Jaap van der Bijl

Self-efficacy and its influence on recovery of patients with stroke : a systematic review

AIMS To provide an overview of the literature focusing on the influence of self-efficacy and self-efficacy enhancing interventions on mobility, activities of daily living, depression and quality of life of patients with stroke. BACKGROUND There is growing evidence for the importance of self-efficacy in the care of people with enduring illness. Therefore, it is important to describe the association of self-efficacy and patient outcomes and the evidence for the effects of self-efficacy interventions for stroke patients. DATA SOURCES Studies were retrieved from a systematic search of published studies over the period of 1996-2009, indexed in the Cumulative Index to Nursing and Allied Health Literature, Medline, Psychinfo and Embase and focusing on stroke, the influence of self-efficacy and self-efficacy enhancing interventions. METHODS A systematic review was carried out. Studies were critically appraised and important characteristics and outcomes were extracted and summarized. RESULTS Seventeen articles were included in the review. Self-efficacy was positively associated with mobility, activities of daily living and quality of life and negatively associated with depression. Four self-efficacy interventions were identified. The evidence for the effects of these interventions was inconclusive. CONCLUSIONS Patients with high self-efficacy are functioning better in daily activities than patients with low self-efficacy. The evidence concerning the determinants influencing self-efficacy and the self-efficacy interventions makes clear how nurses can develop and tailor self-efficacy interventions for the clinical practice of people with stroke. Therefore, it is necessary to further emphasize the role of self-efficacy in the care for stroke patients in the nursing curriculum.

Self-Monitoring of Blood Glucose Professional Advice and Daily Practice of Patients With Diabetes

Purpose This study investigated the advice given by diabetes educators in Europe, and the daily practice of Dutch patients with diabetes regarding the use of the first or second drop of blood and other aspects concerning self-monitoring of blood glucose (SMBG). Method During a diabetes conference in 2009, 96 European diabetes educators (including 46 Dutch educators) completed a single-item questionnaire about the use of the first or second drop of blood for glucose monitoring. A self-reported questionnaire with 20 questions about performing SMBG was filled out by 111 patients from an outpatient diabetes clinic of a Dutch hospital. Results Patients were advised to wash their hands with water and soap and use the first drop of blood by 89% of the Dutch and 72% of other European diabetes educators, while 58% of the patients reported to do this. When the patient cannot wash the hands, 85% of the Dutch and 52% of the other European educators advised to use the second drop of blood, while 26% of the patients reported always using the first drop without washing hands. Always using the side of the fingertip and using the lancet once, as advised in guidelines, was reported by only 41% and 55% of the patients, respectively. Conclusions There is no general agreement between professionals regarding the advice on aspects concerning SMBG. Patients also reported different acts in daily practice. Developing uniform international SMBG guidelines, education, and repeated evaluation of the process of collecting an accurate blood sample are needed.

SELF‐EFFICACY AND LONG‐TERM MEDICATION USE IN PATIENTS WITH CHRONIC KIDNEY DISEASE

BACKGROUND Long-term medication use in patients with chronic kidney disease is necessary to prevent further kidney damage. Medication adherence is positively influenced by high self-efficacy ratings. AIM To determine if by discussing self-efficacy scores, leads to higher self-efficacy scores, regarding long-term medication use by patients with chronic kidney disease. METHOD A total of 54 patients, randomised to a control or intervention group, rated their self-efficacy using the Long-Term Medication Behaviour Self-Efficacy Scale (LTMBSES). Their scores were only discussed in the intervention group. Self-efficacy enhancing interventions were used to influence self-efficacy scores. RESULTS The intervention group had significant higher self-efficacy scores at posttest (p = 0.013). Transplantation had no effect on the mean self-efficacy. Patients ≤ 55 years had significant higher self-efficacy scores than patients > 55 years (p = 0.015). CONCLUSIONS Discussing self-efficacy scores can lead to increased self-efficacy scores in patients with chronic kidney disease.

Systematic review of self-management in patients with schizophrenia: psychometric assessment of tools, levels of self-management and associated factors.

AIMS The aim of this study was to provide an overview of existing knowledge about self-management assessment tools used in patients with schizophrenia, and levels of self-management and associated factors in these patients. BACKGROUND Self-management empowers patients with chronic conditions to manage their illness and psychosocial consequences. With respect to patients with schizophrenia, knowledge concerning self-management is scarce. A systematic review of existing literature focusing on self-management in these patients may contribute to further research programming and practice development. DESIGN A systematic review of the literature. DATA SOURCES A systematic literature search was conducted in March 2015 in Medline, Embase, PsycINFO and CINAHL. REVIEW METHODS Twelve articles were included. Data were extracted and categorized following the objectives of this review: (1) self-management assessment tools and their psychometric properties; (2) level of self-management; and (3) factors associated with self-management in patients with schizophrenia. RESULTS The PIH scale, the PAM-MH and the IMR scale were used to assess self-management. The overall psychometric quality of these instruments showed to be fair to poor. The level of self-management in patients with schizophrenia is comparable with other mental health conditions, higher than general population and lower than patients with physical health conditions. Several factors (e.g. sense of coherence, recovery and hope) were found to be associated. CONCLUSION Further efforts are needed to increase the methodological quality of psychometric research on self-management assessment tools. More insight in the level of self-management and associated factors may enhance the development of future interventions.

Psychometric Properties of the Diabetes Management Self-Efficacy Scale in Korean Patients with Type 2 Diabetes

Objectives. The aims of this study were to perform a cultural translation of the DMSES and evaluate the psychometric properties of the translated scale in a Korean population with type 2 diabetics. Methods. This study was conducted in patients with diabetes recruited from university hospitals. The first stage of this study involved translating the DMSES into Korean using a forward- and backward-translation technique. The content validity was assessed by an expert group. In the second stage, the psychometric properties of the Korean version of the DMSES (K-DMSES) were evaluated. Results. The content validity of the K-DMSES was satisfactory. Sixteen-items clustered into four-subscales were extracted by exploratory factor analysis, and supported by confirmatory factor analysis. The construct validity of the K-DMSES with the Summary of Diabetes Self-Care Activities scale was satisfactory (r = 0.50, P<0.001). The Cronbachs alpha and intraclass correlation coefficient were 0.92 and 0.85 (P<0.001; 95% CI = 0.75–0.91), respectively, which indicate excellent internal consistency reliability and test-retest reliability. Conclusions. The K-DMSES is a brief instrument that has demonstrated good psychometric properties. It is therefore feasible to use in practice, and is ready for use in clinical research involving Korean patients with type 2 diabetes.

Improving communication and practical skills in working with inpatients who self-harm: a pre- test/post-test study of the effects of a training programme

BackgroundDiffering perspectives of self-harm may result in a struggle between patients and treatment staff. As a consequence, both sides have difficulty communicating effectively about the underlying problems and feelings surrounding self-harm. Between 2009 and 2011, a programme was developed and implemented to train mental health care staff (nurses, social workers, psychologists, psychiatrists, and occupational therapists) in how to communicate effectively with and care for patients who self-harm. An art exhibition focusing on self-harm supported the programme. Lay experts in self-harm, i.e. people who currently harm themselves, or who have harmed themselves in the past and have the skills to disseminate their knowledge and experience, played an important role throughout the programme.MethodsPaired sample t-tests were conducted to measure the effects of the training programme using the Attitude Towards Deliberate Self-Harm Questionnaire, the Self-Perceived Efficacy in Dealing with Self-Harm Questionnaire, and the Patient Contact Questionnaire. Effect sizes were calculated using r. Participants evaluated the training programme with the help of a survey. The questionnaires used in the survey were analysed descriptively.ResultsOf the 281 persons who followed the training programme, 178 completed the questionnaires. The results show a significant increase in the total scores of the three questionnaires, with large to moderate effect sizes. Respondents were positive about the training, especially about the role of the lay expert.ConclusionA specialised training programme in how to care for patients who self-harm can result in a more positive attitude towards self-harm patients, an improved self-efficacy in caring for patients who self-harm, and a greater closeness with the patients. The deployment of lay experts is essential here.

Adaptation and validation of the Diabetes Management Self-Efficacy Scale to Brazilian Portuguese

Objective: to perform the cultural adaptation and validation of the Diabetes Management Self-efficacy Scale for Patients with Type 2 Diabetes Mellitus with a Brazilian population sample. Method: cross-sectional methodological study in which the adaptation and validation process included the stages recommended in the literature. Construct validity and reliability were assessed with 200 adults with type 2 diabetes mellitus. Results: the items indicated by the panel of judges and by the target population were adjusted in the cultural adaptation to improve clarity and understanding. The instruments four factors remained in the confirmatory factor analysis with factor loadings of items greater than 0.30, except for factor 4; convergent validity, verified by the multitrait-multimethod analysis, presented inter-item correlations from 0.37 to 0.92, while for discriminant validity, 100% of the items presented greater correlation in their own factors. Cronbachs coefficient alpha for the total scale was 0.78, ranging from 0.57 to 0.86 among factors. Conclusion: semantic, cultural, conceptual and idiomatic equivalences were achieved and the instruments Brazilian version also presented psychometric properties that showed evidence of reliability and validity. Thus, it can be applied both in clinical practice and research. Self-efficacy is useful for planning and assessing educational interventions, as well as predicting behavior modification in self-care.Objetivo: realizar la adaptacion cultural y validacion de la Diabetes Management Self-efficacy Scale for Patients with Type 2 Diabetes Mellitus en una muestra poblacional brasilena. Metodo: estudio metodologico transversal, cuyo proceso de adaptacion y validacion incluyo las etapas preconizadas por la literatura. La validez de constructo y la confiabilidad fueron evaluadas en 200 adultos con diabetes mellitus tipo 2. Resultados: para mayor clareza y comprension, en la adaptacion cultural fueron ajustados los items indicados por el Comite de Jueces y por la poblacion objetivo. En el analisis factorial confirmatorio se mantuvieron los cuatro factores, con cargas factoriales de los items superiores a 0,30, excepto para el factor 4; el analisis multirrasgo y multimetodo mostro para la validez convergente, correlaciones entre items de 0,37 a 0,92, y en el caso del discriminante que 100% de los items obtuvieron mayor valor de correlacion en su propio factor. El coeficiente alfa de Cronbach para la escala total fue de 0,78, con variacion de 0,57 a 0,86 entre los factores. Conclusion: las equivalencias semantica, cultural, conceptual e idiomatica fueron mantenidas; las propiedades psicometricas mostraron evidencias de confiabilidad y de validez en la version brasilena del instrumento; por tanto, la adaptacion podra tener aplicacion en la clinica e investigaciones. La autoeficacia es util para planificar y evaluar intervenciones educativas y predecir cambios comportamentales para el cuidado.

Adaptación y validación de la Diabetes Management Self-efficacy Scale para el idioma portugués de Brasil

Objective: to perform the cultural adaptation and validation of the Diabetes Management Self-efficacy Scale for Patients with Type 2 Diabetes Mellitus with a Brazilian population sample. Method: cross-sectional methodological study in which the adaptation and validation process included the stages recommended in the literature. Construct validity and reliability were assessed with 200 adults with type 2 diabetes mellitus. Results: the items indicated by the panel of judges and by the target population were adjusted in the cultural adaptation to improve clarity and understanding. The instruments four factors remained in the confirmatory factor analysis with factor loadings of items greater than 0.30, except for factor 4; convergent validity, verified by the multitrait-multimethod analysis, presented inter-item correlations from 0.37 to 0.92, while for discriminant validity, 100% of the items presented greater correlation in their own factors. Cronbachs coefficient alpha for the total scale was 0.78, ranging from 0.57 to 0.86 among factors. Conclusion: semantic, cultural, conceptual and idiomatic equivalences were achieved and the instruments Brazilian version also presented psychometric properties that showed evidence of reliability and validity. Thus, it can be applied both in clinical practice and research. Self-efficacy is useful for planning and assessing educational interventions, as well as predicting behavior modification in self-care.Objetivo: realizar la adaptacion cultural y validacion de la Diabetes Management Self-efficacy Scale for Patients with Type 2 Diabetes Mellitus en una muestra poblacional brasilena. Metodo: estudio metodologico transversal, cuyo proceso de adaptacion y validacion incluyo las etapas preconizadas por la literatura. La validez de constructo y la confiabilidad fueron evaluadas en 200 adultos con diabetes mellitus tipo 2. Resultados: para mayor clareza y comprension, en la adaptacion cultural fueron ajustados los items indicados por el Comite de Jueces y por la poblacion objetivo. En el analisis factorial confirmatorio se mantuvieron los cuatro factores, con cargas factoriales de los items superiores a 0,30, excepto para el factor 4; el analisis multirrasgo y multimetodo mostro para la validez convergente, correlaciones entre items de 0,37 a 0,92, y en el caso del discriminante que 100% de los items obtuvieron mayor valor de correlacion en su propio factor. El coeficiente alfa de Cronbach para la escala total fue de 0,78, con variacion de 0,57 a 0,86 entre los factores. Conclusion: las equivalencias semantica, cultural, conceptual e idiomatica fueron mantenidas; las propiedades psicometricas mostraron evidencias de confiabilidad y de validez en la version brasilena del instrumento; por tanto, la adaptacion podra tener aplicacion en la clinica e investigaciones. La autoeficacia es util para planificar y evaluar intervenciones educativas y predecir cambios comportamentales para el cuidado.

Adaptação e validação da Diabetes Management Self-efficacy Scale para a língua portuguesa do Brasil

Objective: to perform the cultural adaptation and validation of the Diabetes Management Self-efficacy Scale for Patients with Type 2 Diabetes Mellitus with a Brazilian population sample. Method: cross-sectional methodological study in which the adaptation and validation process included the stages recommended in the literature. Construct validity and reliability were assessed with 200 adults with type 2 diabetes mellitus. Results: the items indicated by the panel of judges and by the target population were adjusted in the cultural adaptation to improve clarity and understanding. The instruments four factors remained in the confirmatory factor analysis with factor loadings of items greater than 0.30, except for factor 4; convergent validity, verified by the multitrait-multimethod analysis, presented inter-item correlations from 0.37 to 0.92, while for discriminant validity, 100% of the items presented greater correlation in their own factors. Cronbachs coefficient alpha for the total scale was 0.78, ranging from 0.57 to 0.86 among factors. Conclusion: semantic, cultural, conceptual and idiomatic equivalences were achieved and the instruments Brazilian version also presented psychometric properties that showed evidence of reliability and validity. Thus, it can be applied both in clinical practice and research. Self-efficacy is useful for planning and assessing educational interventions, as well as predicting behavior modification in self-care.Objetivo: realizar la adaptacion cultural y validacion de la Diabetes Management Self-efficacy Scale for Patients with Type 2 Diabetes Mellitus en una muestra poblacional brasilena. Metodo: estudio metodologico transversal, cuyo proceso de adaptacion y validacion incluyo las etapas preconizadas por la literatura. La validez de constructo y la confiabilidad fueron evaluadas en 200 adultos con diabetes mellitus tipo 2. Resultados: para mayor clareza y comprension, en la adaptacion cultural fueron ajustados los items indicados por el Comite de Jueces y por la poblacion objetivo. En el analisis factorial confirmatorio se mantuvieron los cuatro factores, con cargas factoriales de los items superiores a 0,30, excepto para el factor 4; el analisis multirrasgo y multimetodo mostro para la validez convergente, correlaciones entre items de 0,37 a 0,92, y en el caso del discriminante que 100% de los items obtuvieron mayor valor de correlacion en su propio factor. El coeficiente alfa de Cronbach para la escala total fue de 0,78, con variacion de 0,57 a 0,86 entre los factores. Conclusion: las equivalencias semantica, cultural, conceptual e idiomatica fueron mantenidas; las propiedades psicometricas mostraron evidencias de confiabilidad y de validez en la version brasilena del instrumento; por tanto, la adaptacion podra tener aplicacion en la clinica e investigaciones. La autoeficacia es util para planificar y evaluar intervenciones educativas y predecir cambios comportamentales para el cuidado.

Development and validation of the Perception of Self-Monitoring of Blood Glucose Scale in insulin-treated patients with diabetes.

Background and Purpose: The Perception of Self-Monitoring of Blood Glucose (P-SMBG) scale was developed and validated to assess perceptions of self-monitoring of blood glucose (SMBG) in insulin-treated patients with diabetes. Method: An initial 68-item version of the P-SMBG has been evaluated by a panel of professionals and patients. A sample of 375 patients tested the revised scale. Results: Factor analysis suggested a 19-item scale and a 2-factor structure, separating negatively and positively worded items. Cronbach’s alpha was .84 and .72, and the intraclass correlation coefficient was .66 and .57, respectively for both factors. Item–total correlations were in the range of .23–.66. Convergent/divergent validity was confirmed for the negatively worded items. Conclusions: The final P-SMBG scale (21 items) can be used to assess positive and negative perceptions of SMBG in insulin-treated patients with diabetes.