Impact of Health Literacy, Self-efficacy, and Outcome Expectations on Adherence to Self-care Behaviors in Iranians with Type 2 Diabetes.

OBJECTIVES: Diabetic patients with higher health literacy (HL) may feel more confident in their ability to perform self-care behaviors and may have strong beliefs that diabetes-related behaviors will lead to specific outcomes. Our study aimed to document the relationships between HL, self-efficacy, outcome expectations, and diabetes self-care of patients with type 2 diabetes mellitus (T2DM) in Iran. METHODS: We conducted a cross-sectional observational study of 187 patients with T2DM. Participants completed the Functional Communicative and Critical Health Literacy scale, the Summary of Diabetes Self-Care Activities, the Diabetes Management Self-Efficacy Scale, Outcome Expectations Questionnaire, and a demographic questionnaire. RESULTS: Participants who received diabetes education (t = 5.79, p<0.001) and were married (F = 3.04, p<0.050) had better diabetes self-care behavior. There was a significant positive correlation between self-care behaviors and communicative HL (r = 0.455, p<0.010), critical HL (r = 0.297, p<0.010), self-efficacy (r = 0.512, p<0.010) and outcome expectations (r = 0.387, p<0.010). Diabetes education and marital status accounted for 16.9% of the variance in diabetes self-care. Self-efficacy, outcome expectations, communicative, and critical HL explained 28.0%, 1.5%, 3.7%, and 1.4% of the variance, respectively. CONCLUSIONS: This study revealed that the potential impact of self-efficacy, outcome expectations, communicative, and critical HL should be considered in the education program for patients with diabetes. We found self-efficacy to be the most important predictor of diabetes self-care. Therefore, the use of self-efficacy theory when designing patient education interventions could enhance diabetes self-care. It is essential that health care providers assess patient's HL levels to tailor health-related information specific to a domain of HL. This would fully inform patients and promote empowerment rather than simple compliance

Utilizing a health-promotion model to predict self-care adherence in patients undergoing coronary angioplasty in Bushehr, Iran

Background: Self-care refers to the conscious actions and behaviors that patients engage in to maintain and promote their own health and to the decisions that they make about managing signs or symptoms. Despite the importance of self-care in improving the health status of patients with cardiovascular disease, such as those undergoing angioplasty, these patients do not implement self-care optimally. This study aimed to identify factors affecting self-care behaviors in cardiac patients undergoing angioplasty based on a health-promotion model. Methods: A cross-sectional study was conducted among 200 cardiovascular patients undergoing angioplasty referred to the Bushehr Health Center. Health-promotion-model constructs and self-care behaviors were assessed by a researcher-made questionnaire. Data were analyzed by SPSS version 22 using multiple linear regression analyses. Results: Stepwise regression revealed that three variables – perceived barriers, perceived self-efficacy, and social support – were significant predictors of self-care behaviors among patients undergoing angioplasty. These factors accounted for 43.1% (R2 =0.431) of variance in self-care. Among the health-promotion-model constructs, self-efficacy (β =0.237, P<0.001) was the strongest predictor of self-care behaviors, followed by perceived barriers (β =-0.195, P<0.001) and perceived social support (β =0.13, P<0.001). Perceived benefits did not significantly predict self-care behaviors. Conclusion: According to the results of this study, it is suggested that designing and implementing training programs to improve self-efficacy and perceived social support of cardiovascular patients and also decreasing barriers to self-care may improve self-care behaviors among patients undergoing angioplasty

Investigating the stress management status in middle-aged women in bushehr based on a transtheoretical model

Aims The present study aimed to investigate the relationship between self-efficacy, decision-making balance, and change processes with stress management in middle-aged women. Instrument & Methods This cross-sectional study was performed in 2019 on 600 middle-aged women covered by Bushehr Comprehensive Health Services Centers. The method of sampling was stratified. Data was gathered by demographic questionnaire and TTM based questionnaire, including self-efficacy, decisional balance (perceived barriers and benefits), processes of change, and stage of changes. Data were analyzed using ANOVA and Tukey post hoc test in SPSS 20 software. Findings The lowest and highest mean stress management scores were in the women in pre-contemplation (13.64±3.79) and maintenance (22.58±4.10), respectively. The mean score of self-efficacy in the women during the stages of change from pre-contemplation (15.71±6.80) to maintenance (33.06±5.09) was upward, and this average score in the stages of pre-contemplation, contemplation, and preparation was significantly lower than the stages of action and maintenance (p<0.001). Regarding processes of change, consciousness-raising, dramatic relief, environmental reevaluation, self-evaluation, social liberation, self-liberation, stimulus control, counter conditioning, helping relationships, and reinforcement management are significantly lower pre-contemplation and contemplation than action and maintenance (p<0.001). Conclusion The results indicate the importance of TTM constructs in advancing individuals to higher levels of change. Based on this, it is recommended to design and implement educational interventions based on TTM to improve stress management behaviors. Copyright© 2021, the Authors | Publishing Rights, ASPI. This open-access article is published under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License which permits Share (copy and redistribute the material in any medium or format) and Adapt (remix, transform, and build upon the material) under the Attribution-NonCommercial terms

Utilizing a health-promotion model to predict self-care adherence in patients undergoing coronary angioplasty in Bushehr, Iran

Azime Khodaminasab,1 Mahnoush Reisi,1 Hakime Vahedparast,2 Rahim Tahmasebi,3 Homamodin Javadzade1 1Department of Health Education and Health Promotion, Bushehr University of Medical Sciences, Bushehr, Iran; 2Department of Medical Surgical Nursing, Bushehr University of Medical Sciences, Bushehr, Iran; 3Department of Biostatistics, Bushehr University of Medical Sciences, Bushehr, Iran Background: Self-care refers to the conscious actions and behaviors that patients engage in to maintain and promote their own health and to the decisions that they make about managing signs or symptoms. Despite the importance of self-care in improving the health status of patients with cardiovascular disease, such as those undergoing angioplasty, these patients do not impleself-care optimally. This study aimed to identify factors affecting self-care behaviors in cardiac patients undergoing angioplasty based on a health-promotion model. Methods: A cross-sectional study was conducted among 200 cardiovascular patients undergoing angioplasty referred to the Bushehr Health Center. Health-promotion-model constructs and self-care behaviors were assessed by a researcher-made questionnaire. Data were analyzed by SPSS version 22 using multiple linear regression analyses.Results: Stepwise regression revealed that three variables &ndash; perceived barriers, perceived self-efficacy, and social support &ndash; were significant predictors of self-care behaviors among patients undergoing angioplasty. These factors accounted for 43.1% (R2=0.431) of variance in self-care. Among the health-promotion-model constructs, self-efficacy (&beta;=0.237, P&lt;0.001) was the strongest predictor of self-care behaviors, followed by perceived barriers (&beta;=-0.195, P&lt;0.001) and perceived social support (&beta;=0.13, P&lt;0.001). Perceived benefits did not significantly predict self-care behaviors.Conclusion: According to the results of this study, it is suggested that designing and implementing training programs to improve self-efficacy and perceived social support of cardiovascular patients and also decreasing barriers to self-care may improve self-care behaviors among patients undergoing angioplasty. Keywords: self-care adherence, health-promotion model, coronary angioplast

The effect of web-based educational intervention on physical activity-related energy expenditure among middle-aged women with overweight and obesity: An application of social cognitive theory

Introduction: Obesity and being overweight are serious health problems worldwide. One of the most effective strategies for controlling and treating obesity is physical activity (PA), which unfortunately is not performed desirably by people. The present study aims to determine the effectiveness of web-based educational intervention based on social cognitive theory (SCT) on physical activity-related energy expenditure among women with overweight and obesity. Methods: This quasi-experimental study was conducted on 91 middle-aged women with overweight and obesity (47 in the intervention and 44 in the control group). The intervention group received theory-based training through the web. Data were collected by a questionnaire consisting of demographic, SCT constructs and a seven-day standard PA inventory in three stages (before, two-weeks and three-months after training). Data were analyzed by SPSS software v.22. Results: After intervention, the differences between the two groups in terms of SCT constructs were statistically significant as follows: knowledge (P = 0.012), self-regulation (P = 0.001), self-efficacy (P = 0.013), social-support from friends (P = 0.002) and family (P = 0.001) except for the outcome-expectation (P = 0.663). The level of energy expenditure from PA in the intervention group had a significant increase during the study (P = 0.005), while the control group was significantly decreased (P = 0.024). Conclusion: The findings of this study showed the effectiveness of the web and theory-based intervention in increasing awareness, promoting the major constructs of SCT and, finally, improving the PA behavior in women with overweight and obesity. The experience of this study showed that e-learning could be welcomed by these people and encouraged them to engage in PA

Determination of health belief model structures and health-promoting nutritional behaviors in prevention of cardiovascular disease

Cardiovascular diseases are the main cause of death and disabilities in the world. The purpose of the present study is to determine Health Belief Model structures and Health-Promoting nutritional behaviors In Prevention of cardiovascular disease. Methods: This study was a descriptive-analytic survey in 2010. A total number of 68 housewives were recruited in this study using a randomly sampling method. Data were collected using a self-made questionnaire and FFQ. Obtained data analyzed by SPSS16 software in two categories of descriptive and inferential statistics. Results: Results indicated that the scores of HBM structures were low. Also Mean consumption of fruits in housewives was 130/24±57/72 and Mean consumption of vegetables in housewives was 220/73±112/85. There was a significant relation between all the HBM structures and consumption of fruit and vegetables (p&lt;0.001). Conclusion: It seems necessary; using interventional and educational approaches appropriate for target group features can help us take effective steps towards health promotion and Prevention of cardiovascular disease