DETERMINANTS OF HIGH SELF-CONFIDENCE IN DIABETES MANAGEMENT AMONG OLDER DIABETES PATIENTS

Abstract

completed diabetes survey in 2003. We conducted regression analysis, controlling age, gender, education level, marital status, and types of diabetes. Results revealed that patients who reported higher confidence in diabetes management tended to experience less difficulties in self-care, better understanding of self-care methods, and greater social support. Additionally, those who had higher confidence in self-care gave higher ratings for their self-care and perceived higher self-rated health. Importantly, receiving emotional and tangible support from family and friends is significantly associated with increasing patients' confidence in self-care activities. These results indicate that improving confidence in self-care is essential to have successful diabetes management. Our findings can aid healthcare providers in identifying patients who will potentially struggle with self-care practices. Nonalcoholic fatty liver disease (NAFLD), a metabolic disorder related to insulin resistance and metabolic syndrome,has become a public health concernworldwide. Currently,principaltherapeutic modalities targeting NAFLD are lifestyle interventions. However, the efficacy of long-term lifestyle interventions in NAFLD management remains largely unexplored.This study aimed to evaluate theefficacy of long-term lifestyle interventions inmiddle-aged and elderly men with NAFLD. All the280 eligible patients were randomizedto control or test group. In test group,patients received counseling bytwo physiciansevery 3 months via phone visit. A diet tailored to their calorie need and increased physical activities according to individual situations were prescribed.Patients in control groupreceived no intervention.Afterperiodic interventions for 2 years, body weight, abdominal circumference, ALT, TCH, LDL-C and HDL-C decreased in test group. Specially, fatty liver index (FLI) and NAFLD-fibrosis score (NAFLD-FS) in test group reduced markedly.However, in control group, there was only significant decrease in LDL-C, HDL-C level and NAFLD-FS (P< 0.001), whereas other parameters remained essentially unchanged.Liver steatosis grade in test group decreased significantly, while the situation aggravated in control group. In NAFLD, long-term lifestyle interventionsexert an anti-obesity effect and attenuated liver dysfunction and steatosis. The bad nutrition that occurs in the elderly may be due to physiological changes of aging, the socioeconomic conditions, diseases and the interaction between nutrients and drugs. The food served to the elderly should be mostly cooked or prepared to facilitate mastication. These types of food contain less vitamins, minerals and fiber. Examine the association between body mass index, waist-hip ratio, waist circumference and nutritional profile in groups of elderly relating it to their food habits and observer by type of shelter of this population taken care of in one of them Centers in Manaus, aiming at to know the reason of the search of the aged, the medical attendance, types of requested examinations. During 2015, 1076 elderly was accompanied, amongst routine medical consultations; inclusion revisit. Excrement and blood biochemical analysis had been requested, and gauging of the arterial pressure. The highest BMI, WHR, and WC quartiles and predefined BMI categories were analyzed as predictive variables. The alimentary consumption was registered during 3 days and each specific nutrient. We used a statistical analyzed by SPSS. Was found overweight prevalence's (65, 8%), 87% hypertension, 48% intestinal parasitism; 45% high cholesterol , 47% anemic and 32% diabetics. The diet compared to the Dietary Reference Intakes showed inadequate. BMI = 30,3 ± 10,5 e 28,3 ± 4,0 and WHR= 0,91 ± 0,05 e 0,93 ± 0,08. DELIVERING TAILORED REHABILITATION THROUGH AN ELECTRONIC PATIENT RECORD TO PROMOTE PHYSICAL FUNCTION Rehabilitation has potential to exploit technology to address changes in physical functioning associated with chronic diseases and aging. This cohort study was designed to determine feasibility of using an electronic patient health record to prevent the physical functional decline in persons ≥44years with and without chronic diseases/condi-tions. Participants completed self-report measures including assessments of function and preclinical disability, the Rapid Assessment of Physical Activity (RAPA), at baseline, 6, 12, and 18 months. Participants, 97 persons with chronic dis-eases/conditions (CD) and 50 persons without (NCD), identified goals using the Patient Specific Functional Scale (PSFS). Using the assessment results, physical and occupational therapists tailored recommendations delivered electronically to address the goals. A library of therapist intervention pages (TIPs) on rehabilitation strategies was created, with topics such as back pain, energy conservation, managing arthritis, balance exercises etc.. Forty-two percent of persons with CD had no difficulty or preclinical changes at baseline compared to 92% without chronic disease; 35% with CD and 8% (NCD) had early changes or difficulty; while 23% (CD) had established difficulty in physical functioning, experiencing significant or longstanding difficulties with physical functioning, mobility, or activities of daily living. Although the range of health-related activities identified with the PSFS varied, functional mobility and exercise/physical activity items were prominent. After 6 months, significant changes in physical activities (RAPA; p=0.05) were detected in the CD group. Findings suggest that on-line monitoring and delivery of rehabilitation strategies support improvements in physical activities and thus promote physical functioning for people with chronic conditions.