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Huang H, Zhang L, Tu L, Zhang X, Zhong H, Liu Q, Liu Y, Chen H. The Impact of Stigma on Self-Management Behavior Among People with HIV in China: The Role of Social Support and Self-Esteem. AIDS Patient Care STDS 2024. [PMID: 39126267 DOI: 10.1089/apc.2024.0104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2024] Open
Abstract
Understanding the psychosocial factors influencing self-management behaviors among people with HIV (PWH) is crucial for effective medical interventions and improving their quality of life. However, there has been limited research exploring the psychosocial mechanisms influencing self-management behaviors among PWH in China. Our study examined the relationship between stigma, social support, self-esteem, and self-management behaviors among PWH, as well as whether social support and self-esteem mediate these relationships. Cross-sectional data were collected from 282 PWH in Sichuan Province, China. Data were collected using four validated self-report measures (HIV Stigma Scale, HIV/AIDS Patient Self-Management Scale, Social Support Rating Scale, and Self-Esteem Scale). Structural equation modeling was used to examine the different pathways influencing self-management behaviors. All the impacts on self-management behavior outcomes were found to be significant. The final mediation model indicated that social support and self-esteem significantly mediated the relationship between stigma and self-management behaviors. These findings underscore the importance of addressing stigma and enhancing social support and self-esteem in interventions aimed at promoting self-management behaviors among PWH.
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Affiliation(s)
- Haitao Huang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Liao Zhang
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Ling Tu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiaona Zhang
- School of Public Administration, Sichuan University, Chengdu, China
| | - Hua Zhong
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Qianwen Liu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Ying Liu
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Hong Chen
- Department of Nursing, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
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Lv Q, Zhang X, Wang Y, Xu X, Zang X. Cross-cultural adaptation and validation of the caregiver self-efficacy in contributing to patient self-care scale in China. BMC Public Health 2024; 24:1977. [PMID: 39049013 PMCID: PMC11267960 DOI: 10.1186/s12889-024-19534-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 07/18/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Caregiver self-efficacy is crucial in improving patient outcomes and caregiver well-being, but there is a lack of suitable scales to assess this concept within the context of Chinese culture. This study aimed to cross-culturally translate the Caregiver Self-Efficacy in Contributing to Patient Self-Care (CSE-CSC) Scale and evaluate its psychometric properties using classical test theory and item response theory. METHODS The CSE-CSC scale was adapted using Brislin's translation model after obtaining authorization from the original author. A multicenter, cross-sectional study was conducted to assess the psychometric properties of this scale. Classical test theory was used to evaluate reliability (internal consistency, test-retest reliability), validity (content validity, structural validity, convergent validity), and floor and ceiling effects. Item response theory was employed to assess the fit of the rating scale model, reliability, item difficulties, and measurement invariance. RESULTS The translation and cultural adaptation process was completed. Classical test theory demonstrated good internal consistency (Cronbach's α = 0.935) and test-retest reliability (ICC from 0.784 to 0.829, p<0.001). The I-CVI and K* of each item ranged from 0.875 to 1.00 and 0.871 to 1.00. The first-order 2-factor model fit well (χ2/df = 3.71, RMSEA = 0.082, SRMR = 0.032, CFI = 0.973, TLI = 0.60). Convergent validity showed that the CSE-CSC scores had a strong positive correlation with three separate scales of the CC-SC-CII. There was no floor and ceiling effect in this scale. Rasch analysis showed that the CSE-CSC scale demonstrated a good fit to the rating scale model and exhibited excellent reliability (person/item separation index>2, person/item reliability coefficients>0.8). The Wright map showed that item difficulty matched the respondents' measured abilities. The analysis of differential item functioning (DIF) showed that all items were comparable in gender. CONCLUSIONS This study indicated that the CSE-CSC scale had good reliability, validity, difficulty degree, and measurement invariance. The CSE-CSC scale can be used to measure caregiver self-efficacy of Chinese patients with multiple chronic conditions.
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Affiliation(s)
- Qingyun Lv
- Tianjin Med Univ, Sch Nursing, 22 Qixiangtai Rd, Tianjin, 300070, P. R. China
| | - Xiaonan Zhang
- Tianjin Med Univ, Sch Nursing, 22 Qixiangtai Rd, Tianjin, 300070, P. R. China
| | - Yaqi Wang
- Tianjin Med Univ, Sch Nursing, 22 Qixiangtai Rd, Tianjin, 300070, P. R. China
| | - Xueying Xu
- Tianjin Med Univ, Sch Nursing, 22 Qixiangtai Rd, Tianjin, 300070, P. R. China
| | - Xiaoying Zang
- Tianjin Med Univ, Sch Nursing, 22 Qixiangtai Rd, Tianjin, 300070, P. R. China.
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Li D, Huang LT, Zhang F, Wang JH. Comparative effectiveness of ehealth self-management interventions for patients with heart failure: A Bayesian network meta-analysis. PATIENT EDUCATION AND COUNSELING 2024; 124:108277. [PMID: 38613991 DOI: 10.1016/j.pec.2024.108277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 03/15/2024] [Accepted: 03/23/2024] [Indexed: 04/15/2024]
Abstract
OBJECTIVE This study evaluated the effectiveness of electronic self-management support interventions in reducing all-cause mortality, cardiovascular mortality, readmission rates, and HF-related readmission in heart failure patients. METHODS Following the PRISMA-P guidelines and PRISMS taxonomy, we searched Pubmed, Cochrane Library, and Embase for RCTs and trials of electronic health technologies for heart failure interventions. Develop support programs in advance for education, monitoring, reminders, or a combination of these to screen and categorize studies. The Cochrane ROB2 tool was used to assess the risk of bias. RESULTS The monitoring interventions may improve all-cause mortality (OR 0.77, 95% CI 0.63 to 0.93) and cardiovascular mortality (OR 0.75, 95% CI 0.61 to 0.93) compared to usual care. Reminder interventions were associated with significantly reducing readmission rates (OR 0.07, 95% CI 0.00 to 0.94). Mixed interventions were most effective in reducing HF-related readmission rates (OR 0.75, 95% CI 0.56 to 0.99). CONCLUSION Electronic self-management interventions, particularly monitoring and reminders, can potentially improve outcomes of heart failure patients, including reducing all-cause mortality, cardiovascular mortality, and readmission rates. PRACTICE IMPLICATIONS The eHealth model and the combination of self-management are significant for long-term intervention in patients with HF to improve their quality of life and prognosis.
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Affiliation(s)
- Dan Li
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, PR China
| | - Le-Tian Huang
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, PR China
| | - Fei Zhang
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, PR China
| | - Jia-He Wang
- Department of Family Medicine, Shengjing Hospital of China Medical University, Shenyang, PR China.
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Takale G, Handore A, Jeyakumar A, Godbharle S. Prevalence and determinants of multiple chronic conditions (MCC) among young adults in Indian households: an analysis of NFHS-5. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:77. [PMID: 38835054 DOI: 10.1186/s41043-024-00560-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 05/03/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND Multiple chronic conditions (MCC) are defined as the presence of two or more chronic conditions, that significantly impact health status, functional capacity, quality of life, and overall healthcare management. Despite the significant evidence on chronic disease burden, the co-existence of MCC within a household in low- and middle-income countries (LMICs) is less studied. This study therefore estimates the prevalence of MCC and its determinants among adults in the Indian households. METHODS Data used in this study were drawn from the fifth round of the National Family Health Survey (NFHS) conducted in 2019-21. Data sets of men (15-54 years) and women (15-49 years) were used for the study. The total sample size of adults for this analysis was N = 239,848. The outcome variable of this study was multiple chronic conditions (MCC) in adults which included a total of nine chronic conditions (hypertension, diabetes, chronic respiratory diseases, chronic kidney disorders, cancer, thyroid disorders, obesity, and heart diseases, consuming alcohol, chewing tobacco, and smoking) documented in NFHS-5. Descriptive statistics and binary logistic regression analysis were used to quantify the results. RESULTS A prevalence of 5.5% of MCC in adults emerged from our study. Logistic regression analysis identified that younger age, males (AOR 0.36 (0.33-0.39)), urban areas (AOR 1.11 (1.02-1.17)) as the place of residence, and participants representing SC (AOR 0.89 (0.81-0.97)), and ST (AOR 1.30 (1.17-1.45)), had a higher risk of MCC irrespective of level of education, type of occupation, marital status, or wealth index, and states from any category of social progress. CONCLUSION A 5% prevalence of MCC specifically obesity, substance use, and hypertension calls for integrated efforts aiming at behavior change, and regulatory efforts to prevent further increase of MCC among young adults in India.
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Affiliation(s)
- Geetanjali Takale
- Department of Health Sciences, Savitribai Phule Pune University, Ganeshkhind Road, Pune, Maharashtra, India
| | - Avantika Handore
- Department of Health Sciences, Savitribai Phule Pune University, Ganeshkhind Road, Pune, Maharashtra, India
| | - Angeline Jeyakumar
- Food Evolution Research Laboratory (FERL), School of Tourism and Hospitality Management, College of Business and Economics, University of Johannesburg, Johannesburg, South Africa
- Department of Nutrition, University of Nevada, Reno, NV, USA
| | - Swapnil Godbharle
- Department of Health Sciences, Savitribai Phule Pune University, Ganeshkhind Road, Pune, Maharashtra, India.
- Food Evolution Research Laboratory (FERL), School of Tourism and Hospitality Management, College of Business and Economics, University of Johannesburg, Johannesburg, South Africa.
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Campillejo A, Gefaell-Larrondo I, Ramos-García V, Koatz D, Santos-Álvarez A, Barrio-Cortes J, Gómez-Rueda S, Calderón-Larrañaga A, Cifuentes P, Company-Sancho C, Domínguez-Coello S, García-García FJ, Garrido-Elustondo S, González de León B, Ramón-Vazquez J, Martín C, Suárez-Fernández C, Parra-Caballero P, Vicente-Rabaneda EF, Quiroga-Colina P, Ramírez-Puerta AB, Ruíz-López M, Tello-Bernabé ME, Sanchez-Gamborino E, Ugalde-Abiega B, Vall-Roqué H, Duarte-Díaz A, Abt-Sacks A, Hernández-Yumar A, Torres-Castaño A, Álvarez-Pérez Y, Muth C, van den Akker M, Montori VM, Orrego C, Perestelo-Pérez L, González-González AI. Implementation of a virtual community of practice to promote the empowerment of middle-aged people with multimorbidity: study protocol of a randomised controlled trial. BMJ Open 2024; 14:e084937. [PMID: 38803252 PMCID: PMC11129026 DOI: 10.1136/bmjopen-2024-084937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/30/2024] [Indexed: 05/29/2024] Open
Abstract
INTRODUCTION Empowering people living with multimorbidity (multiple chronic conditions) to gain greater confidence in managing their health can enhance their quality of life. Education focused on self-management is a key tool for fostering patient empowerment and is mostly provided on an individual basis. Virtual communities of practice (VCoP) present a unique opportunity for online education in chronic condition self-management within a social context. This research aims to evaluate the effectiveness/cost-effectiveness of individualised, online self-management education compared with VCoP among middle-aged individuals living with multiple chronic conditions. METHODS AND ANALYSIS People aged 30-60, living with ≥2 chronic conditions and receiving care in primary care (PC) centres and outpatient hospital-based clinics in Madrid and Canary Islands will enrol in an 18-month parallel-design, blinded (intervention assessment and data analysts), pragmatic (adhering to the intention-to-treat principle), individually randomised trial. The trial will compare two 12-month web-based educational offers of identical content; one delivered individually (control) and the other with online social interaction (VCoP, intervention). Using repeated measures mixed linear models, with the patient as random effect and allocation groups and time per group as fixed effects, we will estimate between-arm differences in the change in Patient Activation Measure from baseline to 12 months (primary endpoint), including measurements at 6-month and 18-month follow-up. Other outcomes will include measures of depression and anxiety, treatment burden, quality of life. In addition to a process evaluation of the VCoP, we will conduct an economic evaluation estimating the relative cost-effectiveness of the VCoP from the perspectives of both the National Health System and the Community. ETHICS AND DISSEMINATION The trial was approved by Clinical Research Ethics Committees of Gregorio Marañón University Hospital in Madrid/Nuestra Señora Candelaria University Hospital in Santa Cruz de Tenerife. The results will be disseminated through workshops, policy briefs, peer-reviewed publications and local/international conferences. TRIAL REGISTRATION NUMBER NCT06046326.
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Affiliation(s)
- Alba Campillejo
- Foundation for Biosanitary Research and Innovation in Primary Care, Community of Madrid Madrid Health Service, Madrid, Spain
| | - Ileana Gefaell-Larrondo
- Foundation for Biosanitary Research and Innovation in Primary Care, Community of Madrid Madrid Health Service, Madrid, Spain
| | - Vanesa Ramos-García
- Canary Islands Health Research Institute Foundation, Canary Islands Health Service, Santa Cruz de Tenerife, Spain
| | - Débora Koatz
- Avedis Donabedian Research Institute (FAD), Autonomous University of Barcelona, Barcelona, Spain
- Research Network on Chronicity Primary Care and Prevention and Health Promotion, Barcelona, Spain
| | - Anthea Santos-Álvarez
- Canary Islands Health Research Institute Foundation, Canary Islands Health Service, Santa Cruz de Tenerife, Spain
| | - Jaime Barrio-Cortes
- Foundation for Biosanitary Research and Innovation in Primary Care, Community of Madrid Madrid Health Service, Madrid, Spain
| | - Sara Gómez-Rueda
- Gregorio Marañón Research Institute, Community of Madrid Madrid Health Service, Madrid, Spain
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Science and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Patricia Cifuentes
- University Hospital of Alcorcón, Community of Madrid Ministry of Health, Madrid, Spain
| | - Consuelo Company-Sancho
- General Directorate of Public Health, Canary Islands Health Service, Santa Cruz de Tenerife, Spain
| | - Santiago Domínguez-Coello
- La Laguna Health Care Center - Family and Community Care teaching unit, Canary Islands Health Service, Santa Cruz de Tenerife, Canarias, Spain
| | - Francisco Javier García-García
- Quality Care Unit - Nuestra Señora de La Candelaria University Hospital (HUNSC), Canary Islands Health Service, Santa Cruz de Tenerife, Spain
| | - Sofía Garrido-Elustondo
- Centre Family and Community Care Teaching Multiprofessional Unit, Comunidad de Madrid Consejeria de Sanidad, Madrid, Spain
| | | | - José Ramón-Vazquez
- Tenerife Primary Care Management, Canary Islands Health Service, Santa Cruz de Tenerife, Spain
| | - Candelaria Martín
- Internal Medicine Department, Hospital Universitario de Canarias, La Laguna, Spain
| | | | | | | | | | - Ana Belén Ramírez-Puerta
- Technical Support Unit, Primary Care Management, Community of Madrid Madrid Health Service, Madrid, Spain
| | - Marta Ruíz-López
- Vicente Muzas Health Center, Community of Madrid Madrid Health Service, Madrid, Spain
| | | | | | - Beatriz Ugalde-Abiega
- Ramón y Cajal University Hospital, Community of Madrid Madrid Health Service, Madrid, Spain
| | - Helena Vall-Roqué
- Avedis Donabedian Research Institute (FAD), Autonomous University of Barcelona, Barcelona, Spain
- Research Network on Chronicity Primary Care and Prevention and Health Promotion, Barcelona, Spain
| | - Andrea Duarte-Díaz
- Canary Islands Health Research Institute Foundation, Canary Islands Health Service, Santa Cruz de Tenerife, Spain
| | - Analía Abt-Sacks
- Canary Islands Health Research Institute Foundation, Canary Islands Health Service, Santa Cruz de Tenerife, Spain
| | - Aránzazu Hernández-Yumar
- Canary Islands Health Research Institute Foundation, Canary Islands Health Service, Santa Cruz de Tenerife, Spain
| | - Alezandra Torres-Castaño
- Canary Islands Health Research Institute Foundation, Canary Islands Health Service, Santa Cruz de Tenerife, Spain
| | - Yolanda Álvarez-Pérez
- Canary Islands Health Research Institute Foundation, Canary Islands Health Service, Santa Cruz de Tenerife, Spain
| | - Christiane Muth
- Department of General Practice and Family Medicine, University Hospital OWL of Bielefeld University Campus Hospital Lippe, Detmold, Germany
| | - Marjan van den Akker
- Institute of General Practice, University of Frankfurt, Frankfurt am Main, Germany
| | - Victor M Montori
- Knowledge and Encounter Research Unit, Mayo Clinic, Rochester, Minnesota, USA
| | - Carola Orrego
- Research Network on Chronicity Primary Care and Prevention and Health Promotion, Barcelona, Spain
- Avedis Donabedian Research Institute, Autonomous University of Barcelona, Barcelona, Spain
| | - Lilisbeth Perestelo-Pérez
- Research Network on Chronicity Primary Care and Prevention and Health Promotion, Barcelona, Spain
- Evaluation Unit, Canary Islands Health Service, Santa Cruz de Tenerife, Spain
| | - Ana Isabel González-González
- Gregorio Marañón Research Institute, Community of Madrid Madrid Health Service, Madrid, Spain
- Innovation & International Projects Unit, General Subdirectorate of Research and Documentation, Vice-Ministry of Health of the Community of Madrid, Community of Madrid Madrid Health Service, Madrid, Spain
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Oh H, Moorhead S, Chae S. Validation of Nursing Outcomes Classification: Knowledge and Self-management for Cardiac Disease. Comput Inform Nurs 2023; 41:655-664. [PMID: 36728361 DOI: 10.1097/cin.0000000000000998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The Nursing Outcomes Classification provides two outcomes, Knowledge: Cardiac Disease and Self-management: Cardiac Disease, to assess knowledge and self-management behaviors of adults with cardiac disease. The purpose of this study was to validate the two nursing-sensitive outcomes to establish content validity. A methodological design was used using the Delphi technique. A total of 13 nurse experts in two domains participated in this study: five in standardized nursing terminologies and eight in self-management. Descriptive statistics and the Nurse-Patient Outcome Content Validity method were used to validate four aspects: definition adequacy of each outcome, clinical usefulness of measurement scales, importance of outcome indicators, and content similarity between the two outcomes. The definition adequacy, clinical usefulness, and content similarity of both outcomes were acceptable. A total of 81 indicators from the two outcomes were validated, and 60 were designated as critical. Nurses can evaluate cardiac patient outcomes effectively and accurately using these validated outcomes. The validated Nursing Outcomes Classification outcomes will also support the clinical decision-making of nursing students when they learn about patients with cardiac disease.
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Affiliation(s)
- Hyunkyoung Oh
- Author Affiliations : University of Wisconsin-Milwaukee College of Nursing (Dr Oh); and University of Iowa College of Nursing (Drs Moorhead and Chae)
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Liu Z, Luo L, Zhang Y, Chen R, Liu A. A new theory to promote self-management of symptom clusters and healthcare quality in patients with decompensated cirrhosis. Medicine (Baltimore) 2023; 102:e34595. [PMID: 37653778 PMCID: PMC10470793 DOI: 10.1097/md.0000000000034595] [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: 05/30/2023] [Revised: 07/06/2023] [Accepted: 07/13/2023] [Indexed: 09/02/2023] Open
Abstract
Patients with decompensated cirrhosis, a symptomatic phase of cirrhosis, commonly experience multiple symptoms concurrently, referred to as symptom clusters. Effective self-management of symptoms is known to improve outcomes in various chronic diseases. However, a theory for self-management of symptom clusters in decompensated cirrhosis is lacking. In this study, we applied grounded theory research methodology to construct a new theory of self-management of symptom clusters in these patients. This qualitative study prospectively enrolled 20 patients with decompensated cirrhosis within 1 week after hospital admission. Data related to patients' experiences, needs, perspectives, and abilities related to their symptoms were collected via a semi-structured, in-depth interview and analyzed with Nvivo version 20 software. Grounded theory methodology with 3 coding steps (open, axial, and selective coding) was applied to generate a theory of self-management of symptom clusters. From the step-by-step coding process, 2 core categories or major themes were identified: patients' experiences with symptoms and coping with symptoms. The first major theme included symptom clustering, multidimensionality, recurrence, and specificity, while the second consisted of endogenous motivation, endogenous resistance, and external support needs. A new theory of self-management of symptom clusters was then constructed and delineated to enhance self-management among patients with decompensated cirrhosis. Using patient experience data, we developed a new theory of self-management of symptom clusters in patients with decompensated cirrhosis. Use of this theory has the potential to promote patient self-management and guide healthcare providers in planning optimal treatments and implementing timely interventions, ultimately improving in patient outcomes.
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Affiliation(s)
- Zhen Liu
- Department of Infectious Diseases, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ling Luo
- Department of Infectious Diseases, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yunzhi Zhang
- Department of Infectious Diseases, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Rong Chen
- Department of Infectious Diseases, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Anlin Liu
- Department of Infectious Diseases, Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Khraim F, Munir S, Johnson J, Alqudah M, Kan'an H. Arabic translation, cultural adaptation, and pilot-testing of multimorbidity self-management self-efficacy scales. Chronic Illn 2023; 19:221-232. [PMID: 35040356 DOI: 10.1177/17423953211073369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE This study aimed to translate to Arabic language and culturally adapt the Self-Efficacy for Managing Chronic Diseases Scale (SEMCD) and The Perceived Medical Condition Self-Management Scale (PMCSMS). DESIGN The translation of the two scales was conducted according to the framework by Beaton et al. Then, these scales were tested in a cross-sectional correlational study with 85 Arabic-speaking participants with multimorbidities in Qatar. Psychometric tests to assess the reliability and validity of the translated scales were done. RESULTS The internal consistency reliability (α) for the Arabic version of both PMCSMS and SEMCD scales was 0.953 and 0.949, respectively. Correlation coefficient (r) used to assess convergent validity between the PMCSMS and the SEMCD was 0.76 (p < 0.5). Number of morbidities negatively correlated with scores of self-management self- efficacy scores of the PMCSMS and the SEMCD (r = -0.50 and -0.51, respectively). DISCUSSION The translated PMCSMS and SEMCD are valid and reliable scales that can be used by researchers and healthcare providers to assess levels of self-efficacy among individuals with multimorbidities. The translated scales can be employed in research or interventional programmes that aim to improve self-management or self-efficacy among individuals with multimorbidities.
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Affiliation(s)
- Fadi Khraim
- Faculty of Nursing, 234141University of Calgary Qatar, Doha, Qatar
| | - Sadia Munir
- Faculty of Nursing, 234141University of Calgary Qatar, Doha, Qatar
| | - Jessie Johnson
- Faculty of Nursing, 234141University of Calgary Qatar, Doha, Qatar
| | - Maha Alqudah
- Faculty of Nursing, 234141University of Calgary Qatar, Doha, Qatar
| | - Haitham Kan'an
- Faculty of Nursing, 234141University of Calgary Qatar, Doha, Qatar
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Liu S, Li J, Wan DY, Li R, Qu Z, Hu Y, Liu J. Effectiveness of eHealth Self-management Interventions in Patients With Heart Failure: Systematic Review and Meta-analysis. J Med Internet Res 2022; 24:e38697. [PMID: 36155484 PMCID: PMC9555330 DOI: 10.2196/38697] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 08/02/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background Heart failure (HF) is a common clinical syndrome associated with substantial morbidity, a heavy economic burden, and high risk of readmission. eHealth self-management interventions may be an effective way to improve HF clinical outcomes. Objective The aim of this study was to systematically review the evidence for the effectiveness of eHealth self-management in patients with HF. Methods This study included only randomized controlled trials (RCTs) that compared the effects of eHealth interventions with usual care in adult patients with HF using searches of the EMBASE, PubMed, CENTRAL (Cochrane Central Register of Controlled Trials), and CINAHL databases from January 1, 2011, to July 12, 2022. The Cochrane Risk of Bias tool (RoB 2) was used to assess the risk of bias for each study. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria were used to rate the certainty of the evidence for each outcome of interest. Meta-analyses were performed using Review Manager (RevMan v.5.4) and R (v.4.1.0 x64) software. Results In total, 24 RCTs with 9634 participants met the inclusion criteria. Compared with the usual-care group, eHealth self-management interventions could significantly reduce all-cause mortality (odds ratio [OR] 0.83, 95% CI 0.71-0.98, P=.03; GRADE: low quality) and cardiovascular mortality (OR 0.74, 95% CI 0.59-0.92, P=.008; GRADE: moderate quality), as well as all-cause readmissions (OR 0.82, 95% CI 0.73-0.93, P=.002; GRADE: low quality) and HF-related readmissions (OR 0.77, 95% CI 0.66-0.90, P<.001; GRADE: moderate quality). The meta-analyses also showed that eHealth interventions could increase patients’ knowledge of HF and improve their quality of life, but there were no statistically significant effects. However, eHealth interventions could significantly increase medication adherence (OR 1.82, 95% CI 1.42-2.34, P<.001; GRADE: low quality) and improve self-care behaviors (standardized mean difference –1.34, 95% CI –2.46 to –0.22, P=.02; GRADE: very low quality). A subgroup analysis of primary outcomes regarding the enrolled population setting found that eHealth interventions were more effective in patients with HF after discharge compared with those in the ambulatory clinic setting. Conclusions eHealth self-management interventions could benefit the health of patients with HF in various ways. However, the clinical effects of eHealth interventions in patients with HF are affected by multiple aspects, and more high-quality studies are needed to demonstrate effectiveness.
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Affiliation(s)
- Siru Liu
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Jili Li
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Ding-Yuan Wan
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Runyi Li
- College of Computer Science, Sichuan University, Chengdu, China
| | - Zhan Qu
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Yundi Hu
- School of Data Science, Fudan University, Shanghai, China
| | - Jialin Liu
- Department of Medical Informatics, West China Hospital, Sichuan University, Chengdu, China
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Fu Y, Zhang J, Cao L, Ma J, Zhu H, Dong Y, Yin M, Shi L. Nursing students' attitudes and associated factors towards older people in Heilongjiang Province, northern China: A cross-sectional study. Nurs Open 2022; 9:2454-2460. [PMID: 35678477 PMCID: PMC9374393 DOI: 10.1002/nop2.1262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 06/29/2021] [Accepted: 05/13/2022] [Indexed: 11/30/2022] Open
Abstract
Aim Attitudes toward older persons could affect services that are provided to them and change the value of the care they receive. The attitude of nursing students toward older persons is very important as it will affect their care of older patients in future. However, in China, the attitude of higher vocational nursing students toward older persons has not been widely studied. The purpose of this study is to explore the attitudes and factors toward older people among nursing students in higher vocational colleges in Heilongjiang Province. Design A cross‐sectional study. Methods A cross‐sectional study was conducted using cluster sampling. A total of 1106 nursing students from two higher vocational colleges in Heilongjiang Province participated. Multiple linear regression analysis was conducted to identify the factors influencing nursing students’ attitudes toward older people. Conclusion This study showed that the vocational college nursing students have a positive attitude towardolder persons. However, the proportion of respondents taking care of older persons as their first choice in their future career needs to be increased. Advanced vocational colleges should pay attention to the attitudes of nursing students toward older persons, and strengthen the education of career development planning, which has practical significance in meeting the diversified health needs of older persons and ensuring healthy aging.
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Affiliation(s)
- Yang Fu
- School of Humanities, Harbin Medical University, Harbin, China
| | - Jiarui Zhang
- Office of the Party Committee, Shenzhen Second People's Hospital, Shenzhen, China
| | - Lei Cao
- Department of Nursing, Heilongjiang Nursing College, Harbin, China
| | - Junling Ma
- School of Humanities, Harbin Medical University, Harbin, China
| | - Hong Zhu
- Renji Hospital Affiliated to Medical College of Shanghai Jiaotong University, Shanghai, China
| | - Yan Dong
- College of Foreign Language Teaching and Research, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Mei Yin
- School of Humanities, Harbin Medical University, Harbin, China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, China
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11
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Gonçalves I, Mendes DA, Caldeira S, Jesus E, Nunes E. Nurse‐led care management models for patients with multimorbidity in hospital settings: a scoping review. J Nurs Manag 2022; 30:1960-1973. [DOI: 10.1111/jonm.13621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/13/2022] [Accepted: 04/05/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Isabel Gonçalves
- Universidade Católica Portuguesa Institute of Health Sciences, Centre for Interdisciplinary Research in Health Portugal
| | | | - Sílvia Caldeira
- Universidade Católica Portuguesa Institute of Health Sciences, Centre for Interdisciplinary Research in Health Portugal
| | - Elvio Jesus
- Universidade Católica Portuguesa Institute of Health Sciences, Centre for Interdisciplinary Research in Health Portugal
| | - Elisabete Nunes
- Universidade Católica Portuguesa Institute of Health Sciences, Centre for Interdisciplinary Research in Health Portugal
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12
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Aboumatar H, Pitts S, Sharma R, Das A, Smith BM, Day J, Holzhauer K, Yang S, Bass EB, Bennett WL. Patient engagement strategies for adults with chronic conditions: an evidence map. Syst Rev 2022; 11:39. [PMID: 35248149 PMCID: PMC8898416 DOI: 10.1186/s13643-021-01873-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 12/17/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Patient and family engagement (PFE) has been defined as a partnership between patients, families, and health care providers to achieve positive health care outcomes. There is evidence that PFE is critical to improving outcomes. We sought to systematically identify and map the evidence on PFE strategies for adults with chronic conditions and identify areas needing more research. METHODS We searched PubMed, CINAHL, EMBASE, and Cochrane, January 2015 to September 2021 for systematic reviews on strategies for engaging patients with chronic conditions and their caregivers. From each review, we abstracted search dates, number and type of studies, populations, interventions, and outcomes. PFE strategies were categorized into direct patient care, health system, and community-policy level strategies. We found few systematic reviews on strategies at the health system, and none at the community-policy level. In view of this, we also searched for original studies that focused on PFE strategies at those two levels and reviewed the PFE strategies used and study findings. RESULTS We found 131 reviews of direct patient care strategies, 5 reviews of health system strategies, and no reviews of community-policy strategies. Four original studies addressed PFE at the health system or community-policy levels. Most direct patient care reviews focused on self-management support (SMS) (n = 85) and shared decision-making (SDM) (n = 43). Forty-nine reviews reported positive effects, 35 reported potential benefits, 37 reported unclear benefits, and 4 reported no benefits. Health system level strategies mainly involved patients and caregivers serving on advisory councils. PFE strategies with the strongest evidence focused on SMS particularly for patients with diabetes. Many SDM reviews reported potential benefits especially for patients with cancer. DISCUSSION Much more evidence exists on the effects of direct patient care strategies on PFE than on the effects of health system or community-policy strategies. Most reviews indicated that direct patient care strategies had positive effects or potential benefits. A limitation of this evidence map is that due to its focus on reviews, which were plentiful, it did not capture details of individual interventions. Nevertheless, this evidence map should help to focus attention on gaps that require more research in efforts to improve PFE.
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Affiliation(s)
- Hanan Aboumatar
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA.
| | - Samantha Pitts
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA
| | - Ritu Sharma
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Asar Das
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Brandon M Smith
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jeff Day
- Department of Art as Applied to Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Katherine Holzhauer
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA
| | - Sejean Yang
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA
| | - Eric B Bass
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA.,Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Wendy L Bennett
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA
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13
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González-González AI, Brünn R, Nothacker J, Schwarz C, Nury E, Dinh TS, Brueckle MS, Dieckelmann M, Müller BS, van den Akker M. Everyday Lives of Middle-Aged Persons with Multimorbidity: A Mixed Methods Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:6. [PMID: 35010264 PMCID: PMC8751163 DOI: 10.3390/ijerph19010006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/06/2021] [Accepted: 12/15/2021] [Indexed: 01/01/2023]
Abstract
The healthcare burden of patients with multimorbidity may negatively affect their family lives, leisure time and professional activities. This mixed methods systematic review synthesizes studies to assess how multimorbidity affects the everyday lives of middle-aged persons, and identifies skills and resources that may help them overcome that burden. Two independent reviewers screened title/abstracts/full texts in seven databases, extracted data and used the Mixed Methods Appraisal Tool (MMAT) to assess risk of bias (RoB). We synthesized findings from 44 studies (49,519 patients) narratively and, where possible, quantitatively. Over half the studies provided insufficient information to assess representativeness or response bias. Two studies assessed global functioning, 15 examined physical functioning, 18 psychosocial functioning and 28 work functioning. Nineteen studies explored skills and resources that help people cope with multimorbidity. Middle-aged persons with multimorbidity have greater impairment in global, physical and psychosocial functioning, as well as lower employment rates and work productivity, than those without. Certain skills and resources help them cope with their everyday lives. To provide holistic and dynamic health care plans that meet the needs of middle-aged persons, health professionals need greater understanding of the experience of coping with multimorbidity and the associated healthcare burden.
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Affiliation(s)
- Ana Isabel González-González
- Institute of General Practice, Goethe University, 60590 Frankfurt am Main, Germany; (R.B.); (T.S.D.); (M.-S.B.); (M.D.); (B.S.M.); (M.v.d.A.)
- Health Services Research on Chronic Patients Network (REDISSEC), 28035 Madrid, Spain
| | - Robin Brünn
- Institute of General Practice, Goethe University, 60590 Frankfurt am Main, Germany; (R.B.); (T.S.D.); (M.-S.B.); (M.D.); (B.S.M.); (M.v.d.A.)
| | - Julia Nothacker
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (J.N.); (E.N.)
| | | | - Edris Nury
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Center, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (J.N.); (E.N.)
| | - Truc Sophia Dinh
- Institute of General Practice, Goethe University, 60590 Frankfurt am Main, Germany; (R.B.); (T.S.D.); (M.-S.B.); (M.D.); (B.S.M.); (M.v.d.A.)
| | - Maria-Sophie Brueckle
- Institute of General Practice, Goethe University, 60590 Frankfurt am Main, Germany; (R.B.); (T.S.D.); (M.-S.B.); (M.D.); (B.S.M.); (M.v.d.A.)
| | - Mirjam Dieckelmann
- Institute of General Practice, Goethe University, 60590 Frankfurt am Main, Germany; (R.B.); (T.S.D.); (M.-S.B.); (M.D.); (B.S.M.); (M.v.d.A.)
| | - Beate Sigrid Müller
- Institute of General Practice, Goethe University, 60590 Frankfurt am Main, Germany; (R.B.); (T.S.D.); (M.-S.B.); (M.D.); (B.S.M.); (M.v.d.A.)
| | - Marjan van den Akker
- Institute of General Practice, Goethe University, 60590 Frankfurt am Main, Germany; (R.B.); (T.S.D.); (M.-S.B.); (M.D.); (B.S.M.); (M.v.d.A.)
- Department of Family Medicine, School CAPHRI, Maastricht University, 6200 Maastricht, The Netherlands
- Academic Center for General Practice, Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium
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14
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Litchfield I, Greenfield S, Harper L. Addressing the transition to a chronic condition: exploring independent adoption of self-management by patients with ANCA-associated vasculitis. Rheumatol Adv Pract 2021; 5:rkab075. [PMID: 34778700 PMCID: PMC8578693 DOI: 10.1093/rap/rkab075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 08/05/2021] [Indexed: 11/14/2022] Open
Abstract
Objective Improvements in care have led to the recognition of ANCA-associated vasculitis (AAV) as a chronic condition; however, the self-management strategies considered a crucial component of the care model for patients with more prevalent chronic conditions are yet to be integrated formally into the treatment of AAV patients. The aim of the work we present here is to identify those self-management processes and tasks already being adopted by patients with AAV to help inform existing care and the development of a structured self-management programme. Methods We conducted a series of focus groups and semi-structured interviews with AAV patients, collating the data and performing a post hoc deductive analysis based on a consolidated framework of self-management processes. Results Despite the unique attributes and demands of AAV, patients adopted self-management behaviours previously identified and supported in patients with more prevalent chronic diseases. They accessed information on their disease proactively and learnt to mitigate their symptoms and side-effects. They pursued a range of health-promotion activities and accessed support from their social network and beyond and, ultimately, learnt to integrate the condition into their everyday life. Conclusion Our work has highlighted some key areas of self-management that might be addressed usefully and immediately, including the provision of more consistent information relating to evolving symptoms and side-effects, additional support in accessing both appropriate care and community-based resources, and the use of interventions to bolster resilience. Our findings will inform the development of a tailored self-management programme, but in the meantime provide a more contemporary context for current clinician-patient conversations.
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Affiliation(s)
- Ian Litchfield
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham
| | - Sheila Greenfield
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham
| | - Lorraine Harper
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham.,University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK
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15
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Vick JB, Wolff JL. A Scoping Review of Person and Family Engagement in the context of Multiple Chronic Conditions. Health Serv Res 2021; 56 Suppl 1:990-1005. [PMID: 34363217 DOI: 10.1111/1475-6773.13857] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 07/07/2021] [Accepted: 07/19/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To review definitions, concepts, and evidence regarding person and family engagement for persons with multiple chronic conditions (MCC) in order to identify opportunities to advance the field. DATA SOURCE Ovid MEDLINE STUDY DESIGN: We performed a two-step process: (1) a critical review of conceptual models of engagement to identify key concepts most pertinent to engagement among persons with MCC as a "launch pad" to our scoping review, and (2) a scoping review of reviews of engagement for persons living with MCC. DATA COLLECTION/EXTRACTION METHODS First, we critically reviewed six models of engagement. Second, our scoping review identified 1297 citations, with 67 articles meeting criteria for inclusion. Of these, we focused on reviews, of which there were nine titles/abstracts retained for full text consideration. Six full-text reviews were included in the final analysis. The purpose, review type, population, number/type of included studies, theoretical framework, and findings of each study were extracted and analyzed thematically. PRINCIPAL FINDINGS Conceptual models of engagement differ with respect to areas of emphasis (e.g., systems or clinical encounters) as well as attention to vulnerable populations; involvement of family; consideration of cost-benefit tradeoffs; and attention to outcomes that matter most. Our scoping review of reviews identified just one article explicitly focused on engagement interventions for those with MCC. Other reviews examined elements of self-management and involvement in decision-making, conceptually related to engagement without explicit use of the word. We find that existing evidence has predominantly described individual-level strategies rather than targeting organizations, systems, or policies. Barriers to engagement are not well described, nor are potential downsides to engagement. Family engagement is rarely considered. CONCLUSIONS Promising areas of future work include attention to barriers to engagement including trust, goal-based care, the design of structural changes to care delivery, tradeoffs between benefits and costs, and family engagement. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Judith B Vick
- Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jennifer L Wolff
- Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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16
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Brandberg C, Ekstedt M, Flink M. Self-management challenges following hospital discharge for patients with multimorbidity: a longitudinal qualitative study of a motivational interviewing intervention. BMJ Open 2021; 11:e046896. [PMID: 34330857 PMCID: PMC8327841 DOI: 10.1136/bmjopen-2020-046896] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The aim of this study was to describe challenges in self-management activities among people with multimorbidity during a 4-week post-discharge period. DESIGN This is a longitudinal qualitative study using data from a randomised controlled trial (RCT) of motivational interviewing (MI) sessions. SETTING The RCT was conducted at six wards in two hospitals-one university hospital and one general hospital in Stockholm, Sweden, during 2016-2018. PARTICIPANTS Sixteen participants from the intervention group, diagnosed with heart failure or chronic obstructive pulmonary disease and at least one other chronic condition, were purposively selected for this study. INTERVENTIONS Each participant had four or five post-discharge MI sessions with a trained social worker during a period of approximately 4 weeks. The sessions were recorded digitally and analysed using content analysis. Altogether, 70 recorded sessions were analysed. RESULTS Self-management after hospital discharge was a dynamic process with several shifting features that evolved gradually over time. Patients with multimorbidity experienced two major challenges with self-management in the first 4 weeks following hospital discharge: 'Managing a system-centred care' and 'Handling the burden of living with multiple illnesses at home post-discharge'. CONCLUSIONS Self-management for patients with multimorbidity in the first post-discharge period does not equate to a fixed set of tasks, but varies over the post-discharge period. Self-management challenges include not only the burden of the disease itself, but also that of navigating and understanding the healthcare system. Hence, self-management support post-discharge involves both aiding patients with care coordination and meeting their gradually shifting disease-related needs. TRIAL REGISTRATION NUMBER NCT02823795.
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Affiliation(s)
- Carina Brandberg
- Department of Learning, Informatics, Managmenet and Ethics (LIME), Karolinska Institute, Stockholm, Sweden
| | - Mirjam Ekstedt
- Department of Learning, Informatics, Managmenet and Ethics (LIME), Karolinska Institute, Stockholm, Sweden
- School of Health and Caring Sciences, Linnaeus University Faculty of Health and Life Sciences, Kalmar, Sweden
| | - Maria Flink
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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17
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Schulman-Green D, Feder SL, Montano AR, Batten J, Tan H, Hoang K, Grey M. Use of the self- and family management framework and implications for further development. Nurs Outlook 2021; 69:991-1020. [PMID: 34183187 DOI: 10.1016/j.outlook.2021.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/20/2021] [Accepted: 05/02/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND The Self- and Family Management Framework (SFMF) was created in 2006 and revised in 2015 to guide research on self- and family management of chronic conditions. There has been no review of use of the SFMF. PURPOSE We reviewed articles citing the SFMF to identify the frequency and nature of use. METHOD We conducted a citation analysis, searching Web of Science, Scopus, and Google Scholar databases and extracted key data from identified articles. FINDINGS Of 126 articles, 84(66%) cited the 2006 SFMF, 37(29%) cited the 2015 SFMF, and 6(5%) cited both. The SFMF was used most to inform study design. Users noted strengths (e.g., considers family context) and limitations (e.g., non-specification of patient- family caregiver synergies) of the framework. DISCUSSION The SFMF has been used broadly to guide research on self- and family management of chronic conditions. Findings will inform development of a third version of the SFMF.
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Affiliation(s)
| | | | | | | | - Hui Tan
- Yale New Haven Health Bridgeport Hospital, Bridgeport, CT
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18
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Lee MC, Wu SFV, Lu KC, Wang WH, Chen YY, Chen HM. Effect of patient-centred self-management programme on mental health, self-efficacy and self-management of patients with hypertensive nephropathy: A randomised controlled trial. J Clin Nurs 2021; 30:3205-3217. [PMID: 33942419 DOI: 10.1111/jocn.15825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/23/2021] [Accepted: 04/12/2021] [Indexed: 11/28/2022]
Abstract
AIM AND OBJECTIVES To evaluate the effect of patient-centred self-management programme on mental health, self-efficacy and self-management of patients with hypertensive nephropathy. BACKGROUND If the symptoms of hypertension are not well-controlled, deterioration of renal function will accelerate and evolve into hypertensive nephropathy. DESIGN A randomised single-blind trial. This article follows the requirements of CONSORT statement. METHODS The experimental group (n = 35) after pre-test used patient-centred self-management programme once a week for a total of 4 weeks and the intervention effect was measured after 3 months for post-test. Contrarily, the traditional care was employed for the control group (n = 35). The measuring outcomes included mental health, self-efficacy and self-management. Trial registry is listed under https://clinicaltrials.gov/ with Identifier No. NCT04633993. RESULTS After the intervention, the average score of mental health for the experimental group was 20.79 (SD = 0.82) which was higher than the 19.27 points for the control group (SD = 0.77) and showed a significant difference (F = 8.31, p = .005, partial eta2 = 0.133). In terms of self-efficacy, the average score for the experimental group was 214.13 (SD = 6.40), which was higher than the 189.58 points for the control group (SD = 6.03) and exhibited a significant difference (F = 11.82, p = .001, partial eta2 = 0.197). Regarding self-management, the average score of the experimental group was 75.12 (SD = 2.29) which was significantly higher than the 68.80 points of the control group (SD = 2.43) (F = 11.17, p = .001, partial eta2 = 0.190). CONCLUSIONS In addition to promoting mental health of individual cases, this intervention also increases their self-confidence in disease control and improves their self-management on diseases. RELEVANCE TO CLINICAL PRACTICE The intervention provides an effective option for clinical care workers as a replacement for or supplement to the traditional care.
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Affiliation(s)
- Mei-Chen Lee
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shu-Fang Vivienne Wu
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Kuo-Cheng Lu
- Division of Nephrology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.,School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan
| | - Wen-Hug Wang
- Medical Intensive Care Unit, Cardinal Tien Hospital, New Taipei City, Taiwan
| | - Yen-Yen Chen
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Hui-Mei Chen
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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19
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Gárate FJ, Chausa P, Whetham J, Jones CI, García F, Cáceres C, Sánchez-González P, Wallitt E, Gómez EJ. EmERGE mHealth Platform: Implementation and Technical Evaluation of a Digital Supported Pathway of Care for Medically Stable HIV. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063156. [PMID: 33803821 PMCID: PMC8003226 DOI: 10.3390/ijerph18063156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 12/21/2022]
Abstract
In this article, we described a new mobile-Health (mHealth) supported clinical pathway of care for people living with medically stable HIV in terms of platform acceptability, usability and technical feasibility. The EmERGE mHealth platform was codesigned with clinicians and the community, developed using Scrum agile methodology, integrated with hospital information systems and validated in a large prospective cohort study of 2251 participants. The evaluation of this new paradigm of care was conducted using a tailored Health Technology Assessment: the Model for Assessment of Telemedicine Applications. Usability and acceptability were assessed through the System Usability Score and a Patient Reported Experience Measure. The EmERGE platform was successfully deployed across diverse care settings in five European countries and used by 2251 patients and more than 20 clinicians for up to 30 months. Results from the formal evaluation demonstrated that the EmERGE platform is feasible and acceptable, with a high level of usability (median System Usability Score (SUS) 85.0%) and very positive patient-reported experiences (94.2% would recommend to a friend). The EmERGE platform is a secure and General Data Protection Regulation (GDPR)-compliant system with a complete set of functionalities that could be easily adapted to other clinical conditions, clinical sites and health systems thanks to its modular technical architecture.
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Affiliation(s)
- Francisco J. Gárate
- Biomedical Engineering and Telemedicine Centre, ETSI Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (C.C.); (P.S.-G.); (E.J.G.)
- Correspondence: (F.J.G.); (P.C.)
| | - Paloma Chausa
- Biomedical Engineering and Telemedicine Centre, ETSI Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (C.C.); (P.S.-G.); (E.J.G.)
- Correspondence: (F.J.G.); (P.C.)
| | - Jennifer Whetham
- Department of Sexual Health and HIV Medicine, Brighton and Sussex University Hospitals NHS Trust, BN2 5BE Brighton, UK;
| | | | - Felipe García
- Infectious Diseases Department, Fundacio Privada Clinic per a la Recerca Biomedica—IDIBAPS, University of Barcelona, 08036 Barcelona, Spain;
| | - César Cáceres
- Biomedical Engineering and Telemedicine Centre, ETSI Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (C.C.); (P.S.-G.); (E.J.G.)
- Computer Science Department, Universidad Rey Juan Carlos, 28933 Madrid, Spain
| | - Patricia Sánchez-González
- Biomedical Engineering and Telemedicine Centre, ETSI Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (C.C.); (P.S.-G.); (E.J.G.)
- Centro de Investigación Biomédica en Red, Biomateriales y Nanomedicina (CIBER-BBN), 28029 Madrid, Spain
| | | | - Enrique J. Gómez
- Biomedical Engineering and Telemedicine Centre, ETSI Telecomunicación, Center for Biomedical Technology, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (C.C.); (P.S.-G.); (E.J.G.)
- Centro de Investigación Biomédica en Red, Biomateriales y Nanomedicina (CIBER-BBN), 28029 Madrid, Spain
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20
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Van Truong P, Wulan Apriliyasari R, Lin MY, Chiu HY, Tsai PS. Effects of self-management programs on blood pressure, self-efficacy, medication adherence and body mass index in older adults with hypertension: Meta-analysis of randomized controlled trials. Int J Nurs Pract 2021; 27:e12920. [PMID: 33590947 DOI: 10.1111/ijn.12920] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 12/11/2020] [Accepted: 12/30/2020] [Indexed: 11/30/2022]
Abstract
AIM To assess the effects of self-management interventions on systolic blood pressure, diastolic blood pressure, self-efficacy, medication adherence and body mass index in older adults with hypertension. BACKGROUND Effective treatment of hypertension may require the practice of self-management behaviours. However, evidence on effects of self-management interventions on blood pressure, self-efficacy, medication adherence and body mass index in older adults with hypertension is lacking. DESIGN A systematic review and meta-analysis. DATA SOURCES CINAHL, Cochrane Library, Embase, Ovid-Medline, PubMed, Scopus, Web of Science and other sources were searched to October 2020. REVIEW METHODS Data were analysed using Comprehensive Meta-Analysis 2.0 and quality assessment was done using ROB 2.0. The pooled effect sizes were reported as Hedges' g values with corresponding 95% confidence intervals using a random-effects model. RESULTS Twelve randomized controlled trials met our inclusion criteria. The results revealed that self-management interventions significantly decreased blood pressure and increased self-efficacy and medication adherence in older adult patients with hypertension, with no significant effect on body mass index. CONCLUSIONS Self-management interventions have considerable beneficial effects in older adults with hypertension. Health care providers should implement self-management interventions to strengthen the patient's role in managing their health.
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Affiliation(s)
- Pham Van Truong
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Nursing Department, Vinmec Times City Hospital, Vinmec HealthCare System, Hanoi, Vietnam
| | - Renny Wulan Apriliyasari
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Department of Nursing, Cendekia Utama, Kudus, Central Java, Indonesia
| | - Mei-Yu Lin
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan
| | - Hsiao-Yean Chiu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Pei-Shan Tsai
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Department of Nursing and Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan
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21
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Kim KY, Lee E, Cho J. Factors Affecting Healthcare Utilization among Patients with Single and Multiple Chronic Diseases. IRANIAN JOURNAL OF PUBLIC HEALTH 2020; 49:2367-2375. [PMID: 34178743 PMCID: PMC8215075 DOI: 10.18502/ijph.v49i12.4820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background We aimed to investigate the factors affecting healthcare utilization among patients with single and multiple chronic diseases using the Andersen healthcare utilization model. Methods We used a combination of the data from the sixth and seventh Korea National Health and Nutrition Survey (2014-2016). The study population was 3,901 patients with single chronic disease and 1,829 patients with multiple chronic diseases as defined by the WHO. Participants were aged 19 yr or older. Multiple regression analysis was employed using the Andersen model to identify factors affecting healthcare utilization (inpatient and outpatient). Results According to the Andersen model (comprising predisposing, enabling, and need factors and health behaviors), the factors that increased outpatients with single chronic disease were female, being aged 65 yr or older, having basic livelihood security benefit, immobility, and poor subjective health status. Factors that increased inpatients with single chronic disease were being aged under 65, having private insurance, immobility, poor subjective health status, and nondrinking. Moreover, factors that increased outpatients and inpatients with multiple chronic diseases were female, being aged under 65, immobility, and poor subjective health status and immobility, poor subjective health status, nondrinking, and not engaging in physical activity, respectively. Conclusion We identified factors affecting outpatient and inpatient care utilization among patients with single and multiple chronic diseases, using the Andersen healthcare utilization model. The findings can be used as foundational data to develop preventive and management strategies in healthcare utilization among patients with single and multiple chronic diseases.
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Affiliation(s)
- Ka Young Kim
- College of Nursing, Gachon University, Hambakmoeiro 191, Yeonsu-gu, Incheon 21936, South Korea
| | - Eunmi Lee
- Department of Nursing, Hoseo University, 79-20, Hoseo-ro, Baebang-eup, Asan-si, Chungcheongnam-do 31499, South Korea
| | - Jeonghyun Cho
- College of Nursing, Inje University, 75, Bokji-ro, Busanjin-gu, Busan 47392, South Korea
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Ko D, Bratzke LC. Cognitive Function in Liver Transplant Recipients Who Survived More Than 6 Months. Prog Transplant 2020; 30:335-341. [DOI: 10.1177/1526924820958144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Introduction: Current research in the areas of liver transplant and cognitive function has primarily examined cognitive changes from pre- to 1-year posttransplant, resulting in an insufficient understanding of cognitive trajectory beyond early periods of transplant and its impact on self-management. This study aimed (1) to describe global and domain-specific cognitive function in liver transplant recipients who survived more than 6 months after transplant and (2) to describe patient and clinical characteristics of recipients with impaired global and/or domain-specific cognitive function. Further, this study explored the potential relationships between cognitive function and self-management by examining differences in cognitive function by levels of self-management. Design: This secondary data analysis included 107 adult liver transplant recipients, who had a functioning transplant for at least 6 months. Data of cognitive function, demographic and clinical characteristics, and self-management were extracted for this study. T tests, Mann-Whitney tests, and Kruskal-Wallis tests were used to examine differences in cognitive function by variables. Results: More than half of the recipients had global cognitive impairment. Significant differences were found in global and domain-specific cognitive function. Older, male, married, or deceased donor recipients had lower cognitive test scores than younger, female, single, or living donor recipients. There were no significant differences in global and domain-specific cognitive function by time since transplant and levels of self-management. Discussion: Future longitudinal studies should examine the long-term trajectory of cognitive function posttransplant. Other factors such as caregivers’ participation in self-management should be accounted for in future studies when examining the relationship between cognitive function and self-management.
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Affiliation(s)
- Dami Ko
- School of Nursing, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
| | - Lisa C. Bratzke
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
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Difficulties with health self-management by older adults: The role of well-being. Geriatr Nurs 2020; 41:984-991. [PMID: 32768151 DOI: 10.1016/j.gerinurse.2020.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/15/2020] [Accepted: 07/16/2020] [Indexed: 11/21/2022]
Abstract
The purpose of this study was to investigate the association between three aspects of well-being (positive and negative affect, self-realization, and self-efficacy and resilience) and disease self-management or difficulties in managing care. Logistic regression models were used to analyze data from a sample of community-dwelling Medicare beneficiaries 65-years or older who participated in the National Health and Aging Trends Study and responded to well-being and engagement in health care questions (n = 1663). All three aspects of well-being were significantly associated with reduced difficulties in care management for both the participants and their family and friends who assist them. Self-efficacy and resilience had the strongest association; older adults with higher levels of self-efficacy and resilience were more likely to handle care by self. Our findings highlight the importance of incorporating strategies to enhance well-being of older adults to reduce the difficulties of managing activities necessary to stay healthy.
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Development and Validation of the Self-care in Motor Neuron Disease Index. J Neurosci Nurs 2019; 51:325-330. [PMID: 31626077 DOI: 10.1097/jnn.0000000000000473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to develop and psychometrically test the properties of the Self-care in Motor Neuron Disease (SCMND) Index. METHODS This instrument development and validation study was conducted in 3 phases. The first is to identify self-care behaviors in people with motor neuron disease (MND), and the second is to evaluate the content validity of the SCMND Index. Then, between March 2017 and March 2018, the tool was administered to 107 people with MND for psychometric tests. RESULTS The SCMND Index was developed based on the middle-range theory of self-care of chronic illness, including 15 self-care behaviors related to respiration, nutrition, mobility, medication, medical visits, and complication management. Content validity was excellent. Data analysis suggests that the instrument has a good internal consistency in all 3 domains and excellent reproducibility. Increased self-care behaviors' median values were associated with mechanical ventilation, cough assistance, and dysphagia. Domains differed significantly based on access (maintenance), hospital admissions (monitoring and management), and respiratory infection (management). CONCLUSIONS Self-care is a patient-centered outcome, and it is a key point of healthcare. Results suggest that the SCMND Index is useful for both clinicians and researchers to evaluate self-care in MND.
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Zhang Y, Tan X. Compliance with care and poor sleep quality among hypertensive adults in a mountainous area of Hubei Province, People's Republic of China. Patient Prefer Adherence 2019; 13:1221-1227. [PMID: 31413550 PMCID: PMC6662512 DOI: 10.2147/ppa.s212241] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 07/07/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Little information is available concerning the relationship between compliance with hypertensive care and poor quality of sleep among Chinese adults in rural areas. This study aimed to evaluate the association between the compliance with hypertensive care and sleep quality for hypertension of adults in a mountainous area in People's Republic of China. METHODS A total of 551 hypertensive patients (30-96 years of age) living in a remote mountainous area were recruited. Poor sleep quality was assessed using the standard Pittsburgh Sleep Quality Index (PSQI), and compliance with care was measured based on the Compliance of Hypertensive Patients Scale (CHPS). Hypertension was defined as blood pressure ≥140/90 mmHg or treated with antihypertensive medication. The associations between sleep quality and compliance variables were examined using Pearson's correlation. Multiple linear regressions were established to verify significant variables associated with respondents' compliance with care and poor sleep quality. RESULTS The average age of the sample was 67.15 years (SD=10.20), and 56.44% of the participants were female. The mean CHPS total score was 41.97 (SD=5.91), and the PSQI total score was 7.91 on average (SD=4.10). Correlation analysis revealed that patients with higher intention, healthier lifestyle, positive attitude and total compliance were more likely to have an increased risk of poor sleep quality. According to the results of multiple linear regression analyses, hypertension compliance was significantly associated with being female, married, non-rural residence and years of hypertension, while poor sleep quality had a significant association with living in rural areas, having concomitant disease and poor hypertension compliance. CONCLUSIONS There is a significant association between hypertension compliance and poor sleep quality. Future intervention programs should focus on improving compliance behavior as a modifiable background factor for sleep quality.
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Affiliation(s)
- Yuting Zhang
- Department of Occupational and Environmental Health, School of Health Sciences, Wuhan University, Wuhan430071, People’s Republic of China
| | - Xiaodong Tan
- Department of Occupational and Environmental Health, School of Health Sciences, Wuhan University, Wuhan430071, People’s Republic of China
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