Editorial

3 pages, 198 KiB

Open AccessEditorial

Personalized Nursing and Health Care: Advancing Positive Patient Outcomes in Complex and Multilevel Care Environments

by Riitta Suhonen, Minna Stolt and David Edvardsson

J. Pers. Med. 2022, 12(11), 1801; https://doi.org/10.3390/jpm12111801 - 01 Nov 2022

Cited by 2 | Viewed by 1465

This Special Issue of the Journal of Personalised Medicine invited manuscripts that further establish the current state of science relating to personalized nursing and health care [...] Full article

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Research

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16 pages, 645 KiB

Open AccessArticle

Women’s Experiences with Compliance with Pelvic Floor Home Exercise Therapy and Lifestyle Changes for Pelvic Organ Prolapse Symptoms: A Qualitative Study

by María Torres-Lacomba, Beatriz Navarro-Brazález, María José Yuste-Sánchez, Beatriz Sánchez-Sánchez, Virginia Prieto-Gómez and Fernando Vergara-Pérez

J. Pers. Med. 2022, 12(3), 498; https://doi.org/10.3390/jpm12030498 - 19 Mar 2022

Cited by 6 | Viewed by 3224

Abstract

In this study, we aimed to investigate women’s experiences with compliance with prescribed pelvic floor muscle exercises (PFMEs) and lifestyle changes 6–12 months after completing an individual pelvic floor physiotherapy program. This study was targeted to understanding factors affecting adherence to PFMEs and [...] Read more.

In this study, we aimed to investigate women’s experiences with compliance with prescribed pelvic floor muscle exercises (PFMEs) and lifestyle changes 6–12 months after completing an individual pelvic floor physiotherapy program. This study was targeted to understanding factors affecting adherence to PFMEs and lifestyle changes to deal with pelvic organ prolapse (POP) symptoms. We designed this research as a descriptive qualitative study. We conducted this study from December 2016 to September 2017 in Madrid, Spain. Twenty-six women with symptomatic POP selected using a purposive sampling method participated in six focus groups and three one-to-one semi-structured interviews. Three authors coded and inductively analyzed transcript contents with iterative theme development. A thematic analysis revealed three main themes: (1) symptoms change; (2) PFMEs and lifestyle changes performance; and (3) a health practitioner–patient relationship. Women identified as adherent reported improvement in physical symptoms and emotional and general state as a result of the new knowledge achieved. Fear also promoted compliance with performing PFMEs and adopting lifestyle changes. Likewise, PFMEs preference and routine, integration of PFMEs and lifestyle changes into activities of daily living, support guides, therapeutic alliance, individual supervision, follow-up, and feedback were also identified as adherence facilitators. One of the biggest barriers that we identified was responsibility. Compliance with prescribed PFMEs and lifestyle changes can be improved with effective individual, women-centered, and supervised physiotherapy programs reducing symptoms, including exercises aligned with women’s preferences that are easy to integrate in daily living, promoting knowledge and awareness of their condition, providing written or electronic guidelines, with routine follow-up visits offering both positive feedback and clear and consistent messages, and enhancing therapeutic alliance. Full article

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10 pages, 371 KiB

Open AccessArticle

Extracting New Temporal Features to Improve the Interpretability of Undiagnosed Type 2 Diabetes Mellitus Prediction Models

by Simon Kocbek, Primož Kocbek, Lucija Gosak, Nino Fijačko and Gregor Štiglic

J. Pers. Med. 2022, 12(3), 368; https://doi.org/10.3390/jpm12030368 - 28 Feb 2022

Cited by 6 | Viewed by 2037

Abstract

Type 2 diabetes mellitus (T2DM) often results in high morbidity and mortality. In addition, T2DM presents a substantial financial burden for individuals and their families, health systems, and societies. According to studies and reports, globally, the incidence and prevalence of T2DM are increasing [...] Read more.

Type 2 diabetes mellitus (T2DM) often results in high morbidity and mortality. In addition, T2DM presents a substantial financial burden for individuals and their families, health systems, and societies. According to studies and reports, globally, the incidence and prevalence of T2DM are increasing rapidly. Several models have been built to predict T2DM onset in the future or detect undiagnosed T2DM in patients. Additional to the performance of such models, their interpretability is crucial for health experts, especially in personalized clinical prediction models. Data collected over 42 months from health check-up examinations and prescribed drugs data repositories of four primary healthcare providers were used in this study. We propose a framework consisting of LogicRegression based feature extraction and Least Absolute Shrinkage and Selection operator based prediction modeling for undiagnosed T2DM prediction. Performance of the models was measured using Area under the ROC curve (AUC) with corresponding confidence intervals. Results show that using LogicRegression based feature extraction resulted in simpler models, which are easier for healthcare experts to interpret, especially in cases with many binary features. Models developed using the proposed framework resulted in an AUC of 0.818 (95% Confidence Interval (CI): 0.812−0.823) that was comparable to more complex models (i.e., models with a larger number of features), where all features were included in prediction model development with the AUC of 0.816 (95% CI: 0.810−0.822). However, the difference in the number of used features was significant. This study proposes a framework for building interpretable models in healthcare that can contribute to higher trust in prediction models from healthcare experts. Full article

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12 pages, 277 KiB

Open AccessArticle

What Influences Women to Adhere to Pelvic Floor Exercises after Physiotherapy Treatment? A Qualitative Study for Individualized Pelvic Health Care

by Beatriz Navarro-Brazález, Fernando Vergara-Pérez, Virginia Prieto-Gómez, Beatriz Sánchez-Sánchez, María José Yuste-Sánchez and María Torres-Lacomba

J. Pers. Med. 2021, 11(12), 1368; https://doi.org/10.3390/jpm11121368 - 14 Dec 2021

Cited by 12 | Viewed by 4123

Abstract

Conservative treatment of pelvic floor dysfunction (PFD) includes therapeutic exercise for pelvic floor muscle (PFM) training or other complementary exercise modalities, such as hypopressive exercises. However, the long-term effectiveness of the conservative treatment depends on a patient’s adherence to the exercises and the [...] Read more.

Conservative treatment of pelvic floor dysfunction (PFD) includes therapeutic exercise for pelvic floor muscle (PFM) training or other complementary exercise modalities, such as hypopressive exercises. However, the long-term effectiveness of the conservative treatment depends on a patient’s adherence to the exercises and the integration of professional health advice into their daily life. The objective of this study was to establish the adherence experience of women with diagnosed PFD in home-based exercises after an intensive face-to-face physiotherapy treatment. A qualitative study from an interpretive paradigm was developed. Semi-structured individual and group interviews were performed 6 months after finishing individual physiotherapy treatment. The interviews were recorded, fully transcribed and analyzed thematically by creating categories. Thirty-one women were interviewed. The women reported that their adherence to home PFM exercises depended on the exercise program itself, its efficacy, their personal experiences with the exercises, intrinsic factors such as self-awareness or beliefs, and extrinsic factors, such as professional or instrumental feedback. Thus, therapeutic adherence could be more likely with effective physiotherapy programs that include mutually agreed home exercises and simple movements women can build into their daily lives. Improving awareness and knowledge of the pelvic region and the importance of PFM treatment as well as consideration for potential worsening of PFD will also encourage women to adhere to the exercises. Full article

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12 pages, 1488 KiB

Open AccessArticle

Functional Profile of Older Adults Hospitalized in Convalescence Units of the National Network of Integrated Continuous Care of Portugal: A Longitudinal Study

by Ana Ramos, César Fonseca, Lara Pinho, Manuel Lopes, Henrique Oliveira and Adriana Henriques

J. Pers. Med. 2021, 11(12), 1350; https://doi.org/10.3390/jpm11121350 - 11 Dec 2021

Cited by 5 | Viewed by 1969

Abstract

Aim: To evaluate the evolution of the functional profile of older adults admitted to a health unit in Portugal; to relate the functional profile of these individuals with age, sex, education level and emotional state; and to evaluate the probability of the degree [...] Read more.

Aim: To evaluate the evolution of the functional profile of older adults admitted to a health unit in Portugal; to relate the functional profile of these individuals with age, sex, education level and emotional state; and to evaluate the probability of the degree of dependence as a function of age and sex. Methods: longitudinal, retrospective study with a sample of 59,013 older adults admitted to convalescence units of the National Network of Integrated Continuous Care of Portugal. Results: In the first 75 days of hospitalization, activities of daily living, mobility and cognitive state improved, but there was a decline after 75 days of hospitalization. The ability to perform instrumental activities of daily living improved in the first 15 days of hospitalization, stabilized until 45 days and then began to worsen. Women had a higher probability of having a severe/complete dependence three years earlier than men (88 years to 91 years). A higher education level and stable emotional state were protective factors against functional decline. Conclusions: The functional profile of older adults improved during the length of stay recommended for hospitalization in convalescence units (30 days). It is critical for health systems to adopt strategies to prevent declines in the emotional state of frail individuals. Full article

(This article belongs to the Special Issue Personalized Nursing and Health Care)

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11 pages, 1499 KiB

Open AccessFeature PaperArticle

Exploring the Social Networks of Women Bereaved by Stillbirth: A Descriptive Qualitative Study

by Tosin Popoola, Joan Skinner and Martin Woods

J. Pers. Med. 2021, 11(11), 1056; https://doi.org/10.3390/jpm11111056 - 21 Oct 2021

Cited by 4 | Viewed by 2358

Abstract

The loss of a baby to stillbirth is a traumatic experience and can lead to secondary losses, such as the loss of social relationships. In Nigeria, stillbirths are a common public health problem. However, limited attention has been given to the social ramifications [...] Read more.

The loss of a baby to stillbirth is a traumatic experience and can lead to secondary losses, such as the loss of social relationships. In Nigeria, stillbirths are a common public health problem. However, limited attention has been given to the social ramifications of stillbirths. This study describes the social networks of women who have experienced a stillbirth and the factors influencing their social networks. Interviews and social network diagrams were used to collect data from 20 women about their social networks before and after stillbirth. Findings suggest that the experience of shame, unmet expectation of support, and a lack of trust led to relationship changes after stillbirth. Most participants met bereavement needs with their existing social networks before stillbirth, but many participants also experienced relationship losses (even among family networks). Information from social network analysis can reveal the risks and strengths inherent in social networks, which can be helpful for the provision of tailored/personalized bereavement care. Full article

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13 pages, 288 KiB

Open AccessArticle

Use of Digital Educational Technologies among Nursing Students and Teachers: An Exploratory Study

by Fernanda Loureiro, Luís Sousa and Vanessa Antunes

J. Pers. Med. 2021, 11(10), 1010; https://doi.org/10.3390/jpm11101010 - 08 Oct 2021

Cited by 10 | Viewed by 2766

Abstract

The emergence of digital educational technologies (DET) raises questions regarding the personalization of both teaching and care. DET use implies profound changes with consequences in nursing care and in nursing teaching-learning process. With the purpose of contributing to the improvement of the teaching-learning [...] Read more.

The emergence of digital educational technologies (DET) raises questions regarding the personalization of both teaching and care. DET use implies profound changes with consequences in nursing care and in nursing teaching-learning process. With the purpose of contributing to the improvement of the teaching-learning process through the use of DET, an exploratory-descriptive, cross-sectional, and observational study, with a quantitative approach (descriptive and inferential statistics), was developed. Online questionnaires were applied (n = 140 students and n = 23 teachers) after ethics committee approval. Results point to low cost and access without time/space limits as the main benefits, and decreased interaction, less physical contact, and technical difficulties as constraints. Globally, there was no difference between students and teachers in the use of DET. Still, men report more constraints than women. In this sample, the use of DET is still at an early stage. Both students and teachers are still unfamiliar with the scope and possibilities of these tools, not taking full advantage of the potential they have to offer. The impact of DET used in personalized nursing care is still yet to be understood. Full article

(This article belongs to the Special Issue Personalized Nursing and Health Care)

12 pages, 2583 KiB

Open AccessArticle

The Impact of the COVID-19 Pandemic on Nursing Care: A Cross-Sectional Survey-Based Study

by Marco Clari, Michela Luciani, Alessio Conti, Veronica Sciannameo, Paola Berchialla, Paola Di Giulio, Sara Campagna and Valerio Dimonte

J. Pers. Med. 2021, 11(10), 945; https://doi.org/10.3390/jpm11100945 - 23 Sep 2021

Cited by 20 | Viewed by 3445

Abstract

The COVID-19 pandemic has had a severe impact on nursing care. This cross-sectional survey-based study compared aspects of nursing care and nurses’ satisfaction with care provided before and during the first wave of the COVID-19 pandemic. A total of 936 registered nurses (RNs) [...] Read more.

The COVID-19 pandemic has had a severe impact on nursing care. This cross-sectional survey-based study compared aspects of nursing care and nurses’ satisfaction with care provided before and during the first wave of the COVID-19 pandemic. A total of 936 registered nurses (RNs) rated the frequency with which they performed fundamental care, nursing techniques, patient education, symptom management, and nurse–patient relationships before and during the pandemic. A recursive partitioning for ordered multivariate response in a conditional inference framework approach was applied. More frequent fundamental cares were associated with their frequency before the pandemic (p < 0.001), caring for COVID-19 patients (p < 0.001), and workplace reassignment (p = 0.004). Caring for COVID-19 patients (p < 0.001), workplace reassignment (p = 0.030), and caring for ≤7.4 COVID-19 patients (p = 0.014) increased nursing techniques. RNs in high-intensity COVID-19 units (p = 0.002) who educated patients before the pandemic, stopped this task. RNs caring for COVID-19 patients reported increased symptom management (p < 0.001), as did RNs caring for more non-COVID-19 patients (p = 0.037). Less frequent nurse–patient relationships before the pandemic and working in high-intensity COVID-19 units decreased nurse–patient relationships (p = 0.002). Despite enormous challenges, nurses continued to provide a high level of care. Ensuring the appropriate deployment and education of nurses is crucial to personalize care and to maintain nurses’ satisfaction with the care provided. Full article

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11 pages, 1007 KiB

Open AccessArticle

Kinesio Taping vs. Auricular Acupressure for the Personalised Treatment of Primary Dysmenorrhoea: A Pilot Randomized Controlled Trial

by Elena Mejías-Gil, Elisa María Garrido-Ardila, Jesús Montanero-Fernández, María Jiménez-Palomares, Juan Rodríguez-Mansilla and María Victoria González López-Arza

J. Pers. Med. 2021, 11(8), 809; https://doi.org/10.3390/jpm11080809 - 19 Aug 2021

Cited by 9 | Viewed by 2739

Abstract

Background: Dysmenorrhoea is the medical term for menstrual pain. The World Health Organization estimates that up to 81% of women of childbearing age are affected by this condition, and it is one of the leading causes of absenteeism from work and school among [...] Read more.

Background: Dysmenorrhoea is the medical term for menstrual pain. The World Health Organization estimates that up to 81% of women of childbearing age are affected by this condition, and it is one of the leading causes of absenteeism from work and school among women. Although there are pharmacological treatments available for menstrual-pain relief, they do not respond to all women’s needs. Therefore, there is a need to study and develop non-pharmacological alternatives to broaden the individualised treatment options for dysmenorrhea. There are scarce studies published on non-pharmacological treatments, such as kinesio tape and auricular acupressure for the relief of menstrual pain, but the scientific evidence available suggest that these techniques may be beneficial in addressing this problem. The objective of this pilot study was to assess and compare the effectiveness of kinesio tape and auricular acupressure to decrease pain and drug intake in women with primary dysmenorrhoea. Methods: This was a double-blind randomized clinical controlled trial. The period of study was from September 2017 to August 2018. Women enrolled in the University of Extremadura and who had primary dysmenorrhoea were randomized to five groups: control (n = 23), kinesio tape (n = 23), placebo kinesio tape (n = 23), auricular acupressure (n = 23) and placebo auricular acupressure (n = 22). Measures were taken during the pretreatment phase (at four menstrual cycles), during the post-intervention phase (at four menstrual cycles) and during the follow-up phase (at the first and third menstrual cycles after the treatment was completed). The primary outcome measures were mean pain intensity, maximum pain intensity, number of painful days and dose of drug intake during menstruation, measured with the Visual Analogue Scale. The secondary outcome measures were the length of the cycle, the length of menstruation, the drug intake and the type of drug. Results: In all, 108 participants completed the study. The statistical analysis (MANOVA, ANOVA, t-paired and McNemar tests) showed that kinesio tape and auricular acupressure have a beneficial effect on pain relief (mean pain intensity, p < 0.001; maximum pain intensity, p < 0.001; number of painful days, p = 0.021; dose of drug intake, p < 0.001). In addition, once the treatments were withdrawn, the auricular-acupressure group maintained lower scores during the first follow-up cycle (p < 0.001). Conclusions: Kinesio tape and auricular acupressure decrease pain and drug intake in women with primary dysmenorrhoea. The changes in the auricular-acupressure group seemed to last longer. The results suggest that these techniques could be used as complementary personalised therapies to the pharmacological treatment and not as a substitution. Full article

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11 pages, 592 KiB

Open AccessArticle

Uncovering the Imprints of Chronic Disease on Patients’ Lives and Self-Perceptions

by Cheryl Lin, Rungting Tu, Brooke Bier and Pikuei Tu

J. Pers. Med. 2021, 11(8), 807; https://doi.org/10.3390/jpm11080807 - 18 Aug 2021

Cited by 6 | Viewed by 2635

Abstract

Rheumatoid arthritis (RA) patients face psychological hardship due to physical discomfort, disabilities, and anxieties. Previous research indicated a bidirectional relationship and patient desire for emotional support from providers. This study examined lesser-understood RA experiences across the psychological and social contexts in relation to [...] Read more.

Rheumatoid arthritis (RA) patients face psychological hardship due to physical discomfort, disabilities, and anxieties. Previous research indicated a bidirectional relationship and patient desire for emotional support from providers. This study examined lesser-understood RA experiences across the psychological and social contexts in relation to self-perception through the patients’ expression of their struggles with these burdens. We conducted four semistructured focus groups and eleven interviews (total n = 31). A codebook was developed and refined through iterative transcript coding via NVivo-12. Four emerging themes were identified by inductive, thematic analysis: (1) the patients’ healthy appearances were a myth, with subthemes revealing a conflict between an inclination to hide the disease and a desire for validation, while feeling embarrassed by symptom manifestations and disappointment at withdrawal from social interactions; (2) an identity crisis due to diminished functionality, autonomy, and sense of self; (3) RA constantly occupied the mind, as its unpredictability dictated daily schedules and altered plans; and (4) the disease’s chronic nature influenced personal outlook to worry about or accept the uncertainty. Even with effective treatment, the invisibility of the disease, the fear and anticipation of flare-ups, and identity clashes caused emotional distress. The insights offer a different perspective on personalized medicine, complementing clinical treatments based on genetic or biomarker profile. For patient-centered holistic care, education is needed to prompt both patients and providers to discuss psychological issues for more customized, integrated interventions. The findings can help inform healthcare teams and families in recognizing and supporting these physical-psychological intertwined experiences, thereby ameliorating patients’ wellbeing. Full article

(This article belongs to the Special Issue Personalized Nursing and Health Care)

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14 pages, 276 KiB

Open AccessArticle

Individualized Health Care for Older Diabetes Patients from the Perspective of Health Professionals and Service Consumers

by Birute Bartkeviciute, Vita Lesauskaite and Olga Riklikiene

J. Pers. Med. 2021, 11(7), 608; https://doi.org/10.3390/jpm11070608 - 27 Jun 2021

Cited by 4 | Viewed by 2188

Abstract

Background: Individualized nursing care as a form of person-centered care delivery is a well-known approach in the health care context and is accepted as best practice by organizations and professionals, yet its implementation in everyday practice creates serious challenges. The aim was to [...] Read more.

Background: Individualized nursing care as a form of person-centered care delivery is a well-known approach in the health care context and is accepted as best practice by organizations and professionals, yet its implementation in everyday practice creates serious challenges. The aim was to assess and compare the perceptions of health professionals and older diabetes patients on their individual care in regard to the patient’s clinical situation, personal life situation, and decisional control. Methods: The quantitative study with a cross-sectional survey design was conducted from March 2019 until January 2021. The Individualized Care Scale was applied for the data collection. Health professionals (nurses and physicians, n = 70) and older diabetes patients (n = 145) participated in the study. The average duration of diabetes was 15.8 years (SD = 10.0) and type 2 diabetes was the most common (89.0%). The current glucose-lowering therapy for 51.0% of the patients was oral medications, 37.9% used injected insulin, and 11.1% were treated by combined therapy. Results: The highest-rated aspects of individualized care on both dimensions of the scale from the health professionals’ perspective related to the clinical situation, and the scores for provision were significantly higher than those for support. The highest means of patients’ ratings on the support dimension related to the clinical situation and the decisions over care sub-scale; for the care provision dimension, the highest individuality in care was assigned to the decisions over care sub-scale. The lowest ratings of individualized care, both in the health professionals’ and patients’ samples, related to the personal life situation sub-scale. Conclusions: Health professionals are more positive in regard to individualized care support and provisions for older diabetes patients than the patients themselves. Patient characteristics, such as the type of glucose-lowering therapy, education, and nutritional status, make a difference in patients’ understanding and experience of individuality in care. Full article

(This article belongs to the Special Issue Personalized Nursing and Health Care)

12 pages, 625 KiB

Open AccessArticle

Validation of the Patient-Centred Care Competency Scale Instrument for Finnish Nurses

by Riitta Suhonen, Katja Lahtinen, Minna Stolt, Miko Pasanen and Terhi Lemetti

J. Pers. Med. 2021, 11(6), 583; https://doi.org/10.3390/jpm11060583 - 21 Jun 2021

Cited by 6 | Viewed by 2325

Abstract

Patient-centredness in care is a core healthcare value and an effective healthcare delivery design requiring specific nurse competences. The aim of this study was to assess (1) the reliability, validity, and sensitivity of the Finnish version of the Patient-centred Care Competency (PCC) scale [...] Read more.

Patient-centredness in care is a core healthcare value and an effective healthcare delivery design requiring specific nurse competences. The aim of this study was to assess (1) the reliability, validity, and sensitivity of the Finnish version of the Patient-centred Care Competency (PCC) scale and (2) Finnish nurses’ self-assessed level of patient-centred care competency. The PCC was translated to Finnish (PCC-Fin) before data collection and analyses: descriptive statistics; Cronbach’s alpha coefficients; item analysis; exploratory and confirmatory factor analyses; inter-scale correlational analysis; and sensitivity. Cronbach’s alpha coefficients were acceptable, high for the total scale, and satisfactory for the four sub-scales. Item analysis supported the internal homogeneity of the items-to-total and inter-items within the sub-scales. Explorative factor analysis suggested a three-factor solution, but the confirmatory factor analysis confirmed the four-factor structure (Tucker–Lewis index (TLI) 0.92, goodness-of-fit index (GFI) 0.99, root mean square error of approximation (RMSEA) 0.065, standardized root mean square residual (SRMR) 0.045) with 61.2% explained variance. Analysis of the secondary data detected no differences in nurses’ self-evaluations of contextual competence, so the inter-scale correlations were high. The PCC-Fin was found to be a reliable and valid instrument for the measurement of nurses’ patient-centred care competence. Rasch model analysis would provide some further information about the item level functioning within the instrument. Full article

(This article belongs to the Special Issue Personalized Nursing and Health Care)

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9 pages, 1255 KiB

Open AccessArticle

Effect of a Music Therapy Intervention Using Gerdner and Colleagues’ Protocol for Caregivers and Elderly Patients with Dementia: A Single-Blind Randomized Controlled Study

by Guido Edoardo D’Aniello, Davide Maria Cammisuli, Alice Cattaneo, Gian Mauro Manzoni, Enrico Molinari and Gianluca Castelnuovo

J. Pers. Med. 2021, 11(6), 455; https://doi.org/10.3390/jpm11060455 - 23 May 2021

Cited by 9 | Viewed by 4758

Abstract

Music therapy (MT) is considered one of the complementary strategies to pharmacological treatment for behavioral and psychological symptoms (BPSD) of dementia. However, studies adopting MT protocols tailored for institutionalized people with dementia are limited and their usefulness for supporting caregivers is under investigated [...] Read more.

Music therapy (MT) is considered one of the complementary strategies to pharmacological treatment for behavioral and psychological symptoms (BPSD) of dementia. However, studies adopting MT protocols tailored for institutionalized people with dementia are limited and their usefulness for supporting caregivers is under investigated to date. Our study aimed at evaluating the effects of an MT intervention according to Gerdner and colleagues’ protocol in a sample of 60 elderly people with moderate-to-severe dementia of the Auxologico Institute (Milan, Italy) and associated caregivers, randomly assigned to an Experimental Group (EG) (n = 30) undergoing 30 min of MT two times a week for 8 weeks and to a Control Group (n = 30) (CG) receiving standard care. Before and after the intervention, residents-associated caregivers were administered the Caregiver Burden Inventory (CBI) and the Neuropsychiatric Inventory (NPI). Depression and worry were also assessed in caregivers prior to the intervention, by the Beck Depression Inventory-II and the Penn State Worry Questionnaire, respectively. A mixed model ANCOVA revealed a Time*Group effect (p = 0.006) with regard to CBI decreasing after the intervention for the EG and Time*Group effects (p = 0.001) with regard to NPI_frequencyXseverity and NPI_distress, with a greater effect for the EG than the CG. Implications for MT protocols implementations are discussed. Full article

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9 pages, 237 KiB

Open AccessFeature PaperArticle

Older Adults’ Perceived Barriers to Participation in a Falls Prevention Strategy

by Júlio Belo Fernandes, Sónia Belo Fernandes, Ana Silva Almeida, Diana Alves Vareta and Carol A. Miller

J. Pers. Med. 2021, 11(6), 450; https://doi.org/10.3390/jpm11060450 - 23 May 2021

Cited by 27 | Viewed by 3609

Abstract

There is a need to increase older adults’ access and adherence to falls prevention strategies. This study aims to explore older adults’ perceived barriers to participation in a fall prevention strategy. A qualitative descriptive approach was used. Semi-structured interviews were conducted with 18 [...] Read more.

There is a need to increase older adults’ access and adherence to falls prevention strategies. This study aims to explore older adults’ perceived barriers to participation in a fall prevention strategy. A qualitative descriptive approach was used. Semi-structured interviews were conducted with 18 older adult users of a Day Care Unit from a Private Institution of Social Solidarity in the region of Lisbon and Tagus Valley in Portugal. The recruitment was made in September 2019. The interviews were recorded transcribed verbatim and analysed thematically using the method of constant comparisons. The barriers to participation in a fall prevention strategy are healthcare system gaps, social context, economic context, health status, psychological capability, and lack of knowledge to demystify myths and misconceptions about falls. There are different barriers to participate in a fall prevention strategy. It is urgent to eliminate or reduce the effect of these barriers to increase older adults’ participation in fall prevention strategies. Full article

(This article belongs to the Special Issue Personalized Nursing and Health Care)

15 pages, 250 KiB

Open AccessFeature PaperArticle

Complexity of Nurse Practitioners’ Role in Facilitating a Dignified Death for Long-Term Care Home Residents during the COVID-19 Pandemic

by Shirin Vellani, Veronique Boscart, Astrid Escrig-Pinol, Alexia Cumal, Alexandra Krassikova, Souraya Sidani, Nancy Zheng, Lydia Yeung and Katherine S. McGilton

J. Pers. Med. 2021, 11(5), 433; https://doi.org/10.3390/jpm11050433 - 19 May 2021

Cited by 18 | Viewed by 4368

Abstract

Due to the interplay of multiple complex and interrelated factors, long-term care (LTC) home residents are increasingly vulnerable to sustaining poor outcomes in crisis situations such as the COVID-19 pandemic. While death is considered an unavoidable end for LTC home residents, the importance [...] Read more.

Due to the interplay of multiple complex and interrelated factors, long-term care (LTC) home residents are increasingly vulnerable to sustaining poor outcomes in crisis situations such as the COVID-19 pandemic. While death is considered an unavoidable end for LTC home residents, the importance of facilitating a good death is one of the primary goals of palliative and end-of-life care. Nurse practitioners (NPs) are well-situated to optimize the palliative and end-of-life care needs of LTC home residents. This study explores the role of NPs in facilitating a dignified death for LTC home residents while also facing increased pressures related to the COVID-19 pandemic. The current exploratory qualitative study employed a phenomenological approach. A purposive sample of 14 NPs working in LTC homes was recruited. Data were generated using semi-structured interviews and examined using thematic analysis. Three categories were derived: (a) advance care planning and goals of care discussions; (b) pain and symptom management at the end-of-life; and (c) care after death. The findings suggest that further implementation of the NP role in LTC homes in collaboration with LTC home team and external partners will promote a good death and optimize the experiences of residents and their care partners during the end-of-life journey. Full article

(This article belongs to the Special Issue Personalized Nursing and Health Care)

12 pages, 2909 KiB

Open AccessArticle

The Development of a Personalized Symptom Management Mobile Health Application for Persons Living with HIV in China

by Shuyu Han, Yaolin Pei, Lina Wang, Yan Hu, Xiang Qi, Rui Zhao, Lin Zhang, Wenxiu Sun, Zheng Zhu and Bei Wu

J. Pers. Med. 2021, 11(5), 346; https://doi.org/10.3390/jpm11050346 - 25 Apr 2021

Cited by 8 | Viewed by 2666

Abstract

Persons living with HIV (PLWH) continuously experience symptom burdens. Their symptom prevalence and severity are also quite different. Mobile health (mHealth) applications (apps) offer exceptional opportunities for using personalized interventions when and where PLWH are needed. This study aimed to demonstrate the development [...] Read more.

Persons living with HIV (PLWH) continuously experience symptom burdens. Their symptom prevalence and severity are also quite different. Mobile health (mHealth) applications (apps) offer exceptional opportunities for using personalized interventions when and where PLWH are needed. This study aimed to demonstrate the development process of the symptom management (SM) app and the structure and content of it. Our research team systematically searched for evidence-based resources and summarized up-to-date evidence for symptom management and health education. Our multidisciplinary research team that included physicians, nurses, software engineers, and nursing professors, evaluated the structure and content of the drafted app. Both quantitative data and qualitative results were collected at a group discussion meeting. Quantitative data were scores of sufficient evidence, situational suitability, practicability, cost-effectiveness, and understandability (ranged from one to four) for 119 items of the app contents, including the health tracking module, the self-assessment module, coping strategies for 18 symptoms (80 items), medication management, complementary therapy, diet management, exercise, relaxation techniques, and the obtaining support module. The SM app was comprised of eight modules and provided several personalized symptom management functions, including assessing symptoms and receiving different symptom management strategies, tracking health indicators, and communicating with medical staff. The SM app was a promising and flexible tool for HIV symptom management. It provided PLWH with personalized symptom management strategies and facilitated the case management for medical staff. Future studies are needed to further test the app’s usability among PLWH users and its effects on symptom management. Full article

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14 pages, 605 KiB

Open AccessArticle

Personalized Healthcare: The Importance of Patients’ Rights in Clinical Practice from the Perspective of Nursing Students in Poland, Spain and Slovakia—A Cross-Sectional Study

by Ewa Kupcewicz, Elżbieta Grochans, Helena Kadučáková, Marzena Mikla, Aleksandra Bentkowska, Adam Kupcewicz, Anna Andruszkiewicz and Marcin Jóźwik

J. Pers. Med. 2021, 11(3), 191; https://doi.org/10.3390/jpm11030191 - 11 Mar 2021

Cited by 8 | Viewed by 2134

Abstract

Background: This study aimed to define the role and importance of patients’ rights in personalized healthcare from the perspective of nursing students in Poland, Spain and Slovakia. Methods: The research was carried out by means of a diagnostic survey, using the survey technique, [...] Read more.

Background: This study aimed to define the role and importance of patients’ rights in personalized healthcare from the perspective of nursing students in Poland, Spain and Slovakia. Methods: The research was carried out by means of a diagnostic survey, using the survey technique, with the participation of 1002 nursing students attending a full-time undergraduate study program at three European countries. The “Patients’ rights” questionnaire was used as a research tool. The average age of students was 21.6 years (±3.4). The empirical material collected was subjected to a statistical analysis. Results: The study demonstrated that 72.1% of nursing students from Spain, 51.2% from Poland and 38.5% from Slovakia believe that patients’ rights are respected at a good level in their country. Significant intergroup differences (F = 67.43; p < 0.0001) were observed in the self-assessment of students’ knowledge of patients’ rights. The highest average values were obtained by students from Spain (3.54 ± 0.92), while 35.9% of students from Slovakia and 25.5% from Poland were quite critical and pointed to their low level of knowledge of patients’ rights in their self-assessment. When ranking patients’ rights related to respecting dignity, students from Spain obtained much higher average values (4.37 ± 0.92) than students from the other two countries. Conclusions: The level of students’ knowledge of patients’ rights and the respect for patients’ rights by medical personnel is, in the opinion of the respondents, quite diverse and requires in-depth educational activities among nursing students at the university level in respective countries. Full article

(This article belongs to the Special Issue Personalized Nursing and Health Care)

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16 pages, 1075 KiB

Open AccessArticle

Maternal Psychological and Biological Factors Associated to Gestational Complications

by David Ramiro-Cortijo, Maria de la Calle, Vanesa Benitez, Andrea Gila-Diaz, Bernardo Moreno-Jiménez, Silvia M. Arribas and Eva Garrosa

J. Pers. Med. 2021, 11(3), 183; https://doi.org/10.3390/jpm11030183 - 05 Mar 2021

Cited by 11 | Viewed by 3086

Abstract

Early detection of gestational complications is a priority in obstetrics. In our social context, this is linked to maternity age. Most studies are focused on biological factors. However, pregnancy is also influenced by social and psychological factors, which have not been deeply explored. [...] Read more.

Early detection of gestational complications is a priority in obstetrics. In our social context, this is linked to maternity age. Most studies are focused on biological factors. However, pregnancy is also influenced by social and psychological factors, which have not been deeply explored. We aimed to identify biopsychosocial risk and protective factors associated with the development of maternal and fetal complications. We enrolled 182 healthy pregnant women, and plasma melatonin and cortisol levels were measured in the first trimester by chemiluminescent immunoassays. At different time points along gestation, women answered several questionnaires (positive and negative affect schedule, hospital anxiety and depression scale, pregnancy concerns scale, life orientation test, resilience scale, life satisfaction scale and life–work conflicts scale). They were followed up until delivery and categorized as normal pregnancy, maternal or fetal complications. Maternal complications were associated with low melatonin (OR = 0.99 [0.98; 1.00]; p-value = 0.08) and life satisfaction (OR = 0.64 [0.41; 0.93]; p-value = 0.03) and fetal complications were associated with high cortisol (OR = 1.06 [1.02; 1.13]; p-value = 0.04), anxiety (OR = 2.21 [1.10; 4.55]; p-value = 0.03) and life–work conflicts (OR = 1.92 [1.04; 3.75]; p-value = 0.05). We conclude that psychological factors influence pregnancy outcomes in association with melatonin and cortisol alterations. High maternal melatonin and life satisfaction levels could be potential protective factors against the development of maternal complications during pregnancy. Low anxiety and cortisol levels and reduced work–life conflicts could prevent fetal complications. Full article

(This article belongs to the Special Issue Personalized Nursing and Health Care)

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Review

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17 pages, 794 KiB

Open AccessReview

How to Measure Foot Self-Care? A Methodological Review of Instruments

by Jenni Sipilä, Anne-Marie Mäkelä, Sasu Hyytiä and Minna Stolt

J. Pers. Med. 2023, 13(3), 434; https://doi.org/10.3390/jpm13030434 - 28 Feb 2023

Viewed by 1852

Abstract

Foot self-care is an important element of caring for and promoting foot health. However, little is known about the validity and reliability of existing foot self-care instruments. The purpose of this review is to describe and analyze the focus, content, and psychometric evidence [...] Read more.

Foot self-care is an important element of caring for and promoting foot health. However, little is known about the validity and reliability of existing foot self-care instruments. The purpose of this review is to describe and analyze the focus, content, and psychometric evidence of existing instruments for measuring foot self-care. A methodological review of three international scientific databases—Medline (PubMed), CINAHL (Ebsco), and Embase—was conducted in May 2022. The search produced 3520 hits, of which 53 studies were included in the final analysis based on a two-phase selection process. A total of 31 instruments were identified, of which six were observed to have been used more than once. Subsequently, the methodological quality of these six instruments was evaluated. It is noted that although a considerable variety of instruments are used in measuring foot self-care, only a small proportion are used consistently. In general, the psychometric testing instruments seem to primarily focus on analyzing content validity and homogeneity. In the future, comprehensive testing of instrument psychometrics could enhance the cumulative evidence of the methodological quality of these instruments. Furthermore, researchers and clinicians can use the information in this review to make informed choices when selecting an instrument for their purposes. Full article

(This article belongs to the Special Issue Personalized Nursing and Health Care)

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16 pages, 758 KiB

Open AccessFeature PaperReview

Moving towards Integrated and Personalized Care in Parkinson’s Disease: A Framework Proposal for Training Parkinson Nurses

by Marlena van Munster, Johanne Stümpel, Franziska Thieken, David J. Pedrosa, Angelo Antonini, Diane Côté, Margherita Fabbri, Joaquim J. Ferreira, Evžen Růžička, David Grimes and Tiago A. Mestre

J. Pers. Med. 2021, 11(7), 623; https://doi.org/10.3390/jpm11070623 - 30 Jun 2021

Cited by 18 | Viewed by 4552

Abstract

Delivering healthcare to people living with Parkinson’s disease (PD) may be challenging in face of differentiated care needs during a PD journey and a growing complexity. In this regard, integrative care models may foster flexible solutions on patients’ care needs whereas Parkinson Nurses [...] Read more.

Delivering healthcare to people living with Parkinson’s disease (PD) may be challenging in face of differentiated care needs during a PD journey and a growing complexity. In this regard, integrative care models may foster flexible solutions on patients’ care needs whereas Parkinson Nurses (PN) may be pivotal facilitators. However, at present hardly any training opportunities tailored to the care priorities of PD-patients are to be found for nurses. Following a conceptual approach, this article aims at setting a framework for training PN by reviewing existing literature on care priorities for PD. As a result, six prerequisites were formulated concerning a framework for training PN. The proposed training framework consist of three modules covering topics of PD: (i) comprehensive care, (ii) self-management support and (iii) health coaching. A fourth module on telemedicine may be added if applicable. The framework streamlines important theoretical concepts of professional PD management and may enable the development of novel, personalized care approaches. Full article

(This article belongs to the Special Issue Personalized Nursing and Health Care)

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