穴位敷贴联合自我管理治疗膝骨关节炎疗效观察

目的:观察穴位敷贴联合自我管理治疗膝骨关节炎的临床疗效。方法:70例患者随机分为治疗组和对照组,每组35例,对照组行基础治疗及自我管理,治疗组在对照组基础上给予穴位敷贴治疗,分别于治疗前、治疗6周后和治疗结束后6个月时采用WOMAC量表、SF-36问卷量表评定比较两组患者治疗前后的膝关节功能及生活质量。结果:治疗前、治疗6周后及治疗结束后6个月WOMAC评分、SF-36问卷评分比较:治疗6周后及治疗结束6个月后,两组患者WOMAC评分均显著低于治疗前(P<0.05),治疗组WOMAC评分显著低于对照组(P<0.05);治疗6周后及治疗结束6月后,两组患者SF-36问卷评分均明显高于治疗前(P<0.05),治疗组SF-36问卷评分显著高于对照组(P<0.05)。结论:穴位敷贴联合自我管理治疗膝骨关节炎疗效显著,可明显改善老年膝骨关节炎患者关节功能及生活质量。

Independent and combined effects of environmental factors and miR-126, miR-143, and miR-145 on the risk of coronary heart disease

Objective To evaluate the effects of environmental factors and microRNAs （miRNAs） （miR-126, miR-143, and miR-145） on the risk of coronary heart disease （CHD）. Methods A frequency-matched case-control study （450 patients, 450 controls） was conducted from April 2014 to December 2016 in Fuzhou City, China. Environmental factors were investigated using a self-administered questionnaire, and the expression levels of miR-126, rniR-143, and miR-145 were determined by quantitative real-time Polymerase Chain Reaction （PCR） in pe- ripheral blood mononuclear cells. Unconditional logistic regression models were used for statistical evaluation. Results Alcohol consumption, high-salt diets, high-intensity work, and lack of physical activity were significantly associated with increased CHD risk, whereas light diet was significantly associated with decreased risk. MiR-126, miR-143, and miR-145 were highly expressed in the CHD group compared with the control group. After adjustment for other environmental factors, unconditional logistic regression results revealed that miR-126, miR-143, and depression were the independent risk factors of CHD, and light diet was the independent protective factor of CHD. Conclusions Our data suggest that a family history of CHD, anxiety, and alcohol consumption was significantly associated with increased CHD risk, whereas light diet was significantly associated with decreased risk. Furthermore, miR-126 and miR-143 in combination with several risk factors, could play a joint role in the development of CHD. Therefore, it is necessary to manage patients with CHD in all directions and multiple level.

Self-management of coronary heart disease in older patients after elective percutaneous transluminal coronary angioplasty

Objective To explore how older patients self-manage their coronary heart disease （CHD） aider undergoing elective percutaneous transluminal coronary angioplasty （PTCA）. Methods This mixed methods study used a sequential, explanatory design and recruited a convenience sample of patients （n = 93） approximately three months after elective PTCA. The study was conducted in two phases. Quantitative data collected in Phase 1 by means of a self-administered survey were subject to univariate and bivariate analysis. Phase 1 findings in- formed the purposive samplhag for Phase 2 where ten participants were selected from the original sample for an in-depth interview. Qualita- tive data were analysed using thematic analysis. This paper will primarily report the findings from a sub-group of older participants （n = 47） classified as 65 years of age or older. Results 78.7% （n = 37） of participants indicated that they would manage recurring angina symptoms by taking glyceryl trinitrate and 34% （n = 16） thought that resting would help. Regardless of the duration or severity of the symptoms 40.5% （n = 19） would call their general practitioner or an emergency ambulance for assistance during any recurrence of angina symptoms. Older participants weighed less （P = 0.02） and smoked less （P = 0.01） than their younger counterparts in the study. Age did not seem to affect PTCA patients＇ likelihood of altering dietary factors such as fruit, vegetable and saturated fat consumption （P = 0.237）. Conclusions The findings suggest that older people in the study were less likely to know how to correctly manage any recurring angina symptoms than their younger counterparts but they had fewer risk factors for CHD. Age was not a factor that influenced participants＇ likelihood to alter lifestyle factors.

Development and validation of a self-management behavior questionnaire for Chinese enterostomy patients

Objectives:This study aimed to develop a self-management behavior questionnaire for Chinese enter-ostomy patients and examine its reliability and validity.Methods:Guided by the theory of self-management,an initial questionnaire was generated through literature review,group meetings,and two rounds of an expert consultation.Finally,the reliability and validity of the questionnaire were validated through a questionnaire survey of 200 enterostomy patients were selected from the Affiliated Hospital of Medical University from June 2016 to March 2017.Results:The content validity index was 0.80e1.00.The exploratory factor analysis yielded a five-factor(dietary behavior,psychosocial behavior,symptom management behavior,medical compliance behavior,information management behavior),consisting of 40 items.The cumulative variance contri-bution rate was 65.42%.The Cronbach’s a coefficient for the total questionnaire was 0.972,and for the five factors ranged from 0.797 to 0.939,indicating a good internal consistency.The test-retest reliability was 0.867(P<0.01).The self-management behavior questionnaire score was negatively related to the Ostomy Skin Tool score(r=-0.800,P<0.01).Conclusions:The self-management behavior questionnaire developed in this study showed good reli-ability and validity and can be used to assess the self-management behavior of Chinese enterostomy patients.

Predictors of diabetes self-management among type 2 diabetics in Indonesia:Application theory of the health promotion model

Objective:This study aimed to identify factors predicting diabetes self-management among adults with type 2 diabetes mellitus in Malang City,East Java,Indonesia.Methods:A cross-sectional design was used in this study.Participants were selected from five primary health centers in Malang City,East Java,Indonesia using the multistage sampling method.A total of 127 adults with type 2 diabetes mellitus were recruited.Data were collected by questionnaires which were the general diabetes knowledge,the Beliefs of Treatment Effectiveness,the Diabetes Distress Scale,the Self-efficacy for Diabetes Scale,the brief Chronic Illness Resources Survey,the Situational Questionnaire and the Summary of Diabetes Self-care Activities.A self-administered questionnaire was used to collect the data.Multiple linear regression with stepwise method was used toanalyze the data.Results:The scores of seven questionnaires(i.e,diabetes knowledge,perceived benefit of diabetes self-management,diabetes distress,perceived self-efficacy,social support,situational influence,and diabetes self-management)were 13.75±3.59,34.9±4.89,3.03±0.86,3.60±0.53,27.79±5.56,3.27±0.58,3.81±1.08,respectively.The significant predictors of diabetes self-management were treatment,perceived self-efficacy,and situational influences.These variables explained 20.8%(adjusted R^(2)=0.208)of the variance in diabetes self-management among adults with type 2 diabetes mellitus in Malang City.Conclusion:Diabetes self-management among adults with type 2 diabetes mellitus could be improved by enhancing their perceived self-efficacy to achieve their self-management behavior,such as having a healthy diet,exercising regularly,actively monitoring blood glucose level,taking medication and foot care,and providing support to promote good situational influence.

Psychometric properties and characteristics of the Diabetes Self Management Scale

Objective:Assessing diabetes self care management is essential for nursing care for diabetes.There is a need to have valid and reliable scales that assess the actual performance of diabetes self management,The purpose of this study was to revise and conduct psychometric testing and analysis of the Diabetes Self Management Scale(DSMS).Methods:A cross-sectional methodological design was used.A convenience sample was used and 78 adults with diabetes and taking insulin from five sites in the Midwest area of the U.S participated in the study.Reliability analysis was done using Ferketich techniques to make decisions about whether any given item should be retained or deleted.Results:A descriptive analysis for the 60 items of the scale was conducted;several items had low variability compared to the other items on the scale.The correlation matrices showed that a total of 20 items had poor item characteristics.These 20 items were deleted resulting in developing 40-item version of the scale.The 40-item scale had high level of internal consistency(Cronbach'sα=0.947).The validity testing of the 40-item scale was guided by the Research Model for Diabetes Self Care Management;results were congruent with the model and showed strong correlation with self efficacy,moderate correlation with self care agency,and weak correlation with diabetes knowledge.Conclusion:The items and the scale(DSMS)have undergone careful psychometric testing.The 40-item DSMS is a reliable and valid instrument to measure diabetes self care management among people with diabetes.

Type D personality negatively associated with self-care in Chinese heart failure patients

Background Little is known about the association between type D personality and self-care behaviors in heart failure （HF） patients. We examined the effect of type D personality on self-care behaviors and self-efficacy among Chinese HF patients. Methods A cross-sectional study with a convenience sample was conducted. All participants completed the questionnaires of the self-care of HF index （V6） and type D personality scale. Demographic and clinical variables were obtained from medical records and patient interviews. The me- thods used for data analysis included descriptive analysis, independent-sample t-test, Z2 test, and multiple linear regression. Results A total of 127 HF patients were included and 61.4% of them were male. The average age for this study sample was 64.9± 12.34 years. The majority of the participants were in a New York Heart Association class III or IV （87%）, and the average length of living with HF was 38.24 ± 41.1 months. A total of 33.1% of the participants were identified as having type D personality. No significant differences were determined in the demographic and clinical variables between type D and non-type D patients, except for the mean age and the length of living with HF. Type D patients were younger and had a shorter time of living with HF than their non-type D counterparts. Multiple regression demonstrated significant associations between type D personality and self-care maintenance and self-efficacy after adjusting the demographic and clinical factors. However, type D personality was not significantly associated with self-care management behaviors. Conclusions Type D personality was negatively related to self-care maintenance and self-efficacy in Chinese HF patients. Future study is warranted to develop a tailored intervention to improve engagement in self-care behaviors in HF patients with type D personality.

Professional nurses’facilitation of self-care in intensive care units:A concept analysis

Objective:This article aims to provide an in-depth analysis of the concept of self-care in the intensive care unit and outline its defining attributes,antecedents,consequences and empirical referents.Methods:The literature was searched electronically using databases such as CINAHL,Medline,Psych INFO,ERIC,ScienceDirect,Amed,EBSCO(Health Source:Nursing and Academic Edition),Sage,Ujoogle and Google Scholar.Articles from 2013 to 2020 were searched to target recent and up-to-date information about the definitions,attributes,antecedents and consequences of the concept of self-care.Walker and Avant’s framework was utilised to analyse the concept of self-care.Results:The results of the concept analysis identified seven attributes,namely process,activity,capability,autonomous choice,education,self-control and interaction.The seven identified antecedents are self-motivation,participation,commitment,resources,religious and cultural beliefs,social,spiritual and professional support,and the availability of time.The consequences are the maintenance of health and wellbeing,autonomy,increased self-esteem,disease prevention,empowerment,increased social support and the ability to cope with stress.

The development and implementation of a model to facilitate self-care of the professional nurses caring for critically ill patients

Objectives This article aimed to describe the development,implementation,and evaluation of the model’s effectiveness to facilitate self-care of professional nurses caring for critically ill patients in ICUs.Methods The methods of Chinn and Kramer,Walker and Avant were utilized to generate this model.The study included four steps to develop,implement and evaluate the model:Step 1-concept analysis;Step 2-placing the concept in relationship statements;Step 3-description and evaluation of the model;and Step 4-implementation and evaluation of the model.The implementation and evaluation of the model included two phases:a one-day workshop to present the model,and three months of model implementation.The study was conducted in a specific tertiary hospital in Gauteng Province,South Africa.Twenty-five participants were identified amongst the five ICUs,and only eight participants accepted the invitation.Out of the eight participants,only six professional nurses working in different ICUs in the public sector were interviewed.Results The model was divided into three stages:relationship,working,and termination;it comprised the primary and secondary contexts in which the facilitation of self-care occurs.The model process occurred in a spiral form.The registered nurses benefitted holistically from the three presenters at the workshop,and the social worker contributed to their emotional self-care activities.Three themes emerged:The model brought positive experiences,change,and self-awareness;the model benefitted the registered nurses holistically;role modeling self-care practices motivated and benefitted others.Conclusion The model implementation assisted the registered nurses’in developing self-awareness and resilience.They gained more knowledge regarding self-care,and the model encouraged them to implement improved self-care practices.They became role models of self-care and motivated their friends and families.

Effects of a symptom management intervention based on group sessions combined with a mobile health application for persons living with HIV in China:A randomized controlled trial

Objective:This study aims to evaluate the effects of a symptom management intervention(SMI)based on symptom management group sessions combined with a mobile health(mHealth)application(app)on the knowledge of symptom management,the certainty of symptom self-management,symptom severity,symptom distress,medication adherence,social support,and quality of life among persons living with HIV(PLWH)in China.Methods:A parallel randomized controlled trial with 61 PLWH was conducted in Shanghai,China.The participants in the control group(n¼30)downloaded the Symptom Management(SM)app according to their needs and preferences,and received routine follow-ups.The participants in the intervention group(n¼31)were guided to download and use the SM app,and received four tailored weekly group sessions at routine follow-ups.Each group session lasted for approximately 2 h and targeted one of the major modules of the SM app.All the outcomes were assessed at baseline and post-intervention.The study was registered with the Chinese Clinical Trial Registry(ChiCTR1900024821).Results:The symptom management knowledge and certainty of symptom self-management were significantly improved after the intervention(all P<0.01).Compared with the control group,the scores of symptoms reasons knowledge score improved 11.47 points(95%CI:3.41,19.53)and scores of symptoms self-management knowledge score improved 12.80 points(95%CI:4.55,21.05)in the intervention group after controlling for covariates.However,other outcomes did not show statistically significant differences between the intervention group and the control group(P>0.05).Conclusion:The SMI could improve PLWH’s symptom management knowledge and certainty of symptom self-management.Multi-center studies with larger sample sizes and longer follow-ups are needed to further understand the effects of SM app on ameliorating symptom severity and symptom distress.More innovative strategies are also needed to promote and maintain the sustainability of the SM app.

Self-management A concept analysis of self-management for cancer patients’ home-based rehabilitation

Objective： To explore and clarify the concept of self-management in the context of cancer patients’ home-basedrehabilitation. This concept analysis will provide a theoretical lens for nurses to help cancer patients to developself-management strategies and enables them to improve their ability in symptom self-management of home-basedrehabilitation. Method： Walker and Avant’s framework （2011） was used to analyse the concept of self-management.Results： Self-management is defined as a dynamic process that involves perception of one’s needs, resource utilisation,problem solving and active participation. Antecedents of self-management include self-efficacy, disease knowledge andsocial support. Improving cancer patients’ ability in symptom self-management can improve their health outcomes andquality of life and reduce healthcare expenditures. Although Strategy and Effectiveness of Symptom Self-Managementscale is perceived as an ideal instrument to measure self-management and thus it is used worldwide, whether thisinstrument fits to measure this concept for cancer patients in Chinese context has still not yet been verified and thusfurther research is needed. Conclusion： According to the concept analysis, nurses should encourage cancer patients toinvolve actively in making a home-based rehabilitation plan and promote their ability in symptom self-management ofhome-based rehabilitation so as to improve their health outcomes and reduce healthcare expenditures.

Research on Human Resource Management in the ＂Internet plus＂ Era

Today＇s society has entered the Intemet era, the Internet technology has brought great changes to all walks of life.With the development of＂Internet plus＂,traditional industry, service industry and business have to make the appropriate changes to meet the demand of the ＂Internet plus＂ era.Similarly,human resource management has to face new challenges in ＂Intemet plus＂ era.This paper expounds the characteristics of＂Internet plus＂ era and the changes brought to the human resource management,put forward the idea that human resources management should make changes to meet the demand of the ＂Internet plus＂ era from three aspects：big data,decentration and staff self management,establishing a new talent incentive mechanism.

Psychometric evaluation of the Thai translation of the Diabetes Self-management Questionnaire in type 2 diabetes

Objectives:To explore the content validity and the internal consistency of the diabetes Self-management Questionnaire(DSMQ)for persons with T2DM in Thailand.Methods:Diabetes Self-management Questionnaire(DSMQ)was developed in English.The translation of DSMQ into Thai language was performed by native Thai translators.A panel of five experts in Thailand evaluated the translation.Content validity was quantified by the content validity index(CVI).A crosssectional design was used to test internal consistency by calculating Cronbach's alpha.Results:The DSMQ contains 16 items.There are eleven items(69%)which showed excellent CVI;two items(12.5%)showed good CVI and three items showed acceptable CVI.The average scale of CVI was 0.90.The internal consistency of the DSMQ was 0.73.Conclusion:The Thai version of DSMQ showed excellent content validity;good internal consistency.The instruments can be used among Thai adults with DM in future research studies.

Policy Optimization Study Based on Evolutionary Learning

In order to achieve an intelligent and automated self-management network,dynamic policy configuration and selection are needed.A certain policy only suits to a certain network environment.If the network environment changes,the certain policy does not suit any more.Thereby,the policy-based management should also have similar "natural selection" process.Useful policy will be retained,and policies which have lost their effectiveness are eliminated.A policy optimization method based on evolutionary learning was proposed.For different shooting times,the priority of policy with high shooting times is improved,while policy with a low rate has lower priority,and long-term no shooting policy will be dormant.Thus the strategy for the survival of the fittest is realized,and the degree of self-learning in policy management is improved.

A Phenomenological Understanding of Digital Processes of Subjectification： The Example of Lifelogging

By lifelogging, we understand a specific, very recent phenomenon of digital technology, which falls within the range of practices of the quantified self. It is a complex form of self-management through self-monitoring and self-tracking practices, which combines the use of wearable computers for measuring psycho-physical performances through specific apps for the processing, selecting and describing of the data collected, possibly in combination with video recordings. Given that lifelogging is becoming increasingly widespread in technologically advanced societies and that practices related to it are becoming part of most people＇s everyday lives, it is more important than ever to gain an understanding of the phenomenon. In this paper, I am interested in particular in exploring the issue of the transformations in the perception, comprehension, and construction of self, and hence in subjectification practices, deriving from the new digital technologies, and especially lifelogging.

On the Self Management in MET Development

Maritime English teaching has placed higher requirements on the part of the teachers. In combination with the requirements and the characteristics of maritime English teaching, this article puts forth new viewpoints for the self management of maritime English teachers and provides evidence in the aspects of theory and practice.

Five Success Factors in Elite Interviewing for Qualitative Research

The purpose of this paper is to describe the challenges of elite interviewing and identify key factors that ensure success for qualitative researchers. The authors draw on their own experiences of interviewing powerful and influential members of government and various professions as well as tips from experienced researchers from the fields of social sciences and health. They identify five essential steps to successful interviewing： （1） identifying the key informants; （2） negotiating access; （3） background research and preparation; （4） site selection, presentation questioning approach, and execution; and （5） follow-up. Each of them is discussed in detail. The authors argue that the most important quality for the elite interviewer is self-management which involves developing an individual style of interviewing that is responsive to setbacks and unexpected opportunities

Empirical study on factors motivating business students to move to the entrepreneurial sector

This exploratory study is attempting to examine how employable individuals turn their focus to start-ups. Today, majority of employees still practice a more or less self-protective strategy. In this paper the authors have reported the results of an empirical study of factors motivating degreed potential employees to move to self-enterprising. The deciding factors to become an entrepreneur and of sustainable employment-oriented factors are analyzed in order to discover how they differ. Participants consisted of 200 students from Malaysia entered final year of business undergraduate and postgraduate programs. Self-administered questionnaires were used to gather data on factors and types of relationships influencing career choice and entrepreneurial intention. The results will serve as a basis for improvement of employment practices and promising entrepreneurial curriculum in universities to support start-ups in creating sustainable businesses.

Dreaming a Possible Dream： Getting Thai Students to Speak in English in a Public Speaking Class

The paper is an analysis of how much success Thai teachers of English have had throughout four decades of teaching English as a Foreign Language （TEFL） and the future direction to take. Thai teachers are aware that their students are not confident of their speaking abilities. That is why they try to avoid making mistakes in pronunciation and connected speech making as mistakes are taken as signs of inability. It is a common sight in an English class that Thai students prefer to remain in their comfort zone of using the Thai language. Speaking is a productive skill; teaching someone to speak cannot be successfully done through listening to the ＂how to＂ lecture. The author proposes that to dream a possible dream, the teachers need to change their course design to adopt the goals of English for communication and enhancement of soft skills such as networking skill, teamwork skill, self-management skill, creativity, and work attitude. An example of a course design used is discussed with the underlining learning theories for the course, the course organization, and the fruits of this endeavor. This course is adopting the ＂Teach Less and Learn More＂ approach, a route to take for real learning.

Moving the Goalpost： ＂Come-We-Stay＂ Practice in Menchum Division （MD）, Cameroon

This paper seeks to understand people＇s perception of ＂come-we-stay＂ （CWS） cohabitation in Menchum Division （MD）, Cameroon. As in most of Africa, marriage is a valued institution that ensures the continuation of the family tree. The emergence of CWS is gathering momentum fast in many communities in the country much to the dislike,of the church and custodians of tradition who perceive CWS to be a cheap union form that breaches marriage norms. This paper seeks to address whether the emergence of CWS has affected marriage perceptions in MD. Initially, quantitative data were collected via online survey disseminated via Facebook. The time-efficiency, economic viability, convenience and anonymity of this method made it a viable method for this study. Later, however, due to a low response to the Facebook link, the online survey was constructed into a questionnaire and administered to the same target population. Questionnaires were relevant to this study because they could be self-administered. However, the questionnaires were limited as they did not allow for attention to details. The data were analysed using content analysis.