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Li X, Xu D, Lou S, Li J. Application and effect evaluation of case management nursing practice mode in patients with precision radiotherapy for nasopharyngeal carcinoma. PRECISION MEDICAL SCIENCES 2023. [DOI: 10.1002/prm2.12096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
Affiliation(s)
- Xiaodong Li
- Jiangsu Cancer Hospital Nanjing Jiangsu China
| | - Dejing Xu
- Jiangsu Cancer Hospital Nanjing Jiangsu China
| | | | - Jun Li
- Jiangsu Cancer Hospital Nanjing Jiangsu China
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Ulibarri-Ochoa A, Sánchez-Gómez S, Gamboa-Moreno E, Duo-Trecet I, Garate-Echenique L, Belarra-Tellechea B, de Retana-García LO. Impact of the "Looking after my health after cancer" peer-led active patient education program on cancer survivors and their caregivers: A qualitative study. PLoS One 2023; 18:e0282018. [PMID: 36827237 PMCID: PMC9955581 DOI: 10.1371/journal.pone.0282018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Cancer survival has doubled and is likely to continue increasing in the near future. Cancer survivors experience long-term adverse effects, with associated psychological changes, and often they have needs that are yet to be met. Recognizing the lack of continuity-of-care initiatives for cancer survivors and caregivers, Osakidetza Basque Health Service has started to implement through primary care a peer-led active patient education program called "Looking after my health after cancer". This study explores how cancer survivors and their caregivers rate the experience of participating in the program, to what extent the program helps them understand and address their unmet felt needs, and helps them improve their activation for self-care and self-management. METHODS A qualitative exploratory phenomenological study was conducted using five focus groups: four with cancer survivors (n = 29) and caregivers (n = 2), and one with peer leaders (n = 7). Narrative content analysis was performed using the constant comparison method, facilitated by Atlas-ti software. Descriptive analysis of sociodemographic and clinical data was performed. The study was developed according to the Consolidated criteria for reporting qualitative research (COREQ) checklist. RESULTS Five main themes emerged from the content analysis: 1) satisfaction with the program as a positive learning experience; 2) peer sharing and learning ("if they can, so can I"); 3) fears prior to attending the program; 4) becoming more aware of unmet felt needs and feeling understood in the "new normal"; and 5) a more positive view of their experience, helping them become active in self-care and empowered in the self-management of their condition. CONCLUSIONS The peer education program has shown to have a positive impact on cancer survivors and caregivers. It is necessary to design, implement and evaluate interventions of this type to address unmet felt needs during cancer survivorship and improve their quality of life.
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Affiliation(s)
- Ainhoa Ulibarri-Ochoa
- Bioaraba Health Research Institute, Clinical Nursing and Community Health Research Group, Vitoria-Gasteiz, Spain
- Osakidetza Basque Health Service, Araba Integrated Health Organisation, Vitoria-Gasteiz, Spain
- Vitoria-Gasteiz School of Nursing, University of the Basque Country, Vitoria-Gasteiz, Spain
- * E-mail:
| | - Sheila Sánchez-Gómez
- Bioaraba Health Research Institute, Healthcare Research Group, Vitoria-Gasteiz, Spain
- Osakidetza Basque Health Service, Araba Integrated Health Organisation, Directorate for Healthcare Integration, Vitoria-Gasteiz, Spain
- Osakidetza Basque Health Service, General Directorate, Nursing Subcommittee, Araba Multidisciplinary Teaching Unit for Family and Community Healthcare, Vitoria-Gasteiz, Spain
| | - Estíbaliz Gamboa-Moreno
- Biodonostia Health Research Institute, Primary Care Research Unit, San Sebastián-Donostia, Spain
- Osakidetza Basque Health Service, Donostialdea Integrated Health Organisation, San Sebastián-Donostia, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS)
| | - Irene Duo-Trecet
- Biodonostia Health Research Institute, Primary Care Research Unit, San Sebastián-Donostia, Spain
- Osakidetza Basque Health Service, Active Patient Program (Paziente Bizia-Paciente Activo), Subdirectorate for Primary Care Coordination, San Sebastián-Donostia, Spain
| | - Lucia Garate-Echenique
- Osakidetza Basque Health Service, Coordination of Strategic Plans, Subdirectorate for Nursing, Vitoria-Gasteiz, Spain
| | - Begoña Belarra-Tellechea
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain
- Osakidetza Basque Health Service, School of Health (Osasun Eskola), Subdirectorate for Primary Care Coordination, Vitoria-Gasteiz, Spain
| | - Lourdes Ochoa de Retana-García
- Biodonostia Health Research Institute, Primary Care Research Unit, San Sebastián-Donostia, Spain
- Osakidetza Basque Health Service, Active Patient Program (Paziente Bizia-Paciente Activo), Subdirectorate for Primary Care Coordination, San Sebastián-Donostia, Spain
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Chan NCT, Michaels D. Brief, structured, group art therapy for women with breast and/or gynaecological cancer. INTERNATIONAL JOURNAL OF ART THERAPY 2022. [DOI: 10.1080/17454832.2022.2088818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
| | - Debbie Michaels
- Art Therapy Northern Programme, Sheffield Hallam University, Sheffield, UK
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Kantilal K, Hardeman W, Whiteside H, Karapanagioutou E, Small M, Bhattacharya D. Facilitating healthcare practitioners to deliver self-management support in adult cancer survivors: A realist review. Res Social Adm Pharm 2022; 18:3870-3883. [DOI: 10.1016/j.sapharm.2022.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 11/30/2022]
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Foster C. The need for quality self-management support in cancer care. BMJ Qual Saf 2021; 31:1-4. [PMID: 34916269 DOI: 10.1136/bmjqs-2021-013366] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2021] [Indexed: 12/20/2022]
Affiliation(s)
- Claire Foster
- School of Health Sciences, University of Southampton, Southampton, UK
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6
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Hong HC, Min A, Kim YM. The effectiveness of digital self-management interventions on health outcomes among childhood cancer survivors: A systematic review and meta-analysis. J Adv Nurs 2021; 77:4387-4399. [PMID: 34129263 DOI: 10.1111/jan.14925] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/28/2021] [Accepted: 05/24/2021] [Indexed: 01/21/2023]
Abstract
AIMS The study aimed to review the evidence about existing digital interventions for childhood cancer survivors and examine their effectiveness on health outcomes. DESIGN Systematic review and meta-analysis. DATA SOURCES PUBMED, EMBASE, Cochrane, CINAHL, Web of Science, PsycArticles, SCOPUS and PQDT Global databases were searched, and the date last searched was 16 September 2019. REVIEW METHODS This systematic review followed PRISMA guidelines. Randomized and nonrandomized controlled trials, as well as before-and-after studies, were included. The main outcomes were health-related quality of life and moderate-to-vigorous physical activity. Two authors independently reviewed included studies and assessed methodological quality. Meta-analysis was conducted using statistical software STATA 16.0. RESULTS Out of the eight eligible studies, four were included in the meta-analysis. The digital self-management interventions were not effective on health-related quality of life and moderate-to-vigorous physical activity. Additionally, the digital self-management interventions increased the moderate-to-vigorous physical activity over time but was not statistically significant. CONCLUSIONS There is insufficient evidence on the effectiveness of digital self-management interventions in improving health outcomes among childhood cancer survivors. Future randomized controlled trials should be conducted from multiple locations and should include objective measures and means to encourage interaction with health care providers. IMPACT Digital interventions are increasingly implemented to improve health outcomes among childhood cancer survivors, but their results are inconsistent. Well-designed digital interventions may be beneficial for this population over time. The recommendations proposed in the current review may be useful for developing digital interventions and designing related studies in the future, thereby reducing late effects and improving healthy behaviours among this population.
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Affiliation(s)
- Hye Chong Hong
- Department of Nursing, Chung-Ang University, Seoul, South Korea
| | - Ari Min
- Department of Nursing, Chung-Ang University, Seoul, South Korea
| | - Young Man Kim
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Jeonju, South Korea
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Walshe C, Roberts D, Calman L, Appleton L, Croft R, Skevington S, Lloyd-Williams M, Grande G, Perez Algorta G. Peer support to maintain psychological wellbeing in people with advanced cancer: findings from a feasibility study for a randomised controlled trial. BMC Palliat Care 2020; 19:129. [PMID: 32807157 PMCID: PMC7433175 DOI: 10.1186/s12904-020-00631-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 08/07/2020] [Indexed: 12/12/2022] Open
Abstract
Background Advanced cancer affects people’s lives, often causing stress, anxiety and depression. Peer mentor interventions are used to address psychosocial concerns, but their outcomes and effect are not known. Our objective was to determine the feasibility of delivering and investigating a novel peer mentor intervention to promote and maintain psychological wellbeing in people with advanced cancer. Methods A mixed methods design incorporating a two-armed controlled trial (random allocation ratio 1:1) of a proactive peer mentor intervention plus usual care, vs. usual care alone, and a qualitative process evaluation. Peer mentors were recruited, trained, and matched with people with advanced cancer. Quantitative data assessed quality of life, coping styles, depression, social support and use of healthcare and other supports. Qualitative interviews probed experiences of the study and intervention. Results Peer mentor training and numbers (n = 12) met feasibility targets. Patient participants (n = 12, from 181 eligible who received an information pack) were not recruited to feasibility targets. Those who entered the study demonstrated that intervention delivery and data collection were feasible. Outcome data must be treated with extreme caution due to small numbers, but indicate that the intervention may have a positive effect on quality of life. Conclusions Peer mentor interventions are worthy of further study and researchers can learn from these feasibility data in planning participant recruitment and data collection strategies. Pragmatic trials, where the effectiveness of an intervention is tested in real-world routine practice, may be most appropriate. Peer mentor interventions may have merit in enabling survivors with advanced cancer cope with their disease. Trial Registration The trial was prospectively registered 13.6.2016: ISRCTN10276684.
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Affiliation(s)
- Catherine Walshe
- International Observatory on End of Life Care, Division of Health Research, Lancaster University, Bailrigg, Lancaster, UK.
| | - Diane Roberts
- Division of Nursing, Midwifery and Social Work, Manchester University, Manchester, UK
| | - Lynn Calman
- Macmillan Survivorship Research Group, School of Health Sciences, Southampton University, Southampton, UK
| | - Lynda Appleton
- Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, UK
| | | | - Suzanne Skevington
- Manchester Centre for Health Psychology, School of Psychological Sciences, Manchester University, Manchester, UK
| | | | - Gunn Grande
- Division of Nursing, Midwifery and Social Work, Manchester University, Manchester, UK
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Martin F, Wright H, Moody L, Whiteman B, McGillion M, Clyne W, Pearce G, Turner A. Help to Overcome Problems Effectively for Cancer Survivors: Development and Evaluation of a Digital Self-Management Program. J Med Internet Res 2020; 22:e17824. [PMID: 32209529 PMCID: PMC7268001 DOI: 10.2196/17824] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 03/19/2020] [Accepted: 03/21/2020] [Indexed: 12/29/2022] Open
Abstract
Background People living with cancer face numerous psychosocial challenges, including cancer-related fatigue, fear of recurrence, and depression. There is a lack of digital interventions tailored to the needs of people living with all types of cancer. We developed a 6-week, digital, peer-delivered, self-management program: iHOPE (Help to Overcome Problems Effectively; where ‘i’ indicates the digital version of the program). The program is underpinned by positive psychology and cognitive behavioral therapy to meet these psychosocial challenges. Objective This study aimed to assess the feasibility of the iHOPE program among people living with cancer. Program adherence and satisfaction along with changes in psychological distress and positive well-being were measured. Methods A pre-post, acceptability, and feasibility design was used. People living with cancer (N=114) were recruited via a national cancer charity in the United Kingdom and were given access to the iHOPE program. Demographic and other participant characteristics were recorded. Participants completed digital measures at baseline and the end of the 6-week program for depression, anxiety, cancer-related fatigue, cancer worry or fear of cancer recurrence, positive mental well-being, hope, gratitude, and health status. The website’s system recorded data on the usage of the program. Satisfaction with the program was also measured. Results A total of 114 participants completed the baseline questionnaires. Of these, 70 people (61.4%) participated in all 6 sessions. The mean number of sessions undertaken was 5.0 (SD 1.5). Moreover, 44.7% (51/114) of participants completed at least three sessions and end-of-program outcome measures. A total of 59 participants completed the satisfaction questionnaire, where ≥90% (54/58) of participants reported that the program was easy to navigate and was well managed by the peer facilitators, and that they found the social networking tools useful. Preliminary efficacy testing among the 51 participants who completed baseline and postprogram outcome measures showed that postprogram scores decreased for depression, anxiety, cancer-related fatigue, and fear of recurrence (all P<.001) and increased for positive mental well-being (P<.001), hope (both P<.001), and gratitude (P=.02). Conclusions The feasibility evidence is promising, showing that the peer-delivered digital iHOPE program is acceptable and practical. Implementation of the iHOPE program on a wider scale will incorporate further research and development to maximize the completion rates of the measures. Initial effectiveness data suggest positive impacts on important cancer-related quality of life and mental well-being outcomes. A randomized controlled trial design with a longer follow-up is needed to confirm the potential of the iHOPE program for improving mental and physical health outcomes for cancer survivors.
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Affiliation(s)
- Faith Martin
- Faculty of Health and Applied Science, University of the West of England, Bristol, United Kingdom
| | - Hayley Wright
- Faculty Research Centre for Intelligent Healthcare, Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom
| | - Louise Moody
- Faculty Research Centre for Arts, Memory and Communities, Faculty of Arts and Humanities, Coventry University, Coventry, United Kingdom
| | - Becky Whiteman
- UK Early Cancer Detection Consortium, Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom.,Baxter Healthcare, Compton, Newbury, United Kingdom
| | | | - Wendy Clyne
- Hope for The Community, Community Interest Company, The Enterprise Hub, Coventry, United Kingdom.,National Institute for Health Research, Research Design Service South West, Peninsula Medical School, Plymouth University, Devon, United Kingdom
| | - Gemma Pearce
- Faculty of Health and Life Sciences, School of Psychological, Social and Behavioural Sciences, Coventry University, Coventry, United Kingdom
| | - Andy Turner
- Faculty Research Centre for Intelligent Healthcare, Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom
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Tan SS, Pisano MM, Boone AL, Baker G, Pers YM, Pilotto A, Valsecchi V, Zora S, Zhang X, Fierloos I, Raat H. Evaluation Design of EFFICHRONIC: The Chronic Disease Self-Management Programme (CDSMP) Intervention for Citizens with a Low Socioeconomic Position. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16111883. [PMID: 31142017 PMCID: PMC6603786 DOI: 10.3390/ijerph16111883] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 05/14/2019] [Accepted: 05/25/2019] [Indexed: 12/21/2022]
Abstract
Background/rationale: The Chronic Disease Self-Management Programme (CDSMP) intervention is an evidence-based program that aims to encourage citizens with a chronic condition, as well as their caregivers, to better manage and maintain their own health. CDSMP intervention is expected to achieve greater health gains in citizens with a low socioeconomic position (SEP), because citizens with a low SEP have fewer opportunities to adhere to a healthy lifestyle, more adverse chronic conditions and a poorer overall health compared to citizens with a higher SEP. In the EFFICHRONIC project, CDSMP intervention is offered specifically to adults with a chronic condition and a low SEP, as well as to their caregivers (target population). Study objective: The objective of our study is to evaluate the benefits of offering CDSMP intervention to the target population. Methods: A total of 2500 participants (500 in each study site) are recruited to receive the CDSMP intervention. The evaluation study has a pre-post design. Data will be collected from participants before the start of the intervention (baseline) and six months later (follow up). Benefits of the intervention include self-management in healthy lifestyle, depression, sleep and fatigue, medication adherence and health-related quality of life, health literacy, communication with healthcare professionals, prevalence of perceived medical errors and satisfaction with the intervention. The study further includes a preliminary cost-effectiveness analysis with a time horizon of six months. Conclusion: The EFFICHRONIC project will measure the effects of the CDSMP intervention on the target population and the societal cost savings in five European settings.
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Affiliation(s)
- Siok Swan Tan
- Department of Public Health, Erasmus MC University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Marta M Pisano
- Fundación para el Fomento en Asturias de la Investigación Científica Aplicada y la Tecnología (FICYT), Cabo Noval St, 11, 1ºC, 33007 Oviedo-Asturias, Spain.
| | - An Ld Boone
- Public Health General Directorate, Principality of Asturias (CSPA), C/ Ciriaco Miguel Vigil 9, 33006 Oviedo, Spain.
| | - Graham Baker
- Quality Institute for Self Management Education & Training (QISMET), Harbour Court, Compass Road, North Harbour, Portsmouth, Hampshire PO6 4ST, UK.
| | - Yves-Marie Pers
- Clinical Immunology and Osteoarticular Diseases Therapeutic Unit, Lapeyronie University Hospital, Montpellier, 371, Avenue du Doyen Gaston Giraud, 34295 Montpellier CEDEX 5, France.
| | - Alberto Pilotto
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy.
| | - Verushka Valsecchi
- Clinical Immunology and Osteoarticular Diseases Therapeutic Unit, Lapeyronie University Hospital, Montpellier, 371, Avenue du Doyen Gaston Giraud, 34295 Montpellier CEDEX 5, France.
| | - Sabrina Zora
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Mura delle Cappuccine 14, 16128 Genoa, Italy.
| | - Xuxi Zhang
- Department of Public Health, Erasmus MC University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Irene Fierloos
- Department of Public Health, Erasmus MC University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Hein Raat
- Department of Public Health, Erasmus MC University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
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Buitron de la Vega P, Coe C, Paasche-Orlow MK, Clark JA, Waite K, Sanchez MJ, Armstrong E, Bokhour BG. "It's like a mirror image of my illness": Exploring Patient Perceptions About Illness Using Health Mind Mapping-a Qualitative Study. J Gen Intern Med 2018; 33:1692-1699. [PMID: 29992428 PMCID: PMC6153235 DOI: 10.1007/s11606-018-4557-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 02/06/2018] [Accepted: 06/18/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND A patient's self-management of chronic disease is influenced in part by their explanatory model of illness (EMI) and daily lived experiences (DLE). Unfortunately, assessing patient's EMI and using this information to engage patients in chronic illness self-management continues to be a challenge. OBJECTIVE "Health mind mapping" (HMM) is a novel process that captures a patient's EMI and DLE through the use of a graphic representation of ideas. We aimed to explore patient's experiences using HMM. DESIGN Qualitative study utilizing semi-structured interviews. PARTICIPANTS Adult patients with uncontrolled type 2 diabetes from a primary care clinic. APPROACH A facilitator guided 20 participants through the process of developing a health mind map. Subsequently, each participant completed a semi-structured interview about their experience with the process and perceptions about how their maps could be used. The process and interviews were video and audio recorded. We conducted a content analysis of the maps and a thematic analysis, using an inductive approach, of the interview data. RESULTS Participants explored a wide range of EMs and DLEs in their HMM process. Participants reported that the HMM process (1) helped to develop insight about self and illness; (2) was a catalyst for wanting to take actions to improve illness; and (3) represented an opportunity to actively share illness experiences. They reported potential uses of the map: (1) to communicate about their illness to others in their social network; (2) to communicate about their illness to providers; (3) to help others with diabetes manage their illness; and (4) to encourage ongoing engagement in diabetes self-care. CONCLUSIONS Participants reported that HMM helped them develop new insight about their illness and was a catalyst for encouraging them to take control of their illness. HMM has the potential to facilitate communication with providers and engage patients in collaborative goal setting to improve self-care in chronic illness.
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Affiliation(s)
- Pablo Buitron de la Vega
- General Internal Medicine, Boston Medical Center, Boston, MA, USA.
- Boston University School of Medicine, Boston, MA, USA.
| | | | - Michael K Paasche-Orlow
- General Internal Medicine, Boston Medical Center, Boston, MA, USA
- Boston University School of Medicine, Boston, MA, USA
| | - Jack A Clark
- Boston University School of Public Health, Boston, MA, USA
| | - Katherine Waite
- General Internal Medicine, Boston Medical Center, Boston, MA, USA
| | | | - Emily Armstrong
- General Internal Medicine, Boston Medical Center, Boston, MA, USA
| | - Barbara G Bokhour
- Boston University School of Public Health, Boston, MA, USA
- Center for Healthcare Organizations and Implementation Research, Edith Nourse Rogers VA Medical Center, Bedford, MA, USA
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11
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Han A, Choi JS. Factors influencing infection prevention self-care behaviors in patients with hematologic cancer after discharge. Eur J Oncol Nurs 2018; 35:102-106. [PMID: 30057076 DOI: 10.1016/j.ejon.2018.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 05/15/2018] [Accepted: 06/25/2018] [Indexed: 02/01/2023]
Abstract
PURPOSE The purpose of this study is to investigate the conditions and influencing factors behind infection prevention self-care behaviors performed at home by hematologic cancer patients with a central venous catheter inserted before hospital discharge, and to identify additional external factors influencing these self-care behaviors. METHODS This is a descriptive survey study conducted with 147 patients with hematologic cancer who were hospitalized and re-admitted to a university hospital in Korea. Infection prevention self-care behaviors, knowledge, and family support were measured using scales developed through a preliminary survey and validity testing. RESULTS The score for infection prevention self-care behaviors was 3.67 ± 0.81 (out of 5), knowledge was 68.8 ± 18.2 (out of 100), and family support was 4.21 ± 2.14 (out of 7). Infection prevention self-care knowledge (β = 0.443, p < 0.001) and economic status (β = 2.102, p = 0.05) both had a significant effect on infection prevention self-care behaviors. The total explanatory power for infection prevention self-care behaviors by two variables was 37.1%. CONCLUSIONS Infection prevention self-care behaviors were found to be significantly affected by infection prevention self-care knowledge and economic status. Developing and applying effective educational programs to improve infection prevention self-care knowledge will increase self-care behaviors. Additionally, nursing interventions should assess patients' economic status, their performance of oral care and knowledge of central venous catheter management.
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Affiliation(s)
- Areum Han
- Institute for Refractory Cancer Research, Samsung Medical Center, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, South Korea.
| | - Jeong Sil Choi
- Gachon University, College of Nursing, 191, Hambakmoero, Yeonsu-dong, Yeonsu-gu, Incheon, 21936, South Korea.
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Perspectives of Women Considering Bilateral Prophylactic Mastectomy and their Peers towards a Telephone-Based Peer Support Intervention. J Genet Couns 2017; 27:274-288. [PMID: 28916957 DOI: 10.1007/s10897-017-0148-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Accepted: 08/16/2017] [Indexed: 01/26/2023]
Abstract
Prophylactic mastectomy is an effective strategy to reduce the risk of breast cancer for women carrying a BRCA1/2 germline mutation. This decision is complex and may raise various concerns. Women considering this surgery have reported their desire to discuss the implications of this procedure with women who have undergone prophylactic mastectomy. We conducted a qualitative study to describe the topics covered during a telephone-based peer support intervention between women considering prophylactic mastectomy (recipients) and women who had undergone this surgery (peers), and to explore their perspectives regarding the intervention. Thirteen dyads were formed and data from participant logbooks and evaluation questionnaires were analyzed using a thematic content analysis. Three main dimensions emerged: physical, psychological, and social. The most frequent topics discussed were: surgery (92%), recovery (77%), pain and physical comfort (69%), impacts on intimacy and sexuality (54%), cancer-related anxiety (54%), experience related to loss of breasts (46%). Peers and recipients report that sharing experiences and thoughts about prophylactic mastectomy and the sense of mutual support within the dyad contributed significantly to their satisfaction. Special attention should be paid to the similarities between personal and medical profiles in order to create harmonious matches.
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Conceptualisation of the 'good' self-manager: A qualitative investigation of stakeholder views on the self-management of long-term health conditions. Soc Sci Med 2017; 176:25-33. [PMID: 28126586 DOI: 10.1016/j.socscimed.2017.01.018] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 01/12/2017] [Accepted: 01/13/2017] [Indexed: 11/21/2022]
Abstract
Healthcare policy in developed countries has, in recent years, promoted self-management among people with long-term conditions. Such policies are underpinned by neoliberal philosophy, as seen in the promotion of greater individual responsibility for health through increased support for self-management. Yet still little is known about how self-management is understood by commissioners of healthcare services, healthcare professionals, people with long-term conditions and family care-givers. The evidence presented here is drawn from a two-year study, which investigated how self-management is conceptualised by these stakeholder groups. Conducted in the UK between 2013 and 2015, this study focused on three exemplar long-term conditions, stroke, diabetes and colorectal cancer, to explore the issue. Semi-structured interviews and focus groups were carried out with 174 participants (97 patients, 35 family care-givers, 20 healthcare professionals and 22 commissioners). The data is used to demonstrate how self-management is framed in terms of what it means to be a 'good' self-manager. The 'good' self-manager is an individual who is remoralised; thus taking responsibility for their health; is knowledgeable and uses this to manage risks; and, is 'active' in using information to make informed decisions regarding health and social wellbeing. This paper examines the conceptualisation of the 'good' self-manager. It demonstrates how the remoralised, knowledgeable and active elements are inextricably linked, that is, how action is knowledge applied and how morality underlies all action of the 'good' self-manager. Through unpicking the 'good' self-manager the problems of neoliberalism are also revealed and addressed here.
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14
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Van Hecke A, Heinen M, Fernández-Ortega P, Graue M, Hendriks JM, Høy B, Köpke S, Lithner M, Van Gaal BG. Systematic literature review on effectiveness of self-management support interventions in patients with chronic conditions and low socio-economic status. J Adv Nurs 2016; 73:775-793. [DOI: 10.1111/jan.13159] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Ann Van Hecke
- Faculty of Medicine and Health Sciences; University Center for Nursing and Midwifery; Ghent University; Belgium
| | - Maud Heinen
- Nursing Science and Allied Healthcare; Radboud Institute for Health Sciences, IQ healthcare; Radboud University Medical Center; Nijmegen The Netherlands
| | | | - Marit Graue
- Faculty of Health and Social Sciences; Centre for Evidence-Based Practice; Bergen University College; Norway
| | - Jeroen M.L. Hendriks
- Centre for Heart Rhythm Disorders; Royal Adelaide Hospital and University of Adelaide; South Australia Australia
| | - Bente Høy
- Department of Health care and Social Sciences; VIA University College; Aarhus Denmark
| | - Sascha Köpke
- Institute for Social Medicine and Epidemiology; Nursing Research Unit; University of Lübeck; Germany
| | - Maria Lithner
- Department of Surgery; Skane University Hospital Lund; Sweden
| | - Betsie G.I. Van Gaal
- Nursing Science and Allied Healthcare; Radboud Institute for Health Sciences, IQ healthcare; Radboud University Medical Center; Nijmegen The Netherlands
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Park JY. Implementing a central venous catheter self-management education program for patients with cancer. Eur J Oncol Nurs 2016; 25:1-8. [PMID: 27865247 DOI: 10.1016/j.ejon.2016.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 08/29/2016] [Accepted: 08/31/2016] [Indexed: 12/25/2022]
Abstract
PURPOSE To evaluate the effects of the central venous catheter self-management education program (CVC S-MEP) in improving knowledge, attitude, and behavior regarding CVC and in decreasing CVC-related complications in patients with cancer during homecare service. METHODS A quasi-experimental, sequential cohort design study of patients with cancer and who have CVCs was performed to compare the effect of CVC S-MEP with usual care. RESULTS The study group consisted of 45 participants (26 male and 19 female), and the mean age was 46.1 (SD, 10.5) years. The subjects of the CVC S-MEP had significantly high mean levels of self-management knowledge (p = 0.007), attitude (p < 0.001), and behavior (p = 0.002). Also, the participants in the CVC S-MEP had significantly lower frequency of catheter-related complications (p = 0.030). CONCLUSIONS The CVC S-MEP helped improve patients' ability to resolve problems and adequately respond to CVC-related emergency situations by fostering greater self-care ability. Additionally, providing practical information for CVC self-management in a gradual and repetitive manner had a notable positive effect on patients.
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16
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Koom WS, Choi MY, Lee J, Park EJ, Kim JH, Kim SH, Kim YB. Art therapy using famous painting appreciation maintains fatigue levels during radiotherapy in cancer patients. Radiat Oncol J 2016; 34:135-44. [PMID: 27306778 PMCID: PMC4938348 DOI: 10.3857/roj.2016.01760] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 04/22/2016] [Accepted: 05/09/2016] [Indexed: 11/03/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate the efficacy of art therapy to control fatigue in cancer patients during course of radiotherapy and its impact on quality of life (QoL). MATERIALS AND METHODS Fifty cancer patients receiving radiotherapy received weekly art therapy sessions using famous painting appreciation. Fatigue and QoL were assessed using the Brief Fatigue Inventory (BFI) Scale and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) at baseline before starting radiotherapy, every week for 4 weeks during radiotherapy, and at the end of radiotherapy. Mean changes of scores over time were analyzed using a generalized linear mixed model. RESULTS Of the 50 patients, 34 (68%) participated in 4 sessions of art therapy. Generalized linear mixed models testing for the effect of time on mean score changes showed no significant changes in scores from baseline for the BFI and FACIT-F. The mean BFI score and FACIT-F total score changed from 3.1 to 2.7 and from 110.7 to 109.2, respectively. Art therapy based on the appreciation of famous paintings led to increases in self-esteem by increasing self-realization and forming social relationships. CONCLUSION Fatigue and QoL in cancer patients with art therapy do not deteriorate during a period of radiotherapy. Despite the single-arm small number of participants and pilot design, this study provides a strong initial demonstration that art therapy of appreciation for famous painting is worthy of further study for fatigue and QoL improvement. Further, it can play an important role in routine practice in cancer patients during radiotherapy.
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Affiliation(s)
- Woong Sub Koom
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea.,Cancer Information Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, Korea
| | - Mi Yeon Choi
- Graduate School of Clinical Art Therapy, CHA University, Pocheon, Korea
| | - Jeongshim Lee
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Jung Park
- Graduate School of Clinical Art Therapy, CHA University, Pocheon, Korea
| | - Ju Hye Kim
- Graduate School of Clinical Art Therapy, CHA University, Pocheon, Korea
| | - Sun-Hyun Kim
- Graduate School of Clinical Art Therapy, CHA University, Pocheon, Korea
| | - Yong Bae Kim
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea
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17
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Chiapperino L, Tengland PA. Empowerment in healthcare policy making: three domains of substantive controversy. Health Promot J Austr 2016; 26:210-215. [PMID: 26650538 DOI: 10.1071/he15035] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 10/19/2015] [Indexed: 11/23/2022] Open
Abstract
This paper distinguishes between the uses of empowerment across different contexts in healthcare policy and health promotion, providing a model for the ethical and political scrutiny of those uses. We argue that the controversies currently engendered by empowerment are better understood by means of a historical distinction between two concepts of empowerment, namely, what we call the radical empowerment approach and the new wave of empowerment. Building on this distinction, we present a research agenda for ethicists and policy makers, highlighting three domains of controversy raised by the new wave of empowerment, namely: (1) the relationship between empowerment and paternalistic interferences on the part of professionals; (2) the evaluative commitment of empowerment strategies to the achievement of health-related goals; and (3) the problems arising from the emphasis on responsibility for health in recent uses of empowerment. Finally, we encourage the explicit theorisation of these moral controversies as a necessary step for the development and implementation of ethically legitimate empowerment processes.
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Affiliation(s)
- Luca Chiapperino
- European Institute of Oncology, via Adamello 16, 20139 Milan, Italy
| | - Per-Anders Tengland
- Faculty of Health and Society, Jan Waldenströms gata 25, Malmö University, 20506 Malmö, Sweden
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18
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Cancer survivors’ perspectives on adjustment-focused self-management interventions: a qualitative meta-synthesis. J Cancer Surviv 2016; 10:1012-1034. [DOI: 10.1007/s11764-016-0546-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 04/27/2016] [Indexed: 10/21/2022]
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19
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Haslbeck J, Zanoni S, Hartung U, Klein M, Gabriel E, Eicher M, Schulz PJ. Introducing the chronic disease self-management program in Switzerland and other German-speaking countries: findings of a cross-border adaptation using a multiple-methods approach. BMC Health Serv Res 2015; 15:576. [PMID: 26711458 PMCID: PMC4692063 DOI: 10.1186/s12913-015-1251-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 12/22/2015] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Stanford's Chronic Disease Self-Management Program (CDSMP) stands out as having a large evidence-base and being broadly disseminated across various countries. To date, neither evidence nor practice exists of its systematic adaptation into a German-speaking context. The objective of this paper is to describe the systematic German adaptation and implementation process of the CDSMP (2010-2014), report the language-specific adaptation of Franco-Canadian CDSMP for the French-speaking part of Switzerland and report findings from the initial evaluation process. METHODS Multiple research methods were integrated to explore the perspective of workshop attendees, combining a longitudinal quantitative survey with self-report questionnaires, qualitative focus groups, and interviews. The evaluation process was conducted in for both the German and French adapted versions to gain insights into participants' experiences in the program and to evaluate its impact. Perceived self-efficacy was measured using the German version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6G). RESULTS Two hundred seventy eight people attending 35 workshops in Switzerland and Austria participated in the study. The study participants were receptive to the program content, peer-led approach and found principal methods useful, yet the structured approach did not address all their needs or expectations. Both short and long-term impact on self-efficacy were observed following the workshop participation (albeit with a minor decrease at 6-months). Participants reported positive impacts on aspects of coping and self-care, but limited effects on healthcare service utilization. CONCLUSIONS Our findings suggest that the process for cross-border adaptation was effective, and that the CDSMP can successfully be implemented in diverse healthcare and community settings. The adapted CDSMP can be considered an asset for supporting self-management in both German-and French-speaking central European countries. It could have meaningful, wide-ranging implications for chronic illness care and primary prevention and potentially tertiary prevention of chronic disease. Further investigations are needed to tailor the program for better access to vulnerable and disadvantaged groups who might benefit the most, in terms of facilitating their health literacy in chronic illness.
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Affiliation(s)
- Jörg Haslbeck
- Research Institute of the Kalaidos University of Applied Science Department of Health, Careum Research, Zurich, Switzerland.
| | - Sylvie Zanoni
- Research Institute of the Kalaidos University of Applied Science Department of Health, Careum Research, Zurich, Switzerland.
| | - Uwe Hartung
- Institute of Communication and Health (ICH), Università della Svizzera Italiana, Lugano, Switzerland.
| | | | | | | | - Peter J Schulz
- Institute of Communication and Health (ICH), Università della Svizzera Italiana, Lugano, Switzerland.
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20
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Money AG, Barnett J, Kuljis J, Duffin D. Patient perceptions and expectations of an anticoagulation service: a quantitative comparison study of clinic-based testers and patient self-testers. Scand J Caring Sci 2015; 29:662-78. [PMID: 25684404 PMCID: PMC4964929 DOI: 10.1111/scs.12195] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 10/17/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Government initiatives see the provision of technology-assisted self-care as one of the key areas in which there is capacity for improving quality of care whilst reducing costs. However, levels of patient engagement in self-testing and management (STM) remain low. Little emphasis has been placed on understanding the patients' perspectives of the reasons for this limited engagement. Typically, patient engagement in STM is achieved via the provision of patient education programmes, which aim to enable patients to make the changes necessary to become competent self-carers. However, placing the onus to change on the individual patient is unrealistic. If levels of patient engagement are to be improved, patient needs and expectations of clinical services must be better understood and service provision must be adapted accordingly. OBJECTIVE Explore patient perceptions and expectations of clinical service provision and their views of having and making choices about care. METHODS Participants [N = 191, 103 patient self-tester managers (PSTMs) and 87 clinic-based testers (CBTs)] completed the SERVQUAL and ChQ instruments to capture perspectives on service quality and choice, respectively. A comparative statistical analysis explored the similarities and differences between PSTMs' and CBTs' responses. RESULTS Clinic-based testers' perceptions of service quality were significantly more positive than PSTMs', as were their expectations of the 'tangible' aspects of service delivery. PSTMs' expectations of service quality were significantly higher than their perceptions. PSTMs attributed significantly more value to making choices compared with CBTs. CONCLUSIONS AND RECOMMENDATIONS To close the gap between PSTMs expectations and perceptions of service quality and better cater for their choice preferences, service providers may benefit from taking into account the following practice considerations: maintain frequent, timely, personalised and direct interactions with PSTMs; prioritise investment in resources to facilitate patient/practitioner interaction over tangible facilities; ensure that PSTMs are given the opportunity to make choices about their care.
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Affiliation(s)
- Arthur G. Money
- Department of Computer ScienceBrunel University LondonUxbridge, LondonUK, UB8 3PH
| | - Julie Barnett
- Department of Computer ScienceBrunel University LondonUxbridge, LondonUK, UB8 3PH
| | - Jasna Kuljis
- Department of Computer ScienceBrunel University LondonUxbridge, LondonUK, UB8 3PH
| | - Debbie Duffin
- Haemostasis and Thrombosis UnitNottingham University Hospitals NHS TrustQueen's Medical Centre CampusDerby RoadNottinghamNG7 2UH
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21
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Pereira Neto A, Barbosa L, Silva AD, Dantas MLG. [The informed patient and medical knowledge: a virtual ethnography study of Facebook communities of the infirm]. HISTORIA, CIENCIAS, SAUDE--MANGUINHOS 2015; 22 Suppl:1653-1671. [PMID: 26785872 DOI: 10.1590/s0104-59702015000500007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 04/01/2015] [Indexed: 06/05/2023]
Abstract
Today's world has brought the emergence of the "informed patient:" someone who becomes well-informed about his or her medical condition through extensive research and information-sharing on the Internet. The article explores the following question: Do informed patients foster citizen empowerment or do they expand the command of existing biomedical knowledge? Using virtual ethnography, an exploratory study was conducted on three online Facebook groups of people with diabetes, hepatitis C, and Aids. Findings suggest points of tension between Facebook members and their healthcare providers. It may be that the empowerment fostered by the Internet and the validity of current medical knowledge are not mutually exclusive.
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22
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Boulton M, Adams E, Horne A, Durrant L, Rose P, Watson E. A qualitative study of cancer survivors’ responses to information on the long-term and late effects of pelvic radiotherapy 1-11 years post treatment. Eur J Cancer Care (Engl) 2015. [DOI: 10.1111/ecc.12356] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M. Boulton
- Department of Clinical Health Care; Oxford Brookes University; Oxford UK
| | - E. Adams
- School of Psychology; College of Life Sciences; Birmingham University; Birmingham UK
| | - A. Horne
- Oxford University Hospitals NHS Trust; Department of Radiotherapy; Oxford Cancer and Haematology Centre; Churchill Hospital; Oxford UK
| | - L. Durrant
- Oxford University Hospitals NHS Trust; Department of Radiotherapy; Oxford Cancer and Haematology Centre; Churchill Hospital; Oxford UK
| | - P. Rose
- Department of Primary Health Care Sciences; University of Oxford; Oxford UK
| | - E. Watson
- Department of Clinical Health Care; Oxford Brookes University; Oxford UK
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23
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Ahn S, Smith ML, Altpeter M, Post L, Ory MG. Healthcare cost savings estimator tool for chronic disease self-management program: a new tool for program administrators and decision makers. Front Public Health 2015; 3:42. [PMID: 25964946 PMCID: PMC4410329 DOI: 10.3389/fpubh.2015.00042] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 02/17/2015] [Indexed: 11/13/2022] Open
Abstract
Chronic disease self-management education (CDSME) programs have been delivered to more than 100,000 older Americans with chronic conditions. As one of the Stanford suite of evidence-based CDSME programs, the chronic disease self-management program (CDSMP) has been disseminated in diverse populations and settings. The objective of this paper is to introduce a practical, universally applicable tool to assist program administrators and decision makers plan implementation efforts and make the case for continued program delivery. This tool was developed utilizing data from a recent National Study of CDSMP to estimate national savings associated with program participation. Potential annual healthcare savings per CDSMP participant were calculated based on averted emergency room visits and hospitalizations. While national data can be utilized to estimate cost savings, the tool has built-in features allowing users to tailor calculations based on their site-specific data. Building upon the National Study of CDSMP's documented potential savings of $3.3 billion in healthcare costs by reaching 5% of adults with one or more chronic conditions, two heuristic case examples were also explored based on different population projections. The case examples show how a small county and large metropolitan city were not only able to estimate healthcare savings ($38,803 for the small county; $732,290 for the large metropolitan city) for their existing participant populations but also to project significant healthcare savings if they plan to reach higher proportions of middle-aged and older adults. Having a tool to demonstrate the monetary value of CDSMP can contribute to the ongoing dissemination and sustainability of such community-based interventions. Next steps will be creating a user-friendly, internet-based version of Healthcare Cost Savings Estimator Tool: CDSMP, followed by broadening the tool to consider cost savings for other evidence-based programs.
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Affiliation(s)
- SangNam Ahn
- Division of Health Systems Management and Policy, School of Public Health, The University of Memphis , Memphis, TN , USA ; Department of Health Promotion and Community Health Sciences, Texas A&M University Health Science Center, School of Public Health , College Station, TX , USA
| | - Matthew Lee Smith
- Department of Health Promotion and Behavior, College of Public Health, The University of Georgia , Athens, GA , USA
| | - Mary Altpeter
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill , Chapel Hill, NC , USA
| | - Lindsey Post
- Division of Health Systems Management and Policy, School of Public Health, The University of Memphis , Memphis, TN , USA
| | - Marcia G Ory
- Department of Health Promotion and Community Health Sciences, Texas A&M University Health Science Center, School of Public Health , College Station, TX , USA
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Padrnos L, Dueck AC, Scherber R, Glassley P, Stigge R, Northfelt D, Mikhael J, Aguirre A, Bennett RM, Mesa RA. Quality of life and disease understanding: impact of attending a patient-centered cancer symposium. Cancer Med 2015; 4:800-7. [PMID: 25641947 PMCID: PMC4472202 DOI: 10.1002/cam4.422] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 12/12/2014] [Accepted: 12/16/2014] [Indexed: 12/26/2022] Open
Abstract
To evaluate the impact of a patient-centered symposium as an educational intervention on a broad population of cancer patients. We developed a comprehensive patient symposium. Through voluntary questionnaires, we studied the impact of this cancer symposium on quality of life, cancer-specific knowledge, and symptom management among cancer patients. Symposium attendees were provided surveys prior to and 3 months following the educational intervention. Surveys included (1) EORTC-QLQ-C30; (2) disease understanding tool developed for this conference; (3) validated disease-specific questionnaires. Changes over time were assessed using McNemar's tests and paired t-tests for categorical and continuous variables, respectively. A total of 158 attendees completed the pre-convention survey. Most respondents reported at least “quite a bit” of understanding regarding treatment options, screening modalities, symptomatology, and cancer-related side effects. Attendees endorsed the least understanding of disease-related stress, risk factors, fatigue management, and legal issues related to disease/treatment. At 3 months, there was improvement in understanding (12 of 14 areas of self-reported knowledge especially regarding nutrition, and stress/fatigue management). However, no significant change was seen in QLQ-C30 functioning, fatigue, pain, or insomnia. A patient symposium, as an educational intervention improves a solid knowledge base amongst attendees regarding their disease, increases knowledge in symptom management, but may be insufficient to impact QoL as a single intervention.
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Affiliation(s)
- Leslie Padrnos
- Internal Medicine Residency Program, Mayo Clinic, Scottsdale, Arizona
| | - Amylou C Dueck
- Division of Health Sciences Research, Mayo Clinic, Scottsdale, Arizona
| | - Robyn Scherber
- Internal Medicine Residency Program, Mayo Clinic, Scottsdale, Arizona
| | - Pamela Glassley
- Division of Hematology and Medical Oncology, Mayo Clinic, Scottsdale, Arizona
| | - Rachel Stigge
- Division of Hematology and Medical Oncology, Mayo Clinic, Scottsdale, Arizona
| | - Donald Northfelt
- Division of Hematology and Medical Oncology, Mayo Clinic, Scottsdale, Arizona
| | - Joseph Mikhael
- Division of Hematology and Medical Oncology, Mayo Clinic, Scottsdale, Arizona
| | - Annette Aguirre
- Division of Hematology and Medical Oncology, Mayo Clinic, Scottsdale, Arizona
| | | | - Ruben A Mesa
- Division of Hematology and Medical Oncology, Mayo Clinic, Scottsdale, Arizona
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25
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Aantjes CJ, Ramerman L, Bunders JFG. A systematic review of the literature on self-management interventions and discussion of their potential relevance for people living with HIV in sub-Saharan Africa. PATIENT EDUCATION AND COUNSELING 2014; 95:185-200. [PMID: 24560067 DOI: 10.1016/j.pec.2014.01.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 01/16/2014] [Accepted: 01/18/2014] [Indexed: 05/06/2023]
Abstract
OBJECTIVE This study systematically reviews the literature on self-management interventions provided by health care teams, community partners, patients and families and discusses the potential relevance of these interventions for people living with HIV in sub-Saharan Africa. METHODS We searched major databases for literature published between 1995 and 2012. 52 studies were included in this review. RESULTS The review found very few studies covering people living with HIV and generally inconclusive evidence to inform the development of chronic care policy and practice in sub-Saharan Africa. CONCLUSION Chronic care models and self-management interventions for sub-Saharan Africa has not been a research priority. Furthermore, the results question the applicability of these models and interventions in sub-Saharan Africa. There is a need for studies to fill this gap in view of the rapidly increasing number of people needing chronic care services in Africa. PRACTICE IMPLICATIONS The established practices for long-term support for HIV patients are still the most valid basis for promoting self-management. This will be the case until there are more studies which assess those practices and their effect on self-management outcomes and other studies which assess the utility and feasibility of applying chronic care models that have been developed in high-income countries.
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Affiliation(s)
- Carolien J Aantjes
- Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, The Netherlands; ETC Foundation, The Netherlands.
| | - Lotte Ramerman
- Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, The Netherlands
| | - Joske F G Bunders
- Athena Institute for Research on Innovation and Communication in Health and Life Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, The Netherlands
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Paterson C, Jones M, Rattray J, Lauder W. Identifying the self-management behaviours performed by prostate cancer survivors: a systematic review of the evidence. J Res Nurs 2014. [DOI: 10.1177/1744987114523976] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Purpose Prostate cancer survivors are keen to engage as active partners in the management of their condition but have voiced a number of unmet support needs that make effective self-management problematic. Identifying self-management behaviours and evaluating how self-management changes over time may provide valuable insights into how men can be better supported to self-manage. Our systematic review aimed to identify the self-management behaviours for prostate cancer survivors and to evaluate whether these change over time. Methods Using the PRISMA statement we performed a systematic review of studies that identified the self-management behaviours of prostate cancer survivors. Databases searched included: DARE, CDSR, Medline, CINAHL, PsycINFO and ASSIA. Studies were classified by levels of evidence and quality assessment. Results 111 publications were retrieved from the search and 5 publications were included. Men performed a variety of self-management behaviours for psychological and physical problems. Only one study assessed changes in self-management behaviours over time and was limited to men treated by radiotherapy. Conclusion Despite the recent political drive for cancer survivors to self-manage, this review has demonstrated the evidence base is under-developed and a wide range of research is needed to address the unmet supportive care needs of prostate cancer survivors. Practically, this review has identified that Dodd’s Self-Care Log was found to have the strongest psychometric properties for additional research in this area.
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Affiliation(s)
- Catherine Paterson
- Research Fellow (RAII) in Cancer Care, Faculty of Health and Medical Sciences, School of Health and Social Care, University of Surrey, UK
| | - Martyn Jones
- Professor of Healthcare Research in School of Nursing and Midwifery, University of Dundee, UK
| | - Janice Rattray
- Reader in Acute and Critical Care Nursing, School of Nursing and Midwifery, University of Dundee, UK
| | - William Lauder
- Professor of Nursing at the University of Stirling, UK; Visiting Professor at the University of South Florida, USA
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27
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The Psychosocial Influences of Food Choices Made by Cancer Patients. Nutr Cancer 2013. [DOI: 10.1002/9781118788707.ch7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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28
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Martin F, Turner A, Bourne C, Batehup L. Development and qualitative evaluation of a self-management workshop for testicular cancer survivor-initiated follow-up. Oncol Nurs Forum 2013; 40:E14-23. [PMID: 23269777 DOI: 10.1188/13.onf.e14-e23] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To describe the needs of testicular cancer survivors, develop a nurse-led workshop, and explore the experience of participation. RESEARCH APPROACH A systematic intervention development process was used to design a self-management workshop for cancer survivors, which then was evaluated qualitatively. SETTING Outpatient clinic in England. PARTICIPANTS 26 healthcare professionals, charity workers, family members, and testicular cancer survivors participated in the intervention development process. Six testicular cancer survivors attended the workshop and participated in the postintervention focus group discussion. METHODOLOGIC APPROACH Ten participants, including four survivors, completed the initial needs assessment interviews. Twenty-six participants then rated the identified needs on two dimensions: importance to self-management and changeability via a self-management intervention. Literature review and expert consultation were used to identify potential workshop components. To explore the experience of attending the intervention, six testicular cancer survivors who participated in the nurse-led workshop were interviewed six weeks later. FINDINGS The workshop was well received by participants, who appreciated the goal-setting and information provision activities. The men also felt that they had benefited from the experience of being in the group. CONCLUSIONS Testicular cancer survivors had unmet post-treatment needs. The systematic intervention development method led to an evidence-based workshop to address those needs. Men reported benefits from attending the workshop, which may help maintain and improve health. INTERPRETATION Nurse-led workshops can address the current unmet needs of testicular cancer survivors. KNOWLEDGE TRANSLATION Testicular cancer survivors may require support with health information, maintaining psychological health, and monitoring cancer symptoms. Survivors also need help planning and maintaining an active lifestyle. In addition, a brief workshop approach to intervention delivery is acceptable to testicular cancer survivors.
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Affiliation(s)
- Faith Martin
- Applied Research Centre for Health and Lifestyle Interventions, Coventry University, England.
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29
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Datta J, Petticrew M. Challenges to evaluating complex interventions: a content analysis of published papers. BMC Public Health 2013; 13:568. [PMID: 23758638 PMCID: PMC3699389 DOI: 10.1186/1471-2458-13-568] [Citation(s) in RCA: 153] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 05/30/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is continuing interest among practitioners, policymakers and researchers in the evaluation of complex interventions stemming from the need to further develop the evidence base on the effectiveness of healthcare and public health interventions, and an awareness that evaluation becomes more challenging if interventions are complex.We undertook an analysis of published journal articles in order to identify aspects of complexity described by writers, the fields in which complex interventions are being evaluated and the challenges experienced in design, implementation and evaluation. This paper outlines the findings of this documentary analysis. METHODS The PubMed electronic database was searched for the ten year period, January 2002 to December 2011, using the term "complex intervention*" in the title and/or abstract of a paper. We extracted text from papers to a table and carried out a thematic analysis to identify authors' descriptions of challenges faced in developing, implementing and evaluating complex interventions. RESULTS The search resulted in a sample of 221 papers of which full text of 216 was obtained and 207 were included in the analysis. The 207 papers broadly cover clinical, public health and methodological topics. Challenges described included the content and standardisation of interventions, the impact of the people involved (staff and patients), the organisational context of implementation, the development of outcome measures, and evaluation. CONCLUSIONS Our analysis of these papers suggests that more detailed reporting of information on outcomes, context and intervention is required for complex interventions. Future revisions to reporting guidelines for both primary and secondary research may need to take aspects of complexity into account to enhance their value to both researchers and users of research.
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Affiliation(s)
- Jessica Datta
- Department of Social and Environmental Health Research, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, UK.
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Abstract
BACKGROUND With increased cancer survivorship, cancer, in its chronic form, self-management among cancer patients has become an international research focus. Self-management programmes are used to guide the self-care process. Over the past 10 years, six self-management programmes for cancer patients (Taking CHARGE, Expert Patients Programme, Living with Cancer Education Program, Focus Program, PRO-SELF Program and Oncologist-referred exercise self-management programme) were used in a variety of self-management studies for cancer patients. AIM The aims of this paper are to describe, compare and critique these six self-management programmes that are commonly used to guide self-management for cancer patients, and propose directions for new self-management programme development among cancer patients. METHODS Medline, Pubmed and Embase, Springer, Elsevier, EBSCO and ProQuest were searched for literatures on self-management programmes for cancer patients from 2000 to November 2010. Search terms such as 'self-management' or 'self-care' or 'patient education' or 'self-management' or 'self-care' or 'self-efficacy', 'intervention' or 'program*' 'cancer' or 'carcinoma' or 'neoplasms' were used. RESULTS Comparison and critique of these programmes revealed important limitations of cancer self-management programmes including lack of the facilitators' training process, failure to assess the cultural differences and failure to cover all of the outcome measures. CONCLUSION Researchers and clinicians need to build more individualized and dynamic self-management programmes that parallel advances in clinical research and practice for cancer patients.
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Affiliation(s)
- W J Gao
- College of Nursing, Second Military Medical University, Shanghai, China
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Procter S, Wilson PM, Brooks F, Kendall S. Success and failure in integrated models of nursing for long term conditions: multiple case studies of whole systems. Int J Nurs Stud 2012; 50:632-43. [PMID: 23131723 DOI: 10.1016/j.ijnurstu.2012.10.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Revised: 10/10/2012] [Accepted: 10/11/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Current projections indicate that the UK faces a 252% increase in people aged over 65 with one or more long term conditions (LTC) by 2050. Nurses, managing their own caseloads and clinics, working across sectors and organisational boundaries and as part of a wider multi-disciplinary team, are frequently seen as key to managing this growing demand. However, the evidence base informing the nursing role in managing LTC, the most effective configuration of the multi-disciplinary team and the policy evidence relating to the infrastructure required to support cross organisational working, remains weak. OBJECTIVES To explore, identify and characterise the origins, processes and outcomes of effective chronic disease management models and the nursing contributions to such models. DESIGN Case study whole systems analysis using qualitative interview methods. SETTINGS Two community matron services, two primary care (GP) practice nursing services, two hospital based specialist nursing services were purposefully sampled from across England and Wales. PARTICIPANTS Selection criteria were derived using a consensus conference. The nurses in the service, all patients and carers on the caseload, members of the multi-disciplinary team and stakeholders were invited to participate. METHODS Semi-structured interviews with all participants, thematic analysis within a whole system framework. RESULTS The study found high levels of clinical nursing expertise which in the case of the community matrons was meeting the aim of reducing hospital admissions. Both the primary care and hospital nurse specialist indicate similar levels of clinical expertise which was highly valued by medical colleagues and patients. Patients continued to experience fragmented care determined by diagnostic categories rather than patient need and by the specific remit of the clinic or service the patient was using. Patient data systems are still organised around the impact on services and prevalence of disease at an individual level and not around the patient experience of disease. CONCLUSION Nurses are making a major contribution to meeting the policy objectives for long term conditions. Primary care nurses and hospital nurse specialists do broadly similar roles. The scope of the nursing roles and services studied were idiosyncratic, opportunistic and reactive, rather than planned and commissioned on an analysis of local population need.
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Berg C, Hayashi RJ. Participation and Self-Management Strategies of Young Adult Childhood Cancer Survivors. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2012. [DOI: 10.3928/15394492-20120607-01] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
This study describes a connection between late effects, engagement in major life activities, and self-management strategies in young adult childhood cancer survivors. A mailed survey focused on late effects of pain, fatigue, depression, cognition, memory, and body image distortion and their impact on work, education, independent living, and community and social engagement. Additionally, survivors identified self-management strategies that minimize their late effects. Eighty-eight percent of the 42 responders struggled with at least one of the six late effects. Work and educational pursuits were affected, with memory and fatigue the most intrusive to daily activities. Self-management strategies of sleep/rest, fitness, quiet leisure, and support of family/friends were the most common. Reaching out to long-term follow-up cancer clinics, health professionals, survivors, or community resources were the least employed management strategies. Occupational therapists can look to community models for educating survivors about self-management, and take this opportunity to define new collaborative partnerships with long-term follow-up cancer clinics and community agencies to assist young adult survivors transitioning to adult roles.
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Chaplin H, Hazan J, Wilson P. Self-management for people with long-term neurological conditions. Br J Community Nurs 2012; 17:250-257. [PMID: 22875160 DOI: 10.12968/bjcn.2012.17.6.250] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Although English government policy has encouraged the implementation of self-management programmes in services for people with long-term conditions, the evidence for their efficacy has been limited. People with long-term neurological conditions use community-based health services including community nursing, and have particular needs in regards to self-management. This article provides an overview of the evidence for the effectiveness of self-management interventions for people with long-term neurological conditions, in particular those with stroke, Parkinson's disease and multiple sclerosis. The current need for better interventions is highlighted, particularly the importance of providing condition-specific information and deliverance of interventions in a group setting to improve self-management outcomes. In response to weaknesses of previous self-management interventions for this population, an innovative Hertfordshire Neurological Service self-management programme is discussed, and the implications for future research are described.
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Affiliation(s)
- Hema Chaplin
- Centre for Lifespan and Chronic Illness Research, University of Hertfordshire, Hatfield
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Cheng F, Xu Q, Dai XD, Yang LL. Evaluation of the Expert Patient Program in a Chinese Population With Permanent Colostomy. Cancer Nurs 2012; 35:E27-33. [DOI: 10.1097/ncc.0b013e318217cbe9] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Purpose: This article reports on the concept analysis of self-management support (SMS) to provide clarity for systematic implementation in practice. Background: SMS is a concept in its early phase of development. It is increasingly evident in literature on chronic illness care. However, the definition has been simplified or vague leading to variable SMS programs and inconsistent outcomes. Elucidation of SMS is necessary in chronic illness care to facilitate clear understanding and implementation. Method: Rodgers’ evolutionary concept analysis method was used to examine SMS. Data sources included systematic multidisciplinary searches of multiple search engines. Results: SMS refers to comprehensive sustaining approaches toward improving chronic illness outcomes consisting of patient-centered attributes (involving patients as partners; providing diverse, innovative educational modalities specific to patients’ needs; individualizing patient care), provider attributes (possessing adequate knowledge, skills, attitudes in providing care), and organizational attributes (putting an organized system of care in place, having multidisciplinary team approach, using tangible and social support). Implications: A well-clarified SMS concept is important in theory development. The attributes offer necessary components in SMS programs for systematic implementation, evaluation, and research. There is great potential that SMS can help improve outcomes of chronic illness care.
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Wilson PM, Goodman C. Evaluation of a modified chronic disease self-management programme for people with intellectual disabilities. ACTA ACUST UNITED AC 2011. [DOI: 10.1111/j.1752-9824.2011.01105.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Wood MJM, Molassiotis A, Payne S. What research evidence is there for the use of art therapy in the management of symptoms in adults with cancer? A systematic review. Psychooncology 2011; 20:135-45. [PMID: 20878827 DOI: 10.1002/pon.1722] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Common psychosocial difficulties experienced by cancer patients are fatigue, depression, anxiety, and existential and relational concerns. Art therapy is one intervention being developed to address these difficulties. The purpose of this research was to assess and synthesize the available research evidence for the use of art therapy in the management of symptoms in adults with cancer. METHODS A literature search of electronic databases, 'grey' literature, hand searching of key journals, and personal contacts was undertaken. Keywords searched were 'art therapy' and 'cancer' or 'neoplasm'. The inclusion criteria were: research studies of any design; adult cancer population; and art therapy intervention. There were no language or date restrictions. Data extraction occurred and quality appraisal was undertaken. Data were analyzed using narrative synthesis. RESULTS Fourteen papers reporting 12 studies met the inclusion criteria. Symptoms investigated spanned emotional, physical, social and global functioning, and existential/spiritual concerns. Measures used were questionnaires, in-depth interviews, patients' artwork, therapists' narratives of sessions, and stress markers in salivary samples. No overall effect size was determined owing to heterogeneity of studies. Narrative synthesis of the studies shows art therapy is used at all stages of the cancer trajectory, most frequently by women, the most common cancer site in participants being breast. CONCLUSION Art therapy is a psychotherapeutic approach that is being used by adults with cancer to manage a spectrum of treatment-related symptoms and facilitate the process of psychological readjustment to the loss, change, and uncertainty characteristic of cancer survivorship. Research in this area is still in its infancy.
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Atkin K, Stapley S, Easton A. No one listens to me, nobody believes me: self management and the experience of living with encephalitis. Soc Sci Med 2010; 71:386-393. [PMID: 20488605 DOI: 10.1016/j.socscimed.2010.04.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2009] [Revised: 04/01/2010] [Accepted: 04/13/2010] [Indexed: 11/25/2022]
Abstract
Over the past twenty years, there has been considerable interest in individuals' experience of chronic illness. In addition to the more established concerns of medical sociology, recent policy reflects an interest in how individuals manage their condition. Using material from qualitative interviews with 23 individuals carried out in the United Kingdom, this paper examines a person's experience following encephalitis, as a way of exploring the potential value of current policy initiatives associated with self-management. Our findings suggest that individuals' illness experiences become embedded in conditional acceptance derived from and sustained through their social relationships. This raises a fundamental policy tension: is the purpose of current self-management strategies to help individuals cope better with illness or with the context in which their illness experience is realised? We conclude that policy needs to question how it 'imagines' long-standing conditions, without recourse to generalised notions of coping and adjustment. This, in turn, means adapting a less instrumental and more contextualised approach to self-management.
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Affiliation(s)
- Karl Atkin
- Department of Health Sciences, Alcuin College, University of York, Seebohm Rowntree Building, York YO10 5DD, United Kingdom.
| | - Sally Stapley
- Department of Health Sciences, Alcuin College, University of York, Seebohm Rowntree Building, York YO10 5DD, United Kingdom
| | - Ava Easton
- The Encephalitis Society, 7B Saville Street, Malton, North Yorkshire YO17 7LL, United Kingdom
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