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Dementia resulting from type 2 diabetes mellitus (T2DM) complications significantly impacts older adults' quality of life, increasing suffering for both patients and their families. Numerous studies have identified self-management as a key factor in adopting appropriate health behaviors to prevent diabetes-related complications. However, internationally, there is insufficient empirical evidence for individual and family process factors predicting dementia prevention behaviors in older adults with T2DM. Therefore, we aimed to explore how dementia-preventive self-management behaviors (outcome dimension) are related to contextual and process dimensions based on the Individual and Family Self-Management Theory (IFSMT).
A cross-sectional observational study.
The 444 older adults with T2DM from six community hospitals in Chiang Mai completed valid and reliable self-reported measures, including a Socio-demographic Questionnaire, the Dementia Prevention of Individual and Family Self-Management Process Questionnaire (DP-IFSM-PQ), and the Dementia Preventive Self-Management Behavior Questionnaire (DPSMBQ). Data were analyzed using bivariate correlations, partial correlations, and multivariate linear regression with the stepwise method.
Most participants exhibited high levels of individual and family self-management processes and dementia-preventive self-management behaviors. Bivariate and partial correlation analyses revealed a significant association between DP-IFSM-PQ and DPSMBQ scores. Stepwise multiple linear regression identified self-efficacy, a subdomain of DP-IFSM-PQ, as the strongest predictor of DPSMBQ scores. Other significant predictors included awareness of dementia prevention among family members, neighbors, and the community; family income sufficiency; history of comorbidities; distance to the hospital; and knowledge and beliefs (a subdomain of the DP-IFSM-PQ). The regression model was statistically significant (F [1, 437] = 46.662, p = 0.000, Adjusted R 2 = 0.382).
Self-efficacy and knowledge and beliefs, based on IFSMT, are key predictors of dementia-preventive behaviors among older adults with T2DM. These predictors could be used as potential intervention components in a subsequent co-design study for promoting dementia preventive self-management behaviors in older adults with T2DM. The results also reinforce the importance of family members and healthcare providers in supporting older adults with T2DM to enhance their dementia prevention behaviors.
Approximately 25% of the Brazilian population suffers from mental disorders, a prevalence exacerbated by systemic and cultural factors such as socioeconomic inequalities, underfunded mental health services, regional disparities, and persistent stigma. These conditions significantly impact hospital care. Nurses, due to their direct contact with these patients, face challenges ranging from managing physical conditions to handling verbal aggression and psychiatric crises. This study aimed to assess the scientific evidence regarding nursing care for hospitalized patients with psychiatric disorders.
A systematic review with a mixed-methods approach was conducted, registered in PROSPERO (#CRD42022359288) and guided by PRISMA standards. Databases, such as MEDLINE, LILACS, PubMed, Web of Science, Scopus, and BDEnf, were searched using keywords like “Mental disorder,” “Psychiatric health,” “Nursing care,” and “Hospital.” Methodological quality was assessed using JBI and SQUIRE tools. The integration of quantitative and qualitative components occurred through meta-aggregation of qualitative data and frequency-based coding of quantitative themes, allowing thematic convergence across study designs.
Six studies were included. Meta-aggregation revealed frequent terms, such as “Nurse,” “Emergency,” “Screening,” “Patient,” and “Care.” Similarity analysis linked “Nurse” with “perception” and “experience” and “Emergency” with “Screening” and “Mental health,” highlighting the importance of experience and training. Five categories emerged: (1) professional experience (19.05%, showing skill gaps despite experience); (2) caring process (19.05%, stressing efficient screening); (3) barriers and challenges (19.05%, revealing difficulty with comorbidities); (4) training process (19.05%, identifying training deficiencies); and (5) therapeutic interventions (23.81%, discussing restraint use). These percentages refer to the proportional frequency of themes identified across the total number of studies analyzed. For thematic classification, only statistically significant chi-square values (p < 0.05) were considered in the grouping of content.
Nursing care for psychiatric patients in hospitals faces challenges like insufficient training and difficulty managing psychiatric comorbidities. Recommendations include incorporating structured mental health content into nursing curricula and hospital-based continuing education programs. These strategies may guide future healthcare policies in Brazil by improving patient safety, reducing hospital readmissions, and promoting more humane, evidence-based therapeutic interventions.
The findings emphasize the urgent need for targeted education and training to improve nursing care for psychiatric patients in hospital settings.
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