self-care

Promoting self-care is especially crucial as a primary approach to enhancing public health. Self-care refers to the behaviors that individuals use to manage their health status and plays a fundamental role in disease prevention, chronic disease management, and enhancing quality of life. In this era of rapidly increasing health and social challenges, the need to promote self-care and promote a culture of health is clearly felt. Self-care can reduce the need for complex and costly treatments and, consequently, minimize the financial pressure on the health system. Promoting a health-oriented culture in communities additionally increases social empowerment and encourages individuals to engage in initiative. Because of global developments and the spread of diseases, there is a greater necessity than ever to create research and educational initiatives focused on self-care and health culture is felt more than ever. Therefore, it is suggested that scientific studies in this field be seriously considered. Today, given the widespread nature of chronic diseases, psychological stress, and lifestyle-related injuries, increasing public awareness about the importance of self-care has become an urgent need. Self-care involves individuals utilizing their knowledge, skills, and abilities as a resource to manage their health independently. In fact, self-care is an voluntary behavior that occures based on the will and wishes of individuals, allowing them, by acquiring sufficient knowledge and skills, can take care of their health with self-reliance. Better self-care is associated with a better quality of life. Conversely, self-care leads to improved lifestyles, reduced treatment costs, increased self-efficacy, reduced dependence on others, and increased well-being and vitality.

Bipolar disorder is a chronic condition that requires lifelong self-care. Many personal experiences are obtained in self-care. Therefore, gathering and utilizing these experiences is crucial for managing the condition effectively. This qualitative study explores the perspective of stakeholders on personal knowledge management in the context of bipolar disorder.

The current qualitative study was conducted in 2024 in Tabriz. First, semi-structured interviews were carried out with patients diagnosed with bipolar disorder, their families, and healthcare staff working in psychiatric departments to identify self-care experiences. The content analysis approach and MAXQDA software version 2020 were used for data analysis. Then, the Delphi technique was employed to assess the level of agreement among experts regarding the indicators of personal knowledge management for self-care among patients with bipolar disorder.

By coding the interview transcripts, seven themes and 24 categories were identified. Two of these themes pertained to patients, including: 1) educational strategies for patients and their families, and 2) strategies for enhancing patients' engagement in the treatment process. Additionally, five themes related to healthcare providers were identifies: 1) attention to the privacy of service recipients, 2) barriers to self-care knowledge management, 3) essential input for self-care knowledge management, 4) processes for managing patients' personal experiences and 5) education in information technology. In the second stage, 41 out of 65 codes received an average score above 7.5 in the first round of Delphi process, while the remaining codes proceeded to the second round. According to the results of the second round, only seven codes achieved an agreement above 0.6. The remaining codes were removed due to having an agreement below 0.6.

According to the results, providing face-to-face training to patients with bipolar disorder and their families can enhance patients’ self-care practices. Also, sharing reliable experiences among patients via social media can enhance self-care behaviors. In addition to providing education, fostering the positive attitude among patients and their families toward the impact of sharing experiences can lead to effective behavioral changes.

Celiac disease has a significant impact on the quality of life of children and their families. Orem’s theory, with its focus on empowerment and self-efficacy, provides an appropriate framework for designing self-care interventions. Therefore, this study aims to investigate the effect of self-care education based on Orem’s theory on the quality of life of parents of children with celiac disease.

In this semi-experimental study (pre-test–post-test design), 70 parents of children with celiac disease attending educational hospitals in Zahedan in 2024 were selected using a convenience sampling method and randomly assigned into two groups of 35 each (intervention and control) by coin toss. In the intervention group, four in-person self-care education sessions based on Orem’s self-care theory were conducted. Before and one month after the intervention, quality of life was measured using the World Health Organization Quality of Life questionnaire. Data were analyzed using SPSS version 27, employing Chi-square, paired t-test, and independent t-test statistical tests.

The mean age of children in the intervention group was 8.65 ± 1.74 years, and in the control group, it was 8 ± 2.07 years. The mean general quality of life score before the intervention in the intervention and control groups was 50.37 ± 5.04 and 49.71 ± 5.51, respectively. After the intervention, in the intervention group, it increased to 56.02 ± 5.01, while in the control group, it was 50.17 ± 5.69. Self-care education based on Orem's model significantly improved the quality of life in all domains for the intervention group (p<0.001).

The results indicate that the self-care model based on Orem’s theory is an effective method for improving the quality of life of parents of children with celiac disease, and it is recommended to be included in support programs for these parents.

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.

Family-centered empowerment involves engaging clients and their families in decision-making processes to improve health outcomes, thereby enabling them to exert control over their health status through informed choices. Self-efficacy is considered the most crucial component of empowerment and holds significant importance in the management of chronic diseases and the enhancement of self-efficacy. This study was conducted to compare the effects of patient-centered and family-centered empowerment model-based training on perceived self-efficacy and fasting blood glucose levels in patients with type 2 diabetes mellitus.

This quasi-experimental study was conducted on 120 patients with type 2 diabetes who attended rural comprehensive health centers in Gorgan, Iran, during 2023. Patients were enrolled in the study using a multi-stage cluster sampling method and were divided into three groups of 40: A control group, a family-centered empowerment group, and a patient-centered empowerment group. The interventions in the patient-centered and family-centered groups were delivered in 6-8 people groups based on a four-stage model. These stages included threat perception, problem-solving, educational participation, and evaluation. Patients in the control group received only the routine health center training. Data collection instruments included the standard Perceived Self-Efficacy Questionnaire in middle-aged diabetic patients and a checklist for recording clinical characteristics.

The fasting blood glucose levels decreased in all three groups after the intervention; however, this difference was not statistically significant among the groups in either the pre-test or the post-test. In the post-test, a statistically significant increase in perceived self-efficacy was observed between the patient-centered group and the family-centered group, as well as between the patient-centered group and the control group (P<0.05).

The patient-centered and family-centered empowerment model-based training on patients’ perceived self-efficacy was evaluated as effective; however, it had no effect on the fasting blood glucose levels of patients with type 2 diabetes.

Considering the growing trend of the elderly population in Iran, problems related to their care and health, attention to psychological treatments, and issues such as self-care behaviors and psychological well-being are important. Therefore, the aim of this research was to the effectiveness of behavioral activation intervention on increasing self-care behaviors and psychological well-being of the elderly.

The current study was a quasi-experimental study with a pre-test-post-test design with a 2-month follow-up and a control group. Among all the elderly people aged 65-90 who visited the communication center in Saeed Abad town in 2023, 40 people were selected by convenience sampling and assigned into 2 groups of experimental and control. The self-care questionnaire of Hemmati Maslak Pak et al (2015) and the psychological well-being scale of Ryff (1989) were used to collect data at three time points: pre-test, post-test, and follow-up. The experimental group received 8 sessions of Kanter et al.'s (2009) behavioral activation intervention protocol. The data were analyzed using univariate covariance analysis (ANCOVA) by SPSS-26 software.

There was a significant difference between the experimental and control groups in terms of self-care behaviors (F=46.18) and psychological well-being (F=54.74). These results were consistent after a 2-month follow-up (P<0.001). After receiving the behavioral activation intervention, the experimental group showed significant improvements in both self-care behaviors and psychological well-being.

This study suggests that a behavioral activation intervention can be an effective method for improving the self-care behaviors and psychological well-being of elderly individuals

 Individuals undergoing chronic hemodialysis face various daily challenges due to their unique lifestyle, which significantly reduces their quality of life. Self-care plays a crucial role in improving health behaviors and delaying the progression to the final stages of the disease. Since self-care is comprehensive, learnable, and improvable, this study aimed to investigate the relationship between loneliness and self- care in elderly patients undergoing hemodialysis.

This cross-sectional study involved 138 elderly patients undergoing hemodialysis at the Citizen Dialysis Center in Sari, selected through a census method. Data collection tools included a socio-demographic questionnaire, the Standardized Elderly Self-Care Scale, and the Russell Loneliness Scale. Data were analyzed using SPSS version 22, employing both descriptive and inferential statistics. The significance level was set at P≤ 0.05.

The average age of the participants was 68.67±6.28 years, and the majority (51.4%) were female. Pearson correlation analysis revealed no significant association between total self-care scores and loneliness (r=0.14,P=0.108), physical self-care scores and loneliness (r=-0.03,p=0.694), or illness-related self-care scores and loneliness (r=0.11,P=0.218). However, a significant negative correlation was observed between spiritual self-care scores and loneliness (r=-0.33,P=0.001) and between social self-care scores and loneliness (r=-0.20,P=0.018). As loneliness scores increased, spiritual and social self-care scores declined.

The findings underscore the importance of addressing the emotional and social needs of elderly hemodialysis patients along with their physical health needs to enhance their overall quality of life. Healthcare providers and policymakers should implement self-care interventions, particularly those emphasizing spiritual and social aspects, into care plans for elderly hemodialysis patients to reduce the negative impact of loneliness and promote their well-being.

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.

Diabetes is one of the most important chronic diseases of elderhood. Adherence to treatment and self-care, is one of the main pillars of controlling diabetes and reducing disease complications. Therefore, this study aimed to determine the relation among  adherence to treatment and self-care of elderly with type 2 diabetics.

This descriptive correlational study was conducted on 116 elderly with type 2 diabetes who referred to the diabetes clinic of Gorgan in 2022. The sampling was performed using the convenience method, and the data collection tools were adherence to treatment and self-care Questionnaire. The data were analyzed using SPSS-21 software by descriptive statistics (table, mean, standard deviation) and inferential statistics (Spearman, U-Man-Whitney and Kruskal-Wallis correlation coefficient) at a significance level of 0.05.

The results related to adherence to treatment and self-care rates were achieved in mean and standard deviation as much as 84.24 ± 8.87 and 76.83 ± 8.69, respectively. Spearman's correlation coefficient test did not show a significant relationship between adherence to treatment and self-care of the elderly (r=0.03, P=0.712).

According to the results, there was no significant relationship between adherence to treatment and self-care of the elderly. Patient participation in self-care in the treatment of diabetes plays a crucial role in the treatment and prevention of the disease. Therefore, Health care workers, especially nursing staff, should identify the care needs of elderly diabetics and develop educational and care programs to improve patients’ adherence to treatment and self-care.

Work measurement and time study of services offer insights into human resource management and workload and is crucial for accurate human resource estimation. This study aimed to estimate the workload and time required for health care providers to train and implement a self-care program for middle-aged individuals.

This was a cross-sectional study. Activities were observed and recorded during the study into time study checklist that was designed based on service delivery process, approved and finalized by experts from the Iranian Ministry of Health and the Medical Universities. Prior to data collection, the checklist was assessed in a pilot study. The sample size comprised 240 middle-aged participants. The health care worker completed the checklist based on the process and duration of the activities.

The time study and evaluation of the self-care program for middle-aged individuals were conducted in three stages: recruitment, training, and evaluation. Assuming all anticipated activities in the middle-aged self-care program, the program implementation requires 292.13 minutes per client. The average time for the recruitment phase was 24.02 minutes. The training phase, which included teaching self-care booklets, took 175.47 minutes. The evaluation phase in the first and second modes took 92.41 minutes. The total time was different in different Medical Universities (p. value<0.05)

The average time spent on the self-care program for middle-aged individuals (292.13 minutes) exceeds the average time health-care programs for other age groups (204 minutes). The program revision and rearranging human resources of health centers are required for proper implementation of self-care program for middle-aged.

Understanding the link between health literacy and self-care in hypertensive patients is crucial for managing the disease, improving quality of life, and preventing complications.

This study systematically explores the relationships among health literacy, blood pressure, and self-care behaviors.

This systematic review adhered to the Cochrane Handbook and Guidelines for Systematic Reviews, following the PRISMA 2020 criteria. Relevant studies were identified by searching the PubMed, Cochrane Library, Embase, Scopus, and Web of Science databases for publications between April 20, 1980, and April 24, 2023, using English keywords such as hypertension, "health literacy," "blood pressure," and "self-care." Two independent reviewers assessed the titles and abstracts before reviewing the full texts of selected articles, with any disagreements resolved by a third reviewer.

Out of 1,151 articles, 11 meeting the inclusion criteria were reviewed: eight crosssectional studies, two cohort studies, and one randomized controlled trial. Three articles examined the link between health literacy and blood pressure control, while eight focused on self-care. All studies demonstrated a correlation between health literacy levels and either blood pressure control or self-care behaviors.

Individuals with hypertension who possess higher health literacy are better at managing their blood pressure. However, evidence regarding the effect of health literacy on selfcare behaviors is limited. Thus, employing consistent and appropriate tools to evaluate self-care effectiveness in health promotion programs is crucial.