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Foot Self-Care Experiences Among Patients With Diabetes: A Systematic Review of Qualitative Studies.Wound Management & Prevention Apr 2020Research that explores foot self-care practices and clinical foot care recommendations for persons with diabetes mellitus is limited.
UNLABELLED
Research that explores foot self-care practices and clinical foot care recommendations for persons with diabetes mellitus is limited.
PURPOSE
The aim of this systematic review was to understand the gaps between the American Diabetes Association clinical recommendations on preventive foot self-care and perceptions of and actions taken by patients with diabetes and diabetic foot ulcers (DFUs).
METHODS
PubMed, the Cumulative Index of Nursing and Allied Health Literature, Cochrane Online Library, Psychological Information Database, and Google Scholar were systematically searched for qualitative research literature published in English from January 1, 2001, to October 21, 2016, using the MeSH terms diabetes mellitus, diabetic foot ulcers, foot care, experiences, and perception to examine the experiences of patients with diabetes regarding foot self-care practices. Publications were screened for inclusion according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and The Standard for Reporting Qualitative Research was used to appraise trustworthiness and publication bias. Publication details (author, year, title, country in which the study was conducted, and the type of publication), study aims, design (study methodology, method of sampling, and analysis method), and participant details were abstracted to Excel sheets for analysis of foot self-care experiences and to determine common themes (foot self-care issues) among patients with diabetes.
RESULTS
Of the 14 publications identified, 9 (that included 113 patients with diabetes [95 with or history of DFUs and 18 with no DFUs] and 28 health care professionals [14 podiatrists, 8 physicians, and 6 registered nurses]) met the inclusion criteria for analysis. Research included 4 qualitative descriptive design studies, 2 descriptive phenomenology studies, 1 grounded theory study, 1 interpretive phenomenology study, and 1 exploratory qualitative design study. Four (4) studies were found to lack transparency, and 7 studies did not address trustworthiness. The common themes identified were the high clinical and lifestyle burden of DFUs, poor foot self-care knowledge, perception barriers and resistance, adoption of self-management practices, and discordance between patient and provider impressions and expectations.
CONCLUSION
Several barriers to optimal foot care in persons with diabetes with and without foot ulcers were identified and may be explained and addressed by considering the Health Belief Model. Clinical interventions should be individualized to identify and address patient-specific barriers to optimal foot self-care. Future clinical studies are needed to examine the outcomes of individualized interventions.
Topics: Diabetes Mellitus; Diabetic Foot; Humans; Self Care
PubMed: 32294056
DOI: 10.25270/wmp.2020.4.1625 -
Journal of Affective Disorders Aug 2023Bipolar disorder is a severe and chronic mental illness characterized by recurrent major depressive episodes and mania or hypomania. In addition to the burden of the... (Review)
Review
BACKGROUND
Bipolar disorder is a severe and chronic mental illness characterized by recurrent major depressive episodes and mania or hypomania. In addition to the burden of the disease and its consequences, self-stigma can impact people with bipolar disorder. This review investigates the current state of research in self-stigma in bipolar disorder.
METHODS
An electronic search was carried out until February 2022. Three academic databases were systematically searched, and best-evidence synthesis was made.
RESULTS
Sixty-six articles were related to self-stigma in bipolar disorder. Seven key themes were extracted from these studies: 1/ Comparison of self-stigma in bipolar disorder and other mental illnesses, 2/ Sociocultural context and self-stigma, 3/ Correlates and predictors of self-stigma, 4/ Consequences of self-stigma, 5/ Treatments and self-stigma, 6/ Management of self-stigma, and 7/ Self-stigma and recovery in bipolar disorder.
LIMITATIONS
Firstly, a meta-analysis could not be performed due to the heterogeneity of the studies. Secondly, limiting the search to self-stigma has excluded other forms of stigma that also have an impact. Thirdly, the under-reporting of negative or nonsignificant results due to publication bias and unpublished studies might have limited the accuracy of this reviews' synthesis.
CONCLUSION
Research on self-stigma in persons with bipolar disorder has been the focused on different aspects, and interventions to reduce self-stigmatization have been developed, but evidence of their effectiveness is still sparse. Clinicians need to be attentive to self-stigma, its assessment, and its empowerment in their daily clinical practice. Future work is required to establish valid strategies to fight self-stigma.
Topics: Humans; Bipolar Disorder; Depressive Disorder, Major; Social Stigma; Mania
PubMed: 37207946
DOI: 10.1016/j.jad.2023.05.041 -
International Journal of Environmental... Nov 2019This meta-analysis aimed to estimate the global lifetime and 12-month prevalence of suicidal behavior, deliberate self-harm and non-suicidal self-injury in children and... (Meta-Analysis)
Meta-Analysis
Global Lifetime and 12-Month Prevalence of Suicidal Behavior, Deliberate Self-Harm and Non-Suicidal Self-Injury in Children and Adolescents between 1989 and 2018: A Meta-Analysis.
OBJECTIVE
This meta-analysis aimed to estimate the global lifetime and 12-month prevalence of suicidal behavior, deliberate self-harm and non-suicidal self-injury in children and adolescents.
METHODS
A systematic search for relevant articles published between 1989 to 2018 was performed in multiple electronic databases. The aggregate 12-month and lifetime prevalence of suicidal behavior, deliberate self-harm, and non-suicidal self-injury were calculated based on the random-effects model. Subgroup analyses were performed to compare the prevalence according to school attendance and geographical regions. : A total of 686,672 children and adolescents were included. The aggregate lifetime and 12-month prevalence of suicide attempts was 6% (95% CI: 4.7-7.7%) and 4.5% (95% CI: 3.4-5.9%) respectively. The aggregate lifetime and 12-month prevalence of suicidal plan was 9.9% (95% CI: 5.5-17%) and 7.5% (95% CI: 4.5-12.1%) respectively. The aggregate lifetime and 12-month prevalence of suicidal ideation was 18% (95% CI: 14.2-22.7%) and 14.2% (95% CI: 11.6-17.3%) respectively. The aggregate lifetime and 12-month prevalence of non-suicidal self-injury was 22.1% (95% CI: 16.9-28.4%) and 19.5% (95% CI: 13.3-27.6%) respectively. The aggregate lifetime and 12-month prevalence of deliberate self-harm was 13.7% (95% CI: 11.0-17.0%) and 14.2% (95% CI: 10.1-19.5%) respectively. Subgroup analyses showed that full-time school attendance, non-Western countries, low and middle-income countries, and geographical locations might contribute to the higher aggregate prevalence of suicidal behaviors, deliberate self-harm, and non-suicidal self-injury. : This meta-analysis found that non-suicidal self-injury, suicidal ideation, and deliberate self-harm were the three most common suicidal and self-harm behaviors in children and adolescents.
Topics: Adolescent; Adult; Child; Female; Forecasting; History, 20th Century; History, 21st Century; Humans; Male; Prevalence; Self-Injurious Behavior; Suicidal Ideation; Suicide, Attempted; Time Factors; Young Adult
PubMed: 31752375
DOI: 10.3390/ijerph16224581 -
Journal of Affective Disorders Oct 2016A growing body of research has explored altered physical pain threshold and tolerance in non-suicidal self-injury (NSSI) and suicidal self-harm. The evidence, however,... (Review)
Review
BACKGROUND
A growing body of research has explored altered physical pain threshold and tolerance in non-suicidal self-injury (NSSI) and suicidal self-harm. The evidence, however, is inconsistent such that the nature of the relationship is unclear, and whether or not this effect is also present in suicidal self-harm is equivocal.
METHODS
A keyword search of three major psychological and medical databases (PsycINFO, Medline and Web of Knowledge) was conducted, yielding 1873 records. Following duplicate removal and screening, 25 articles were quality assessed, and included in the final systematic review.
RESULTS
There is strong evidence for increased pain tolerance in NSSI, and some evidence for this in suicidal individuals, but notably, there were no prospective studies. The review found a lack of substantive focus on psychological correlates of altered pain tolerance in this population. Several candidate explanatory mechanisms were proposed within the reviewed studies.
LIMITATIONS
The current review was a narrative systematic review; methods used to assess pain were considered too heterogeneous to conduct a meta-analysis.
CONCLUSIONS
The evidence suggests that there is elevated pain tolerance among those who engage in NSSI. Future prospective research should determine if altered pain tolerance is a cause or a consequence of the behaviour. The identification of psychological correlates of increased pain tolerance is a neglected area of research. It could provide opportunities for treatment/intervention development, if mediating or moderating pathways can be identified. Too few studies have directly investigated candidate explanatory mechanisms to draw definitive conclusions.
Topics: Humans; Pain; Pain Threshold; Self-Injurious Behavior; Suicidal Ideation
PubMed: 27323296
DOI: 10.1016/j.jad.2016.05.068 -
Frontiers in Psychiatry 2021Nonsuicidal self-injury (NSSI) and perfectionism mean a huge concern related to mental health and psychopathology. Recently, there has been a growing interest in...
Nonsuicidal self-injury (NSSI) and perfectionism mean a huge concern related to mental health and psychopathology. Recently, there has been a growing interest in research on the exploration of the association of perfectionism and NSSI, but till today there is no systematic review has been prepared in this topic. Therefore, we performed a systematic literature review of published studies that investigated the association between NSSI and perfectionism. The systematic search was made on PubMed, OVID Medline, PsychInfo, Scopus, and Web of Science. The search terms were ("nonsuicidal self-injury" OR "nonsuicidal self-injury" OR NSSI OR "self-injury" OR "self-injurious behavior" OR SIB OR "self-harm" OR "deliberate self-harm" OR DSH) AND (perfectionism). The inclusion criteria were as follows: written in English; reported empirical data; used validated self-report measures; investigated the association of nonsuicidal self-injury and perfectionism. There were no restrictions on participants regarding age, gender, race or ethnicity. Exclusion criteria: not written in English; was a review/meta-analysis; measured suicide behavior; measured self-injury irrespective of motivation or suicidal intent; was not about the association between nonsuicidal self-injury and perfectionism. After the screening process, 15 studies were included in our systematic review. The majority of studies (12) were published in the last 10 years. Nine (60%) recruited participants from community samples, four (26.7%) from clinical populations, and two (13.3%) both from community and clinical participants. Fourteen (93.3%) of the studies were cross-sectional studies, and one study contained a longitudinal investigation. The majority of studies included only or mainly female participants (62.3-87.2%) and two studies contained a balanced male-female ratio population. Fourteen (93.3%) studies from the 15 studies found a significant positive association between NSSI and perfectionism. The heterogeneity of used instruments makes it difficult to compare the results of involved studies. Only two studies investigated populations with balanced gender ratios. Only two studies examined both clinical and community populations. Clinical investigations enrolled mainly eating-disordered (ED) patients. The results of the current systematic review highlight the role of perfectionism in NSSI engagement. This systematic review may help the development of effective prevention initiatives and treatment strategies.
PubMed: 34305684
DOI: 10.3389/fpsyt.2021.691147 -
European Child & Adolescent Psychiatry Apr 2017Research supports an association between impulsivity and self-harm, yet inconsistencies in methodology across studies have complicated understanding of this... (Review)
Review
Research supports an association between impulsivity and self-harm, yet inconsistencies in methodology across studies have complicated understanding of this relationship. This systematic review examines the association between impulsivity and self-harm in community-based adolescents aged 11-25 years and aims to integrate findings according to differing concepts and methods. Electronic searches of EMBASE, MEDLINE, PsychINFO, CINAHL, PubMed and The Cochrane Library, and manual searches of reference lists of relevant reviews identified 4496 articles published up to July 2015, of which 28 met inclusion criteria. Twenty-four of the studies reported an association between broadly specified impulsivity and self-harm. However, findings varied according to the conception and measurement of impulsivity and the precision with which self-harm behaviours were specified. Specifically, lifetime non-suicidal self-injury was most consistently associated with mood-based impulsivity-related traits. However, cognitive facets of impulsivity (relating to difficulties maintaining focus or acting without forethought) differentiated current self-harm from past self-harm. These facets also distinguished those with thoughts of self-harm (ideation) from those who acted on thoughts (enaction). The findings suggested that mood-based impulsivity is related to the initiation of self-harm, while cognitive facets of impulsivity are associated with the maintenance of self-harm. In addition, behavioural impulsivity is most relevant to self-harm under conditions of negative affect. Collectively, the findings indicate that distinct impulsivity facets confer unique risks across the life-course of self-harm. From a clinical perspective, the review suggests that interventions focusing on reducing rash reactivity to emotions or improving self-regulation and decision making may offer most benefit in supporting those who self-harm.
Topics: Adolescent; Adolescent Behavior; Affect; Female; Humans; Impulsive Behavior; Male; Self-Injurious Behavior
PubMed: 27815757
DOI: 10.1007/s00787-016-0915-5 -
BMC Psychiatry May 2017During the last decade there is a growing scientific interest in nonsuicidal self-injury (NSSI). The aim of the current paper was to review systematically the literature... (Review)
Review
BACKGROUND
During the last decade there is a growing scientific interest in nonsuicidal self-injury (NSSI). The aim of the current paper was to review systematically the literature with a special focus on the associations between self-injurious behaviours and externalizing psychopathology. An additional aim was to review terminology and measurements of self-injurious behaviour and the connection between self-injurious behaviours and suicide in the included publications.
METHODS
A systematic literature search was conducted on 31st December 2016 in five databases (PubMed, OVID Medline, OVID PsycINFO, Scopus, Web of Science) with two categories of search terms (1. nonsuicidal self-injury, non-suicidal self-injury, NSSI, self-injurious behaviour, SIB, deliberate self-harm, DSH, self-injury; 2. externalizing disorder, attention deficit hyperactivity disorder, ADHD, conduct disorder, CD, oppositional defiant disorder, OD, ODD).
RESULTS
Finally 35 papers were included. Eleven different terms were found for describing self-injurious behaviours and 20 methods for measuring it. NSSI has the clearest definition. All the examined externalizing psychopathologies had strong associations with self-injurious behaviours according to: higher prevalence rates in externalizing groups than in control groups, higher externalizing scores on the externalizing scales of questionnaires, higher symptom severity in self-injurious groups. Eight studies investigated the relationship between suicide and self-injurious behaviours and found high overlap between the two phenomena and similar risk factors.
CONCLUSIONS
Based on the current findings the association between externalizing psychopathology and self-injurious behaviours has been proven by the scientific literature. Similarly to other reviews on self-injurious behaviours the confusion in terminology and methodology was noticed. NSSI is suggested for use as a distinct term. Further studies should investigate the role of comorbid conditions in NSSI, especially when internalizing and externalizing pathologies are both presented.
Topics: Conduct Disorder; Humans; Risk Factors; Self-Injurious Behavior; Suicide, Attempted; Surveys and Questionnaires
PubMed: 28468644
DOI: 10.1186/s12888-017-1326-y -
Clinical Child Psychology and Psychiatry Jan 2023To conduct a systematic review to establish what is known about the relationship between depression and self-evaluation in adolescents with a chronic illness. (Review)
Review
OBJECTIVE
To conduct a systematic review to establish what is known about the relationship between depression and self-evaluation in adolescents with a chronic illness.
METHODS
A systematic search was conducted using MEDLINE, EMBASE, PsycINFO, Web of Science, The Cochrane Library, and hand-searching. We sought to identify primary research that examined both the cross-sectional and longitudinal associations between depression and self-evaluation in adolescents with chronic illness. The search resulted in 8941 retrieved articles that were screened against an inclusion criteria. A total of 4 papers were included in the review. The MMAT used to assess study methodological quality.
RESULTS
A narrative synthesis was conducted, and a summary figure was included. These 4 studies included 236 adolescents aged 9-18 years with depression and either Type 1 Diabetes (T1D), chronic pain, headaches, or Inflammatory Bowel Disease (IBD). The limited existing evidence indicated that that depression was associated with negative self-evaluation in adolescents in some but not all chronic illnesses investigated to date. We also found some evidence that psychological intervention can help to improve self-evaluation, specifically in adolescents with T1D.
CONCLUSIONS
More robust studies of the association between self-evaluation and depression in adolescents with a chronic illness is needed, with attention to the nuances of differences between chronic illnesses. The existing evidence indicates that there may be a stronger association in some chronic illnesses. Pilot data suggest that specific psychological therapies may improve self-evaluation, although much more extensive evaluation is needed.
Topics: Adolescent; Humans; Cognitive Behavioral Therapy; Depression; Diagnostic Self Evaluation; Diabetes Mellitus, Type 1; Cross-Sectional Studies; Chronic Disease
PubMed: 35853094
DOI: 10.1177/13591045221115287 -
Journal of Affective Disorders Oct 2017Non-suicidal self-injury (NSSI) is a self-destructive act that represents a considerable burden on the individual and society. Low self-esteem may be a psychological... (Review)
Review
BACKGROUND
Non-suicidal self-injury (NSSI) is a self-destructive act that represents a considerable burden on the individual and society. Low self-esteem may be a psychological variable that is related to NSSI. However, little is known about the nature of this relationship in adulthood. This systematic review therefore aimed to provide a synthesis of the available literature on the relationship between self-esteem and NSSI.
METHODS
Articles were independently identified and risk of bias assessed by two reviewers searching PsycINFO, CINAHL, Medline and Web of Science databases. Inclusion criteria were: (1) a mean sample age of eighteen years or over (2) full manuscripts available in English (3) assessment of NSSI (4) assessment(s) of self-esteem. A narrative synthesis of results was undertaken. A random-effects meta-analysis of differences in self-esteem between NSSI and non-NSSI groups was also undertaken.
RESULTS
Seventeen studies were identified and indicated a significant negative relationship between self-esteem and NSSI. The meta-analysis indicated lower self-esteem in those with experiences of NSSI versus those without, d = 0.59 - 1.17. Results suggested that although low self-esteem and NSSI are related in both clinical and non-clinical populations, there are a number of factors which also influence this relationship.
LIMITATIONS
The absence of longitudinal research is a major limitation of this literature.
CONCLUSIONS
It will be important for clinicians to consider the impact of self-esteem in those seeking support for NSSI. Further research should undertake longitudinal research to better understand the self-esteem and NSSI relationship.
Topics: Adult; Humans; Risk Factors; Self Concept; Self-Injurious Behavior
PubMed: 28647667
DOI: 10.1016/j.jad.2017.06.027 -
BMJ Open Feb 2022Urine pregnancy tests are often inaccessible in low-income settings. Expanded provision of home pregnancy testing could support self-care options for sexual and... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Urine pregnancy tests are often inaccessible in low-income settings. Expanded provision of home pregnancy testing could support self-care options for sexual and reproductive health and rights. We conducted a systematic review of pregnancy self-testing effectiveness, values and preferences and cost.
DESIGN
Systematic review and meta-analysis using the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach.
DATA SOURCES
PubMed, CINAHL, LILACS and EMBASE and four trial registries were searched through 2 November 2020.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
We included trials and observational studies that compared urine self-testing for pregnancy to health worker-led pregnancy testing on effectiveness outcomes; quantitative and qualitative studies describing values and preferences of end users and health workers and costs of pregnancy self-testing.
DATA EXTRACTION AND SYNTHESIS
Two independent reviewers used standardised methods to search, screen and code included studies. Risk of bias was assessed using the Cochrane Collaboration and Evidence Project tools. Meta-analysis was conducted using random effects models. Findings were summarised in GRADE evidence profiles and synthesised qualitatively.
RESULTS
For effectiveness, four randomised trials following 5493 individuals after medical abortion showed no difference or improvements in loss to follow-up with home pregnancy self-testing compared with return clinic visits. One additional trial of community health workers offering home pregnancy tests showed a significant increase in pregnancy knowledge and antenatal counselling among 506 clients. Eighteen diverse values and preferences studies found support for pregnancy self-testing because of quick results, convenience, confidentiality/privacy, cost and accuracy. Most individuals receiving pregnancy self-tests for postabortion home management preferred this option. No studies reported cost data.
CONCLUSION
Pregnancy self-testing is acceptable and valued by end users. Effectiveness data come mostly from articles on postabortion care, and cost data are lacking. Greater availability of pregnancy self-tests, including in postabortion care and CHW programs, may lead to improved health outcomes.
PROSPERO REGISTRATION NUMBER
CRD42021231656.
Topics: Abortion, Induced; Female; Health Personnel; Humans; Pregnancy; Qualitative Research; Self-Testing
PubMed: 35228285
DOI: 10.1136/bmjopen-2021-054120