Effect of Diabetes Self-Management Education on Glycaemic Control in Sudanese Adults with Type 2 Diabetes

Research Background: The high prevalence of diabetes in Sudan, estimated at 16%, highlights the importance of effective health education in diabetes management. Diabetes self-management education has been identified as a crucial tool in enhancing the knowledge, attitudes, and abilities necessary for self-management among individuals with diabetes. Aim: To assess the impact of diabetes self-management education on medication adherence and glycemic control in Sudanese adults with type 2 diabetes before and 3 months after the DSME intervention. Method: The study was conducted in Sudan between September 2022 and March 2023, it was an interventional, one-group, pre- and post-test study that aimed to assess the impact of diabetes self-management education (DSME) on medication adherence and diabetes control in Sudanese adults with type 2 diabetes. The research was conducted in primary health care centers in six cities in Sudan and involved 244 participants. The data entry and statistical analysis were conducted using the Statistical Package for Social Sciences version 27.0. A paired t test was used for analysis. Results: The study included 244 participants, 67% of whom were males. The age mean ± SD was 48.6 ± 9.3 years, and 85.3% of participants were married. Age at onset of diabetes mean ± SD was 40.60 ± 7.81 years;44.6% had diabetes for less than 5 years;and 84.1% had a positive family history of diabetes mellitus. The levels of poor, low, and partial adherence to medication decreased by 8.2%, 4%, and 20.6%, respectively, after the intervention. The levels of good and high medication regime adherence increased by 13% and 19.8%, respectively;BMI decreased by 1.1 ± 0.73 kg/m2 (p = 0.005). The fasting blood sugar decreased by 69 ± 32.9 mg/dl (p = 0.049), and the glycated hemoglobin decreased by 1.21 ± 0.28% (p = 0.001). Conclusions: The findings of this study reinforce the importance of patient education in improving glycemic control and enhancing self-management behaviors. Patient education plays a critical role in enhancing glycemic control and self-management behaviors. It is essential for healthcare providers to adopt a patient-centered approach, taking into account the individual's beliefs, attitudes, and knowledge about their illness and treatment. Overcoming these challenges necessitates a comprehensive approach, including enhancing healthcare professionals’ knowledge and communication skills, offering accessible and culturally sensitive diabetes education programs, and addressing barriers to resources and support for self-management.

Assessing the relationship between health literacy intervention and hypertension self-management:A 7-year systematic review from January 2016 to December 2022

Hypertension(HTN)is one of the most common chronic diseases affecting over 30%of the adult population globally,with a growing incidence rate.This review assesses the relationship between health literacy(HL)intervention and hypertension(HTN)self-management among people with HTN.The study design was a systematic review of empirical research articles using a well-defined strategy.Online journals were accessed through databases such as PubMed,CINAHL,Google Scholar,ProQuest,Global Health,WHOLIS,Embase,and EbscoHost,spanning from January 2016 to December 2022 as the scope of the study.Articles selected for inclusion were those published in English during the specified time frame and adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Sample,Phenomenon of Interest,Design,Evaluation,Research Type framework for systematic review,focusing on criteria related to the sample,the phenomenon of interest,study design,evaluation,and research type.Out of 180 studies initially identified in the database search,20 studies were ultimately included in the review.The findings were reported based on these five emerging themes:Relationship between HL and HTN self-management;Effect of HL intervention on HTN self-management;Factors predicting self-care behaviors among HTN patients with low HL;Effect of HL and self-management efficacy on health-related quality of life(HRQoL);and level of self-care practices.This review highlights a relationship between HL,self-efficacy,self-care,and HRQoL,underscoring the necessity for further well-designed intervention studies focused on enhancing HL in individuals with HTN in Nigeria to enhance their quality of life.

Application Effect of WeChat Platform Continuity of Care Model Based on KAP Theory on Self-Management of Stroke Patients with Hypertension

Objective: To explore the impact of the WeChat platform continuity of care model based on the KAP (knowledge, attitudes, and practices) theory on the self-management of stroke patients with hypertension after discharge from the hospital. Methods: 62 stroke patients with hypertension discharged from the rehabilitation department of a tertiary A hospital in Nanning City, Guangxi Zhuang Autonomous Region, from October 2022 to April 2023 were sampled by convenience sampling method. Patients discharged from Rehabilitation I were included in the control group, and conventional nursing care was used;while patients discharged from Rehabilitation II were included in the observation group, and WeChat platform continuity of nursing care model based on the KAP theory was implemented. The intervention effect of the two groups was compared. Results: After 4 and 12 weeks of intervention, the diastolic and systolic blood pressure of the patients in the observation group were lower than those in the control group (P < 0.05);after 12 weeks of intervention, the rate of medication adherence and the score of adherence to hypertension treatment in the observation group were significantly higher than those in the control group (P < 0.05). Conclusion: The application of the WeChat platform continuity of care model based on KAP theory to stroke patients with hypertension can improve blood pressure, medication adherence rate, hypertension treatment adherence, and overall enhance the self-management level of these patients.

Conceptual Analysis of Self-Management in Patients with Hypertension

Objective:To clarify the concept of self-management in hypertensive patients by analyzing the definition,attributes,and measurement tools through a literature review.Methods:An Internet-based search of the databases was conducted using Academic Search Complete,Medical Line,CINAHL,Health Source:Nursing/Scholarly Edition,and Google Scholar.In the search process,keywords or free text were combined by using Boolean operators,with the search terms“self of management”or“self-management,”“concept*analysis”or“concept*definition,”and Walker and Avant’s concept analysis method was used.Results:Analysis of relevant literature summarized the conceptual attributes of self-management in hypertensive patients as the active participation of patients in the treatment process;the presence of interaction provided by patients and health care providers;the use of certain health management tools;and the aim of maintaining and improving the health status and living capacity of hypertensive patients.Conclusion:The concept of self-management for hypertensive patients was clarified,which helps to promote the application of hypertensive self-management in clinical work and improve outcomes and quality of life for patients with hypertension.

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.

Use of cognitive-behavioral career coaching to reduce work anxiety and depression in public employees

BACKGROUND Public employees worldwide are increasingly concerned about work anxiety and depression.Cognitive-behavioral career coaching has emerged as a promising strategy for addressing these mental health disorders,which can negatively impact on a person's overall well-being and performance.AIM To examine whether cognitive-behavioral career coaching reduces work anxiety and depression among Nigerian public employees.METHODS A total of 120 public employees(n=60)suffering from severe anxiety and depression were randomly assigned to the treatment or control groups in this study.Cognitive behavioral coaching was provided twice a week to those in the treatment group,whereas no treatment was given to those in the control group.As part of the study,the Hamilton Anxiety Rating Scales and Beck Depression Inventory were used to collect data.RESULTS Analysis of covariance of the data from participants indicates a significant effect of cognitive-behavioral career coaching on work anxiety and depression.CONCLUSION Insights into the underlying mechanisms by which cognitive behavior career coaching exerts its effects have been gained from this study.Also,the study has gathered valuable data that can inform future practice and guide the development of strategies for supporting mental health at work.

Research Progress on Career Development of Nursing Staff

There are few studies on career development as an exclusive concept in the field of nursing in China.Currently,research related to the career development of nursing staff primarily relies on inductive evaluation tools,and there is less systematic summarization of this research.This paper reviews the concept,evaluation tools,and influencing factors of nursing career development,aiming to provide a reference for future research in this area.

Vocational Identity and Agency of Chinese College Students: Effects of Filial Piety and Implications in Career Education

Balancing family obligations and personal aspirations is crucial for college students in making life decisions.This critical review examined empirical studies on the effects of filial piety on college students’vocational identity and agency.According to identity capital theory,college students need a sense of agency to construct identity consciously and adapt to adulthood.Filial piety may profoundly influence this process as the core value and internalized social structure for the role of being an adult child in a Chinese family.However,no studies have been conducted from the identity capital perspective.This review found that filial piety had direct effects on college students'vocational identity and also indirect effects by shaping specific agency competencies.The impact of filial piety on the agency was more likely to occur through providing normative guidance about adult roles,influencing how college students view family as a supportive resource,and perpetuating parenting experiences.Based on these findings,this article suggested further examining the mediating role of agency between filial piety and identity development,as well as the effects of filial piety on the psychological foundation of agency development.This review suggested enhancing the agency of college students and encouraging reflections on filial piety in career education.

Research on the Education Strategy of College Students’Career Planning in the New Era

Career planning is the key educational content for college students,which is related to students’career choices and future development after graduation.However,there are some common problems related to career planning among college students.At the same time,career planning education itself fails to break through the limitations of traditional education,which,to some extent,hinders the future development planning of college students.Based on this,schools should actively introduce advanced education methods in the new era,combine the characteristics of college students on the basis of summarizing the previous planning experience in education,constantly improve and innovate the content and form of career planning education,promote the improvement of college students’education,and enhance the quality of education.

Study on Path Selection and Implementation Effect of Counselors in College Students’Career Planning Education

Under the background of a severe job market and fierce talent competition,the career planning education of college students is of great importance.In this study,a combination of quantitative and qualitative research methods was used;500 students in Shenzhen Polytechnic of Information Technology were surveyed by questionnaire,and 40 counselors were interviewed in depth to comprehensively analyze the role and practical effect of counselors in career planning education.The research showed that the role positioning of counselors includes the guide of students’career development,emotional support,and job-hunting strategy,and the specific path selection involves the strengthening of professional knowledge,the construction of interpersonal relationship networks,and personalized counseling.Based on the survey and interview data,this paper constructed a model for enhancing the role of counselors in career planning education and put forward a set of targeted work paths.

Study on the Coordination Mechanism Between Higher Vocational Students’Career Development Planning and School Management

The coordination mechanism between the career development planning of vocational students and the management of vocational colleges is an important means to improve the quality of education and students’vocational competitiveness.The application of synergy theory in the field of education emphasizes the interaction and coordination of various elements in the system and pursues the optimization of overall efficiency.Based on the theory of coordination and its relevance to the management of higher vocational colleges,this paper analyzes the current development status and problems of the coordination mechanism and puts forward the strategy of building an efficient coordination mechanism designed to enhance the students’employment competitiveness,promote the all-round development,and provide theoretical and practical support for the reform and development of higher vocational education.

Impact of chronic disease self-management programs on type 2 diabetes management in primary care

AIM: To assess the effectiveness of the Chronic Disease Self-Management Program(CDSMP) on glycated hemoglobin A1c(HbA1c) and selected self-reported measures.METHODS: We compared patients who received a diabetes self-care behavioral intervention, the CDSMP developed at the Stanford University, with controls whoreceived usual care on their HbA1c and selected self-reported measures, including diabetes self-care activities, health-related quality of life(HRQOL), pain and fatigue. The subjects were a subset of participants enrolled in a randomized controlled trial that took place at seven regional clinics of a university-affiliated integrated healthcare system of a multi-specialty group practice between January 2009 and June 2011. The primary outcome was change in HbA1c from randomization to 12 mo. Data were analyzed using multilevel statistical models and linear mixed models to provide unbiased estimates of intervention effects.RESULTS: Demographic and baseline clinical characteristics were generally comparable between the two groups. The average baseline HbA1c values in the CDSMP and control groups were 9.4% and 9.2%, respectively. Significant reductions in HbA1c were seen at 12 mo for the two groups, with adjusted changes around 0.6%(P < 0.0001), but the reductions did not differ significantly between the two groups(P = 0.885). Few significant differences were observed in participants' diabetes self-care activities. No significant differences were observed in the participants' HRQOL, pain, or fatigue measures.CONCLUSION: The CDSMP intervention may not lower HbA1c any better than good routine care in an integrated healthcare system. More research is needed to understand the benefits of self-management programs in primary care in different settings and populations.

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.

Technology and diabetes self-management: An integrative review

Technology can be used to supplement healthcare provider diabetes care by providing both educational and motivational support. Education can be provided using technology allowing patients to learn new practices and routines related to diabetes management. Technology can support daily diabetes self-management activities including blood glucose monitoring, exercising, healthy eating, taking medication, monitoring for complications, and problem-solving. This article describes an integrative review conducted to evaluate the types of technology being used to facilitate diabetes self-management and the effect of that technology on self-management and diabetes outcomes for adults living with type 2 diabetes mellitus. A literature review was conducted by searching Medline, Pub Med, and Psych INFO databases using the search terms: diabetes self-management, technology, type 2 diabetes, smartphones, cell phones, and diabetes mellitus covering the years from 2008-2013. Articles relying on secondary data(editorials, systematic reviews) and articles describing study protocol only were excluded. Fourteen studies including qualitative, quasiexperimental, and randomized controlled trial designs were identified and included in the review. The review found that technological interventions had positive impacts on diabetes outcomes including improvements in hemoglobin A1 C levels, diabetes self-management behaviors, and diabetes self-efficacy. Results indicate that technological interventions can benefit people living with diabetes when used in conjunction with diabetes care delivered by healthcare providers.

Self-management and self-efficacy status in liver recipients

BACKGROUND： Liver transplantation （LT） is a viable treatment for patients with end-stage chronic liver diseases. The main aim of LT is to prolong life and improve life quality. However, although survival after LT continues to improve, some aspects of recipient＇s health-related quality of life such as self-man- agement and self-efficacy have been largely ignored.

Patient attitudes about financial incentives for diabetes self-management:A survey

AIM:To study the acceptability of incentives for behavior changes in individuals with diabetes,comparing financial incentives to self-rewards and non-financial incentives.METHODS:A national online survey of United States adults with diabetes was conducted in March 2013(n = 153).This survey was designed for this study,with iterative testing and modifications in a pilot population.We measured the demographics of individuals,their interest in incentives,as well as the perceived challenge of diabetes self-management tasks,and expectations of incentives to improve diabetes self-management(financial,non-financial and self-rewards).Using an ordered logistic regression model,we assessed the association between a 32-point score of the perceived challenge of the self-management tasks and the three types of rewards.RESULTS:Ninety-six percent of individuals were interested in financial incentives,60% in non-financial incentives and 72% in self-rewards.Patients were less likely to use financial incentives when they perceived the behavior to be more challenging(odds ratio of using financial incentives of 0.82(95%CI:0.72-0.93) for each point of the behavior score).While the effectiveness of incentives may vary according to the perceived level of challenge of each behavior,participants did not expect to need large amounts to motivate them to modify their behavior.The expected average amounts needed to motivate a 5 lb weight loss in our population and to maintain this weight change for a year was $258(interquartile range of $10-100) and $713(interquartile range of $25-250) for a 15 lb weight loss.The difference in mean amount estimates for 5 lb and 15 lb weight loss was significant(P < 0.001).CONCLUSION:Individuals with diabetes are willing to consider financial incentives to improve diabetes selfmanagement.Future studies are needed to explore incentive programs and their effectiveness for diabetes.

What are the self-management experiences of the elderly with diabetes?A systematic review of qualitative research

BACKGROUND The number of elderly individuals with diabetes is dramatically increasing.Diabetes is a long-term condition and a noncommunicable disease and requires intensive daily self-management.Understanding of self-management from the patients’perspectives is important to nurses,healthcare providers,and researchers and benefits people by improving their self-management skills.AIM To examine and synthesize qualitative studies that explore the experiences of elderly people in self-managing diabetes.METHODS Electronic databases were searched,including MEDLINE,CINAH,PsycINFO,PubMed,CNKI,and WANFADATA.Relevant research was identified by manually searching reference lists and gray literature.Only English and Chinese publications were included.The Critical Appraisal Skills Program was used to assess the quality of the research.The Confidence in the Evidence from Reviews of Qualitative research approach was used to assess the confidence of the findings.RESULTS A total of 10 qualitative studies were included,and content analysis was performed.Five themes were identified:The need for knowledge about diabetes care,support systems,functional decline,attitudes toward diabetes,and healthy lifestyle challenges.CONCLUSION This present review provides a deep and broad understanding of the experiences in the self-management of diabetes and can be valuable to nursing practice and provide recommendations for future research.

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.

Diabetes self-management (DSM) in Omani with type-2 diabetes

Objective:The aim of this study was to assess the status of diabetes self-management(DSM)among Omanis with type-2 diabetes and its relationship with glycemic control and demographic variables.Methods:A correlational descriptive design using questionnaire was conducted with a convenience sample of 266 Omani patients with type-2 diabetes to collect the data.Results:The findings indicated that DSM among the study subject is sub-optimal.Only 1%of them were regular on SMBG;9.5%of them exercise regularly;and 18%of them maintain healthy diet practices.No significant relationship between DSM and glycemic control(p>0.05)was found.DSM was found to be associated with age,gender,level of education,and duration of diabetes.Examining the differences between two regions in Oman(Muscat&Aldhakiliyah)indicated that participants from Muscat differ only in practicing SMBG.Conclusion:Results indicated that many Omani patients with type-2 diabetes do not perform DSM consistently.Practice implications:The findings of this study set the stage to develop teaching strategies that will improve DSM and subsequently improve diabetes management in patient with type-2 diabetes in Oman.

The Process of How Elderly Patients with Lung Cancer Who Are Receiving Molecularly Targeted Therapy with Oral Agents Establish Self-Management

Purpose: In Japan, many elderly cancer patients are receiving chemotherapy using oral molecularly targeted drugs. They receive treatment in outpatient setting and have a need to self-manage at home. The purpose of this study was to clarify how elderly patients with lung cancer who are undergoing treatment with molecularly targeted drugs in outpatient setting establish self-management. Methods: The study used Kinoshita’s Modified Grounded Theory. Semi-structured interviews were conducted with 17 patients (eight males and nine females). Results: This study identified six categories: Accepting life with cancer, Maintaining activities of daily living without feeling shackled by cancer, Reconsidering how to continue being themselves in daily life until life comes to an end, Using trial and error to integrate treatment and daily living, Formulating their criteria for continuing treatment, and Obtaining help from caregivers. Conclusion: The self-management process in elderly patients consisted of maintaining treatment and integrating treatment with daily living. And they are exploring the effects of treatment and side effects in order to live their own life. Implications for Nursing: In many elderly patients with lung cancer the purpose of treatment is curative extension of survival and improved quality of life. Our findings suggest that is important we help patients to identify how patients want to live, identify ways to improve their quality of life, and share the goals of treatment between the patient and the caregiver.