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Hannum SM, Rubinstein RL. The meaningfulness of time; Narratives of cancer among chronically ill older adults. J Aging Stud 2016; 36:17-25. [PMID: 26880601 PMCID: PMC4757851 DOI: 10.1016/j.jaging.2015.12.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 10/20/2015] [Accepted: 12/01/2015] [Indexed: 11/30/2022]
Abstract
This study, using ethnographically-based interviews, sought to describe how chronically ill older adults experience a new cancer diagnosis and the effects of this on their interpretations of personal health, aging, and the future. Three semi-structured interviews were conducted with each of the fifteen informants. We asked questions that explored each individual's life history, chronic illness occurrence, and direct experiences with cancer. Interviews were structured to provide social and historical contexts to enhance our understanding of the informants' illness narratives. Interview transcripts were analyzed thematically to describe how individuals described the cancer experience, its meaning, and its consequences. One of the major findings of our study was the role of cancer in disrupting individual biography, an interruption that fragmented time into three distinct segments: the Recalled Past, the Existent Present, and the Imagined Future. We highlight three main themes around the experience of illness-related time: (1) disruption found in individual biographical accounts as a result of fragmented time dimensions; (2) altered projections of a continuous sense of self into the future; and (3) modified treatment decisions resulting from a perceived altered life course and the finitude of advancing age. We further introduce the concept of Anomalous Time as a permutation of time central to individual experiences of cancer. Implications for how older adults understood their cancer and individual reactions relevant to seeking care are discussed.
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Affiliation(s)
- Susan M Hannum
- Cancer Epidemiology, Prevention, and Control Training Fellowship, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Rm. 263, Baltimore, MD 21205, United States.
| | - Robert L Rubinstein
- Department of Sociology and Anthropology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, United States.
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Sell K, Amella E, Mueller M, Andrews J, Wachs J. Use of Social Cognitive Theory to Assess Salient Clinical Research in Chronic Disease Self-Management for Older Adults: An Integrative Review. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/ojn.2016.63022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Collen M. Operationalizing Pain Treatment in the Biopsychosocial Model: Take a Daily "SWEM"--Socialize, Work, Exercise, Meditate. J Pain Palliat Care Pharmacother 2015; 29:290-9. [PMID: 26367791 DOI: 10.3109/15360288.2015.1063563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
In the United States, chronic pain is often poorly treated at an exceedingly high cost. The use of the biomedical model to manage pain is frequently ineffective, and evidence suggests that the biopsychosocial (BPS) model is a better choice. A problem with the BPS model is that it has not been operationalized in terms of patient behavior. This commentary addresses that issue by suggesting that people with chronic pain and illness participate daily in four self-management health behaviors: socialize, work, exercise, and meditation, and discusses evidence that supports these recommendations. These self-management behaviors may decrease pain and thus reduce the need for pain medications and other medical interventions. Additional topics include patient adherence and health coaching.
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Liddy C. Challenges of self-management when living with multiple chronic conditions: systematic review of the qualitative literature. CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2014; 60:1123-1133. [PMID: 25642490 PMCID: PMC4264810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To explore the perspectives of patients who live with multiple chronic conditions as they relate to the challenges of self-management. DATA SOURCES On September 30, 2013, we searched MEDLINE, EMBASE, and CINAHL using relevant key words including chronic disease, comorbidity, multimorbidity, multiple chronic conditions, self-care, self-management, perspective, and perception. STUDY SELECTION Three reviewers assessed and extracted the data from the included studies after study quality was rated. Qualitative thematic synthesis method was then used to identify common themes. Twenty-three articles met the inclusion criteria, with most coming from the United States. SYNTHESIS Important themes raised by people living with multiple chronic conditions related to their ability to self-manage included living with undesirable physical and emotional symptoms, with pain and depression highlighted. Issues with conflicting knowledge, access to care, and communication with health care providers were raised. The use of cognitive strategies, including reframing, prioritizing, and changing beliefs, was reported to improve people's ability to self-manage their multiple chronic conditions. CONCLUSION This study provides a unique view into patients' perspectives of living with multiple chronic conditions, which are clearly linked to common functional challenges as opposed to specific diseases. Future policy and programming in self-management support should be better aligned with patients' perspectives on living with multiple chronic conditions. This might be achieved by ensuring a more patient-centred approach is adopted by providers and health service organizations.
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Affiliation(s)
- Clare Liddy
- Correspondence: Dr Clare Liddy, University of Ottawa, Family Medicine, Bruyère Research Institute, 43 Bruyère St, Ottawa, ON K1N 5C8; e-mail
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Abstract
OBJECTIVE To describe the experience of pregnancy with a chronic illness. DESIGN Qualitative description. SETTING Tertiary Medical Center, Northeast United States. PARTICIPANTS A purposive sample of eight pregnant women with various chronic conditions. METHODS Telephone interviews. RESULTS The participants described their chronic illnesses as deviations from normality and their pregnancies brought them closer to normality. They described pregnancy as a balancing act between the fantasy of being normal and the reality of having a chronic disease. At the same time, women acknowledged the blessings and burdens of physical changes and intense vigilance. Participants also described emotional demands related to the need to be vigilant, additional physiological alternations, and information overload. CONCLUSION Pregnancy may alter chronic illness, increase stress, and create new health care needs for women. In turn, increased stress associated with chronic illness may alter perinatal outcomes. Pregnant women with chronic illness may benefit from interventions aimed at helping them balance the blessings and burdens associated with the symptoms of pregnancy.
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Illness trajectories and their relevance to the care of adults with kidney disease. Curr Opin Nephrol Hypertens 2014; 22:316-24. [PMID: 23518464 DOI: 10.1097/mnh.0b013e32835ffaaf] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW Existing practice guidelines for chronic kidney disease advocate a stage-based approach to management, in which treatment recommendations are based largely on the severity of kidney disease, and future risk for adverse health outcomes. However, the course of kidney disease can vary widely among patients with similar levels of kidney function, and each patient will experience their illness in unique ways. RECENT FINDINGS We summarize recent studies of patterns of kidney function over time among patients with chronic kidney disease, and discuss these findings in the context of relevant conceptual models of illness and communication. Although knowledge of disease severity can provide useful information on life expectancy and risk for future health events, an understanding of each patient's illness trajectory and their unique experience of illness is essential in supporting patient-centered care for patients with kidney disease. This information can be helpful in setting realistic expectations for the future, in communicating about prognosis and in aligning treatment decisions with each patient's goals and preferences. SUMMARY We here explain how an understanding of illness trajectories may be useful in predicting and guiding care and decision-making in patients with kidney disease. We highlight the importance of competing disease trajectories, the heterogeneity in renal function trajectories among patients with kidney disease, and the variability in these trajectories over time in individual patients. We discuss how individual disease trajectories can shape each patient's experience of illness. Finally, we explain how an understanding of an individual patient's illness trajectory and experience of illness may be useful in guiding discussions about prognosis and treatment decisions and in supporting a patient-centered approach to care.
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Kang M, Kim J, Bae SS, Choi YJ, Shin DS. Older adults' perception of chronic illness management in South Korea. J Prev Med Public Health 2014; 47:236-43. [PMID: 25139170 PMCID: PMC4162119 DOI: 10.3961/jpmph.2014.47.4.236] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 07/16/2014] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Despite the recent emphasis on a patient-centered chronic care model, few studies have investigated its use in older adults in South Korea. We explored how older Korean adults perceive and cope with their chronic illness. METHODS We conducted focus group interviews in Seoul, Korea in January 2010. Focus groups were formed by disease type (hypertension and type 2 diabetes) and gender using purposive sampling. Inclusion criteria were patients aged 60 and over who had been diagnosed with diabetes or hypertension and received care at a community health center for at least six months prior to participation. Interview data were analyzed through descriptive content analysis. RESULTS Among personal factors, most participants felt overwhelmed when they received their diagnosis. However, with time and control of their acute symptoms using medication, their worry diminished and participants tended to denying being identified as a patient or sick person. Among socio-familial factors, participants reported experiencing stigma with their chronic illness and feeling it was a symbol of weakness. Instead of modifying their lifestyles, which might interfere with their social relationships, they resorted to only following their medicine regime prescribed by their doctor. Participants also reported feeling that their doctor only prescribed medications and acted in an authoritative and threatening manner to induce and reinforce participants' compliance with treatment. CONCLUSIONS For successful patient-centered management of chronic illnesses, supportive environments that include family, friends, and healthcare providers should be established. OBJECTIVES Despite the recent emphasis on a patient-centered chronic care model, few studies have investigated its use in older adults in South Korea. We explored how older Korean adults perceive and cope with their chronic illness. METHODS We conducted focus group interviews in Seoul, Korea in January 2010. Focus groups were formed by disease type (hypertension and type 2 diabetes) and gender using purposive sampling. Inclusion criteria were patients aged 60 and over who had been diagnosed with diabetes or hypertension and received care at a community health center for at least six months prior to participation. Interview data were analyzed through descriptive content analysis. RESULTS Among personal factors, most participants felt overwhelmed when they received their diagnosis. However, with time and control of their acute symptoms using medication, their worry diminished and participants tended to denying being identified as a patient or sick person. Among socio-familial factors, participants reported experiencing stigma with their chronic illness and feeling it was a symbol of weakness. Instead of modifying their lifestyles, which might interfere with their social relationships, they resorted to only following their medicine regime prescribed by their doctor. Participants also reported feeling that their doctor only prescribed medications and acted in an authoritative and threatening manner to induce and reinforce participants’ compliance with treatment. CONCLUSIONS For successful patient-centered management of chronic illnesses, supportive environments that include family, friends, and healthcare providers should be established.
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Affiliation(s)
- Minah Kang
- Department of Public Administration, College of Social Sciences, Ewha Womans University, Seoul, Korea
| | - Jaiyong Kim
- Health Services Research Center, Hallym University, Seoul, Korea
| | - Sang-Soo Bae
- Health Services Research Center, Hallym University, Seoul, Korea ; Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Yong-Jun Choi
- Health Services Research Center, Hallym University, Seoul, Korea ; Department of Social and Preventive Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Dong-Soo Shin
- Division of Nursing, Hallym University, Chuncheon, Korea
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Kneck Å, Fagerberg I, Eriksson LE, Lundman B. Living with diabetes - development of learning patterns over a 3-year period. Int J Qual Stud Health Well-being 2014; 9:24375. [PMID: 25030359 PMCID: PMC4101455 DOI: 10.3402/qhw.v9.24375] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/24/2014] [Indexed: 11/14/2022] Open
Abstract
Background Learning involves acquiring new knowledge and skills, and changing our ways of thinking, acting, and feeling. Learning in relation to living with diabetes is a lifelong process where there is limited knowledge of how it is experienced and established over time. It was considered important to explore how learning was developed over time for persons living with diabetes. Aim The aim of the study was to identify patterns in learning when living with diabetes, from recently being diagnosed, and over a 3-year period. Materials and methods A longitudinal qualitative descriptive design was used. Thirteen participants, with both type I and type II diabetes, were interviewed at three different occasions during a 3-year period. Qualitative content analysis was used in different steps in order to distinguish patterns. Findings Five main patterns of learning were identified. Two of the patterns (I and II) were characterized by gradually becoming comfortable living with diabetes, whereas for one pattern (IV) living with diabetes became gradually more difficult. For pattern V living with diabetes was making only a limited impact on life, whereas for Pattern III there was a constant management of obstacles related to illness. The different patterns in the present study showed common and different ways of learning and using different learning strategies at different timespans. Conclusion The present study showed that duration of illness is not of importance for how far a person has come in his own learning process. A person-centered care is needed to meet the different and changing needs of persons living with diabetes in relation to learning to live with a lifelong illness.
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Affiliation(s)
- Åsa Kneck
- Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden; Division of Nursing, Department of Neurolobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden;
| | - Ingegerd Fagerberg
- Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden; Division of Nursing, Department of Neurolobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
| | - Lars E Eriksson
- Division of Nursing, Department of Neurolobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden; School of Health Sciences, City University London, London, United Kingdom
| | - Berit Lundman
- Department of Nursing, Umeå Universitet, Umeå, Sweden
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Stephens M, McKenzie H, Jordens CFC. The work of living with a rare cancer: multiple myeloma. J Adv Nurs 2014; 70:2800-9. [PMID: 24725097 DOI: 10.1111/jan.12430] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2014] [Indexed: 01/17/2023]
Abstract
AIM To report findings from a qualitative study of the experiences of long-term survivors of multiple myeloma. BACKGROUND Multiple Myeloma is a malignant disease of the bone marrow. Until recently, it was rapidly fatal. Although it remains incurable, people diagnosed with it are living longer on average, largely due to new treatments, some of which have onerous side effects. DESIGN Prospective descriptive study. METHOD A series of 47 in-depth interviews were conducted at 6-12 month intervals over 18 months in 2008-2010 with 10 long-term survivors of myeloma and their primary support person. Interviews were analysed using the constant comparative method (Grounded Theory). FINDINGS To adapt to the effects of both the disease and ongoing medical treatments, participants undertook extensive 'illness work'. Most of this work fell into two broad categories. Risk work aimed to mitigate risks to the well-being of both the person with myeloma and his/her carer. Emotion work aimed to manage the feelings of self and others in a protracted cycle of remission and relapse. CONCLUSION The experience of myeloma is increasingly characterized by issues associated with chronic disease and 'survivorship'. It is important for nurses working with people with myeloma to understand the overwhelming nature of illness work in this context. Nurses can put in place supportive measures to address the two main 'drivers' of this work: constant risk to well-being of survivors (including carers) and the recurrent need to manage emotions in social interactions.
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Affiliation(s)
- Moira Stephens
- School of Nursing and Midwifery, University of Wollongong, New South Wales, Australia; Centre for Values, Ethics & Law in Medicine (VELIM), School of Public Health, University of Sydney, New South Wales, Australia
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Yi M, Koh M, Son HM. Rearranging Everyday Lives among People with Type 2 Diabetes in Korea. ACTA ACUST UNITED AC 2014. [DOI: 10.7475/kjan.2014.26.6.703] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Myungsun Yi
- College of Nursing, The Research Institute of Nursing Science, Seoul National University, Seoul, Korea
| | - Moonhee Koh
- Department of Nursing, Chodang University, Muan, Korea
| | - Haeng-Mi Son
- Department of Nursing, University of Ulsan, Ulsan, Korea
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Martinez-Marcos M, De la Cuesta-Benjumea C. How women caregivers deal with their own long-term illness: a qualitative study. J Adv Nurs 2013; 70:1825-36. [DOI: 10.1111/jan.12341] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2013] [Indexed: 01/01/2023]
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Enhancing self-efficacy for optimized patient outcomes through the theory of symptom self-management. Cancer Nurs 2013; 36:E16-26. [PMID: 22495550 DOI: 10.1097/ncc.0b013e31824a730a] [Citation(s) in RCA: 116] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND In today's world, greater patient empowerment is imperative because 90 million Americans live with 1 or more chronic conditions such as cancer. Evidence reveals that healthy behaviors such as effective symptom self-management can prevent or reduce much of the suffering from cancer. Oncology nurses play a pivotal role in developing a symptom self-management plan that is critical to optimizing a patient's symptom self-management behaviors. OBJECTIVE This article uses exemplars to describe how oncology nurses can apply a tested middle-range theory, the Theory of Symptom Self-management, to clinical practice by incorporating interventions to increase a patient's perceived self-efficacy to optimize patient outcomes. METHODS The Theory of Symptom Self-management provides a means to understand the dynamic aspects of symptom self-management and provides a tested framework for the development of efficacy-enhancing interventions for use by oncology nurses in clinical practice. RESULTS Exemplars based on the Theory of Symptom Self-management depict how oncology nursing can use perceived self-efficacy-enhancing symptom self-management interventions to improve the functional status and quality of life of their patients. CONCLUSION Guided by a theoretical approach, oncology nurses can have a significant positive impact on the lives of their patients by reducing the symptom burden associated with cancer and its treatment. IMPLICATIONS FOR PRACTICE Oncology nurses can partner with their patients to design tailored approaches to symptom self-management. These tailored approaches provide the ability to implement patient-specific behaviors that recognize, prevent, relieve, or decrease the timing, intensity, distress, concurrence, and unpleasant quality of symptoms.
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Trento M, Panero F, Porta M, Gruden G, Barutta F, Cerutti F, Gambino R, Perotto M, Cavallo Perin P, Bruno G. Diabetes-specific variables associated with quality of life changes in young diabetic people: the type 1 diabetes Registry of Turin (Italy). Nutr Metab Cardiovasc Dis 2013; 23:1031-1036. [PMID: 23466181 DOI: 10.1016/j.numecd.2013.01.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 01/07/2013] [Accepted: 01/07/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS Type 1 diabetes (T1DM) affects young people during the most active years of their life. Our aim was to assess quality of life (QoL) and associated variables in a large cohort of adults with childhood-onset and adult-onset T1DM. METHODS A cohort of adult patients (18 years and older) from the T1DM Registry of Turin, Italy, was recruited. Clinical characteristics and Diabetes QoL (DQOL) questionnaire were assessed by standardized procedures. RESULTS 310 adults completed the questionnaire. Age and diabetes duration at assessment (mean ± SD) were 32.8 ± 7.3 years and 17.3 ± 6.3 years, respectively. DQOL and its subscores were in the lower quartiles of their distributions, indicating a good level of QoL. However, scores were significantly higher in females than in males, particularly for the subscale of diabetes-related worries. In multivariate analysis, lower QoL was independently associated with female sex (β = 1.07, 95% CI 1.03-1.11, p = 0.003), higher age at onset (β = 1.03, 1.00-1.05, p = 0.009), lower schooling (β = 1.05, 1.00-1.09, p = 0.02), higher fasting plasma glucose (β = 1.03, 1.01-1.05, p = 0.008), daily SMBG >4 (β = 1.06, 1.01-1.10, p = 0.01), severe hypoglycemia over the last year (β = 1.06, 1.01-1.11, p = 0.02), lower numbers of diabetologic visits (β = 1.07, 1.01-1.13, p = 0.02) and hypertension (β = 1.06, 1.02-1.10, p = 0.005). Autonomic neuropathy was associated with diabetes impact. Female sex (β = 4.36, 2.43-7.83) and daily SMBG >4 (β = 3.77, 1.72-8.30) were independently associated with worst level and CSII with better level (β = 0.22, 0.07-0.68) of diabetes-related worries. CONCLUSIONS The impact of T1DM on QoL may depend on demographic, metabolic control-related variables, presence of complications and insulin delivery modality.
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Affiliation(s)
- M Trento
- Laboratory of Clinical Pedagogy, Dept of Medical Sciences, University of Turin, Italy
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Abstract
OBJECTIVE Recent literature acknowledges the impact of this progressive and debilitating disease on psychological and social well-being, but the plight of those with chronic pancreatitis remains unknown and hidden. The aim of this study was to develop an understanding of what it means to live with chronic pancreatitis. DESIGN Qualitative study based on philosophical hermeneutics using multiple unstructured interviews. PARTICIPANTS Fourteen people with chronic pancreatitis and five relatives took part in 41 interviews in 2007-2008. SETTING Tertiary clinic in Ireland. RESULTS The meaning of living with chronic pancreatitis for participants in this study is 'enduring disruption'. Enduring has a two-fold meaning; it symbolises the perpetual or permanent nature of disruption that occurs at physiological, social and psychological levels (i.e., 'suffering'). Enduring also means 'to tolerate' and encompasses how the participants and their families cope and manage the overall transition from well person to a person with chronic pancreatitis. DISCUSSION This study offers an alternative perspective to previous quality of life research and presents a challenge to the emphasis on management of the pathophysiological processes and treatment of chronic pancreatitis that is decontextualised from the person's everyday living. Healthcare professionals need to understand and support people with chronic pancreatitis.
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Affiliation(s)
- Patricia Cronin
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland.
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Carroll DL. Antecedents to the integration process for recovery in older patients and spouses after a cardiovascular procedure. Int J Nurs Pract 2013; 20:97-105. [PMID: 24580980 DOI: 10.1111/ijn.12127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Diane L Carroll
- Institute for Patient Care; Massachusetts General Hospital; Boston Massachusetts USA
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Zarkadas M, Dubois S, MacIsaac K, Cantin I, Rashid M, Roberts KC, La Vieille S, Godefroy S, Pulido OM. Living with coeliac disease and a gluten-free diet: a Canadian perspective. J Hum Nutr Diet 2012; 26:10-23. [DOI: 10.1111/j.1365-277x.2012.01288.x] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- M. Zarkadas
- Canadian Celiac Association; Professional Advisory Board; Mississauga; ON; Canada
| | - S. Dubois
- Food Directorate; Health Canada; Ottawa; ON; Canada
| | - K. MacIsaac
- Canadian Celiac Association; Mississauga; ON; Canada
| | - I. Cantin
- Food Directorate; Health Canada; Ottawa; ON; Canada
| | | | - K. C. Roberts
- Centre for Chronic Disease Prevention; Public Health Agency of Canada; Ottawa; ON; Canada
| | | | - S. Godefroy
- Food Directorate; Health Canada; Ottawa; ON; Canada
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Audulv A, Asplund K, Norbergh KG. The integration of chronic illness self-management. QUALITATIVE HEALTH RESEARCH 2012; 22:332-345. [PMID: 22167155 DOI: 10.1177/1049732311430497] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Self-management is crucial for people living with chronic diseases, but the actual process of integrating self-management has not been explored in depth. In this article, we investigate the integration of self-management into the lives of people with chronic illness. In this longitudinal study, we used an interpretive description approach. Twenty-one individuals were interviewed regularly during the first 3 years after they were diagnosed with a chronic condition. We found self-management integration to be an ongoing process that included four phases: seeking effective self-management strategies, considering costs and benefits, creating routines and plans of action, and negotiating self-management that fits one's life. The participants managed the phases according to their context, e.g., illness experience, life situation, personal beliefs, and social support. Health care providers should therefore facilitate self-management integration by providing support that is adjusted to the person's phase of self-management integration and life context.
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Affiliation(s)
- Asa Audulv
- Mid Sweden University, Sundsvall, Sweden.
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Lin CC, Wu CC, Anderson RM, Chang CS, Chang SC, Hwang SJ, Chen HC. The chronic kidney disease self-efficacy (CKD-SE) instrument: development and psychometric evaluation. Nephrol Dial Transplant 2012; 27:3828-34. [PMID: 22344776 DOI: 10.1093/ndt/gfr788] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Self-management has been associated with positive health outcomes among adults with chronic kidney disease (CKD). Perceived disease-related self-efficacy (DSE) is considered a critical component in the successful self-management of chronic disease. A valid and reliable instrument for measuring CKD patients' self-efficacy is needed. This study aims to develop and test a new instrument to measure the DSE of patients with early stage CKD. METHODS A total of 594 Taiwanese patients with early stage CKD recruited from two medical centers and one regional hospital in southern Taiwan completed the questionnaire. The CKD self-efficacy (CKD-SE) was evaluated using exploratory factor analyses (EFA) and measures of reliability. RESULTS EFA identified four distinct factors with loadings ranging from 0.557 to 0.970: autonomy, self-integration, problem solving and seeking social support, accounting for 64.348% of the total variance. Cronbach's alpha coefficients for the subscales ranged from 0.843 to 0.901. CONCLUSION This promising 25-item CKD-SE instrument can be used for the early identification of patients with low DSE, thus allowing the development of interventions to help these patients attain an appropriate level of DSE.
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Affiliation(s)
- Chiu-Chu Lin
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Kneck Å, Klang B, Fagerberg I. Learning to live with diabetes - integrating an illness or objectifying a disease. J Adv Nurs 2012; 68:2486-95. [DOI: 10.1111/j.1365-2648.2012.05947.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Norton BA, Thomas R, Lomax KG, Dudley-Brown S. Patient perspectives on the impact of Crohn's disease: results from group interviews. Patient Prefer Adherence 2012; 6:509-20. [PMID: 22879737 PMCID: PMC3413071 DOI: 10.2147/ppa.s32690] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
AIM To understand the impact of Crohn's disease (CD) on various aspects of daily life from the perspective of patients living with CD. Awareness of the disease and biologic therapies, patient satisfaction and adherence, and physician (provider) relationships were also assessed. BACKGROUND CD is a chronic, inflammatory, autoimmune disorder of the gastrointestinal tract that substantially impacts patients' physical and emotional well-being. For patients eligible for biologic therapy, anti-tumor necrosis factor agents represent an important addition to the available therapies for CD. METHODS The study sample included biologic-naïve and biologic-experienced patients who had self-reported moderate to severe CD, were under the care of a specialist, and agreed to film a video diary and participate in a focus group. Data from the videos and group interviews were collected from May to June of 2009 and summarized qualitatively by grouping similar answers and quotations. RESULTS Of the 44 participants who submitted video diaries, 23 were biologic-experienced and 21 were biologic-naïve. Participants stated that CD caused fear and embarrassment, that they were reluctant to share the full impact of CD with family and providers, and that they relied on their provider for treatment decisions. Many participants accepted a new state of normalcy if their current medication helped their most bothersome symptoms without providing sustained remission. Participants receiving biologic therapy generally were more informed, more satisfied, and more likely to adhere to treatment regimens. CONCLUSION Participants' responses suggest a need for more patient education and more collaborative relationships between patients and providers (physicians) regarding treatment decisions.
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Affiliation(s)
- Beth-Ann Norton
- Massachusetts General Hospital, Boston, MA, USA
- Correspondence: B Norton, Massachusetts General Hospital, 165 Cambridge St, 9th Floor, Boston, MA 01224 USA, Fax +1 212 426 5099, Email
| | | | | | - Sharon Dudley-Brown
- Johns Hopkins University, Schools of Medicine and Nursing, Baltimore, MD, USA
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71
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Schudrich W, Gross D, Rowshandel J. Lupus and community-based social work. SOCIAL WORK IN HEALTH CARE 2012; 51:627-639. [PMID: 22905978 DOI: 10.1080/00981389.2012.683694] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Systemic lupus erythematous (SLE) is a chronic autoimmune disease that disproportionately strikes women of color. SLE patients frequently experience physical, emotional, and social challenges that often result in unmet biopsychosocial needs. Because of the nature of the disease and the needs of patients, agencies serving SLE patients that engage in community-based social work can positively impact their clients' lives. The S.L.E. Lupus Foundation participates in a myriad of community-based social work practices to help address the needs of their clients. These services include helping economically disadvantaged patients access appropriate services within their communities, building awareness about SLE in society, connecting with government officials at all levels, and collaborating with health care organizations to serve those affected by SLE. Specific examples of community-based activities at the S.L.E. Lupus Foundation are described in detail.
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Affiliation(s)
- Wendy Schudrich
- Wurzweiler School of Social Work, Yeshiva University, New York, New York 10033, USA.
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72
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Ring Jacobsson L, Friedrichsen M, Göransson A, Hallert C. Does a Coeliac School increase psychological well-being in women suffering from coeliac disease, living on a gluten-free diet? J Clin Nurs 2011; 21:766-75. [PMID: 22039932 DOI: 10.1111/j.1365-2702.2011.03953.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIM AND OBJECTIVE To assess the effects of an active method of patient education on the psychological well-being of women with coeliac disease in remission. BACKGROUND Despite remission with a gluten-free diet, adults with coeliac disease and especially women experience a subjective poor health. Self-management education seems to be promising tool to help patients suffering from coeliac disease to cope with their disorder. DESIGN A randomised controlled trial. METHODS A total of 106 women, ≥ 20 years, with confirmed coeliac disease, who had been on a gluten-free diet for a minimum of five years. The intervention group (n = 54) underwent a 10-session educational programme, 'Coeliac School', based on problem-based learning. The controls (n = 52) received information regarding coeliac disease sent home on a regular basis. The primary outcomes were psychological general well-being measured with a validated questionnaire. RESULTS Participants in the Coeliac School reported a significant improvement in psychological well-being at 10 weeks, whereas the controls given usual care reported a worsening in psychological well-being. After six months, a significant improvement remained for the index of vitality. CONCLUSIONS Patient education increased psychological well-being in women with coeliac disease. There is a need to refine the methods of patient education to make the effects of well-being more pronounced over time. RELEVANCE TO CLINICAL PRACTICE Patient education using problem-based learning promotes self-management in coeliac disease by improving the well-being of patients who have been struggling with the gluten-free diet for years.
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Affiliation(s)
- Lisa Ring Jacobsson
- Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden.
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73
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Roos S, Wilhelmsson S, Vulcan A, Sjöberg K, Hallert C. Bowel symptoms, self-image and comorbidity impact on well-being of women with coeliac disease. ACTA ACUST UNITED AC 2011. [DOI: 10.1111/j.1752-9824.2011.01104.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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74
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Ha BC, Robinson G. Chronic care model implementation in the California State Prison System. JOURNAL OF CORRECTIONAL HEALTH CARE 2011; 17:173-82. [PMID: 21525120 DOI: 10.1177/1078345810396859] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The chronic care model (CCM) deployed through a learning collaborative strategy, such as the Institute for Healthcare Improvement's Breakthrough Series (BTS), is a widely adopted approach to improve care that has guided clinical quality initiatives nationally and internationally. The BTS collaborative approach has been used to improve chronic conditions at national and state levels and in single health care delivery systems but not in correctional health care. Combining the CCM with a learning collaborative strategy in prison health care is a new frontier. This article describes the adoption of the CCM using a learning collaborative approach in the California prison system under the mandate of a federal receivership and elucidates some barriers to implementation. Results from the first phase of a pilot study were positive in terms of benefit/ cost analysis and suggest financial and political viability to continue the program.
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Affiliation(s)
- Betsy Chang Ha
- California Prison Health Care Receivership Corporation, Office of the Receiver, Sacramento, California, USA.
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75
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Deshaies K, Hernandez CA. Integration: A Phenomenon to Explore in Chronic Nonmalignant Pain (CNP). Pain Manag Nurs 2011; 12:2-14. [DOI: 10.1016/j.pmn.2009.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Revised: 10/24/2009] [Accepted: 10/26/2009] [Indexed: 10/19/2022]
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76
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Hörnsten Å, Jutterström L, Audulv Å, Lundman B. A model of integration of illness and self-management in type 2 diabetes. ACTA ACUST UNITED AC 2011. [DOI: 10.1111/j.1752-9824.2010.01078.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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77
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Haahr A, Kirkevold M, Hall EO, Østergaard K. From miracle to reconciliation: A hermeneutic phenomenological study exploring the experience of living with Parkinson's disease following Deep Brain Stimulation. Int J Nurs Stud 2010; 47:1228-36. [DOI: 10.1016/j.ijnurstu.2010.03.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Revised: 03/08/2010] [Accepted: 03/09/2010] [Indexed: 11/26/2022]
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Hassankhani H, Taleghani F, Mills J, Birks M, Francis K, Ahmadi F. Being hopeful and continuing to move ahead: religious coping in Iranian chemical warfare poisoned veterans, a qualitative study. JOURNAL OF RELIGION AND HEALTH 2010; 49:311-21. [PMID: 19396547 DOI: 10.1007/s10943-009-9252-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2008] [Accepted: 04/06/2009] [Indexed: 05/11/2023]
Abstract
There is a substantial number of Iranian war veterans, exposed to sulfur mustard, who suffer from serious long term progressive health problems involving their respiratory organs, eyes, and skin. Little is known, however, about these casualties' experiences of living with the consequences of sulfur mustard poisoning. This qualitative study aims to provide greater insight into how war veterans live with the consequences of the poisoning and involved 17 Iranian war veterans who had been poisoned by sulfur mustard during the Iran-Iraq conflict. Each participant was interviewed using a semi-structured interview schedule and the data generated through this process was analyzed using constant comparative data analysis technique. Data analysis resulted in "religious beliefs and practices" as a main category, which included two sub-categories: religious value centered life and religious support. Findings suggest that religious belief assists veterans to accept the impact of poisoning on their lives and adapt their lifestyles accordingly, to participate in religious social activities and feel socially supported, and to be hopeful about the future and live their lives as fully as possible.
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Affiliation(s)
- Hadi Hassankhani
- Nursing and Midwifery Faculty, Isfahan University of Medical Sciences, Isfahan, Iran.
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79
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Creating an interface between the International Classification of Functioning, Disability and Health and physical therapist practice. Phys Ther 2010; 90:1053-63. [PMID: 20448104 DOI: 10.2522/ptj.20090326] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The American Physical Therapy Association (APTA) has endorsed the International Classification of Functioning, Disability and Health (ICF) as a framework to be integrated into physical therapist practice. The ICF is a universal and inclusive platform for the understanding of health and disability and a comprehensive classification system for describing functioning. The APTA's Guide to Physical Therapist Practice was designed to guide patient management, given the different settings and health conditions that physical therapists encounter in their daily clinical practice. However, physical therapists may be unclear as to how to concretely apply the ICF in their clinical practice and to translate the application in a way that is meaningful to them and to their patients. This perspective article proposes ways to integrate the ICF and the Guide to Physical Therapist Practice to facilitate clinical documentation by physical therapists.
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Abstract
BACKGROUND Familial adenomatous polyposis (FAP) is an inherited condition that requires prophylactic surgery (colectomy) followed by a lifetime program of endoscopic surveillance to prevent colorectal cancer. Patients are normally free of symptoms before surgery but a majority report problems related to bowel function postoperatively. OBJECTIVE The aim of the study was to gain a deeper understanding of how FAP affects life by exploring patients' view of what it is like living with the illness and being committed to a lifelong screening program. METHODS Three focus group interviews were conducted, and data were analyzed using descriptive qualitative content analysis. RESULTS The analysis resulted in two categories related to the participants' view of living with FAP. The first category was associated with concerns related to the hereditary and lifelong nature of the disease as well as to the prophylactic surgery and the second category was related to patients' ways of managing life. CONCLUSION Most participants expressed unmet needs, such as lack of healthcare providers with good knowledge about FAP, practical and psychosocial support, FAP educational programs, and organized meetings with other persons with the condition. IMPLICATIONS FOR PRACTICE One important aspect of living with FAP shared by the participants concerned ways of managing life concerns, something that healthcare providers caring for patients with FAP should identify and support. Furthermore, continuity of care by health care providers with good knowledge about FAP can be an important way of reducing patient concerns.
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81
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Meesters JJL, Verhoef J, Liem ISL, Putter H, Vliet Vlieland TPM. Validity and responsiveness of the World Health Organization Disability Assessment Schedule II to assess disability in rheumatoid arthritis patients. Rheumatology (Oxford) 2009; 49:326-33. [DOI: 10.1093/rheumatology/kep369] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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82
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Karwowski CA, Keljo D, Szigethy E. Strategies to improve quality of life in adolescents with inflammatory bowel disease. Inflamm Bowel Dis 2009; 15:1755-64. [PMID: 19472359 DOI: 10.1002/ibd.20919] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Inflammatory bowel disease (IBD), which encompasses Crohn's disease (CD) and ulcerative colitis (UC), are chronic and debilitating conditions with unpredictable courses and complicated treatment. Pediatric IBD carries implications that extend beyond the health of the gastrointestinal tract. When these lifelong illnesses are diagnosed during adolescence, a critical developmental period, the transition to adulthood can be even more turbulent. Like other chronic diseases of childhood, patients with IBD are at risk for depression, anxiety, social isolation, and altered self-image, which can all negatively affect health-related quality of life (HRQOL). The review will draw from pertinent adult and pediatric literature about HRQOL over the past 10 years using a PubMed literature search to summarize instruments with which HRQOL is measured, and address factors that affect HRQOL in adolescents and young adults with IBD. Psychosocial interventions that have been utilized to improve quality of life in this population will also be covered. Identifying patients with impaired quality of life is of paramount importance, as is implementing strategies that may improve HRQOL, so that they may have an easier transition to adulthood while living with IBD.
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Affiliation(s)
- Christine A Karwowski
- Children's Hospital of Pittsburgh, Division of Gastroenterology, Pittsburgh, Pennsylvania 15213, USA
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83
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Curtis CE, Rothstein M, Hong BA. Stage-specific educational interventions for patients with end-stage renal disease: psychological and psychiatric considerations. Prog Transplant 2009. [PMID: 19341059 DOI: 10.7182/prtr.19.1.y176571453728025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
To optimize the success of educational interventions for adults with end-stage renal disease, we developed a psychosocial framework of illness adjustment. Currently, no stage-specific guidelines are available for understanding the psychosocial concerns of patients with end-stage renal disease nor are there specific models of coping with the disease. The content and implementation of educational programs must correspond to a patient's stage of adjustment to the illness. Psychological or psychiatric concerns may also affect participation in and response to educational interventions. Recommendations for structuring and implementing educational interventions about renal replacement that are specific to the unique psychosocial tasks associated with adjusting to each stage of end-stage renal disease are presented. Increased information about this disease and the treatment options available can be instrumental in improving patients' quality of life.
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Affiliation(s)
- Carmen E Curtis
- Washington University School of Medicine, Campus Box 8134, 660 S. Euclid Ave, St Louis, MO 6311, USA
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84
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Curtis CE, Rothstein M, Hong BA. Stage-Specific Educational Interventions for Patients with End-Stage Renal Disease: Psychological and Psychiatric Considerations. Prog Transplant 2009; 19:18-24. [DOI: 10.1177/152692480901900103] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To optimize the success of educational interventions for adults with end-stage renal disease, we developed a psychosocial framework of illness adjustment. Currently, no stage-specific guidelines are available for understanding the psychosocial concerns of patients with end-stage renal disease nor are there specific models of coping with the disease. The content and implementation of educational programs must correspond to a patient's stage of adjustment to the illness. Psychological or psychiatric concerns may also affect participation in and response to educational interventions. Recommendations for structuring and implementing educational interventions about renal replacement that are specific to the unique psychosocial tasks associated with adjusting to each stage of end-stage renal disease are presented. Increased information about this disease and the treatment options available can be instrumental in improving patients' quality of life.
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Affiliation(s)
| | | | - Barry A. Hong
- Washington University School of Medicine, St Louis, Missouri
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