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.

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.

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.

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.

Influence of Sorbitan Monooleate on Morphology and Drug Release Behavior of Emulsion Electrospinning Polycaprolactone Nanofibers

Ultrafine polycaprolactone(PCL)fibers containing watersoluble drug tetracycline hydrochloride(Tet)were prepared by emulsion electrospinning.Sorbitan monooleate(Span80)was added as an essential additive to form stable water/oil emulsions and fabricate fibers with core-sheath structure.Different concentrations of Span80(0-40 g/L)were used to investigate the stability of emulsion and size of dispersed droplets.The scanning electron microscope(SEM)images indicated that the morphology of the fibers with Span80 were beaded-free with diameters of 200-400 nm,and Span80 enhanced the spinnability of electrospinning solution.The laser scanning confocal microscope(LSCM)images indicated that Tet was well encapsulated into the core region of the PCL fibers.The transmission electron microscope(TEM)image showed the formation of core-sheath structure.The loading efficiency(LE)and entrapment efficiency(EE)of Tet were calculated and release profiles in artificial saliva buffer solution(pH=6.8)were also analyzed.The results revealed that LE and EE of fibers with Span80decreased with the increase of its concentration.Fibers with coresheath structure had a longer effective release lifetime than without Span80.The increase of Span80 resulted in higher hydrophilicity of fibers and faster release rate of Tet.

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.

Chitosan-g-PAA Hydrogels for Colon-Specific Drug Delivery: Preparation, Swelling Behavior and in vitro Degradability

A series of cross-linked hydrogels for colon-specific drug delivery were synthesized by graft copolymerization of Chitosan and acrylic acid using N, N＇-methylene-bis-（acrylamide） as a cross-linker. Their swelling behavior in different pH buffer solutions and colonic enzymatic degradability were studied. The obtained results show that these hydrogels have good pH sensitivity which can avoid drug release in stomach, and their swelling kinetics in stimulant intestinal environment follow second-order swelling kinetics equation. The factors influencing the swelling kinetics include the degree of cross-linking and the composition, which may control no release or a little amount release of drug inside the hydrogels in the small intestine by tailoring these factors. The gels are degradable by colonic enzymes and there is a correlativity between the degradation of networks and the swelling degree of the gels, which may trigger the release of drug in the colon. The hydrogels show a great potential for their application in oral colon-specific drug delivery system.

Share Videos, Not Pills: A Content Analysis of Prescription Drug Videos on YouTube for Presence of Behavior Change Theory

Objective: To identify the extent to which YouTube.com videos targeting prescription drug abuse include health behavior theory in their content and design. Methods: This study used a content analysis of 209 YouTube.com videos. Coders used an established theory-based instrument to rate each video’s inclusion of theoretical constructs from four prominent health behavior theories. Each YouTube.com video was coded for twenty-two theoretical items, which were summed to create a total theory score. Results: The mean theory score of videos was 3.26 out of a possible 22. Among the top 10% of videos with highest theory scores, social cognitive theory constructs were coded most often and transtheoretical constructs were coded least often. Conclusion: It is not unexpected that YouTube.com videos are largely void of theoretical content since these videos are made by a variety of organizations and sources that may not be trained in the application of health behavior theories. There is an opportunity for the organizations that create these videos to collaborate with health and behavior change experts in creating videos with more theoretical constructs, possibly resulting in better health outcomes.

Prevalence of Human Immunodeficiency Virus (HIV), Risk Behavior, and Recent Substance Use in a Sample of Urban Drug Users: Findings by Race and Sex

The aim of the current study was to examine the prevalence of HIV, past six-month illicit drug use, and risk behaviors among a population of heavy drug users living in an urban setting. Although many studies investigate substance use, sex-risk behavior, and HIV by race and gender, no studies have examined these variables simultaneously. The current study seeks to fill this gap in the literature by exploring HIV prevalence among a predominantly heterosexual sample of recent substance users by injection drug use (IDU) status, race, and sex. Baseline data from the Baltimore site of the NEURO-HIV epidemiologic study was used in this study. This study examines neuropsychological and social-behavioral risk factors of HIV, hepatitis A, hepatitis B, and hepatitis C among both injection and non-injection drug users. Descriptive statistics and chi-square statistics were used in data analyses. Blood and urine samples were obtained to test for the presence of recent drug use, viral hepatitis, HIV, and other sexually transmitted diseases (STDs). Findings presented here have several important implications for HIV prevention and care among substance users. Intervention programs that incorporate substance use treatment in addition to HIV education, particularly with respect to substance use and sex risk behavior are imperative.

Drug-Seeking Behavior Is Significantly Attenuated in Nutritionally Supplemented Cocaine Withdrawn Sprague-Dawley Rats

Aim: The effect of patented nutritional supplementation on drug-seeking behavior in cocaine addicted rats during acute drug withdrawal was investigated using a biased Conditioned Place Preference (CPP) paradigm. Method: Twenty-four (24) male Sprague-Dawley rats with pre-conditioned preference for the black chamber of the CPP box were randomly divided into Cocaine (COC) or Saline (SAL) treated groups. Rats (n = 12) treated with cocaine hydrochloride 20 mg/kg/ml, i.p. (COC group) were confined individually to the white chamber on days 1, 3, 5 and 7. On alternate days, they were given 1 ml saline vehicle, i.p. and confined to the black chamber. Control rats (SAL group, n = 12) received only vehicle on all 8 days and were confined on alternate days to the white or black chamber. Positive place preference was confirmed for COC rats, which subsequently received 6 increasing daily doses of cocaine. CPP performances of both COC and SAL rats were recorded following an acute 3-day withdrawal period. All animals were then randomly assigned to rats fed either chow reconstituted with the nutritional supplement (COC-S and SAL-S) or standard rat chow (COC-N and SAL-N) for 8 weeks, followed by final CPP performances. Results: Following supplementation, COC-S rats made significantly less entries and time spent in the white chamber (p < 0.05) compared with COC-N rats. COC-S rats exhibited significant place aversion to the white chamber similar to drug-naive animals;whereas COC-N continued to show positive place preference. Conclusion: Drug-seeking behavior that persisted during cocaine withdrawal was significantly diminished in the nutritionally supplemented.

Self-management behavior preferences and influencing factors in Chinese patients with recurrent gout:A qualitative study

Objectives:This study aimed to explore the preferences and influencing factors of self-management behaviors in patients with recurrent gout and provide a theoretical basis for developing targeted strategies to improve self-management preferences.Methods:A total of 10 patients with recurrent gout were recruited from the gout specialist outpatient clinic at a tertiary hospital in Shenyang,Liaoning Province,China.Semi-structured interviews were conducted with these patients,and the Kawakita Jiro(KJ)method was used to analyze the interview data.Results:After four rounds of screening by five researchers,35 codes were selected from an initial 132.After three rounds of discussion and induction,the KJ method identified seven domains of selfmanagement behavior preferences in patients with recurrent gout:1)extensive knowledge of gout,yet difficulty in distinguishing between accurate and inaccurate information;2)a passive attitude of“no pain,no management”;3)the challenge of changing entrenched daily habits;4)the optimistic but unrealistic belief of“self-delusion”;5)a tendency to seek medical attention late due to hopelessness of cure and familiarity with recurrences;6)preference for analgesics for gout recurrences while neglecting long-term urate-lowering therapy(ULT);and 7)gout-related stigma.Conclusion:The results of this study showed that the self-management behavior of patients with recurrent gout could be improved,especially in the aspects of medical seeking behavior,medication compliance,daily management and emotional management.At the same time,we found that gout stigma,difficulty in distinguishing true and false knowledge of gout and negative attitude of“ignoring pain”were significantly associated with self-management behavior.

Survey of HIV Infection among Injection Drug Users in Guangdong, China

Objective： To understand the prevalence and behavioral risk factors of HIV infection among injection drug users in the Pearl River Delta Region （PRDR） of Guangdong province, and to provide evidence for establishing effective intervention strategies. Methods： Face to face interviews were conducted and serum samples from injection drug users from detoxification centers and the community were collected for HIV screening. Results： 655 drug users were recruited and interviewed. The HIV seropositive rate was 29.0%. 99.5 % of subjects were injection drug users （IDUs）, of whom,75.4% reported sharing injection equipment. Conclusion： HIV prevalence among injection drug users is high in the PRDR of Guangdong. Injection drug use is the principal behavioral risk factor for HIV transmission. Pragmatic harm reduction programs should be implemented to prevent the spread of HIV infection.

Influence of transitional nursing on the compliance behavior and disease knowledge of children with purpura nephritis

BACKGROUND Purpura nephritis,also called Henoch-Schönlein purpura nephritis,is a systemic disease with small dead vasculitis as the main pathological change.AIM To observe the influence of transitional nursing activities on the compliance behaviors and disease knowledge of children with purpura nephritis.METHODS A total of 82 children with purpura nephritis were included and divided into a general nursing group(41 children)and transitional nursing group(41 children)using the envelope method.The general nursing group received routine nursing care,while the transitional nursing group received transitional nursing care.The behaviors,knowledge of the disease,and self-management ability of the two groups were evaluated after nursing care was provided.RESULTS The scores of four items(self-care ability,self-responsibility,health knowledge level,and self-concept)in the transitional nursing group were significantly higher than those in the general nursing group.CONCLUSION Transitional nursing can directly improve the disease knowledge level and selfmanagement ability of children with purpura nephritis and effectively reduce complications.

Problematic Internet use in drug addicts under treatment in public rehab centers

BACKGROUND Problematic Internet use(PIU)or Internet addiction has been recognized to be a behavioral addiction characterized by excessive or poorly controlled preoccupations,urges,or behaviors regarding computer use and Internet access that leads to impairment or distress resembling substance abuse.AIM To investigate the prevalence and characteristics of Internet use and abuse in a group of drug addicts from Southern Italy,by means of a specific questionnaire[“Questionario sull’Utilizzo delle Nuove Tecnologie”(QUNT)].METHODS All subjects(183)were heavy smokers,almost 50%of them used heroin and/or opioid compounds,30%alcohol,10%cannabis,8%cocaine,and 5%were polydrug users.Almost 10%of the individuals were also suffering from gambling disorder.RESULTS The time spent online was more than 4 hours a day in the total sample,with a slight prevalence in male subjects.Cocaine and cannabis users spent more than 6 hours online,significantly more than opioid and alcohol abusers.Distribution of the QUNT factors was not different in both sexes.Cocaine users showed higher scores at the“loss of control”,“pornography addiction”,and“addiction to social networks”factors,for the stimulant effect of this substance.Moreover,15 out of the total 17 cocaine users were pathological gamblers.Positive and statistically significant relationships were observed between some QUNT factors and body mass index.CONCLUSION These findings indicate that PIU is less severe in subjects taking sedative substances,such as heroin/opioids and alcohol,than in subjects taking stimulants.Alternatively,it may be used as a“stimulant”trigger in cocaine and cannabis users.Flattening effect of abuse drugs was noted on possible sex-related differences in QUNT items.We observed a sort of“protective”effect of a love relationship and/or living together with a partner,as those engaged subjects showed lower scores on different items than single subjects or those living alone.The relationship between time spent online(and related sedentary lifestyle)and body mass index would suggest that Internet use might be a contributing factor to increasing weight gain and obesity amongst adolescents and young adults worldwide.Our findings also highlighted the specific vulnerability of drug addicts who use stimulants,rather than sedative compounds,to other kinds of behavioral addictions,such as gambling disorder.