Thesis (D.N.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / This study investigated of the capacity of self-efficiency (SE) and the Health Belief Model (HBM) to predict diabetes self care. Research questions derived from Bandura's Social Cognitive Theory asked the associations between SE, HBM, and their interaction on reported self care (SC). / 2999-01-01

Hjärtvikt är en vanligt förekommande kronisk sjukdom i Sverige som ger symtomen trötthet, andfåddhet och ben svullnader. Personers förmåga att utöva en god egenvård är en mycket viktig del, och kan öka livskvalitén och överlevnaden vid hjärtsvikt. Litteraturgenomgången tyder på att det hos vissa personer med hjärtsvikt finns en bristande förmåga att utöva egenvård. Syfte: Att beskriva och identifiera vilka faktorer som påverkar personers egenvård vid hjärtsvikt. Metod: En litteraturöversikt med kvalitativ ansats utfördes. Totalt 10 studier granskades och analyserades med hjälp av Fribergs femstegsmodell. Resultat: Ur granskningen och analysen kom fem subteman fram som sedan delades in i två huvudteman. Huvudteman blev sociala faktorer och hälsofaktorer. Resultatets underteman blev miljöfaktorer, erfarenhet och kunskap, relationer och stöd, emotionella uttryck samt fysiologiska faktorer. Några av de faktorer som redovisades i resultatets olika underteman var ålder, tillgänglighet, nedstämdhet och bristfällig kunskap, de faktorerna påverkade egenvården hos personer. Slutsats: Det är viktigt att som sjuksköterska vara medveten om att olika faktorer kan ha olika betydelse för personens egenvårds hantering, vikten av personcentrerad omvårdnad är tydlig Nyckelord: hjärtsvikt, omvårdnad, egenvård, egenvårdshantering / Heart failure is a common chronic disease occurring in Sweden. Symptom that can arise is fatigue, shortness of breath and edema. The ability to practice a good self-care is a really important part and can increase the quality of life and the survival with heart failure. A review of previous studies suggests that some person’s with heart failure have a lacking ability to practice an adequate self-care. Purpose: The purpose of the study is to describe and identify the factors that influence a person’s self-care in heart failure. Method: A literature review with a qualitative approach was carried out. A total of 10 studies was reviewed and analyzed with the use of the five step-model created by Friberg. Result: Out of the survey and the analysis, five subthemes were found which later were divided into two themes. The themes that were created were social factors, and health factors. The subthemes of the result were factors in the environment, experience and knowledge, relations and support, emotional expression and physiological factors. Some of the factors that will be found in the subthemes are, age, availability, depression and lack of knowledge, which was factors that gave an impact to the self-care of a person. Conclusion: It is important as a nurse to be aware of the fact that different factors could have various meanings for a person’s self-care management, the importance of person-centered-care is very clear. Keywords: heart failure, self-care, nursing, self-care management

Board Certified Behavior Analysts (BCBAs) serve as the primary practitioners within this field, providing direct services to individuals with socially significant problem behaviors. The purpose of this study was to expand research on the behavior analytic practitioner regarding their self-care practices and develop an understanding of their lived experience using Orem's theory of self-care. Data were collected from 10 BCBAs via face-to-face interviews derived of questions regarding self-care practices. The interview questions included discussions around self-care behaviors as well as beneficial and problematic effects regarding individual self-care practices. Interpretive phenomenological analysis was used to gather information regarding practices and interpret the lived experience of current practitioners. It was found that BCBAs have informal exposure to self-care and share effects like burnout with other helping professions. Some practitioners indicated that lack of self-care resulted in diminished relationships, lowered quality of care for clients, and poor quality of life outcomes. This research indicated social change implications that include using the results to improve self-care practices among BCBAs could result in less burnout and improved care for patients. If improvements to self-care repertoires are made, client outcomes may also improve, reducing the need for behavior analysis services long term.

<p>The aim of this qualitative study was to explore experiences of malaria and attitudes to malaria prevention among nurses from Tanzania. Eleven nurses from three hospitals in northern Tanzania were interviewed. The analysis resulted in following categories: <em>The m</em><em>alaria situation was so severe at that time, Being both nurse and parent, Hindrances in the battle, Sharing knowledge </em>and<em> There is a change. </em>Ten out of eleven nurses had had malaria and all of them had been treated with anti-malarial drugs and many of them still had malaria regularly. They remembered times when the malaria situation was worse and the disease killed many more people. Having children resulted in constant worry. Being a nurse had advantages because they lived close to the hospitals so they could initiate early treatment and because they could afford to take preventive measures. Hindrances in the battle against malaria were other people’s lack of knowledge, poverty and difficulty to change lifestyle and environmental conditions. They were proud to be nurses and knowledge was their strength. There were geographical differences in how much hope they had for the future. The nurses in Zanzibar were the most optimistic. The nurses supported the governmental actions against malaria.</p> / <p>Syftet med denna kvalitativa studie var att undersöka vilka upplevelser sjuksköterskor från Tanzania hade av malaria och deras attityder till malariaförebyggande åtgärder. Elva sjuksköterskor från tre sjukhus i norra Tanzania intervjuades. Analysen resulterade i följande kategorier: <em>Malariasituationen var så allvarlig på den tiden, Att vara sjuksköterska och förälder, Hinder i kampen, Att dela kunskap </em>och<em> Det har blivit en förändring.</em> Tio av de elva sjuksköterskorna hade haft malaria och alla hade fått malariabehandling och flera av dem hade fortfarande malaria regelbundet. De hade minnen från när malariasituationen var värre och många fler människor dog av sjukdomen. Att vara förälder innebar konstant oro. Att vara sjuksköterska hade fördelar eftersom de bodde nära sjukhusen och därför kunde inleda snabb behandling och för att de hade råd att genomföra förebyggande åtgärder. Hinder i kampen mot malaria var andra människors okunskap, fattigdom och svårigheter att förändra livsstil. De var stolta över att vara sjuksköterskor och kunskap var deras styrka. Det fanns geografiska skillnader när det gällde deras framtidstro. Sjuksköterskorna på Zanzibar var de mest hoppfulla. Sjuksköterskorna stödde de statliga insatserna mot malaria.</p>

Thesis (Ph. D.)--University of Missouri--Columbia, 2001. / Typescript. Vita. Includes bibliographical references (leaves 163-171). Also available on the Internet.

The aim of this qualitative study was to explore experiences of malaria and attitudes to malaria prevention among nurses from Tanzania. Eleven nurses from three hospitals in northern Tanzania were interviewed. The analysis resulted in following categories: The malaria situation was so severe at that time, Being both nurse and parent, Hindrances in the battle, Sharing knowledge and There is a change. Ten out of eleven nurses had had malaria and all of them had been treated with anti-malarial drugs and many of them still had malaria regularly. They remembered times when the malaria situation was worse and the disease killed many more people. Having children resulted in constant worry. Being a nurse had advantages because they lived close to the hospitals so they could initiate early treatment and because they could afford to take preventive measures. Hindrances in the battle against malaria were other people’s lack of knowledge, poverty and difficulty to change lifestyle and environmental conditions. They were proud to be nurses and knowledge was their strength. There were geographical differences in how much hope they had for the future. The nurses in Zanzibar were the most optimistic. The nurses supported the governmental actions against malaria. / Syftet med denna kvalitativa studie var att undersöka vilka upplevelser sjuksköterskor från Tanzania hade av malaria och deras attityder till malariaförebyggande åtgärder. Elva sjuksköterskor från tre sjukhus i norra Tanzania intervjuades. Analysen resulterade i följande kategorier: Malariasituationen var så allvarlig på den tiden, Att vara sjuksköterska och förälder, Hinder i kampen, Att dela kunskap och Det har blivit en förändring. Tio av de elva sjuksköterskorna hade haft malaria och alla hade fått malariabehandling och flera av dem hade fortfarande malaria regelbundet. De hade minnen från när malariasituationen var värre och många fler människor dog av sjukdomen. Att vara förälder innebar konstant oro. Att vara sjuksköterska hade fördelar eftersom de bodde nära sjukhusen och därför kunde inleda snabb behandling och för att de hade råd att genomföra förebyggande åtgärder. Hinder i kampen mot malaria var andra människors okunskap, fattigdom och svårigheter att förändra livsstil. De var stolta över att vara sjuksköterskor och kunskap var deras styrka. Det fanns geografiska skillnader när det gällde deras framtidstro. Sjuksköterskorna på Zanzibar var de mest hoppfulla. Sjuksköterskorna stödde de statliga insatserna mot malaria.

Over the past 100 years the average life span of humans has increased in developed countries. Mortality rates have changed because of the virtual eradication of infectious diseases, such as polio and smallpox, and the increase in chronic diseases. Chronic diseases, such as coronary heart disease, are related to lifestyle behaviour, a factor over which the individual has some control. Matarazazo (1984) believes that 'behavioural pathogens are the key to understanding health behaviours of the individual and subsequently designing more effective methods of dealing with chronic disease and illness. Fries (1980) suggests another approach to dealing with chronic disease, through the strategy of 'compressed morbidity'. This refers to the postponement of chronic infirmity relative to average life duration. By achieving compressed morbidity, it is expected that health costs will decrease and improvement of quality of life will occur. This may be possible in at least two ways: firstly, by self-empowerment of the individual and secondly by the development of health self-efficacy. Thus giving the individual the power to act upon certain health-damaging behaviours as well as the confidence to influence behavioural change and persistence to cope with difficulties whilst the process of change is occurring. Thirdly, as a result of this, behaviour changes will occur and this would lead to a reduction in health cost which would be of overall benefit to the community. One method of reducing these health care costs is through health promotion and health education. Improvements in health knowledge and skills through health education and health promotion has been shown to facilitate changes in lifestyle and so reduce the incidence of various diseases. This study examined the effectiveness of two types of self-care models, health self-care and medical self-care. Health self-care refers to individuals assuming more responsibility for prevention, detection and the treatment of health problems using self-care information. Medical self-care involves the use of General Practitioners (GP) offering advice to their patients and subsequently patients making informed decisions about their health. The health self-care model Healthtrac, attempts to provide an effective use of the Australian health care system. Healthtrac is an information and skills based mail delivery program designed to assist individuals in elevating their perceptions of health self-efficacy and improve their lifestyle behaviours. Better Health is the medical self-care model which is designed with the perspective that GP's are the best suited as the initiators of change in individual health self-care. Participants (N = 864) are adult males and females. The methodology for this study involved 864 high risk of chronic disease participants who have been identified using the Healthtrac Health Risk Assessment (HRA) instrument. There were (n = 343) participants in the health self-care group, (n =66) in the medical self-care group and (n = 455) in the control group. This instrument was designed to identify individuals who have or are at high risk of developing chronic disease. These participants were part of the Better Health promotion program of a Health Insurance company. All the participants received a letter of advice detailing the presence of certain risk factors as determined by their health risk appraisal. They were requested to visit their local GP who recommended the necessary behavioural changes and medical support required for medically satisfactory outcomes. They were encouraged to follow the advice of the GP and received a second HRA after 6 months and again12 months after the start of the project. The Healthtrac component of the study involved 343 subjects who completed the HRA instrument. Participants in this group were matched with the Better Health subjects for variables such as age, gender, employment, disease or lifestyle and educational level. Baseline impact variables were calculated and compared with the same variables at 6 monthly intervals during the 12 month period of the study. Process variables such as user satisfaction were determined by a questionnaire. Investigation of the Health Benefits Organisation records were used to gather data on the number of claims for hospitalisation and other medical costs. A control group of 455 participants were matched with the same variables as those participants in the health self-care model and medical self-care groups. The analysis of results indicate that variables such as number of doctor's visits, days spent in hospital and total risks scores for the health self-care model were lower than the Medical model scores. The variable, cost of disease findings indicate that there were no significant differences between the two experimental groups, from the baseline data (Q1) to the 12 month period (Q3). The cost of diseases for heart disease was able to be lowered more by participants in the health self-care than the medical self-care model. The opposite occurred for the blood pressure condition. The health self-efficacy questionnaire results indicate that the health self-care group participants reported higher self-efficacy scores, therefore they were more confident about the self-management of their health behaviours than the members of the medical self-care group. No significant differences occurred among the experimental and control groups on such variables as achievement of outcomes and management of disease on self-efficacy scores. Both experimental groups, health self-care and the medical self-care model philosophies have strengths and weaknesses. Health self-care provides health information and support through printed materials whereas the medical self-care model provides health information through GP's. Both health promotion programs are important in making the individual aware of methods needed to improve health and in developing the knowledge necessary to modify clients health behaviours. This in turn is an important factor in the reduction of medical costs and the prevention of some diseases.

This doctoral portfolio presents two separate but related research study reports on ‘self-care practices of adults with poorly controlled diabetes in Malaysia’. It is comprised of five sections. Section one which is the introduction begins with a general discussion on diabetes mellitus (henceforth referred to as diabetes), a common, growing, serious and costly health problem. The importance of self-care in the management of diabetes and its many disabling long-term complications are emphasised. This is followed by a specific discussion of diabetes in Malaysia - its prevalence, the quality of care, cost and the need for research to uncover new information to improve the care provided to Malaysians with diabetes. Section two is the report on the first research study that investigates the four cornerstones of diabetes self-care practices, namely: dietary intakes, medication adherence, physical activity and self-monitoring of blood glucose in Malaysian adults with poorly controlled diabetes. It also explores the factors that influence these self-care practices. Section three is the report on the second research study that assessed the efficacy of an out-patient diabetes educational program based on a self-efficacy theoretical approach to improve firstly, self-care practices and secondly, clinical outcomes of adults with poorly controlled diabetes in Malaysia. It also identified some of the factors that facilitate or impede such a programme in the Malaysian context. Section four integrates the findings of the two related research studies - the first defining the problem and the second providing possible solutions in the Malaysian context. It points out limited diabetes knowledge on self-care can compromise or create problems regarding self-care practices for Malaysians with poor glycaemic control. It also identifies possible areas of research that can uncover new knowledge that may improve the quality of diabetes care and enhance the quality of life of Malaysian with diabetes. Section five includes publication originating from this work. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1374559 / Thesis (D.Nurs.) -- University of Adelaide, School of Population Health and Clinical Practice, 2009

This doctoral portfolio presents two separate but related research study reports on ‘self-care practices of adults with poorly controlled diabetes in Malaysia’. It is comprised of five sections. Section one which is the introduction begins with a general discussion on diabetes mellitus (henceforth referred to as diabetes), a common, growing, serious and costly health problem. The importance of self-care in the management of diabetes and its many disabling long-term complications are emphasised. This is followed by a specific discussion of diabetes in Malaysia - its prevalence, the quality of care, cost and the need for research to uncover new information to improve the care provided to Malaysians with diabetes. Section two is the report on the first research study that investigates the four cornerstones of diabetes self-care practices, namely: dietary intakes, medication adherence, physical activity and self-monitoring of blood glucose in Malaysian adults with poorly controlled diabetes. It also explores the factors that influence these self-care practices. Section three is the report on the second research study that assessed the efficacy of an out-patient diabetes educational program based on a self-efficacy theoretical approach to improve firstly, self-care practices and secondly, clinical outcomes of adults with poorly controlled diabetes in Malaysia. It also identified some of the factors that facilitate or impede such a programme in the Malaysian context. Section four integrates the findings of the two related research studies - the first defining the problem and the second providing possible solutions in the Malaysian context. It points out limited diabetes knowledge on self-care can compromise or create problems regarding self-care practices for Malaysians with poor glycaemic control. It also identifies possible areas of research that can uncover new knowledge that may improve the quality of diabetes care and enhance the quality of life of Malaysian with diabetes. Section five includes publication originating from this work. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1374559 / Thesis (D.Nurs.) -- University of Adelaide, School of Population Health and Clinical Practice, 2009

Thesis (M.S.)--University of Michigan, 1983.