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Aims and objectives: This review aimed to demonstrate the self‐care behaviours of first‐generation Chinese immigrants with cardiovascular disease in western countries and identify related cultural factors. Background: Self‐care is the cornerstone to mitigate disease symptoms and maintain health status. Chinese immigrants to western countries, operating within a cross‐cultural context, may find self‐care to manage their cardiovascular disease challenging. Design: An integrative review was conducted. Methods: Seven databases were searched Scopus, ProQuest Health & Medicine, Medline (Ovid), Embase (Ovid), AMED (Ovid), PsycINFO and CINAHL, with output limited to peer‐reviewed studies published from 2000 to 2020 in English or Chinese. Initially, 2037 papers were screened. Six papers were retained and critiqued using the Joanna Briggs Institute critical appraisal tools. Deductive and inductive approaches were utilised to analyse the findings. The PRISMA 2020 checklist informed review reportage. Result: In general, Chinese immigrants with cardiovascular disease took an active role in management of their cardiovascular disease, including through diet and activity adaptation and adherence to western medication. Families also played a significant role in disease decision‐making and management. However, language and cultural barriers impeded their access to health information and resources in host countries. Relevance to clinical practice: Understanding self‐care behaviours and associated cultural factors among Chinese immigrants with cardiovascular disease is important to improve nurses' culturally sensitive practices and provide tailored health education interventions to promote self‐care behaviours among immigrant populations. The scarcity of literature on self‐care behaviours among Chinese first‐generation immigrants with cardiovascular disease indicates the need for further research in this area. Development of culturally and linguistically sensitive health resources and education programs is urgently needed. [ABSTRACT FROM AUTHOR]

Aims and objectives The aim of this paper is to explore how people live life successfully with Parkinson's disease and what contributed to the level of success. Objectives To examine the level of success as defined by people with Parkinson's disease. To find what contributed to the level of success. Background Self-care support has gained importance for supporting people with their chronic diseases including Parkinson's disease. Although self-care and life adjustments can improve patients' general well-being, it is unclear which approaches best facilitate positive adjustments to illness. Design Semi-structured interviews with participants with Parkinson's disease. Methods Eight participants living with Parkinson's disease for 2-16 years were recruited from a Parkinson's disease voluntary group in the UK. Interviews covered their perceived level of success and the factors which they perceived led to that success. Thematic analysis was used to analyse the data. Results Participants rated a high level of success in living with Parkinson's disease with an average personal rating 75/100 despite facing difficulties. Successful living was perceived to have taken place when people were either (1) able to return to their usual state of health or (2) considered themselves to be stable within a new/readjusted state of health. Aspects which were perceived to support positive psychosocial adjustment included a positive mindset, determination, acceptance of new challenges and family support. Conclusion Maintaining usual life and physical ability is the major concern among the people with Parkinson's disease. It would be helpful for health care professionals to identify what constitutes a 'usual' life for that person and to support them to develop a positive mindset and acceptance of new challenges, drawing on the determination of the person as well as any available family support. Relevance to clinical practice In supporting self-care, it is helpful to gain information about the subjective experience of living with Parkinson's disease including their perceived level of success at the time and what led to that perceived success for that person. [ABSTRACT FROM AUTHOR]

To develop a scale to measure parental self-efficacy in the care of pre-school children during periods of health and minor illness. Children account for many health service consultations at all levels, but particularly in primary care. There are logistical, financial and social reasons for encouraging self-care by parents and other family members during periods of health and minor illness. In the absence of valid parental self-efficacy measurement tool, this paper describes the development of such a tool. A psychometric approach combining elements of social policy and health scale development is outlined. UK health and social policies were searched and from this a systematised concept was developed. This was assessed for international durability by checking the concept against other policies, including those from major international organisations. Statements were developed from this and sent to a panel representing a wide range of stakeholders who were asked to rate the proposed items of the scale and changes were made accordingly. Widespread agreement among panel members supported the systematised concept. Some alterations to the proposed items, particularly increasing the range of health service providers, were made. The study suggests a new method for clinical health policy research, including elements of social policy and health services research. The resulting scale can be contextualised for different circumstances and now needs extensive field testing and refinement. There is increasing diversity in the provision of healthcare; however parents remain the primary carers of young children in both health and illness. This tool can be used to measure the impact of health and social policy upon their confidence and knowledge, and to evaluate new initiatives. The emphasis upon health and social policy ensures that those using the tool have a holistic approach to evaluation. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the effects of type 2 diabetes on British-Pakistani women's identity and its relationship with self-management. Background Type 2 diabetes is more prevalent and has worse outcomes among some ethnic minority groups. This may be due to poorer self-management and an inadequate match of health services to patient needs. The influence that type 2 diabetes has on British-Pakistani women's identity and subsequent self-management has received limited attention. Design An explorative qualitative study. Methods Face-to-face semi-structured English and Urdu language interviews were conducted with a purposively selected heterogeneous sample of 15 British-Pakistani women with type 2 diabetes. Transcripts were analysed thematically. Results Four themes emerged: Perceived change in self emphasised how British-Pakistani women underwent a conscious adaptation of identity following diagnosis; Familiarity with ill health reflected women's adjustment to their changed identity over time; Diagnosis improves social support enabled women to accept changes within themselves and Supporting family is a barrier to self-management demonstrated how family roles were an aspect of women's identities that was resilient to change. The over-arching theme Role re-alignment enables successful self-management encapsulated how self-management was a continuous process where achievements needed to be sustained. Inter-generational differences were also noted: first generation women talked about challenges associated with ageing and co-morbidities; second generation women talked about familial and work roles competing with self-management. Conclusions The complex nature of British-Pakistani women's self-identification requires consideration when planning and delivering healthcare. Relevance to clinical practice Culturally competent practice should recognise how generational status influences self-identity and diabetes self-management in ethnically diverse women. Health professionals should remain mindful of effective self-management occurring alongside, and being influenced by, other aspects of life. [ABSTRACT FROM AUTHOR]

Aims and objectives To investigate factors influencing patients' self-management of urgent diabetes problems that precipitated unscheduled hospital care. Background Diabetes is placing increasing resource demands on health services and current policy advocates management in primary care and community settings whenever possible. Such policy has implications for patient education and empowerment and on mechanisms within primary and community care to support the management of diabetes when urgent healthcare problems arise. Design Qualitative, descriptive investigation, across two contrasting sites. Methods Forty-five people admitted to hospital for urgent/emergency care due to diabetes-related problems were recruited from urban and rural localities in the UK. Semi-structured interviews were conducted and data analysed using nvivo version 8 and framework techniques. Results Self-management of diabetes was typically habitual, and urgent problems that proved difficult to resolve necessitated recourse to unscheduled hospital care. Though skills relating to problem-solving, decision-making, resource use and formation of patient-provider partnerships were evident among some participants, these required further development. Evidence of action planning or self-tailoring skills was sparse. Conclusions Education plays an important role in assisting individuals to self-manage their diabetes on a daily basis, but urgent, unexpected health problems proved challenging for both patients and health service providers. A greater focus on empowering patients with core self-management skills is required to enhance ability to successfully manage unexpected diabetes complications, coupled with enhanced primary care resources, particularly out-of-hours. Relevance to clinical practice The importance of informal and structured diabetes education should not be underestimated; however, the challenge of improving skills such as problem-solving to manage urgent healthcare needs must be tackled. This study provokes debate regarding how best to deliver appropriate education and health services to cover urgent unscheduled care needs without automatically referring to emergency department hospital care. [ABSTRACT FROM AUTHOR]

Aims and objectives To evaluate the usability of the educational needs assessment tool in clinical practice, from a practitioner and patient perspective and to establish whether patients perceive that they are getting an equally good or equally inadequate education service for their needs. Background The educational needs assessment tool was developed to enable patients with Rheumatoid Arthritis to assess their education needs prior to a consultation with a health professional. The educational needs assessment tool has been translated into nine languages and measurement properties have been established, however, its usability in clinical practice has not been studied. Design A qualitative study embedded into a multicentre RCT in which patients had been randomised into either educational needs assessment tool-focused education (Experimental Group) or usual care (control group). Methods Both groups were seen by a clinical nurse specialist. Sixteen patients and four clinical nurse specialists were recruited from the Rheumatology Outpatient Departments of three Acute Hospitals within the U K. Data were collected by interviews with patients and clinical nurse specialist. Analysis followed the Framework approach. Results Patients and clinical nurse specialist found completion of the educational needs assessment tool straightforward, comprehensive and easy to use. Completing the educational needs assessment tool helped patients to focus on what they needed to know from the clinical nurse specialist. Patients in both the control group and the experimental group felt supported and reassured by their clinical nurse specialist and perceived that they received a good and adequate education provision. Conclusion This study provides useful insights into the ability of the educational needs assessment tool to assess the educational needs of patients with rheumatoid arthritis in routine clinical practice. Relevance to clinical practice The educational needs assessment tool would be useful as a structured guide for nurses when assessing and meeting individual patient educational needs. This has the potential to improve patient-centred care, involve patients more actively in their care and enhance the long-term effects of patient education provision. [ABSTRACT FROM AUTHOR]

Aims and objectives. To explore patients' experiences following discharge from the day surgery unit. Background. The shape of twenty-first surgical care is changing. Due to political drivers, the self-care ethos and cost containment as well as technological advances, surgery, which previously required a lengthy hospital stay can now be performed in a day. Care that was previously performed by nurses is now transferred to the patient and their carer. Design. A Glaserian grounded theory methodology was used. Methodology. A semi-structured interview took place by telephone on two occasions following discharge from 2004-2006. One hundred and forty-five patients and their carers were recruited from two day surgery units in the UK. Analysis took place by constant comparisons of interview data, line by line analysis and referral to field notes and memos until core categories emerged. Results. Three major themes emerged from this study: the difficulties patients encountered in caring for themselves or their loved ones; the desire for obtaining professional support once they were discharged home; and nostalgia for past times. Conclusion. This study adds new insights to the discharge experiences of day surgery patients. Discharge planning should be started at the pre-assessment stage of the day surgery process and should be a joint venture between community staff, patients and day surgery nurses. More information should be given concerning community services available to the patients and educational programmes need to be developed to address the changing nature of surgical care. Relevance to clinical practice. Raising awareness of the problems patients may experience following discharge from day surgery may encourage a more pro-active attitude towards planning discharge services by a combined approach from day surgery nurses and community (district) nurses. [ABSTRACT FROM AUTHOR]