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Self-administration medication errors at home and its predictors among illiterate and low-literate community-dwelling older adults with polypharmacy: A negative binomial hierarchical regression

by Nafiseh Ghassab-Abdollahi, Haidar Nadrian, Elnaz Shaseb, Narges Kheirollahi, Mina Hashemiparast

Background

Older adults with polypharmacy are more prone to medication errors. People with low educational attainment have more difficulties in taking their medications.

Objectives

This study aimed to identify the extent of medication self-administration errors (MSEs) and the contributing factors among illiterate and low-literate community-dwelling older adults with polypharmacy.

Method

The present cross-sectional study was conducted among people aged 60 and above. The data were collected using the sociodemographic, clinical, and Belief about Medicines Questionnaires (BMQ). To determine the extent of MSE, a medication error checklist was used. The negative binomial hierarchical regression model in the five blocks was performed.

Results

The final sample size was 276 people. The frequency of MSEs in the last 6 months was 69.2%. Sixteen percent of participants had made four or more mistakes. The most common MSEs were forgetting, improper taking of medications with food, improper timing, incorrect dosage (lower dose), and forgetting the doctor’s instructions. Near 18% of participants reported adverse events following their mistakes. The significant predictors of MSEs were being completely illiterate (p = 0.021), the higher number of doctor visits per year (p = 0.014), irregularly seeing doctors (p Conclusion

Despite the high prevalence of MSEs among older patients, practical strategies to deal with them at their homes have not been established among health systems. MSE as a multifactorial event can be caused by a collection of internal and external factors. Further studies to identify the role of patients, clinicians, procedures, and systems in developing MSEs as interconnected components are needed.

Information needs on type 1 diabetes mellitus (T1DM) and its management in children and adolescents: a qualitative study

Por: Muhammed Elamin · S. · Muhamad Arshad · N. F. · Md Redzuan · A. · Abdul Aziz · S. A. · Hong · J. · Chua · X. Y. · Bin-Abbas · B. S. · Alsagheir · A. · Mohamed Shah · N.
Objective

The objective of this study is to explore the information needs related to insulin therapy in children and adolescents with type 1 diabetes mellitus (T1DM) from the children’s perspectives as well as their caregivers.

Design

Qualitative study; semistructured interviews. To identify emerging themes relating to information needs, open coding and thematic analysis were employed.

Setting

Participants were recruited from a tertiary care children’s hospital in Kuala Lumpur, Malaysia and a specialist hospital in Riyadh, Saudi Arabia.

Participants

Thirty one children with a mean age of 11.5 years (SD=1.9) and their caregivers were interviewed. Seventeen participants were from Malaysia and 14 were from Saudi Arabia.

Results

Four themes of information emerged from the interviews, including information related to (1) hypoglycaemia and hyperglycaemia, (2) insulin therapy, (3) injection technique and (4) other information needs pertaining to continuous glucose monitoring, access to peer groups and future advances in insulin therapy.

Conclusion

This study provided valuable insights into the information needs related to T1DM and insulin therapy among children and adolescents with T1DM that should be considered by stakeholders in the development of age-appropriate education materials. Such materials will assist children and adolescents to better manage their life-long T1DM condition from adolescence until adulthood.

Knowledge, attitude and practices of insulin therapy among patients with type 2 diabetes: a cross-sectional study

Por: Almheiri · A. · Binjab · E. A. · Albloushi · M. M. · Alshamsi · M. T. · Khansaheb · H. H. · Zidan · M. · Hassoun · A. A. K.
Objectives

This study aimed to assess the knowledge, attitude and practices of patients with type 2 diabetes on insulin regarding insulin therapy.

Design

A cross-sectional study.

Setting

This study was conducted at the Dubai Diabetes Center from 1 December 2018 to 1 March 2020.

Participants

Face-to-face interviews were conducted for 350 participants with type 2 diabetes at the Dubai Diabetes Center. Interviews followed the structured format of a questionnaire designed to obtain demographic details and score participants on knowledge, attitude and practices. We included patients aged >18 years and receiving insulin therapy. Patients with type 1 diabetes, pregnant women with gestational diabetes, those aged

Results

The median age of participants was 61 years (first quartile, 53 years; third quartile, 67 years); 35.7% were male individuals and 64.3% were female individuals. The median percentage scores for knowledge, attitude and practices were 62.5% (62.5%, 75%), 85.7% (71.4%, 100%) and 77.7% (66.6%, 88.8%), respectively. Highly educated participants had a high level of knowledge. Significant negative correlations were found between the percentage knowledge scores and participants’ age and between the participants’ percentage attitude scores and haemoglobin A1C levels; Spearman’s correlations were –0.182 (p

Conclusion

Patients with type 2 diabetes receiving insulin therapy and attending the Dubai Diabetes Center had adequate knowledge, a positive attitude and correct practice regarding insulin therapy. However, knowledge of specific facts did not always translate into correct behaviours and practices.

Improving properties of platelet‐rich fibrin scaffold with tannic acid for wound healing

Abstract

Platelet-rich fibrin (PRF), which is the rich source of growth factors, has been used as an efficient scaffold in tissue engineering and wound healing. In this study, tannic acid as a green cross-linker with different concentrations (0.5%, 1%, 5% and 10%) was used to improve the properties of PRF. The cross-linked gel scaffolds were evaluated by analyses such as scanning electron microscopy, Fourier transform infrared spectroscopy, swelling and degradation, mechanical strength, cell toxicity, cell adhesion and antibacterial test. The results showed that the scaffold structure changes by increasing cross-linker concentration. The swelling rate decreased from 49% to 5% for the samples without the cross-linker and with tannic acid (10%), respectively. The degradation percentage for the cross-linked samples was 8%, which showed a lower degradation rate than the non-cross-linked samples (63%). The mechanical strength of the scaffold with the cross-linker increased up to three times (Young's modulus for the non-cross linked and the cross-linked samples: 0.01 and 0.6 MPa, respectively). Cytotoxicity was not observed up to 10% cross-linker concentration. The cells proliferated well on the cross-linked scaffolds and also showed a good antibacterial effect. In general, tannic acid can improve the physical and mechanical properties of PRF without negatively affecting its biological properties.

El lugar del racismo en la enfermería brasileña: una revisión integradora de la literatura

Objetivo: conocer la producción científica brasileña sobre el racismo
en la profesión de enfermería. Método: se realizó una revisión integradora
de literatura en las siguientes bases de datos: Scientific Electronic
Library Online, Literatura Latinoamericana y del Caribe en Ciencias de la
Salud, Portal de Revistas de la Comisión para el Perfeccionamiento del
Personal de Educación Superior y Google Scholar. Se utilizaron los siguientes
descriptores: racismo, enfermería, enfermeros y enfermeros, con
los booleanos AND y OR, y sin demarcación temporal. Resultados: se seleccionaron
18 artículos en portugués, publicados entre 1997 y 2018. El
racismo aparece en la profesión desde sus inicios, en su formación y en el
mercado profesional, siendo abordado a través de una perspectiva histórica,
capaz de señalar a la mujer negra como su principal objetivo. En los
últimos años ha habido una mayor producción académica sobre el tema, que se ha convertido en una forma de enfrentar el racismo. Consideraciones finales: la producción académica sobre el racismo en la profesión de enfermería es escasa. Hay un silencio sobre el tema que dificulta el debate, así como las formas de enfrentar este tipo de violencia en la profesión.
Urge la apropiación teórico-conceptual del tema por estudiantes y profesionales de enfermería para que ocupe un lugar relevante en la literatura científica.

Prototyping Process and Usability Testing of a Serious Game for Brazilian Children With Type 1 Diabetes

imageThis study aims to describe the prototype development and testing of a serious game designed for Brazilian children with diabetes. Following an approach of user-centered design, the researchers assessed game's preferences and diabetes learning needs to develop a Paper Prototype. The gameplay strategies included diabetes pathophysiology, self-care tasks, glycemic management, and food group learning. Diabetes and technology experts (n = 12) tested the prototype during audio-recorded sessions. Next, they answered a survey to evaluate the content, organization, presentation, and educational game aspects. The prototype showed a high content validity ratio (0.80), with three items not achieving the critical values (0.66). Experts recommended improving the game content and food illustrations. This evaluation contributed to the medium-fidelity prototype version, which after testing with diabetes experts (n = 12) achieved high content validity values (0.88). One item did not meet the critical values. Experts suggested increasing the options of outdoor activities and meals. Researchers also observed and video-recorded children with diabetes (n = 5) playing the game with satisfactory interaction. They considered the game enjoyable. The interdisciplinary team plays an important role guiding the designers in the use of theories and real needs of children. Prototypes are a low-cost usability and a successful method for evaluating games.

Consulta puerperal: ¿las enfermeras egresadas de una residencia obstétrica realizan esta práctica?

Objetivo principal: comprender cómo se ha realizado la asistencia ofrecida en consultas puerperales por enfermeros egresados de un programa de residencia en enfermería obstétrica en una Universidad Pública del Sur de Minas Gerais. Metodología: estudio cualitativo, descriptivo y exploratorio, se utilizó el análisis de contenido de Bardin. La población está compuesta por ocho enfermeras parteras y la recolección de datos consistió en entrevistas semiestructuradas, en línea, a través de la plataforma Skype. Principales resultados: surgieron cuatro categorías temáticas, entre ellas: “Atención integral en la consulta puerperal”; “Facilidades, dificultades y posibilidades para realizar la consulta puerperal”; “Uso de metodologías activas en las consultas prenatales y puerperales para la educación en salud”, y “Las bases de la humanización del cuidado de enfermería a la puérpera”. Principal conclusión: se verificó que actúan de forma calificada, humanizada, integral, en concordancia con la literatura científica e identificadas dificultades, facilidades y posibilidades, así como la realización de la educación en salud y humanización de la atención puerperal.

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