Psychometric testing of the cross-culturally adapted Thai version of the Self-Care Self-Efficacy Scale version 3.0 in individuals with chronic illnesses

Objective:To assess the psychometric properties of the Thai version of the Self-Care Self-Efficacy Scale version 3.0(SCSES-v3.0)in individuals with chronic illnesses.Although originally developed and tested in a Western context,its applicability in Asian populations,including Thailand,remains inadequately explored.Methods:Psychometric tests were guided by COSMIN principles.This included the translation of the English version into Thai based on the ISPOR framework.Nine nursing experts evaluated the content validity.Data were obtained from a multicenter cross-sectional study conducted between July and November 2022.This study included individuals with chronic conditions from 16 primary care centers in Thailand.We tested the structural validity using exploratory factor analysis(EFA)and confirmatory factor analysis(CFA),and concurrent validity in relation to the Self-Care of Chronic Illness Inventory version 4.c(SC-CII-v4.c).We tested the scale’s reliability with McDonald’s u,Cronbach’s a,and the intraclass correlation coefficient(ICC).Results:The Thai SCSES-v3.0 demonstrated excellent content validity(k¼1.00).Thefinal analysis included a total of 385 participants.The EFA with thefirst split-half subsample(n¼193)extracted a twofactor structure.One reflected SCSES for maintenance and monitoring behaviors and another captured SCSES for management behaviors(item 6e10).CFA with the second split-half subsample(n¼192)and the overall sample(n¼385)supported the scale’s two-factor model with high factor loadings.Each dimension and the overall SCSES-v3.0 positively correlated with each scale and the overall SC-CII-v4.c.McDonald’s u and Cronbach’s a(both ranged 0.91e0.94)and ICC(ranged 0.95e0.96),indicated excellent internal reliability and test-retest reliability,respectively.Conclusions:The identification of a valid and reliable two-factor model for the Thai SCSES-v3.0 renders it a valuable tool for clinicians and investigators,facilitating the assessment of self-efficacy in self-care across diverse contexts.

A pilot study of self-care education for psychotherapists

Objective:Existing research shows that psychotherapists may experience secondary trauma and burnout,often neglecting self-care.This study aims to examine the effectiveness of self-care education in enhancing self-care efficacy among psychotherapists and explore factors affecting improvements in their self-care abilities.Methods:A self-care workshop was conducted for 159 psychotherapists from various fields.Participants’demographic information and self-care ability data were collected.The Exercise of Self-Care Agency Scale(ESCA)was used to assess the participant’s self-care levels before and after the workshop.Results:Post-workshop,ESCA total scores and subscale scores of participants showed significant increases(all P<0.001).Notably,score improvement levels differed by gender and years of practice,with female therapists showing greater improvement than male therapists(t=2.069,P=0.040)and those with longer work experience showing greater improvement than those with shorter experience(F=2.537,P=0.042).Conclusion:Providing self-care education for psychotherapists is essential.Future self care education programs or interventions for psychotherapists should consider gender and work experience factors to better support their self-care enhancement.

Decision-Making and Management of Self-Care in Persons with Traumatic Spinal Cord Injuries: A Preliminary Study

Patients and physicians understand the importance of self-care following spinal cord injury (SCI), yet many individuals with SCI do not adhere to recommended self-care activities despite logistical supports. Neurobehavioral determinants of SCI self-care behavior, such as impulsivity, are not widely studied, yet understanding them could inform efforts to improve SCI self-care. We explored associations between impulsivity and self-care in an observational study of 35 US adults age 18 - 50 who had traumatic SCI with paraplegia at least six months before assessment. The primary outcome measure was self-reported self-care. In LASSO regression models that included all neurobehavioral measures and demographics as predictors of self-care, dispositional measures of greater impulsivity (negative urgency, lack of premeditation, lack of perseverance), and reduced mindfulness were associated with reduced self-care. Outcome (magnitude) sensitivity, a latent decision-making parameter derived from computationally modeling successive choices in a gambling task, was also associated with self-care behavior. These results are preliminary;more research is needed to demonstrate the utility of these findings in clinical settings. Information about associations between impulsivity and poor self-care in people with SCI could guide the development of interventions to improve SCI self-care and help patients with elevated risks related to self-care and secondary health conditions.

Investigation of Treatment-Related Symptoms and Self-Care Strategies in Lung Cancer Patients

This study aimed to investigate treatment-related symptoms in lung cancer patients undergoing chemotherapy and radiotherapy,as well as effective self-care strategies to alleviate these symptoms.A total of 202 lung cancer patients were surveyed using a treatment-related symptom checklist,Karnofsky Performance Status scale,and a self-care symptom relief questionnaire.The results showed that the most common treatment-related symptoms included fatigue(93.07%),loss of appetite(88.12%),nausea(82.67),hair loss(74.75%),vomiting(66.83%),pain(64.85%),taste changes(62.87%)and constipation(60.89%).The study also gathered patients’self-care methods that they found effective in alleviating these symptoms.Findings suggest that lung cancer patients bear a significant burden of treatment-related symptoms,and various self-care strategies reported by the patients were effective in managing these symptoms.

Effect of the LEARNS Model on Self-Care Agency and Compliance in Hemodialysis Patients with Fluid Overload

Objective:To explore an intervention strategy for patients with fluid overload undergoing maintenance hemodialysis and to evaluate the effects of the LEARNS model on improving self-care agency and patient compliance.Methods:A total of 76 patients with fluid overload undergoing maintenance hemodialysis at our hospital from March 2023 to March 2024 were selected for the study.Patients were randomly divided into two groups,with 38 in each group.The control group received conventional interventions,while the observation group was treated using the LEARNS model.Self-care agency,compliance,and quality of life outcomes in both groups were analyzed and compared.Results:Before the intervention,no statistically significant differences were observed in the self-care agency scores between the two groups(P>0.05).After the intervention,patients’self-care agency improved significantly,with the observation group showing notably higher scores than the control group(P<0.05).Patient compliance in the observation group was also significantly higher than in the control group(P<0.05).Quality of life,assessed using the SF-36 scale,showed no significant differences between the two groups prior to intervention(P>0.05).After the intervention,quality of life scores improved significantly in both groups,with the observation group exhibiting significantly higher scores than the control group(P<0.05).Conclusion:The LEARNS model is effective in improving patient compliance,enhancing self-care agency,and improving quality of life in maintenance hemodialysis patients with fluid overload,making it a promising approach for broader application.

Analysis of the Effect of Comfort Care in The Perioperative Care of Patients with Hysteromyomectomy and its Influence on Self-Care Ability

Objective:To analyze the effect of perioperative comfort care for patients with hysteromyomectomy(HYS).Methods:Seventy cases of HYS patients admitted to our hospital from October 2022 to October 2023 were randomly selected and divided into Group A(control group,35 cases,conventional care)and Group B(observation group 35 cases,comfort care).The effects of the two groups before and after nursing care were compared.Results:The self-rating anxiety(SAS)scores,exercise of self-care agency(ESCA)scores,and nursing satisfaction scores at the time of discharge of Group B were better than in Group A after nursing care(P<0.05).Conclusion:Perioperative comfort care for HYS patients improved the patient’s adverse emotions,self-care ability,and nursing satisfaction.

Impact of applying the theory of human becoming and self-care deficit theory of nursing on insomnia in after stroke urinary incontinence patients

Objective:To determine the impact of applying the theory of human becoming and self-care deficit theory of nursing in overcoming insomnia in patients of urinary incontinence(UI)after stroke.Insomnia is a sleep disorder experienced by UI patients after stroke which can exacerbate problems related to brain damage and can complicate the recovery process.Methods:This study was a quasi-experimental conducted in 4 hospitals.Fifty-six patients were selected by convenience sampling and divided into 2 groups(the intervention and control group).Participants in the intervention group received“applying the theory of Human becoming and self-care deficit theory of nursing,”starting when the patient is about to go home from the hospital and continuing at the house.Measurement of insomnia is done using the Pittsburgh Sleep Quality Index(PSQI).Results:The mean insomnia scores of participants from both groups increased in the first and third measurements.The second and third insomnia measurements found a significant difference(P<0.001).This intervention decreased the average score of insomnia by 4.11 times in the second measurement and 5.82 times in the third measurement.The most important item that decreased in the third measurement of insomnia was sleep efficiency.Conclusions:Applying the theory of human becoming and self-care deficit theory of nursing in this study significantly decreased the insomnia score of post-stroke UI patients.It can be used as a guide for nurses,patients,and families in managing insomnia.In addition,the application of nursing theory in nursing practice can systematize nursing care plans and organize the knowledge of professionals into a conceptual framework,as well as provide effective guidance for nurses on what to do.

Effect of Brisk Walking on Self-Care Agency or Care Dependency among Colorectal Cancer Patients with Permanent Stoma

Objective:The purpose of this study was to determine the effectiveness of brisk walking as an intervention for self-care agency and care dependency in patients with permanent colorectal cancer stoma.Method:This study adopted a quasi-experimental research design,specifically a non-equivalent control group pre-test and post-test design.Utilizing the Exercise of Self-Care Agency Scale(ESCA)and Care Dependency Scale(CDS),a survey was administered to 64 patients from a hospital in Shandong Province.The statistical methods used for analyzing data included frequency,mean,standard deviation(SD),independent t-test,P-value calculation,and dependent t-test.Result:After two months of a brisk walking exercise program,participants in the experimental group had a higher level of self-care agency than before the experiment(P<0.05),and their level of care dependency was significantly reduced(P<0.05).Participants in the control group also showed higher levels of self-care agency(P<0.05)and lower levels of care dependency(P<0.05)after two months compared to their levels before the two months.Conclusion:The brisk walking program had a positive impact on patients’self-care agency and reduced their care dependency.

Analysis of the Role of Cognitive Behavioral Therapy on Self-Care in Thyroid Cancer Patients

Objective:To explore the effect of cognitive behavioral therapy on self-care in thyroid cancer patients.Methods:A total of 144 thyroid cancer patients treated at the Affiliated Hospital of Hebei University from January 2022 to August 2023 were selected as research subjects.Using the random number table method,they were divided into a control group and an experimental group,each consisting of 72 cases.The control group received routine nursing intervention,while the experimental group received cognitive behavioral therapy based on standard nursing practices.The self-care ability(self-concept,self-efficacy,self-care skills,health knowledge level),coping style(confrontation,avoidance,and surrender),and quality of life(psychological function,social function,material life,physical function)of both groups before and after the intervention were compared.Results:In comparison to the pre-intervention period,the experimental group exhibited significantly higher self-care ability,quality of life,and confrontation scores after the intervention,as opposed to the control group.Additionally,the avoidance and surrender scores were lower in the experimental group than in the control group,with these differences proving to be statistically significant(P<0.01).Conclusion:The application of cognitive behavioral therapy can enhance the self-care ability of thyroid cancer patients,aid in better disease coping,and improve their overall quality of life.This approach is deserving of further promotion.

Study on the Intervention of Collaborative Nursing Mode in Oral Health and Self-Care of Patients with Colorectal Cancer After Chemotherapy

Objective:To analyze the effects of a coordinated intervention plan combining oral health and self-care on the oral health,self-care ability,and hospitalization satisfaction of colorectal cancer patients post-chemotherapy.Methods:A total of 106 patients undergoing postoperative chemotherapy for colorectal cancer from October 2022 to August 2023 were randomly divided into two groups.Both groups received routine nursing care,while the intervention group also received a coordinated intervention program.The effectiveness of the intervention was evaluated using the oral odor score,Beck oral rating scale,self-care ability scale,and patient hospitalization satisfaction scale.Data was collected before the intervention,and on the 7th and 14th days after the intervention.Results:No significant differences were found between the two groups before the intervention(P>0.05).After the intervention,the intervention group showed significant improvements in Beck oral score,dry mouth,and bad breath scores(P<0.05),compared to the control group.There was no significant difference in oral pH between groups(P>0.05).Self-care ability improved significantly in the intervention group(P<0.05).Independent sample t-tests revealed that the intervention group had significant improvements in satisfaction with medical care,including doctors’and nurses’professional skills and humanistic care(P<0.05).No significant differences were found in waiting time and hospital environment(P>0.05).Conclusion:The coordinated intervention plan combining oral health and self-care for colorectal cancer patients post-chemotherapy significantly improves oral health,self-care ability,and hospitalization satisfaction.This approach,integrating traditional Chinese and Western medicine,has great potential for clinical application.

Analysis of the Application Effect of Family Collaborative Care Model on Elderly Patients with Type 2 Diabetes Mellitus and the Situation of Self-Care Ability

Objective: To study the application effect of the family collaborative care model on elderly patients with type 2 diabetes mellitus and its influence on self-care ability. Methods: The elderly type 2 diabetes mellitus patients (400 cases) treated in our hospital between March 2020 and July 2023 were divided into two groups by randomized grouping method;the control group received the conventional nursing program, while the observation group received the family collaborative nursing model. Blood glucose level, self-care ability, and quality of life were compared between the groups. Results: The blood glucose level of the observation group was lower than that of the control group (P < 0.05). The self- care ability and quality of life scores of the observation group were higher than those of the control group (P < 0.05). Conclusion: The family collaborative care model for elderly patients with type 2 diabetes mellitus can promote their self- care ability, improve the effect of glycemic control, and improve their quality of life, and is suitable for further promotion and application.

Comprehensive Evaluation on Drought Tolerance of Widely-used Rice Varieties with Subordinate Function Method

Using drought-tolerant cultivar IAPAR 9 （upland rice from Brazil） and drought-sensitive varieties IR64 as the controls, the drought tolerances of total 26 rice varieties widely used in production were evaluated with subordinate function method based on morphological, physiological and yield traits. The results showed that the trait values of grain yield per plant （GYP）, effective panicles per plant （EPP）, seed-setting rate （SSR）, panicle length （PL）, leaf relative water content （RWC） and chlorophyll content （SPAD） in all tested varieties decreased significantly under the conditions of drought stress. The subordinate function values of these traits of all tested rice varieties were thus calculated varieties. Based on the aver- age subordinate function values of all these traits, total 7 （i.e. Y Liangyou 1） and 3 （i.e. Liangyou Peijiu） rice varieties were identified as drought-tolerant and drought- sensitive varieties, respectively.

Application of self-care based on full-course individualized health education in patients with chronic heart failure and its influencing factors

BACKGROUND The treatment of heart failure not only needs to relieve the clinical symptoms and improve the quality of life for patients but also needs to select scientific and reasonable ways to prevent or delay the progression of the disease,thus reducing the mortality and hospitalization rate.Although the previous regimen can effectively relieve symptoms in the early stage of treatment,long-term use may cause adverse events,such as arrhythmia,and even increase mortality.Therefore,conventional treatment cannot meet the actual health needs of patients,and scientific nursing intervention is very necessary.AIM To investigate the application of self-care based on full-course individualized health education (FCIHE) and its influencing factors in patients with chronic heart failure (CHF).METHODS We enrolled CHF patients who were admitted to our center between September 2015 and June 2016 and divided them into an intervention group (n = 50) and control group (n = 50) using a random number table.Routine nursing care was applied to the control group,and FCIHE was offered to the intervention group.The self-care behavior,6-min walking distance (6MWD),and 36-item short form health survey (SF-36) scores were compared between the two groups.The influencing factors of the self-care were also analyzed.RESULTS The 6MWD was not significantly different between the two groups at admission (P > 0.05);however,at 3 and 6 mo after discharge,6MWD was significantly increased,and it was significantly longer in the intervention group (P < 0.05).The scores for self-care behavior showed no significant difference at admission between the two groups (P > 0.05);however,at 3 and 6 mo after discharge,the total scores for self-care maintenance,management,confidence,and behavior of the intervention group were significantly higher than those of the control group (P < 0.05).There were no significant differences in the SF-36 scores at admission (P > 0.05);however,at 3 mo and 6 mo after discharge,the scores for all eight subscales,including physical functioning,role limitations due to physical problems,bodily pain,general health perceptions,vitality,social functioning,role-limitations due to emotional problems,and mental health,were significantly higher in the intervention group (P < 0.05).As shown by logistic regression analysis,the influencing factors of self-care mainly included age,cardiac function class,and education background (odds ratio > 1;all P < 0.05).CONCLUSION FCIHE improved self-care behavior and cardiac function in CHF patients.Age,cardiac function,and education level affected the implementation of self-care among CHF patients.

Dynamic interaction nursing intervention on functional rehabilitation and self-care ability of patients after aneurysm surgery

BACKGROUND Nursing practices based on the dynamic interaction model have been shown to be superior to generic nursing practices.However,whether this model is effective in patients recovering from intracranial aneurysm surgery is not well studied.AIM To investigate the effect of nursing based on a dynamic interaction model on functional rehabilitation of patients after aneurysm surgery.METHODS A total of 86 cases in our hospital with intracranial aneurysm from April 2019 to April 2021,were selected and divided into the study group and the control group,with 43 patients in each group.The control group received routine nursing,and the research group received nursing intervention based on a dynamic interaction model.The daily living ability(activities of daily living,ADL),cognitive function(Simple Intelligent Mental State Scale,MMSE),quality of life(Generic Quality of Life Inventory-74,GQOL-74),self-care ability(Exercise of Self-Care Agency scale),incidence of complications,and nursing satisfaction were recorded before and after intervention.RESULTS Before intervention,ADL(52.09±6.44),MMSE(18.03±4.11),and GQOL-74(53.68±4.34)scores in the study group were not significantly different from those in the control group(ADL:50.97±7.32,MMSE:17.59±3.82,GQOL-74:55.06±3.98)(P>0.05).After intervention,ADL(86.12±5.07),MMSE(26.64±2.66),and GQOL-74(83.13±5.67)scores in the study group were higher than those in the control group(ADL:79.81±6.35,MMSE:24.51±3.00,and GQOL-74:77.96±6.27)(P<0.05).Before intervention,self-concept(17.46±4.44),self-care skills(25.22±4.20),self-care knowledge(22.35±4.74),and self-care responsibility(15.06±3.29)scores in the study group was similar to those in the control group(self-concept:16.89±5.53,self-care skills:24.59±4.46,self-care knowledge:21.80±3.61,and self-care responsibility:14.83±3.11)(P>0.05).After the intervention,self-concept(26.01±3.18),self-care skills(37.68±6.05),self-care knowledge(45.56±5.83),and self-care responsibility(22.01±3.77)scores in the study group were higher than those in the control group(self-concept:22.97±3.46,self-care skills:33.02±5.65,selfcare skills knowledge:36.81±5.54,and self-care responsibility:17.97±3.56 points)(P<0.05).The incidence of complications in the study group(4.65%)was lower than that in the control group(18.60%)(P<0.05).Nursing satisfaction in the study group(95.35%)was higher than that in the control group(81.40%)(P<0.05).CONCLUSION Nursing intervention based on a dynamic interaction model can improve postoperative cognitive function,daily living ability,self-care ability,quality of life,and patient satisfaction,while reducing the risk of complications.

Diabetes self-care in primary health facilities in India-challenges and the way forward

India has approximately 73 million people living with diabetes and another 37 million with prediabetes while nearly 47% of the diabetes cases are undiagnosed. The high burden of poor glycemic control and early onset of complications with associated economic costs indicates a high prevalence of poor self-management practices. It is well-established that achieving patient-centered primary care consistent with a chronic care model ensures optimum diabetes self-management support and improves long-term clinical and health outcomes in diabetes patients. The public sector primary care system in India provides services free of cost to beneficiaries but lacks patient-centered care that undermines diabetes selfmanagement education and support. Furthermore, factors like poor patient knowledge of diabetes, suboptimal medication adherence, persistent clinical inertia, lack of data for monitoring and evaluation through clinical audit worsens the standards of diabetes care in primary care settings of India. There is a need for government initiatives to be directed towards the provision of comprehensive outpatient care that is inclusive of uninterrupted supply of drugs, provision of essential laboratory investigators, training and availability of qualified diabetes educators and availability of specialist support when required. Furthermore, the integration of depression screening and smoking cessation services at the primary care level is warranted.

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.

Factors affecting anxiety, depression, and self-care ability in patients who have undergone liver transplantation

BACKGROUND Depression,anxiety,and altered self-care ability are among the most important factors affecting the quality of life of liver transplant recipients.Depending on the severity of the underlying liver disease,signs and symptoms of anxiety and depression may become more pronounced.AIM To evaluate the factors affecting depression,anxiety and self-care abilities of liver transplant recipients.METHODS Recipients who are≥18 years and who underwent liver transplantation at Inonu University Liver Transplantation Institute were included in this descriptive and cross-sectional study.Sample size analysis showed that the minimum number of recipients should be 301(confidence level=95%,confidence interval=2.5,population=1382).Three hundred and twenty recipients were interviewed and 316 recipients that have answered the questionnaires accurately were analyzed.The dependent variables were the Beck Depression Scale,State-Trait Anxiety Scale(Form I and II),and Self-Care Agency Scale.The independent variables of the study were sociodemographic characteristics,biliary complications,hepatocellular carcinoma,recommending liver transplantation to other patients,and the interval of out-patient clinic visits.RESULTS Self-care ability scores were lower(P=0.002)and anxiety scores were higher(P=0.004)in recipients with biliary complications.On the other hand,in recipients with hepatocellular carcinoma,self-care scores were lower(P=0.006)while depression(P=0.003)and anxiety scores(P=0.009)were higher.Liver transplantation recipients with a monthly income<3000 Turkish liras had higher depression(P<0.001)and anxiety(P=0.003)scores.The recipients who stated that they would not recommend liver transplantation to others had lower self-care scores(P=0.002),higher depression(P<0.001),higher state anxiety(P=0.02),and trait anxiety(P<0.001)scores.CONCLUSION Presence of biliary complications and hepatocellular carcinoma,low income level,and an obligation for monthly visits to the outpatient clinic are factors that are found to affect self-care capability,depression,and anxiety.

Gender differences in self-care maintenance and its associations among patients with chronic heart failure

Objectives:To identify the gender differences in self-care maintenance and its associations among chronic heart failure patients using the Information-Motivation-Behavioral Skills model.Methods:Two hundred and ten patients(54.0%female)with chronic heart failure participated in this cross-sectional study.Self-care,knowledge of heart failure,social support and illness perception were measured using the Self-Care of Heart Failure Index,the questionnaire of heart failure knowledge,the Perceived Social Support Scale,and the Revised Illness Perception Questionnaire,respectively.Results:Mean scores for self-care maintenance were 51.4±14.8 in men and 55.6±14.1 in women(t=-2.066,P<0.05).Associated factors of self-care maintenance were social support and self-care confidence in men and the knowledge of heart failure,self-care management and self-care confidence in women.The relationship between social support and self-care maintenance was meditated by selfcare confidence in men,whereas the relationship between knowledge of heart failure and self-care maintenance was meditated by self-care management and self-care confidence in women.Conclusions:Self-care maintenance were inadequate in both genders with chronic heart failure.Interventions for enhancing social support and self-care confidence in men patients,and strengthening knowledge of heart failure,self-care management and self-care confidence in women patients,may facilitate self-care maintenance.

Motivational interviewing to improve the self-care behaviors for patients with chronic heart failure: A randomized controlled trial

Objectives:This study aimed to investigate the effect of motivational interviewing on the self-care behaviours in patients with chronic heart failure.Methods:Sixty-two hospitalized patients with chronic heart failure were recruited in this study from April 2014 to April 2015 from a hospital.Twenty-nine patients were in the intervention group,and 33 patients were in the control group.Patients in the intervention group received four sessions of motivational interviewing,whereas those in the control group received traditional health education.At 2,4,and 8 weeks post-discharge,the intervention group underwent telephone follow-up based on motivational interviewing,whereas the control group underwent routine telephone follow-up.Primary outcome was measured using the Self-care of Heart Failure Index at baseline and at 2 months postdischarge.Results:Before intervention,the self-care behaviours scores were 79.00±48.80 in the intervention group and 88.68±29.26in the control group.No statistically significant differences were found between two groups in scores for each subscale and total scale(P>0.05).After intervention,the scores of self-care behaviours in the two groups were both improved at 155.13±35.65 for the intervention group and 115.44±22.82 for the control group with statistically significance(P<0.01).The score of self-care behaviours increased by 76.13 point in the intervention group on average,whereas 26.76 point in the control group.There was significant difference between increases in scores of self-care behaviours in two groups(P<0.01).Conclusions:The self-care behaviours of patients with chronic heart failure could be improved effectively through motivational interviewing.

Self-care practices and health-seeking behavior among older persons in a developing country:Theories-based research

Purpose:The aim of this study was to examine the self-care practices and health-seeking behaviours of older adults in urban Indonesia.Methods:The cross-sectional study was performed from January to March 2014 in the Tammua sub-district of Indonesia.At the time of the study,273 older adults resided in Tammua,and half of them(51.2%)participated in this study.Data collection was carried out including self-care practices,health literacy,self-efficacy and basic conditioning factors.Results:It was found that most respondents(124;88.6%)always ate various protein sources daily.However,many participants never limited consumption of sugar(55;39.3%)or salt(40;28.6%),and more than half of respondents(96;68.6%)did not regularly visit MHCs.Health status(p<0.05),health maintenance(p<0.01)and salt limitation(p<0.05)were all significantly associated with salt limitation.It was found that respondents with higher selfefficacy,those who did not want to get information,and those of younger ages are less likely to visit MHCs regularly.Conclusion:An understanding of self-care practices and self-efficacy is needed to improve health care in developing countries.High self-efficacy should be promoted along with adequate health literacy.Older persons should learn the importance of regular health examinations to promote health,prevent diseases,and slow the progress of chronic diseases.The number of respondents who never limit their sugar and salt intake was especially surprising.An intervention program should be developed to limit salt and sugar intake of Indonesian elderly and to motivate older persons to use primary health services.