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Javier SJ, Risbud R, Rossi FS, Slightam C, Aikens J, Guetterman T, Piette JD, Trivedi R. Improving depression management with support from close others: A thematic analysis of individuals with depression and their partners in care. Chronic Illn 2024; 20:283-295. [PMID: 37904531 DOI: 10.1177/17423953231175690] [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] [Indexed: 11/01/2023]
Abstract
OBJECTIVES With support from others, individuals with depression can build skills and implement lifestyle changes that help them manage their illness. The objective of the current study was to understand how the CarePartners for Depression Program, a randomized clinical trial aimed at enhancing the role of caregivers in the management of depression, improved communication and shared understandings of depression among individuals with depression and their close others. METHODS We conducted in-depth, semi-structured interviews with individuals with depression and their caregivers who participated in the CarePartners program. Interviews were qualitatively coded using a thematic analytic framework. RESULTS We conducted individual interviews with 39 participants in the CarePartners program, including 18 individuals with depression, 14 out-of-home care partners, and 7 informal caregivers. Three central themes were derived from analyses: (a) The quality of interpersonal relationships influenced the management of depression; (2) having clearly defined roles for CarePartners improved communication between CarePartners and individuals with depression; and (3) shared understanding of depression improved management of depression. DISCUSSION Our findings established the conditions under which the management of depression was influenced in a dyadic intervention. Dyadic interventions may make it easier for individuals to support patients with depression by fostering communication and collaboration.
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Affiliation(s)
- Sarah J Javier
- Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Menlo Park, CA, USA
- Center for Health Policy and Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, CA, USA
| | - Rashmi Risbud
- Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Menlo Park, CA, USA
| | - Fernanda S Rossi
- Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Menlo Park, CA, USA
- Center for Health Policy and Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, CA, USA
| | - Cindie Slightam
- Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Menlo Park, CA, USA
- Department of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - James Aikens
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Tim Guetterman
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - John D Piette
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Ranak Trivedi
- Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Menlo Park, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
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Nichol L, Rodriguez AD, Pitt R, Wallace SJ, Hill AJ. "Self-management has to be the way of the future": Exploring the perspectives of speech-language pathologists who work with people with aphasia. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:327-341. [PMID: 35473422 DOI: 10.1080/17549507.2022.2055144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
PURPOSE Healthcare models have incorporated self-management approaches to facilitate increased patient responsibility for chronic condition management. As aphasia is a chronic condition, self-management may be beneficial for people with aphasia; however, the possible impacts of the language disorder on self-management must be acknowledged and addressed. Speech-language pathologists would likely be principal providers of self-management support; therefore, their perspectives should be sought when considering development of aphasia self-management approaches. This study aims to explore speech-language pathologist perspectives of aphasia self-management. METHOD In-depth, semi-structured interviews conducted with 15 speech-language pathologists in Australia. Interview data analysed using qualitative content analysis. RESULT Aphasia self-management was viewed as a person- and family-centred approach enabling comprehensive long-term care for people with aphasia and promoting control, responsibility, and independence. Speech-language pathologists were seen to have a substantial role providing self-management support and consultation, and training was required to expand this role. Communication partners and peer support were highly valued. Personal and environmental factors may influence successful aphasia self-management. Differences between aphasia self-management and chronic condition self-management were considered. CONCLUSION Self-management could facilitate long-term sustainable aphasia management. Aphasia self-management approaches should factor in how to maximise communication partner and peer support. Aphasia-friendly self-management resources are necessary.
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Affiliation(s)
- Leana Nichol
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Amy D Rodriguez
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center, Decatur, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Rachelle Pitt
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
- West Moreton Health, Ipswich, Australia
| | - Sarah J Wallace
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
| | - Annie J Hill
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
- Surgical, Treatment and Rehabilitation Service (STARS), Metro North Hospital and Health Service, Brisbane, Australia
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Banerjee A, Hendrick P, Blake H. Predictors of self-management in patients with chronic low back pain: a longitudinal study. BMC Musculoskelet Disord 2022; 23:1071. [PMID: 36476492 PMCID: PMC9727914 DOI: 10.1186/s12891-022-05933-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 10/28/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Self-management (SM) is a key recommended strategy for managing chronic low back pain (CLBP). However, SM programmes generate small to moderate benefits for reducing pain and disability in patients with CLBP. The benefits of the SM programme can potentially be optimised by identifying specific subgroups of patients who are the best responders. To date, no longitudinal study has examined the predictive relationships between SM and biopsychosocial factors in patients with CLBP. The aim was to determine whether biopsychosocial factors predict SM and its change over time in patients with CLBP. METHODS In this multi-centre longitudinal cohort study, we recruited 270 working-age patients with CLBP (mean age 43.74, 61% female) who consulted outpatient physiotherapy for their CLBP. Participants completed self-reported validated measures of pain intensity, disability, physical activity, kinesiophobia, catastrophising, depression and SM at baseline and six months. SM constructs were measured using eight subscales of the Health Education Impact Questionnaire (heiQ), including Health Directed Activity (HDA), Positive and Active Engagement in Life (PAEL), Emotional Distress (ED), Self-Monitoring and Insight (SMI), Constructive Attitudes and Approaches (CAA), Skill and Technique Acquisition (STA), Social Integration and Support (SIS) and Health Service Navigation (HSN). Data were analysed using General Linear Model (GLM) regression. RESULTS Physical activity and healthcare use (positively) and disability, depression, kinesiophobia, catastrophising (negatively) predicted (p < 0.05, R2 0.07-0.55) SM constructs at baseline in patients with CLBP. Baseline depression (constructs: PAEL, ED, SMI, CAA and STA), kinesiophobia (constructs: CAA and HSN), catastrophising (construct: ED), and physical disability (constructs: PAEL, CAA and SIS) negatively predicted a range of SM constructs. Changes over six months in SM constructs were predicted by changes in depression, kinesiophobia, catastrophising, and physical activity (p < 0.05, R2 0.13-0.32). CONCLUSIONS Self-reported disability, physical activity, depression, catastrophising and kinesiophobia predicted multiple constructs of SM measured using the heiQ subscales in working-age patients with CLBP. Knowledge of biopsychosocial predictors of SM may help triage patients with CLBP into targeted pain management programmes. TRIAL REGISTRATION The study protocol was registered at ClinicalTrials.gov on 22 December 2015 (ID: NCT02636777).
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Affiliation(s)
- A. Banerjee
- grid.9757.c0000 0004 0415 6205Keele University, School of Allied Health Professions, Staffordshire, ST5 5BG UK ,Nottingham CityCare Partnership CIC, Nottingham, UK
| | - P. Hendrick
- grid.4563.40000 0004 1936 8868University of Nottingham, School of Health Sciences, Nottingham, UK
| | - H. Blake
- grid.4563.40000 0004 1936 8868University of Nottingham, School of Health Sciences, Nottingham, UK ,grid.511312.50000 0004 9032 5393NIHR Nottingham Biomedical Research Centre, Nottingham, UK
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Cuevas H, Heitkemper E, Huang YC, Jang DE, García AA, Zuñiga JA. A systematic review and meta-analysis of patient activation in people living with chronic conditions. PATIENT EDUCATION AND COUNSELING 2021; 104:2200-2212. [PMID: 33610334 DOI: 10.1016/j.pec.2021.02.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 02/01/2021] [Accepted: 02/08/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The objectives of this review are to (1) describe the state of the science of patient activation interventions for the self-management of chronic conditions; (2) identify effective intervention elements for improving patient activation; and (3) compare intervention effectiveness across chronic conditions. METHODS This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA). PubMed, CINAHL, and Web of Science databases were searched. RESULTS Thirty-two articles published between 2005 and 2019 were identified with intervention elements of self-management, disease management, and education. Meta-analysis of a subset of seven randomized controlled trials (n = 7) that used the 13-item version of the Patient Activation Measure with data collection points at 6 months demonstrated that patient activation did not change significantly in comparison with controls (MD = 0.25, 95 % CI = 0.02-0.47). CONCLUSION Most interventions reported significant improvement in patient activation and were linked to tasks such as regular exercise and monitoring glucose. However, the meta-analysis of RCTs did not confirm these findings. PRACTICE IMPLICATIONS Patient activation can be assessed and addressed uniformly across all chronic conditions to improve patient engagement in care.
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Affiliation(s)
- Heather Cuevas
- The University of Texas at Austin, School of Nursing, USA.
| | | | - Ya-Ching Huang
- Texas State University, St. David's School of Nursing, USA
| | - Dong Eun Jang
- The University of Texas at Austin, School of Nursing, USA
| | | | - Julie A Zuñiga
- The University of Texas at Austin, School of Nursing, USA
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Liu S, Yang BX, Gong X, Chen J, Liu Z, Zhang J, Wang XQ. Prevalence and Influencing Factors of Depression Self-Management Among Chinese Community Residents: A Cross-Sectional Study. Front Psychiatry 2021; 12:559844. [PMID: 34025464 PMCID: PMC8138045 DOI: 10.3389/fpsyt.2021.559844] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 04/06/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This study aimed to investigate the current status of depression self-management (DSM), and to identify influencing factors of DSM among Chinese community residents. Methods: Stratified random sampling methodology was adopted in this cross-sectional survey. Respondents completed a collection of self-administered questionnaires Results: The majority of participants were female (72.2%), having a mean age of 39 years (SD = 17.3). The total mean score on the DSSM was low (31.63 ± 4.69). Using multiple linear regression analysis, age ranging from 25 to 64 years old (Beta = -0.176, p = 0.008), having personal stigma (Beta = -0.143, p = 0.020) and perceived stigma (Beta = 0.127, p = 0.037), and having a nuclear family structure (Beta = -0.313, p = 0.046), good family function (Beta = 0.278, p < 0.001) and good help-seeking attitude (Beta = 0.159, p = 0.008) were associated with DSSM-knowledge. Older age (≥65 years) (Beta = -0.152, p = 0.034), higher CES-D scores (Beta = -0.162, p = 0.005), having a father with a bachelor's degree or higher level of education (Beta = -0.134, p = 0.047), being female (Beta = 0.147, p = 0.012), indicating a religious preference (Beta = 0.145, p = 0.017) and having good family function (Beta = 0.247, p = 0.001) were significantly associated with DSSM-activities. Conclusions: Reducing stigma related to depression and enhancing help-seeking attitudes may be potential strategies for managing depressive symptoms among Chinese community residents.
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Affiliation(s)
- Shuo Liu
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Bing Xiang Yang
- School of Health Sciences, Wuhan University, Wuhan, China.,Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xuan Gong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jie Chen
- School of Nursing, University of Connecticut, Storrs, CT, United States
| | - Zhongchun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jun Zhang
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Xiao Qin Wang
- School of Health Sciences, Wuhan University, Wuhan, China
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Rasalingam A, Fegran L, Brekke I, Helseth S. Young people with long-term health challenges experiences in transition to adulthood: A qualitative metasynthesis. J Adv Nurs 2020; 77:595-607. [PMID: 33245156 DOI: 10.1111/jan.14641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/27/2020] [Indexed: 11/28/2022]
Abstract
AIMS The aim of this study was to describe the experiences of the transition to adulthood for young people with long-term health challenges. DESIGN The metasynthesis approach was based on the guidelines by Sandelowski and Barroso for synthesizing qualitative research. DATA SOURCES Seven electronic databases: CINAHL, Medline, Embase, PsycINFO, Web of Science, Scopus, and SocIndex were searched on 6-10 February 2020. REVIEW METHODS Studies were critically appraised using the Joanna Briggs critical appraisal tool. Qualitative data were extracted, meta-summarised, then meta-synthesized. FINDINGS Nineteen qualitative studies were included in this review. Six themes illustrated experiences in the transition to adulthood: wishing for an 'ordinary' life, significance of close network, working towards independence, in need of systemic resources and services, psychosocial challenges and keeping a positive attitude. CONCLUSION Young people with long-term health challenges wished for as 'ordinary' a life as possible in the future. In the transition to adulthood, they gradually gained more competence in self-management skills and knowledge and strived to become more independent. By having a positive attitude and using other coping strategies, young people can work on some of the difficulties they experience in this phase. However, to achieve and maintain independence young people with long-term health challenges are dependent on the support of a close network and systemic support and services. IMPACT The findings highlight the need to help alleviate the fears and worries of young people with long-term health challenges and create opportunities for successful transition to adulthood by increased awareness and interventions from policy-makers and professionals in the health and social system.
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Affiliation(s)
- Anurajee Rasalingam
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Liv Fegran
- Faculty of Health and Sport Sciences, Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Idunn Brekke
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.,Division of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Sølvi Helseth
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
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Pozza A, Osborne RH, Elsworth GR, Gualtieri G, Ferretti F, Coluccia A. Evaluation of the Health Education Impact Questionnaire (heiQ), a Self-Management Skill Assessment Tool, in Italian Chronic Patients. Psychol Res Behav Manag 2020; 13:459-471. [PMID: 32547268 PMCID: PMC7246315 DOI: 10.2147/prbm.s245063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 02/27/2020] [Indexed: 11/23/2022] Open
Abstract
Background The Health Education Impact Questionnaire (heiQ) aims to evaluate eight self-management skills in people with chronic conditions. Knowledge about the relations between these self-management skills and different quality of life (QoL) outcomes has received little attention. It is also important to provide further evidence on its properties in non-English healthcare contexts, as the questionnaire is being used in cross-cultural research. Furthermore, in the Italian healthcare context, the relationship between the medical staff and the patients remains asymmetrical, with the latter having the role of passive recipients of medical prescriptions and services. The current study provided further evidence about the psychometric properties of the heiQ among Italian people with chronic conditions, specifically by assessing the factor structure, reliability, convergent/divergent and criterion validity (ie, the specific contribution of each of the self-management skills to QoL outcomes). Methods Two hundred ninety-nine individuals with a chronic condition (mean age = 61.4 years, 50% females) completed the heiQ and the Medical Outcomes Study-Short Form (MOS SF-36). Confirmatory factor analyses, Composite Reliability Indices (CRI), bivariate correlations and linear regression analyses were computed. Results A model with 8 correlated factors showed good fit, in a similar way to previous studies. CRI values were acceptable to good for all the subscales. Associations between some of the heiQ subscales and some of the MOS SF-36 subscales supported criterion validity. In particular, it was confirmed by the moderate associations between the constructive attitudes and approaches subscale and the MOS SF-36 vitality and perceived mental health and by the moderate correlations between the health directed activities subscale and the MOS SF-36 Vitality. In linear regressions, higher emotional distress predicted higher physical and mental QoL, while higher mental QoL was also associated with stronger constructive attitudes and approaches. Conclusion The heiQ has robust properties across translations and it can also be used routinely in Italian healthcare contexts. The evidence that all the other self-management skills did not predict either physical or mental QoL could suggest that the self-management model of chronic diseases is still not sufficiently developed in the Italian context, where patients are passive recipients of medical instructions.
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Affiliation(s)
- Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Richard H Osborne
- Centre for Global Health and Equity, Swinburne University of Technology, Melbourne, Australia.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Gerald R Elsworth
- Centre for Global Health and Equity, Swinburne University of Technology, Melbourne, Australia
| | - Giacomo Gualtieri
- Legal Medicine Unit, Santa Maria alle Scotte University Hospital, Siena, Siena, Italy
| | - Fabio Ferretti
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Anna Coluccia
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
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Climent‐Sanz C, Gea‐Sánchez M, Moreno‐Casbas MT, Blanco‐Blanco J, García‐Martínez E, Valenzuela‐Pascual F. A web‐based therapeutic patient education intervention for pain and sleep for women with fibromyalgia: A sequential exploratory mixed‐methods research protocol. J Adv Nurs 2020; 76:1425-1435. [DOI: 10.1111/jan.14333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/29/2020] [Accepted: 02/05/2020] [Indexed: 12/30/2022]
Affiliation(s)
- Carolina Climent‐Sanz
- Faculty of Nursing and Physiotherapy University of Lleida Lleida Spain
- Grup d'Estudis Societat, Salut, Educació i Cultura GESEC Department of Nursing and Physiotherapy University of Lleida Lleida Spain
- Grup de Recerca de Cures en Salut GRECS Institut de Recerca Biomèdica Lleida Spain
| | - Montserrat Gea‐Sánchez
- Faculty of Nursing and Physiotherapy University of Lleida Lleida Spain
- Grup d'Estudis Societat, Salut, Educació i Cultura GESEC Department of Nursing and Physiotherapy University of Lleida Lleida Spain
- Grup de Recerca de Cures en Salut GRECS Institut de Recerca Biomèdica Lleida Spain
| | - María T. Moreno‐Casbas
- Instituto de Salud Carlos III Nursing and Healthcare Research Unit (Investen‐isciii) Madrid Spain
- Ciber Fragilidad y Envejecimiento Saludable (CIBERFES) Madrid Spain
| | - Joan Blanco‐Blanco
- Faculty of Nursing and Physiotherapy University of Lleida Lleida Spain
- Grup d'Estudis Societat, Salut, Educació i Cultura GESEC Department of Nursing and Physiotherapy University of Lleida Lleida Spain
- Grup de Recerca de Cures en Salut GRECS Institut de Recerca Biomèdica Lleida Spain
| | - Ester García‐Martínez
- Faculty of Nursing and Physiotherapy University of Lleida Lleida Spain
- Grup de Recerca de Cures en Salut GRECS Institut de Recerca Biomèdica Lleida Spain
| | - Fran Valenzuela‐Pascual
- Faculty of Nursing and Physiotherapy University of Lleida Lleida Spain
- Grup d'Estudis Societat, Salut, Educació i Cultura GESEC Department of Nursing and Physiotherapy University of Lleida Lleida Spain
- Grup de Recerca de Cures en Salut GRECS Institut de Recerca Biomèdica Lleida Spain
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Delaney C, Barrere C, Bark L. A Metaphor Analysis of Patients' With Chronic Conditions Experiences With Holistic Nurse Coaching. Holist Nurs Pract 2019; 34:24-34. [PMID: 31725097 DOI: 10.1097/hnp.0000000000000359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to examine metaphors used by patients with chronic conditions to describe their experience with holistic nurse coaching. A secondary analysis was conducted using Metaphor Identification Procedure to analyze the corpus of 112 pages of typed transcription. Five metaphors emerged: (1) taking personal power back like acquiring a new toolbox; (2) seeing health challenges from different angles like a duck pond race; (3) shifting perception of a chronic condition like a spider turned into a friend; (4) engaging in self-care like caring for a favorite plant; and (5) choosing to focus on the positive like a collage that changed from dark to light. Specific interventions can be developed to address each of these metaphors to help patients live well with chronic conditions.
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Affiliation(s)
- Colleen Delaney
- School of Nursing, University of Connecticut, Storrs (Dr Delaney); School of Nursing, Quinnipiac University, Hamden, Connecticut (Dr Barrere); and Wisdom of the Whole Coaching Academy, Alameda, California (Dr Bark)
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10
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Tang L, Li K, Wu CJJ. Thirty-day readmission, length of stay and self-management behaviour among patients with acute coronary syndrome and type 2 diabetes mellitus: A scoping review. J Clin Nurs 2019; 29:320-329. [PMID: 31698508 DOI: 10.1111/jocn.15087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 09/16/2019] [Accepted: 10/20/2019] [Indexed: 01/22/2023]
Abstract
AIMS AND OBJECTIVES To summarise the current evidence on comorbid type 2 diabetes mellitus (T2DM) related to 30-day readmission and hospital length of stay (LOS) among patients with acute coronary syndrome (ACS) and evidence on the effectiveness of self-management programmes for patients with both conditions. BACKGROUND Acute coronary syndrome and T2DM remain two major diseases leading to serious consequences. Thirty-day readmission and LOS were considered indicators of the quality of care, with the understanding that the potential significant effects of these outcomes could be varied. DESIGN This scoping review followed the methodology described by Arksey and O'Malley. METHODS Five databases including PubMed, Embase, Cochrane Library, Web of Science and CINAHL were searched, and a total of 20 articles involving 913,807 patients were included. Results were reported in accordance with PRISMA-ScR guidelines. RESULTS The results indicated that patients with both ACS and T2DM have prolonged LOS and increased 30-day readmission rates. The findings supported that improvements in patient self-management behaviour for optimal health outcomes were partially successful by effective self-management programmes; however, few articles on intervention programmes specifically designed for patients with two conditions were found. CONCLUSION Prolonged LOS and increased 30-day readmission rates are found among patients with ACS and T2DM. Based on few pilot studies building on each other, the effectiveness of self-management programmes in promoting self-care behaviour, self-efficacy and knowledge for patients with ACS and T2DM cannot be concluded. RELEVANCE TO CLINICAL PRACTICE Findings from this review provide valuable information on and a better understanding of readmissions and LOS among patients with ACS and T2DM for healthcare providers. Future developments and implementations of effective self-management programmes should target patients with dual diagnoses to improve health behaviour and reduce readmission and LOS.
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Affiliation(s)
- Liya Tang
- School of Nursing, Jilin University, Changchun, China
| | - Kun Li
- School of Nursing, Jilin University, Changchun, China
| | - Chiung-Jung Jo Wu
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast (USC), Sippy Downs, QLD, Australia.,Royal Brisbane and Women's Hospital (RBWH), Brisbane, QLD, Australia.,Mater Medical Research Institute-University of Queensland (MMRI-UQ), Brisbane, QLD, Australia
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11
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Kong LN, He S, Li L, Lei QS, Wang T, Yao Y. Factors for self-management activities among rural patients with chronic hepatitis B: A cross-sectional study. J Clin Nurs 2019; 28:3949-3956. [PMID: 31408559 DOI: 10.1111/jocn.15037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 04/03/2019] [Accepted: 08/04/2019] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To assess the self-management activities among rural patients with chronic hepatitis B (CHB), and the influence of psychosocial and demographic factors on their self-management activities. BACKGROUND Chronic hepatitis B is a serious public health concern. Rural patients may have limited access to healthcare services. Although self-management is important for controlling chronic hepatitis B, few studies focus on the self-management activities among rural patients with chronic hepatitis B. Understanding self-management activities and related factors in this population are important to design and implement appropriate intervention strategies. DESIGN A cross-sectional study. METHODS From June-December 2017, totally 236 rural patients with chronic hepatitis B were recruited from hepatology department in two hospitals in Chongqing, China. The questionnaire included demographic characteristics, Chronic Hepatitis B Self-Management Scale, Self-Efficacy for Managing Chronic Disease, and Social Support Rating Scale. The study followed the STROBE checklist. RESULTS Rural patients with chronic hepatitis B reported poor self-management activities for the score indexes of symptom management (57.36%), lifestyle management (54.89%), psychosocial coping (54.84%) and disease information management (53.11%) were all below 60%. Self-efficacy, objective support, subjective support, gender, education level and marital status showed significant effect on self-management activities. CONCLUSION Rural patients with chronic hepatitis B were found to perform insufficient self-management activities. Self-efficacy, social support, gender, education level and marital status were identified to influence their self-management activities. RELEVANCE TO CLINICAL PRACTICE Self-management activities should be promoted among rural patients with chronic hepatitis B. The factors that were identified in this study should be addressed when developing interventions to promote the performance of self-management activities for rural patients with chronic hepatitis B.
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Affiliation(s)
- Ling-Na Kong
- School of Nursing, Chongqing Medical University, Chongqing, PR China.,School of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Shan He
- School of Nursing, Chongqing Medical University, Chongqing, PR China
| | - Lin Li
- Department of liver disease, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, PR China
| | - Qing-Song Lei
- Department of infectious disease, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Tian Wang
- Department of infectious disease, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Yu Yao
- School of Nursing, Chongqing Medical and Pharmaceutical College, Chongqing, PR China
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García-Goñi M. Specializing Nurses as An Indirect Education Program for Stoma Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2272. [PMID: 31252585 PMCID: PMC6651232 DOI: 10.3390/ijerph16132272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/21/2019] [Accepted: 06/23/2019] [Indexed: 11/29/2022]
Abstract
Education programs are beneficial for patients with different chronic conditions. Prior studies have examined direct education, where information is transferred directly to patients. In contrast, in this program, information is transferred directly to nurses who become specialists and transfer education individually to patients. Hence, this paper evaluates the impact of having specialist nurses for stoma patients at hospitals, as those nurses provide healthcare to patients but also inform and educate patients about their condition and needs. The analysis uses an observational study with ostomized patients in Spain at hospitals with and without specialist nurses, and measures health service utilization and health-related quality of life (HRQL), besides performing a cost analysis and a cost-effectiveness analysis at both types of hospitals. The results show that patients with access to specialist nurses self-manage better, present lower adverse events and a better evolution of HRQL, and significantly demand more consultations with specialist nurses and less to A&E, primary care or specialists, resulting in important savings for the health system. Consequently, specializing or hiring nurses to provide indirect education to stoma patients is cost-effective and highly beneficial for patients. This type of indirect education strategy might be considered for specific conditions with low incidence or difficulties in identifying target patients or delivering information directly to them.
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Affiliation(s)
- Manuel García-Goñi
- Department of Applied & Structural Economics and History, Universidad Complutense de Madrid, Campus de Somosaguas, 28223 Pozuelo de Alarcón, Madrid, Spain.
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Self-management and health related quality of life in persons with chronic obstructive pulmonary disease. Qual Life Res 2019; 28:2889-2899. [DOI: 10.1007/s11136-019-02231-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2019] [Indexed: 12/20/2022]
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Amtmann D, Bamer AM, Nery-Hurwit MB, Liljenquist KS, Yorkston K. Factors associated with disease self-efficacy in individuals aging with a disability. PSYCHOL HEALTH MED 2019; 24:1171-1181. [PMID: 31033342 DOI: 10.1080/13548506.2019.1612082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Self-management of a disability consists of treatment adherence, obtaining information about the disease and treatment options, caring for oneself, participating in decisions, and maintaining social relationships and emotional balance. Understanding and measuring an individual's beliefs about their ability to successfully self-manage and live well with a disability allows researchers and clinicians to better target interventions aimed at increasing disability management self-efficacy (DMSE). The purpose of this study was to examine the associations between demographic and clinical indicators, and self-efficacy for DMSE in individuals with chronic physical conditions. Adults (N = 815) with muscular dystrophy, multiple sclerosis, spinal cord injury, or post-polio syndrome completed a self-report mailed survey assessing DMSE, perceived social support, depression symptoms, resilience, fatigue, pain interference, satisfaction with participation in social roles, physical function, and demographics. A cross-sectional regression model was used to examine the associations between the clinical and demographic factors, and DMSE. The model explained 67% of the variance in DMSE. Satisfaction with participation in social roles, resilience, pain interference, social support, and fatigue were statistically significant. Better social functioning, more resilience, and less pain and fatigue were most strongly associated with DMSE. Interventions aimed at increasing DMSE should include strategies for improving social participation.
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Affiliation(s)
- Dagmar Amtmann
- Department of Rehabilitation Medicine, University of Washington , Seattle , WA , USA
| | - Alyssa M Bamer
- Department of Rehabilitation Medicine, University of Washington , Seattle , WA , USA
| | - Mara B Nery-Hurwit
- Department of Rehabilitation Medicine, University of Washington , Seattle , WA , USA
| | - Kendra S Liljenquist
- Department of Rehabilitation Medicine, University of Washington , Seattle , WA , USA
| | - Kathryn Yorkston
- Department of Rehabilitation Medicine, University of Washington , Seattle , WA , USA
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15
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Liu HY, Tsai WC, Chiu MJ, Tang LY, Lee HJ, Shyu YIL. Mild cognitive impairment in combination with comorbid diabetes mellitus and hypertension is negatively associated with health-related quality of life among older persons in Taiwan. Qual Life Res 2019; 28:1281-1291. [PMID: 30635850 DOI: 10.1007/s11136-019-02101-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE To fill the gap in knowledge about associations of health-related quality of life (HRQoL) with comorbid diabetes mellitus (DM), hypertension (HTN), and/or mild cognitive impairment (MCI) in the elderly, we explored associations of comorbid DM, HTN, and/or MCI with HRQoL. METHODS Data for this study were from a population-based cross-sectional survey of elderly Taiwanese (≥ 65 years old). Participants (N = 4,634; 47.9% male) were categorized into eight chronic-illness groups: DM only (n = 224); HTN only (n = 1226); DM and HTN (n = 365); MCI only (n = 497); DM and MCI (n = 58); HTN and MCI (n = 303); DM, HTN, and MCI (n = 101); and none (healthy; n = 1860). Associations were examined between the eight chronic-illness groups and HRQoL (measured by EQ-5D scores) using binary logistic regression analyses and generalized linear models adjusted for covariates. Index scores were calculated from EQ-5D scores using Taiwan's general population-preference weights. RESULTS Compared to the healthy group, after adjusting covariates, MCI alone or with other comorbidities was significantly, negatively associated with HRQoL. Among all chronic-illness groups, comorbid DM, HTN, and MCI exhibited the lowest HRQoL. After adjusting covariates, between-group odds ratios for index scores were significant when comparing comorbid DM and MCI to DM only, comparing comorbid HTN and MCI to HTN only and comorbid DM, comparing HTN and MCI to comorbid DM and HTN, suggesting that MCI additively affects HRQoL. CONCLUSIONS HRQoL of older Taiwanese adults was negatively associated with having MCI. Thus, clinicians managing older persons with chronic illnesses should assess their cognitive function to identify high-risk groups needing HRQoL assistance.
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Affiliation(s)
- Hsin-Yun Liu
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Wen-Che Tsai
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Jang Chiu
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
- College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Psychology, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Biomedical Engineering and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Li-Yu Tang
- Taiwan Alzheimer's Disease Association, Taipei, Taiwan
| | - Huey-Jane Lee
- Taiwan Alzheimer's Disease Association, Taipei, Taiwan
| | - Yea-Ing L Shyu
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
- School of Nursing, College of Medicine, Chang Gung University, 259 Wenhua 1st Road, Guishan District, Taoyuan, 33302, Taiwan.
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
- Department of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
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16
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Testing the relationship between a self-management intervention for recurrent depression and health outcomes. Appl Nurs Res 2018; 44:76-81. [DOI: 10.1016/j.apnr.2018.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 10/01/2018] [Accepted: 10/03/2018] [Indexed: 11/19/2022]
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17
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Abbasi A, Ghezeljeh TN, Farahani MA. Effect of the self-management education program on the quality of life in people with chronic heart failure: a randomized controlled trial. Electron Physician 2018; 10:7028-7037. [PMID: 30128093 PMCID: PMC6092147 DOI: 10.19082/7028] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 05/12/2018] [Indexed: 02/03/2023] Open
Abstract
Background Chronic Heart Failure (CHF) is a syndrome that negatively affects a person's Quality of Life (QOL). The efficient self-management education program increases the individual's abilities and skills for following and participating in a long-term healthcare plan. Objective The aim of this study was to determine the effect of the self-management education program on QOL in people with CHF. Methods This randomized controlled trial study was conducted on 60 people with CHF and without sensory-cognitive problem from April-August 2015. They were selected using the convenience sampling method, and were randomly assigned into the intervention and control groups. The control group received the routine education presented to participants at discharge. However, besides the routine education, the intervention group received the self-management education program consisting of three sessions followed for a 3-month period. The Iranian heart failure QOL questionnaire was used for data collection before and after the intervention. The independent-samples and paired-samples t-tests, Chi-square and Fisher exact tests were used for data analysis via the SPSS v.16 software. P<0.05 was considered statistically significant. Results No statistically significant differences were reported between the groups in terms of demographic and clinical characteristics, indicating that they were homogeneous. A statistically significant difference was reported between the two groups after the intervention in terms of the mean changes of total QOL (p<0.001) and its dimensions, including symptoms (p=0.002), social interference (p=0.01), psychological condition (p=0.013), and self-efficacy and knowledge (p<0.001). In addition, an improvement was observed in the total QOL in the intervention group after the education (p<0.001). Conclusions According to the results of this study, the self-management education program can be considered an appropriate strategy for improving the QOL in people suffering from CHF by health care providers. Trial registration The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the IRCT ID: IRCT2015032021521N1. Funding The authors received financial support for the research, authorship, and/or publication of this article from Iran University of Medical Sciences (No: 107/105/94/D, date April 11, 2015).
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Affiliation(s)
- Alireza Abbasi
- MSc of Medical-Surgical Nursing, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Tahereh Najafi Ghezeljeh
- PhD, Associate Professor, Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Critical Care Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Mansoureh Ashghali Farahani
- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran.,PhD, Associate Professor, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
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Hagerty BM, Bathish MA, Kuchman E. Development and testing of a self-regulation model for recurrent depression. J Health Psychol 2018; 25:1732-1742. [PMID: 29722280 DOI: 10.1177/1359105318772083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Self-regulation is a strategy for self-management of depression. Study aims were to (1) describe development of an intervention based on metacognition and self-regulation, (2) test intervention feasibility and utility, and (3) determine its effectiveness in reducing depressive symptoms. The Self-Regulated Illness Management of Depression intervention was developed and taught to 22 participants with recurrent depression. There was no attrition 6 months post intervention. At 6 months, there was a significant decrease in depressive symptoms (M = 10.21, standard deviation = 8.0), t(18) = 5.60, p < .001, and 73 percent of participants used Self-Regulated Illness Management of Depression frequently. Results indicated that Self-Regulated Illness Management of Depression was feasible and useful.
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Jespersen LN, Michelsen SI, Tjørnhøj-Thomsen T, Svensson MK, Holstein BE, Due P. Living with a disability: a qualitative study of associations between social relations, social participation and quality of life. Disabil Rehabil 2018; 41:1275-1286. [PMID: 29357697 DOI: 10.1080/09638288.2018.1424949] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE We explored which shared aspects of social relations were considered important to the quality of life of persons between the ages of 10 and 40 years living with a disability. We examined how social relations were experienced as affecting quality of life and social participation. MATERIALS AND METHODS Fifteen focus groups involving 48 persons with disabilities were conducted using photo elicitation, preference ranking and props. Focus group interviews were supplemented with seven individual interviews with individuals unable to participate in focus groups. All focus group interviews and individual interviews were audiotaped, transcribed, and thematic data analysis was conducted. RESULTS We identified caregiving, dependency, and understanding as essential for quality of life. Acceptance from society, discrimination and prejudice, and the ability to participate in society were also highlighted as affecting quality of life. The use of social tactics to avoid confrontation with certain aspects of their disability was common among participants. CONCLUSIONS Across disabilities, caregiving, dependency, understanding and acceptance, and discrimination and prejudice were all important aspects for the quality of life of the individuals. Social relations were closely related to social participation, and the latter affected the quality of life of the participants. Social tactics were used to navigate social relations. Implications for rehabilitation We suggest to formalize the concept of social tactics and use it in patient education to enhance quality of life in individuals living with disabilities. People may accept and learn to cope with the impact of their disability, but how they maintain their social participation and social relations also impact on their quality of life. In their assessment, professionals working with individuals with disabilities should, therefore, give more priority to analyze the impact of social relations. When intervening, an effort to establish and maintain social relations should be considered along with psychological help, allocation of aids and economical support aiming to enhance quality of life and social participation among individuals with disabilities. When evaluating efforts to improve quality of life, it is important to investigate whether the intervention has improved the social relations.
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Affiliation(s)
- Louise Norman Jespersen
- a National Institute of Public Health , University of Southern Denmark , Copenhagen , Denmark
| | - Susan Ishøy Michelsen
- a National Institute of Public Health , University of Southern Denmark , Copenhagen , Denmark
| | - Tine Tjørnhøj-Thomsen
- a National Institute of Public Health , University of Southern Denmark , Copenhagen , Denmark
| | | | - Bjørn Evald Holstein
- a National Institute of Public Health , University of Southern Denmark , Copenhagen , Denmark
| | - Pernille Due
- a National Institute of Public Health , University of Southern Denmark , Copenhagen , Denmark
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Taype-Rondan A, Abbs ES, Lazo-Porras M, Checkley W, Gilman RH, Smeeth L, Miranda JJ, Bernabe-Ortiz A. Association between chronic conditions and health-related quality of life: differences by level of urbanization in Peru. Qual Life Res 2017; 26:3439-3447. [PMID: 28712003 PMCID: PMC5681970 DOI: 10.1007/s11136-017-1649-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2017] [Indexed: 11/30/2022]
Abstract
Purpose To evaluate the role of urbanization as an effect modifier for the association between specific chronic conditions and number of conditions with health-related quality of life (QOL). Methods We analyzed cross-sectional data from the CRONICAS Cohort Study conducted in Lima (highly urbanized), Tumbes (semi-urban), as well as rural and urban sites in Puno. Exposures of interest were chronic bronchitis, depressive mood, hypertension, type 2 diabetes, and a composite variable aggregating the number of chronic conditions (the four exposures plus heart disease and stroke). QOL outcomes were assessed with EuroQol’s EQ-5D visual analogue scale (EQ-VAS). We fitted linear regressions with robust variance to evaluate the associations of interest. Study site was assessed as a potential effect modifier using the likelihood-ratio (LR) test. Results We evaluated data on 2433 subjects: 51.3% were female, mean age was 57.2 years. Study site was found to be an effect modifier only for the association between depressive mood and EQ-VAS score (LR test p < 0.001). Compared to those without depressive mood, participants with depressive mood scored −13.7 points on the EQ-VAS in Lima, −7.9 in urban Puno, −11.0 in semi-urban Tumbes, and −2.7 in rural Puno. Study site was not found to be an effect modifier for the association between the number of chronic conditions and EQ-VAS (LR test p = 0.64). Conclusion The impact of depressive mood on EQ-VAS was larger in urban than in rural sites, while site was not an effect modifier for the remaining associations. Electronic supplementary material The online version of this article (doi:10.1007/s11136-017-1649-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alvaro Taype-Rondan
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Armendáriz 497, Miraflores, 18, Lima, Peru
| | - Elizabeth Sarah Abbs
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Armendáriz 497, Miraflores, 18, Lima, Peru.,School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Maria Lazo-Porras
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Armendáriz 497, Miraflores, 18, Lima, Peru
| | - William Checkley
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Armendáriz 497, Miraflores, 18, Lima, Peru.,Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Robert H Gilman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Liam Smeeth
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Armendáriz 497, Miraflores, 18, Lima, Peru
| | - Antonio Bernabe-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Armendáriz 497, Miraflores, 18, Lima, Peru. .,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
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Abstract
Zusammenfassung
Chronisch Kranke benötigen Kompetenzen, die sie dazu befähigen, möglichst selbstbestimmt mit ihrer Erkrankung umzugehen (Selbstmanagement). Solche Kompetenzen können durch Patientenschulungen vermittelt werden (Empowerment). Kontrollierte Studien konnten Effekte innovativer, interaktiver Schulungsprogramme auf Gesundheitskompetenz und Selbstmanagement-Outcomes nachweisen. Außerdem zeigte sich, dass Verbesserungen der Gesundheitskompetenz Verbesserungen der Lebensqualität mit sich bringen.
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Affiliation(s)
- Hermann Faller
- Universität Würzburg, Abteilung für Medizinische Psychologie, Medizinische Soziologie und Rehabilitationswissenschaften , Klinikstraße 3, 97070 Würzburg , Germany
| | - Karin Meng
- Universität Würzburg, Abteilung für Medizinische Psychologie, Medizinische Soziologie und Rehabilitationswissenschaften , Würzburg , Germany
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Musekamp G, Schuler M, Seekatz B, Bengel J, Faller H, Meng K. Does improvement in self-management skills predict improvement in quality of life and depressive symptoms? A prospective study in patients with heart failure up to one year after self-management education. BMC Cardiovasc Disord 2017; 17:51. [PMID: 28196523 PMCID: PMC5309929 DOI: 10.1186/s12872-017-0486-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 01/27/2017] [Indexed: 01/07/2023] Open
Abstract
Background Heart failure (HF) patient education aims to foster patients’ self-management skills. These are assumed to bring about, in turn, improvements in distal outcomes such as quality of life. The purpose of this study was to test the hypothesis that change in self-reported self-management skills observed after participation in self-management education predicts changes in physical and mental quality of life and depressive symptoms up to one year thereafter. Methods The sample comprised 342 patients with chronic heart failure, treated in inpatient rehabilitation clinics, who received a heart failure self-management education program. Latent change modelling was used to analyze relationships between both short-term (during inpatient rehabilitation) and intermediate-term (after six months) changes in self-reported self-management skills and both intermediate-term and long-term (after twelve months) changes in physical and mental quality of life and depressive symptoms. Results Short-term changes in self-reported self-management skills predicted intermediate-term changes in mental quality of life and long-term changes in physical quality of life. Intermediate-term changes in self-reported self-management skills predicted long-term changes in all outcomes. Conclusions These findings support the assumption that improvements in self-management skills may foster improvements in distal outcomes.
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Affiliation(s)
- Gunda Musekamp
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Klinikstr. 3, D-97070, Würzburg, Germany.
| | - Michael Schuler
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Klinikstr. 3, D-97070, Würzburg, Germany
| | - Bettina Seekatz
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Klinikstr. 3, D-97070, Würzburg, Germany
| | - Jürgen Bengel
- Institute of Psychology, Department of Rehabilitation Psychology and Psychotherapy, University of Freiburg, Engelbergerstraße 41, D-79085, Freiburg, Germany
| | - Hermann Faller
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Klinikstr. 3, D-97070, Würzburg, Germany
| | - Karin Meng
- Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Klinikstr. 3, D-97070, Würzburg, Germany
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Reusch A, Musekamp G, Küffner R, Dorn M, Braun J, Ehlebracht-König I. Wirksamkeitsprüfung rheumatologischer Schulungen. Z Rheumatol 2016; 76:613-621. [DOI: 10.1007/s00393-016-0120-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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