationship between CKD-A and kidney function after controlling for demographics, HL, and CKD-SMB(P < 0.05). CONCLUSION CKD-A is not associated with HL, or better CKD-SMBs. CKD-A is significantly associated with kidney function and substantially lower e GFR, suggesting the need for focused patient education in CKD stages 1.

Positive correlations between the health locus of control and self-management behaviors in hemodialysis patients in Xiamen

Objective:To investigate the association between the health locus of control and selfmanagement behaviors in patients receiving hemodialysis.Methods:Patients receiving hemodialysis in Xiamen,Fujian province,from December 2014 to March 2015 answered the Chinese version of the Multidimensional Health Locus of Control scale and the self-management behavior questionnaire.Results:The participants in this study indicated that they believed others exerted more control over their health than themselves or chance.In addition,the majority of participants had a medium to low level of self-management behaviors.Positive correlations were also observed between a participant's health locus of control and their level of selfmanagement behaviors.Internal health locus of control and external(others)health locus of control were significant predictors of self-management behaviors controlling for the effect of payment method.Conclusion:The results of this study provided evidence that there is a strong relationship between the health locus of control and self-management behaviors in hemodialysis patients.This study provides important information for medical professionals as they design strategies to educate hemodialysis patients on their health locus of control and selfmanagement behaviors.

Status of Understanding of the Disease and Self-Management Behavior among Patients with Hypertension

Background: Hypertension is a lifestyle-related disease that has no subjective symptoms but could lead to severe complications. The goals of treatment for hypertension are to maintain blood pressure with medications and prevent complications. Measuring blood pressure at home regularly is critical for patients with hypertension. Purpose: This study aimed to 1) clarify the status of patients’ understanding of hypertension and self-management, 2) identify nursing practices that could support patients with hypertension in making them aware of the need for understanding hypertension, monitoring blood pressure at home, and engaging in self-management. Method: A questionnaire survey on understanding of the disease and self-management behavior was conducted among patients with hypertension who regularly visited outpatient clinics. As for data analysis, descriptive statistics were computed for patients’ attributes, clinical findings, understanding of the disease, and self-management behavior. Cross-tabulation and the chi-square test were used for each item on understanding of the disease and self-management behaviors. Results: Data were obtained from 150 participants (93 males and 57 females) with a mean age of 70 years. Patients with a higher understanding of the disease and those who were aware of the target blood pressure were more likely to engage in self-management behavior, including monitoring blood pressure at home, ensuring regular outpatient visits, and consulting with nurses or physicians. In addition, the percentage of patients who recognized the need to achieve their target blood pressure was higher among those who had a spouse and lived with their family. Discussion: Regular monitoring and recording of blood pressure at home are the most important self-management behaviors. Understanding of the disease and self-management behavior and support from the family are critical for maintaining appropriate self-management. Therefore, in cooperation with physicians, nurses should provide health education to patients and their families to enable them to perform appropriate self-management. Health expenditures increase with age, especially in those aged 65 years and over. The prevalence of hypertension increases with age;patients aged 65 years and over need to engage in self-management to maintain their target blood pressure. Nurses should provide patients with hypertension aged 65 years and over with appropriate nursing care to enable them to measure and record their blood pressure at home appropriately and regularly. Appropriate nursing care may help reduce the health expenditure. This may help reduce the health expenditure.

Factors That Promote Autonomous and Controlled Motivation in Self-management Behavior of Hemodialysis Patients

This study examined the differences and primary factors from the impact of autonomous motivation and controlled motivation on the self-management behavior of hemodialysis patients.Anonymous,self-describing questionnaires were used for research on nine different dialysis facilities of 413 people who regularly visit.From using the primary factor results of multiple regression analysis,that took autonomous motivation and controlled motivation as the dependent variable,a path diagram was created that led to each motivation.The acknowledgement of autonomy support facilitated whether it was autonomous motivation or controlled motivation(The standardized coefficient was 0.385,0.346,p<0.0001).Positive evaluation coping skills were a primary factor that promoted autonomous motivation,while trait anxiety,disorders of social activities,and lack of motivation were primary factors that promoted controlled motivation.In order to raise the autonomous motivation to promote self-management behavior in patients with hemodialysis treatment,situations that easily cause amotivation and anxiety,as well as tendencies for depression should be assessed.Also the encouragement to attain positive evaluation coping skills to support patient autonomy appears to be effective.

Effects of the self-management training program on self-management behavior and blood pressure levels among elderly people with hypertension

Objective:To determine the effects of the Self-Management Training Program on self-management behavior and blood pressure(BP)levels among elderly people with hypertension(HT).Methods:This study was based on a quasi-experimental design using sampling groups composed of elderly residents of Pathum Thani Province with HT.Simple random sampling was applied to two sampling groups,an experimental group and a control group.However,the experimental group had been on the Self-Management Training Program based on the Creer concept.The Program’s contents included small-group health-education sessions and the patients’manual,Self-Management Training Skills for Self-Management Behavior.Small group discussions were held for self-reflection,to stimulate follow-up for self-management behavior training during home visits.The Self-Management Training Program was compared with programs involving the more usual care.Data were collected using the Self-Management Behavior for Hypertension Control Questionnaire and BP assessment tests.Data were analyzed using a descriptive statistic,chi-square test,pair t-test,repeated-measures Analysis of Variance(ANOVA),and repeated-measures Analysis Covariance(ANCOVA).Results:It was found that at 13 weeks after entering the program,the experimental group demonstrated a significantly lower systolic and diastolic BP with a baseline statistical significance(P<0.005),and that at the 4th week and the 13th week,there was a decrease in BP in the experimental group.The experimental group also had above-baseline self-management behavior scores that were higher than in the control group(P<0.01).Conclusions:Results from this study show that the Self-Management Program was useful for BP control and promoted sustainable self-management behavior.

Exploring the Influences of Continuous Self-Management Education on the Self-Care Skills and Health Behavior of Patients with PICC Intubation

Objective:To analyze the effects of continuous self-management education on the selfcare ability and health behavior of patients with tumor through peripherally inserted central venous catheters(PICC).Methods:The period from August 2018 to August 2020 was used as the research time range,and the random number table method was used as the basis for grouping.80 patients with malignant tumors who regularly performed fixed catheter maintenance care in the PICC clinic of our hospital were admitted in the experimental group(given PICC specialist nursing,and implemented continuous self-management education),and 80 patients with PICC tube malignant tumors discharged from the superior hospital during this time range served as the control group(return to the original catheterization hospital from time to time or perform catheter maintenance care in the nursing clinic of our hospital).The self-care ability scores,health behavior scores,and complications during intubation between both groups were analyzed.Results:(1)There was no significant difference in self-care ability score and healthy behavior score between groups before the intervention,P>0.05;the self-care ability score and health behavior score of the research group were better than the control group after intervention,P<0.05;(2)After investigation,the incidence of complications in the research group(2.50%)was lower than that of the control group(10.00%),but there was no difference between the groups,P>0.05.Conclusion:Continuous self-management education has good effects on improving the self-care ability of tumor patients with PICC intubation.It can urge patients to maintain good health behaviors and reduce complications.It is worthy of promotion.

运动员过往成绩和个人品德对大学生体育道德判断的影响研究

体育道德判断对个体的体育道德行为具有重要影响。研究使用《体育道德与非体育道德行为判断问卷》调查了909名大学生(男生=520人,女生=389人,平均年龄=19.76±2.92岁)。检验了大学生对体育道德行为和非体育道德行为在道德判断和奖惩判断的差异,以及运动员过往成绩和个人品德对大学生体育道德判断的影响。结果表明,(1)运动员的过往成绩和个人品德对大学生的体育道德判断和奖惩判断产生了显著影响,但在对具体行为的影响性质上存在差异;(2)运动员过往成绩和个人品德在影响大学生体育道德判断过程中存在相互作用,削弱了两者的独立影响效应。在体育教育过程中要发挥道德情绪的积极作用,排除干扰道德判断的影响因素,引导大学生在道德判断中坚持道德原则。

心理特权与亲领导不道德行为——有调节的中介模型

现有研究主要强调了领导者因素对下属亲领导不道德行为的影响,忽视了下属个体特质对这种行为的影响。基于社会认知理论与特质激活理论,本研究探讨了心理特权对亲领导不道德行为的作用机制与边界条件。研究结果表明,心理特权对道德推脱产生显著的正向影响,道德推脱在心理特权与亲领导不道德行为之间起部分中介效应。领导幽默不仅增强了心理特权与道德推脱之间的正向关系,而且调节了心理特权通过道德推脱对亲领导不道德行为的间接影响,即在高领导幽默的条件下,这一中介效应较强。

道德自我、社会支持对大学生非安全性行为的影响

目的探索道德自我、社会支持对大学生非安全性行为的影响。方法于2022年5月采用大学生道德自我问卷、社会支持评定量表、青少年健康相关危险行为问卷对1024名大学生进行调查,分析调查结果。结果(1)大学生道德自我与社会支持呈显著正相关(r=0.31,P<0.01);(2)道德自我与大学生非安全性行为呈显著负相关(r=-0.26,P<0.01);(3)社会支持与大学生非安全性行为呈显著负相关(r=-0.19,P<0.01);(4)社会支持在道德自我与大学生非安全性行为的预测机制中起部分中介作用,中介效应占总效应的36.5%。结论道德自我、社会支持可以较好地预测大学生非安全性行为,社会支持在道德自我和大学生非安全性行为之间起到部分中介作用,这一作用机制对于大学生性健康和性道德教育具有积极的理论和实践意义。

失当与适当:价值认同视域下高职学生德育行为的生成逻辑

“立德树人”是高职院校应当秉持的本质使命和历史重任,核心是促进高职学生核心价值观的认同与内化。德育行为借助于高职学生的价值认同来内发生成,其生成机制较为侧重于德育规律的内在生成逻辑,凸显着德育本体论意涵,发挥着德育的价值关切和高职学生发展的意义诉求。高职学生德育行为的生成境遇价值悬置、功能遮蔽、过程偏移和行为失范等失当表现,引发德育工作“失语”风险,造成学生主体出现价值认同危机倾向。高职学生德育行为生成需要从价值复归、功能凸显、过程凝聚和行为内生等方面进行适当调适,最终形成理性僭越、隐而不彰的行为生成图景,建立兼具德育价值认同和行为生成导向的境脉勾勒时空。

医院医德医风量化积分考评系统的建设与应用探讨

通过对医院医德医风考评体系进行分析,发现医院考评存在缺乏基础数据收集途径、指标设置不够全面、信息化水平不足等问题。针对这些问题,医院构建了由医德医风基础指标体系、医德量化积分平台、医德医风等级评定系统构成的医院医德医风综合考评系统,实现了相关评价指标数据的自动抽取和个人医德量化积分的自动计算及智能化等级评定。系统的应用,实现了医德医风客观、量化、高效考评,对医务人员的医疗行为发挥了正向引导和激励作用,提高了医院精细化管理水平。

道德自我知觉对欺骗行为的影响:解释水平的调节作用

道德自我知觉的提升对道德行为的影响存在道德一致性效应与道德心理许可效应两种矛盾现象,造成这种不一致结果的原因可能是解释水平在其中起到调节作用。本研究通过两个实验考察了解释水平在道德自我知觉提升与欺骗行为关系中的调节作用。实验1和实验2分别以179名和192名大学生为被试,采用数字矩阵任务测量欺骗行为,采用过去时间距离和未来时间距离操纵解释水平。结果发现:高解释水平下(较远的过去、未来),道德自我知觉启动组的欺骗行为显著低于道德自我知觉未启动组,而低解释水平下(较近的过去、未来),道德自我知觉启动组的欺骗行为显著高于道德自我知觉未启动组。因此,解释水平调节道德自我知觉对欺骗行为的影响,即高解释水平下,道德自我知觉提升产生了道德一致性效应;而低解释水平下,道德自我知觉提升产生了道德心理许可效应。

农村初中生道德自我知觉对亲社会意愿和欺骗行为的影响

研究探讨了农村初中生道德自我知觉对其亲社会意愿和欺骗行为的影响。实验1选取375名农村初中生,考察农村初中生道德自我知觉对亲社会意愿的影响。结果发现,道德自我知觉提升组和道德自我知觉降低组的亲社会意愿均显著高于控制组;实验2选取与实验1不同的333名农村初中生,考察农村初中生道德自我知觉对欺骗行为的影响。结果发现,道德自我知觉提升组的欺骗行为显著高于道德自我知觉降低组和控制组,道德自我知觉降低组的欺骗行为显著低于控制组。研究表明,道德自我知觉提升的农村初中生在亲社会行为中出现了道德一致性效应,在欺骗行为中出现了道德心理许可效应;而道德自我知觉降低的农村初中生无论在亲社会行为还是欺骗行为中,都出现了道德净化效应。

肿瘤科护士伦理行为现状及影响因素分析

目的了解肿瘤科护士伦理行为现状,分析其影响因素,为制定针对性干预措施提供参考。方法便利抽取郑州市3所三级甲等医院肿瘤科护士552人,采用一般资料调查表、护士伦理行为量表、拉什顿道德复原力量表、医院伦理氛围量表进行调查。结果肿瘤科护士伦理行为得分为(75.85±10.75)分。多元线性回归分析结果显示,工作年限、道德韧性、医院伦理氛围是肿瘤科护士伦理行为的主要影响因素(均P<0.05),共解释总变异的50.0%。结论肿瘤科护士伦理行为处于中等偏上水平。护理管理者可通过提升肿瘤科护士道德韧性水平,营造良好的医院伦理氛围,从而改善肿瘤科护士伦理行为。