DESIGN: This is a cross-sectional study using a self-administered questionnaire. The questionnaire was distributed to 1093 healthcare workers. The data were analysed using multiple logistic regression with significance level p<0.05. Ethical clearance and consent of the participants were duly obtained.
SETTING: In three public hospitals that provide tertiary-level healthcare in Sana'a City, Yemen.
PARTICIPANTS: There were 692 nurses and doctors (response rate 63.3%) completed the questionnaires.
RESULTS: Almost half of the participants 55.1% were nurses and 44.9% were doctors. The study found that self-efficacy was associated with willingness to participate in disaster response for any type of disasters (OR 1.319, 95% CI 1.197 to 1.453), natural disasters (OR 1.143, 95% CI 1.069 to 1.221) and influenza pandemic (OR 1.114, 95% CI 1.050 to 1.182). The results further show that willingness is associated with healthcare workers being young, male and having higher educational qualifications.
CONCLUSION: Self-efficacy has been found to be an important factor associated with willingness. Improving self-efficacy through training in disaster preparedness may increase willingness of healthcare workers to participate in a disaster.
Methods: This cross-sectional study was conducted among 282 stroke patients who provided informed consent and were in follow-up at the Neurology Outpatient Department of Hospital Kuala Lumpur, Malaysia. The study employed a data-collection form that gathered information on sociodemographics, clinical treatment, outcome measures on MUSE, and medication-nonadherence reasons.
Results: The prevalence of poor medication understanding and use self-efficacy among stroke patients was 46.5%, of which 29.1% had poor "learning about medication" self-efficacy, while 36.2% lacked self-efficacy in taking medication. Beliefs about medicine (74.02%) was the commonest reason for medication nonadherence, followed by medication-management issues (44.8%). In the multivariate model, independent variables significantly associated with MUSE were health literacy (AOR 0.2, 95% CI 0.069-0.581; P=0.003), medication-management issues (AOR 0.073, 95% CI 0.020-0.266; P<0.001), multiple-medication issues (AOR 0.28, 95% CI 0.085-0.925; P=0.037), beliefs about medicine (AOR 0.131, 95% CI 0.032-0.542; P=0.005), and forgetfulness/convenience issues (AOR 0.173, 95% CI 0.050-0.600; P=0.006).
Conclusion: The relatively poor learning about medication and medication-taking self-efficacy in this study was highly associated with health literacy and modifiable behavioral issues related to nonadherence, such as medication management, beliefs about medicine, and forgetfulness/convenience. Further research ought to explore these underlying reasons using vigorous techniques to enhance medication understanding and use self-efficacy among stroke survivors to determine cause-effect relationships.
METHODS: A prepost study design was conducted in 2017. The 8-hour Smoking Cessation Organising, Planning and Execution (SCOPE) training comprised lectures, practical sessions and role-play sessions to 218 healthcare providers. A validated evaluation tool, Providers' Smoking Cessation Training Evaluation, was administered to assess the impact of training on knowledge, attitude and self-efficacy on smoking cessation intervention.
RESULTS: After SCOPE training, the knowledge score increased significantly from 7.96±2.34 to 10.35±1.57 (p<0.001). Attitude and self-efficacy in smoking cessation intervention also increased significantly from 34.32±4.12 to 37.04±3.92 (p<0.001) and 40.31±8.61 to 54.67±7.45 (p<0.001) respectively. Pretraining and post-training scores improved significantly for all professions, and each measure, particularly self-efficacy.
CONCLUSION: This study demonstrates that SCOPE training could improve healthcare providers' knowledge, attitude and self-efficacy on smoking cessation intervention. Future training is recommended to equip healthcare providers with current knowledge, positive attitude and high self-efficacy to integrate what they have learned into practice successfully.
Purpose: To investigate the effects of 'graded exercise integrated with education' on physical fitness, exercise self-efficacy (ESE), and physical activity (PA) levels among subacute and chronic wheelchair-dependent paraplegia patients.
Overview of Literature: Most of the chronic spinal cord injury (SCI) patients had low physical fitness due to a sedentary lifestyle and lack of ESE after discharge from a rehabilitation program. Education may encourage them to engage with exercise to regain and maintain their physical fitness. However, there is a lack of research to support the effects of exercise integrated with education after an SCI.
Methods: A total of 44 participants will be assigned to either the experimental group (graded exercise integrated with education) or active control (conventional physical therapy). The experimental group will receive graded strength and aerobic exercise training according to their progression criteria. They will attend an education program during and after the rehabilitation program. The control group will only receive conventional physical therapy during their in-rehabilitation program. This study will be conducted during a period of 16 weeks, consisting of 8 weeks of in-rehabilitation and 8 weeks post-rehabilitation. Statistical analysis will be performed using the IBM SPSS ver. 21.0 (IBM Corp., Armonk, NY, USA) at a significance level of p≤0.05.
Results: The primary outcome measures will be upper-limb isokinetic strength, isometric grip strength, and cardiorespiratory fitness. The secondary outcomes will be ESE and PA levels.
Conclusions: An intervention that combines exercise training and education may be warranted to enhance the physical fitness, ESE, and PA levels in SCI patients. This trial was registered with ClinicalTrials.gov (NCT03420170).
Methods: A quasi-experimental design was conducted. The intervention and control groups consisted of 66 nurses randomly selected from the Tumpat and Pasir Mas districts, respectively, in Kelantan. The intervention group received an antenatal-exercise counseling module, and the control group performed counseling based on self-reading. Knowledge and self-efficacy were assessed at the baseline and at week 4. Analysis of variance and repeated measure analysis of covariance were performed using SPSS.
Results: There was a significant difference in the knowledge scores [estimated marginal mean (95% confidence interval, CI): 33.9 (33.29, 34.53) versus 27.4 (26.52, 28.29); P < 0.001)] and the self-efficacy scores [estimated marginal mean (95% CI): 31.3 (30.55, 32.03) versus 27.4 (26.03, 28.74); P = 0.005)] between intervention and control groups at week 4 after adjusting for duration of practice and formal training.
Conclusion: The antenatal-exercise counseling module is recommended for use in routine counseling in health centers to promote healthy lifestyles among pregnant women.
METHODS AND ANALYSIS: This biopsychosocial intervention randomised controlled trial will engage patients (n=156) diagnosed with type 2 diabetes mellitus (T2DM) from four primary healthcare clinics in Putrajaya. Participants will be randomised to either OHP plus treatment as usual. The 2-hour weekly sessions over five consecutive weeks, and 2-hour booster session post 3 months will be facilitated by trained mental health practitioners and diabetes educators. Primary outcomes will include self-efficacy measures, while secondary outcomes will include well-being, anxiety, depression, self-care behaviours and haemoglobin A1c glucose test. Outcome measures will be assessed at baseline, immediately postintervention, as well as at 3 months and 6 months postintervention. Where appropriate, intention-to-treat analyses will be performed.
ETHICS AND DISSEMINATION: This study has ethics approval from the Medical Research and Ethics Committee, Ministry of Health Malaysia (NMRR-17-3426-38212). Study findings will be shared with the Ministry of Health Malaysia and participating healthcare clinics. Outcomes will also be shared through publication, conference presentations and publication in a peer-reviewed journal.
TRIAL REGISTRATION NUMBER: NCT03601884.
METHODS: We recruited one hundred and ninety four overweight and obese (BMI>27.5 kg/m2) employees from a local university. They were randomly allocated to either Group Support Lifestyle Modification (GSLiM) (intervention)(n = 97) or dietary counseling (comparison)(n = 97). The GSLIM activities included self monitoring, cognitive-behaviour sessions, exercise as well as dietary change advocacy, which were conducted through seminars and group sessions over 24 weeks. The comparison group was given dietary counselling once in 12 weeks. Both groups were followed up for additional 12 weeks to check for intervention effect sustenance. Anthropometric and biochemical parameters were measured at baseline, 12, 24 and 36 weeks; while dietary intake, physical activities, psychological measures and quality of life measured at baseline, 24 and 36 weeks. Data analysis was conducted using ANOVA repeated measures with intention to treat principle.
RESULTS: The participants were predominantly women with mean (standard deviation) age of 40.5 (9.3) years. A total of 19.6% of the participants in GSLiM achieved 6% weight loss compared to 4.1% in the comparison group (Risk Ratio 4.75; 95% CI: 1.68, 13.45). At 24 weeks, the retention rate was 83.5% for GSLiM and 82.5% for comparison group. GSLiM participants also achieved significant improvement in total weight self-efficacy score, negative emotions and physical discomfort subscales, MDPSS friend subscale and all domains in quality of life. Participants in the comparison group experienced reduction in negative self-thoughts.
CONCLUSION: The GSLiM programme proved to be more effective in achieving targeted weight loss, improving weight self-efficacy, friend social support, and quality of life compared to dietary counseling.
TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT201104056127N1.
MATERIAL AND METHODS: This cluster randomised controlled trial (RCT) will involve 207 Arab students (14-18 years old) from 12 Arabic schools in the Klang Valley. The schools will be assigned randomly to an intervention (online life skills programme) or control group at a 1:1 ratio. The researcher will deliver eight one-hour sessions to the intervention group weekly. The control group will receive the intervention at the evaluation end. Both groups will complete assessments at baseline, and immediately and three months after the intervention. The primary outcome is anxiety, depression, and stress [Depression Anxiety and Stress Scale-21 (DASS-21)]. The secondary outcomes are self-efficacy (General Self-Efficacy Scale) and coping skills (Brief COPE Inventory). Data analysis will involve the Generalised Estimation Equation with a 95% confidence interval. P < .05 will indicate significant inter- and intra-group differences.
DISCUSSION: This will be the first cluster RCT of an online life skills education programme involving Arab adolescent migrants in Malaysia. The results could support programme effectiveness for improving the participants' mental health problems (depression, anxiety, stress), increasing their self-efficacy, and enhancing their coping skills. The evidence could transform approaches for ameliorating migrant children and adolescents' mental well-being.
TRIAL REGISTRATION: The study is registered with the Clinical Trial Registry (Identifier: NCT05370443).
Methods: In this clinical trial study, 98 participants were randomly allocated to an HBM group (n = 48) and a control group (n = 50). The HBM group received an audiovisual compact disc (CD) that contained information about nutritional behaviour of colorectal cancer (CRC) prevention based on HBM that lasted 45 min. Both groups completed questionnaires regarding demographic factors, knowledge and HBM constructs, and a three-day dietary recall at the beginning of the study, 1 week after, and 3 months after the education. The outcome of this study was measured by the amount of food servings consumed and dietary micronutrient intake.
Results: At the baseline, there were no significant differences between groups regarding demographic factors. Findings showed that self-efficacy (P < 0.001), severity (P < 0.001), and benefits (P < 0.001) were perceived to be higher, and knowledge (P < 0.001) was increased in the HBM group compared to control group 3 months after education. There was a significant increase in fruit and vegetable (P < 0.001) and dairy (P = 0.001) intake and a significant decrease in red meat servings (P = 0.016) in the HBM group compared to the control group. Also, intake of vitamin D (P < 0.001), folate (P < 0.001), calcium (P = 0.008), and dietary fibre (P < 0.001) was increased in the HBM group compared to the control group 3 months after education.
Conclusion: Education plans based on HBM and implemented through multimedia can change nutritional beliefs and behaviours for the prevention of colorectal cancer.
MATERIALS AND METHODS: This Study used a pre-experimental design method with a One-Group Pre-Post test design approach. We recruited 60 breastfeeding mothers in Padang, Indonesia, selected with consecutive sampling. Online Education Based On Family Centered Maternity Care was provided for the respondent. Data were collected using the Breastfeeding Self efficacy Scale ShortForm (BSE-SF) and The Breastfeeding Knowledge (BKQ) Questionnaires.
RESULTS: The respondents had significant differences in selfefficacy and knowledge before and after the health education Based On Family Centered Maternity Care (p<0.001).
CONCLUSION: After Education Package Based On Family Centered Maternity Care influenced the Self Efficacy And Knowledge of Breastfeeding Mothers. It could be provided as a nursing intervention to assist Breastfeeding Mothers.
METHODS: Patients with T2D and overweight/obesity (n = 230) were randomized either into the tDNA group which included a structured low-calorie meal plan using normal foods, incorporation of diabetes-specific meal replacements, and an exercise prescription or usual T2D care (UC) for 6 months. Patients in the tDNA group also received either counseling with motivational interviewing (tDNA-MI) or conventional counseling (tDNA-CC). The UC group received standard dietary and exercise advice using conventional counseling. Eating self-efficacy was assessed using a locally validated Weight Efficacy Lifestyle (WEL) questionnaire. All patients were followed up for additional 6 months' post-intervention.
RESULTS: There was a significant change in WEL scores with intervention over one-year [Group X Time effect: F = 51.4, df = (3.4, 318.7), p<0.001]. Compared to baseline, WEL scores improved in both the tDNA groups with significantly higher improvement in the tDNA-MI group compared to the tDNA-CC and UC groups at 6 months (tDNA-MI: 25.4±2.1 vs. tDNA-CC: 12.9±2.8 vs. UC: -6.9±1.9, p<0.001). At 12 months' follow-up, both the tDNA groups maintained improvement in the WEL scores, with significantly higher scores in the tDNA-MI group than tDNA-CC group, and the UC group had decreased WEL scores (tDNA-MI: 28.9±3.1 vs. tDNA-CC: 11.6±3.6 vs. UC: -13.2±2.1, p<0.001). Patients in the tDNA-MI group with greater weight loss and hemoglobin A1C reduction also had a higher eating self-efficacy, with a similar trend observed in comparative groups.
CONCLUSION: Eating self-efficacy improved in patients with T2D and overweight/obesity who maintained their weight loss and glycemic control following a structured lifestyle intervention based on the Malaysian customized tDNA and the improvement was further enhanced with motivational interviewing.
CLINICAL TRIAL: This randomized clinical trial was registered under National Medical Research Registry, Ministry of Health Malaysia with registration number: NMRR-14-1042-19455 and also under ClinicalTrials.gov with registration number: NCT03881540.