خودمدیریتی

Patients with diabetes face many problems in reducing their life expectancy and self-management. Teaching self-care to the patient and family reduces the complications of the disease. This study aims to compare the effect of self-care education in patient-centered and family-centered ways on self-management and life expectancy in patients with insulin-dependent diabetes.

This study is quasi-experimental and has two patient-centered and family-centered groups. The samples were randomly divided into two groups, with 50 people in each group. Data were collected using demographic information forms, a life expectancy scale, and diabetes self-management. The training sessions for both groups were uploaded to the Soroush messenger, and one month later, the questionnaires were completed again. Data analysis was done using SPSS version 26 software and descriptive and analytical statistical methods.

The results indicated that the average score of life expectancy and self-management in the dimensions of diet control and self-care is higher in the family-oriented group than in the patient-oriented group, but this difference was not significant in other dimensions.

Considering the increase in self-management and life expectancy of people with insulin-dependent diabetes after the intervention's implementation, it is recommended that health and treatment workers use this educational method for diabetic patients.

Patient education through portals plays a vital role in improving health outcomes of patients. Therefore, this systematic review aimed to investigate the effects of using patient portals on patient education.

This systematic review was conducted by searching keywords in the title, abstract, and keywords of the studies indexed in scientific databases including Embase, Web of Science, Scopus, and PubMed on March 4, 2024, without any time limitations. The method of data analysis was qualitative.  Data was extracted and the synthesized and results were presented qualitatively.

Eleven studies were finally included. The educational interventions focused on four aspects: self-management, self-care, knowledge improvement, and disease management. Educational approaches were classified into seven categories including text messages, video messages, image messages, e-mail, frequently asked questions, links to educational resources, and YouTube videos. Text messaging was the most common educational approach for delivering educational content through portals. Most (Four) studies dealt with the design of portals for cardiovascular diseases which indicated the effective role of portals for educating this group of patients.

This review showed that educational interventions through patient portals could improve the quality of life related to health, improve knowledge, and facilitate communication with healthcare providers by providing patient self-care recommendations.

Gestational diabetes is one of the most common problems during pregnancy. To reduce this disease, patients must intervene actively in its control. This study was conducted to determine the effect of the self-management program based on the five-A model on the self-efficacy of women with gestational diabetes referred to the diabetes center of Tohid Hospital in Sanandaj in 2022.

This semi-experimental study was conducted on 60 eligible pregnant women referred to the diabetes center of Tohid Hospital in Sanandaj. Information was collected using demographic and midwifery profile forms and a self-efficacy questionnaire related to diabetic patients before and after the intervention.  Participants were selected as available and were randomly divided into intervention and control groups. For the intervention group, four training sessions were held for four weeks, while the control group received usual care.

Based on the results, the two groups had no statistically significant differences in demographic and obstetric variables. Before the intervention, the average self-efficacy score in the intervention and control groups was 33.4 ± 0.7 and 33.1 ± 0.4, respectively (P = 0.840). Finally, the average self-efficacy score at the end of the study was significantly higher in the intervention group (52 ± 0.15 vs. 33.9 ± 4.1, P = 0.001).

The results of the study showed that the self-management program implementation based on the five-A model in pregnant women with gestational diabetes could lead to an increase in self-efficacy, so it can be suggested to use this program in the treatment plan and pregnancy care protocol for pregnant women.

Despite advancements in scientific research and improvements in medical treatments, individuals with chronic conditions such as type 1 diabetes are living longer than ever before. However, they face significant challenges related to mental health and adaptation. This study aimed to predict health-related quality of life (HRQoL) based on health anxiety, diabetes self-management, and emotional self-awareness, with emotion regulation as a mediating variable among adolescents with type I diabetes.

This descriptive-correlational study included 250 adolescents diagnosed with type I diabetes from Isfahan province, selected through convenience sampling based on pre-defined inclusion criteria. Data were collected using a demographic information questionnaire, the World Health Organization Quality of Life Questionnaire (1992), the Health Anxiety Questionnaire (Salkovskis & Warwick, 2002), the Diabetes Self-Management Scale (Schmitt et al., 2013), the Emotional Awareness Questionnaire (Grant et al., 2002), and the Emotion Regulation Scale (Garnefski et al., 2001). The data were analyzed using SPSS 24 and AMOS 21 software at both descriptive and inferential levels.

The findings indicated that health anxiety, diabetes self-management, and emotional self-awareness were significantly correlated with emotion regulation, collectively explaining 29% of the variance in this construct. Furthermore, emotion regulation and emotional self-awareness were significantly associated with HRQoL, together accounting for 49% of the variance in this outcome.

The results suggest that improving emotion regulation through interventions targeting health anxiety, diabetes self-management, and emotional self-awareness may enhance HRQoL in adolescents with type I diabetes. This, in turn, could promote better mental health and help mitigate the complications associated with type I diabetes.

Cancer is the second leading cause of death due to non-communicable diseases and is one of the biggest challenges facing the global healthcare system. Patients with cancer often require long-term care due to their multiple symptoms, and informal caregivers play a crucial role in supporting these patients. However, this responsibility can have a negative impact on the physical and mental health of the caregivers themselves. The present study outlines a protocol for a randomized controlled clinical trial aimed at "determining the impact of a self-management program based on the 5A model on self-care and quality of life of cancer patients' caregivers.

"Method & Materials: 

The present study was a controlled clinical trial that included 66 informal caregivers of cancer patients. The participants were selected randomly, using the Random Number Generator V2 software, from the list of cancer patients who met the criteria for entering the research, and their caregivers were randomly assigned to two Intervention and control groups, using the same software. The intervention group received the 5A self-management program in 5 stages and during 10 weeks. The quality of life and self-care in both groups were measured before, immediately and 3 months after the intervention. The data was analyzed using SPSS 21 software.

This study may provide evidence for the implementation of supportive programs for cancer caregivers and could also enhance the role of nurses in specialized oncology clinics, leading to improved care for both patients and their caregivers.

Hemodialysis is one of the most common methods of treating patients with chronic kidney failure. People undergoing hemodialysis face various self-management challenges such as physical, emotional, and psychological problems. Mobile phone applications are useful tools for the self-management process of chronic patients. The purpose of this study was to identify and introduce the requirements needed in designing a mobile phone-based self-management application for hemodialysis patients.

This descriptive cross-sectional study was conducted in 2024. The data collection tool was a researcher-made electronic questionnaire that included information-educational needs and application capabilities. A needs assessment was conducted on 33 people (11 doctors and 22 patients) in Afzalipour Hospital in Kerman. Data analysis was done using SPSS version 27 and descriptive statistics.

A total of 89 information-educational needs and application capabilities were identified for hemodialysis patients. The data elements identified for application capabilities were divided into 10 groups: patient profile, clinical data, medication administration, nutrition and dietary management, psychological and psychiatric challenges management, sleep management, pain management, communication, and exercise. According to the views of doctors and patients, all information-educational needs (26 data elements) and application capabilities (63 data elements) except surname, national code, and contact number, with an average greater than and equal to 2.50 (50 percent) were considered essential for designing an application program.

The identified information-educational needs and the application capabilities in this study, can assist designers in creating efficient and user-friendly self-management applications for hemodialysis.

Type II diabetes significantly impacts the quality of life of affected individuals. This study aimed to assess the effectiveness of self-compassion-based intervention on mental health and self-management in patients with type II diabetes.

A semi-experimental design with pre-test, post-test, and control group was employed. The study included all type II diabetic patients attending a diabetes center in Yazd province. A targeted sampling method was used to select 30 participants, who were randomly assigned to experimental and control groups (n=15 each). Both groups completed the Depression, Anxiety, and Stress Questionnaire (DASS) by Levi Band and Levy Band (1983) before and after the intervention. The experimental group received an 8-session, 1.5-hour compassionate intervention, while the control group received no intervention. Data were analyzed using covariance analysis.

Compassion-based therapy was found effective in reducing depression, anxiety, and stress in patients with type II diabetes. Additionally, self-affirmation through self-management was effective in diabetes control.

The study suggests that psychological treatments, including self-compassion, should be integrated into programs and services for patients with diabetes to enhance their mental health and self-management

The health assistant and treatment assistant in the Ministry of Health and Medicine are in charge of educating people with diabetes and empowering them to achieve self-management of diabetes. The present study was conducted with the aim of determining the status of education and support for diabetes self-management in comprehensive health service centers and diabetes clinics in Isfahan province.

The diabetes education units of 20 comprehensive health service centers and 11 diabetes clinics in Isfahan province formed the sample size. The data collection tool was a checklist with 107 items, which was completed by observing and reviewing 170 paper/electronic files of patients with diabetes.

In more than two-thirds of the files of diabetes centers/clinics, initial assessment were neither performed nor recorded. Educational needs assessment was recorded in 5% of the files and educational planning was not recorded in nearly 100% of them. In more than a third of the files (36.5%), diet education was recorded once when the case was filed. In 3.4% of files, educational effectiveness evaluation was recorded and in three quarters of files (75.78%), continuous support for self-management was not recorded.

There is a significant gap between the status of education and support for diabetes self-management and the process and outcome standards of DSMES in the educational units covered by the provincial health and treatment department. This gap seriously and negatively affects the results of this approach.

The high prevalence and consequences of hypertension in teachers has doubled the importance of identifying factors affecting blood pressure disease, the purpose of this study was to investigate the role of the diagnostic role of health-oriented strategies, self-management and incompatible strategies on hypertension: A discriminant analysis in Khorram Abad city. The current research method was cross-sectional in year1402. The statistical population was made up of teachers in Khorramabad city, the sample size of the study was equal to 324 people, of which 175 teachers without hypertension and 149 teachers with hypertension were selected by available sampling method. In this study, the standard questionnaire of psychological factors affecting blood pressure was used to collect data, and these data were analyzed with the help of spss-24 software and by variance analysis and discriminant analysis. The results of the discriminant analysis showed that the discriminant function has a very high clean power to distinguish and diagnose teachers with and without hypertension (p<0.05), such that 81.7% of the position of the discriminant function is based on the components of health-oriented strategies, self-management and inconsistent strategies. Also, the diagnostic power related to the subscale of awareness of the disease has been higher(p<0.05). Based on the findings of the present research, it can be concluded that psychological factors play an important role in diagnosing and predicting teacher’s hypertension, and for this purpose, psychologists, counselors and education professionals should pay attention to these factors to prevent and treat teacher’s hypertension.

Considering the global spread of COVID-19, it seems that correct information obtained from reliable sources and training based on the need for self-care behaviors are useful solutions to reduce the harm caused by the disease. This study aimed at assessing the educational needs of people in Mazandaran province about COVID-19.

In a cross-sectional study, 1220 people were recruited via convenience sampling in 2020. A researcher-made questionnaire was administered and information such as demographic characteristics, disease condition, and educational needs for COVID-19 were recorded. Data were analyzed using descriptive statistics and parametric tests, correlation, analysis of variance, and t-test.

The mean age of the participants was 39.34 ± 8.74. Educational level included diploma (42.5%) and university education (38.9%). About 73.3% of the participants were women. According to findings the main sources of information about COVID-19 were social networks (68.4%), satellite programs (20.9%), Ministry of Health notices (8.1%), national media (1.6%), other sources (0.6%), and family members (0.4%). Online methods were the most desirable educational methods (94.6%) reported by the people living in Mazandaran province. The overall mean score for educational needs was 3.89±0.96. The educational need for the disease (3.76±0.84) and self-care needs (4.03±1.07) indicated high needs for educational trainings and significant differences between these areas (P=001).

In this study, social networks and media were the primary sources of information about COVID-19. Designing and implementing self-management and self-care training programs could improve the health of people in Mazandaran province and prevent the spread of COVID-19.

Medication and nutritional adherence include accurate consumption of medication and following the diet according to the recommendations provided by healthcare personnel, which leads to maintaining and promoting the health of the elderly. The present study aimed to evaluate the effect of teach-back self-management training on medication and nutritional adherence of the elderly with type 2 diabetes in the selected comprehensive health service centers in Mashhad, Iran.

This experimental study was conducted on 104 type 2 diabetic patients who were randomly divided into intervention and control groups. In the intervention group, self-management training was provided by return training method, and in the control group, routine training was provided. To collect data, the Moriski medication adherence questionnaire and the Midas dietry compliance questionnaire were completed before and after the intervention. Data analysis was performed using SPSS statistical software (version 20), and Chi-square, Fisher, independent t-test, and paired t-test.

Based on the findings of the present research, the mean scores of the medication and nutritional adherence in the two groups before the intervention were not significantly different (P<0.05). However, after the intervention, medication and nutritional adherence of the intervention group was significantly increased compared to the control group (P<0.05).

The use of teach-back self-management training is suggested as an effective method in increasing medication and nutritional adherence of the elderly with type 2 diabetes

Chronic diseases have been increased in the last decade. Treatment of these diseases requires frequent visits to the hospital and monitoring of symptoms [1]. Type 2 diabetes (T2D) as a chronic disease, is one of the most important health challenges in the world, which affects the quality of life and leads to other diseases. The prevalence of T2D has increased with the increase of population due to lifestyle changes. This increase is more in developing countries facing challenges in receiving public health services. The growth and development of digital technologies, including mobile health, have led to their increased use in managing chronic diseases and thus have led to changes in the way healthcare services are delivered [2, 3].

Recent developments in the use of mobile technologies have given rise to opportunities for more effective and cost-efficient services for people with chronic diseases. Considering the relatively high prevalence of post-traumatic stress disorder (PTSD) in Iran and the lack of a native application for the self-management of many complications of this disorder, the present study aims to develop and evaluate a mobile application for PTSD self-management.

This developmental-applied study was conducted in two stages. In the first stage, interviews and a literature review were carried out to identify users’ requirements and expectations of the application. Then, the application was modeled, designed, developed, and tested based on the requirements. In the second stage, the usability of developed application was evaluated by experts and users.

The following services were implemented in the application: psychoeducation, coping skills, breathing exercise, relaxation, positive affect, social support, self-assessment, reminders, useful links, and self-monitoring. According to experts’ evaluation, the application was of acceptable quality (78.25%). The application was relatively acceptable from the users’ point of view (68.67%). In the evaluation process, experts were most satisfied with the functionality of the application (80 %), and users were most satisfied with the application’s ease of use (76%).

Using the application can be useful in promoting access to healthcare services for patients with PTSD, and in addition to saving time and costs, it can be effective in the self-management of this disorder.

Chronic back pain is the most common type of musculoskeletal pain and the main cause of disability in the elderly. The self-management training program for chronic back pain control has positive consequences for the elderly and the health system. This research was conducted with the aim of determining the effect of implementing a self-management program on self-efficacy and acceptance of pain in the elderly with chronic back pain who referred to the specialized clinics of Babol University of Medical Sciences in 2021.

The present study was a clinical trial of a pre-test-post-test design, applied type. The research sample of 100 elderly people was allocated to two intervention and control groups by means of available sampling and random sequence using variable blocks method. The self-management program included awareness and cognition, problem solving process, stress control, muscle relaxation, and sports exercises. The patients were trained for four weeks and followed up for one month. Data were collected with pain self-efficacy questionnaire and pain acceptance questionnaire before, after and one month after the intervention. The results were analyzed using SPSS version 22 software at a significance level of <0.05.

There was no significant difference in the average self-efficacy and pain acceptance between the intervention and control groups before the intervention, while there was a significant difference between the two groups after the intervention in the average self-efficacy and pain acceptance (P<0.001). Also, the findings indicated that there was a significant improvement in the average self-efficacy and acceptance of pain before and after the implementation of the intervention in the intervention group (P<0.001).

Self-management program training has a positive effect on improving self-efficacy and acceptance of pain in the elderly, so the use of this non-pharmacological and supportive method can be used by nurses as an effective method to control chronic back pain.

Due to the prevalence of type 1 diabetes in children and the importance of this developmental period, self-management plays a very important role in disease management. This study was designed to determine the relationship between self-monitoring of blood sugar (SMBG) and self-management behaviors in children with type 1 diabetes.

The present study was a correlational-descriptive study which carried out in Besat’s Teaching University hospital in the city of Hamadan, 2021. Through simple random sampling, 92 children with type 1 diabetes, aged between 9 to 12 were included to the study. Subjects completed the demographic, self-monitoring and diabetes self-management questionnaires validated by Cheraghi et al. (2013). Data analysis was done by independent t-test and Pearson correlation in SPSS-20.

The average scores of self-management dimensions were obtained, including blood sugar measurement range (14.63±3.50), compliance with insulin therapy (39.39±8.49), compliance with diet (41.84±10.36) and physical activity (19.60±4.69). There was a direct and significant relationship between total self-management behavior score and self-management dimensions’ score with blood sugar self-monitoring (p<0.001).

There was a significant relationship between self-monitoring of blood sugar and self-management behaviors in children with type 1 diabetes. Therefore, it is recommended that self-monitoring of blood sugar by children with type 1 diabetes should be done more carefully and regularly so that the children with type 1 diabetes can have better self-management upon this disease.

Migraine is a chronic disease and the most common type of debilitating headache in children.The aim of this study was to determine the relationship between self-management and headache severity, quality of life and physical activity in children with migraine.

In this cross-sectional study, 200 children with chronic migraine referred to the clinic of Besat Hospital and Imam Khomeini Clinic in Hamadan during the years 2019-2021 were studied. The research tools consisted of questionnaires for demographic information, stages of pain transformation, examining the effect of headache, Kindle quality of life and physical activity. Analysis of variance and Pearson correlation test were used to analyze the data. The significance level was at 0.05.

One-way analysis of variance test showed that there was no statistically significant difference between the mean scores of headache self-management and the duration of migraine attacks in terms of headache severity. There was a direct and significant relationship between headache intensity score and quality of life and the number of migraine headache symptoms (P < 0.05)and a significant inverse relationship (P < 0.01)with the number of migraine attacks per month. There was a statistically significant difference between number of migraine episodes in a month and the severity of headache (P < 0.01).

Self-management was not associated with the headache severity, quality of life and physical activity, but severe headache reduced the quality of life and decreased the frequency of symptoms and increased the number of migraine episodes per month.

Multiple sclerosis is one of the most common chronic and debilitating diseases of the nervous system. Sleep disorder is one of the most important complications of this disease that affects the patient's quality of life. This study was conducted with the aim of investigating the effect of a self-management program based on virtual group discussion on sleep quality in the patients with multiple sclerosis patients.

The current research is a semi-experimental study with a pre-post-test design, conducted with the participation of 60 patients referred to the Urmia MS association in 2021, who were selected by convenient sampling and divided randomly into control and experimental groups (30 patients in each group). Patients of the intervention group received the educational content of self-management program through discussions with other group members on WhatsApp during 6 sessions and for one month. Patients of the intervention group received the educational content of the self-management program through discussions with other group members on WhatsApp during 6 sessions and for one month. Patients in the control group did not receive any training. Pittsburgh sleep quality questionnaire (PSQI) and demographic questionnaires were completed by the patients before and after the intervention. The collected data were analyzed using descriptive and inferential statistics by SPSS version 22 statistical software.

The study groups were homogeneous in terms of demographic variables there was no significant difference between them (p>0.05). The results of the paired t-test showed that, unlike the control group, the mean score of sleep quality decreased significantly after the intervention (p = 0.001). Also, the results showed that the average score of sleep quality after the intervention had a statistically significant difference between the groups, so that after the implementation of the self-management program, sleep quality improved significantly in the intervention group (p<0.05).

The results of the study showed that the implementation of a self-management program based on group discussion in a virtual way has an effect on the sleep quality of multiple sclerosis patients and so could be used as one of the methods to improve the symptoms and improve the sleep quality in this patients.

Adherence to the regular medication has an important role in controlling and treatment of AIDS. The aim of the present research was to develop, implement, and evaluation of an interventional program to promote medication adherence among AIDS patients referred to Behavioral Diseases Counseling Centers in Kermanshah by using the I-Change model.

The present research was a quasi-experimental interventional efficacy study among a total of 150 AIDS patients in Kermanshah, 2021 who were randomly selected and assigned to intervention and control (each, n = 75) groups. The intervention development was based on the I-Change model needs assessment and intervention mapping approach, the collected data was evaluated before and three months after the implementation intervention. Data were analyzed by SPSS-16.

The mean age of patients was 39.11 [SD: 6.07], ranging from 22 -51 years. After implementing the intervention in the intervention group, the mean score of regular medication adherence behaviors (P <0.001, d= 0.48) and knowledge (P = 0.028, d= 0.31) was significantly higher and the perceived barrier (P = 0.020, d= 0.35) was lower than in the control group.

I-Change model can be used as a basis for the development of interventional programs to improve medication adherence among AIDS patients.

One of the biggest challenges of the health systems in the 21st century is the increasing burden of chronic diseases. To address this challenge, many developed countries have begun to adopt self-management education programs. There are various tools for measuring the effectiveness of these programs in patients with chronic diseases. Some of these tools are designed to measure self-management in a particular disease, while some tools are used generally for a wide range of chronic diseases. This study aim to review the general tools used for measuring self-management in chronic diseases.

This is a narrative review. To find the studies used the tools for assessing self-management, a searched in online databases such as PubMed, Web of Science, Scopus, and Google Scholar on related studies published from 2000 to 2020.

The general tools available for assessing self-management in chronic diseases were: Self-Management Screening (SeMaS) Scale, Self-Management Ability Scale (SMAS), Self-Control and Self-Management Scale (SCMS), Partners in Health Scale (PIH), and Health Education Impact Questionnaire (heiQ).

There are various general tools for self-management evaluation in chronic diseases. It is necessary to select the appropriate tool based on the goals.