Review: Self-management Support Program on Dietary Behaviors in Patients with Type 2 Diabetes Mellitus

Background: Dietary behaviors are the cornerstone in diabetes management. Diabetes self-management support program in which patients play an active role to determine their health care is an important strategy to improve dietary behaviors in type 2 diabetes mellitus (T2DM) patients. Its elements which contribute to the successfulness of the program need to be identified.Purpose: To review and identify the elements of self-management support program to improve dietary behaviors in T2DM patients.Method: An integrative review was conducted. Relevant studies published in English language during last 10-year, measured dietary behaviors in T2DM patients, and retrieved from CINAHL and PubMed were included.Results: 13 experimental studies and 3 meta-analysis studies were reviewed. Goal setting and action planning combined with other strategies (brief counseling and problem solving) seemed more effective to improve dietary behaviors. Either trained lay people or clinicians could lead the program although clinician-led programs were common. Contents and materials of the education vary across the studies. The effects on dietary behaviors could be detected in short term duration of program (<6 months). Continuing follow-up was essential element which face-to-face follow-up as the most common strategy. The utilization of technology such as telephone-call and internet based follow-up might provide more benefits for patients.Conclusion: Diabetes self-management support program is effective to improve dietary behaviors in T2DM patients. Further research is needed to test the effectiveness of goal setting strategy and technology utilization for follow-up strategy such telephone call in Indonesian T2DM population

Cardiac Rehabilitation on Health Behaviors and Clinical Outcomes Among Myocardial Infarction Patients

The lack of adherence to health behaviors in cardiac rehabilitation (CR) is the leading cause of recurrent myocardial infarction (MI) in Indonesia. This randomized control trial (RCT) study was conducted to examine the effect of a family based self-efficacy enhancing cardiac rehabilitation program on self-efficacy in cardiac health behaviors, health behaviors, and clinical outcomes among MI patients in Indonesia. Sixty MI patients who met the inclusion criteria were randomized by the modified stratified-block method and assigned into either the control group or the experimental group. The patients in the experimental group received the program during phase I over two days and continued to phase II of CR with weekly follow-up sessions. Patients were asked to complete the Self-Efficacy in Cardiac Health Behaviors Scale (SECHBS) and the Modified Myocardial Infarction Health Behaviors Questionnaire (Modified MIHBQ). The results revealed that self-efficacy, health behaviors, and clinical outcomes such as fasting blood glucose, total cholesterol, LDL, triglyceride, and BMI of the patients after receiving the intervention were significantly better than before receiving the intervention, except for blood pressure, and HDL levels. Self-efficacy, health behaviors, and clinical outcomes such as total cholesterol, LDL, and triglyceride were significantly better in patients in the experimental group than those in the control group (p &lt; .05), except for blood pressure, HDL, BMI, and blood glucose levels (p &gt; .05). In conclusion, the family based self-efficacy enhancing cardiac rehabilitation program shows evidence of effectiveness in enhancing self-efficacy, health behaviors, and some clinical outcomes in MI patients

Correlation Between Coping Strategies and Quality of Life Among Myocardial Infarction Patients in Nepal

Objective: To examine the correlation between coping strategies and quality of life (QoL) among patients with myocardial infarction (MI) Method: A descriptive correlational design was used to examine the relationship between coping strategies and QoL among 88 patients with MI who were older than 18 years, 2 months after the initial diagnosis of MI. QoL was assessed using the cardiac version of the Quality of Life Index. Coping strategy was assessed using Jalowiec Coping Scale. Problem-focused coping and emotion-focused coping were also compared in male and female patients.Results: Problem-focused coping was significantly positively associated with overall QoL (r = .41, p = <.01), particularly the health and functioning dimension (rs = .39, p = <.01) and socio-economic dimension (rs = .46, p = <.01) but not with psychological & spiritual and family dimension. Men used more problem-focused coping strategies than women. The problem-focused coping score was significantly different between men and women (t = 4.9, p <.05).Conclusion: The results revealed that patients who used more of problem-focused coping had better QoL than patients who used less problem-focused coping. Educating patients to enhance the use of appropriate coping strategies may be useful to promote the QoL of Nepalese patients with MI

Dietary Behaviors Among Patients with Type 2 Diabetes Mellitus in YOGYAKARTA, Indonesia

Purpose: To describe dietary behaviors and examine relationships between selected factors and dietary behaviors among type 2 diabetes mellitus (T2DM) patients in Yogyakarta, Indonesia.Method: Seventy T2DM patients from a hospital in Yogyakarta who met the inclusion criteria were recruited. Patient\u27s dietary behaviors were measured by the Dietary Behaviors Questionnaire developed for this study with adequate reliability. The questionnaire comprised of four dimensions: recognizing the amount of calorie needs, selecting healthy diet, arranging a meal plan, and managing dietary behaviors challenges. Higher scores indicate better dietary behaviors.Result: More than half of the patients were women (54.3%) with an average age of 56.8 years and diabetes duration of 9.7 years. The results revealed a moderate level of the total score of dietary behaviors. Considering each dimension, the results showed a moderate level of recognizing the amount of calorie needs, selecting healthy diet, and managing dietary behaviors challenges. The patients reported a high level of arranging meal plans. Pearson\u27s correlation was used to examine the relationships between selected factors and dietary behaviors. There was a positive significant relationship between the knowledge regarding diabetic diet and the total dietary behaviors scores (r = .36, p< .01). There were positive significant relationships between the knowledge regarding diabetic diet and the dimensions of recognizing the amount of calorie needs (r = .27, p< .05), selecting healthy diet (r = .35, p< .01), and managing dietary behaviors challenges (r = .28, p< .05). In contrast, the findings indicated no significant relationship between knowledge regarding diabetic diet and arranging a meal plan dimension. Furthermore, there was no significant relationship between the diabetes duration and dietary behaviors.Conclusion: Dietary behaviors among T2DM patients in Yogyakarta were at a moderate level. Knowledge regarding diabetic diet is essential. Further study regarding intervention in increasing patients\u27 knowledge is needed to achieve better dietary behaviors

Development of Family-Based Dietary Self-Management Support Program on Dietary Behaviors in Patients with Type 2 Diabetes Mellitus in Indonesia: a Literature Review

Background: WHO statistics show that Indonesia has the fourth highest number of diabetes sufferers. The International Diabetes Federation‟s 5th estimated that in 2011 there were 71.4 million people in South East Asia region were suffering with DM Purpose: To develop a family-based dietary self-management support program to improve dietary behaviors in patients with T2DM. Method: A literature review was conducted by reviewing articles related evidence-based practices. Only articles in the English and Indonesian languages were reviewed. The search found eleven published experimental studies related to the topic. Result: Even though dietary self-management has benefits for patients with diabetes, many studies have found that these patients often have difficulty in establishing or maintaining an effective program to self-manage their dietary behaviors. Lack of family support is one factor that often seems to be related to such failures. Family participation in a diabetes education program also had positive psychosocial impacts. Otherwise, another study found that family might not always have a positive impact on self-management. Therefore, this review recommends that development of a family-based support program could be a positive factor in helping to improve dietary self-management behaviors in patients with T2DM. Self-management theory by Funnell and Anderson‟s work (2004) can guide the development of a program with the goal of empowering individuals and families in improving the patient‟s dietary behaviors. The program consists of: (1) reflecting on current and/or past self-management experiences by listening to the patient about their dietary behaviors, (2) discussing the emotions and feelings of the patients, (3) engaging the patient in improving their situation by active listening and helping the patient reflect on their problems and identifying effective strategies, (4) providing information about dietary management and problem-solving strategies, and (5) goal-setting and action planning by assisting the patient to write the goals and action plan on a specially prepared form. All of these sessions would involve the patient‟s family. Follow-up visits may be needed to evaluate the dietary behaviors of patients. Conclusion: The collaboration of patients, family and health care professionals can have a positive impact on the dietary self-management behaviors of patients with T2DM. Further study is needed, as there is a growing awareness of the important role in diabetes management of integrating family support into routine diabetes management

The Effect of Dietary and Exercise Self-Management Support Program on Dietary Behavior Exercise Behavior and Clinical Outcomes in Muslim Patients with Poorly Controlled Type 2 DM in a Community Setting in Indonesia

Purpose: The objective of this study was to examine the effect of dietary and exercise self-management support program on the dietary behavior, exercise behavior, and clinical outcomes of Muslim patients with poorly controlled type 2 DM in Indonesia. Methods: This study was a quasi-experimental, two group, pre-test and post-test design. The experimental group received the dietary and exercise self-management support program and usual care, whereas the control group only received the usual nursing care.Result: 35 subjects in the experimental group and 35 subjects in the control group completed the program, respectively. The findings indicated that there are significantly differences in dietary behavior (p=.00), exercise behavior (p=.00) and clinical outcomes: fasting blood glucose (FBG) (p=.00), cholesterol total level (p=.01) and systolic blood pressure (p=.00) between the experimental group and control group. However, for the BMI status (p=.84) and diastolic blood pressure (BP) (p=.32) were no significant differences between two groups. Conclusion: The dietary and exercise self-management support program was effective for improving the dietary behavior, exercise behavior, FBG, and total cholesterol level for individuals with poorly controlled type 2 diabetes mellitus. Further studies should be replicated using larger groups over a longer time frame

Surgery for Acute Stroke: Current Status

Although investigations regarding surgery for acute ischemic stroke span 4 decades, the topic remains controversial. This review considers emergency carotid surgery for acute stroke from four perspectives: an operation attempting to reverse an acute neurological deficit, an operation soon after acute stroke to prevent further neurologic deficit, reoperative surgery for acute neurological deficit early after carotid endarterectomy (CEA), and management of severe carotid stenosis after successful thrombolytic therapy for acute ischemic stroke. The available clinical data are absent or incomplete for each of these unusual aspects of carotid surgery. In the absence of a badly needed ran domized trial, case selection is important and should be accompanied by a proven record of successful, low-morbidity, elective carotid surgery before undertaking more controversial indications. Delaying CEA for 4 to 6 weeks after stroke has repeatedly been shown to be unnecessary and to increase risk of interval new stroke. Finally, the impact of new thrombolytic treatment upon reoperative surgery for complications of CEA and for planning semielective reconstructive surgery needs to be considered.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68503/2/10.1177_153100359901000111.pd

Illness Perception And Cardiovascular Health Behaviors In Persons With Ischemic Heart Disease: A Literature Review

This article explores illness perception and cardiovascular health behaviors in persons with ischemic heart disease. The article also reviews the concept of ischemic heart disease. A literature review was conducted by analyzing 35 scholar papers including research articles, theses/dissertations, and books which met the inclusion criteria’s. Data were searched through CINAHL, Medline, PubMed, Springer-link. Science Direct, and Wiley & Wilkins. The keywords used were illness perception, behaviors, health behaviors, cardiovascular health behaviors, combined with, ischemic heart disease. The result of analysis presents factors related to illness perception and cardiovascular health behaviors. The nursing scholars noted that one of the factors related to cardiovascular health behaviors is illness perception. Illness Perception and cardiovascular health behaviors can be used as a framework of nursing to develop a new model to improve quality care for patients, families, community even among nursing colleagues

Illness Perception Among Patients With Hypertension in Nepal

Illness perception among hypertensive patients influences their coping behavior. The aim of the study was to assess illness perception among patients with hypertensive in Nepal. A descriptive cross-sectional study design was employed. We recruited 85 patients with hypertension registered at the out- patient department of Sahid Gangalal National Heart Centre, Nepal and collected data using the Extended Brief Illness Perception Questionnaire. Hypertensive patients had a moderate threatening view about their illness. Patients represented hypertension as a long-lasting illness that can be controlled with treatment. Patients believed hypertension might have serious consequences associated with heart attack, brain hemorrhage, paralysis of body and death. The overriding causes of hypertension as perceived by patients were unhealthy diet and stress. Patients favored taking medicines than lifestyle modifications for controlling their blood pressure. These illness perceptions of patients were influenced by the experiences and information inherent in Nepalese culture. Assessing illness perception helps to understand hypertensive patients’ implicit views regarding their illness and contributes to their better management. The findings can be used as baseline information to understand illness perception among patients with hypertension in Nepalese community and further develop an intervention

Self-Efficacy to Perform Activities of Daily Living Predicts Independence in Activities of Daily Living in Subacute Stroke Patients

This study was purposed to investigate the characteristics of self-efficacy to perform activities of daily living (ADL), characteristics of independence in ADL, and correlation between self-efficacy to perform activities of daily living (ADL) and independence in ADL in subacute stroke patients. The study was a descriptive correlation design. Forty- eight participants were recruited with mean age 57.23 (7.80) years, mean days of stroke onset 6.06 (5.00) days, who diagnosed with ischemic stroke. Modified Stroke Self-Efficacy Questionnaire (MSSEQ) measured self-efficacy to perform ADL and Functional Assessment Measure (FIM+FAM) measured independence in ADL. The influencing variables of participant such as age, gender, BI Score, side stroke and participant knowledge were not significantly correlated to self- efficacy to perform ADL and independence in ADL. The mean score of self-efficacy to perform ADL was at a moderate level (67.7%) and the mean score of independence in ADL was at a moderate dependence (50.5%). A positive and significant modified correlations were found between self-efficacy to perform ADL and independence in ADL (r = .30, p = .05). Self- efficacy to perform ADL predicted 7% of the variance in the independence in ADL. This finding indicates higher self- efficacy to perform ADL of subacute stroke patients contributes to more independence in ADL. The description of initial level of self-efficacy to perform ADL in early phase rehabilitation following stroke as a reference to design continuous intervention to enhance self-efficacy and functional independence for stroke patients