1,721,266 research outputs found
Advancing knowledge of self-care instruments
No full textThere is growing interest in self-care including those theory-based research instruments designed to measure self-care, such as the Self-Care of Heart Failure Index (SCHFI),1 the Self-Care of Chronic Illness Inventory (SC-CII),2 the Self-Care of Diabetes Inventory (SCODI),3 and the Self-Care of Chronic Obstructive Pulmonary Disease Inventory (SC-COPDI).4 All these instruments, and others available on the website https://self-care-measures.com, are based on the Middle-Range Theory of Self-Care of Chronic Illness,5 which provides a theoretical basis on which to develop and validate the self-care instruments of chronic diseases. These self-care instruments have been translated in several languages and their psychometric properties have been assessed in several studies. Among them we can cite the recent article by Bugajski and colleagues (2021)6 that evaluated the validity and reliability of the SC-COPDI in a U.S. sample of people with chronic obstructive pulmonary disease. In spite of the theoretical basis and other examples of psychometric evaluation available in the published literature, it is still common to see publications in which the reliability and validity of self-care instruments were assessed using outdated methods and techniques. For this reason. we want to provide some recommendations on how best to perform the psychometric analysis of the self-care instruments derived from the Middle-Range Theory of Self-care of Chronic illness. We believe that well-conducted validation study will help to advance knowledge of self-care and the self-care instruments used to study self-care. The self-care instruments are important in both research and clinical practice as they can help to identify people at risk of poor self-care who would benefit from specific educational interventions to increase their self-care and improve their clinical outcomes and quality of lif
Generalizability of the self-care of diabetes inventory across cultures and languages: Italy and the United States
No full textMeasuring self-care behaviors is crucial in diabetes research worldwide. Having a common measure of self-care represents an unmet need limiting the development of the science. The Self-Care of Diabetes Inventory was developed to address limitations of previous tools that were not theoretically grounded, strong in psychometrics, and clinically validated. However, the generalizability and comparability of the Self-Care of Diabetes Inventory has not been tested across cultures and languages. The aim of this study was to test the invariance of the Self-Care of Diabetes Inventory measurement model between Italy and the United States. Data from two multicenter cross-sectional studies were used. Two diabetes clinics and two hospitals in Italy and the United States were involved. We enrolled 200 adults in Italy and 226 in the United States, all with a confirmed diagnosis of type 1 or type 2 diabetes. The Self-Care of Diabetes Inventory was used to measure self-care maintenance, monitoring, and management behaviors as described in the middle range theory of self-care of chronic illness. Configural, metric, scalar, and strict invariance were tested for each scale. Three of the four measurement equivalence levels were supported in the three Self-Care of Diabetes Inventory Scales, whereas strict invariance—the highest level—was reached only by the Self-Care Maintenance and Self-Care Monitoring Scales. Clear support for the use of the Self-Care of Diabetes Inventory in diabetes research was provided. Cross-national comparisons of self-care between groups of Italian and U.S. patients are supported, based on the invariance of the measurement model. Aggregation of research data obtained using the Self-Care of Diabetes Inventory across countries could support knowledge development in the field of diabetes self-care
Abstract 13276: Dyad Gender and Relationship Quality Are Related to Heart Failure Self-care Maintenance. Circulation. 2020;142(Supp. 3): A13276-A13276
No full textMeasures of self-care in heart failure: Issues with factorial structure and reliability
No full textBackground: Lay caregivers are important in contributing to self-care of patients with heart failure (HF). The Caregiver Contributions to Self-Care of Heart Failure Index (CC-SCHFI) measures these contributions, but after developing the Situation-Specific Theory of Caregiver Contributions to Heart Failure Self-Care, the CC-SCHFI needed updating to reflect the theory.
Objective: The aim of this study was to test the psychometric characteristics of the CC-SCHFI 2 that measures caregiver contributions (CC) to HF self-care with 3 scales: CC to self-care maintenance, CC to symptom perception, and CC to self-care management.
Methods: This is a cross-sectional study. We tested the CC-SCHFI 2 with confirmatory factor analysis, internal consistency, item-total correlations, and test-retest reliability. With the CC-SCHFI 2, we also administered the Self-Care of Heart Failure Index v.7.2 to patients and the Caregiver Contribution to Heart Failure Self-Care Scale to caregivers to assess concurrent validity.
Results: A sample of 277 caregivers was enrolled (mean [SD] age, 52.7 [14.9] years; 70.4% female). In confirmatory factor analysis, each CC-SCHFI 2 scale had supportive fit indices: comparative fit index ranged between 0.94 and 0.95, and root mean square error of approximation ranged between 0.05 and 0.07. Internal consistency of the 3 scales was evident with a Cronbach α between .81 and .83 and a global reliability index between 0.79 and 0.86. Item-total correlations were all greater than 0.30. In concurrent validity testing, there were significant correlations between the CC-SCHFI 2 and the Self-Care of Heart Failure Index v.7.2 and the Caregiver Contribution to Heart Failure Self-Care Scale. Test-retest reliability showed intraclass correlation coefficients between 0.72 and 0.91.
Conclusions: Testing of the CC-SCHFI 2 supported validity and reliability, indicating that the instrument can be used in clinical practice and research to evaluate CC to the self-care of patients with HF
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Self-care confidence totally mediates the influence of simple attention and working memory on self-care in adults with heart failure
No full textSelf-Care Confidence Mediates the Relationship Between Cognition and Self-Care Behaviors in Adults With Heart Failure
No full textBackground: Confidence in the ability to perform self-care is a powerful predictor of behavior. Little is known about factors associated with HF self-care confidence. We hypothesized that subtle levels of cognitive impairment decrease self-care confidence and thereby impair HF self-care. The aim was to test the mediating role of self-care confidence in the relationship between cognition and self-care behaviors.
Methods: A descriptive study was conducted with a convenience sample of 628 patients with a confirmed diagnosis of chronic HF. Participants were selected from 24 cardiovascular centers across Italy if they were >18 years old and stable for the past 3 months. Self-care maintenance, management and confidence were measured with the Self-Care of Heart Failure Index (SCHFI v.6.2) (0-100, higher score=better self-care). Cognition was measured with the Mini Mental State Examination (MMSE, 0-30, higher score=better cognition). Structural equation modeling was used to test the mediating role of self-care confidence in the relationship between cognition and self-care maintenance and management.
Results: Participants were mean age 73 years (SD 11), 58% male, 77% NYHA class II/III, mean ejection fraction 43%. Self-care was poor (mean score range 53 to 55). Mean MMSE was 23 (SD 6.3) or slightly impaired. The specified model fit adequately: {chi}2(1) = 1.825, p=.18; CFI=1.00; TLI=.99; RMSEA=.036 (CI=.000 - .120), p=.47; SRMR=.012. Self-care confidence totally mediated the relationship between MMSE and self-care maintenance and partially mediated the relationship between MMSE and self-care management even though management was explained mostly by confidence and not MMSE (Figure).
Conclusion: One mechanism by which cognition influences self-care appears to be through its effect on self-care confidence. Interventions aimed at improving self-care confidence may be useful in improving HF self-care behaviors in patients with mild cognitive impairment
Patient-, caregiver-, and relationship-level characteristics influence heart failure self-care maintenance behaviors in patient-caregiver dyads
No full textIntroduction. Many heart failure (HF) patients rely on informal caregivers to assist them with self-care maintenance behaviors that are essential to maintaining clinical stability. However, few studies examining maintenance utilize a dyadic approach that controls for statistical interdependence between patients and caregivers.
Hypothesis. Patient-, caregiver-, and relationship-level characteristics influence maintenance behaviors.
Methods. This was a secondary analysis of cross-sectional data from an Italian convenience sample of community-dwelling HF patients and their caregivers. Patient and caregiver contributions to HF self-care maintenance were measured using parallel versions of the Self-Care of Heart Failure Index. Patient health status, impairment in activities of daily living (ADL), cognition, and HF-specific quality-of-life (QOL) were measured using the SF-12, Barthel Index, Mini-Mental State Exam, and Minnesota Living with HF Questionnaire, respectively. Clinical HF data (duration and hospitalization numbers) were abstracted from the medical record. Caregiver social support was measured with the Carers of Older People in Europe Index. A single item measure was used to assess dyad relationship quality. Data were analyzed using multilevel modeling (MLM), controlling for dyadic interdependence and common confounders.
Results. The average age of the sample (n=364 dyads) was 76.3±10.8 for patients and 57.7±14.6 for caregivers. Most patients were male (57.3%) with NYHA Class II/III HF (72.2%). Most caregivers were female (51.7%) and adult children (53.6%) or spouses (34.0%). Patient and caregiver maintenance were highly correlated (r=0.70), with significant variability across dyads. Patient cognition (β=0.29±0.14, p<0.05), less ADL impairment (β=0.13±0.05, p<0.01), worse physical health (β=-0.28±0.10, p<0.01), longer HF duration (β=0.03±0.02, p<0.05), worse HF emotional QOL (β = 0.47±0.21, p<0.05), number of hospitalizations (β=-1.86±0.89, p<0.05), caregiver gender (female β=3.06±1.4, p<0.05), higher social support (β=0.77±0.31, p<0.05), and better dyad relationship quality (β=2.0±0.75, p<0.05) were significant determinants of patient self-care maintenance. Only longer HF duration (β=0.05±0.02, p<0.01) and worse patient HF emotional QOL (β=1.03±0.23, p<0.001) were significant determinants of caregiver contributions to maintenance.
Conclusions. In this analysis of HF patient-caregiver dyads, a combination of patient, caregiver, and dyadic characteristics predicted patient self-care maintenance, while only patient characteristics predicted caregiver contributions to maintenance. This innovative analytic approach provides a robust means to examine the complexity and interdependent nature of dyadic care relationships that influence self-care
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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