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????????????????????????? EU ?? (????? 2010/32/EU) ??2013 ? 5 ? 11 ?????? EU ??????????????????????????????????????????????????????????????????????????????????????????????????????????????????EU ?????????????????????????????????????????? ????????????????

????: ?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????: ??????? ?????????????????????????? 230 ???????????????????????????????????????????????????????????? ?????????? ?????????????????????? ????????????????????: ???? 80% ????????????????? ?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????: ??????????????????????????????????????????????????????????????????????????? ??????????????????????????????????????????????????????????????????????????????????? ???????????????????????

?????????????????????????????????????????????????????????????????????????????????LILACS?MEDLINE?Cochrane?Embase?CINAHL?PubMed???? Ovid ???????????????279 ?????????? 5 ??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????

???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????2006?????????????????????????????65??????????????????????????????????????????????????????????????????????????????????????????????????????????????

????: ????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????2012 ? 3 ??? 4 ???????????????????????????????????????????????????????????????: ????????????????????????????????????? 374 ?????????????????????????????????????????????????????????????????????

??: ????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????: ????????????????????????????????????????????????????????????????????????????????????11 ??????????????? 10 ?????????????? (???????) ???????????????: ????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????

??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????36????????????????????????????????????39??????????????????????????????????????t?????????????????????????????????????????????97.4%??????????84.6%????????????????t=5.783 p<0.01?????????t=2.041 p<0.05??????????t= 5.818 p<0.01?????????????t=4.638 p<0.01??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????

Background: Although a common thread among diabetic behavior is the importance of perceived glycemic control, little is known of the factors that lead to psychosocial status in this population. Purpose: We determine whether the psychosocial factors of health locus of control, self-efficacy, self-care behavior, and depression relate to glycemic control in type 2 diabetes. Method: We used a descriptive correlational design. In total, 285 subjects were enrolled from diabetic outpatient clinics in Southern Taiwan. We applied the health locus of control, self-efficacy, self-care behavior and depression questionnaires. Glycemic control was assessed by HbA1c. Results: The internal health locus of control was significantly positively correlated with self-efficacy and self-care behavior, and significantly negatively correlated with depression. Combined depression and self-efficacy partly mediated the relationship between internal locus of control and self-care behavior (P ＜.01), and completely mediated the relationship between external health locus of control and self-care behavior (P ＜.01). Depression and initial HbA1c directly and significantly affected final HbA1c value. Higher depression had the worst HbA1c. Conclusion: Internal health locus of control was partly mediated the relationship between depression and self efficacy. The finding could form a basis for caring people with type 2 diabetes and provide a reference for further research.

There is proportionate increase in the health problems along with increase in elderly population in India. Nurses need to be well equipped with knowledge and should also have a positive attitude regarding elderly care. The current cross sectional study was undertaken with an objective to assess the knowledge and attitude of nursing students regarding care of elderly. Using purposive sampling technique, 267 undergraduate nursing students were enrolled in the study. A pre validated self-administered questionnaire was used to assess the knowledge and attitude of nursing students regarding elderly care. The knowledge questionnaire consisted of 28 multiple choice questions with one right answer. Total score was further categorized as poor, average and good as per the score obtained by the subjects. The attitude was assessed on a Likert five-point scale, ranged from ‘strongly agree’ with 5 score to ‘strongly disagree’ with 1 score. It consisted of 16 items. The total score was further categorized as unfavorable, neutral and favorable attitude as per the scores obtained. Majority (95.5%) of the subjects were females. Mean age (yrs) ± SD was 22.61 ± 3.31 with the range of 19-48 yrs. More than half (53.9) were from urban locality. Only 29.2% were staying with the grandparents. Mean knowledge score ± S.D. was 22.10 ± 2.91, with the range of 9-27. Around two third (76.4) were in the good category of knowledge score. Mean attitude score ± S.D. was 60.38 ± 8.95 with the range of 22-78. 64.6% were in the positive category of attitude. Knowledge and attitude were positively correlated.

Diabetes is a chronic incurable disease of high prevalence in older people due to changes in glucose homeostasis, diabetes-related complications and other comorbidities that affect physical and cognitive functioning and have implications for medicines use. Polypharmacy is common and represents a significant medicine and selfcare burden, risk of medicine-related adverse events, and inappropriate prescribing. Some medicines used to treat diabetes such as insulin, sulphonylureas, warfarin and antiplatelet agents are known as ‘high risk’ medicines because of their association with adverse events. Managing medicines is a complex process that requires particular knowledge and skills and strategies to proactively identify risks and plan care to reduce the risk such as following evidence based recommendations/ guidelines, comprehensive assessment and monitoring, using decision support tools such as BEERs, STOPP and START criteria, and importantly, involving the individual and/or carers in medicine decisions to personalise medicines education and the medicine regimen.

Women in the developing world are experiencing "unimaginable suffering" due to lack of effective care during pregnancy and childbirth as many end up with debilitating injuries such as Vesico Vaginal Fistula (VVF). VVF is an abnormal communication between the urinary bladder and the vagina that results in the continuous involuntary discharge of urine. Most women affected are living in shame and isolation, often abandoned by their husbands and relatives. The aim of this study was to assess the extent to which abandonment, social isolation and stigmatization significantly influence the coping strategies of women affected by VVF in Akwa Ibom State, Nigeria. The study adopted Ex- post Facto design using mixed method of quantitative and qualitative approach. Transactional model of stress and coping directed the study. A sample of 120 VVF women (inpatients and outpatients), 18 VVF women coming back for follow-up care after repairs and 3 key informants were purposively selected for the study. Instruments for data collection were structured interview guide and in-depth (unstructured) interview. Regression analyses was used for quantitative data analysis and verbatim transcription/coding for qualitative with result presented in themes. The results showed that the three independent variables were significant predictors of coping strategies of VVF women in the area of study, with abandonment and stigmatization having a high influence though with a negative coefficient while social isolation exerted a weak influence. This implied that the more abandoned and stigmatized the VVF women, the less active their coping abilities while social isolation exerted less influence on their coping strategies. The study concluded that there exist a significant influence of abandonment stigmatization and social isolation on the coping strategies of VVF affected women.

Problem The purpose of this research was to evaluate the impact of an advanced practice nurse-directed patient education approach to heart failure treatment integrating the use of an interactive 4G android tablet, will enable patients to experience enhanced patient activation and engagement in chronic disease self-management and fewer 30-day rereadmissions. Data source This was a prospective patient randomization, multi-center quasi-experimental design study of 50 patients comparing an advanced practice nurse-directed education of disease self-management and use of a 4G android tablet (TC) group (n = 25) and routine medical management (MC) group. The study length was 12 months. Conclusions Descriptive statistics were computed, and the intervention and control groups were compared for differences. Descriptive statistics using ANOVA was conducted to calculate for statistical significance of readmissions between the two groups at 30 days. T-tests showed that the 30-day readmissions rate was significantly lower for the tablet groups compared to the medical group at 30 days (8% and 28% respectively; P=0.010). Implications for Practice The results support that integrating 4G android tablet technology does have a significant impact on enhancing patient activation and engagement in chronic disease self-management and correlated to reduced 30-day readmissions in people with heart failure.