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Hafeez H, Abdullah MI, Riaz A, Shafique I. Prevention of occupational injuries and accidents: A social capital perspective. Nurs Inq 2020; 27:e12354. [PMID: 32406124 DOI: 10.1111/nin.12354] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 04/10/2020] [Accepted: 04/18/2020] [Indexed: 12/30/2022]
Abstract
Prior research has consistently established the pragmatic nature of literature regarding occupational injuries and accidental happenings faced by nursing professionals. However, current realities require a subjective approach to identify preventative measures that could influence occupational health and safety in healthcare sectors. A qualitative design followed a descriptive approach to assess unbiased opinions towards occupational obstructions that lead to accidental happenings. This study used the social capital framework in particular as a support resource to eliminate its detrimental effects on nurse's capacity to serve their patients. The findings extended the fundamental understanding of social capital from social ties to workplace and personal ties as potential mechanisms of support. Healthcare organizations need to redefine their control policies to provide the ultimate support to their care agents. A social capital model offers nursing practitioners and nursing managers an approach for building evidence-based policies with implications for nurse's safety, education and training.
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Affiliation(s)
- Hira Hafeez
- University of Lahore, Gujrat, Pakistan.,COMSATS University Islamabad, Lahore, Pakistan
| | | | - Amir Riaz
- COMSATS University Islamabad, Lahore, Pakistan
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Reidy C, Foster C, Rogers A. A Facilitated Web-Based Self-Management Tool for People With Type 1 Diabetes Using an Insulin Pump: Intervention Development Using the Behavior Change Wheel and Theoretical Domains Framework. J Med Internet Res 2020; 22:e13980. [PMID: 32356776 PMCID: PMC7229530 DOI: 10.2196/13980] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 11/08/2019] [Accepted: 12/16/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Type 1 diabetes (T1D) requires intensive self-management (SM). An insulin pump is designed to better support personal T1D management, but at the same time, it exacerbates the complexity and requirements of SM. Research shows that people with diabetes are likely to benefit from navigating and connecting to local means of social support and resources through web-based interventions that offer flexible, innovative, and accessible SM. However, questions remain as to which behavior change mechanisms within such resources benefit patients most and how to foster engagement with and endorsement of SM interventions. OBJECTIVE The aim of this study was to evaluate the perspectives and experiences of people with T1D using an insulin pump and specialist health care professionals (HCPs) and determine what behavior change characteristics and strategies are required to inform the optimization of an existing web-based social network (SN) intervention to support SM. METHODS Focus groups with insulin pump users (n=19) and specialist HCPs (n=20) in 6 National Health Service (NHS) trusts across the south of England examined the barriers and enablers to incorporating and self-managing an insulin pump. An analysis was undertaken using the Behavior Change Wheel and Theoretical Domains Framework, followed by a taxonomy of behavior change techniques (BCTs) to identify the contents of and strategies for the implementation of a complex health intervention. RESULTS A total of 4 themes represent the SM perspectives and experiences of stakeholders: (1) a desire for access to tailored and appropriate resources and information-the support and information required for successful SM are situational and contextual, and these vary according to time and life circumstances, and therefore, these need to be tailored and appropriate; (2) specific social support preferences-taking away isolation as well as providing shared learnings and practical tips, but limitations included the fear of judgment from others and self-pity from peers; (3) the environmental context, that is, capacity and knowledge of pump clinic HCPs-HCPs acknowledge the patient's need for holistic support but lack confidence in providing it; and (4) professional responsibility and associated risks and dangers, whereas HCPs are fearful of the consequences of promoting non-NHSSM support, and they question whether SM support fits into their role. BCTs were identified to address these issues. CONCLUSIONS The use of behavioral theory and a validated implementation framework provided a comprehensive approach for systematically identifying barriers and enablers of self-managing T1D with an insulin pump. A web-based SN intervention appears to offer additional forms of SM support while complementing NHS services. However, for intervention implementation, HCPs' apprehensions about responsibility when signposting to non-NHS SM support would need to be addressed, and opportunistic features would need to be added, through which pump users could actively engage with other people living with T1D.
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Affiliation(s)
- Claire Reidy
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, School of Health Sciences, Faculty of Environmental & Life Sciences, University of Southampton, Southampton, United Kingdom.,School of Primary Care, Population Health & Medical Education, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Claire Foster
- Macmillan Survivorship Research Group, School of Health Sciences, Faculty of Environmental & Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Anne Rogers
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, School of Health Sciences, Faculty of Environmental & Life Sciences, University of Southampton, Southampton, United Kingdom
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Satisfaction with Social Support Received from Social Relationships in Cases of Chronic Pain: The Influence of Personal Network Characteristics in Terms of Structure, Composition and Functional Content. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082706. [PMID: 32326411 PMCID: PMC7215382 DOI: 10.3390/ijerph17082706] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/30/2020] [Accepted: 04/10/2020] [Indexed: 11/17/2022]
Abstract
The worldwide burden of chronic illnesses, constitutes a major public health concern and a serious challenge for health systems. In addition to the strategies of self-management support developed by nursing and health organizations, an individual’s personal network represents a major resource of social support in the long-term. Adopting a cross-sectional design based on personal network analysis methods, the main aim of this study is to explore the relationship between satisfaction with the social support received by individuals suffering chronic pain and the structure, composition, and functional content in social support of their personal networks. We collected personal and support network data from 30 people with chronic pain (20 person’s contacts (alters) for each individual (ego), 600 relationships in total). Additionally, we examined the level of satisfaction with social support in each of the 600 relationships. Bivariate and multivariate tests were performed to analyze the satisfaction with the social support received. Using cluster analysis, we established a typology of the 600 relationships under study. Results showed that higher satisfaction was associated with a balance between degree centrality and betweenness (i.e., measures of network cohesion and network modularity, respectively). Finally, new lines of research are proposed in order to broaden our understanding of this subject.
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Does social support effect knowledge and diabetes self-management practices in older persons with Type 2 diabetes attending primary care clinics in Cape Town, South Africa? PLoS One 2020; 15:e0230173. [PMID: 32168342 PMCID: PMC7069645 DOI: 10.1371/journal.pone.0230173] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 02/24/2020] [Indexed: 11/24/2022] Open
Abstract
Background In South Africa with one of the most rapidly ageing populations in Africa despite the demographic impact of the HIV/AIDS epidemic, diabetes is a major cause of morbidity and mortality. Self-management is challenging for all those with the condition but is likely to create a higher demand for those who may have existing co-morbidities associated with age, and long-standing chronic diseases. Objective To determine the relationship of social support, especially that of family and friends with their self-management. Methods This cross-sectional study was undertaken in the Cape Town metropole primary care clinics. The sample comprised 406 people drawn from four community health centres (CHC) that are served by Groote Schuur Hospital at the tertiary level. Results Of the 406 participants, 68.5% were females, 60.5% were living with a family member, and almost half were married. The mean duration of diabetes from diagnosis was eight years. More than half (57.4%) had no or only primary education. Half the participants (50.2%) had poor knowledge level in relation to symptoms and complications of diabetes. Multivariable linear regression showed older age was associated with poor knowledge (®: -1.893, 95% CI-3.754; -0.031) and higher income was associated with self-management practice (®: 3.434, 95% CI 0.797; 6.070). Most participants received family support to follow aspects of diabetes self-management. The ordinal logistic regression indicated that family support was positively associated with the self-management practice score for following a diabetic meal plan, taking care of feet, physical activity, testing blood sugar and handling participants’ feelings about being diabetic, but not for taking medication. Conclusions Consideration needs to be given to developing and testing education programmes that focus on needs of older people with diabetes and emphases the role of family and friends.
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James E, Kennedy A, Vassilev I, Ellis J, Rogers A. Mediating engagement in a social network intervention for people living with a long-term condition: A qualitative study of the role of facilitation. Health Expect 2020; 23:681-690. [PMID: 32162435 PMCID: PMC7321728 DOI: 10.1111/hex.13048] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 12/25/2022] Open
Abstract
Background Successful facilitation of patient‐centred interventions for self‐management support has traditionally focussed on individual behaviour change. A social network approach to self‐management support implicates the need for facilitation that includes an orientation to connecting to and mobilizing support and resources from other people and the local environment. Objective To identify the facilitation processes through which engagement with a social network approach to self‐management is achieved. Method Thematic analysis was used to analyse data from a longitudinal study design using quasi‐ethnographic methods comprising non‐participant observation, video and qualitative interviews involving 30 participants living with a long‐term condition recruited from a marginalized community. Results Findings centred on three themes about the social network approach facilitation processes: reversing the focus on the self by bringing others into view; visualization and reflection as a mediator of positive disruption and linking to new connections; personalized matching of valued activities as a means of realizing preference elicitation. Discussion and conclusions Engagement processes with a social network approach illuminated the relevance of cognizance of an individual's immediate social context and forefronting social participation with others as the bases of self‐management support of a long‐term condition. This differs from traditional guided facilitation of health behaviour interventions that frame health as a matter of personal choice and individual responsibility.
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Affiliation(s)
- Elizabeth James
- School of Health Sciences, University of Southampton, Southampton, UK.,NIHR CLAHRC Wessex, University of Southampton, Southampton, UK
| | - Anne Kennedy
- School of Health Sciences, University of Southampton, Southampton, UK.,NIHR CLAHRC Wessex, University of Southampton, Southampton, UK
| | - Ivaylo Vassilev
- School of Health Sciences, University of Southampton, Southampton, UK.,NIHR CLAHRC Wessex, University of Southampton, Southampton, UK
| | - Jaimie Ellis
- School of Health Sciences, University of Southampton, Southampton, UK.,NIHR CLAHRC Wessex, University of Southampton, Southampton, UK
| | - Anne Rogers
- School of Health Sciences, University of Southampton, Southampton, UK.,NIHR CLAHRC Wessex, University of Southampton, Southampton, UK
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56
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Doekhie KD, Buljac-Samardzic M, Strating MMH, Paauwe J. Elderly patients' decision-making embedded in the social context: a mixed-method analysis of subjective norms and social support. BMC Geriatr 2020; 20:53. [PMID: 32050911 PMCID: PMC7017481 DOI: 10.1186/s12877-020-1458-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 02/03/2020] [Indexed: 02/07/2023] Open
Abstract
Background Older patients are increasingly encouraged to be actively involved but how they perceive their role in the decision-making process varies according to their health care providers and their health situation. Their role could be influenced by their social context but more specifically by subjective norms (i.e. patients’ view of the role that significant others expect them to play in the decision-making process) and perceived social support. We explore how social context (i.e. subjective norms and social support) relates to how the patient perceives their role in the decision-making process. Also, we explore the level of alignment on subjective norms between patients and their informal caregivers and nurses. Methods Mixed-method study among older patients, informal caregivers and nurses. For the quantitative questionnaire, a home care organisation randomly selected patients. The patients were asked to identify their informal caregiver and the home care organisation was asked to identify the nurse who was most involved in their care. In total 133 patients, 64 informal caregivers and 72 nurses were questioned. Participants for the qualitative interviews were selected using convenience sampling, resulting in the inclusion of ten patients, five informal caregivers and six nurses. Subjective norms were based on a previous study. Social support was measured with the ‘social support for health scale’ of the Health Literacy Questionnaire. The Control Preference Scale was used as outcome variable. The interviews focused on subjective norms, social support and how the patient perceived their role. Quantitative analysis included the calculation of subjective norm difference scores between respondent groups, one-way analysis of variance and multinomial logistic regression analysis. Directed content analysis was applied to the interviews using Atlas TI. Results Lower difference scores were found for patient-informal caregiver dyads (mean = 0.95), implying more alignment than in patient-nurse dyads (mean = 2.12). Patients perceiving themselves to have a shared or passive role tend to believe that they are expected to leave decision-making to the health care provider. Higher social support scores related more to a shared role. Alignment relates to: familiarity with the patient’s preferences, overprotectiveness or valuing the care provider’s opinion and the severity of the patient’s medical history. Conclusion Patients and informal caregivers align on whether the patient should make decisions. The more patients believe that they are expected to leave decision-making to the health care provider, the more they perceive themselves as having a passive role. The more patients who feel they have support, the more they perceive themselves as having a shared role. Patients and caregivers could be facilitated to make role expectations explicit. Examining support resources in the social network is desirable.
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Affiliation(s)
- Kirti D Doekhie
- Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam, PO Box 1738, 3000 DR, Rotterdam, The Netherlands.
| | - Martina Buljac-Samardzic
- Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam, PO Box 1738, 3000 DR, Rotterdam, The Netherlands
| | - Mathilde M H Strating
- Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam, PO Box 1738, 3000 DR, Rotterdam, The Netherlands
| | - Jaap Paauwe
- Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam, PO Box 1738, 3000 DR, Rotterdam, The Netherlands.,Department of Applied Economics, Erasmus University Rotterdam, Rotterdam, Netherlands.,Department of Human Resource Studies, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands
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57
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Bloom I, Welch L, Vassilev I, Rogers A, Jameson K, Cooper C, Robinson S, Baird J. Findings from an exploration of a social network intervention to promote diet quality and health behaviours in older adults with COPD: a feasibility study. Pilot Feasibility Stud 2020; 6:15. [PMID: 32042439 PMCID: PMC7003327 DOI: 10.1186/s40814-020-0553-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 01/22/2020] [Indexed: 02/01/2023] Open
Abstract
Background Diet quality in older people with chronic obstructive pulmonary disease (COPD) is associated with better health and lung function. Social factors, such as social support, social networks and participation in activities, have been linked with diet quality in older age. A social network tool—GENIE (Generating Engagement in Network Involvement)—was implemented in a COPD community care context. The study aimed to assess the feasibility of the GENIE intervention to promote diet quality and other health behaviours in COPD. Methods Twenty-two community-dwelling older adults with COPD were recruited from a local COPD service. Participants were offered usual care or the GENIE intervention. Process evaluation methods were used to assess intervention implementation, context and mechanisms of impact; these included observations of patient interactions with the intervention, documented in observational field notes and in films of a patient group discussion. Diet quality was assessed by food frequency questionnaire; ‘prudent’ diet scores were used to describe diet quality at baseline and at 3-month follow-up. Change in diet quality was expressed per month, from baseline to follow-up. Results Feasibility data showed that the GENIE intervention could be implemented in this sample of community-living older people. The intervention was acceptable to clinicians and older people with COPD, especially for those with less severe disease, when facilitated appropriately and considering the levels of literacy of participants. There was no significant change in diet quality in the intervention group over the follow-up period (median change in prudent diet score per month (interquartile range (IQR), 0.03 (− 0.24–0.07)), whereas an overall fall in diet quality was observed in the control group (− 0.15 (− 0.24–0.03)). Conclusion The process evaluation findings suggest that this intervention is feasible and acceptable to both patients and clinicians. Although the sample size achieved in this study was small, findings suggest that the intervention may have a protective effect against declines in diet quality, and other health behaviours, in an older COPD population. Findings from this feasibility study indicate that further evaluation of the GENIE intervention is warranted in a larger study, with a longer follow-up. Trial registration ClinicalTrials.gov, NCT02935452. NIH U.S. National Library of Medicine. Registered 17 October 2016.
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Affiliation(s)
- Ilse Bloom
- 1MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD UK.,2NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Lindsay Welch
- 3Solent NHS Trust, Bitterne Health Centre, Commercial Road, Bitterne, Southampton, UK.,4Faculty of Environmental and Life Sciences, School of Health Sciences, University of Southampton, Southampton, UK.,NIHR Collaboration for Leadership in Applied Health Research (CLAHRC) Wessex, Southampton, UK
| | - Ivaylo Vassilev
- 4Faculty of Environmental and Life Sciences, School of Health Sciences, University of Southampton, Southampton, UK.,NIHR Collaboration for Leadership in Applied Health Research (CLAHRC) Wessex, Southampton, UK
| | - Anne Rogers
- 4Faculty of Environmental and Life Sciences, School of Health Sciences, University of Southampton, Southampton, UK.,NIHR Collaboration for Leadership in Applied Health Research (CLAHRC) Wessex, Southampton, UK
| | - Karen Jameson
- 1MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD UK
| | - Cyrus Cooper
- 1MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD UK.,2NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.,6NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
| | - Sian Robinson
- 1MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD UK.,7AGE Research Group, Biomedical Research Building, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Janis Baird
- 1MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD UK.,2NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Warren JR, Muller C, Hummer RA, Grodsky E, Humphries M. Which Aspects of Education Matter for Early Adult Mortality? Evidence from the High School and Beyond Cohort. SOCIUS : SOCIOLOGICAL RESEARCH FOR A DYNAMIC WORLD 2020; 6:10.1177/2378023120918082. [PMID: 33094163 PMCID: PMC7575125 DOI: 10.1177/2378023120918082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
What dimensions of education matter for people's chances of surviving young adulthood? Do cognitive skills, non-cognitive skills, course taking patterns, and school social contexts matter for young adult mortality, even net of educational attainment? We analyze data from High School & Beyond-a nationally representative cohort of ~25,000 high school students first interviewed in 1980. Many dimensions of education are associated with young adult mortality, and high school students' math course taking retain their associations with mortality net of educational attainment. Our work draws on theories and measures from sociological and educational research and enriches public health, economic, and demographic research on educational gradients in mortality that has almost exclusively relied on ideas of human capital accumulation and measures of degree attainment. Our findings also call on social and education researchers to engage together in research on the life-long consequences of educational processes, school structures, and inequalities in opportunities to learn.
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Affiliation(s)
- John Robert Warren
- Department of Sociology ~ Minnesota Population Center, University of Minnesota
| | - Chandra Muller
- Department of Sociology ~ Population Research Center, University of Texas
| | - Robert A Hummer
- Department of Sociology ~ Carolina Population Center, University of North Carolina
| | - Eric Grodsky
- Department of Sociology ~ Center for Demography and Ecology, University of Wisconsin
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Sawyer JM, Sallnow L, Kupeli N, Stone P, Sampson EL. Social networks, social capital and end-of-life care for people with dementia: a realist review. BMJ Open 2019; 9:e030703. [PMID: 31822539 PMCID: PMC6924787 DOI: 10.1136/bmjopen-2019-030703] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES (1) To develop an understanding of how social capital may be conceptualised within the context of end-of-life care and how it can influence outcomes for people with dementia and their families with specific reference to the context and mechanisms that explain observed outcomes. (2) To produce guidance for healthcare systems and researchers to better structure and design a public health approach to end-of-life care for people with dementia. DESIGN A realist review. DATA SOURCES MEDLINE, EMBASE, CINAHL and grey literature. ANALYSIS We conceptualised social capital as a complex intervention and, in order to understand how change is generated, used realist evaluation methods to create different configurations of context, mechanism and outcomes. We conducted an iterative search focusing on social capital, social networks and end-of-life care in dementia. All study designs and outcomes were screened and analysed to elicit explanations for a range of outcomes identified. Explanations were consolidated into an overarching programme theory that drew on substantive theory from the social sciences and a public health approach to palliative care. RESULTS We identified 118 articles from 16 countries ranging from 1992 to 2018. A total of 40 context-mechanism-outcome configurations help explain how social capital may influence end-of-life care for people with dementia. Such influence was identified within five key areas. These included: (1) socially orientating a person with dementia following diagnosis; (2) transitions in the physical environment of care; (3) how the caregiving experience is viewed by those directly involved with it; (4) transition of a person with dementia into the fourth age; (5) the decision making processes underpinning such processes. CONCLUSION This review contributes to the dispassionate understanding of how complex systems such as community and social capital might be viewed as a tool to improve end-of-life care for people with dementia. PROSPERO REGISTRATION NUMBER CRD42018084524.
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Affiliation(s)
- Joseph M Sawyer
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Libby Sallnow
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
- Camden, Islington ELiPSe and UCLH & HCA Palliative Care Service, London, UK
| | - Nuriye Kupeli
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Patrick Stone
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Elizabeth L Sampson
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
- Barnet Enfield and Haringey Mental Health Trust Liaison Psychiatry Team, North Middlesex University Hospital, London, UK
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Gray KE, Hoerster KD, Reiber GE, Bastian LA, Nelson KM. Multiple domains of social support are associated with diabetes self-management among Veterans. Chronic Illn 2019; 15:264-275. [PMID: 29635933 DOI: 10.1177/1742395318763489] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objectives To examine, among Veterans, relationships of general social support and diabetes-specific social support for physical activity and healthy eating with diabetes self-management behaviors. Methods Patients from VA Puget Sound, Seattle completed a cross-sectional survey in 2012–2013 ( N = 717). We measured (a) general social support and (b) diabetes-specific social support for healthy eating and physical activity with domains reflecting support person participation, encouragement, and sharing ideas. Among 189 self-reporting diabetes patients, we fit linear and modified Poisson regression models estimating associations of social support with diabetes self-management behaviors: adherence to general and diabetes-specific diets and blood glucose monitoring (days/week); physical activity (< vs. ≥150 min/week); and smoking status (smoker/non-smoker). Results General social support was not associated with diabetes self-management. For diabetes-specific social support, higher healthy eating support scores across all domains were associated with better adherence to general and diabetes-specific diets. Higher physical activity support scores were positively associated with ≥150 min/week of physical activity only for the participation domain. Discussion Diabetes-specific social support was a stronger and more consistent correlate of improved self-management than general social support, particularly for lifestyle behaviors. Incorporating family/friends into Veterans’ diabetes self-management routines may lead to better self-management and improvements in disease control and outcomes.
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Affiliation(s)
- Kristen E Gray
- 1 VA Puget Sound Health Care System, Health Services Research & Development, VA Puget Sound Health Care System, Seattle, WA, USA.,2 Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA
| | - Katherine D Hoerster
- 1 VA Puget Sound Health Care System, Health Services Research & Development, VA Puget Sound Health Care System, Seattle, WA, USA.,3 Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Gayle E Reiber
- 1 VA Puget Sound Health Care System, Health Services Research & Development, VA Puget Sound Health Care System, Seattle, WA, USA.,2 Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA.,4 Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
| | - Lori A Bastian
- 5 Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, West Haven, CT, USA.,6 Department of Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Karin M Nelson
- 7 Department of Medicine, University of Washington, Seattle, WA, USA
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Wulfovich S, Fiordelli M, Rivas H, Concepcion W, Wac K. " I Must Try Harder": Design Implications for Mobile Apps and Wearables Contributing to Self-Efficacy of Patients With Chronic Conditions. Front Psychol 2019; 10:2388. [PMID: 31749733 PMCID: PMC6842939 DOI: 10.3389/fpsyg.2019.02388] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Accepted: 10/07/2019] [Indexed: 12/12/2022] Open
Abstract
Background Diverse wellness-promoting mobile health technologies, including mobile apps and wearable trackers, became increasingly popular due to their ability to support patients' self-management of health conditions. However, the patient's acceptance and use depend on the perceived experience and the app appropriateness to the patient's context and needs. We have some understating of the experience and factors influencing the use of these technologies in the general public, but we have a limited understanding of these issues in patients. Objective By presenting results from an explorative study, this paper aims to identify implications for the design of mobile apps and wearables to effectively support patients' efforts in self-management of health with a special emphasis on support for self-efficacy of activities contributing to health. Methods An explorative mixed-method study involving 200 chronically ill patients of Stanford Medical Center (Stanford, CA, United States) was conducted between mid-2016 and end of 2018. Amongst these, 20 patients were involved in a 4-weeks study, in which we collected the underlying wearable device use logs (e.g., Fitbit) and subjective use experience [via an Ecological Momentary Assessment (EMA)], as well as patients' momentary perception of general self-efficacy in their natural environments and different daily contexts. Results The results indicate that mobile apps for health and wearables have the potential to enable better self-management and improve patients' wellbeing but must be further refined to address different human aspects of their use. Specifically, the apps/wearables should be easier to use, more personalized and context-aware for the patient's overall routine and lifestyle choices, as well as with respect to the momentary patient state (e.g., location, type of people around) and health(care) needs. Additionally, apps and devices should be more battery efficient and accurate; providing timely, non-judgmental feedback and personalized advice to the patients anywhere-anytime-anyhow. These results are mapped on major sources of the individuals' self-efficacy. Conclusion Our results show how the apps/wearables that are aimed at supporting the patients' self-management should be designed to leverage and further improve the patients' general self-efficacy and self-efficacy of activities contributing to chronic disease management.
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Affiliation(s)
| | - Maddalena Fiordelli
- Faculty of Communication Sciences, Institute of Communication and Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Homero Rivas
- Department of Surgery, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Waldo Concepcion
- Department of Surgery - Multi-Organ Transplantation, Stanford University, Stanford, CA, United States
| | - Katarzyna Wac
- Department of Surgery - Multi-Organ Transplantation, Stanford University, Stanford, CA, United States.,Department of Computer Science, University of Copenhagen, Copenhagen, Denmark.,Department of Computer Science, Université de Genève, Geneva, Switzerland
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Litchman ML, Edelman LS. Perceptions of the Diabetes Online Community's Credibility, Social Capital, and Help and Harm: Cross-Sectional Comparison Between Baby Boomers and Younger Adults. JMIR Aging 2019; 2:e10857. [PMID: 31573907 PMCID: PMC6787528 DOI: 10.2196/10857] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 02/01/2019] [Accepted: 04/04/2019] [Indexed: 01/05/2023] Open
Abstract
Background The use of online health communities such as the diabetes online community (DOC) is growing. Individuals who engage in the DOC are able to interact with peers who have the same medical condition. It is not known if older adults are perceiving the DOC differently compared with younger adults. Objective The purpose of this study was to explore and understand how the DOC is perceived in terms of social capital, source credibility, and help and harm. The findings from this study will shed light on how users of different age groups (baby boomers and younger adult counterparts) perceive DOC use. Methods This study represents a subset of participants from a larger study of DOC users. Baby boomers and younger adults with diabetes were recruited from the DOC to participate in a cross-sectional survey. Demographics, electronic health use (reasons to join the DOC, DOC intensity, DOC engagement, internet social capital, and help or harm from the DOC), source credibility, health-related quality of life, and diabetes self-care data were collected. We examined the differences between baby boomer and younger adult responses. Results The participants included baby boomers (N=76) and younger adult counterparts (N=102). Participants scored their diabetes health care team (mean 33.5 [SD 8]) significantly higher than the DOC (mean 32 [SD 6.4]) with regard to competence (P<.05) and trustworthiness (diabetes health care team mean 36.3 [SD 7.1]; DOC mean 33.6 [SD 6.2]; P<.001). High bonding and bridging social capital correlated with high DOC intensity (r=.629; P<.001 and r=.676; P<.001, respectively) and high DOC engagement (r=.474; P<.01 and r=.507; P≤.01, respectively). The greater majority (69.8%) reported the DOC as being helpful, and 1.8% reported that the DOC had caused minor harm. Baby boomers perceived DOC credibility, social capital, help, and harm similarly to their younger adult counterparts. Conclusions Baby boomers are using and perceiving the DOC similarly to younger adults. DOC users find the DOC to be credible; however, they scored their health care team higher with regard to competence and trustworthiness. The DOC is beneficial with low risk and may augment current diabetes care.
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Affiliation(s)
| | - Linda S Edelman
- University of Utah, College of Nursing, Salt Lake City, UT, United States
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Kong LN, He S, Li L, Lei QS, Wang T, Yao Y. Factors for self-management activities among rural patients with chronic hepatitis B: A cross-sectional study. J Clin Nurs 2019; 28:3949-3956. [PMID: 31408559 DOI: 10.1111/jocn.15037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 04/03/2019] [Accepted: 08/04/2019] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To assess the self-management activities among rural patients with chronic hepatitis B (CHB), and the influence of psychosocial and demographic factors on their self-management activities. BACKGROUND Chronic hepatitis B is a serious public health concern. Rural patients may have limited access to healthcare services. Although self-management is important for controlling chronic hepatitis B, few studies focus on the self-management activities among rural patients with chronic hepatitis B. Understanding self-management activities and related factors in this population are important to design and implement appropriate intervention strategies. DESIGN A cross-sectional study. METHODS From June-December 2017, totally 236 rural patients with chronic hepatitis B were recruited from hepatology department in two hospitals in Chongqing, China. The questionnaire included demographic characteristics, Chronic Hepatitis B Self-Management Scale, Self-Efficacy for Managing Chronic Disease, and Social Support Rating Scale. The study followed the STROBE checklist. RESULTS Rural patients with chronic hepatitis B reported poor self-management activities for the score indexes of symptom management (57.36%), lifestyle management (54.89%), psychosocial coping (54.84%) and disease information management (53.11%) were all below 60%. Self-efficacy, objective support, subjective support, gender, education level and marital status showed significant effect on self-management activities. CONCLUSION Rural patients with chronic hepatitis B were found to perform insufficient self-management activities. Self-efficacy, social support, gender, education level and marital status were identified to influence their self-management activities. RELEVANCE TO CLINICAL PRACTICE Self-management activities should be promoted among rural patients with chronic hepatitis B. The factors that were identified in this study should be addressed when developing interventions to promote the performance of self-management activities for rural patients with chronic hepatitis B.
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Affiliation(s)
- Ling-Na Kong
- School of Nursing, Chongqing Medical University, Chongqing, PR China.,School of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Shan He
- School of Nursing, Chongqing Medical University, Chongqing, PR China
| | - Lin Li
- Department of liver disease, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, PR China
| | - Qing-Song Lei
- Department of infectious disease, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Tian Wang
- Department of infectious disease, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Yu Yao
- School of Nursing, Chongqing Medical and Pharmaceutical College, Chongqing, PR China
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Vassilev I, Band R, Kennedy A, James E, Rogers A. The role of collective efficacy in long-term condition management: A metasynthesis. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:e588-e603. [PMID: 31231928 PMCID: PMC6852408 DOI: 10.1111/hsc.12779] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 04/07/2019] [Accepted: 04/12/2019] [Indexed: 06/09/2023]
Abstract
Social networks have been found to have a valuable role in supporting the management of long-term conditions. However, the focus on the quality and how well self-management interventions work focus on individualised behavioural outcomes such as self-efficacy and there is a need for understanding that focuses on the role of wider collective processes in self-management support. Collective efficacy presents a potentially useful candidate concept in the development and understanding of self-management support interventions. To date it has mainly been utilised in the context of organisations and neighbourhoods related to social phenomena such as community cohesion. Drawing on Bandura's original theorisation this meta-synthesis explores how studies of collective efficacy might illuminate collective elements operating within the personal communities of people with long-term conditions. A qualitative meta-synthesis was undertaken. Studies published between 1998 and 2018 that examined collective efficacy in relation to health and well-being using qualitative and mixed methods was eligible for inclusion. Timing of engagement with others, building trust in the group, and legitimising ongoing engagement with the group arised as central elements of collective efficacy. The two themes forming third order constructs were related to the presence of continuous interaction and ongoing relational work between members of the group. Collective efficacy can develop and be sustained over time in a range of situations where individuals may not have intense relationships with one another and have limited commitment and contact with one another. Extending this to the personal communities of people with long-term conditions it may be the case that collective efficacy enables a number of engagement opportunities which can be oriented towards assisting with support from networks over a sustained length of time. This may include negotiating acceptable connections to resources and activities which in turn may help change existing practice in ways that improve long-term condition management.
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Affiliation(s)
- Ivaylo Vassilev
- NIHR Collaboration for Leadership in Applied Health Research (CLAHRC)WessexUniversity of SouthamptonSouthamptonUK
| | - Rebecca Band
- NIHR Collaboration for Leadership in Applied Health Research (CLAHRC)WessexUniversity of SouthamptonSouthamptonUK
| | - Anne Kennedy
- NIHR Collaboration for Leadership in Applied Health Research (CLAHRC)WessexUniversity of SouthamptonSouthamptonUK
| | - Elizabeth James
- NIHR Collaboration for Leadership in Applied Health Research (CLAHRC)WessexUniversity of SouthamptonSouthamptonUK
| | - Anne Rogers
- NIHR Collaboration for Leadership in Applied Health Research (CLAHRC)WessexUniversity of SouthamptonSouthamptonUK
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65
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McKinlay E, McDonald J, Darlow B, Perry M. Social networks of patients with multimorbidity: a qualitative study of patients' and supporters' views. J Prim Health Care 2019. [PMID: 29530227 DOI: 10.1071/hc16062] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Multimorbidity impacts on patients' health and wellbeing, but relationships experienced within social networks can support people to live well. AIM This study sought to elicit the views of New Zealanders with multimorbidity about their social networks and the views of their nominated supporters. METHODS Ten patients with multimorbidity and their nominated supporters each independently recorded their views of the patient's social network on a five-concentric-circle template, indicating supporting role and importance to each patient. Sets of patients' and nominated supporters' templates were compared followed by comparing matched pairs of patient-supporter templates. Nominated supporters' views about the patients' networks and why they were nominated were collated. RESULTS Three patients nominated family members as supporters and seven nominated health professionals. Nominated family members identified a greater range of supporters than nominated health professionals. Nominated family members perceived that they played an integral role, whereas health professionals were less comfortable viewing relationships with patients in this way. Family members were not surprised to be nominated as supporters, and some described a considerable burden of care. Health professionals described themselves as coordinators of support and having positive relationships with patients. DISCUSSION Patients with multimorbidity have rich and diverse social networks. They view partners, family and health professionals as providing significant support. Family members are more aware of their role and have a deeper understanding of other network members than health professionals. Further research is needed on the use of social networks in clinical practice to support the health and wellbeing of those with multimorbidity.
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Band R, Ewings S, Cheetham-Blake T, Ellis J, Breheny K, Vassilev I, Portillo MC, Yardley L, Blickem C, Kandiyali R, Culliford D, Rogers A. Study protocol for 'The Project About Loneliness and Social networks (PALS)': a pragmatic, randomised trial comparing a facilitated social network intervention (Genie) with a wait-list control for lonely and socially isolated people. BMJ Open 2019; 9:e028718. [PMID: 31427326 PMCID: PMC6701612 DOI: 10.1136/bmjopen-2018-028718] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/13/2019] [Accepted: 06/17/2019] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Loneliness and social isolation have been identified as significant public health concerns, but improving relationships and increasing social participation may improve health outcomes and quality of life. The aim of the Project About Loneliness and Social networks (PALS) study is to assess the effectiveness and cost-effectiveness of a guided social network intervention within a community setting among individuals experiencing loneliness and isolation and to understand implementation of Generating Engagement in Network Involvement (Genie) in the context of different organisations. METHODS AND ANALYSIS The PALS trial will be a pragmatic, randomised controlled trial comparing participants receiving the Genie intervention to a wait-list control group. Eligible participants will be recruited from organisations working within a community setting: any adult identified as socially isolated or at-risk of loneliness and living in the community will be eligible. Genie will be delivered by trained facilitators recruited from community organisations. The primary outcome will be the difference in the SF-12 Mental Health composite scale score at 6-month follow-up between the intervention and control group using a mixed effects model (accounting for clustering within facilitators and organisation). Secondary outcomes will be loneliness, social isolation, well-being, physical health and engagement with new activities. The economic evaluation will use a cost-utility approach, and adopt a public sector perspective to include health-related resource use and costs incurred by other public services. Exploratory analysis will use a societal perspective, and explore broader measures of benefit (capability well-being). A qualitative process evaluation will explore organisational and environmental arrangements, as well as stakeholder and participant experiences of the study to understand the factors likely to influence future sustainability, implementation and scalability of using a social network intervention within this context. ETHICS AND DISSEMINATION This study has received NHS ethical approval (REC reference: 18/SC/0245). The findings from PALS will be disseminated widely through peer-reviewed publications, conferences and workshops in collaboration with our community partners. TRIAL REGISTRATION NUMBER ISRCTN19193075.
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Affiliation(s)
- Rebecca Band
- Psychology, University of Southampton, Southampton, UK
- Health Sciences, University of Southampton, Southampton, UK
- NIHR Collaboration for Leadership in Applied Health Research and Care Wessex, NIHR, Wessex, UK
| | - Sean Ewings
- Health Sciences, University of Southampton, Southampton, UK
| | - Tara Cheetham-Blake
- Health Sciences, University of Southampton, Southampton, UK
- NIHR Collaboration for Leadership in Applied Health Research and Care Wessex, NIHR, Wessex, UK
| | - Jaimie Ellis
- Health Sciences, University of Southampton, Southampton, UK
- NIHR Collaboration for Leadership in Applied Health Research and Care Wessex, NIHR, Wessex, UK
| | - Katie Breheny
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Ivaylo Vassilev
- Health Sciences, University of Southampton, Southampton, UK
- NIHR Collaboration for Leadership in Applied Health Research and Care Wessex, NIHR, Wessex, UK
| | - Mari Carmen Portillo
- Health Sciences, University of Southampton, Southampton, UK
- NIHR Collaboration for Leadership in Applied Health Research and Care Wessex, NIHR, Wessex, UK
| | - Lucy Yardley
- Academic Unit of Psychology, University of Southampton, Southampton, UK
- School of Psychological Science, University of Bristol, Bristol, UK
| | | | - Rebecca Kandiyali
- Centre for Child and Adolescent Health, University of Bristol School of Social and Community Medicine, Bristol, UK
| | - David Culliford
- NIHR Collaboration for Leadership in Applied Health Research and Care Wessex, NIHR, Wessex, UK
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Anne Rogers
- Health Sciences, University of Southampton, Southampton, UK
- NIHR Collaboration for Leadership in Applied Health Research and Care Wessex, NIHR, Wessex, UK
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Jager MJ, van der Sande R, Essink-Bot ML, van den Muijsenbergh METC. Views and experiences of ethnic minority diabetes patients on dietetic care in the Netherlands - a qualitative study. Eur J Public Health 2019; 29:208-213. [PMID: 30204883 PMCID: PMC6426026 DOI: 10.1093/eurpub/cky186] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Diabetes type 2 is more prevalent in people from ethnic minorities in the Netherlands, and outcomes of care are worse compared with other Dutch people. Dieticians experience difficulties in managing these groups in self-management and adherence to dietary advice. The aim of this study was to explore the views regarding a healthy diet and dietetic care among ethnic minority type 2 diabetes patients. Methods Semi-structured interviews were held with 12 migrants with diabetes from Turkey, Morocco, Iraq and Curacao, who visited a dietician. Inclusion went on until saturation was reached. The interview guide was based on the Attitudes, Social influence and self-Efficacy (ASE) model and Kleinman’s explanatory model of illness. Interviews were held in the language preferred by the respondent. Transcripts were coded and thematically analyzed. Results Several respondents expected a more rigorous, directive and technical approach of the dietician. All respondents acknowledged the importance of a healthy diet. What they considered healthy was determined by culturally influenced ideas about health benefits of specific foods. Important hindrances for dietary change were lack of self-efficacy and social support. Social influences were experienced both as supportive and a hindrance. Conclusions Migrant diabetic patients’ opinions about healthy food are determined by culturally influenced ideas rather than by dietary guidelines. Dutch dietary care is not tailored to the needs of these patients and should take into account migrants’ expectations, cultural differences in dietary habits and specifically address the role of family.
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Affiliation(s)
- Mirjam J Jager
- Nutrition and Dietetics, HAN University of Applied Sciences, Nijmegen, The Netherlands.,Department of Public Health, Academic Medical Centre, Amsterdam, The Netherlands
| | - Rob van der Sande
- Primary and Community Care, HAN University of Applied Sciences, Nijmegen, The Netherlands.,Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Maria E T C van den Muijsenbergh
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands.,Prevention and care programme, Pharos, National Centre of Expertise on Health Disparities, Utrecht, The Netherlands
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68
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Kong LN, Zhu WF, Li L, Lei QS, Wang T, Li YL. Self-management behaviors in adults with chronic hepatitis B: A structural equation model. Int J Nurs Stud 2019; 116:103382. [PMID: 31402047 DOI: 10.1016/j.ijnurstu.2019.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 06/08/2019] [Accepted: 06/12/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Chronic hepatitis B is a serious and chronic health problem, requiring self-management to control the disease and related complications. OBJECTIVES To develop a structural model to identify how social support, self-efficacy and disease knowledge contribute to their self-management behaviors in adults with chronic hepatitis B. DESIGN A cross-sectional study. SETTINGS Hepatology units in two hospitals in Chongqing, China. PARTICIPANTS A total of 306 patients with chronic hepatitis B were recruited. METHODS Data were collected using Social Support Rating Scale, Self-Efficacy for Managing Chronic Disease, Hepatitis B Knowledge Questionnaire and Chronic Hepatitis B Self-Management Scale. Structural equation model was applied to analyze the data. RESULTS The final model showed good model fit. Social support directly influenced self-management behaviors (β = 0.19, p < 0.01), and indirectly influenced self-management behaviors (β = 0.20, p < 0.01) through self-efficacy. Self-efficacy directly influenced self-management behaviors (β = 0.37, p < 0.05). Disease knowledge indirectly influenced self-management behaviors (β = 0.12, p < 0.05) through self-efficacy. CONCLUSIONS Our findings indicated that social support, self-efficacy and disease knowledge directly or indirectly affected self-management behaviors in adults with chronic hepatitis B. This provides a theoretical basis for developing self-management interventions for patients with chronic hepatitis B, which may lead to health improvements in this population.
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Affiliation(s)
- Ling-Na Kong
- School of Nursing, Chongqing Medical University, Chongqing, PR China; School of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China.
| | - Wen-Fen Zhu
- School of Nursing, Chongqing Medical University, Chongqing, PR China
| | - Lin Li
- Department of Liver Disease, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, PR China
| | - Qing-Song Lei
- Department of Oncology Radiotherapy Center, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, PR China
| | - Tian Wang
- Department of Infectious Disease, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Yi-Lan Li
- Department of Infectious Disease, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
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Hughes S, Lewis S, Willis K, Rogers A, Wyke S, Smith L. Goal setting in group programmes for long-term condition self-management support: experiences of patients and healthcare professionals. Psychol Health 2019; 35:70-86. [DOI: 10.1080/08870446.2019.1623891] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Stephen Hughes
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, the University of Sydney, NSW, Australia
| | - Sophie Lewis
- Faculty of Arts and Social Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Karen Willis
- Allied Health Research, Melbourne Health, La Trobe University, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Anne Rogers
- Faculty of Health Sciences, University of Southampton, Highfield, Southampton, United Kingdom
| | - Sally Wyke
- Institute for Health and Wellbeing, College of Social Sciences, United Kingdom
| | - Lorraine Smith
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, the University of Sydney, NSW, Australia
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Maintenance and Development of Social Connection by People with Long-term Conditions: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16111875. [PMID: 31141893 PMCID: PMC6603716 DOI: 10.3390/ijerph16111875] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/20/2019] [Accepted: 05/24/2019] [Indexed: 11/19/2022]
Abstract
Social connection is important for people’s health and well-being. Social isolation arising from a lack of meaningful connection with others can result in deterioration of well-being with negative consequences for health. For people living with multiple long-term conditions, the building and maintaining of social connection may be challenging. The aim of this study was to explore with people with long-term conditions how they perceive they maintain and develop social connections. We undertook semi-structured interviews with seventeen adults, and analyzed the data for themes. Themes were “Meaningful connection”, “Wherewithal for social connection” and “Impact of a major change in life course”. The findings suggest that social connection is valued, and facilitates meaningful ways to reciprocate support with others, thus enabling access to knowledge and resources for better health and well-being. However, people with long-term conditions can experience challenges to developing and maintaining social connectedness after a major change in life course. We suggest that healthcare providers are well placed to facilitate ways for people with long-term conditions to socially connect with others in their neighbourhood and community, and that this in particular be attended to after a major life change.
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Ellis J, Vassilev I, Kennedy A, Moore M, Rogers A. Help seeking for antibiotics; is the influence of a personal social network relevant? BMC FAMILY PRACTICE 2019; 20:63. [PMID: 31088394 PMCID: PMC6518744 DOI: 10.1186/s12875-019-0955-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 04/30/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Health policy focuses on reducing antibiotic prescribing that in order to succeed requires the public to hold similar attitudes towards judicious use. Social network influences on health behaviour and attitudes are well established and yet these influences are not sufficiently acknowledged in the UK's antibiotic stewardship programmes. Therefore, the aim of this study was to evaluate individuals' attitudes and behaviours towards antibiotics and also identify the social network influences on these in the process of help seeking for self-limiting illnesses. METHODS From a social network approach the methods used were a personal community mapping exercise which was carried out ahead of a semi-structured interview. A purposive sample was drawn from across the Wessex region and participants were recruited via GP practices and pharmacists. In total 14 adults, and 10 parents of children, who had received a prescription for antibiotics for a self-limiting illness within the 3 months preceding the interview were recruited and interviewed. RESULTS Three network types were identified; diverse, family and friend and restricted. The type of network an individual has appears to have an influence on antibiotic attitudes and behaviours. Most notably, the more diverse a network the more likely the individual will delay in help seeking from healthcare professionals as they draw upon self-care strategies advised by network members. The role of the GP varies according to network type too. Individuals' with diverse networks draw upon GP network members to provide clarity and certainty following a period of self-care. People with restricted networks are more reliant upon the GP, seek help quicker and also more likely to prioritise the GPs advice over other sources of information. CONCLUSION The understanding a social network approach brings to help seeking behaviour for antibiotics could help practitioners modify their consultation approach to mitigate some uncertainties and perceptions around prescribing behaviour.
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Affiliation(s)
- J Ellis
- NIHR CLAHRC Wessex, School of Health Sciences, University of Southampton, Building 67, University Road, Southampton, SO17 1BJ, UK.
| | - I Vassilev
- NIHR CLAHRC Wessex, School of Health Sciences, University of Southampton, Building 67, University Road, Southampton, SO17 1BJ, UK
| | - A Kennedy
- NIHR CLAHRC Wessex, School of Health Sciences, University of Southampton, Building 67, University Road, Southampton, SO17 1BJ, UK
| | - M Moore
- NIHR CLAHRC Wessex, Primary Care and Population Science, Aldermoor Health Centre, Aldermoor Close, Southampton, SO16 5ST, UK
| | - A Rogers
- NIHR CLAHRC Wessex, School of Health Sciences, University of Southampton, Building 67, University Road, Southampton, SO17 1BJ, UK
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Stellefson M, Paige S, Apperson A, Spratt S. Social Media Content Analysis of Public Diabetes Facebook Groups. J Diabetes Sci Technol 2019; 13:428-438. [PMID: 30931593 PMCID: PMC6501525 DOI: 10.1177/1932296819839099] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Relatively little is known about how Facebook groups are used to facilitate diabetes self-management support. This study provides a critical analysis of public diabetes Facebook groups and their content. METHODS Two trained researchers independently identified 34 public Facebook diabetes groups. A coding and classification scheme was applied to the 20 most recent "wall posts" within 15 of the 34 (44.1%) largest groups (n = 300 posts). Nonparametric Mann-Whiney U tests examined differences in group characteristics between groups with more (active) and less (inactive) than 50 posts in the past month. Multivariable logistic regressions evaluated associations between group purpose, post types, membership (engagement leader vs regular user), and modality. RESULTS We identified 193 458 members of the 34 largest diabetes Facebook groups (Mdn size = 3124 members, IQR = 1298-8523 members). Many groups (20/34, 58.8%) were created to provide instrumental support, while fewer (12/34, 35.8%) aimed to provide emotional support. Nutrition was the only diabetes self-management topic addressed in more than 30% of posts (n = 107). Posts made by engagement leaders were almost five times more likely to appear within inactive compared to active groups. DISCUSSION Diabetes Facebook groups are used to share both information and emotional support, with greater emphasis placed on sharing information about nutrition. While engagement leaders should theoretically increase the credibility of online forums, frequent posts by group engagement leaders may actually lead to group decay. Health and diabetes educators should consider how to more effectively leverage social media engagement leaders to disseminate valid health information on diabetes self-management.
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Affiliation(s)
- Michael Stellefson
- East Carolina University, Greenville, NC, USA
- Michael Stellefson, PhD, MCHES®, Department of Health Education & Promotion, East Carolina University, 3202 Carol G. Belk Building, Greenville, NC 27858, USA.
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Xie J, Liu J, Liu M, Yan J, Ding S, Ma K. Self-management and Related Psychosocial Variables Among Renal Transplant Patients. Transplant Proc 2019; 51:734-741. [PMID: 30979458 DOI: 10.1016/j.transproceed.2019.01.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 01/04/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To explore the influential factors of kidney transplant patients' self-management, especially psychosocial variables. STUDY DESIGN This was a cross-sectional study. METHODS Questionnaires were administered to patients with the assistance of our team members to gather sociodemographic information, medical characteristics, self-management, social support, depression, and flourishing. RESULTS The study included 483 patients, 64.4% of whom were male. The score index of the total self-management scale was 81.95% and the "social psychology" dimension had the lowest index, at 75.63%. Higher scores for flourishing, shorter length of post-renal transplantation, more social support, lower body mass index, being female, and being employed were proved to be determinants of better self-management, and flourishing was identified as having the greatest influence. Some other indicators were also related to patients' self-management, particularly age, residence, income, hypertension, renal function, and depression. CONCLUSION The overall self-management of KT patients was middling, and the status of psychology management was not optimistic. This emphasized the importance of psychological intervention. For further exploration, flourishing was identified as contributing to better self-management, which implied that strengthening this factor could be another method of improving self-management, except that involves enhancing of social support and reducing depression. Age was also found to have differing degrees of influence on KT patients' self-management, which implies that younger patients should receive more support in self-management.
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Affiliation(s)
- J Xie
- Third Xiangya Hospital, Central South University, Changsha, China; Xiangya Nursing School, Central South University, Changsha, China
| | - J Liu
- Third Xiangya Hospital, Central South University, Changsha, China; Xiangya Nursing School, Central South University, Changsha, China
| | - M Liu
- Third Xiangya Hospital, Central South University, Changsha, China
| | - J Yan
- Third Xiangya Hospital, Central South University, Changsha, China; Xiangya Nursing School, Central South University, Changsha, China
| | - S Ding
- Third Xiangya Hospital, Central South University, Changsha, China; Xiangya Nursing School, Central South University, Changsha, China.
| | - K Ma
- Xiangya Nursing School, Central South University, Changsha, China.
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Gellatly J, Bee P, Kolade A, Hunter D, Gega L, Callender C, Hope H, Abel KM. Developing an Intervention to Improve the Health Related Quality of Life in Children and Young People With Serious Parental Mental Illness. Front Psychiatry 2019; 10:155. [PMID: 31024349 PMCID: PMC6465622 DOI: 10.3389/fpsyt.2019.00155] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 03/04/2019] [Indexed: 11/16/2022] Open
Abstract
Introduction: Children and adolescents living with parental mental illness (CAPRI) are at increased risk of behavioral, social and educational difficulties, mental and physical health problems and have poorer quality of life (QoL). Adverse outcomes can extend into adulthood but are not inevitable. Recent policy and stakeholder consultation recognize the urgent need for interventions that extend beyond objective, service-led measures of health. Systematic evidence synthesis has demonstrated a lack of evidence-based interventions for enhancing holistic, child-centered outcomes. We aimed to co-develop a manualised, community-based intervention to improve QoL in CAPRI. Precedence was given to the QoL domains that were prioritized by stakeholders and deemed feasible to modify within a health and social care context. We describe here the modeling phase of developing the intervention emphasizing co-production activities with CAPRI, their families and professionals who support them. Methods: Semi-structured interviews and focus groups with CAPRI (n = 14), parents (n = 7), and professionals from health, social and educational sectors (n = 31) in the UK. Topic guides qualitatively explored participants prior experiences, unmet needs, perceived barriers and facilitators to receiving/delivering support, and their ideals for a new intervention. Findings were synthesized with existing research evidence and presented to a mixed panel of clinical academics and health and social care professionals. A consensus exercise was used to identify the preferred structure, format and content of the manualised intervention. Results: An 8-week group intervention for 6-16 year olds and their parents, called Young SMILES, has been co-developed along with associated training materials for facilitators. Each session addresses an identified need, but is underpinned by cross-cutting themes pertaining to mental health literacy, parent-child communication, and problem solving skills. Sessions are delivered by two trained facilitators and held in accessible and acceptable community locations weekly for 2 h. Conclusion: Young SMILES captures a broad age range and level of need for CAPRI and can be evaluated with quantifiable child-centered outcomes. In line with current policy directives, this is the first UK-based, multi-context intervention to improve QoL in this population. Implementation and referral mechanisms are currently being evaluated in a multi-site feasibility trial.
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Affiliation(s)
- Judith Gellatly
- Faculty of Biology, Medicine and Health, Centre for Women's Mental Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
- Division of Nursing, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Penny Bee
- Division of Nursing, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Adekeye Kolade
- Faculty of Biology, Medicine and Health, Centre for Women's Mental Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | | | - Lina Gega
- Department of Health Sciences, Hull York Medical School, University of York, York, United Kingdom
| | - Craig Callender
- St. Nicholas Hospital, Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Holly Hope
- Faculty of Biology, Medicine and Health, Centre for Women's Mental Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Kathryn M. Abel
- Faculty of Biology, Medicine and Health, Centre for Women's Mental Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
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75
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Levy M, Deschênes SS, Burns RJ, Elgendy R, Schmitz N. Trajectories of social support in adults with type 2 diabetes: Associations with depressive symptoms and functional disability. Int J Geriatr Psychiatry 2019; 34:480-487. [PMID: 30480332 DOI: 10.1002/gps.5042] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 10/18/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Little is known about temporal trajectories of social support in adults with type 2 diabetes (T2D) and how they are associated with diabetes-related outcomes. This study identified and explored different trajectories of social support in a community sample of adults with T2D, as well as the extent to which different trajectories were prospectively associated with depressive symptoms and functional disability. METHODS Data came from five annual waves of the Evaluation of Diabetes Treatment study (N = 1077). Social support, depressive symptoms, and functional disability were assessed via self-report. Separate analyses were conducted to examine the associations between social support trajectories, depressive symptoms, and functional disability, adjusting for demographic characteristics, diabetes-related covariates, and baseline depressive symptoms and functional disability. RESULTS Latent class growth modeling identified four distinct social support trajectories. Trajectory Groups 1 and 2 comprised participants with persistently low and persistently moderate-low social support, respectively. Trajectory Groups 3 and 4 included participants with persistently moderate-high and persistently high social support, respectively. People with persistently low social support reported higher functional disability relative to those with persistently moderate-high and persistently high social support. CONCLUSIONS The findings of the present study indicate that temporal patterns of social support are a predictor of future functional disability among adults with T2D.
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Affiliation(s)
- Melanie Levy
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Sonya S Deschênes
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Rachel J Burns
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Randa Elgendy
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Norbert Schmitz
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada
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76
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Dover DC, Belon AP. The health equity measurement framework: a comprehensive model to measure social inequities in health. Int J Equity Health 2019; 18:36. [PMID: 30782161 PMCID: PMC6379929 DOI: 10.1186/s12939-019-0935-0] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 01/31/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Despite the wealth of frameworks on social determinants of health (SDOH), two current limitations include the relative superficial description of factors affecting health and a lack of focus on measuring health equity. The Health Equity Measurement Framework (HEMF) addresses these gaps by providing a more encompassing view of the multitude of SDOH and drivers of health service utilisation and by guiding quantitative analysis for public health surveillance and policy development. The objective of this paper is to present the HEMF, which was specifically designed to measure the direct and indirect effects of SDOH to support improved statistical modelling and measurement of health equity. METHODS Based on a framework synthesis, the HEMF development involved initially integrating theoretical components from existing SDOH and health system utilisation frameworks. To further develop the framework, relevant publications on SDOH and health equity were identified through a literature review in major electronic databases. White and grey literatures were critically reviewed to identify strengths and gaps in the existing frameworks in order to inform the development of a unique health equity measurement framework. Finally, over a two-year period of consultation, scholars, health practitioners, and local policy influencers from municipal and provincial governments provided critical feedback on the framework regarding its components and causal relationships. RESULTS This unified framework includes the socioeconomic, cultural, and political context, health policy context, social stratification, social location, material and social circumstances, environment, biological factors, health-related behaviours and beliefs, stress, quality of care, and healthcare utilisation. Alongside the HEMF's self-exploratory diagram showing the causal pathways in-depth, a number of examples are provided to illustrate the framework's usefulness in measuring and monitoring health equity as well as informing policy-making. CONCLUSIONS The HEMF highlights intervention areas to be influenced by strategic public policy for any organisation whose purview has an effect on health, including helping non-health sectors (such as education and labour) to better understand how their policies influence population health and perceive their role in health equity promotion. The HEMF recognises the complexity surrounding the SDOH and provides a clear, overarching direction for empirical work on health equity.
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Affiliation(s)
- Douglas C. Dover
- Alberta Health, Government of Alberta, Edmonton, AB Canada
- Concordia University of Edmonton, Edmonton, AB Canada
| | - Ana Paula Belon
- School of Public Health, University of Alberta, Edmonton, AB Canada
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77
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McIntyre M, Ehrlich C, Kendall E. Informal care management after traumatic brain injury: perspectives on informal carer workload and capacity. Disabil Rehabil 2018; 42:754-762. [DOI: 10.1080/09638288.2018.1508511] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Michelle McIntyre
- Synapse Australia Ltd. Brisbane, Australia
- The Hopkins Centre, Menzies Health Institiute Queensland, Griffith University, Brisbane, Australia
| | - Carolyn Ehrlich
- The Hopkins Centre, Menzies Health Institiute Queensland, Griffith University, Brisbane, Australia
| | - Elizabeth Kendall
- The Hopkins Centre, Menzies Health Institiute Queensland, Griffith University, Brisbane, Australia
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78
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Nemanic T, Sarc I, Skrgat S, Flezar M, Cukjati I, Marc Malovrh M. Telemonitoring in asthma control: a randomized controlled trial. J Asthma 2018; 56:782-790. [PMID: 30063840 DOI: 10.1080/02770903.2018.1493599] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Telemonitoring seems to be a useful tool for patients' management. The aim of our project was to test the applicability and potential effects of a 12-month telemonitoring of patients with asthma supported by information and communication technologies. METHODS We included 100 patients with asthma followed in the outpatient pulmonary clinic in a randomized controlled clinical trial. The patients' data were collected by study questionnaires and lung function tests at the inclusion and at the end of interventional period. In the interventional group, asthma control test (ACT) and peak expiratory flow measurements (PEF) were stimulated to be regularly reported by Short Message Service (SMS). As a response to reported values, the patients automatically received a preformed text or a call from a study nurse in case of detected predefined critical values. RESULTS The compliance of reporting PEF and ACT values was higher than 80% in 96% of patients. Although we did not detect significant differences in ACT score improvement between the two study groups, we found more prominent improvement of ACT score in the subgroup of patients with two or more exacerbations prior to inclusion in the interventional group, compared to the control group. 40 (78%) patients in the interventional group listed at least one positive effect of telemonitoring on management of asthma. CONCLUSIONS The developed program for home monitoring of patients with asthma was applicable and offered the patients support in managing their disease. Further studies with more selected patients are needed to confirm its usefulness in improving asthma control.
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Affiliation(s)
- Tiva Nemanic
- a University Clinic of Pulmonary and Allergic Diseases Golnik , Golnik , Slovenia
| | - Irena Sarc
- a University Clinic of Pulmonary and Allergic Diseases Golnik , Golnik , Slovenia
| | - Sabina Skrgat
- a University Clinic of Pulmonary and Allergic Diseases Golnik , Golnik , Slovenia
| | - Matjaz Flezar
- a University Clinic of Pulmonary and Allergic Diseases Golnik , Golnik , Slovenia
| | - Iztok Cukjati
- b Faculty of Medicine , University of Ljubljana , Ljubljana , Slovenia.,c AdriaData d.o.o. , Ljubljana , Slovenia
| | - Mateja Marc Malovrh
- a University Clinic of Pulmonary and Allergic Diseases Golnik , Golnik , Slovenia
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79
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Pallotti F, Tubaro P, Casilli AA, Valente TW. "You See Yourself Like in a Mirror": The Effects of Internet-Mediated Personal Networks on Body Image and Eating Disorders. HEALTH COMMUNICATION 2018; 33:1166-1176. [PMID: 28682123 DOI: 10.1080/10410236.2017.1339371] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Body image issues associated with eating disorders involve attitudinal and perceptual components: individuals' dissatisfaction with body shape or weight, and inability to assess body size correctly. While prior research has mainly explored social pressures produced by the media, fashion, and advertising industries, this paper focuses on the effects of personal networks on body image, particularly in the context of internet communities. We use data collected on a sample of participants to websites on eating disorders, and map their personal networks. We specify and estimate a model for the joint distribution of attitudinal and perceptual components of body image as a function of network-related characteristics and attributional factors. Supported by information gathered through in-depth interviews, the empirical estimates provide evidence that personal networks can be conducive to positive body image development, and that the influence of personal networks varies significantly by body size. We situate our discussion in current debates about the effects of computer-mediated and face-to-face communication networks on eating disorders and related behaviors.
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Affiliation(s)
- Francesca Pallotti
- a Department of International Business and Economics , Business School, University of Greenwich
- b Institute of Management , Universita' della Svizzera Italiana
| | - Paola Tubaro
- a Department of International Business and Economics , Business School, University of Greenwich
- c Laboratoire de Recherche en Informatique , Centre National de la Recherche Scientifique
| | - Antonio A Casilli
- d Telecom ParisTech , Interdisciplinary Institute for Innovation
- e Centre Edgar Morin , Ecole des Hautes Etudes en Sciences Sociales
| | - Thomas W Valente
- f Department of Preventive Medicine , Institute for Prevention Research, Keck School of Medicine, University of Southern California
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80
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Amoah PA, Koduah AO, Gyasi RM. "Who'll do all these if I'm not around?": Bonding social capital and health and well-being of inpatients. Int J Qual Stud Health Well-being 2018; 13:1435108. [PMID: 29447613 PMCID: PMC5827639 DOI: 10.1080/17482631.2018.1435108] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose: Although social capital influences health-related decisions and behavioural patterns in many developing countries, minimal attention has been paid to the nuances of its effect on healthcare. This paper examines how bonding social capital affects healthcare delivery for inpatients in Ghana. Methods: Semi-structured in-depth interviews were used and thematic analysis method employed to analyse the data. Interviews were conducted with health professionals and relatives and close friends of inpatients in three public health facilities in Ashanti region. Results: Relatives and close friends of inpatients were a critical source of instrumental support such as provision of meals, laundry services, running errands and financial assistance as well as emotional support. These functions—that were both ‘expected’ and ‘encouraged’— reduced the burden on the health facilities, which apparently had limited resources to offer adequate care. However, the relatives of inpatients sometimes inadvertently obstructed efficient healthcare delivery through actions such as extending ‘unapproved’ alternative care to patients. Moreover, the process of contributing towards health and well-being of the sick exposed the relatives to health risks due to poor living conditions. Conclusion: A well-defined and befitting role must be devised for at least an immediate social relation of inpatients to improve the positive effects of bonding social capital on healthcare delivery.
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Affiliation(s)
- Padmore Adusei Amoah
- a Division of Graduate Studies and Asia Pacific Institute of Aging Studies , Lingnan University , Tuen Mun , Hong Kong (SAR)
| | | | - Razak Mohammed Gyasi
- c Department of Sociology and Social Policy , Lingnan University , Tuen Mun , Hong Kong (SAR)
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81
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Exploring medicines management by COPD patients and their social networks after hospital discharge. Int J Clin Pharm 2018; 40:1019-1029. [PMID: 30056568 PMCID: PMC6208597 DOI: 10.1007/s11096-018-0688-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 07/05/2018] [Indexed: 12/17/2022]
Abstract
Background Unplanned hospital admissions (UHAs) for chronic obstructive pulmonary disease (COPD) are a major burden on health services. Effective medicines management is crucial to avoid such admissions but little is known about the role of social networks in supporting medicines-taking. Objective To examine the activities and strategies recently discharged COPD patients and their social network members (SNMs) utilise to manage their medicines. Setting COPD patients recently discharged from an acute NHS Trust in Northwest England. Methods Semi-structured, face-to-face interviews; audio-recorded and transcribed with consent, NVivo v11 facilitated qualitative thematic analysis. NHS ethical approved. Main outcome measure Interview topic guide and analysis informed by Cheraghi-Sohi et al.’s conceptual framework for ‘medication work’ exploring medication–articulation, informational, emotional and surveillance work. Results Twelve interviews were conducted during March–August 2016. Participants’ social networks were small (n < 5) and restricted to family members and healthcare professionals. Participants social network members performed similar medication–articulation and surveillance work to coronary heart disease, arthritis and diabetes patients. When participants social network members resolved issues identified by surveillance work, this medication work was conceptualised as surveillance–articulation work. The social network members performed little emotional work and were infrequently involved in informational work despite some participants describing informational needs. After discharge, participants reverted to pre-admission routines/habits/strategies for obtaining medication supplies, organising medicines, keeping track of supplies, ensuring adherence within daily regimens, and monitoring symptoms, which could cause issues. Conclusion This study applied Cheraghi-Sohi’s framework for medication work to COPD patients and described the role of the social network members. Pharmacists could proactively explore medication infrastructures and work with patients and their close social network members to support medication work.
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82
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Lewis JA, Gee PM, Ho CLL, Miller LMS. Understanding Why Older Adults With Type 2 Diabetes Join Diabetes Online Communities: Semantic Network Analyses. JMIR Aging 2018; 1:e10649. [PMID: 31518243 PMCID: PMC6715014 DOI: 10.2196/10649] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/11/2018] [Accepted: 05/29/2018] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND As individuals age, chronic health difficulties may disrupt physical and social well-being. Individuals can turn to online communities to interact with similar peers, which may help buffer negative effects resulting from health difficulties. OBJECTIVE This study investigated the reasons that older adults join a diabetes online community to better understand the specific resources that are being sought. METHODS We used semantic network analyses to categorize the reasons participants provided for joining a community during the sign-up process. RESULTS The most frequent reasons for joining were to seek information about their health condition, to help with self-management of health difficulties, for feelings of informational and social support, and for having a community with whom to share. Women were more likely to go online for sharing and companionship as well as for information and social support reasons, whereas men were more likely to go online for general information and self-management reasons. CONCLUSIONS This study shows the reasons older adults seek to join a diabetes online community: for increased information and support regarding chronic health difficulties. Practitioners may want to consider ways to promote access to online communities among their older patients as a source of health information and a resource to provide a sense of community.
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Affiliation(s)
- Jakeem Amir Lewis
- Department of Human Ecology, University of California, Davis, Davis, CA, United States
| | - Perry M Gee
- Nursing Research and Analytics, Dignity Health, San Francisco, CA, United States.,College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Chia-Ling Lynn Ho
- Department of Communication, University of California, Davis, Davis, CA, United States
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Mirkovic J, Jessen S, Kristjansdottir OB, Krogseth T, Koricho AT, Ruland CM. Developing Technology to Mobilize Personal Strengths in People with Chronic Illness: Positive Codesign Approach. JMIR Form Res 2018; 2:e10774. [PMID: 30684404 PMCID: PMC6334702 DOI: 10.2196/10774] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 05/11/2018] [Accepted: 05/11/2018] [Indexed: 12/11/2022] Open
Abstract
Background Emerging research from psychology and the bio-behavioral sciences recognizes the importance of supporting patients to mobilize their personal strengths to live well with chronic illness. Positive technology and positive computing could be used as underlying design approaches to guide design and development of new technology-based interventions for this user group that support mobilizing their personal strengths. Objective A codesigning workshop was organized with the aim to explore user requirements and ideas for how technology can be used to help people with chronic illness activate their personal strengths in managing their everyday challenges. Methods Thirty-five participants from diverse backgrounds (patients, health care providers, designers, software developers, and researchers) participated. The workshop combined principles of (1) participatory and service design to enable meaningful participation and collaboration of different stakeholders and (2) an appreciative inquiry methodology to shift participants’ attention to positive traits, values, and aspects that are meaningful and life-giving and stimulate participants’ creativity, engagement, and collaboration. Utilizing these principles, participants were engaged in group activities to develop ideas for strengths-supportive tools. Each group consisted of 3-8 participants with different backgrounds. All group work was analysed using thematic analyses. Results Participants were highly engaged in all activities and reported a wide variety of requirements and ideas, including more than 150 personal strength examples, more than 100 everyday challenges that could be addressed by using personal strengths, and a wide range of functionality requirements (eg, social support, strength awareness and reflection, and coping strategies). 6 concepts for strength-supportive tools were created. These included the following: a mobile app to support a person to store, reflect on, and mobilize one’s strengths (Strengths treasure chest app); “empathy glasses” enabling a person to see a situation from another person’s perspective (Empathy Simulator); and a mobile app allowing a person to receive supportive messages from close people in a safe user-controlled environment (Cheering squad app). Suggested design elements for making the tools engaging included: metaphors (eg, trees, treasure island), visualization techniques (eg, dashboards, color coding), and multimedia (eg, graphics). Maintaining a positive focus throughout the tool was an important requirement, especially for feedback and framing of content. Conclusions Combining participatory, service design, and appreciative inquiry methods were highly useful to engage participants in creating innovative ideas. Building on peoples’ core values and positive experiences empowered the participants to expand their horizons from addressing problems and symptoms, which is a very common approach in health care today, to focusing on their capacities and that which is possible, despite their chronic illness. The ideas and user requirements, combined with insights from relevant theories (eg, positive technology, self-management) and evidence from the related literature, are critical to guide the development of future more personalized and strengths-focused self-management tools.
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Affiliation(s)
- Jelena Mirkovic
- Center for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hostipal, Oslo, Norway
| | - Stian Jessen
- Center for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hostipal, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Olöf Birna Kristjansdottir
- Center for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hostipal, Oslo, Norway
| | - Tonje Krogseth
- Center for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hostipal, Oslo, Norway.,Center for Learning and Mastery for Children, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Absera Teshome Koricho
- Center for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hostipal, Oslo, Norway.,Center for Learning and Mastery for Children, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Cornelia M Ruland
- Center for Shared Decision Making and Collaborative Care Research, Division of Medicine, Oslo University Hostipal, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
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Hester KLM, Newton J, Rapley T, De Soyza A. Patient information, education and self-management in bronchiectasis: facilitating improvements to optimise health outcomes. BMC Pulm Med 2018; 18:80. [PMID: 29788946 PMCID: PMC5964899 DOI: 10.1186/s12890-018-0633-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 04/25/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Bronchiectasis is an incurable lung disease characterised by irreversible airway dilatation. It causes symptoms including chronic productive cough, dyspnoea, and recurrent respiratory infections often requiring hospital admission. Fatigue and reductions in quality of life are also reported in bronchiectasis. Patients often require multi-modal treatments that can be burdensome, leading to issues with adherence. In this article we review the provision of, and requirement for, education and information in bronchiectasis. DISCUSSION To date, little research has been undertaken to improve self-management in bronchiectasis in comparison to other chronic conditions, such as COPD, for which there has been a wealth of recent developments. Qualitative work has begun to establish that information deficit is one of the potential barriers to self-management, and that patients feel having credible information is fundamental when learning to live with and manage bronchiectasis. Emerging research offers some insights into ways of improving treatment adherence and approaches to self-management education; highlighting ways of addressing the specific unmet information needs of patients and their families who are living with bronchiectasis. CONCLUSIONS We propose non-pharmacological recommendations to optimise patient self-management and symptom recognition; with the aim of facilitating measurable improvements in health outcomes for patients with bronchiectasis.
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Affiliation(s)
- Katy L. M. Hester
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, NE2 4HH UK
- Adult Bronchiectasis Service, Freeman Hospital, Newcastle upon Tyne, NE7 7DN UK
| | - Julia Newton
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE2 4HH UK
| | - Tim Rapley
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, NE7 7XA UK
| | - Anthony De Soyza
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, NE2 4HH UK
- Adult Bronchiectasis Service, Freeman Hospital, Newcastle upon Tyne, NE7 7DN UK
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Milette K, Thombs BD, Maiorino K, Nielson WR, Körner A, Peláez S. Challenges and strategies for coping with scleroderma: implications for a scleroderma-specific self-management program. Disabil Rehabil 2018; 41:2506-2515. [PMID: 29741963 DOI: 10.1080/09638288.2018.1470263] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Purpose: The purpose of this study was to explore challenges faced by patients with systemic sclerosis, also called scleroderma, in coping with their disease and the strategies they used to face those challenges. Method: Five focus groups were held with scleroderma patients (4 groups, n = 34) and health care professionals who have experience treating scleroderma (1 group, n = 8). Participants' discussions were recorded, transcribed and analyzed using thematic analysis. Results: Participants reported challenges accessing information (e.g., knowledgeable specialists), dealing with negative emotions (e.g., stress due to misunderstandings with loved ones), and accessing resources (e.g., helpful products or devices). Strategies for overcoming challenges were also discussed (e.g., advocating for own needs). Conclusion: When faced with significant challenges while coping with scleroderma, patients develop strategies to manage better and improve their quality of life. To help them cope, patients would benefit from easier access to supportive interventions, including tailored scleroderma self-management programs. Although the challenges experienced by patients with scleroderma are unique, findings from this study might help better understand patients' perspectives regarding coping and disease management for other chronic diseases as well. Implications for Rehabilitation People living with rare diseases, including the rare autoimmune disease scleroderma, face unique challenges and often do not have access to disease-specific educational or other support resources. People with scleroderma report that they face challenges in accessing information, including knowledgeable healthcare providers; managing difficult social interactions and negative emotions; and accessing resources. Strategies employed by scleroderma patients to overcome these challenges include seeking connections to other people with scleroderma or scleroderma patient organizations, actively seeking out local resources, and learning to communicate and advocate more effectively. Rehabilitation professionals can support people with scleroderma by providing them with information on connecting with scleroderma patient organizations or by facilitating local patient support networks.
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Affiliation(s)
- Katherine Milette
- Lady Davis Institute for Medical Research, Jewish General Hospital , Montréal , Canada.,Department of Educational and Counselling Psychology, McGill University , Montréal , Canada
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital , Montréal , Canada.,Department of Educational and Counselling Psychology, McGill University , Montréal , Canada.,Department of Psychiatry, McGill University , Montréal , Canada.,Department of Epidemiology, Biostatistics, and Occupational Health, McGill University , Montréal , Canada
| | - Kristina Maiorino
- Department of Educational and Counselling Psychology, McGill University , Montréal , Canada
| | - Warren R Nielson
- Department of Psychology, Western University, Lawson Health Research Institute , London , Ontario , Canada
| | - Annett Körner
- Lady Davis Institute for Medical Research, Jewish General Hospital , Montréal , Canada.,Department of Educational and Counselling Psychology, McGill University , Montréal , Canada
| | - Sandra Peláez
- Lady Davis Institute for Medical Research, Jewish General Hospital , Montréal , Canada.,Department of Educational and Counselling Psychology, McGill University , Montréal , Canada
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86
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Hartley SE. Re-imagining the role of the physiotherapist when managing people with long-term conditions. Physiother Theory Pract 2018; 35:1005-1014. [DOI: 10.1080/09593985.2018.1467989] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Sandra Elaine Hartley
- Department of Health Professions, Brooks Building, Birley Fields Campus, Manchester, England
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87
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Litchman ML, Edelman LS, Donaldson GW. Effect of Diabetes Online Community Engagement on Health Indicators: Cross-Sectional Study. JMIR Diabetes 2018; 3:e8. [PMID: 30291079 PMCID: PMC6238850 DOI: 10.2196/diabetes.8603] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 01/31/2018] [Accepted: 02/18/2018] [Indexed: 12/18/2022] Open
Abstract
Background Successful diabetes management requires ongoing lifelong self-care and can require that individuals with diabetes become experts in translating care recommendations into real-life day-to-day diabetes self-care strategies. The diabetes online community comprises multiple websites that include social media sites, blogs, and discussion groups for people with diabetes to chat and exchange information. Online communities can provide disease-specific practical advice and emotional support, allow users to share experiences, and encourage self-advocacy and patient empowerment. However, there has been little research about whether diabetes online community use is associated with better diabetes self-care or quality of life. Objective The aim of this study was to survey adults with diabetes who participated in the diabetes online community to better understand and describe who is using the diabetes online community, how they are using it, and whether the use of the diabetes online community was associated with health indicators. Methods We recruited adults diagnosed with diabetes who used at least one of 4 different diabetes-related online communities to complete an online survey. Participants’ demographics, reported glycated hemoglobin (HbA1c), health-related quality of life (SF-12v2), level of diabetes self-care (Self-Care Inventory-Revised), and diabetes online community use (level of intensity and engagement) were collected. We examined the relationships between demographics, diabetes online community use, and health indicators (health-related quality of life, self-care, and HbA1c levels). We used binary logistic regression to determine the extent to which diabetes online community use predicted an HbA1c <7% or ≥7% after controlling statistically for other variables in the model. Results A total of 183 adults participated in this study. Participants were mostly female (71.6%, 131/183), white (95.1%, 174/183), US citizens (82.5%, 151/183), had type 1 diabetes (69.7%, 129/183), with a mean age of 44.7 years (SD 14) and diabetes duration of 18.2 years (SD 14.6). Participants had higher diabetes self-care (P<.001, mean 72.4, SD 12.1) and better health-related quality of life (physical component summary P<.001, mean 64.8, SD 19; mental component summary P<.001, mean 66.6, SD 21.6) when compared with norms for diabetes. Diabetes online community engagement was a strong predictor of A1c, reducing the odds of having an A1c ≥7% by 33.8% for every point increase in diabetes online community engagement (0-5). Our data also indicated that study participants are oftentimes (67.2%, 123/183) not informing their healthcare providers about their diabetes online community use even though most (91.2%, 161/181) are seeing their healthcare provider on a regular basis. Conclusions Our results suggest that individuals highly engaged with diabetes online community are more likely to have better glycemic levels compared with those with lower engagement. Furthermore, diabetes online community users have high health-related quality of life and diabetes self-care levels. Supplementing usual healthcare activities with diabetes online community use may encourage knowledge and support among a population that needs to optimize its diabetes self-care. Further studies are needed to determine how diabetes online community engagement may affect health outcomes.
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Affiliation(s)
- Michelle L Litchman
- College of Nursing, University of Utah, Salt Lake City, UT, United States.,Utah Diabetes and Endocrinology Center, Salt Lake City, UT, United States
| | - Linda S Edelman
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Gary W Donaldson
- College of Nursing, University of Utah, Salt Lake City, UT, United States.,Department of Anesthesiology, University of Utah, Salt Lake City, UT, United States
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88
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Litchman ML, Edelman LS, Donaldson GW. Effect of Diabetes Online Community Engagement on Health Indicators: Cross-Sectional Study. JMIR Diabetes 2018. [PMID: 30291079 DOI: 10.2196/diabetes.8603.] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Successful diabetes management requires ongoing lifelong self-care and can require that individuals with diabetes become experts in translating care recommendations into real-life day-to-day diabetes self-care strategies. The diabetes online community comprises multiple websites that include social media sites, blogs, and discussion groups for people with diabetes to chat and exchange information. Online communities can provide disease-specific practical advice and emotional support, allow users to share experiences, and encourage self-advocacy and patient empowerment. However, there has been little research about whether diabetes online community use is associated with better diabetes self-care or quality of life. OBJECTIVE The aim of this study was to survey adults with diabetes who participated in the diabetes online community to better understand and describe who is using the diabetes online community, how they are using it, and whether the use of the diabetes online community was associated with health indicators. METHODS We recruited adults diagnosed with diabetes who used at least one of 4 different diabetes-related online communities to complete an online survey. Participants' demographics, reported glycated hemoglobin (HbA1c), health-related quality of life (SF-12v2), level of diabetes self-care (Self-Care Inventory-Revised), and diabetes online community use (level of intensity and engagement) were collected. We examined the relationships between demographics, diabetes online community use, and health indicators (health-related quality of life, self-care, and HbA1c levels). We used binary logistic regression to determine the extent to which diabetes online community use predicted an HbA1c <7% or ≥7% after controlling statistically for other variables in the model. RESULTS A total of 183 adults participated in this study. Participants were mostly female (71.6%, 131/183), white (95.1%, 174/183), US citizens (82.5%, 151/183), had type 1 diabetes (69.7%, 129/183), with a mean age of 44.7 years (SD 14) and diabetes duration of 18.2 years (SD 14.6). Participants had higher diabetes self-care (P<.001, mean 72.4, SD 12.1) and better health-related quality of life (physical component summary P<.001, mean 64.8, SD 19; mental component summary P<.001, mean 66.6, SD 21.6) when compared with norms for diabetes. Diabetes online community engagement was a strong predictor of A1c, reducing the odds of having an A1c ≥7% by 33.8% for every point increase in diabetes online community engagement (0-5). Our data also indicated that study participants are oftentimes (67.2%, 123/183) not informing their healthcare providers about their diabetes online community use even though most (91.2%, 161/181) are seeing their healthcare provider on a regular basis. CONCLUSIONS Our results suggest that individuals highly engaged with diabetes online community are more likely to have better glycemic levels compared with those with lower engagement. Furthermore, diabetes online community users have high health-related quality of life and diabetes self-care levels. Supplementing usual healthcare activities with diabetes online community use may encourage knowledge and support among a population that needs to optimize its diabetes self-care. Further studies are needed to determine how diabetes online community engagement may affect health outcomes.
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Affiliation(s)
- Michelle L Litchman
- College of Nursing, University of Utah, Salt Lake City, UT, United States.,Utah Diabetes and Endocrinology Center, Salt Lake City, UT, United States
| | - Linda S Edelman
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Gary W Donaldson
- College of Nursing, University of Utah, Salt Lake City, UT, United States.,Department of Anesthesiology, University of Utah, Salt Lake City, UT, United States
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89
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Desveaux L, Shaw J, Saragosa M, Soobiah C, Marani H, Hensel J, Agarwal P, Onabajo N, Bhatia RS, Jeffs L. A Mobile App to Improve Self-Management of Individuals With Type 2 Diabetes: Qualitative Realist Evaluation. J Med Internet Res 2018; 20:e81. [PMID: 29549070 PMCID: PMC5878364 DOI: 10.2196/jmir.8712] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 11/13/2017] [Accepted: 11/30/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The increasing use of Web-based solutions for health prevention and promotion presents opportunities to improve self-management and adherence to guideline-based therapy for individuals with type 2 diabetes (T2DM). Despite promising preliminary evidence, many users stop using Web-based solutions due to the burden of data entry, hidden costs, loss of interest, and a lack of comprehensive features. Evaluations tend to focus on effectiveness or impact and fail to evaluate the nuanced variables that may interact to contribute to outcome success (or failure). OBJECTIVE This study aimed to evaluate a Web-based solution for improving self-management in T2DM to identify key combinations of contextual variables and mechanisms of action that explain for whom the solution worked best and in what circumstances. METHODS A qualitative realist evaluation was conducted with one-on-one, semistructured telephonic interviews completed at baseline, and again toward the end of the intervention period (3 months). Topics included participants' experiences of using the Web-based solution, barriers and facilitators of self-management, and barriers and facilitators to effective use. Transcripts were analyzed using thematic analysis strategies, after which the key themes were used to develop statements of the relationships between the key contextual factors, mechanisms of action, and impact on the primary outcome (glycated hemoglobin, HbA1c). RESULTS Twenty-six interviews (14 baseline, 12 follow-up) were completed with 16 participants with T2DM, and the following 3 key groups emerged: the easiest fit, the best fit, and those who failed to activate. Self-efficacy and willingness to engage with the solution facilitated improvement in HbA1c, whereas competing priorities and psychosocial issues created barriers to engagement. Individuals with high baseline self-efficacy who were motivated, took ownership for their actions, and prioritized diabetes management were early and eager adopters of the app and recorded improvements in HbA1c over the intervention period. Individuals with moderate baseline self-efficacy and no competing priorities, who identified gaps in understanding of how their actions influence their health, were slow to adopt use but recorded the greatest improvements in HbA1c. The final group had low baseline self-efficacy and identified a range of psychosocial issues and competing priorities. These participants were uncertain of the benefits of using a Web-based solution to support self-management, ultimately resulting in minimal engagement and no improvement in HbA1c. CONCLUSIONS Self-efficacy, competing priorities, previous behavior change, and beliefs about Web-based solutions interact to determine engagement and impact on the clinical outcomes. Considering the balance of these patient characteristics is likely to help health care providers identify individuals who are apt to benefit from a Web-based solution to support self-management of T2DM. Web-based solutions could be modified to incorporate the existing screening measures to identify individuals who are at risk of suboptimal adherence to inform the provision of additional support(s) as needed.
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Affiliation(s)
- Laura Desveaux
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada.,Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | - James Shaw
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada.,Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Marianne Saragosa
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
| | - Charlene Soobiah
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada.,Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Husayn Marani
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
| | - Jennifer Hensel
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
| | - Payal Agarwal
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
| | - Nike Onabajo
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
| | - R Sacha Bhatia
- Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada.,Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Lianne Jeffs
- Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,American Academy of Nursing, Washington, DC, United States
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90
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Assessing information needs and use of online resources for disease self-management in patients with rheumatoid arthritis: a qualitative study. Clin Rheumatol 2018; 37:1791-1797. [DOI: 10.1007/s10067-018-4047-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 02/05/2018] [Accepted: 02/19/2018] [Indexed: 10/17/2022]
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91
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Palafox B, Goryakin Y, Stuckler D, Suhrcke M, Balabanova D, Alhabib KF, Avezum A, Bahonar A, Bai X, Chifamba J, Dans AL, Diaz R, Gupta R, Iqbal R, Ismail N, Kaur M, Keskinler MV, Khatib R, Kruger A, Kruger IM, Lanas F, Lear SA, Li W, Liu J, Lopez-Jaramillo P, Peer N, Poirier P, Rahman O, Pillai RK, Rangarajan S, Rosengren A, Swaminathan S, Szuba A, Teo K, Wang Y, Wielgosz A, Yeates KE, Yusufali A, Yusuf S, McKee M. Does greater individual social capital improve the management of hypertension? Cross-national analysis of 61 229 individuals in 21 countries. BMJ Glob Health 2018; 2:e000443. [PMID: 29333284 PMCID: PMC5759715 DOI: 10.1136/bmjgh-2017-000443] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 10/06/2017] [Accepted: 10/25/2017] [Indexed: 11/18/2022] Open
Abstract
Introduction Social capital, characterised by trust, reciprocity and cooperation, is positively associated with a number of health outcomes. We test the hypothesis that among hypertensive individuals, those with greater social capital are more likely to have their hypertension detected, treated and controlled. Methods Cross-sectional data from 21 countries in the Prospective Urban and Rural Epidemiology study were collected covering 61 229 hypertensive individuals aged 35–70 years, their households and the 656 communities in which they live. Outcomes include whether hypertensive participants have their condition detected, treated and/or controlled. Multivariate statistical models adjusting for community fixed effects were used to assess the associations of three social capital measures: (1) membership of any social organisation, (2) trust in other people and (3) trust in organisations, stratified into high-income and low-income country samples. Results In low-income countries, membership of any social organisation was associated with a 3% greater likelihood of having one’s hypertension detected and controlled, while greater trust in organisations significantly increased the likelihood of detection by 4%. These associations were not observed among participants in high-income countries. Conclusion Although the observed associations are modest, some aspects of social capital are associated with better management of hypertension in low-income countries where health systems are often weak. Given that hypertension affects millions in these countries, even modest gains at all points along the treatment pathway could improve management for many, and translate into the prevention of thousands of cardiovascular events each year.
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Affiliation(s)
- Benjamin Palafox
- The Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, UK
| | - Yevgeniy Goryakin
- Organization for Economic Cooperation and Development, Paris, France
| | - David Stuckler
- Department of Policy Analysis and Public Management and Dondena Research Centre, University of Bocconi, Milan, Italy
| | - Marc Suhrcke
- Centre for Health Economics, University of York, York, UK
| | - Dina Balabanova
- The Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, UK
| | - Khalid F Alhabib
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Alvaro Avezum
- Dante Pazzanese Institute of Cardiology, São Paulo, Brazil
| | - Ahmad Bahonar
- Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, The Islamic Republic of Iran
| | - Xiulin Bai
- National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Jephat Chifamba
- College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Antonio L Dans
- UP College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Rafael Diaz
- Estudios Clinicos Latino America, Rosario, Argentina
| | - Rajeev Gupta
- Eternal Heart Care Centre and Research Institute, Jaipur, India
| | - Romaina Iqbal
- Departments of Community Health Sciences and Medicine, Aga Khan University, Karachi, Pakistan
| | - Noorhassim Ismail
- Department of Community Health, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Manmeet Kaur
- School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Mirac V Keskinler
- Department of Internal Medicine, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Rasha Khatib
- Department of Public Health Sciences, Loyola University Medical Center, Maywood, Illinois, USA
| | - Annamarie Kruger
- Africa Unit for Transdisciplinary Health Research, North-West University, Potchefstroom, South Africa
| | - Iolanthe M Kruger
- Africa Unit for Transdisciplinary Health Research, North-West University, Potchefstroom, South Africa
| | | | - Scott A Lear
- Simon Fraser University, Burnaby, British Columbia, Canada
| | - Wei Li
- National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Jia Liu
- National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | | | - Nasheeta Peer
- South African Medical Research Council, Durban, South Africa
| | - Paul Poirier
- Institut universitaire de cardiologie et de pneumologie de Quebec, Quebec, Canada
| | | | | | - Sumathy Rangarajan
- Population Health Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, University of Gothenburg, Goteborg, Sweden
| | | | - Andrzej Szuba
- Division of Angiology, Wroclaw Medical University, Wroclaw, Poland
| | - Koon Teo
- Population Health Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Yang Wang
- National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | | | - Karen E Yeates
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Afzalhussein Yusufali
- Hatta Hospital, Dubai Health Authority/Dubai Medical University, Dubai, United Arab Emirates
| | - Salim Yusuf
- Population Health Research Institute, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Martin McKee
- The Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, UK
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92
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Hashem F, Merritt R. Supporting patients self-managing respiratory health: a qualitative study on the impact of the Breathe Easy voluntary group network. ERJ Open Res 2018; 4:00076-2017. [PMID: 29450201 PMCID: PMC5809141 DOI: 10.1183/23120541.00076-2017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 11/14/2017] [Indexed: 11/09/2022] Open
Abstract
Self-management strategies are designed to improve lung and respiratory health through structured self-management plans with regular practitioner reviews. Strategies have not, however, focused upon how patient support groups and advocacy networks can help with the management of these conditions; therefore, it is unknown what impact they may have on patient self-management. A qualitative study was designed to help understand what impact the British Lung Foundation's Breathe Easy (BE) groups have on patients managing their lung and respiratory conditions. A semistructured telephone interview schedule was developed to study the network. Topics covered included: perceptions about the BE groups; current referrals systems and integration pathways; benefits of attending the BE groups; and integration of the BE groups into the respiratory pathway. Key themes explored included: shared patient experience and peer support; patient self-management and self-education; attendance of healthcare professionals; and the impact of integrating BE groups into the respiratory pathway. BE networks were shown to support self-care initiatives for people attending the groups, and members expressed a social and educational benefit. BE networks were working with the local National Health Service to become an integral part of the respiratory pathway, yet there was evidence of resistance from the health service in incorporating the networks.
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93
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McKinlay E, Young J, Gray B. General practice and patients’ views of the social networks of patients with multimorbidity. J Prim Health Care 2018; 10:258-266. [DOI: 10.1071/hc17050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
ABSTRACT
INTRODUCTION
For patients with multimorbidity to live well, they need the support of not only health professionals but family, friends and organisations. These social networks provide support, potentially enabling the formation of a Community of Clinical Practice approach to multimorbidity care.
AIM
This study aimed to explore general practice knowledge of the social networks of patients with multimorbidity.
METHODS
Social network maps were completed by both patients and general practice. The social network maps of 22 patients with multimorbidity were compared with corresponding social network maps completed by general practice staff.
RESULTS
In 60% (13/22) of the patients, general practice staff held a high or moderate knowledge of individual patients’ social networks. Information on social networks was recalled from staff memory and not systematically recorded in patients’ electronic health records.
DISCUSSION
Social network information is not routinely collected, recorded or used by general practice to understand the support available to patients with multimorbidity. General practice could take an active role in coordinating social network supporters for certain patient groups with complex multimorbidity. For these groups, there is value in systematically recording and regularly updating their social network information for general practice to use as part of a coordinated Community of Clinical Practice.
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94
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Improved Health Status and Life Satisfaction among Older People following Self-Help Group Intervention in Jakarta. Curr Gerontol Geriatr Res 2017; 2017:3879067. [PMID: 29225621 PMCID: PMC5684573 DOI: 10.1155/2017/3879067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Revised: 08/23/2017] [Accepted: 09/06/2017] [Indexed: 11/17/2022] Open
Abstract
Although self-help group for older people gains the effectiveness, the effect of a nursing intervention using a self-help group model as a guideline for self-monitoring and intervention on the health status and life satisfaction among older people still remains. To determine the effectiveness of this nursing intervention, an experimental design using multistage sampling method was used for this study. The self-help intervention included a single 50-70-minute session once a week for 12 weeks done, using the Life Satisfaction Inventory-A (LSI-A) questionnaire, and SF-36 shows a significant difference. Self-help intervention could be implemented by nurses for older people in the community to improve health and well-being.
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95
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Hughes S, Lewis S, Willis K, Rogers A, Wyke S, Smith L. The experience of facilitators and participants of long term condition self-management group programmes: A qualitative synthesis. PATIENT EDUCATION AND COUNSELING 2017; 100:2244-2254. [PMID: 28711415 DOI: 10.1016/j.pec.2017.06.035] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 06/21/2017] [Accepted: 06/26/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Our aim was to systematically review the qualitative literature about the experiences of both facilitators and participants in a range of group-based programmes to support the self-management of long-term conditions. METHODS We searched 7 databases using the terms 'self-management', 'group' and 'qualitative'. Full text articles meeting the inclusion criteria were retrieved for review. A thematic synthesis approach was used to analyse the studies. RESULTS 2126 articles were identified and 24 were included for review. Group participants valued being with similar others and perceived peer support benefits. Facilitators (HCP and lay) had limited group specific training, were uncertain of purpose and prioritised education and medical conformity over supportive group processes and the promotion of self-management agency and engagement. Overall, studies prioritised positive descriptions. CONCLUSION Group programmes' medical self-management focus may reduce their ability to contribute to patient-valued outcomes. Further research is needed to explore this disconnect. PRACTICE IMPLICATIONS This review supports broadening the scope of group-based programmes to foreground shared learning, social support and development of agency. It is of relevance to developers and facilitators of group self-management programmes and their ability to address the burden of long-term conditions.
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Affiliation(s)
| | - Sophie Lewis
- Faculty of Arts and Social Sciences, University of NSW, Australia
| | - Karen Willis
- Royal Melbourne Hospital, LaTrobe University, Australia
| | - Anne Rogers
- Faculty of Health Sciences, University of Southampton, United Kingdom
| | - Sally Wyke
- Institute for Health and Wellbeing, College of Social Sciences, University of Glasgow, United Kingdom
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96
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Duggleby W, Pesut B, Cottrell L, Friesen L, Sullivan K, Warner G. Development, Implementation, and Evaluation of a Curriculum to Prepare Volunteer Navigators to Support Older Persons Living With Serious Illness. Am J Hosp Palliat Care 2017; 35:780-787. [PMID: 29129107 DOI: 10.1177/1049909117740122] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The purpose of this article is to report the development, implementation, and evaluation of a curriculum designed to prepare volunteer navigators to support community-dwelling older persons with serious chronic illness. The role of the volunteer navigator was to facilitate independence and quality of life through building social connections, improving access to resources, and fostering engagement. A curriculum was constructed from evidence-based competencies, piloted and revised, and then implemented in 7 subsequent workshops. Workshop participants were 51 volunteers and health-care providers recruited through local hospice societies and health regions. Curriculum was evaluated through satisfaction and self-efficacy questionnaires completed at workshop conclusion. Postworkshop evaluation indicated a high degree of satisfaction with the training. One workshop cohort of 7 participants was followed for 1 year to provide longitudinal evaluation data. Participants followed longitudinally reported improved self-efficacy over 12 months and some challenges with role transition. Future improvements will include further structured learning opportunities offered by telephone postworkshop, focusing on advocacy, communication, and conflict management. Overall, volunteers were satisfied with the curriculum and reported good self-perceived efficacy in their new role as navigators.
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Affiliation(s)
- Wendy Duggleby
- 1 Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Barbara Pesut
- 2 Faculty of Health and Social Development, University of British Columbia, Okanagan, Kelowna, British Columbia, Canada
| | - Laura Cottrell
- 1 Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Lynnelle Friesen
- 3 School of Nursing, University of British Columbia, Okanagan, Kelowna, British Columbia, Canada
| | - Kelli Sullivan
- 3 School of Nursing, University of British Columbia, Okanagan, Kelowna, British Columbia, Canada
| | - Grace Warner
- 4 School of Occupational Therapy, Dalhousie University, Halifax, Nova Scotia, Canada
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97
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Walker S, Kennedy A, Vassilev I, Rogers A. How do people with long-term mental health problems negotiate relationships with network members at times of crisis? Health Expect 2017; 21:336-346. [PMID: 29024284 PMCID: PMC5750694 DOI: 10.1111/hex.12620] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2017] [Indexed: 11/28/2022] Open
Abstract
Background Social network processes impact on the genesis and management of mental health problems. There is currently less understanding of the way people negotiate networked relationships in times of crisis compared to how they manage at other times. Objective This paper explores the patterns and nature of personal network involvement at times of crises and how these may differ from day‐to‐day networks of recovery and maintenance. Method Semi‐structured interviews with 25 participants with a diagnosis of long‐term mental health (MH) problems drawn from recovery settings in the south of England. Interviews centred on personal network mapping of members and resources providing support. The mapping interviews explored the work of network members and changes in times of crisis. Interviews were recorded, transcribed and analysed using a framework analysis. Results Three key themes were identified: the fluidity of network relationality between crisis and recovery; isolation as a means of crises management; leaning towards peer support. Personal network input retreated at times of crisis often as result of “ejection” from the network by participants who used self‐isolation as a personal management strategy in an attempt to deal with crises. Peer support is considered useful during a crisis, whilst the role of services was viewed with some ambiguity. Conclusions Social networks membership, and type and depth of involvement, is subject to change between times of crisis and everyday support. This has implications for managing mental health in terms of engaging with network support differently in times of crises versus recovery and everyday living.
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Affiliation(s)
- Sandra Walker
- NIHR CLAHRC Wessex, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Anne Kennedy
- NIHR CLAHRC Wessex, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Ivaylo Vassilev
- NIHR CLAHRC Wessex, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Anne Rogers
- NIHR CLAHRC Wessex, Faculty of Health Sciences, University of Southampton, Southampton, UK
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98
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Wray F, Clarke D. Longer-term needs of stroke survivors with communication difficulties living in the community: a systematic review and thematic synthesis of qualitative studies. BMJ Open 2017; 7:e017944. [PMID: 28988185 PMCID: PMC5640038 DOI: 10.1136/bmjopen-2017-017944] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To review and synthesise qualitative literature relating to the longer-term needs of community dwelling stroke survivors with communication difficulties including aphasia, dysarthria and apraxia of speech. DESIGN Systematic review and thematic synthesis. METHOD We included studies employing qualitative methodology which focused on the perceived or expressed needs, views or experiences of stroke survivors with communication difficulties in relation to the day-to-day management of their condition following hospital discharge. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, The Cochrane Library, International Bibliography of the Social Sciences and AMED and undertook grey literature searches. Studies were assessed for methodological quality by two researchers independently and the findings were combined using thematic synthesis. RESULTS Thirty-two studies were included in the thematic synthesis. The synthesis reveals the ongoing difficulties stroke survivors can experience in coming to terms with the loss of communication and in adapting to life with a communication difficulty. While some were able to adjust, others struggled to maintain their social networks and to participate in activities which were meaningful to them. The challenges experienced by stroke survivors with communication difficulties persisted for many years poststroke. Four themes relating to longer-term need were developed: managing communication outside of the home, creating a meaningful role, creating or maintaining a support network and taking control and actively moving forward with life. CONCLUSIONS Understanding the experiences of stroke survivors with communication difficulties is vital for ensuring that longer-term care is designed according to their needs. Wider psychosocial factors must be considered in the rehabilitation of people with poststroke communication difficulties. Self-management interventions may be appropriate to help this subgroup of stroke survivors manage their condition in the longer-term; however, such approaches must be designed to help survivors to manage the unique psychosocial consequences of poststroke communication difficulties.
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Affiliation(s)
- Faye Wray
- Academic Unit of Elderly Care and Rehabilitation, Leeds Institute for Health Sciences, Bradford, UK
| | - David Clarke
- Academic Unit of Elderly Care and Rehabilitation, Leeds Institute for Health Sciences, Bradford, UK
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99
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Heijmans N, van Lieshout J, Wensing M. Social network composition of vascular patients and its associations with health behavior and clinical risk factors. PLoS One 2017; 12:e0185341. [PMID: 28957372 PMCID: PMC5619748 DOI: 10.1371/journal.pone.0185341] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 09/11/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This study aimed to explore linkages of patients' social network composition with health behaviors and clinical risk factors. METHODS/DESIGN This observational study was embedded in a project aimed at improving cardiovascular risk management (CRVM) in primary care. 657 vascular patients (227 with cardiovascular disease, 380 at high vascular risk), mean age 72.4 (SD 9.4) years, were recruited as were individuals patients considered important for dealing with their disease, so called alters (n = 487). Network composition was measured with structured patient questionnaires. Both patients and alters completed questionnaires to measure health behavior (habits for physical activity, diet, and smoking). Clinical risk factors (systolic blood pressure, LDL cholesterol level, and body mass index) were extracted from patients' medical records. Six logistic regression analyses, using generalized estimating equations, were used to test three hypothesized effects of network composition (having alters with healthful behaviors, without depression, and with specialized knowledge) on six outcomes, adjusted for demographic, personal and psychological characteristics. RESULTS Having alters with overall healthful behavior was related to healthful patient diet (OR 2.14, 95%CI: 1.52-3.02). Having non-smoking alters in networks was related to reduced odds for patient smoking (OR 0.17, 95%CI: 0.05-0.60). No effects of presence of non-depressed alters were found. Presence of alters with specialized knowledge on CVRM was inversely related to healthful diet habits of patients (OR 0.47, 95%CI 0.24-0.89). No significant associations between social network composition and clinical risk factors were found. DISCUSSION Diet and smoking, but not physical exercise and clinical risk factors, were associated with social network composition of patients with vascular conditions. In this study of vascular patients, controlling for both personal and psychological factors, fewer network influences were found compared to previous research. Further research is needed to examine network structure characteristics as well as the role of psychological factors to enhance understanding health behavior of patients involved in CVRM.
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Affiliation(s)
- Naomi Heijmans
- Scientific Institute for Quality of Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
- * E-mail:
| | - Jan van Lieshout
- Scientific Institute for Quality of Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Michel Wensing
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
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100
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Reblin M, Wu YP, Pok J, Kane L, Colman H, Cohen AL, Mendivil E, Warner EL, Meyer M, Agutter J. Development of the Electronic Social Network Assessment Program Using the Center for eHealth and Wellbeing Research Roadmap. JMIR Hum Factors 2017; 4:e23. [PMID: 28855149 PMCID: PMC5597796 DOI: 10.2196/humanfactors.7845] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 07/12/2017] [Accepted: 07/29/2017] [Indexed: 11/13/2022] Open
Abstract
Background The number of Web-based psychological and behavioral interventions is growing. Beyond their theoretical underpinnings, a key factor to the success of these interventions is how they are designed and developed to ensure usability over a new method of delivery. Our team has adapted ecomapping, a tool for visualizing family caregiver social network resources, for the Web. Here, we describe how we designed and developed the electronic Social Network Assessment Program (eSNAP) Web-based tool using a framework of the Center for eHealth and Wellbeing Research (CeHRes) Roadmap for Web-based intervention development. The CeHRes Roadmap is still new in terms of tool development and we showcase an example of its application. Objective The aim of our study was to provide an example of the application of the Web-based intervention development process using the CeHRes Roadmap for other research teams to follow. In doing so, we are also sharing our pilot work to enhance eSNAP’s acceptance and usability for users and the feasibility of its implementation. Methods We describe the development of the eSNAP app to support family caregivers of neuro-oncology patients. This development is based on the 5 iterative stages of the CeHRes Roadmap: contextual inquiry, value specification, design, operationalization, and summative evaluation. Research activities to support eSNAP development prior to implementation included literature review, focus groups, and iterative rounds of interviews. Results Key lessons learned in developing the eSNAP app broadly fell under a theme of translating theoretical needs and ideas to the real world. This included how to prioritize needs to be addressed at one time, how the modality of delivery may change design requirements, and how to develop a tool to fit within the context it will be used. Conclusions Using the CeHRes Roadmap to develop Web-based interventions such as eSNAP helps to address potential issues by outlining important intervention development milestones. In addition, by encouraging inclusion of users and other stakeholders in the process, Web-based intervention developers using the Roadmap can identify what will work in the real world and increase feasibility and effectiveness.
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Affiliation(s)
- Maija Reblin
- Department of Health Outcomes & Behavior, Moffitt Cancer Center, Tampa, FL, United States
| | - Yelena P Wu
- University of Utah, Salt Lake City, UT, United States.,Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Justin Pok
- University of Utah, Salt Lake City, UT, United States
| | - Lauren Kane
- University of Utah, Salt Lake City, UT, United States
| | - Howard Colman
- University of Utah, Salt Lake City, UT, United States.,Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Adam L Cohen
- Huntsman Cancer Institute, Salt Lake City, UT, United States
| | | | - Echo L Warner
- University of Utah, Salt Lake City, UT, United States
| | - Miriah Meyer
- University of Utah, Salt Lake City, UT, United States
| | - James Agutter
- University of Utah, Salt Lake City, UT, United States
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