Chronic obstructive pulmonary disease (COPD) signifies a significant public health challenge that is both avoidable and treatable. There was no standardized education offered to the COPD population at the practice location. The scope of the project encompassed standardizing education by developing a self-management packet for the COPD patients. The goal of this project was to examine how the development of a standardized COPD self-management packet enhances the quality of care and strategizes reducing 30-day readmissions compared to nonstandardized delivery of education. Orem's self-care theory and Bandura's self-efficacy concept were used to explain the principle of self-management, while Rosswurm and Larrabee's evidence-based practice model was used to guide practice change. The U.S. Prevention Service Task Force's level of evidence hierarchy was chosen to categorize the strengths and weaknesses of the evidence referenced for this project. Postdevelopment surveys using the Likert scale were distributed to the facility's COPD committee, and a 70% response rate of strongly agreed to all questions was achieved. There were no adverse responses, and the packet was approved unanimously. Based on the positive responses, the packet will be easily adapted and beneficial in practice. The recommendation is to pilot the packet on the medical-surgical unit and follow-up postdischarge with phone calls to ascertain patients' perspective of the packet. Utilization of the education packet will lead to positive social change by affording the stakeholders self-management awareness and positive outcome measures including reducing the COPD 30-day readmission rate, curtailing economic strains, and promoting positive patient-centered relationships.

Heart failure (HF) readmissions create a financial burden for healthcare nationwide and speak to the lack of effective discharge preparation for patients to be successful with self-care at home. The 183-bed hospital where this DNP quality initiative will take place currently reports an observed-over-expected (O/E) readmission rate for HF patients (Centers for Medicare and Medicaid [CMS]). Core measures on HF developed by the Joint Commission and the Centers for Medicare and Medicaid Services do not appear to be enough to ensure successful transitions of care from hospital to home. Guided by the LOGIC model, the purpose of this quality improvement initiative was to develop a HF educational module to improve patients' readiness to learn in order to promote self-care and prevent readmission to the hospital within 30 days. The design of the educational program was supported by the evidence-based literature and incorporated best practices promoted by the Joint Commission, the Institute for Healthcare Improvement, and the Agency for Healthcare Research and Quality. Content evaluation of the newly developed HF educational program was conducted by 10 experts using a quantitative Likert-type scale and qualitative narrative feedback. Descriptive findings from the Likert scale showed a range of 3.9 to 4.0 in the content, process, and design of the program. Recommendations for improvement included more detail around pathophysiology, as well as how to initiate the process in the outpatient setting. Positive social change can result from the program which offers a relevant strategy to reduce readmissions for HF and has wide-application options for many chronic illnesses that can be better managed through effective discharge teaching.

Rural Christian counselors are a distinct group of individuals faced with unique personal and professional challenges. Researchers have indicated that rural counselors experience a higher burnout rate due to wide practice scope; client stigma against receiving help; and physical isolation, making supervision, consultation, and referral difficult. Studies also show that self-care is an effective defense against the symptoms of burnout. Self-care is defined as any legal activity that promotes wellness and brings physical, emotional, mental, or spiritual balance. The central research question of this hermeneutic phenomenology examined the attitudes, perceptions, and experiences of rural Christian counselors with regard to self-care. The conceptual framework was interpreted using social constructivism and hermeneutic phenomenological lenses and was based on self-care, Christian counseling, and action theories. A convenience sample of 9 participants contributed to semistructured interviews; these interviews were analyzed according to methods suggested by Flood, Rubin and Rubin, and Creswell, resulting in saturation and synthesis of the information. Findings indicated that participants understood the importance of and practiced individual styles of self-care, but did not consider current levels of self-care practice as adequate. Feelings of guilt and perceived superior strength in others inhibited self-care efforts. Social change implications include the continued education and encouragement of self-care among this group to help combat burnout, compassion fatigue, and premature retirement. Rural counselors and the small communities they serve could both benefit from increased awareness and practice of self-care activities.

Professionals who work with victims of sexual trauma frequently experience emotional and psychological stressors that affect their everyday life. Vicarious traumatization is an occupational risk among helping professionals, but it is not known how this phenomenon can be identified and minimized among professionals who work with victims of sexual trauma. The purpose of this qualitative narrative study was to explore the personal experiences of licensed and nonlicensed professionals who work with female victims of sexual trauma. Constructivist self-development theory and the traumagenic dynamics model provided the framework for the study. The research questions focused on the evidence of vicarious trauma among participants, the skills and techniques used to minimize the risk of vicarious trauma, and the influence of vicarious traumatization on helping professionals. Data were collected through semistructured interviews with 8 helping professionals in the Southern United States. Findings from data coding and theme analysis indicated that (a) professionals experience psychological and emotional risks in trauma work, (b) establishing boundaries and implementing self-care techniques can minimize vicarious trauma, and (c) consistent training and ongoing discussions about vicarious trauma are essential to professionals who commit their lives to helping sexual trauma victims. Findings may be used to increase awareness and education about vicarious trauma among professionals who work with victims of sexual trauma, and to develop techniques to minimize the risk of vicarious trauma.

The purpose of this literature review is to investigate the most effective forms of self-care that patients can perform to reduce swelling caused by lymphedema. Lymphedema may occur secondary to lymph node trauma, which makes it difficult for lymph fluid to leave an extremity. Even though lymphedema is more recognized as a side effect of breast cancer treatment, it can also be the result of many other ailments or treatments and can be present in any part of the body. By knowing which therapies are most effective, nurses and other health care professionals can educate patients to help ease the burden caused by this debilitating condition. This thesis discusses the results of clinical trials that studied different methods of self-care including exercises, bandaging, compression garments, sequential compression devices, and performing manual lymphatic drainage. The conclusion derived from the review of multiple studies is that participating in a combination of multiple therapies is the most effective means of lymphedema management and should be considered the ideal standard of care.

Problem: Heart failure is the most frequent cause for hospital readmissions in Medicare recipients, with an estimated annual cost of $12 billion. Heart failure hospitalizations are also an independent risk factor for increased mortality. Self-care, thought to be enhanced by perceived social support, is key to managing this syndrome, and up to 50% of readmissions are considered the result of inadequate self-care. Purpose: To evaluate perceived social support and self-care characteristics of patients hospitalized with an exacerbation of heart failure, and to compare these characteristics with a study of ambulatory patients with heart failure. In addition, to assess the relationship between perceived social support and self-care. Methods: This was a multi-site descriptive comparative study. Following informed consent, participants were screened for sufficient cognition to consent. Patients were then administered the Medical Outcome Study-Social Support emotional/informational subscale, and the three Self-Care of Heart Failure Index subscales. Two-sample t tests and multiple regression were utilized to analyze the data. Results were compared with a sample of community-dwelling heart failure patients in another study. Results: Of 161 consented patients 121 passed the cognition screening and were included in the study. Average age was 71 years; gender and type of heart failure was evenly split. Mean Charlson Comorbidity Score was 7.43, and the mean six month number of hospitalizations was 2.43. Approximately 31% of participants were African American. Both perceived social support (t=-4.007, df=211, p < .001) and self-care maintenance (t=-3.343, df=220, p < .002) scores were lower in the hospitalized participants than the comparison group of community dwellers. Perceived social support was associated with self-care confidence (?=.210, t=-2.210, p < .029), but not self-care maintenance or self-care management. Forty-six percent of participants scored higher than the 70% cut point for adequate self-care confidence, which was 1.4 times higher than in the community participants. Self-care confidence was also related to self-care maintenance (?=.388, t=4.676, p < .001) and self-care management (?=.327, t=3.793, p < .001). Conclusions: Results have implications for facilitating self-care knowledge and skills in heart failure patients. Patient education during hospitalization may not be the ideal timing to promote understanding and retention. Interventions to enhance self-care confidence may assist patients to develop self-care skills more than current teaching techniques. Because cognitive deficiencies were found in 25% of pre-screened participants for this study, further research is recommended to determine if hospitalized patients have transient cognitive issues or if cognitive impairments are more prevalent in all heart failure patients.

Background: Heart failure is a complex condition that causes, among other things, shortness of breath and fatigue. The disease challenge patients physically, mentally and socially. Self-care for heart failure is a central part of the treatment process. Heart failure requires a lifestyle change to promote the patient's health, increase well-being and prevent complications. Aim: the aim was to describe patients' experience of self-care in heart failure. Method: This is a literature study that is based on ten qualitative studies, the authors have used the CINAHL and PubMed databases to retrieve scientific articles. Results: The results were divided into one main themes, "obstacles in self-care". Conclusion: Heart failure patients experienced several barriers that negatively affected the quality of their life including physical, psychological and social aspects. The patients also experienced problems financially and many of the patients had too little information about their illness, which was an obstacle to self-care.

A gap exists in the literature exploring the burnout and self-care experiences of novice psychotherapists, despite their greater susceptibility to burnout. The aim of the present study was to begin filling the gap by exploring the lived experiences of burnout among novice psychotherapists and the self-care strategies they employed to combat burnout. Three research questions guided this exploration: (1) How do novice psychotherapists experience burnout? (2) What strategies do novice psychotherapists use to overcome their burnout? (3) How has novice psychotherapists’ self-care strategies changed as a result of experiencing burnout? Four novice psychotherapists were interviewed using a semi-structured interview protocol to gain an insight into their experiences. Using an inductive approach to Thematic Analysis, six main themes, thirteen categories and twenty-eight codes emerged. The six themes were the following: (1) The experience of burnout, which was divided into three categories and included nine codes (2) The strategies employed to combat burnout, which was divided into two categories and included seven codes (3) The meaning of self-care, which was divided into two categories and included three codes (4) Ethical considerations, which was divided into three categories and included three codes (5) Recommendations, which was divided into two categories and included five codes and (6) Looking ahead, which was divided into one category and included one code. Burnout is a debilitating experience that impact personal life, client care, and society. Discussion includes implications for novice psychotherapists, pedagogy and practice, and society.

Att leva med hjärtsvikt innefattar flera olika utmaningar eftersom det är en allvarlig diagnos med många olika symtom som kan begränsa vardagslivet. Behandlingen består av flera delar med bland annat egenvård som är en del av patientutbildningen. Egenvård kan ge möjlighet för patienter att behandla symtom på egen hand och öka självständigheten. Sjuksköterskan kan finnas som stöd vid egenvård genom att informera och motivera. Syftet med studien är att belysa patientens upplevelse av egenvård vid hjärtsvikt. Metoden är en litteraturstudie med inriktning mot kvalitativa artiklar som sökts fram i CINAHL och MEDLINE. Därifrån valdes nio artiklar ut som svarade an på syftet. Resultatet visade varierade upplevelser av egenvård som grundades i patientens egenskaper. För att utföra egenvård krävdes motivation som utformades på olika sätt. Att ha kunskap och stöd var viktiga faktorer för att utföra egenvård, men många patienter upplevde brist på stöd från hälso- och sjukvårdspersonal och att vården inte var personcentrerad. / Living with heart failure involves several different challenges because it is a serious diagnosis with many different symptoms that can limit everyday life. The treatment consists of several parts, including self-care, which is part of patient education. Self-care can give patients the opportunity to treat symptoms on their own and increase independence. The nurse can provide support in self-care by informing and motivating. The purpose of the study is to shed light on the patient's experience of self-care in heart failure. The method is a literature study with a focus on qualitative articles searched in CINAHL and MEDLINE. From there, nine articles were selected that answered the purpose. The results showed varied experiences of self-care that were based on the patient's characteristics. In order to carry out self-care, motivation was required which was designed in different ways. Having knowledge and support were important factors in carrying out self-care, but many patients experienced a lack of support from healthcare professionals and that the care was not person-centered.

Bakgrund: Diabetes mellitus typ 2 (DMT2) är en seriös global folkhälsofråga med allvarligakonsekvenser för de som drabbas av den. Urbanisering och ekonomisk utveckling har ökat förekomstenav sjukdomen och livsstilsfaktorer, såsom en stillasittande livsstil och ohälsosamma matvanor, leder tillhögre BMI och ökad glukoslagring, vilket ökar sannolikheten för försämrad egenvård. Egenvård är enavgörande komponent inom hanterandet av DMT2 i vardagen. Syfte: Syftet var att beskriva egenvård för vuxna patienter med diabetes mellitus typ 2.Metod: En litteraturstudie med kvalitativa egenskaper samt en tematisk analys av resultaten. Studiensresultat inkluderade 12 artiklar. Resultat: Två teman med fyra subteman upptäcktes. Patienternas erfarenheter av egenvård ochkommunikation: Stöd från närstående och sjuksköterskor, kunskap och kommunikation medsjuksköterskor. Viktiga livsstilsförändringar som är avgörande för patienters välmående: Fysisk aktivitet som del av vardagen, kosthantering och dess tillämpning. Slutsats: Denna litteraturöversikt betonar behovet av ett holistiskt tillvägagångssätt för egenvård vidDMT2, med individuellt anpassade svar på patienternas behov och hänsyn till deras socialaomständigheter.