A Pilot Test for Implementing Precision Healthcare Programme in Patients with Diabetes in Indonesia

Background/Aim: An evaluation of precision healthcare interventions among patients with diabetes in a small sample through a pilot test before being tested in a larger sample is needed. Thus, the purpose of this study was to evaluate the feasibility of a precision healthcare program. It also assesses the program's outcome among patients with diabetes in Indonesia. Methods: Data were collected during December 2020. The researchers first gathered data about participant characteristics. Furthermore, the strategies of precision healthcare were implemented in sixty respondents to evaluate the feasibility and outcome of the program in a month. Results: The participants mention that they can follow all procedures of precision healthcare. However, they asked the researcher to provide a guide and monitoring book which provides safe choices information on diet, exercise, glucose monitoring and drug medication. Moreover, participants mentioned that they could complete all questionnaires but needed a company of a research assistant. The benefits of a month of precision healthcare were improved diabetes self-care activity, blood pressure and blood glucose level. However, the body weight, body mass index (BMI), triglyceride, cholesterol and triglyceride glucose index were not significantly improved. Conclusion: A pilot test is needed to ensure the feasibility of the implementation strategy with the culture and background of diabetic patients in Indonesia. Improving diabetes self-care activity stabilised blood pressure and blood glucose during a month, so it can be assumed that precision healthcare approaches were potentially being applied in Indonesia. On the other hand, it is needed more than a month to improve body weight, body mass index (BMI), triglyceride, cholesterol and triglyceride glucose index. Thus, testing the precision healthcare approach in a larger sample with long time series for patients with diabetes in Indonesia through a randomised controlled trial (RCT) is needed

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Rapid Screening of Psychological Well-Being of Patients with Chronic Illness: Reliability and Validity Test on WHO-5 and PHQ-9 Scales

This study intended to test the reliability and validity of two simple psychological screening scales, the World Health Organization Well-being Index (WHO-5) and the 9-item Patient Health Questionnaire (PHQ-9), in patients with chronic illness in Taiwan and to understand the psychological well-being of patients with chronic illness (e.g., metabolic syndrome) in Taiwan and the incidences of psychological problems that follow. The research design of this study was a descriptive cross-sectional study. The sample comprised 310 patients with metabolic syndrome (MS), aged 20 years or more, from the outpatient clinic of a municipal hospital in Taiwan. This study used questionnaires to collect basic information, including physiological indices, WHO-5 and PHQ-9 that were used. “Hospital Anxiety and Depression scale (HADS),” and “World Health Organization Quality of Life—Short-form Version for Taiwan (WHOQOL)”. Results are as follows: (1) compared to PHQ-9, the reliability and validity of WHO-5 are better for screening the psychological well-being of patients with chronic illness. (2) The features of WHO-5 are high sensitivity, briefness, and ease-of-use. The incidence of depression in patients with metabolic syndrome was approximately 1.0–6.5%, which is significantly lower than that of western countries

Prediction of Self-Care Behavior on the Basis of Knowledge about Chronic Kidney Disease Using Self-Efficacy as a mediator

[[abstract]]Aims and objectives This study was to investigate: (1) the important factors in the self-care of chronic kidney disease (CKD) patients and (2) the mediating effects of self-efficacy on knowledge and self-care. Background Chronic kidney disease has become a major global health issue and is one of the top 10 leading causes of death in Taiwan where the dialysis population ranks first in the world. The number of patients with poor self-care behaviours continues to rise despite ongoing health education. Knowledge and self-efficacy are important factors that influence self-care behaviour; however, very few articles have examined the relationships among them. Design Cross-sectional and correlational design. Methods Subject recruitment was conducted by purposive sampling in the renal outpatient clinics and dialysis centres of two teaching hospitals in northern Taiwan. A total of 247 patients with chronic kidney disease (stages 1–5) were enrolled. Results (1) Knowledge was positively correlated with self-efficacy (r = 0·41, p < 0·01) and with self-care (r = 0·18, p < 0·01). Self-efficacy (r = 0·44, p < 0·01) as well as age (r = 0·15, p < 0·01) were positively correlated with self-care. (2) The relationship between knowledge and self-care was fully mediated by self-efficacy (z = 4·82, p < 0·001) and the effect was 50%. Conclusion The results showed that self-efficacy was a crucial mediator between knowledge and self-care. In addition to providing knowledge to chronic kidney disease patients, healthcare professionals should also offer strategies that can enhance self-efficacy to increase self-care behaviours in chronic kidney disease patients and implement effective disease management. Relevance to clinical practice Incorporate self-efficacy strategies into the process of health education to improve knowledge and the effectiveness of self-care. The findings of this study provide evidence of effectiveness of the use of group activity through self-management and self-efficacy enhancement programmes and may influence the policy makers to consider adding or modifying the reimbursement criteria

Rapid Screening of Psychological Well-being of Patients with Chronic Illness: Reliability and Validity Test on WHO-5 and PHQ-9 scales

[[abstract]]This study intended to test the reliability and validity of two simple psychological screening scales, the World Health Organization Well-being Index (WHO-5) and the 9-item Patient Health Questionnaire (PHQ-9), in patients with chronic illness in Taiwan and to understand the psychological well-being of patients with chronic illness (e.g., metabolic syndrome) in Taiwan and the incidences of psychological problems that follow. The research design of this study was a descriptive cross-sectional study. The sample comprised 310 patients with metabolic syndrome (MS), aged 20 years or more, from the outpatient clinic of a municipal hospital in Taiwan. This study used questionnaires to collect basic information, including physiological indices, WHO-5 and PHQ-9 that were used. “Hospital Anxiety and Depression scale (HADS),” and “World Health Organization Quality of Life—Short-form Version for Taiwan (WHOQOL)”. Results are as follows: (1) compared to PHQ-9, the reliability and validity of WHO-5 are better for screening the psychological well-being of patients with chronic illness. (2) The features of WHO-5 are high sensitivity, briefness, and ease-of-use. The incidence of depression in patients with metabolic syndrome was approximately 1.0–6.5%, which is significantly lower than that of western countries

Correlations among social support, depression and anxiety in patients withtype 2 diabetes

[[abstract]]Background: Social support is related to patient self-care and health status. Patients’ psychosocial issues play an important role in diabetes care. Purpose: This study investigates correlations among social support, depression, and anxiety in patients with diabetes. Methods: A cross-sectional study design and purposive sampling were used. One hundred eleven patients with type-2 diabetes were recruited from three regional teaching hospitals in northern, central, and southern Taiwan, respectively. Questionnaires used included the social support and psychological referral inventory, Beck depression inventory, and Beck anxiety inventory. Results: Approximately 12.6% of the study population had depression, and 27.0% had anxiety. Depression and anxiety were positively correlated (r = .65, p < .01), whereas depression was negatively correlated with the sum of disease control types (r = −0.26, p < .01) and social support (r = −0.27, p <.01). The sum of disease control types and social support were the most important explanatory factors for depression in patients, explaining 45.5% of variance. Anxiety was correlated positively with age (r = .26, p < .01), total number of complications (r = .31, p < .01), and depression (r = .65, p < .01). Anxiety correlated negatively with weight (r = −0.20, p < .05) and sum of disease control types (r = −0.25, p < .05). The above variables were important explanatory factors for anxiety, accounting for 15.2% of variance. Conclusions/Implications for Practice: Psychological factors, such as depression and anxiety, are common symptoms in patients with diabetes. If social support can be strengthened in these patients, then psychological factors can be improved. Professional care providers should focus on reducing the patient depression and anxiety levels, strengthening social support, and providing referrals to psychology-related professionals

Self-efficacy, professional commitment, and job satisfaction of diabetic medical care personnel.

[[abstract]]The purpose of this study was to investigate the relationships among the self-efficacy, professional commitment, and job satisfaction of diabetic health-care personnel. The research design was cross-sectional. Three teaching hospitals, one from each of northern, middle and southern parts of Taiwan, were selected for data collection and used questionnaires to collect data; 202 participants were recruited. The demographic data for job title and job satisfaction were not significantly different (F = 2.13, P = 0.090). Self-efficacy was significantly positively correlated with professional commitment (r = 0.29, P = 0.000) and with job satisfaction (r = 0.14, P = 0.041). A total of 34.1% of the variance in job satisfaction was explained by age, years of service in the medical or nursing field, the actual number of years caring for patients with diabetes, self-efficacy, and professional commitment. Understanding the self-efficacy and professional commitment of medical and nursing personnel can help increase job satisfaction and improve the quality of medical and nursing care

Self-efficacy, self-care behavior, anxiety, and depression in Taiwanese with type 2 diabetes: A cross-sectional survey

[[abstract]]The relationships between self-efficacy, self-care behavior, anxiety, and depression for Taiwanese individuals with type 2 diabetes were determined in this study. Depression and anxiety are common symptoms that can contribute toward adverse medical outcomes. A descriptive, cross-sectional, correlational design was used. The sample comprised 201 patients with type 2 diabetes from diabetes outpatient clinics at three teaching hospitals in Taiwan. The results of this study revealed that people with diabetes who had received diabetes health education, regularly made clinical visits, underwent treatment, and did not smoke demonstrated a high self-efficacy score (P < 0.05). Self-efficacy among people with diabetes positively correlated with illness duration (P < 0.05), treatment (P < 0.01), and self-care behavior (P < 0.01). Self-efficacy among people with diabetes negatively correlated with anxiety and depression (P < 0.01). Self-efficacy can be a predictor of anxiety and depression (P < 0.01). This study revealed that enhancing self-efficacy levels might reduce anxiety and depression. Self-efficacy-enhancing programs should be held regularly in clinical practices. Conducting psychological research on diabetes drives policy and healthcare system change

Relationships among depression, anxiety, self-care behavior, and diabetes education difficulties in patients with type 2 diabetes: A cross-sectional questionnaire survey.

[[abstract]]Background Since psychosocial issues appear to be common among people with diabetes, addressing these problems may improve outcomes. Specifically, it is important to understand the factors associated with anxiety and depression in patients with diabetes. Objective The purpose of this study was to investigate the relationships between self-care behaviour, diabetes education difficulties, depression and anxiety among patients with type-2 diabetes in Taiwan. Design This study was cross-sectional and consisted of descriptive statistics and correlations in terms of analyses. Setting Three teaching hospitals, one from each of the northern, middle and southern parts of Taiwan, were selected for data collection. Participant A total of 312 patients diagnosed with type-2 diabetes were recruited to participate in this study. The inclusion criteria of the study subjects included a diagnosis of type-2 diabetes beyond the age of 18 years and the ability to communicate in Mandarin. Methods Various questionnaires were used to assess demographic, disease characteristics, self-care behaviour, diabetes education difficulty, depression and anxiety data. Results (1) Rates of disturbance for depression (10.6%) and anxiety (20.5%) among type-2 diabetes patients were lower than those in Western countries. (2) Anxiety was positively correlated with age (r = 0.15, p < 0.01), complications (r = 0.27, p < 0.01), diabetes education difficulty (r = 0.39, p < 0.01) and depression (r = 0.54, p < 0.01), but negatively correlated with body mass index (BMI) (r = 0.20, p < 0.01). (3) A total of 50.5% of variance in anxiety was explained by age, complications, BMI, diabetes education difficulty and depression. (4) A total of 42.8% of variance in depression was explained by BMI, diabetes education difficulty and anxiety. Conclusion Depression and anxiety are common among patients with diabetes and can have significant effects on the outcome of their medical illness. Addressing psychosocial factors of people with diabetes may improve effects of patient education and disease self-management

The efficacy of a selfmanagement program for people with diabetes, after a special training program for healthcare workers in Taiwan: A quasi-experimental design

[[abstract]]Aims and objectivies To analyse the efficacy of improving disease management after implementing a self-management programme for people with type 2 diabetes administered by healthcare workers who have received special training. Background The needs for diabetic care include increased training for healthcare providers to enhance their confidence and skills in managing patients, both physically and mentally. Design Quasi-experimental design. Methods This study recruited participants from outpatient clinics in 10 hospitals in Taiwan. In 2010, purposive sampling was used to recruit 228 participants from two medical centres, five regional hospitals and three district hospitals. Participants were enrolled in a ‘diabetes self-management programme’ (watching patient videos, reading a diabetes self-care handbook, participating in four consultation courses of diabetes self-efficacy improvement, telephone follow-up and positive reinforcement). Efficacy analysis of post-test diabetes outcome variables of the experimental group was carried out. Sex, age and pretest score were used as the control variables for ancova test. Results Patients in the experimental group had significant improvement in body mass index (p < 0·01), waistline circumference (p < 0·001), haemoglobin A1C levels (p < 0·001), degrees of anxiety and depression (p < 0·001), self-efficacy (p < 0·001) and levels of self-care (p < 0·001). Conclusion Self-efficacy of people with diabetes can be effectively improved by planned implementation of a ‘diabetes self-management programme’ by trained healthcare workers. Relevance to clinical practice The diabetes care professionals are provided the self-management programme to strengthen the awareness and importance of self-management in diabetes care