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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]

mcinnes e., seers k. & tutton l. (2011) Older people's views in relation to risk of falling and need for intervention: a meta-ethnography. Journal of Advanced Nursing 67(12), 2525-2536. Abstract Aim. This paper is a report of a meta-ethnography of qualitative studies of older peoples' views on risk of falling and need for intervention. Background. Falls and falls-related injuries in older people are worldwide problems. A conceptual understanding of older people's views about falls risk and need for intervention is useful for understanding factors likely to impact on acceptance of risk and recommended interventions. Data Sources. Seven electronic databases were searched 1999-2009. Reference lists of included articles were screened for eligible papers. Review Methods. Assessment of quality was carried out. Themes and concepts were extracted using a meta-ethnographic approach to compare similarities and differences across the retrieved studies. A line of argument was developed to produce an explanatory framework of the extracted themes and concepts. Results. Eleven relevant qualitative research articles of reasonable quality were identified. Six key concepts were identified: beyond personal control; rationalizing; salience; life-change and identity; taking control and self-management. A line of argument synthesis describes how older people approach self-appraisal of falls risk and intervention need, and how they cope and adapt to falls risk and intervention need. Conclusion. In response to having an elevated risk status and perceived associations with frailty and impact on an independent life-style, some prefer to adapt to this reality by taking control and implementing self-management strategies. Healthcare professionals should take into account beliefs about risk and negotiate choices for intervention, recognizing that some individuals prefer to drive the decision-making process to preserve identity as a competent and independent person. [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]

kwong e.w.-y., pang s.m.-c., choi p.-p. & wong t.k.-s. (2010) Influenza vaccine preference and uptake among older people in nine countries. Journal of Advanced Nursing 66(10), 2297–2308. Aim. This paper is a report of a study delineating factors that influence older people’s preferences and uptake of the influenza vaccine in nine countries. Background. Vaccination uptake for the aging population in many countries still remains below the World Health Organization recommended rate. Older people who perceive higher susceptibility to and severity of influenza, and more benefits from vaccination and action cues prompting vaccination, tend to accept the vaccine, but those with more perceived barriers to vaccination are less likely to accept it. Method. A total of 208 older people from China, Indonesia, Turkey, Korea, Greece, Canada, the United Kingdom, Brazil and Nigeria were recruited to 14 vaccinated and 12 unvaccinated focus groups. They shared their experiences of influenza, and influenza vaccination, and promotion of influenza vaccination in focus groups. The data were collected in 2007. Findings. We identified five themes and generated a hypothetical framework for in-depth understanding of vaccination behaviour among older people. Participants’ vaccine preferences were determined by their behavioural beliefs in vaccination, which were based on their probability calculation of susceptibility to and severity of influenza and vaccine effectiveness, and their utility calculation of vaccine, healthcare and social costs. Action cues prompting vaccination and vaccine access further affected the vaccine uptake of participants with vaccine preferences. Vaccination coverage was likely to be higher in the countries where normative beliefs in favour of vaccination had formed. Conclusion. The hypothetical framework can be used to guide healthcare providers in developing strategies to foster normative beliefs of older people in vaccination, provide effective action cues and promote vaccine access. [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]

Aim To explore experiences of the diagnosis and management of tuberculosis from the perspective of Somali patients and healthcare professionals involved in their care. Background The Somali population has the third highest incidence of tuberculosis occurring in persons born outside the UK. Tuberculosis is a disease with sociocultural as well as physical consequences. Nurses should understand how the disease is experienced by people from different ethnic backgrounds to implement strategies for prevention and management of tuberculosis. Design A focused ethnography. Method Individual interviews with 14 Somali patients and 18 healthcare professionals with experience of providing care to Somalis were undertaken in 2008-2009. Interviews explored the patient experience from onset of symptoms to completion of treatment. Data were analysed using Framework approach. Findings Despite presenting in primary care early, patients experienced diagnostic delays due to low clinical suspicion of tuberculosis among general practitioners. Although patients reported felt and enacted stigma, it did not adversely affect concordance with treatment. Patients were reticent about sharing their diagnosis among wider networks due to perceived stigma. Psychological support from families and specialist nurses was valued highly. Healthcare professionals perceived that stigmatization of tuberculosis was diminishing among Somalis leading to improved management of tuberculosis. Patients and healthcare professionals raised concerns about the longer term physical and psychosocial implications of tuberculosis once treatment was completed. Conclusion Nurses have a role in promoting early presentation, timely diagnosis, and treatment adherence through supporting Somali patients and raising awareness of the disease among primary care practitioners. [ABSTRACT FROM AUTHOR]

Aims To explore fatigue, the impact it has on daily life and the strategies used to ameliorate the symptom, as described by people with inflammatory bowel disease. Background Fatigue is the most troublesome symptom during remission of inflammatory bowel disease. Fatigue affects people's daily functioning, impacting on quality of life. There is limited understanding of the nature of and the ways fatigue in inflammatory bowel disease is experienced and managed in everyday adult life. Design An epistemological interpretive approach to understand participants' self-reported experiences of disease-related fatigue. Methods A convenience sample of 46 participants was recruited from the Crohn's and Colitis UK member database. Five focus group interviews ( November 2008- February 2009) were conducted, audio-recorded, transcribed, and analysed using an inductive thematic framework. Findings Five themes were identified: the experience of fatigue, causes of fatigue, managing fatigue, consequences of fatigue, and seeking support. Fatigue had a debilitating effect on the social and emotional well-being of participants and limited their employment opportunities. People used a range of strategies to cope and reported that fatigue-related issues seemed to be poorly understood by clinicians and were not addressed in medical consultations. Conclusion Fatigue was an inextricable part of daily life for some people with inflammatory bowel disease. Specialist nurses and medical colleagues need to address the personal, social, and economic consequences of fatigue, whilst further nursing research would improve understanding of the impact of fatigue and help develop appropriate intervention strategies for people with inflammatory bowel disease. [ABSTRACT FROM AUTHOR]

Aims. To report a qualitative study of the experiences of nurse prescribers in managing patients with self-limiting respiratory tract infections. Background. Patients frequently attend primary care with respiratory tract infections. Although a no-prescribing strategy is recommended for these consultations, general practitioners frequently prescribe antibiotics, citing non-clinical reasons such as patient pressure. Nurses increasingly manage people with respiratory tract infections, but research has not yet explored their experiences within such consultations. Design. Semi-structured interviews and focus groups. Methods. Fifteen semi-structured interviews and three focus groups ( n = 5, n = 4, and n = 12) with a purposive sample of nurse prescribers ( n = 34) and other non-medical prescribers ( n = 2) were conducted between November 2009-November 2010. A qualitative approach was used to develop conceptual categories from the dataset, and emerging themes were explored in subsequent interviews/focus groups. Findings. Although participants reported experiencing numerous challenges within these consultations, they believed that they possessed some of the communication skills to deal effectively with patients without prescribing antibiotics. Participants reported that protocols supported their decision-making and welcomed the benefits of peer support in dealing with 'demanding' patients. However, the newness of nurses and other non-medical prescribers to the prescribing role meant that some were cautious in dealing with patients with respiratory tract infections. Conclusion. Training for nurses and other non-medical prescribers should focus on building their confidence and skills to manage people with respiratory tract infections without recourse to antibiotics. Further work should seek to explore which strategies are most effective in managing respiratory tract infections while maintaining patient satisfaction with care. [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]