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- De Maria, Maddalena, et al.
(author)
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Cross-cultural assessment of the Self-Care of Chronic Illness Inventory : A psychometric evaluation
- 2021
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In: International Journal of Nursing Studies. - : PERGAMON-ELSEVIER SCIENCE LTD. - 0020-7489 .- 1873-491X. ; 116
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Journal article (peer-reviewed)abstract
- Background: Self-care refers to behaviors that individuals adopt to prevent or maintain the stability of an illness (self-care maintenance), to monitor signs and symptoms (self-care monitoring), and to respond to signs and symptoms of an illness exacerbation (self-care management). A generic measure of self-care, the Self-Care of Chronic Illness Inventory, based on the Theory of Self-Care of Chronic Illness, was developed for use in individuals with any number and type of chronic conditions. Objective: The current study investigated the measurement equivalence of the Self-Care of Chronic Illness Inventory in individuals from three different cultural groups. We were interested in determining if Italians, Swedes, and Americans interpret the measure in a conceptually similar way. Methods: This cross-sectional study enrolled 1629 patients, 784 recruited in Italy, 438 in Sweden and 407 in the United States. Self-care (self-care maintenance, self-care monitoring and self-care management) was measured with the Self-Care of Chronic Illness Inventory. A multi-group confirmatory factor analytic approach was used to assess the equivalence of the measures across the three countries. Configural, metric, scalar and strict invariance were tested through a series of nested models where increasingly stringent equality constraints were posited. Results: Participants were mostly males (56.3%), older adults (69.8%) and had at least two chronic conditions. Results indicated that three out of four measurement equivalence levels were partially or totally supported in all three of the Self-Care of Chronic Illness Inventory scales. The partial scalar invariance level was reached for self-care maintenance [chi(2)(50)=63.495, p = 0.095; RMSEA =0.022, p = 0.999, 90% CI= 0.000 0.038; CFI =0.981; TLI =0.977; SRMR =0.036], self-care monitoring [chi(2) (22)=28.770, p = 0.095; RMSEA = 0.024, p = 0.978, 90% CI =0.000 0.046; CFI= 0.996; TLI=0.995; SRMR= 0.054], and self-care management [chi(2) (51)=91.334, p = 0.001; RMSEA =0.048, p = 0.576, 90% CI =0.031 0.063; CFI = 0.949; TLI= 0.937; SRMR = 0.047 ] scales. Conclusions: These findings suggest that patients in the three countries used an identical cognitive framework or mental model when responding and used the 1-5 Likert response scale in an almost identical way, almost without bias. In spite of sociocultural differences, patients in these countries seem to share the same fundamental view of self-care. The results of the Self-Care of Chronic Illness Inventory will be comparable in these countries. (C) 2019 Elsevier Ltd. All rights reserved.
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| 2. |
- Forde, Rita, et al.
(author)
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The Impact of the COVID-19 pandemic on people with diabetes and diabetes services : A pan-European survey of diabetes specialist nurses undertaken by the Foundation of European Nurses in Diabetes survey consortium
- 2021
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In: Diabetic Medicine. - : Wiley. - 0742-3071 .- 1464-5491. ; 38:5
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Journal article (peer-reviewed)abstract
- AIM: To describe diabetes nurses' perspectives on the impact of the COVID-19 pandemic on people with diabetes and diabetes services across Europe.METHODS: An online survey developed using a rapid Delphi method. The survey was translated into 17 different languages and disseminated electronically in 27 countries via national diabetes nurse networks.RESULTS: Survey responses from 1829 diabetes nurses were included in the analysis. The responses indicated that 28% (n=504) and 48% (n=873) of diabetes nurses felt the COVID-19 pandemic had impacted 'a lot' on the physical and psychological risks of people with diabetes, respectively. The following clinical problems were identified as having increased 'a lot': anxiety 82% (n=1486); diabetes distress 65% (n=1189); depression 49% (n= 893); acute hyperglycaemia 39% (n=710); and foot complications 17% (n=323). Forty-seven percent (n=771) of respondents identified that the level of care provided to people with diabetes had declined either extremely or quite severely. Self-management support, diabetes education and psychological support were rated by diabetes nurse respondents as having declined extremely or quite severely during the COVID-19 pandemic by 31% (n=499), 63% (n=1,027) and 34% (n=551), respectively.CONCLUSION: The findings show that diabetes nurses across Europe have seen significant increases in both physical and psychological problems in their patient populations during COVID-19. The data also show that clinical diabetes services have been significantly disrupted. As the COVID-19 situation continues we need to adapt care systems with some urgency to minimise the impact of the pandemic on the diabetes population.
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| 3. |
- Riegel, Barbara, et al.
(author)
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Symptom Recognition as a Mediator in the Self-Care of Chronic Illness
- 2022
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In: Frontiers In Public Health. - : FRONTIERS MEDIA SA. - 2296-2565. ; 10
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Journal article (peer-reviewed)abstract
- BackgroundThe recognition of a symptom is needed to initiate a decision to engage in a behavior to ameliorate the symptom. Yet, a surprising number of individuals fail to detect symptoms and delay in addressing early warnings of a health problem. PurposeThe aim of this study was to test the hypothesis that symptom recognition mediates the relationship between monitoring for and management of symptoms of a chronic illness. MethodsA secondary analysis of existing cross-sectional data. A sample of 1,629 patients diagnosed with one or more chronic conditions was enrolled in the United States (US) (n = 407), Italy (n = 784) and Sweden (n = 438) between March 2015 and May 2019. Data on self-care monitoring, symptom recognition, and self-care management was assessed using the Self-Care of Chronic Illness Inventory. After confirming metric invariance in cultural assessment, we used structural equation modeling to test a mediation model where symptom recognition was conceptualized as the mediator linking self-care monitoring and self-care management with autonomous (e.g., Change your activity level) and consulting behaviors (e.g., Call your healthcare provider for guidance). ResultsSymptom recognition mediated the relation between self-care monitoring and autonomous self-care management behaviors (beta = 0.098, beta = 0.122, beta = 0.081, p < 0.001 for US, Italy, and Sweden, respectively). No mediation effect was found for consulting self-care management behaviors. ConclusionOur findings suggests that symptom recognition promotes autonomous self-care behaviors in people with a chronic condition. Self-care monitoring directly affects consulting self-care management behaviors but not through symptom recognition. Further research is needed to fully understand the role of symptom recognition in the self-care process.
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