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Aims Although many studies have examined the predictors of medication adherence (MA), further empirical research is required to clarify the best model for predicting MA for older adults with heart failure (HF). Thus, we hypothesized a model in which information (knowledge), motivation (social support and depressive symptoms), and behavioural skills (barriers to self-efficacy) would be associated with MA in patients with HF. Methods and results Using a cross-sectional survey, 153 adults aged ≥ 65 years taking medication for HF were recruited from a university hospital in Korea. Data were collected based on the information–motivation–behavioural skills (IMB) model constructs and MA. In the hypothesized path model, self-efficacy was directly related to MA (β = −0.335, P = 0.006), whereas social support was indirectly related to MA through self-efficacy (β = −0.078, P = 0.027). Depressive symptoms were directly related to MA (β = 0.359, P = 0.004) and indirectly related to MA through self-efficacy (β = 0.141, P = 0.004). The hypothesized MA model showed a good fit for the data. Knowledge, social support, and depressive symptoms accounted for 44.3% of the variance in self-efficacy (P = 0.004). Left ventricular ejection fraction, knowledge, social support, depressive symptoms, and self-efficacy explained 64.4% of the variance in MA (P = 0.004). Conclusion These results confirmed the IMB model's suitability for predicting MA in older adults with HF. These findings may guide and inform intervention programmes designed to alleviate depressive symptoms in older adults with HF and enhance their HF knowledge, social support, and self-efficacy, with the ultimate goal of improving their MA. [ABSTRACT FROM AUTHOR]

Background: Heart rate variability (HRV) is an indicator of autonomic abnormalities. However, little is known about the role of HRV related to substance use behavior and the association between the changes in HRV and signs of relapse in substance use. Aim: The purpose of this study was to review the existing literature on autonomic response to substance use (i.e., opioids, cocaine, and methamphetamine) measured by HRV and its outcomes related to the risk factors of relapse. Methods: A systematic search of the literature was conducted using PubMed, PsychINFO, and Ovid Medline databases. The study includes full-text articles published in English from 2010 to 2020, using measures of HRV in human subjects who use substances. Results: A total of 14 studies were reviewed. Studies included outpatients with a prescription or nonprescription opioid misuse behavior with a primary diagnosis being chronic pain or substance use disorder (SUD). Significantly decreased resting HRV was found in substance users compared to healthy controls. Lower resting HRV has been significantly associated with stress, craving, and greater symptom severities in individuals with SUD and other substance dependence. HRV indices can be potential measures of homeostatic imbalance and self-regulation flexibility. Conclusion: HRV may be a useful tool for monitoring early indication of relapse so that relapse prevention measures can be implemented in a timely manner. Future studies in substance use may benefit from examining HRV in relations to substance use and relapse signs and symptoms in a larger population to guide future relapse prevention strategies. [ABSTRACT FROM AUTHOR]

Aims: The study aimed to develop and evaluate the effects of a self‐determination theory‐based, nurse‐led, physical activity programme for postmenopausal women with rheumatoid arthritis. Methods: Between December 2019 and April 2020, this randomized controlled trial recruited 62 postmenopausal women with rheumatoid arthritis from a university‐affiliated hospital in South Korea. The intervention group participated in a self‐determination theory‐based, nurse‐led, physical activity programme that consisted of Tai Chi‐based physical activity, a supportive psychosocial strategy, and interactive counselling for 16 weeks, and the control group continued to undergo their usual care. Results: There were statistically significant group‐by‐time interactions in physical activity and perceived sarcopenia, which favoured the intervention group. Additionally, the intervention group showed significant improvements in the perceived therapeutic efficacy of physical activity, grip strength, walking speed, disease activity score, and health‐related quality of life. Conclusions: The programme developed in this study can be an effective and feasible approach for postmenopausal women with rheumatoid arthritis in improving physical activity, selected osteosarcopenic outcomes, and health‐related quality of life. Further research is required to investigate the long‐term effects of this theory‐based programme for postmenopausal women in diverse settings. Summary statement: What is already known about this topic? Tai Chi‐based physical activity has been known to be a component of self‐management for rheumatoid arthritis. What this paper adds? It highlights the efficacy of a theory‐based, nurse‐led, physical activity programme to improve the quality of life of postmenopausal women with rheumatoid arthritis.The evidenced‐based programme could be transferred to postmenopausal women with rheumatoid arthritis in clinical settings. The implications of this paper: The self‐determination theory‐based, nurse‐led, physical activity programme can improve physical and psychosocial outcomes in postmenopausal women with rheumatoid arthritis.Importantly, this nurse‐led and theory‐based programme is expected to be applicable to postmenopausal women with rheumatoid arthritis in clinical settings, including both hospitals and communities. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to examine a hypothetical model of physical activity (PA) and health outcomes related to sarcopenia in women with rheumatoid arthritis (RA) based on self‐determination theory. Design: Cross‐sectional study. Methods: This study included 214 women diagnosed with RA from the outpatient rheumatology department of a university‐affiliated hospital in South Korea. Data were collected from September 2019 to August 2020 through structured questionnaires and anthropometric measurements and analysed using path analysis to test the hypothesized model. The primary health outcomes were perceived health status and sarcopenia‐related health (thigh circumference, handgrip strength and sarcopenia risk). Results: The final model's fit indices were adequate. Physical activity was directly affected by motivation for PA, while depression, self‐efficacy for PA, health care provider's autonomy support and basic psychological needs satisfaction indirectly affected PA. Physical activity directly affected perceived health status and thigh circumference, while perceived sarcopenia risk and handgrip strength were directly affected by disease activity and age. Patient or Public Contribution: Patients were involved in a questionnaire‐based survey. [ABSTRACT FROM AUTHOR]

A 6-month self-efficacy intervention was compared with attention-control intervention on physical activity, clinical outcomes, and mediators immediate postintervention and 6-month postintervention in 182 older adults with knee osteoarthritis and hypertension using a randomized controlled trial design. The intervention group received six weekly individual physical therapy sessions for lower-extremity exercise and fitness walking and nine biweekly nurse telephone counseling sessions. The attention-control group received six weekly and nine biweekly nurse telephone sessions on health topics. Lower-extremity exercise was assessed by e-diary; fitness walking was assessed by accelerometer and e-diary; blood pressure was assessed by automated monitor; function was assessed by performance-based tests and questionnaires; and pain, self-efficacy, and outcome expectancy were assessed by questionnaires. Self-reported lower-extremity exercise and fitness walking, function, pain, self-efficacy, and outcome expectancy showed significant group or group by time effects favoring intervention. The intervention did not improve physical activity by accelerometer and blood pressure. Mean minutes of fitness walking fell short of the 150 min/week goal. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To determine the effectiveness of nurse‐led interventions on medication adherence, medication knowledge and clinical outcomes in adults taking medication for metabolic syndrome. Background: Despite the significance of interventions designed to improve medication adherence, a systematic review of nurse‐led intervention studies for metabolic syndrome is lacking. Design: A systematic review and meta‐analysis of randomised controlled trials. Methods: The study was conducted following the PRISMA guidelines checklist. PubMed, EMBASE, PsychINFO, CINAHL, Cochrane CENTRAL and other manual sources were searched in May 2021.The quality assessment was conducted using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Comprehensive Meta‐Analysis 3.0 was used to calculate the pooled effect sizes with 95% confidence intervals. Results: This review included 20 studies of nurse‐led medication adherence interventions in 6017 adults at risk for metabolic syndrome. The pooled effect size using the random effects model indicated that nurse‐led interventions had a significantly moderate impact on enhancing medication adherence and medication knowledge and improving selected clinical outcomes of available studies in nurse‐led intervention groups compared with control groups. Duration of intervention (median 12 weeks), mode of delivery (group vs. individual) and using multiple strategies influenced outcomes of nurse‐led medication adherence interventions. The results revealed that interventions of moderate‐ to high‐quality studies were more likely to show significant improvements in medication adherence than those of low‐quality studies. Conclusion: The meta‐analyses showed that nurse‐led interventions may enhance medication adherence and knowledge and improve clinical outcomes of this population. Relevance to Clinical Practice: The findings may contribute to evidence‐based information about nurse‐led intervention and its selection of appropriate interventions for improving medication adherence in this population. Patient or public contribution: Patients or the public were not directly involved in this review. [ABSTRACT FROM AUTHOR]

Purpose: The opioid crisis has contributed to the mortality, morbidity, and rising healthcare costs in the United States. Buprenorphine (BUP) is an effective medication for opioid use disorder. The aims of this quality assurance evaluation of a BUP program were to (a) evaluate the clinic's performance in illicit opioid abstinence and (b) identify patient risk and resilience characteristics to improve patient success in recovery with BUP. Methods: A retrospective chart review of open (n = 35) and closed (n = 21) cases and a cross-sectional survey in open cases were completed. Adults (aged ≥18 years) who completed 6 months of BUP treatment at a psychiatric clinic were included. Clinical performance was measured with percentages of opioid-negative urine and completed monthly urine drug tests (UDTs) for the first 6months. Open cases were surveyed regarding risk and resilience characteristics (frequency of opioid cravings and triggers, therapy participation, and coping skills). Descriptive statistics, t test, and chi-square test were used to analyze data. Results: Average opioid-negative urine was significantly higher in open cases than closed cases (88.57% vs. 74.82%; t = 2. 885, p = .004). There was no significant association between open cases (61.4%) and closed cases (73.8%) in completed monthly UDT. Opening and closing of cases stabilized with mandatory monthly UDT. Most individuals reported therapy participation, minimal opioid cravings, and use of distraction to cope with chronic-pain-induced cravings. Conclusions/Implications: This clinic met benchmarks leading to improved substance recovery. Recommendations include regular evaluations of UDT, cravings, and chronic pain; therapy participation; and continuous quality assurance activities. [ABSTRACT FROM AUTHOR]

This study examined the psychometric properties of the Korean version of the Patient Knowledge Questionnaire-Osteoarthritis (PKQ-OA-K). A cross-sectional survey was conducted with 157 adults with osteoarthritis from the outpatient clinic at a university hospital in Korea. The overall correct answer rate for the PKQ-OA-K was 60.4%; notably, the drug therapy subscale had the lowest median score percentage (42.9%). For structural validity, exploratory factor analysis identified the PKQ-OA-K as two-dimensional, explaining 52.4% of the total variance. Confirmatory factor analysis showed that the two-factor model adequately fit the data. The PKQ-OA-K was positively correlated with education level (r = 0.24) and osteoarthritis outcomes (r = 0.17), thus verifying the hypotheses of construct validity. The intraclass correlation coefficient for test-retest reliability was 0.52; alpha was 0.44. The PKQ-OA-K has excellent validity but imperfect reliability for adults with osteoarthritis. This study recommends cautious use of the PKQ-OA-K to assess Korean patients' knowledge of osteoarthritis. [ABSTRACT FROM AUTHOR]

Background: Ophthalmic examinations are a frequent source of pain and stress in premature infants. There is evidence for the use of supportive interventions during infant ophthalmic examinations to reduce pain and stress, but there are no standard recommendations for their implementation.Purpose: The purpose of this quality improvement project was to implement evidence-based, supportive interventions during ophthalmic examinations in premature infants and evaluate the impact on pain, oxygen saturation, heart rate, bradycardic events, and neonatal stress cues.Methods: A preintervention and intervention group design was used. Primary outcomes were pain and oxygen saturation. Secondary outcomes were heart rate, number of bradycardic events, and number of neonatal stress cues. Independent-sample t tests were used to compare means of the measures in the preintervention and intervention groups.Results: Supportive interventions during ophthalmic examinations significantly reduced infant pain (during and after the examination), number of bradycardic events (during and after the examination), and number of neonatal stress cues (before, during, and after the examination). There was also a trend for supportive interventions to decrease pain before the examination.Implications For Practice: Supportive interventions during ophthalmic examinations are effective in reducing pain, bradycardic events, and neonatal stress cues in premature infants and can be successfully implemented as part of a unit-based protocol.Implications For Research: Future research is needed to determine the long-term outcomes associated with supportive interventions during ophthalmic examinations in premature infants. [ABSTRACT FROM AUTHOR]

This single-group repeated-measures pilot study evaluated the effects of a 10-wk, multicomponent, best-practice exercise program on physical activity, performance of activities of daily living (ADLs), physical performance, and depression in community-dwelling older adults from low-income households (N = 15). Comparison of pretest and posttest scores using a one-tailed paired-samples t test showed improvement (p < .05) for 2 of 3 ADL domains on the Activity Measure-Post Acute Care and for 6 physical-performance measures of the Senior Fitness Test. Repeated-measures ANOVA revealed significant main effects for 3 of 8 physical activity measures using the Yale Physical Activity Scale. Retention rate was 78.9%, and the adherence rate for group sessions was 89.7%. Results suggest that participation in a multicomponent, best-practice physical activity program may positively affect sedentary, community-dwelling older adults' physical activity, ADL performance, and physical performance. [ABSTRACT FROM AUTHOR]

A challenge with the aggressive new care model for patients with rheumatoid arthritis has been determining which measures to use to assess disease activity and response to therapy. With an observed functional assessment based on the Multidimensional Health Assessment Questionnaire domains, both the physician and the patient can gain important insights into function during a standard office visit. The presence of impairments in strength, joint range of motion, pain, and coordination--including balance and dexterity--can affect patients' ability to perform functional activities. This assessment allows a physician to observe the impact of these impairments on function. It may help identify patients with significant changes in function who can benefit from effective intervention. (J Musculoskel Med. 2012;29:102-105), Treatment of patients with rheumatoid arthritis (RA) has undergone tremendous advances related to greater understanding of its pathophysiology and the introduction of effective disease-modifying medications. New management strategies for RA [...]

Knowing how rheumatoid arthritis (RA) symptoms are affecting patients' everyday activities enhances your ability to provide best 'treat to target' practice interventions. Impairments can result in activity limitations and participation restrictions. An important impairment in RA is structural joint deformities; others are pain, fatigue, and adverse emotional reactions. Persons with RA often make some type of adaptation to their activities. Activity performance may be assessed by patient self-report with directed questions and by direct observation. Knowledge about RA and perspectives on what constitutes a particular activity differ greatly among patients. A challenge during an office visit is to make an accurate assessment of patients' functional activities. Identifying problems is easier if attention is focused on specific body areas that are likely to be problematic. (J Musculoskel Med. 2012;29:78-81), Assessing function in patients with rheumatoid arthritis (RA) is a challenging but important part of the rheumatology office visit. Knowing how the symptoms of RA are affecting patients' everyday activities [...]

The reasons why patients go to physicians to seek help for musculoskeletal problems, such as pain, difficulty in climbing stairs, and reduced work time, all are aspects of human function but refer to different aspects of function. In 2001, the World Health Organization published a classification to describe the health components of functioning and disability. Included is the entirety of a person's health rather than just the consequences of his or her disease. Patient self-report measures, used in conjunction with routine office visits, provide a practical and feasible way of obtaining information about functional health. The Health Assessment Questionnaire, a frequently used tool, has played a major role in broadening the perspective of chronic disease management from biomedical measurements to include measurement of functional health. (J Musculoskel Med. 2012;29:41-43), Musculoskeletal problems are some of the main reasons why patients go to physicians or other health care professionals. The reasons for seeking help are quite variable. For example, a person [...]