1
|
Sullivan MO, Curtin M, Flynn R, Cronin C, Mahony JO, Trujillo J. Telehealth interventions for transition to self-management in adolescents with allergic conditions: A systematic review. Allergy 2024; 79:861-883. [PMID: 38041398 DOI: 10.1111/all.15963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/14/2023] [Accepted: 11/19/2023] [Indexed: 12/03/2023]
Abstract
Telehealth is an emerging approach that uses technology to provide healthcare remotely. Recent publications have outlined the importance of supporting the transition to self-management of adolescents with allergic conditions. However, no synthesis of the evidence base on the use and impact of telehealth interventions for this purpose has been conducted to date. This review achieves these aims, in addition to exploring the language use surrounding these interventions, and their implementation. Four databases were searched systematically. References were independently screened by two reviewers. Methodological quality was assessed using the Mixed Methods Appraisal Tool. A narrative synthesis was undertaken. Eighteen articles were included, reporting on 15 telehealth interventions. A total of 86% targeted adolescents with asthma. Mobile applications were the most common telehealth modality used, followed by video-conferencing, web-based, virtual reality and artificial intelligence. Five intervention content categories were identified; educational, monitoring, behavioural, psychosocial and healthcare navigational. Peer and/or healthcare professional interaction, gamification and tailoring may increase engagement. The studies showed positive effects of the interventions or no difference from active controls, in self-management outcomes such as knowledge, health outcomes such as quality-of-life, and economic outcomes such as healthcare utilization. The most common implementation outcomes reported were acceptability, appropriateness, feasibility and fidelity.
Collapse
Affiliation(s)
- Meg O' Sullivan
- University College Cork, Cork, Ireland
- Cork University Hospital, Cork, Ireland
| | | | | | | | | | - Juan Trujillo
- University College Cork, Cork, Ireland
- Cork University Hospital, Cork, Ireland
| |
Collapse
|
2
|
Esfandiari E, Miller WC, King S, Payne M, Mortenson WB, Underwood H, MacKay C, Ashe MC. Protocol for a randomized controlled trial to assess the effect of Self-Management for Amputee Rehabilitation using Technology (SMART): An online self-management program for individuals with lower limb loss. PLoS One 2023; 18:e0278418. [PMID: 36952517 PMCID: PMC10035895 DOI: 10.1371/journal.pone.0278418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 10/14/2022] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Lower limb loss (LLL) is a distressing experience with psychological, physical, and social challenges. Education is needed to enhance the coping skills and confidence of patients to improve LLL outcomes. However, access to rehabilitation services and education is limited outside of urban centers. To address this service gap, we co-created an eHealth platform, called Self-Management for Amputee Rehabilitation using Technology (SMART). OBJECTIVES First, we will test the effect of SMART and usual care compared with usual care only on walking capacity and confidence among individuals with LLL. Second, we will describe key implementation factors for program delivery and adoption at the person- and provider-level. METHODS This is a Type 1 Effectiveness-Implementation Hybrid Design, mixed-methods, multi-site (British Columbia and Ontario, Canada), parallel, assessor-blinded randomized controlled trial. Participants will include adults with unilateral LLL, during early prosthetic fitting (<2 years after casting for initial prosthesis). Participants in both groups will receive usual care. The experimental group will receive SMART with weekly support sessions from a trained peer mentor for goal setting and action planning for six weeks. Participants will be encouraged to continue using SMART for an additional four weeks. The control group will receive usual care, and weekly social contacts for six weeks. The primary outcome measure is walking capacity operationalized as the performance based Timed Up and Go test. The secondary outcome is walking confidence using the Ambulatory Self-Confidence Questionnaire. Outcome measures will be assessed at baseline, immediately post-intervention, and four weeks follow-up. We will describe key implementation factors (such as, participant experience, intervention adoption, fidelity) throughout the study using questionnaires, semi-structured interviews, and direct observation. RESULTS No participants have been enrolled. CONCLUSIONS SMART has the potential to provide knowledge and skill development to augment rehabilitation outcomes for adults with LLL. TRIAL REGISTRATION NCT04953364 in Clinical Trial Registry (https://clinicaltrials.gov/).
Collapse
Affiliation(s)
- Elham Esfandiari
- Graduate Program in Rehabilitation Sciences, The University of British Columbia, Vancouver, BC, Canada
- GF Strong Rehabilitation Research Lab, Vancouver Coastal Research Institute, Vancouver, BC, Canada
| | - W C Miller
- Graduate Program in Rehabilitation Sciences, The University of British Columbia, Vancouver, BC, Canada
- GF Strong Rehabilitation Research Lab, Vancouver Coastal Research Institute, Vancouver, BC, Canada
- Department of Occupational Science and Occupational Therapy, The University of British Columbia, Vancouver, BC, Canada
| | - Sheena King
- GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC, Canada
| | - Michael Payne
- Department of Physical Medicine and Rehabilitation, Western University, London, ON, Canada
| | - W Ben Mortenson
- Graduate Program in Rehabilitation Sciences, The University of British Columbia, Vancouver, BC, Canada
- GF Strong Rehabilitation Research Lab, Vancouver Coastal Research Institute, Vancouver, BC, Canada
- Department of Occupational Science and Occupational Therapy, The University of British Columbia, Vancouver, BC, Canada
- International Collaboration on Repair Discoveries, Vancouver, BC, Canada
| | - Heather Underwood
- GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC, Canada
| | - Crystal MacKay
- West Park Healthcare Centre, Toronto, ON, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Maureen C Ashe
- Centre for Hip Health and Mobility, The University of British Columbia, Vancouver, BC, Canada
- Department of Family Practice, The University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
3
|
Klinedinst TC, Ciro CA, Kendzor DE. A pilot, randomized, feasibility study to improve health self-management behaviors in older adults with multiple chronic conditions and functional limitations: Protocol for the Behavioral Activation and Occupational Therapy Trial (BA+OT). JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2023; 13:26335565231163037. [PMID: 36911183 PMCID: PMC9998403 DOI: 10.1177/26335565231163037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/14/2023] [Indexed: 03/14/2023]
Abstract
Background Approximately 45% of older adults in the U.S. have 2 or more chronic health conditions (e.g., arthritis, hypertension, diabetes) in addition to functional limitations that prevent performance of health self-management activities. Self-management continues to be the gold standard for managing MCC, but functional limitations create difficulty with these activities (e.g., physical activity, symptom monitoring). Restricted self-management accelerates the downward spiral of disability and accumulating chronic conditions which, in turn, increases rates of institutionalization and death by 5-fold. Currently, there are no tested interventions designed to improve independence in health self-management activities in older adults with MCC and functional limitations. Research suggests that older adults are more likely to change behavior with interventions that assist with planning health-promoting daily activities, especially when contending with complex medical regimens and functional limitations. Our team asserts that combining occupational therapy (OT) and behavioral activation (BA) shows promise to improve health self-management in populations with chronic conditions and/or functional limitations. This innovative combination uses the goal setting, scheduling/monitoring activities, and problem-solving components of the BA approach as well as the environmental modification, activity adaptation, and focus on daily routines from OT practice. Objectives We will test the effect of this combined approach in a Stage I, randomized controlled pilot feasibility study compared to enhanced usual care. We will recruit 40 older adults with MCC and functional limitation and randomize 20 to the PI- delivered BA-OT protocol. This research will inform modification and larger-scale testing of this novel intervention.
Collapse
Affiliation(s)
- Tara C Klinedinst
- Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center- Schusterman Campus, Tulsa, OK, USA.,Department of Internal Medicine, OU-TU School of Community Medicine, Tulsa, OK, USA
| | - Carrie A Ciro
- Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Darla E Kendzor
- TSET Heath Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.,Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| |
Collapse
|
4
|
Al-Abyadh MHA, Abdel Azeem HAH. Academic Achievement: Influences of University Students’ Self-Management and Perceived Self-Efficacy. J Intell 2022; 10:jintelligence10030055. [PMID: 35997411 PMCID: PMC9396977 DOI: 10.3390/jintelligence10030055] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/16/2022] [Accepted: 08/01/2022] [Indexed: 11/16/2022] Open
Abstract
Successful students are more than just those who have more effective and efficient learning techniques for acquiring and applying information. They can also motivate, evaluate, and adjust their behavior if they are not learning properly. Thus, the objective of this study was to investigate the influence of university students’ self-management during their learning experience and their self-efficacy on their academic achievement. Additionally, the study investigated the differences between the Egyptian and Saudi students’ perceptions of self-management skills and self-efficacy in their academic achievement within the two countries. A total of 889 students from two different Arab countries took part in the study (Egypt and the Kingdom of Saudi Arabia). The sample was given an online questionnaire to evaluate their self-management abilities, perceived self-efficacy, and academic achievement. A quantitative approach using SmartPLS-SEM was deployed. The findings demonstrate that self-management and self-efficacy have positive influences on students’ academic achievement in both countries. Further, self-management skills have been proven to influence self-efficacy, which in turn highly influences academic achievement. Moreover, the findings of the Multi-Group Analysis (MGA) did not report significant differences between the Egyptian and Saudi students in terms of their perception of self-management, self-efficacy, and academic achievement.
Collapse
Affiliation(s)
- Mohammed Hasan Ali Al-Abyadh
- Mental Health Department, College of Education, Prince Sattam bin Abdulaziz University, Alkharj 16273, Saudi Arabia
- College of Education, Thamar University, Thamar 87246, Yemen
- Correspondence:
| | | |
Collapse
|
5
|
Öberg U, Orre CJ, Hörnsten Å, Jutterström L, Isaksson U. Using the Self-Management Assessment Scale for Screening Support Needs in Type 2 Diabetes: Qualitative Study. JMIR Nurs 2020; 3:e16318. [PMID: 34345780 PMCID: PMC8279441 DOI: 10.2196/16318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 05/10/2020] [Accepted: 08/10/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Globally, most countries face a common challenge by moving toward a population-based structure with an increasing number of older people living with chronic conditions such as type 2 diabetes. This creates a considerable burden on health care services. The use of digital tools to tackle health care challenges established views on traditional nursing, based on face-to-face meetings. Self-management is considered a key component of chronic care and can be defined as management of the day-to-day impact of a condition, something that is often a lifelong task. The use of a screening instrument, such as the Self-Management Assessment Scale (SMASc), offers the potential to guide primary health care nurses into person-centered self-management support, which in turn can help people strengthen their empowerment and self-management capabilities. However, research on self-management screening instruments is sparse, and no research on nurses' experiences using a digitalized scale for measuring patients' needs for self-management support in primary health care settings has been found. OBJECTIVE This paper describes diabetes specialist nurses' (DSNs) experiences of a pilot implementation of the SMASc instrument as the basis for person-centered digital self-management support. METHODS This qualitative study is based on observations and interviews analyzed using qualitative content analysis. RESULTS From the perspectives of DSNs, the SMASc instrument offers insights that contribute to strengthened self-management support for people with type 2 diabetes by providing a new way of thinking and acting on the patient's term. Furthermore, the SMASc was seen as a screening instrument with good potential that embraces more than medical issues; it contributed to strengthening person-centered self-management support, and the instrument was considered to lead both parts, that is, DSNs and patients, to develop together through collaboration. CONCLUSIONS Person-centered care is advocated as a model for good clinical practice; however, this is not always complied with. Screening instruments, such as the SMASc, may empower both nurses and patients with type 2 diabetes with more personalized care. Using a screening instrument in a patient meeting may also contribute to a role change in the work and practice of DSNs.
Collapse
Affiliation(s)
- Ulrika Öberg
- Department of Nursing Umeå University Umeå Sweden
| | - Carl Johan Orre
- Department of Computer Science and Media Technology DVMT, Malmö University Malmö Sweden
| | - Åsa Hörnsten
- Department of Nursing Umeå University Umeå Sweden
| | | | - Ulf Isaksson
- Department of Nursing Umeå University Umeå Sweden
| |
Collapse
|
6
|
Schimmer R, Orre C, Öberg U, Danielsson K, Hörnsten Å. Digital Person-Centered Self-Management Support for People With Type 2 Diabetes: Qualitative Study Exploring Design Challenges. JMIR Diabetes 2019; 4:e10702. [PMID: 31538941 PMCID: PMC6754678 DOI: 10.2196/10702] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 04/19/2019] [Accepted: 07/21/2019] [Indexed: 01/20/2023] Open
Abstract
Background Self-management is a substantial part of treatment for patients with type 2 diabetes (T2D). Modern digital technology, being small, available, and ubiquitous, might work well in supporting self-management. This study follows the process of developing a pilot implementation of an electronic health (eHealth) service for T2D self-management support in primary health care. The use of digital health, or eHealth, solutions for supporting self-management for patients with T2D is increasing. There are good examples of successful implementations that can serve as guides in the development of new solutions. However, when adding person-centered principles as a requirement, the examples are scarce. Objective The objective of this study was to explore challenges that could impact the design of a person-centered eHealth service for T2D self-management support. The study included data collection from multiple sources, that is, interviews, observations, focus groups, and a Mentimeter (interactive presentation with polling) survey among stakeholders, representing various perspectives of T2D. Methods A user-centered design approach was used to exploratively collect data from different sources. Data were collected from a workshop, interviews, and observations. The different data sources enabled a triangulation of data. Results Results show that user needs related to an eHealth service for person-centered T2D self-management support are multifaceted and situated in a complex context. The two main user groups, patients and diabetes specialist nurses, express needs that both diverge and converge, which indicates that critical design decisions have to be made. There is also a discrepancy between the needs expressed by the potential users and the current work practice, suggesting more attention toward changing the organization of work to fully support a new eHealth service. Conclusions A total of three overarching challenges—flexible access, reducing administrative tasks, and patient empowerment—each having a significant impact on design, are discussed. These challenges need to be considered and resolved through careful design decisions. Special attention has to be given to the patient user group that could greatly impact current work practice and power structures at the primary care unit. A need for further studies investigating patient needs in everyday life is identified to better support the implementation of technology that does not give specific attention to organizational perspectives but instead approach design with the patient perspective in focus.
Collapse
Affiliation(s)
- Robyn Schimmer
- Department of Informatics, Umeå University, Umeå, Sweden
| | - Carljohan Orre
- Department of Computer Science and Media Technology, Malmö University, Malmö, Sweden
| | - Ulrika Öberg
- Department of Nursing, Umeå University, Umeå, Sweden
| | | | - Åsa Hörnsten
- Department of Nursing, Umeå University, Umeå, Sweden
| |
Collapse
|