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Aim: This study examined the relationships between patient‐centred care, diabetes self‐management and selected health outcomes for Omani patients with type‐2 diabetes. Methods: Cross‐sectional surveys were administered for 237 patients with type‐2 diabetes. Hierarchical regression analyses examined the relationships between the selected study variables. Results: The sample was middle‐aged (M = 48, SD = 11.0 years) with nearly a decade (M = 9.68, SD = 6.11) since being diagnosed with type‐2 diabetes, with higher than ideal glycaemic control measures (M = 8.8%, SD = 2.4%). In bivariate analyses, patient‐centred care was positively associated with diabetes self‐management but not with glycaemic control or quality of life. However, after controlling demographic and clinical characteristics, patient‐centred care was positively associated with both physical and mental aspects of health‐related quality of life. In the final regression model, controlling for demographic and clinical characteristics and patient‐centred care, diabetes self‐management significantly predicted both glycaemic control and both physical and mental aspects of health‐related quality of life. Conclusions: The findings support that providing individualized care may contribute to the self‐management of chronic conditions. For achieving optimal outcomes, it may be necessary for providers to effectively assess patients' unique challenges and motivations. Increasing diabetes self‐management may improve quality of life and reduce diabetes complications. Summary statement: What is already known about this topic? Patient‐centred care (PCC) enhances diabetes self‐management (DSM).Little is known about the primary care nurse's role in promoting DSM within a PCC model. What this paper adds? PCC contributes to DSM and improves patient health outcomes.Expecting patients with diabetes to comply with provided instructions may not be enough to change self‐management behaviours. The implications of this paper Administrators responsible for employing a PCC approach in their clinics may need to establish clear goals and expectations for each team member to achieve overall success and ensue that nurses and physicians have targeted training on specific strategies to encourage patient‐provider partnerships that support the adoption of effective DSM behaviours.As the patient‐centred model of care is implemented in Oman, medical and nursing education programmes may highlight in their curricula its potential impact upon self‐management behaviours.Observational studies and longitudinal research to monitor Oman's progress towards the transition to a PCC model of care may uncover modifiable barriers and facilitators that primary care providers encounter. [ABSTRACT FROM AUTHOR]

This multisite, qualitative study examined the process by which persons living with HIV/AIDS (PLWHA) engage in primary HIV medical care for treatment. Using a grounded theory approach, the analysis of narrative data from semi-structured in-depth interviews with PLWHA (n = 76) led to the development of a model describing a cyclic process of engaging in--and falling out of--care. Perceptions of the client-provider relationship emerged as a central element of the process by which persons with HIV engaged--or remained--in care. Provider behaviors that were characterized as engaging, validating, and partnering facilitated engagement and retention in care; behaviors described as paternalistic served as barriers to care. Participants indicated that they desired a care partnership with an empathetic provider who had effective communication skills. These findings provide recommendations for health providers to engage and retain hard-to-reach PLWHA in timely and appropriate HIV care and services.

This qualitative study investigated the process of engagement in HIV medical care from the perspective of people living with HIV/AIDS (PLWHA). In-depth interviews were conducted with 76 participants in six cities. All participants were considered underserved because of histories of substance use, mental illness, incarceration, homelessness, or cultural barriers to the traditional health care system. A semistructured interview guide elicited narratives related to health care and the role of program interventions in facilitating access to care. Data analysis revealed that participants cycled in and out of care, a process that was influenced by (1) their level of acceptance of being diagnosed with HIV, (2) their ability to cope with substance use, mental illness, and stigma, (3) their health care provider relationships, (4) the presence of external support systems, and (5) their ability to overcome practical barriers to care. Outreach interventions played a role in connecting participants to care by dispelling myths and improving knowledge about HIV, facilitating access to HIV care and treatment, providing support, and reducing the barriers to care. The findings suggest that outreach programs can interrupt this cyclical process and foster sustained, regular HIV care for underserved PLWHA by conducting client-centered risk assessments to identify and reduce sources of instability and improve the quality of provider relationships; implementing strategies that promote healthy practices; creating a network of support services in the community; and supporting adherence through frequent follow-ups for medication and appointment keeping.

Despite decades of research documenting family burden related to mental illness of a relative, little is known about families' responses over time. A grounded theory study was designed to describe families' responses to these severe mental illnesses. Twenty-nine participants representing 17 families were interviewed 3 times over 2 years. Interviews were analyzed using constant comparison. Living with ambiguity of mental illness was the central concern. The basic social process was pursuing normalcy and included confronting the ambiguity of mental illness, seeking to control impact of the illness, and seeing possibilities for the future. Goals were managing crises, containing and controlling symptoms, and crafting a notion of 'normal.' Strategies were being vigilant, setting limits on patients, invoking logic, dealing with sense of loss, seeing patients' strengths, and taking on roles. The study revealed that families were profoundly affected by the social contexts of mental illness.

Introduction: Culture-sensitive (CS) and patient-centered (PC) care are considered essential to achieve high-quality equitable care. The purpose of this study was to determine how expert nurses incorporate CS/PC care into their assessment and care planning practices, especially for culturally diverse and marginalized patients. Methodology: Using a qualitative, descriptive design, we conducted a focus group at the October 2019 Transcultural Nursing Society Conference. Participants (n = 9) discussed how they instilled cultural sensitivity and patient-centeredness into their assessment and care planning skills. Results: Participants revealed attitudes, knowledge, and skills associated with CS/PC assessment and care planning. They also identified specific strategies for translating CS/PC theory into assessment and care planning practices. Discussion: Three principles and many pragmatic strategies for incorporating CS/PC care into daily practice emerged from the data. Nurses may find these principles and strategies helpful in integrating CS/PC care into their daily care of patients in busy clinical settings. [ABSTRACT FROM AUTHOR]

Undergraduate women are at high risk of experiencing sexual assault during their college years. Research has established a strong link between sexual victimization and psychological distress. Although the relationship between sexual victimization and distress has been established, little is known about how the use of university-affiliated sexual assault resources influences mental health outcomes for survivors. The aims of this cross-sectional study were to describe the characteristics of women who used campus survivor resources following a sexual assault during college, examine correlates of campus resource use, and examine correlates and predictors of mental health of women who have been sexually assaulted during college. An online anonymous survey was sent to undergraduate women at two public universities in a mid-Atlantic state. Participants were female, undergraduate students (N = 362) who had been sexually assaulted during their time at college. Few women (n = 98, 27.1%) used campus resources following a sexual assault. We found significant relationships between participants' use of campus survivor resources and experiencing a sexual assault prior to entering college, experiencing more severe sexual assaults, acknowledging the assault as a rape, feeling more self-blame, and experiencing more psychological distress. Campus resource use was significantly associated with poorer mental health outcomes. The cross-sectional nature of this study limited our ability to explore the reason for this. Further research is needed to explore the role campus resources play in supporting survivors during the recovery process. Given the high rate of sexual assaults on college campuses and the known negative psychological impact of sexual assault, it is imperative that campuses offer resources that are effective in meeting the needs of survivors. [ABSTRACT FROM AUTHOR]

Introduction: Second-generation Arab Americans may be at risk for poor cardiovascular health behaviors, but these behaviors are poorly understood. The purpose of this study was to examine the effects of acculturative stress and psychological flexibility on cardiovascular health behaviors among second-generation Arab Americans. Method: In a cross-sectional study, survey data were collected in 2018 at local mosques, churches, and a university campus. Cardiovascular health behaviors were measured with a questionnaire based on the American Heart Association Life's Simple 7. Acculturative stress and psychological flexibility were assessed using reliable and valid measures. Results: Participants (n = 325) with higher acculturative stress were significantly more likely to report intermediate overall cardiovascular health behaviors (p =.01) and poor to intermediate diet (p =.00). Psychological flexibility partially mediated poor/intermediate smoking (p =.02) and intermediate diet (p =.00) scores. Discussion: Nurses may consider the role of acculturation when designing culturally sensitive interventions to promote cardiovascular health in second-generation populations. [ABSTRACT FROM AUTHOR]

The goal of this study was to examine sexual assault survivors' use and perceived helpfulness of university-affiliated resources. Data were collected in online anonymous surveys from women (n = 98) at two universities who experienced a sexual assault during college and used university resources. Participants who perceived university-affiliated survivor resources as helpful had significantly better mental health outcomes than women who perceived resources as unhelpful. The most often used resources were mental health counseling (60.6%) and university health centers (24%). The most helpful resources were survivor advocates, peer counseling, and peer support groups. [ABSTRACT FROM AUTHOR]

Background Kenya did not meet its maternal mortality ratio (MMR) target under the Millennium Development Goals. The aim of this study was to examine the gaps in knowledge of intrapartum care among obstetric care providers (OCPs) in rural Nandi County, Kenya. Methods This cross-sectional study in 2015 surveyed 326 nurses, midwives, clinical officers and physicians about their knowledge, attitudes and practices related to normal labor and childbirth, immediate newborn care and management of obstetric complications. Results Self-reported intrapartum knowledge among OCPs was insufficient according to accepted international standards. The mean total knowledge score for all OCPs based on a validated 30-question inventory was 62% (range 23–90%). Only 14 providers (4%) scored as 'competent' (a score ≥80%). Scores were higher for OCPs who had received pre- and postemployment emergency obstetric care training and those with higher levels of confidence in their skills. Survey respondents identified a lack of knowledge as one of the greatest barriers to high-quality patient care. Conclusions Increasing training opportunities for OCPs may improve the quality of obstetric care provided to women in Kenya and other high-MMR locations in sub-Saharan Africa and enable progress toward achieving the ambitious Sustainable Development Goals target for maternal survival. [ABSTRACT FROM AUTHOR]

Background: Self‐efficacy and family social support are significantly associated with hypertension self‐care behaviours. However, little is known about their mechanism in Saudi Arabia. This cross‐sectional study aimed to examine the relationships among family social support, self‐efficacy, and self‐care behaviours among men with hypertension in Saudi Arabia. Methods: Data were collected from May to August of 2018. The Hypertension Self‐Care Profile and the Perceived Social Support from Friends and Family scales were used to measure the study variables. Multiple linear regression was used to analyse the relationships between the variables, and the Baron and Kenny test was used to assess if self‐efficacy mediated the relationship between family social support and hypertension self‐care behaviours. Results: Respondents (N = 158) from the Jizan and Al‐Sharqia regions of Saudi Arabia completed the survey. Family social support and self‐efficacy were significantly associated with hypertension self‐care behaviours. In regression, self‐efficacy was the only variable significantly associated with hypertension self‐care behaviours. Self‐efficacy fully mediated the relationship between family social support and hypertension self‐care behaviours. Conclusions: Interventions to enhance hypertension self‐care behaviours among Saudi men could focus on increasing individual's self‐confidence to perform specific healthy behaviours. Family support can also contribute to the performance of hypertension self‐care behaviours. SUMMARY STATEMENT: What is already known about this topic? Hypertension is a public health concern in Saudi Arabia, and its control is highly associated with effective self‐care behaviours.Family social support is an important factor that contributes to improved blood pressure control and enhanced patients' quality of life.Self‐efficacy is necessary to promote healthy self‐care behaviours. What this paper adds? There is a need to support family members' engagement in hypertension treatment plan.The study provides evidence that self‐efficacy fully mediates the relationship between family social support and hypertension self‐care behaviours among men in Saudi Arabia. The implications of this paper: Nurses providing care for patients with hypertension should teach the family how to care for their loved ones to prevent unexpected complications.The results of this study can be used for further encouragement to self‐efficacy interventions for patients with hypertension.Based on our analysis of the literature, it is clear that further research is needed on improving self‐efficacy and family social support in hypertension care. [ABSTRACT FROM AUTHOR]

Despite advances in the medical treatment of HIV disease, marginalized populations continue to shoulder a disproportionate burden of HIV/AIDS-related morbidity and mortality. This study explored the process by which clients at HIV-oriented primary care clinics transition from being sporadic users of care to engaging as regular users of care. A model illustrating how participants were striving to maintain normalcy, manage perceptions, and develop life mastery skills contributes to an understanding of living with HIV disease in a social context. Elements of the model are sensitive to nursing interventions aimed at improving health outcomes and reducing health disparities among persons at highest risk.