Aims and objectives
The purpose of this study was to explore the self‐management of patients with early‐stage chronic kidney disease (CKD) and its influencing factors.
Methods
A convenient sample of ...226 patients with early‐stage CKD was recruited from 63 Public Health Centers in Indonesia, from June to September 2020. Demographic characteristics, health literacy, illness perception, self‐efficacy and self‐management were assessed using self‐reported questionnaires. Stepwise multiple linear regression analysis was performed to identify the factors influencing self‐management. This study adhered to the EQUATOR checklist, STROBE.
Results
The mean estimated glomerular filtration rate was 63.45 ml/min/1.73 m2 (standard deviation SD = 15.34). The average scores for health literacy, illness perception, self‐efficacy and self‐management were 32.11 (SD = 4.46), 4.57 (SD = 1.46), 183.64 (SD = 38.23) and 76.92 (SD = 9.45), respectively. The influencing factors were education level, monthly income, family history of comorbidity, health literacy and self‐efficacy, which accounted for 45% of total self‐management score.
Conclusions
Indonesian patients with early‐stage CKD showed low level of health literacy, but positive illness perception and self‐efficacy; these factors significantly affected CKD self‐management. Health literacy was found to influence all dimensions of self‐management: self‐integration, problem‐solving, seeking social support and adherence to the recommended regimen.
Relevance to clinical practice
Adherence to the recommended regimen is the most challenging dimension of CKD self‐management. Health literacy was found to be a major determinant of self‐management. Improving health literacy and motivation of patients with early‐stage CKD may help sustain positive illness perception and self‐efficacy, and improve self‐management.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK, VSZLJ
This review aims to identify attributes of patient-centered self-management (PCSM) in the current literature and explore its implementation in resolving patient obstacles in chronic kidney disease ...(CKD) treatment and management. A search of relevant articles and literature on PCSM, integrated care, and challenges of CKD management was conducted. Vital attributes of PCSM and current self-management interventions employed to resolve patient obstacles in CKD management were identified from inclusion studies. Findings affirm that PCSM strategies have positive effects on CKD management, but a lack of quality primary study, and long-term evidence presents the need for further development. Future research should focus on the development of a standardized and universal integrated PCSM model and a uniform system of data collection in the clinical setting. The difficulty of CKD management lies in how it is a comorbid and progressive disease. A pure biomedical approach is inadequate. Our review recommends that an integrated PCSM approach with health literacy and information technology intervention, which unifies and integrates patient education, can address the difficulties that are contributing to unsuccessful treatment outcomes. An integrated PCSM model should be implemented systematically and methodologically into future CKD management and health policies.
The lack of knowledge of advance care planning and training of communication skills among nurses in Taiwan is one of the main reasons for the low rate of advance directive signing. However, there is ...no specific and effective solution to this problem. The purposes of this study were (1) to develop and pilot testing of an advance care planning simulation-based communication training program and (2) to evaluate the feasibility and acceptability of the program. This study was conducted in three phases. Phase 1: Developing an advance care planning simulation-based communication training program; Phase 2: Conducting a pilot test; Phase 3: Evaluating the feasibility and acceptability of the program. Twelve convenient participants from a medical center in central Taiwan were selected. The participants believed that team-based learning was beneficial for several reasons. First, it helped to clarify the participants' understanding of advance care planning and improve their communication skills. Second, role-playing, as one of the components, was helpful for discovering their own shortcomings in communication skills while debriefing enabled them to identify their blind spots in the communication process. Finally, the reflection log documented their weekly performance so they were able to reflect upon their weekly performance, improve their performance, and become more confident. All twelve participants signed the consent form and completed the whole training program. The participants were satisfied with the program, affirming that the timing and content of the program were appropriate and that the expected learning outcomes could be achieved. According to participant feedback, the program was beneficial in improving their knowledge of advance care planning and confidence in communication. Thus, it is feasible and acceptable to introduce communication of advance care planning programs into the staff training protocols of healthcare organizations.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Aim
To synthesize the effects of Internet empowerment‐based self‐management interventions on adults with metabolic diseases.
Background
Metabolic diseases are prevalent and burden healthcare systems; ...they have become a major health problem worldwide. The effects of IESMIs on lifestyle changes have been shown to improve adults’ physiological and psychological conditions. However, we found no systematic review evaluating these effects.
Design
Systematic review and meta‐analysis of randomized and non‐randomized controlled trials, conducted according to the Cochrane handbook.
Data resources
A literature search was conducted using the Airiti Library, Association for Computing Machinery, CINAHL, Cochrane Library, Embase, ProQuest, PubMed/MEDLINE and Index of the Taiwan Periodical Literature System databases (earliest–June 2016).
Review methods
Two reviewers used the Cochrane Collaboration bias assessment tool to assess the methodological quality of included studies. Extracted data were entered and analysed using RevMan 5.3.5 software. Inverse variance was used to estimate effect sizes. Weighted and standardized mean differences with 95% confidence intervals were calculated using a random effects model. Subgroup and sensitivity analyses were performed.
Results
Twenty‐one randomized controlled trials were reviewed. Meta‐analysis showed that the intervention significantly improved adults’ exercise habits, glycated haemoglobin (HbA1c) levels, body weight, empowerment levels and quality of life.
Conclusion
The intervention significantly improve the health status of adults with metabolic diseases, in particular their exercise habits, HbA1c levels, body weight, empowerment and quality of life. The intervention provides more convenient and faster access to healthcare for busy individuals with time constraints. These results suggest that healthcare professionals could develop accessible and friendly interactive online interfaces for patients to expand the use of these interventions in the clinical setting.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Aims and objectives
This study aims to explore the current state of self‐management behaviours among persons with type 2 diabetes mellitus in the Solomon Islands and to discuss the factors ...influencing these behaviours.
Background
The prevalence of diabetes and diabetes complications is increasing in the Solomon Islands. However, the effective diabetes prevention and care are not provided in the country.
Design
This is a cross‐sectional study.
Methods
A convenience sample of 150 persons with type 2 diabetes mellitus was recruited from a hospital in the Solomon Islands from August 2017–September 2017. Self‐report questionnaires were used to measure the self‐management behaviours, diabetes knowledge and illness perception. In addition, the study adhered to the EQUATOR checklist, STROBE (see Appendix S1).
Results
The overall score for self‐management was 56.9 ± 13.2 and diabetes knowledge and illness perception, as influencing factors of self‐management, earned total scores of 13.3 ± 4.0 and 55.8 ± 12.0, respectively. Stepwise regression analysis identified illness perception, diabetes knowledge and smoking as significant influencing factors, explaining 20.8% of the total variance in self‐management.
Conclusions
The level of diabetes self‐management behaviours demonstrated by persons with type 2 diabetes mellitus in this study was rated as less than ideal. Diabetes knowledge and illness perception were the two main factors influencing patient self‐management in the Solomon Islands.
Relevance to clinical practice
The study addressed the current state of the self‐management behaviours of persons with diabetes and discussed the factors influencing these behaviours. The findings indicated that knowledge and illness perception of diabetes were the two main factors and provided baseline information for policymakers, health planners and healthcare providers highlighting diabetes as an important issue in Solomon Islands.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Introduction: Poor prognosis and higher mortality of chronic kidney disease are linked with cultural beliefs and practices. This study explored cultural beliefs and practices of Javanese people with ...end-stage renal disease undergoing hemodialysis for ≥5 years. Methods: A qualitative narrative inquiry was applied in this study. Data were collected through in-depth narrative interviews, followed by text messages, calls, and audio-visual calls for 6 weeks. Results: There were 14 participants; their mean age was 51.15 years and hemodialysis duration was 5 years and 2 months up to 10 years and 9 months. Four themes emerged: life-and-death acceptance, expectation of end-of-life care, contemplation of withdrawal from hemodialysis, and wishing for a good death. Discussion: Life values guided the ability to survive for the individual. Adherence to renal disease management regimen clashed with cultural values on occasions, such as social gatherings. Therefore, the unmet needs of patients should be addressed with a transcultural approach to modify personal health behaviors.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK, VSZLJ
Background: The prevalence of end-stage renal disease in Taiwan is the highest in the world. The rate of signing advance directives in Taiwan is lower than in Western countries, and most of the ...barriers that have been identified relate to initiating advance care planning (ACP). Purpose: This study was designed to explore the barriers to discussing ACP with patients with chronic kidney disease faced by nephrology nurses. Methods: A descriptive qualitative study design was adopted. The Consolidated Criteria for Reporting Qualitative Research was used to report the findings of this study. Data were collected using purposive sampling. A total of 34 nephrology nurses were recruited from hospitals in northern (2 groups, 10 participants), central (1 group, 4 participants), and southern (5 groups, 20 participants) Taiwan. A qualitative content analysis was conducted to analyze the transcripts of the eight focus groups. Results: Five themes were identified, including (a) lacking the confidence to discuss ACP, (b) difficulty in finding an appropriate opportunity to initiate ACP discussion, (c) personally lacking the characteristics to discuss ACP, (d) conflicting perspectives between doctors and nurses over ACP, and (e) culture and belief-based barriers to discussing ACP. Conclusions/Implications for Practice: The findings obtained from the interviews revealed that nurses must enhance their ACP-related knowledge and communication skills and foster personal confidence in initiating ACP discussions. Furthermore, nurses must be empowered to work with other healthcare professionals. To implement the initial process of discussing ACP in clinical settings, clinical guidelines should be developed for healthcare professionals on initiating ACP. These measures may facilitate improved collaboration in healthcare settings and further encourage patients and their families to participate in shared decision-making that may help patients complete advance directives and thereby achieve better care quality at the end of life.
Aim
The aim of this study was to develop and psychometrically test a new instrument for measuring nurse’s positive energy of retention (NPER).
Background
The shortage of professional nurses is an ...unresolved global issue. Few studies explored the issue of the retention of nurses in terms of a positive psychological viewpoint.
Design
Methodological study.
Methods
Data collection was from June 2016–August 2017. Nurses (N = 947) recruited from northern, central and southern Taiwan covering different levels of hospitals were divided into three samples, which were used for explaratory factor analysis (EFA), confirmatory factor analysis (CFA) and cross‐validation respectively.
Results
EFA resulted in a three‐factor solution: proactive and persevering characteristics, nursing professional identity and passion accounting for 61.8% of total variance. The proposed three‐factor model was confirmed by CFA. Cross‐validation provided further evidence for the construct validity of the NPER instrument with 24 items. Cronbach's alpha coefficient of three subscales of the instrument were 0.95, 0.89, and 0.92 separately and 0.96 for the total scale.
Conclusion
Psychometric properties indicate that the newly formulated NPER instrument is a valid and reliable assessment tool to recruit nurses who are more likely to remain in nursing.
Impact
The study addressed the personal intrinsic factors, which are very important for nurses’ retention. The NPER instrument consisted of three subscales is a reliable and psychometrically valid new instrument. Managers could apply the NPER instrument to recruit nurses possessing the attributes of positive energy of retention. Furthermore, researchers could use the rigorous process provided in the study to establish a new instrument.
目的
本研究的目的是开发一种从积极心理学角度进行的测量护士护理人员留任意愿(NPER)的新型工具并对该方法进行心理测量。
背景
专业护士短缺是一个尚未得到解决的全球性问题。很少有研究从积极心理学角度探讨护士留任问题。
设计
方法研究。
方法
本研究收集了2016年6月至2017年8月期间的数据,将来自台湾北部、中部及南部不同层级医院的护士(N = 947)分为三个样本,对样本分别进行了解释性因子分析(EFA)、验证性因子分析(CFA)及交叉验证。
结果
解释性因子分析的结果显示为三因子解:积极和坚持的特点,护理专业认同和激情共占总方差的61.8%。提出的三因素模型得到了验证性因子分析的验证。交叉验证为24项NPER工具的结构有效性提供了进一步的证明。量表三个方面的克朗巴哈系数分别为0.95、0.89和0.92,总分为0.96。
结论
心理测量学特性表明,新编制的NPER量表是一种有效、可靠的评估工具,可用于招聘更有可能继续留任的护士。
影响
本研究探讨了个人内在因素对护士留任意愿的影响。NPER量表由三个分量表组成,是一种可靠的、心理测量有用的新型量表。管理者可以应用NPER量表招聘具有更愿意留任的护士。此外,研究人员可以利用研究中提供的严谨结果以编制其他新型量表。
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Background and Aim
The aim of this study is to identify gastric cancer burden in Indigenous Taiwanese peoples and conduct a project to evaluate how to reduce the disparities most effectively in ...Indigenous communities.
Methods
First, we quantified the health disparities in gastric cancer in Indigenous peoples using data from the cancer registries during the period of 2006–2014. Second, we identified parameters that might be associated with Helicobacter pylori infection or help identify a good eradication strategy.
Results
Gastric cancer incidence (24.4 vs 12.3 per 100 000 person‐years) and mortality rates (15.8 vs 6.8 per 100 000 person‐years) were higher in Indigenous than in non‐Indigenous, with 2.19‐fold (95% confidence interval CI: 2.06–2.33) and 2.47‐fold (2.28–2.67) increased risk, respectively. In Indigenous communities, H. pylori infection was more prevalent in Indigenous than in non‐Indigenous (59.4% vs 31.5%, P < 0.01). Regression analyses consistently showed that either the mountain or plain Indigenous had 1.89‐fold (95% CI: 1.34–2.66) and 1.73‐fold (95% CI: 1.24–2.41) increased risk for H. pylori infection, respectively, as compared with non‐Indigenous, adjusting for other baseline characteristics. The high infection rates were similarly seen in young, middle‐aged, and older adults. Program eradication rates using clarithromycin‐based triple therapy were suboptimal (73.7%, 95% CI: 70.0–77.4%); the habits of smoking (1.70‐fold, 95% CI: 1.01–2.39) and betel nut chewing (1.54‐fold, 95% CI: 0.93–2.16) were associated with the higher risk of treatment failure.
Conclusion
Gastric cancer burden is higher in Indigenous Taiwanese peoples than in their non‐Indigenous counterparts. Eliminating the prevalent risk factor of H. pylori infection is a top priority to reduce this health disparity.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
The World Health Organization has promoted age-friendly city (AFC) projects in response to the aging population. Taiwan has also promoted AFC policies. This study was conducted in Taitung County, ...where 15.37% of the population is older adults in Taiwan. The aim was to understand the perceptions of older adults and service providers with regard to the current status of AFC policies to influence future policies. The participants of this study were older adults and service providers in various regions of Taitung. Quantitative questionnaires were completed by older adults and qualitative interviews were held with focus groups. The older adults were the most satisfied with the AFC domains of "respect and social inclusion" and "community and health services", and the least satisfied with "transportation" and "civic participation and employment". Homogeneity existed between the older adults' satisfaction levels in different regions and the service providers' opinions; however, there were notable differences between them. Both economic development and the ethnicity of groups in different regions are influential factors that determine the success of government policies. In promoting AFC policies, local governments should consider their applicability based on local conditions and resources to meet the needs of the aging population in rural areas.
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