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Berdal G, Kjeken I, Linge AD, Aasvold AM, Tennebø K, Eppeland SG, Hagland AS, Ohldieck-Fredheim G, Valaas HL, Bø I, Klokkeide Å, Azimi M, Dager TN, Sand-Svartrud AL. Examining the Building Blocks of Health Behavior Change in Rheumatology Rehabilitation: A Theory-Driven Qualitative Study. J Multidiscip Healthc 2024; 17:3649-3662. [PMID: 39100904 PMCID: PMC11297488 DOI: 10.2147/jmdh.s472713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 07/17/2024] [Indexed: 08/06/2024] Open
Abstract
Purpose To identify and describe behavior change techniques (BCTs) used in rehabilitation for patients with rheumatic and musculoskeletal diseases (RMDs), according to their own perceptions. Further, to examine patients' descriptions of their capability, opportunity, motivation, and readiness for health behavior change. Patients and Methods Patients were adults in need of specialized, multidisciplinary rehabilitation services due to inflammatory rheumatic disease, systemic connective tissue disease, or fibromyalgia / chronic widespread pain. Semi-structured interviews of 21 patients were analyzed with deductive qualitative content analysis applying three theoretical frameworks: the Behavior Change Technique Taxonomy, the transtheoretical model and stages of change, and the capability, opportunity, and motivation model of behavior. Results Forty-six BCTs aggregated within 14 BCT groups were identified used by either patients, healthcare professionals (HPs), or both. Goals and planning, feedback and monitoring, social support, shaping knowledge, repetition and substitution were most frequently used to facilitate behavior change. Twenty patients had reached the action stage and made specific lifestyle changes concerning more than half of their goals. Concerning other goals, 6 of these patients reported to be contemplating behavior change and 15 to be preparing for it. The rehabilitation process appeared to strengthen capability, opportunity, motivation, and the desired behaviors. Patient-reported barriers to behavior change were connected with restrictions in physical capability resulting from an unpredictable and fluctuating disease course, weakened motivation, and contextual factors, such as lack of access to healthcare support and training facilities, and high domestic care burden. Conclusion The rehabilitation process seemed to strengthen individual and contextual prerequisites for behavior change and facilitate the use of required techniques and engagement in the desired behaviors. However, patients with RMDs may need prolonged support from HPs to integrate healthy lifestyle changes into everyday life. The findings can be used to optimize rehabilitation interventions and patients' persistent engagement in healthy behaviors.
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Affiliation(s)
- Gunnhild Berdal
- Health Services Research and Innovation Unit, Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - Ingvild Kjeken
- Health Services Research and Innovation Unit, Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | | | | | | | | | | | | | - Helene Lindtvedt Valaas
- Health Services Research and Innovation Unit, Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
- Vikersund Rehabilitation Centre, Vikersund, Norway
| | - Ingvild Bø
- Department of Rehabilitation, Hospital for Rheumatic Diseases, Lillehammer, Norway
| | - Åse Klokkeide
- Rehabilitering Vest Rehabilitation Centre, Haugesund, Norway
| | - Maryam Azimi
- REMEDY Patient Advisory Board, Diakonhjemmet Hospital, Oslo, Norway
| | - Turid N Dager
- Health Services Research and Innovation Unit, Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - Anne-Lene Sand-Svartrud
- Health Services Research and Innovation Unit, Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
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Dalvandi A, Khoshbakht-Pishkhani M, Ebadi A, Hosseini M. Developing post-stroke psychometric properties for an Adherence to rehabilitation regimen scale: A sequential exploratory mixed-method study. JOURNAL OF VASCULAR NURSING 2023; 41:219-225. [PMID: 38072576 DOI: 10.1016/j.jvn.2023.09.001] [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: 01/02/2022] [Revised: 08/17/2023] [Accepted: 09/22/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION Adherence to rehabilitation in patients post-stroke plays a significant role in the effectiveness of rehabilitation and patient recovery. This study aimed to design and determine the psychometric properties of a scale for measuring adherence to the rehabilitation regimen in patients post-stroke in the Iranian community. METHODS The present study used a sequential exploratory mixed method and was conducted in two phases (phase one qualitative and phase two quantitative). Participants in the first phase were patients post-stroke, caregivers, and rehabilitation team members (n=20). The second phase was conducted on patients post-stroke (n=198), and the psychometric steps, including face, content, and construct validity, as well as reliability, were assessed. RESULTS The Adherence to Rehabilitation Regimen Scale (ARRS)was designed with 26 items and four factors of participation: 1) physical exercises, 2) following prescribed regimens, 3) performing the activities of daily living, and 4) psychological follow-up. The internal consistency was 0.96 by calculating Cronbach's alpha coefficient. The Interclass Correlation Coefficient was 0.99 with a confidence interval of 0.96-0.99. CONCLUSION The scale measuring adherence to the rehabilitation regimen in patients post-stroke has optimal psychometric properties. Therefore, as the first specific scale to measure the degree of rehabilitation regimen adherence in patients post-stroke, this tool may be beneficial for other rehabilitation programs interested in managing and improving program adherence.
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Affiliation(s)
- Asghar Dalvandi
- Department of Nursing,School of Rehabilitation, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; School of Nursing and Midwifery, Islamic Azad University of Tehran, Central branch, Tehran, Iran
| | - Maryam Khoshbakht-Pishkhani
- Department of Medical Surgical Nursing, Shahid Beheshti School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran; Department of Nursing,School of Rehabilitation, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Nursing Departement, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammadali Hosseini
- Department of Rehabilitation Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Vasavada K, Shankar DS, Avila A, Lin CC, Marulanda D, Jazrawi LM, Samuels J. Postoperative flares and peri-arthroscopic management of immunosuppressive medications in patients with rheumatic disease. Knee 2023; 41:171-179. [PMID: 36702051 DOI: 10.1016/j.knee.2022.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 10/04/2022] [Accepted: 12/14/2022] [Indexed: 01/26/2023]
Abstract
PURPOSE To determine the rate and characteristics of postoperative flares in rheumatic disease patients undergoing arthroscopic surgery, and the role of perioperative immunosuppression (IS) management in preventing or provoking these exacerbations. METHODS We conducted a retrospective review of arthroscopic surgeries in patients with rheumatologic disease over 11 years. Patients taking IS at baseline and those without were matched 1:1 using propensity scores on age, sex, rheumatic disease type, and procedure complexity. Patients taking IS at baseline were sub-divided into those remaining on IS perioperatively versus those who held IS before surgery. Multivariable logistic regression identified risk factors for postoperative flares for the three IS groups, and survival analysis was used to compare the probability of remaining flare-free up to 12 weeks postoperatively. RESULTS After matching, 428 patients (214 on various types of baseline IS, 214 not on baseline IS) were included, with 110 on baseline IS remaining on it perioperatively. Rates of postoperative flares were similar for those staying on vs holding their baseline IS (9.1% vs 9.6%) but flares were less frequent in patients not on baseline IS (1.9%). Patients who remained on perioperative IS did not have significantly less flares compared to patients taken off perioperative IS (OR 0.764 [0.267, 2.181]; p = 0.61). Patients not on baseline IS had a significantly higher probability ofremaining flare-free up to 12 weeks (p = 0.004). CONCLUSION Rheumatic disease patients who hold IS medication before undergoing arthroscopy, out of concern for potential infection or complications, do not significantly increase their risk of flaring their autoimmune disease whether they had been taking csDMARDs or biologic agents. Those not taking any IS at baseline have a much lower risk of post-arthroscopic flaring, though as a group they likely harbor less of an autoimmune burden.
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Affiliation(s)
- Kinjal Vasavada
- Division of Sports Medicine, Department of Orthopaedic Surgery, New York University Langone Orthopedic Center, New York, NY, USA.
| | - Dhruv S Shankar
- Division of Sports Medicine, Department of Orthopaedic Surgery, New York University Langone Orthopedic Center, New York, NY, USA.
| | - Amanda Avila
- Division of Sports Medicine, Department of Orthopaedic Surgery, New York University Langone Orthopedic Center, New York, NY, USA.
| | - Charles C Lin
- Department of Orthopaedic Surgery, New York University Langone Orthopedic Center, New York, NY, USA.
| | - David Marulanda
- Division of Sports Medicine, Department of Orthopaedic Surgery, New York University Langone Orthopedic Center, New York, NY, USA.
| | - Laith M Jazrawi
- Department of Orthopaedic Surgery, New York University Langone Orthopedic Center, New York, NY, USA.
| | - Jonathan Samuels
- Division of Rheumatology, NYU Langone Health, New York, NY, USA.
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Gavrilescu O, Prelipcean CC, Dranga M, Soponaru C, Mihai C. The specialized educational and psychological counseling in inflammatory bowel disease patients - a target or a challenge? TURKISH JOURNAL OF GASTROENTEROLOGY 2020; 31:760-766. [PMID: 33361038 DOI: 10.5152/tjg.2020.19669] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND/AIMS Stress, in its various forms, plays an important role in the development and evolution of inflammatory bowel disease (IBD). For patients with IBD, the evidence related to the effects of various types of psychological therapies remains inconclusive. This study aimed to evaluate whether cognitive behavioral therapy, in combination with educational counseling, influenced disease activity and quality of life (QoL) among patients with IBD. MATERIALS AND METHODS We conducted a randomized controlled trial with 60 patients diagnosed with IBD. All patients completed the IBD questionnaire-32 (IBDQ-32) and the Big Five Inventory. Group A (experimental group) received specialized educational and psychological counseling (SEPC), and group B (control group) was treated according to the current medical practice. All patients were reassessed after 12 months. RESULTS After the SEPC, there was no improvement in disease activity as estimated by fecal calprotectin levels. However, the QoL of patients in group A was significantly improved. The highest mean difference between the initial and final IBDQ scores was found among patients whose main personality trait was openness to experience (48.58±28.80), and the lowest mean difference between these 2 scores was found among patients whose main personality trait was closedness to experience (3.33±2.97, p=0.009). CONCLUSION Although there was no improvement in disease activity after the SEPC, this therapy improved patients' QoL in terms of both emotional and social functions, especially among patients whose dominant personality trait was openness to experience or neuroticism.
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Affiliation(s)
- Otilia Gavrilescu
- Department of Gastroenterology and Hepatology, Grigore T. Popa University of Medicine and Pharmacy Iasi, "Sf. Spiridon" Emergency University Hospital Iasi, Iasi, Romania
| | - Cristina Cijevschi Prelipcean
- Department of Gastroenterology and Hepatology, Grigore T. Popa University of Medicine and Pharmacy Iasi, "Sf. Spiridon" Emergency University Hospital Iasi, Iasi, Romania
| | - Mihaela Dranga
- Department of Gastroenterology and Hepatology, Grigore T. Popa University of Medicine and Pharmacy Iasi, "Sf. Spiridon" Emergency University Hospital Iasi, Iasi, Romania
| | - Camelia Soponaru
- Alexandru Ioan Cuza University, School of Psychology and Education Sciences, Iasi, Romania
| | - Catalina Mihai
- Department of Gastroenterology and Hepatology, Grigore T. Popa University of Medicine and Pharmacy Iasi, "Sf. Spiridon" Emergency University Hospital Iasi, Iasi, Romania
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Stauner M, Primdahl J. A sanctuary from everyday life: rheumatology patients' experiences of in-patient multidisciplinary rehabilitation - a qualitative study. Disabil Rehabil 2020; 44:1872-1879. [PMID: 32898449 DOI: 10.1080/09638288.2020.1809721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE To explore how rheumatology patients experience the personal impact of an inpatient rehabilitation stay and to elucidate the impact of contextual factors on the outcome. METHODS Exploratory qualitative individual interviews were conducted with 15 rheumatology patients (73% female) who had completed a two-week inpatient rehabilitation stay. Data collection, analysis and interpretation of data were performed within a phenomenological-hermeneutic framework inspired by Paul Ricoeur's interpretative philosophy. RESULTS The analysis derived one core theme, A sanctuary from everyday life, and five subthemes: (1) Being seen, heard and acknowledged as an equal and whole person; (2) Professional care and compassion; (3) Social relations and interactions between patients; (4) Individual rehabilitation, but challenges regarding shared decision making; and (5) Rehabilitation as a personal process but problems with coherence and transferability of learning to everyday life. CONCLUSION Patients experience inpatient rehabilitation as a sanctuary, in the following three ways; through individually planned multidisciplinary interventions at the hospital; recognition and compassion from the multidisciplinary staff and through social relationships and interactions with fellow patients. There is a need for improved coordination across primary and secondary health care, to ease coherence and transfer of learning to the patients' everyday lives.IMPLICATIONS FOR REHABILITATIONPatients can find peace and energy to care for themselves because they are away from everyday life when admitted for inpatient multidisciplinary rehabilitation.Patients need to be prepared for shared decision-making in order to be able to participate in formulating personal and meaningful goals for rehabilitation.There is a need for awareness of organisational and life transitions, to secure transfer of elements from the rehabilitation stay to the patient's everyday life.Rehabilitation professionals should be aware of the significance of fellow patients and facilitate and support the patient-patient relationships.
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Affiliation(s)
- Maria Stauner
- University of Southern Denmark, Odense 5230, Denmark
| | - Jette Primdahl
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Danish Hospital for Rheumatic Diseases, Sønderborg, Denmark.,Hospital of Southern Jutland, University Hospital of Southern Denmark, Aabenraa, Denmark
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Pishkhani MK, Dalvandi A, Ebadi A, Hosseini MA. Adherence to a Rehabilitation Regimen in Stroke Patients: A Concept Analysis. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2020; 25:139-145. [PMID: 32195160 PMCID: PMC7055185 DOI: 10.4103/ijnmr.ijnmr_170_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 12/07/2019] [Accepted: 12/23/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Adherence to rehabilitation regimens is a major issue in the treatment of stroke. Despite the agreement on the importance of adherence, there is still no clear definition of this concept in rehabilitation. The aim of this study was the concept analysis of the concept of adherence to rehabilitation regimens in stroke patients. MATERIALS AND METHODS This qualitative concept analysis was performed using Walker and Avant's method. English and Persian articles were searched using keywords such as "adherence", "compliance", "rehabilitation", "stroke", and other related keywords among articles published from 1997 to 2018 in PubMed, Scopus, Web of Science, Google Scholar, Iranmedex, Magiran, and Scientific Information Database (SID). Related textbooks were also searched and all articles containing definitions, attributes, antecedents, and consequences of the concept were included in the study. RESULTS The attributes of the concept included complex, multidimensional, and dynamic behavior in the treatment process, personal experience, and adaptive behavior in patients, changeable, situational, voluntary, and collaborative behavior, and active communication between the patient and the healthcare provider. Common antecedents of the concept of adherence to the rehabilitation regimen were classified into patient-related and environmental-related categories and the consequences were classified into the three categories of patient-related, healthcare professional-related, and healthcare system-related. CONCLUSIONS This concept analysis can be useful in eliminating any ambiguity of the concept of adherence to rehabilitation regimens. It helps clarify the vague concepts used in nursing rehabilitation instead of adherence. The results of this study can be helpful for researchers for further studies in this context.
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Affiliation(s)
- Maryam Khoshbakht Pishkhani
- Department of Nursing, School of Rehabilitation, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Asghar Dalvandi
- School of Rehabilitation, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- School of Nursing and Midwifery, Islamic Azad University of Tehran, Central Branch, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Hosseini
- Department of Rehabilitation Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Khoshbakht Pishkhani M, Dalvandi A, Ebadi A, Hosseini M. Factors affecting adherence to rehabilitation in Iranian stroke patients: A qualitative study. JOURNAL OF VASCULAR NURSING 2019; 37:264-271. [PMID: 31847981 DOI: 10.1016/j.jvn.2019.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 06/08/2019] [Accepted: 07/02/2019] [Indexed: 02/05/2023]
Abstract
Adherence to rehabilitation has significant effects on patient outcomes. This study aimed to explore factors affecting adherence to rehabilitation in Iranian stroke patients. This is a descriptive, qualitative study. This study was conducted in 2018. Participants were stroke patients, family members, and rehabilitation team members-20 in total. They were purposively recruited from Rofaideh inpatient rehabilitation center in Tehran, and the outpatient physiotherapy center of Poursina hospital in Rasht. Data collection was performed through semistructured interviews and was continued up to data saturation. Data were analyzed by content analysis technique. Factors affecting adherence to rehabilitation in stroke patients were categorized into four main categories, namely patients-related, rehabilitation team, rehabilitation systems, and insurance and social support systems factors. Health care providers can promote patients' adherence to rehabilitation, involvement in the process of treatment, and their quality of life through broadening patients' knowledge about rehabilitation effectiveness, strengthening communication with health care providers, and adequate insurance and social support.
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Affiliation(s)
| | - Asghar Dalvandi
- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; School of Nursing and Midwifery, Islamic Azad University of Tehran, Central Branch, Tehran, Iran.
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Nursing Departement, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammadali Hosseini
- Department of Rehabilitation Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Berdal G, Bø I, Dager TN, Dingsør A, Eppeland SG, Hagfors J, Hamnes B, Mowinckel P, Nielsen M, Sand-Svartrud AL, Slungaard B, Wigers SH, Hagen KB, Dagfinrud HS, Kjeken I. Structured Goal Planning and Supportive Telephone Follow-up in Rheumatology Care: Results From a Pragmatic, Stepped-Wedge, Cluster-Randomized Trial. Arthritis Care Res (Hoboken) 2019; 70:1576-1586. [PMID: 29361197 DOI: 10.1002/acr.23520] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 01/16/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To evaluate patient-reported health effects of an add-on structured goal-planning and supportive telephone follow-up rehabilitation program compared with traditional rehabilitation programs in patients with rheumatic diseases. METHODS In this pragmatic stepped-wedge, cluster-randomized, controlled trial, 389 patients with rheumatic diseases recruited from 6 rehabilitation centers received either traditional rehabilitation or traditional rehabilitation extended with an add-on program tailored to individual needs. The add-on program comprised a self-management booklet, motivational interviewing in structured individualized goal planning, and 4 supportive follow-up phone calls after discharge. Data were collected by questionnaires on admission and discharge from rehabilitation stay, and at 6 months and 12 months after discharge. The primary outcome was health-related quality of life (HRQoL) measured by the Patient Generated Index (range 0-100, where 0 = low). Secondary outcomes included patient-reported health status, self-efficacy, pain, fatigue, global disease activity, and motivation for change. The main statistical analysis was a linear repeated measures mixed model performed on the intent-to-treat population using all available data. RESULTS A significant treatment effect of the add-on intervention on HRQoL was found on discharge (mean difference 3.32 [95% confidence interval 0.27, 6.37]; P = 0.03). No significant between-group differences were found after 6 or 12 months. Both groups showed positive changes in HRQoL following rehabilitation, which gradually declined, although the values remained at higher levels after 6 and 12 months compared with baseline values. CONCLUSION The add-on program enhanced the short-term effect of rehabilitation with respect to patient-specific HRQoL, but it did not prolong the effect as intended.
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Affiliation(s)
| | - Ingvild Bø
- Hospital for Rheumatic Diseases, Lillehammer, Norway
| | | | | | | | - Jon Hagfors
- Norwegian League Against Rheumatism, Oslo, Norway
| | - Bente Hamnes
- Hospital for Rheumatic Diseases, Lillehammer, Norway
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Lee H, Lee S, Kang JW, Lee JD. Liver enzyme abnormalities of inpatients with rheumatic diseases: A 10-year retrospective study in a Korean medicine hospital. Phytother Res 2018; 32:1784-1794. [DOI: 10.1002/ptr.6111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/11/2018] [Accepted: 04/14/2018] [Indexed: 02/05/2023]
Affiliation(s)
- Hyeonhoon Lee
- Department of Acupuncture and Moxibustion Medicine; Kyung Hee University Korean Medicine Hospital; 23 Kyungheedae-ro, Dongdaemun-gu Seoul 02447 Republic of Korea
- Department of Clinical Korean Medicine, Graduate School; Kyung Hee University; 26 Kyungheedae-ro, Dongdaemun-gu Seoul 02447 Republic of Korea
| | - Seunghoon Lee
- Department of Acupuncture and Moxibustion Medicine; Kyung Hee University Korean Medicine Hospital; 23 Kyungheedae-ro, Dongdaemun-gu Seoul 02447 Republic of Korea
| | - Jung Won Kang
- Department of Acupuncture and Moxibustion Medicine; Kyung Hee University Korean Medicine Hospital; 23 Kyungheedae-ro, Dongdaemun-gu Seoul 02447 Republic of Korea
- Department of Clinical Korean Medicine, Graduate School; Kyung Hee University; 26 Kyungheedae-ro, Dongdaemun-gu Seoul 02447 Republic of Korea
| | - Jae-Dong Lee
- Department of Acupuncture and Moxibustion Medicine; Kyung Hee University Korean Medicine Hospital; 23 Kyungheedae-ro, Dongdaemun-gu Seoul 02447 Republic of Korea
- Department of Clinical Korean Medicine, Graduate School; Kyung Hee University; 26 Kyungheedae-ro, Dongdaemun-gu Seoul 02447 Republic of Korea
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Dager TN, Kjeken I, Berdal G, Sand-Svartrud AL, Bø I, Dingsør A, Eppeland SG, Hagfors J, Hamnes B, Nielsen M, Slungaard B, Wigers SH, Hauge MI. Rehabilitation for patients with rheumatic diseases: Patient experiences of a structured goal planning and tailored follow-up programme. SAGE Open Med 2017; 5:2050312117739786. [PMID: 29163943 PMCID: PMC5682579 DOI: 10.1177/2050312117739786] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 10/04/2017] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To explore the significance of the content of rehabilitation in terms of achieving a personal outcome, and to understand the significance of tailored follow-up interventions for individual efforts to prolong health behaviour change after rehabilitation. DESIGN Semi-structured interviews with patients who had received an extended rehabilitation programme. All interviews were transcribed verbatim. A thematic analysis was applied. SUBJECTS A purposeful sample of 18 patients with rheumatic diseases who had attended specialized multidisciplinary rehabilitation with an extended programme consisting of a self-help booklet, structured goal-setting talks and tailored follow-up calls based on motivational interviewing. RESULTS Four overarching and interrelated themes were identified. Experienced Person-centred interventions represented a basis for the patients' motivation and personal outcomes. Confident self-management describes a new confident approach to exercise and illness management after rehabilitation with person-centred interventions. For many, this included reaching a different mindset, a change of illness perception. Continuity of the personal outcomes describes the importance of follow-up telephone calls to maintain the focus on goals and continued efforts. Building on established relationships and practising person-centred communication were essential. CONCLUSION Tailoring of communication and rehabilitation interventions may be a premise for enhancing health behaviour, including a beneficial illness perception. Structured goal setting and follow-up telephone calls using motivational interviewing enhance motivation and may contribute to prolonged goal attainment.
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Affiliation(s)
- Turid Nygaard Dager
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian National Unit for Rehabilitation for Rheumatic Patients, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Ingvild Kjeken
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Gunnhild Berdal
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Anne-Lene Sand-Svartrud
- Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
- Norwegian National Unit for Rehabilitation for Rheumatic Patients, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Ingvild Bø
- Department of Rehabilitation, Lillehammer Hospital for Rheumatic Diseases, Lillehammer, Norway
| | - Anne Dingsør
- Department of Rheumatology, Betanien Hospital, Skien, Norway
| | | | - Jon Hagfors
- The Norwegian Rheumatism Association, Oslo, Norway
| | - Bente Hamnes
- Department of Self-management, Lillehammer Hospital for Rheumatic Diseases, Lillehammer, Norway
| | | | - Bente Slungaard
- Department of Rheumatology, Martina Hansens Hospital, Bærum, Norway
| | | | - Mona-Iren Hauge
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
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Kwan YH, Chua CJ, Kian JXL, Fong W. Top 100 cited articles in the field of rheumatology. Eur J Rheumatol 2017; 4:294-304. [PMID: 29308289 DOI: 10.5152/eurjrheum.2017.17027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 04/29/2017] [Indexed: 01/29/2023] Open
Affiliation(s)
- Yu Heng Kwan
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | | | | | - Warren Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore.,Duke-NUS Medical School, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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