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Soleimani N, Ebrahimi F, Mirzaei M. Self-management education for hypertension, diabetes, and dyslipidemia as major risk factors for cardiovascular disease: Insights from stakeholders' experiences and expectations. PLoS One 2024; 19:e0310961. [PMID: 39325734 PMCID: PMC11426497 DOI: 10.1371/journal.pone.0310961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 09/10/2024] [Indexed: 09/28/2024] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is a leading cause of premature death, with hypertension, diabetes, and dyslipidemia as major risk factors. Effective self-management (SM) is crucial for controlling these conditions and improving quality of life. This study examines stakeholders' experiences and expectations of SM education to enhance program development. METHODS This study employed a qualitative grounded theory approach to explore the perspectives of three stakeholder groups: 19 patients with hypertension, type 2 diabetes, and dyslipidemia, 11 primary healthcare providers, and five provincial health policymakers and managers. Data were collected via semi-structured patient interviews and focus group discussions(FGDs) with health professionals. Coding and analysis were conducted separately using Corbin and Strauss principles with ATLAS. ti version 9.0 software. RESULTS Most patients were women (68%) aged 50-60 years (37%), with education levels from illiterate to master's degree; 32% had completed primary school. Most were housewives (52%), and 12 had multiple chronic diseases. Healthcare providers included six community health workers and five primary care physicians, with average experience of 12 and 19 years, respectively. Health policymakers and managers averaged 25 years of experience. Patient interviews and FGDs resulted in 12 and 13 subthemes, respectively, with five subthemes common to both sources. These subthemes were grouped into broader main themes, including "effective content design," "effective presentation and delivery," "characteristics and conditions of involved parties," and "educational needs," collectively reflect the central concept of "effective self-management education". CONCLUSION Although the core concept and its main themes were evident and consistent across stakeholder groups, significant variations in subthemes from each stakeholder emerged. This underscores the importance of considering diverse viewpoints and highlights that, while overarching concepts may seem uniform, exploring the details of stakeholder perspectives is crucial for understanding their nuanced opinions. Effective education should integrate these insights, focusing on tailored communication, interactivity, and active monitoring.
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Affiliation(s)
- Nazanin Soleimani
- Cardiovascular Research Institute, Cardiac Rehabilitation Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Ebrahimi
- School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Masoud Mirzaei
- Non-Communicable Diseases Research Institute, Yazd Cardiovascular Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Montpetit-Tourangeau K, McGlashan B, Dyer JO, Rochette A. Patient education for the management of subacromial pain syndrome: A scoping review. PATIENT EDUCATION AND COUNSELING 2024; 130:108453. [PMID: 39368437 DOI: 10.1016/j.pec.2024.108453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 09/09/2024] [Accepted: 09/17/2024] [Indexed: 10/07/2024]
Abstract
OBJECTIVE To identify the extent of the literature on patient education for subacromial pain syndrome (SAPS). METHODS A scoping review was conducted in accordance with PRISMA-ScR standards. Nine databases were searched until November 2022 to identify articles describing patient education interventions for the management of SAPS. Interventions were extracted and described according to the Template for intervention description and replication (TIDieR) checklist and the core sets for shoulder-related health conditions of the International Classification of Functioning, Disability and Health (ICF). RESULTS Sixty studies of various designs met the inclusion criteria, including thirty RCTs. Patient education was a primary intervention in seven of the included RCTs. In most of the educational interventions identified in the included studies, the descriptions did not adequately cover a majority of the TIDieR's checklist items. Patient education content was often mentioned and covered most, but not all, of the ICF core sets for shoulder disorders. CONCLUSION Available data in current literature on patient education interventions for SAPS is scarce and lacks description. PRACTICE IMPLICATIONS This study presents the content elements of patient education for the management of SAPS that are described in the literature and that clinicians could consider when treating individuals with SAPS.
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Affiliation(s)
- Katherine Montpetit-Tourangeau
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Canada; Centre for Interdisciplinary Research in Rehabilitation, Montreal, Canada.
| | - Brittany McGlashan
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Canada.
| | - Joseph-Omer Dyer
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Canada; Interdisciplinary Research Group on Cognition and Professional Reasoning, Center for Applied Pedagogy in the Health Sciences, Faculty of Medicine, University of Montreal, Montreal, Canada.
| | - Annie Rochette
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Canada; Centre for Interdisciplinary Research in Rehabilitation, Montreal, Canada.
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Højen AA, Lindegaard SF, Grove EL, Hansen AL, Larsen TB, Kümler T, Johnsen SP, Rolving N. Development of A structured integrated post-Pulmonary Embolism care model: The Attend-PE model. J Thromb Haemost 2024:S1538-7836(24)00437-9. [PMID: 39122195 DOI: 10.1016/j.jtha.2024.06.027] [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: 03/14/2024] [Revised: 06/05/2024] [Accepted: 06/27/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND More than 50% of patients with pulmonary embolism (PE) experience persistent functional limitations. Despite guideline recommendations for a structured integrated care model for patients with PE, consensus on an optimal follow-up strategy is lacking, and evidence is insufficient. OBJECTIVES To describe the development of a structured model for PE follow-up using coproduction methods. METHODS Coproduction of A structured integrated postPulmonary Embolism care (Attend-PE) model was conducted from October 2021 to June 2022, featuring participatory design techniques. This was combined with a stepwise approach based on Intervention Mapping to ensure that the developed model was evidence-based and theoretically grounded. RESULTS Development of the Attend-PE model included 1) a needs assessment mapping follow-up at 18 sites treating PE in Denmark; 2) definition of the overall goal and performance objectives of the Attend-PE model, based on the needs assessment in combination with a literature review; 3) coproduction of the Attend-PE model in workshops with patient representatives, healthcare professionals, and experts in the field; and 4) refinement of the structure and organization of the Attend-PE model and production of the patient education material. The Attend-PE model outlines a structured approach for in-hospital follow-up, involving group-based patient education, individual consultations, and patient-reported outcomes to assess physical and psychological well-being. The model supports a personalized posthospitalization care plan. CONCLUSION The coproduction process was successful in developing a structured follow-up model aligned with patients' needs, health provider perspectives, and existing guidelines. The Attend-PE model is currently undergoing clinical evaluation to determine its effectiveness and usability.
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Affiliation(s)
- Anette Arbjerg Højen
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
| | - Stine Foged Lindegaard
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Erik Lerkevang Grove
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Annesofie Løvdahl Hansen
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | | | - Thomas Kümler
- Department of Cardiology, Herlev-Gentofte Hospital, Copenhagen, Denmark; Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Søren Paaske Johnsen
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Nanna Rolving
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark University Hospital, Aarhus, Denmark; Department of Public Health, Aarhus University, Aarhus, Denmark
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Skliarova T, Pedersen H, Holsbrekken Å, Pedersen SA, Mandal A, De Las Cuevas C, Havnen A, Gråwe R, Lara-Cabrera ML. Psychoeducational group interventions for adults diagnosed with attention-deficit/ hyperactivity disorder: a scoping review of feasibility, acceptability, and outcome measures. BMC Psychiatry 2024; 24:463. [PMID: 38902683 PMCID: PMC11191191 DOI: 10.1186/s12888-024-05908-8] [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: 02/03/2024] [Accepted: 06/13/2024] [Indexed: 06/22/2024] Open
Abstract
INTRODUCTION Although psychoeducational group interventions are increasingly used for adults diagnosed with attention-deficit/hyperactivity disorder (ADHD), a comprehensive review focused on the feasibility and acceptability indicators of these interventions remains lacking. Furthermore, although previous research has explored various aspects of psychoeducation for ADHD, such as its definition and approaches, limited research has focused on the synthesis for outcome measures and patients' experiences related to these interventions. Therefore, this scoping review aims to map the existing evidence reported on psychoeducational group interventions for adults diagnosed with ADHD. The objective is to provide a comprehensive overview of feasibility indicators, acceptability, and outcome measures used in psychoeducational group interventions. METHOD A comprehensive structured literature search on the topic was performed in seven bibliographic databases, and the resulting records were independently screened, and their data extracted by two reviewers. We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-S) to ensure the transparency and rigor of this scoping review. RESULTS The searches yielded 7510 records. Eight studies met the inclusion criteria. These included studies were conducted in European countries and the United States. Among these, six studies used a randomized control design, one an open feasibility trial, and one a pre-post intervention design. All the studies reported some feasibility and acceptability indicators. While all the studies reported on the severity of symptoms of ADHD as an outcome measure, some also reported on outcomes related to psychological or mental-health problems, quality of life, changes in knowledge regarding ADHD, or the level of self-esteem, functioning, and impairment. CONCLUSION This scoping review revealed that psychoeducational group interventions are generally acceptable for patients in terms of patient satisfaction with the group intervention. All included studies reported some feasibility indicators, with some reporting good attendance and relatively low dropout rates. Most studies reported positive effects on ADHD and mental health symptoms, suggesting that these interventions are beneficial for adults with ADHD. However, several gaps exist regarding the reporting on the feasibility indicators, acceptability, and outcome measures employed across studies.
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Affiliation(s)
- Tatiana Skliarova
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Henrik Pedersen
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Division of Psychiatry, Nidaros Community Mental Health Center, St. Olavs University Hospital, Trondheim, Norway
| | - Åshild Holsbrekken
- Division of Psychiatry, Nidaros Community Mental Health Center, St. Olavs University Hospital, Trondheim, Norway
| | - Sindre Andre Pedersen
- Library Section for Research Support, Data and Analysis, NTNU University Library, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Arthur Mandal
- Vårres Regional User-Led Center Mid-Norway, Trondheim, Norway
| | - Carlos De Las Cuevas
- Department of Internal Medicine, Dermatology and Psychiatry, School of Medicine, University of La Laguna, San Cristóbal de La Laguna, Canary Islands, Spain
| | - Audun Havnen
- Library Section for Research Support, Data and Analysis, NTNU University Library, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Rolf Gråwe
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Mental Healthcare, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Mariela Loreto Lara-Cabrera
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Mental Healthcare, Nidelv Community Mental Health Center, St. Olavs University Hospital, Trondheim, Norway
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Bailey C, Agrawal N, Cope S, Proctor B, Mildon B, Butler M, Holt K, Edwards M, Poole N, Nicholson TR. Illness perceptions, experiences of stigma and engagement in functional neurological disorder (FND): exploring the role of multidisciplinary group education sessions. BMJ Neurol Open 2024; 6:e000633. [PMID: 38860228 PMCID: PMC11163674 DOI: 10.1136/bmjno-2024-000633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/21/2024] [Indexed: 06/12/2024] Open
Abstract
Background A critical first step in managing functional neurological disorder (FND) is a positive diagnosis and clear explanation using an understandable illness model. Multidisciplinary group education sessions are one way to achieve this, with some evidence they improve understanding, confidence in diagnosis and outcomes with further treatment. In many conditions, illness perceptions and stigma affect distress, functioning, quality of life and engagement. Exploring relationships between these factors could lead to deeper understanding of the impact of education. Methods Questionnaires assessing illness perceptions, quality of life, mood, anxiety, comorbidities, treatment engagement and stigma (both experienced and anticipated) were completed before, immediately and 1 month after a multidisciplinary online group education session for FND at a regional neurosciences centre. Free-text data on causal attributions and needs were also collected. Results 166 patients attended online education sessions from January 2022 to July 2023; 61 (37%) completed presession surveys, 42 (25%) completed postsession and 35 (21%) completed 1 month postsession surveys. Patients reported multiple comorbidities, poor quality of life, functioning and high levels of stigma. Illness perception scores indicated FND as threatening, mysterious and unpredictable, with low personal or treatment control over symptoms. Illness coherence/understanding (mean difference 2.27, p<0.01, 95% CI 1.22 to 4.23) and engagement (mean difference 2.42, p<0.01, 95% CI 0.46 to 4.36) increased after the session. There were no significant changes in stigma, distress, sense of control or anticipated discrimination. Free-text analysis revealed stress and trauma as the most common causal attributions, followed by physical illnesses. Patients requested personalised formulations, practical disability advice, help with explaining the condition to others (eg, employers), peer support and treatment. Conclusion Multidisciplinary group FND education sessions potentially improve patient understanding and engagement. Clinicians should consider the possible benefits of personalised formulations and linking to practical and peer support. Further work assessing illness perceptions is needed, such as adapting measures for FND.
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Affiliation(s)
- Cate Bailey
- Neuropsychiatry Research and Education Group, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, UK
- East London NHS Foundation Trust, London, UK
| | - Niruj Agrawal
- Neuropsychiatry Service, South West London and St George's Mental Health NHS Trust, London, UK
- Atkinson Morley Regional Neurosciences Centre, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Sarah Cope
- Neuropsychiatry Service, South West London and St George's Mental Health NHS Trust, London, UK
| | - Barnaby Proctor
- Neuropsychiatry Service, South West London and St George's Mental Health NHS Trust, London, UK
| | | | - Matt Butler
- Neuropsychiatry Research and Education Group, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, UK
| | - Kate Holt
- Atkinson Morley Regional Neurosciences Centre, St George's University Hospitals NHS Foundation Trust, London, UK
- Wolfson Neurorehabilitation Centre, Queen Mary's Hospital, London, UK
| | - Mark Edwards
- Neuropsychiatry Research and Education Group, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, UK
| | - Norman Poole
- Neuropsychiatry Research and Education Group, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, UK
- The Lishman Unit (Brain Injury and Functional Neurology), South London and Maudsley NHS Foundation Trust, London, UK
| | - Timothy R Nicholson
- Neuropsychiatry Research and Education Group, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, UK
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Brunner K, Weisschuh L, Jobst S, Kugler C, Rebafka A. Defining Self-Management for Solid Organ Transplantation Recipients: A Mixed Method Study. NURSING REPORTS 2024; 14:961-987. [PMID: 38651485 PMCID: PMC11036239 DOI: 10.3390/nursrep14020073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/15/2024] [Accepted: 03/29/2024] [Indexed: 04/25/2024] Open
Abstract
Patients with Solid Organ Transplantations (SOTx) face long-term lifestyle adaptations, psychological and social adjustments, and complex self-care regimes to maintain health post-transplant. Self-management (SM) skills represent important aspects of nursing communication with SOTx patients; however, there is potential for SM to be defined narrowly in terms of medication adherence. The study presented here collated the existing definitions in a mixed method review in order to identify SM attributes for this group (including those unique to this population). Secondary analysis of a dataset and bibliographic analysis and an expert panel were used to develop a comprehensive working definition of SOTx patients. The analysis comprised critical interpretation of the evolving definition content, concepts, and contexts of application in current usages and over time. We identified eight definitions and 63 cited definition sources from bibliographic analysis. Findings identified limitations of the existing definitions. Population-specific attributes included optimisation of transplant outcomes, active engagement in healthy behaviours, control, structure, and discipline characteristics, and moderating factors of patient motivation, self-efficacy, and cognitive function. A critical appraisal of definitions indicated inadequately defined aspects such as setting, temporal dimension, concept interaction, interventions, and measurable outcomes. The bibliographic analysis highlighted the influence of broader chronic illness constructions of SM, underpinning the generalisable SM attributes in current definitions. Further research may advance the development of a definition in exploring the relevance of SOTx-specific attributes of the definition.
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Affiliation(s)
| | | | | | | | - Anne Rebafka
- Institute of Nursing Science, University Medical Centre, Albert-Ludwigs University Freiburg, Breisacher Straße 153, 79110 Freiburg, Germany (S.J.); (C.K.)
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Van den Wyngaert I, Van Pottelbergh G, Coteur K, Vaes B, Van den Bulck S. Developing a questionnaire to evaluate an automated audit & feedback intervention: a Rand-modified Delphi method. BMC Health Serv Res 2024; 24:433. [PMID: 38581009 PMCID: PMC10998400 DOI: 10.1186/s12913-024-10915-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 03/27/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Audit and feedback (A&F) is a widely used implementation strategy to evaluate and improve medical practice. The optimal design of an A&F system is uncertain and structured process evaluations are currently lacking. This study aimed to develop and validate a questionnaire to evaluate the use of automated A&F systems. METHODS Based on the Clinical Performance Feedback Intervention Theory (CP-FIT) and the REFLECT-52 (REassessing audit & Feedback interventions: a tooL for Evaluating Compliance with suggested besT practices) evaluation tool a questionnaire was designed for the purpose of evaluating automated A&F systems. A Rand-modified Delphi method was used to develop the process evaluation and obtain validation. Fourteen experts from different domains in primary care consented to participate and individually scored the questions on a 9-point Likert scale. Afterwards, the questions were discussed in a consensus meeting. After approval, the final questionnaire was compiled. RESULTS A 34-question questionnaire composed of 57 items was developed and presented to the expert panel. The consensus meeting resulted in a selection of 31 questions, subdivided into 43 items. A final list of 30 questions consisting of 42 items was obtained. CONCLUSION A questionnaire consisting of 30 questions was drawn up for the assessment and improvement of automated A&F systems, based on CP-FIT and REFLECT-52 theory and approved by experts. Next steps will be piloting and implementation of the questionnaire.
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Affiliation(s)
- Ine Van den Wyngaert
- Academic Centre for General Practice, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium.
| | - Gijs Van Pottelbergh
- Academic Centre for General Practice, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
| | - Kristien Coteur
- Academic Centre for General Practice, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
| | - Bert Vaes
- Academic Centre for General Practice, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
| | - Steve Van den Bulck
- Academic Centre for General Practice, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium
- Research Group Healthcare and Ethics, Faculty of Medicine and Life Sciences, UHasselt, Diepenbeek, Belgium
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Ricci L, Minary L, Kivits J, Ayav C, Rat AC. Use of qualitative methods to optimize collaborative practices by highlighting differences in perceptions between professionals: an example of patient education. J Interprof Care 2024; 38:264-272. [PMID: 38375794 DOI: 10.1080/13561820.2023.2289509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 11/27/2023] [Indexed: 02/21/2024]
Abstract
Interprofessional working must be approached within health promotion interventions using systematic methods to identify areas of suboptimal collaboration. We designed a qualitative study with a purposive sample of seven French therapeutic patient education programs. Semi-structured individual interviews were conducted with 14 healthcare providers and seven clinician leaders (coordinators) involved in patient education. We used the same interview guide and thematic grid regardless of the professional's profile to compare their perceptions on elements affecting outcome, participation and sustainability of programs. Healthcare providers and coordinators addressed non-convergent issues at both ends of a continuum from a micro-level nested in the program delivery to a macro-level corresponding to the structured implementation and sustainability of the program. Meso-level issues featured convergent perspectives. Our methodology could be used at the level of health services in a health system to provide a complete recovery of stakeholders' perspectives (without "blind spots" from one stakeholder or another). In our study, we focused on patient education in the French health system and pointed out possible considerations to optimize the functioning of programs. Such considerations include specific training plan development, encouraging reflection on the content and use of initial assessment, leading sessions in pairs to save on work time, and communication on the ins and outs of organizational imperatives that require healthcare providers' contributions.
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Affiliation(s)
- Laetitia Ricci
- Epidémiologie Clinique, CHRU-Nancy, INSERM, Université de Lorraine, CIC, Nancy, France
- Université de Lorraine, Inserm, INSPIIRE, Nancy, France
| | | | - Joëlle Kivits
- APEMAC, équipe MICS, Université de Lorraine, Nancy, France
| | - Carole Ayav
- Epidémiologie Clinique, CHRU-Nancy, INSERM, Université de Lorraine, CIC, Nancy, France
| | - Anne-Christine Rat
- APEMAC, équipe MICS, Université de Lorraine, Nancy, France
- UMR-S 1075-Mobilités: Vieillissement, Pathologie, Santé COMETE, Caen, France, Rheumatology Department, CHU Caen, Caen Normandie University, Caen, France
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Hoel AT, Teig CJ, Lindam A, Øresland T, Bjørnland K. Evaluation of a Group-based Patient Education Program Promoting Self-management in Adults with Hirschsprung Disease and Anorectal Malformations. J Pediatr Surg 2023; 58:2332-2336. [PMID: 37455172 DOI: 10.1016/j.jpedsurg.2023.06.015] [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: 04/10/2023] [Revised: 06/13/2023] [Accepted: 06/25/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Adults with Hirschsprung disease (HD) and anorectal malformations (ARM) may experience persisting and new somatic and psychosocial problems. Patient education programs (PEPs) may improve self-management in patients with chronic illnesses. The aim of this study was to explore HD and ARM adults' experiences with and evaluation of a group-based PEP. We also looked at factors that might influence the attendance rate. METHOD Non-intellectually impaired HD and ARM adults were invited to attend a diagnosis specific PEP at a pelvic floor interdisciplinary center. Eight health care professionals lectured. Aspects of the PEP were graded anonymously in a patient reported experience measure (PREM). Ethical approval was obtained. RESULTS 17% (21/125) of invited adults (10HD, 11ARM) attended four PEPs. 19/21 (90%) PREMs were returned. Participants found meeting peers and sharing experiences especially valuable in addition to improved disease knowledge. Lectures by the pediatric and colorectal surgeons, stoma nurse, and sexologist were rated highest by the participants. The majority reported that the PEP would be helpful in managing everyday life. All participants recommended PEP in adolescence. Factors such as gender and travel distance did not affect attendance rate, but participants were older than non-participants, median 37 versus 24 years (p = 0.01). CONCLUSION Attendance rates were low among HD and ARM adults invited to a PEP, but participants were overall highly satisfied. Peer support, mutual learning, and increased disease knowledge were seen as invaluable assets of the PEP. A web-based PEP was discouraged, while physical PEPs for both adults and adolescents were encouraged. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Anders Telle Hoel
- Department of Pediatric Surgery, Oslo University Hospital, Oslo, Norway; University of Oslo, Institute of Clinical Medicine, Oslo, Norway.
| | - Catherine Joyce Teig
- The Pelvic Floor Center, Division of Surgery, Akershus University Hospital, Oslo, Norway
| | - Anita Lindam
- The Pelvic Floor Center, Division of Surgery, Akershus University Hospital, Oslo, Norway
| | - Tom Øresland
- University of Oslo, Institute of Clinical Medicine, Oslo, Norway; The Pelvic Floor Center, Division of Surgery, Akershus University Hospital, Oslo, Norway
| | - Kristin Bjørnland
- Department of Pediatric Surgery, Oslo University Hospital, Oslo, Norway; University of Oslo, Institute of Clinical Medicine, Oslo, Norway
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Kessler D, McCutcheon T, Rajachandrakumar R, Lees J, Deyell T, Levy M, Liddy C. Understanding barriers to participation in group chronic disease self-management (CDSM) programs: A scoping review. PATIENT EDUCATION AND COUNSELING 2023; 115:107885. [PMID: 37473604 DOI: 10.1016/j.pec.2023.107885] [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: 05/17/2022] [Revised: 06/13/2023] [Accepted: 07/06/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE To identify factors that influence enrollment in and attendance of chronic disease self-management (CDSM) group programs. METHODS A scoping review of peer-reviewed publications that reported on factors of enrollment or attendance in group CDSM programs for adults with any type of chronic condition. Screening was completed by two reviewers and data extraction was checked for accuracy. Data were summarized and key themes were identified in collaboration with the study team. RESULTS Following screening, 52 of 2774 articles were included. Attendance rates that varied from 10.4-98.5% (mean =72.5%). There is considerable overlap between enrollment and attendance factors. These included Competing Commitments, Logistics, Personal characteristics, Perception of illness/health status, Health service provision, and Group dynamics. CONCLUSIONS Varied and individualized factors can facilitate or impede enrollment or attendance in group CDSM programs. Consideration of these factors and tailoring of programs is needed to facilitate patient ability to take part. Participatory co-design is a growing approach to ensure programs meet individual and community needs. More research is needed to identify the specific impact of using codesign on enrollment and attendance in group CDSM programs. PRACTICE IMPLICATIONS Including community members and service users in design and implementation may enhance CDSM program access.
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Affiliation(s)
- Dorothy Kessler
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada.
| | - Tess McCutcheon
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Canada; Department of Family Medicine, University of Ottawa, Ottawa, Canada
| | | | - Jodie Lees
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Tracy Deyell
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Canada
| | - Marisa Levy
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Clare Liddy
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Canada; Department of Family Medicine, University of Ottawa, Ottawa, Canada
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Ricci L, Buzzi M, Kivits J, Rat AC. Patient Satisfaction and Perspectives on Self-Management Education Programs: A Qualitative Study. Patient Prefer Adherence 2023; 17:2175-2186. [PMID: 37675388 PMCID: PMC10478927 DOI: 10.2147/ppa.s414126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/28/2023] [Indexed: 09/08/2023] Open
Abstract
Purpose According to the Centre for Disease Control and Prevention, "Self-management education (SME) refers to programs that help people who have ongoing health conditions learn how to live life to the fullest". Most studies to date have focused on SME outcomes, such as the acquisition of predefined knowledge or skills or quality of life. However, no study has yet investigated patients' satisfaction with SMEs. The aim of the present study was therefore to explore participants' subjective appreciation of SME programs using qualitative methods and formulate propositions based on patients' preferences to improve ultimately clinical outcomes. Patients and Methods Twenty-five participants from five French SME programs to conduct focus groups were recruited. An inductive approach using grounded theory as an overall methodology orientation for the thematic analysis process has been followed. The study was reported in compliance with the consolidated criteria for reporting qualitative research criteria (COREQ). Results Patients expressed great satisfaction concerning the effective delivery of SME sessions. They appreciated the considerations for their concerns and needs, the adaptation of sessions' content to their interests and questions, and learning to take care of themselves. Moreover, patients had a positive opinion on the quality of their relationship with health care providers. However, the major point of improvement of SMEs was the opportunity to repeat the program if needed, as this opportunity was not offered. This consideration was particularly salient when patients did not consider themselves autonomous for disease management at the end of the program, ie, when they had low levels of perceived self-efficacy. Conclusion While patients expressed great satisfaction regarding SME programs, our results suggest that some changes might be needed to make the endpoint of SME interventions coincide with the patient's perception of self-efficacy in disease self-management and ultimately improve clinical outcomes.
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Affiliation(s)
- Laetitia Ricci
- CIC, Epidémiologie Clinique, CHRU-Nancy, INSERM, Université de Lorraine, Nancy, F-54000, France
- APEMAC, équipe MICS, Université de Lorraine, Nancy, F-54000, France
| | - Marie Buzzi
- CIC, Epidémiologie Clinique, CHRU-Nancy, INSERM, Université de Lorraine, Nancy, F-54000, France
- APEMAC, équipe MICS, Université de Lorraine, Nancy, F-54000, France
| | - Joelle Kivits
- APEMAC, équipe MICS, Université de Lorraine, Nancy, F-54000, France
| | - Anne-Christine Rat
- APEMAC, équipe MICS, Université de Lorraine, Nancy, F-54000, France
- UMR-S 1075-Mobilités: Vieillissement, Pathologie, Santé COMETE, Caen Normandie University, Caen, France
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Sagsveen E, Rise MB, Westerlund H, Grønning K, Bratås O. Involvement of service user representatives on a healthcare organizational level at Norwegian Healthy Life Centres: A qualitative study exploring health professionals' experiences. PLoS One 2023; 18:e0289544. [PMID: 37535594 PMCID: PMC10399866 DOI: 10.1371/journal.pone.0289544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/20/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND The involvement of service user representatives in planning, delivering, and evaluating health care services is regarded as essential in Healthy Life Centres (HLCs) to ensure high-quality services. However, information on how HLC-professionals involve service user representatives at a healthcare organizational level at HLCs remains sparse. OBJECTIVE To explore HLC professionals' experiences involving service user representatives in planning, delivering, and evaluating the HLC services. METHODS Five qualitative semi-structured focus group interviews with 27 health professionals from 27 Norwegian HLCs were conducted. Data were analysed using systematic text condensation. RESULTS The involvement of service user representatives at the HLCs varied from well-integrated and systematized to the opposite. The professionals' primary rationale for involving service user representatives was to include the representatives' unique experiential knowledge to ensure the quality of the service. Experiential knowledge was seen as a 'different' competence, which came in addition to professional competence. The professionals' choice of service user representatives depended on the purpose behind the involvement initiative. The HLC professionals often hand-picked former service users according to their health problems, motivation, and the HLC's need. The professionals said they were responsible for initiating the facilitation to accomplish genuine involvement. Support from their leaders to prioritize these tasks was essential. CONCLUSION To meet the demand for adequate service user representatives, the HLCs need access to different service user representatives, representing both diagnose-based and generic service user organisations and the public. To achieve genuine involvement, the rationale behind the involvement and the representatives' role must be clarified, both for the HLC professionals and service user representatives. This will require resources for continuous organizational preparation and facilitation.
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Affiliation(s)
- Espen Sagsveen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marit By Rise
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU) Central Norway, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Heidi Westerlund
- KBT Competence Center for Lived Experience and Service Development, Trondheim, Norway
| | - Kjersti Grønning
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Ola Bratås
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Stanton B, Segal T, Bradley-Westguard A, Edwards M. How to set up a functional neurological disorder education group. Pract Neurol 2023:pn-2023-003713. [PMID: 37100593 DOI: 10.1136/pn-2023-003713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 04/28/2023]
Abstract
Functional neurological disorder (FND) can be a difficult diagnosis for patients to understand and for clinicians to explain. The postdiagnostic support that patients with other chronic neurological illnesses normally receive is often not available to patients with FND. Here, we share our experience of how to set up an FND education group, including the content, practical aspects of delivering groups and how to avoid potential pitfalls. A group education session can improve understanding of the diagnosis among patients and caregivers, reduce stigma and provide self-management advice. Such groups should be multidisciplinary and include input from service users.
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Affiliation(s)
- Biba Stanton
- Neuropsychiatry, South London and Maudsley NHS Trust, London, UK
- Neurology, King's College Hospital, London, UK
| | - Tim Segal
- Neuropsychiatry, South London and Maudsley NHS Trust, London, UK
| | | | - Mark Edwards
- Neuropsychiatry, South London and Maudsley NHS Trust, London, UK
- Institute of Psychiatry Psychology & Neuroscience, King's College London, London, UK
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14
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Acquati C, Head KJ, Rand KL, Alwine JS, Short DN, Cohee AA, Champion VL, Draucker CB. Psychosocial Experiences, Challenges, and Recommendations for Care Delivery among Partners of Breast Cancer Survivors: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2786. [PMID: 36833489 PMCID: PMC9956235 DOI: 10.3390/ijerph20042786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
For women diagnosed with breast cancer, partners are consistently identified as the primary support person. Despite growing consensus about the psychosocial experience and unmet needs of cancer caregivers, limited evidence exists about strategies to offer partner-centered care across the cancer continuum. This study describes challenges endured by partners of breast cancer survivors (BCS), strategies implemented to manage these experiences, and recommendations for healthcare providers to inform targeted psychosocial care. Using convenience sampling, 22 partners of female BCS were recruited and completed semi-structured interviews. Conventional content analysis was used to code and synthesize findings. Participants described undergoing five experiences in their role as romantic partners: (a) assuming the role of caregiver, (b) becoming healthcare advocates for BCS, (c) connecting emotionally with the partner, (d) managing their own painful emotions, and (e) connecting with others for support. Experience-specific coping strategies and recommendations were identified. Romantic partners face multiple transitions across the cancer care continuum, which warrant investigation to sustain their well-being and active participation in illness management. Psychosocial interventions for this group will benefit from flexible implementation and attention to care delivery, mental health, and supportive/social needs.
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Affiliation(s)
- Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, TX 77004, USA
- Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX 77004, USA
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Katharine J. Head
- Department of Communication Studies, School of Liberal Arts, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA
| | - Kevin L. Rand
- School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA
| | | | | | - Andrea A. Cohee
- School of Nursing, Indiana University, Indianapolis, IN 46202, USA
- Melvin and Bren Simon Comprehensive Cancer Center, Indiana University, Indianapolis, IN 46202, USA
| | - Victoria L. Champion
- School of Nursing, Indiana University, Indianapolis, IN 46202, USA
- Melvin and Bren Simon Comprehensive Cancer Center, Indiana University, Indianapolis, IN 46202, USA
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15
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Effect of multidisciplinary collaborative empowerment education on psychological distress and quality of life in patients with colorectal cancer undergoing chemotherapy. Support Care Cancer 2023; 31:116. [PMID: 36645505 PMCID: PMC9841143 DOI: 10.1007/s00520-023-07573-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 01/03/2023] [Indexed: 01/17/2023]
Abstract
PURPOSE To evaluate the effects of multidisciplinary collaborative empowerment education on psychological distress and quality of life (QoL) in patients with colorectal cancer undergoing chemotherapy. METHODS A quasi-experimental study was conducted using repeated measures at pre- and post-intervention in the fourth chemotherapy cycle. Sixty patients with colorectal cancer aged 36-84 years were allocated to the intervention and control groups. The intervention group received multidisciplinary empowerment education, while the control group received routine health education. Psychological distress involving depression and anxiety symptoms was assessed using The Kessler Psychological Distress Scale (K10) and QoL was measured using The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTCQLQ-C30). Repeated-measures analysis of variance was used to examine intervention effects. Statistical analyses were performed using the SPSS software (version 26.0). RESULTS Psychological distress was considerably lower and QoL was considerably better in patients following multidisciplinary empowerment education in the intervention group than those in the control group. In addition, psychological distress significantly decreased and QoL improved in the intervention group compared to baseline. CONCLUSION Multidisciplinary collaborative empowerment education was effective in improving the psychological distress and QoL among patients with colorectal cancer undergoing chemotherapy. These findings suggest that the establishment of multidisciplinary collaborative empowerment education might be considered as an innovative means of clinical patient education during combination chemotherapy to improve health outcomes in patients with colorectal cancer. However, our results should be interpreted with caution because of the small sample size. Further validation in a larger sample or randomized controlled design is necessary in the future.
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16
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Richard BO, Abadi MH, Drake CD, Rychener D, Bauer R. "A reinstilled hope that they can change": Facilitator perspectives on a self-care and health promotion peer group program for veterans. Front Public Health 2023; 10:968281. [PMID: 36684905 PMCID: PMC9851664 DOI: 10.3389/fpubh.2022.968281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 11/21/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction This study assessed the relevance, value, and effectiveness of "Taking Charge of My Life and Health" (TCMLH), a patient wellbeing peer group program for U.S. veterans focused on empowering them to identify what really matters in their lives and to work toward health goals that align with their mission, aspirations, or purpose in life. The potential of TCMLH to empower veterans to engage in self-care behaviors, make health behavior changes, and participate in health care decision making is important, as veterans are more likely than the general population to suffer from multiple chronic conditions that require ongoing self-management. Methods We conducted individual semi-structured interviews with 19 TCMLH facilitators serving in eight U.S. Veteran's Health Administration medical centers. Data were analyzed using an inductive approach to identify salient themes in facilitators' experiences. Results Facilitators reported that TCMLH participants demonstrated positive attitude changes (e.g., greater confidence and hope) and behavior changes (e.g., making healthcare appointments and implementing self-care practices) by program completion. Further, findings show that mindful awareness practices, the peer group setting, Whole Health assessment tools, and goal setting tools were perceived as the most impactful program elements leading to positive health behavior change. Conclusion Overall, findings suggest that this non-clinical peer group program can enhance patient wellbeing, and that there are certain program elements of TCMLH that are driving key attitudinal and behavioral changes.
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Affiliation(s)
- Bonnie O. Richard
- Louisville Center, Pacific Institute for Research and Evaluation, Louisville, KY, United States
| | - Melissa H. Abadi
- Louisville Center, Pacific Institute for Research and Evaluation, Louisville, KY, United States
| | - Connor D. Drake
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, Durham, NC, United States
| | - David Rychener
- Louisville Center, Pacific Institute for Research and Evaluation, Louisville, KY, United States
| | - Rachel Bauer
- Louisville Center, Pacific Institute for Research and Evaluation, Louisville, KY, United States
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17
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Shah J, Kovacs M, Mori D. An Open Group for Patients with Various Chronic Illnesses: A Qualitative Case Evaluation. Int J Group Psychother 2023; 73:44-68. [PMID: 38446577 DOI: 10.1080/00207284.2022.2154674] [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: 01/26/2023]
Abstract
Many self-management and support groups for medical patients target a specific medical condition or diagnosis and are often time-limited. Presented is the Medical Issues Group (MIG), which is an integration of a self-management program and a therapist-led supportive psychotherapy group. This ongoing group is open to individuals with any significant chronic medical condition. Findings from our qualitative evaluation (n = 9) revealed that this group is positively received and can provide individuals who are experiencing challenges associated with living with medical illness a forum to receive high quality social support, address feelings of social isolation and loneliness, and develop adaptive coping strategies to adjust to medical illness. The inclusive structure of the group appears to provide enhanced access to high quality support and intervention for a vulnerable population. Limitations and implications are discussed.
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18
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Patil SJ, Tallon E, Wang Y, Nayyar M, Hodges K, Phad A, Rodriguez E, Gefter L. Effect of Stanford Youth Diabetes Coaches' Program on Youth and Adults in Diverse Communities. FAMILY & COMMUNITY HEALTH 2022; 45:178-186. [PMID: 35385435 PMCID: PMC9156535 DOI: 10.1097/fch.0000000000000323] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The Stanford Youth Diabetes Coaches' Program (SYDCP) trains high school students to become diabetes coaches for friends and adult family members. The objective of this study was to assess effects of SYDCP participation on youth and adults from a rural and urban underserved high school community. We used a mixed-methods approach. Patient-Reported Outcomes Measurement Information System (PROMIS) measures for Pediatric Sense of Meaning and Purpose were measured in high school students. PROMIS Adult Global Health and Self-Efficacy was measured in coached adults. Paired t tests compared pre- and postintervention and 6-month follow-up scores. Thematic analysis was used to analyze focus group discussion of adults. Twenty-five students participated, 15 students coached adults with diabetes or prediabetes. Students' sense of meaning and purpose significantly improved postintervention compared to preintervention. Diet and physical activity behaviors improved. Adolescent-adult relationships mediated participation benefits. Our study showed SYDCP improved adolescents' sense of meaning and purpose. In addition, youth and adult relatedness led to improved health behaviors. These findings have important implications, as a sense of purpose and youth-adult connectedness are associated with health behaviors and psychological well-being. Further larger studies of health education programs that engage related youth-adult dyads and assess long-term behaviors and health outcomes are needed.
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Affiliation(s)
- Sonal J Patil
- Departments of Family and Community Medicine (Drs Patil, Wang, and Hodges) and Endocrinology (Dr Nayyar), University of Missouri, Columbia; University of Missouri Sinclair School of Nursing, Columbia (Ms Tallon); University of Missouri Institute for Data Science & Informatics, Columbia (Ms Tallon); Center for Diabetes Translation Research, Washington University in St Louis, St Louis, Missouri (Ms Phad); Department of Pediatrics, Li Ka Shing Learning and Knowledge Center (Dr Rodriguez), and Division of Primary Care and Population Health (Dr Gefter), Stanford University School of Medicine, Stanford, California. Dr Patil is now at the Department of Wellness & Preventive Medicine, Cleveland Clinic Community Care, Cleveland, Ohio
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Ziegler AML, Shannon Z, Long CR, Vining RD, Walter JA, Coulter ID, Goertz CM. Chiropractic Services and Diagnoses for Low Back Pain in 3 U.S. Department of Defense Military Treatment Facilities: A Secondary Analysis of a Pragmatic Clinical Trial. J Manipulative Physiol Ther 2022; 44:690-698. [PMID: 35752500 DOI: 10.1016/j.jmpt.2022.03.009] [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: 05/05/2021] [Revised: 03/08/2022] [Accepted: 03/08/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to describe the diagnoses and chiropractic services performed by doctors of chiropractic operating within 3 military treatment facilities for patients with low back pain (LBP). METHODS This was a descriptive secondary analysis of a pragmatic clinical trial comparing usual medical care (UMC) plus chiropractic care to UMC alone for U.S. active-duty military personnel with LBP. Participants who were allocated to receive UMC plus 6 weeks of chiropractic care and who attended at least 1 chiropractic visit (n = 350; 1547 unique visits) were included in this analysis. International Classification of Diseases and Current Procedural Terminology codes were transcribed from chiropractic treatment paper forms. The number of participants receiving each diagnosis and service and the number of each service on unique visits was tabulated. Low back pain and co-occurring diagnoses were grouped into neuropathic, nociceptive, bone and/or joint, general pain, and nonallopathic lesions categories. Services were categorized as evaluation, active interventions, and passive interventions. RESULTS The most reported pain diagnoses were lumbalgia (66.1%) and thoracic pain (6.6%). Most reported neuropathic pain diagnoses were sciatica (4.9%) and lumbosacral neuritis or radiculitis (2.9%). For the nociceptive pain, low back sprain and/or strain (15.8%) and lumbar facet syndrome (9.2%) were most common. Most reported diagnoses in the bone and/or joint category were intervertebral disc degeneration (8.6%) and spondylosis (6.0%). Tobacco use disorder (5.7%) was the most common in the other category. Chiropractic care was compromised of passive interventions (94%), with spinal manipulative therapy being the most common, active interventions (77%), with therapeutic exercise being most common, and a combination of passive and active interventions (72%). CONCLUSION For the sample in this study, doctors of chiropractic within 3 military treatment facilities diagnosed, managed, and provided clinical evaluations for a range of LBP conditions. Although spinal manipulation was the most commonly used modality, chiropractic care included a multimodal approach, comprising of both active and passive interventions a majority of the time.
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Affiliation(s)
- Anna-Marie L Ziegler
- Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, Iowa.
| | | | - Cynthia R Long
- Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, Iowa
| | - Robert D Vining
- Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, Iowa
| | | | | | - Christine M Goertz
- Department of Orthopedic Surgery, Duke University, Durham, North Carolina
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20
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Petersson C, Nygårdh A, Hedberg B. To support self-management for people with long-term conditions - The effect on shared decision-making, empowerment and coping after participating in group-learning sessions. Nurs Open 2022; 9:2444-2453. [PMID: 35665483 PMCID: PMC9374400 DOI: 10.1002/nop2.1261] [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: 07/05/2021] [Revised: 03/30/2022] [Accepted: 05/06/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Interventions that support patients to handle the emotional and medical aspects of a long‐term health condition is important. One way is to use peer‐support groups, to help patients solving problems, increasing their knowledge and making decisions. Aim was to investigate the impact on shared decision‐making, empowerment and coping after participation in group‐learning sessions for patients with long‐term conditions (N = 42). Design An intervention following a health education programme based on group‐learning sessions was established. Eight different programmes were held in five different departments at a regional county hospital in Sweden. Methods Questionnaires were analysed using paired‐sample t‐test. Results Results showed that patients might have better opportunities to be more active during their patient encounter after attending the group learning sessions. Interventions directed to patient activation may be one key in future healthcare management, especially concerning long‐term conditions. Empowering patients is central in healthcare, and using different approaches is important.
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Affiliation(s)
- Christina Petersson
- Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jonkoping, Sweden.,Qulturum - Center for Learning and Innovation at Jönköping County, Jonkoping, Sweden
| | - Annette Nygårdh
- Department of Nursing Sciences, School of Health and Welfare, Jönköping University, Jonkoping, Sweden
| | - Berith Hedberg
- Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jonkoping, Sweden
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21
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Sarabia-Cobo C, Taltavull JM, Lladó-Jordan G, González S, Molina-Mula J, Ortego-Mate C, Fernández-Peña R. Comparison between attention and experiences of chronic complex patients: A multicentric study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:976-987. [PMID: 33453131 DOI: 10.1111/hsc.13269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/25/2020] [Accepted: 11/11/2020] [Indexed: 02/05/2023]
Abstract
The aim of this research is to explore and analyse the functional status and experiences of complex patients located at levels 3-4 of the risk pyramid of the chronic care model in primary care, within the hospital system of two regions in Spain. The design was a mixed design (COREQ). The participants were enrolled in programs for chronic complex patients and their caregivers. Sociodemographic variables were gathered, together with the following measures: the Barthel test, the Mini mental test, the Zarit questionnaire, the IEXPAC scale and the Braden scale. A semi-structured interview was conducted individually with patients in order to explore their experiences and narrative on the process of their illness and the support they had received. The sample comprised 206 chronic pluripathological patients, of whom 103 were from Cantabria and a further 103 were from Mallorca. The patient profile in both regions was very similar. There was an equal distribution across both gender and the patients were over 78 years old. They all had a basic (primary) education, an average income and required moderate physical dependence, receiving assistance primarily from their children. The qualitative analysis highlighted patients' awareness of the illness and their concern for the future, noting that, overall, patients were satisfied with the care provided by their caregivers and the health system. We can conclude that is the first multicentric study of these characteristics conducted in Spain, despite it being the country with the second largest ageing population in the world. It is important to test new organisational models with differentiating areas of advanced clinical practice in primary care, whereby both patients and their caregivers can be co-responsible within the care process.
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Affiliation(s)
- Carmen Sarabia-Cobo
- Faculty of Nursing, University of Cantabria, Santander, Spain
- Nursing Research Group IDIVAL, Santander, Spain
| | - J M Taltavull
- Gerencia de Atención Primaria de Mallorca. Servicio Balear de Salud, Islas Baleares, Spain
| | | | | | - Jesús Molina-Mula
- Nursing and Physiotherapy Department, University of Illes Balears, Santander, Spain
| | - Carmen Ortego-Mate
- Faculty of Nursing, University of Cantabria, Santander, Spain
- Nursing Research Group IDIVAL, Santander, Spain
| | - Rosario Fernández-Peña
- Faculty of Nursing, University of Cantabria, Santander, Spain
- Nursing Research Group IDIVAL, Santander, Spain
- SALBIS Research Group, León, Spain
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22
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Jones B, Bennett S, Larsson I, Zangi H, Boström C, Van der Elst K, Fayet F, Fusama M, Herrero Manso MDC, Hoeper JR, Kukkurainen ML, Kwok SK, Frãzao-Mateus E, Minnock P, Nava T, Pavic Nikolic M, Primdahl J, Rawat R, Schoenfelder M, Sierakowska M, Voshaar M, Wammervold E, van Tubergen A, Ndosi M. Disseminating and assessing implementation of the EULAR recommendations for patient education in inflammatory arthritis: a mixed-methods study with patients' perspectives. RMD Open 2022; 8:e002256. [PMID: 35459751 PMCID: PMC9036425 DOI: 10.1136/rmdopen-2022-002256] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/29/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES To explore patients' agreement and reasons for agreement or disagreement with the EULAR recommendations for patient education (PE) for people with inflammatory arthritis (IA). METHODS This mixed-method survey collected data using snowball sampling. The survey had been translated into 20 languages by local healthcare professionals, researchers and patient research partners. It explored the degree to which patients with IA agreed with each recommendation for PE (0=do not agree at all and 10=agree completely) and their rationale for their agreement level in free text questions. Descriptive statistics summarised participants' demographics and agreement levels. Qualitative content analysis was used to analyse the free text data. Sixteen subcategories were developed, describing the reasons for agreement or disagreement with the recommendations, which constituted the categories. RESULTS The sample comprised 2779 participants (79% female), with a mean (SD) age 55.1 (13.1) years and disease duration 17.1 (13.3) years. Participants strongly agreed with most recommendations (median 10 (IQR: 9-10) for most recommendations). Reasons for agreement with the recommendations included the benefit of using PE to facilitate collaborative care and shared decision making, the value of flexible and tailored PE, and the value of gaining support from other patients. Reasons for disagreement included lack of resources for PE, not wanting information to be tailored by healthcare professionals and a reluctance to use telephone-based PE. CONCLUSION The EULAR recommendations for PE have been disseminated among patients with IA. Overall, agreement levels were very high, suggesting that they reflect patients' preferences for engaging in collaborative clinical care and using PE to facilitate and supplement their own understanding of IA. Reasons for not completely agreeing with the recommendations can inform implementation strategies and education of healthcare professionals.
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Affiliation(s)
- Bethan Jones
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Sarah Bennett
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
- Translational Health Sciences, University of Bristol, Bristol, UK
| | - Ingrid Larsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Spenshult Research and Development Centre, Halmstad, Sweden
| | - Heidi Zangi
- National Advisory Unit for Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
- Faculty of Health, VID Specialized University, Oslo, Norway
| | - Carina Boström
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institute, Stockholm, Sweden
| | | | - Françoise Fayet
- Department of Rheumatology, Clermont-Ferrand Teaching Hospital, Clermont-Ferrand, France
| | - Mie Fusama
- School of Nursing, Takarazuka University, Osaka, Japan
| | | | - Juliana Rachel Hoeper
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hanover, Hannover, Germany
- Clinic for Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | | | - Suet Kei Kwok
- Department of Rheumatology and Clinical Immunology Unit, Grantham Hospital, Hong Kong, China
| | | | - Patricia Minnock
- Rheumatic Musculoskeletal Disease Unit, Our Lady's Hospice & Care Services, Dublin, Ireland
| | - Tiziana Nava
- Department of Translational Medicine and Surgery, University of Milan-Bicocca, Milano, Italy
| | - Milena Pavic Nikolic
- Department of Rheumatology, Division of Internal Medicine, University Medical Centre Ljubljana, Kamnik, Slovenia
| | - Jette Primdahl
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg, Denmark
| | - Roopa Rawat
- Joint Disease Clinic, Indian Spinal Injuries Centre, New Delhi, India
| | - Mareen Schoenfelder
- Österreichische Rheumaliga, Vienna, Austria
- Sprachinstitut TREFFPUNKT, Bamberg, Germany
| | - Matylda Sierakowska
- Department of Integrated Medical Care, Medical University of Bialystok, Bialystok, Poland
| | - Marieke Voshaar
- Department of Pharmacy, Radboud University Medical Center for Infectious Diseases, Nijmegen, The Netherlands
| | | | - Astrid van Tubergen
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
- Department of Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Mwidimi Ndosi
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
- Academic Rheumatology Unit, Bristol Royal Infirmary, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
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Factors Influencing Self-Management among Non-Dialysis Chronic Kidney Disease Patients. Healthcare (Basel) 2022; 10:healthcare10030436. [PMID: 35326914 PMCID: PMC8954207 DOI: 10.3390/healthcare10030436] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 02/11/2022] [Accepted: 02/23/2022] [Indexed: 02/04/2023] Open
Abstract
Aim: The new trend in the management of chronic kidney disease (CKD) is based on the adoption of self-management approaches. However, there is a paucity of research assessing the level of self-management behavior among non-dialysis patients. The aim of the study is to assess the association between self-management behaviors and the level of disease-specific knowledge among non-dialysis CKD patients. In addition, this study aimed to assess the predictors of self-management among non-CKD patients. Methods: A convenience sample of 203 non-dialysis patients with stage 3−5 CKD was surveyed from the nephrology clinics in Saudi Arabia. Descriptive statistics and linear regression were used to analyze the data. Results: The mean level of knowledge and self-management was 17.9 ± 3.2 and 76.9 ± 13.3, respectively. The results of the multiple regression of self-management showed that knowledge was independently associated with self-management (r = 0.51, **, p < 0.001). Conclusions: This study demonstrated that knowledge and self-management were associated with each other in non-dialysis patients. More efforts are needed to track and enhance the knowledge levels in patients with CKD. Future research should focus on the effectiveness of educational programs of self-management behavior.
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López-Casaus A, Jiménez-Sánchez C, Cordova-Alegre P, Alfaro-Gervon F, Esteban-Repiso L, Lafuente-Ureta R. Hemophilia Patient Experience in a Physical Therapy-Guided Health Education Intervention: A Mixed-Method Design. Healthcare (Basel) 2021; 9:healthcare9121728. [PMID: 34946454 PMCID: PMC8701070 DOI: 10.3390/healthcare9121728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 11/26/2022] Open
Abstract
People with hemophilia usually have negative joint consequences due to their illness. Evidence suggests that exercise and therapeutic education bring some benefits. An important factor that affects health interventions was the experience and degree of satisfaction. Thus, it is relevant to analyze qualitative and quantitative data to obtain a complete view of the patient’s experience. As a result, a concurrent nested mixed method with quantitative predominance study design was carried out. Nine people with hemophilia of Hemoaralar with a homogeneous environment participated in this study. The items evaluated were the level of satisfaction through the GCPC-UN-ESU survey and the experience with healthcare interventions through a focus group. A high level of satisfaction was obtained, but some divergences between quantitative and qualitative data were found. Further research about physical therapy and this type of intervention in people with hemophilia should be considered to better address the impact of living with the disease.
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25
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Fischer H, Grønning K. Are We Transitioning Toward Person-centered Practice on Self-management Support? An Explorative Case Study Among Rheumatology Outpatient Clinic Nurses in Norway. SAGE Open Nurs 2021; 7:23779608211037494. [PMID: 34869855 PMCID: PMC8642106 DOI: 10.1177/23779608211037494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 07/18/2021] [Indexed: 11/15/2022] Open
Abstract
Introduction There are only a few studies investigating nurses’ views on self-management
in the care of patients with rheumatic diseases. Objective The aim of this study is to explore how Norwegian rheumatology outpatient
nurses describe their ways of supporting patients’ self-management focusing
on the core dimensions of person-centered self-management support. Methods Ten individual semistructured interviews with rheumatology outpatient nurses
were conducted in Norway from March to September 2017. The interviews were
audiorecorded and transcribed verbatim. NVIVO was used to support a
systematic analysis of themes and patterns. Results Nurses’ views on self-management support fell into three approaches; (1)
narrowly biomedically orientated, (2) biomedically and holistic, and (3)
person-centered. The nurse's views of self-management support varied and did
not fully align with the core dimensions of person-centered practice. Conclusion The findings indicate that the biomedical paradigm continues to influence
Norwegian rheumatology outpatient clinic nurses’ approach to self-management
support. If person-centered principles of self-management support are to be
translated into standard nursing practice, including identifying and
supporting patient-defined self-management goals and processes, there is a
need to challenge established structures in health care systems.
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Affiliation(s)
| | - Kjersti Grønning
- Department of Public Health and Nursing, Norwegian University of Science and
Technology (NTNU), Trondheim, Norway
- Department of Rheumatology, St. Olavs hospital, Trondheim University
Hospital, Trondheim, Norway
- Kjersti Grønning, Department of Public
Health and Nursing, Norwegian University of Science and Technology (NTNU),
Postboks 8905, N-7491 Trondheim, Norway.
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Ricci L, Villegente J, Loyal D, Ayav C, Kivits J, Rat AC. Tailored patient therapeutic educational interventions: A patient-centred communication model. Health Expect 2021; 25:276-289. [PMID: 34816546 PMCID: PMC8849242 DOI: 10.1111/hex.13377] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 09/02/2021] [Accepted: 10/17/2021] [Indexed: 11/07/2022] Open
Abstract
Background Tailoring therapeutic education consists of adapting the intervention to patients' needs with the expectation that this individualization will improve the results of the intervention. Communication is the basis for any individualization process. To our knowledge, there is no guide or structured advice to help healthcare providers (HCPs) tailor patient education interventions. Objectives We used a data‐driven qualitative analysis to (1) investigate the reasons why HCPs tailor their educational interventions and (2) identify how this tailoring is effectively conducted. The perspective aimed to better understand how to individualize therapeutic patient education and to disentangle the different elements to set up studies to investigate the mechanisms and effects of individualization. Design Individual semistructured interviews with 28 HCPs involved in patient education were conducted. The present study complied with the COREQ criteria. Results Why individualization is necessary: participants outlined that the person must be thought of as unique and that therapeutic education should be adapted to the patient's personality and cognitive abilities. The first step in the individualization process was formalized by an initial patient assessment. Several informal practices were identified: if needed, giving an individual time or involving a specific professional; eliciting individual objectives; reinforcing the relationship by avoiding asymmetrical posture; focusing on patients' concerns; leading sessions in pairs; and making the patient the actor of decisions. Conclusion From our thematic data analysis, a model for tailoring patient education interventions based on the Haes and Bensing medical communication framework is proposed. The present work paves the way for evaluation, then generation of recommendations and finally implementation of training for individualization in educational interventions. Short Informative Tailoring in therapeutic education consists of an adaptation to patients' needs. Communication is the basis for any individualization process. There is no model of patient‐centred communication in educational interventions. From semistructured interviews with HCPs, we propose a patient‐centred communication model for tailoring patient education intervention.
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Affiliation(s)
- Laetitia Ricci
- CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France
| | - Julie Villegente
- CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France.,Université de Reims Champagne-Ardenne, Reims, France
| | | | - Carole Ayav
- CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France
| | | | - Anne-Christine Rat
- Université de Lorraine, APEMAC, Nancy, France.,University of Caen Normandie, Caen, France.,Rheumatology Department, University Hospital Center Caen, Caen, France
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Jessen S, Mirkovic J, Halvorsen Brendmo E, Solberg Nes L. Evaluating a Strengths-Based mHealth Tool (MyStrengths): Explorative Feasibility Trial. JMIR Form Res 2021; 5:e30572. [PMID: 34787580 PMCID: PMC8663534 DOI: 10.2196/30572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/03/2021] [Accepted: 10/03/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND As the number of people living with chronic illnesses increases, providing wide-reaching and easy-to-use support tools is becoming increasingly important. Supporting people in this group to recognize and use more of their personal strengths has the potential to improve their quality of life. With this in mind, we have developed the MyStrengths app prototype, a gamefully designed app aimed at aiding users in both identifying their strengths and using these strengths more actively in their daily life. OBJECTIVE The goal of this study was to evaluate the user-reported feasibility and usefulness of the MyStrengths app. The study additionally aimed to explore whether the use of MyStrengths could be associated with selected psychosocial outcomes. METHODS A 31-day explorative feasibility trial with a pretest-posttest design and an optional end of study interview was conducted. Data collection included system-use log data, demographic information, pre- and post-psychosocial measures (ie, strengths use, self-efficacy, health-related quality of life, depression), user experience measures (ie, usability, engagement, flow), and interview data. RESULTS In total, 34 people with at least 1 chronic condition were enrolled in the study, with 26 participants (mean age 48 years, range 29-62 years; 1 male) completing the trial. Among these individuals, 18 were also interviewed posttrial. Participants used the MyStrengths app an average of 6 days during the trial period, with 54% (14/26) using the app over a period of at least 19 days. In total, 8738 unique app actions were registered. Of the psychosocial outcome measures, only 1 subscale, general health in the RAND 36-Item Health Survey, yielded significant pre- and posttest changes. Posttrial interviews showed that the number of participants who considered the MyStrengths app to be useful, somewhat useful, or not useful was evenly distributed across 3 groups. However, every participant did voice support for the strengths approach. All participants were able to identify a multitude of personal strengths using the MyStrengths app. Most participants that reported it to be useful had little or no previous experience with the personal strengths approach. A multitude of users welcomed the gameful design choices, particularly the rolling die feature, suggesting strengths exercises, activities that use a specific strength, were well received. CONCLUSIONS Although the reported usefulness and feedback from use varied, most participants were favorable to the strengths-focused approach to care and support. Consequently, low-threshold and wide-reaching mobile health tools that use a strengths-focused approach, such as MyStrengths, hold the potential to support people living with chronic illness in performing self-management and achieving mastery of their life.
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Affiliation(s)
- Stian Jessen
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital HF, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jelena Mirkovic
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital HF, Oslo, Norway
| | - Elanor Halvorsen Brendmo
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital HF, Oslo, Norway
| | - Lise Solberg Nes
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital HF, Oslo, Norway
- Department of Psychiatry and Psychology, Mayo Clinic, College of Medicine and Science, Rochester, MN, United States
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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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Skovlund SE, Troelsen LH, Klim L, Jakobsen PE, Ejskjaer N. The participatory development of a national core set of person-centred diabetes outcome constructs for use in routine diabetes care across healthcare sectors. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:62. [PMID: 34507618 PMCID: PMC8434700 DOI: 10.1186/s40900-021-00309-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 08/31/2021] [Indexed: 05/17/2023]
Abstract
BACKGROUND This study sought to utilise participatory research methods to identify the perspectives of people with diabetes regarding which diabetes outcomes were most important to them. These findings were then used to support an expert working group representing multiple health sectors and healthcare disciplines and people with diabetes to establish a core set of patient-important outcome constructs for use in routine diabetes care. METHODS 26 people with diabetes and family members were recruited through purposive sampling to participate in interviews, focus groups, voting and plenary activities in order to be part of identifying outcome constructs. Content and qualitative analysis methods were used with literature reviews to inform a national multi-stakeholder consensus process for a core set of person-centred diabetes outcome constructs to be used in routine diabetes care across health care settings. RESULTS 21 people with diabetes and 5 family members representing type 1 and 2 diabetes and a range of age groups, treatment regimens and disease burden identified the following patient-reported outcome constructs as an important supplement to clinical indicators for outcome assessment in routine diabetes care: self-rated health, psychological well-being, diabetes related emotional distress and quality of life, symptom distress, treatment burden, blood sugar regulation and hypoglycemia burden, confidence in self-management and confidence in access to person-centred care and support. Consensus was reached by a national multi-stakeholder expert group to adopt measures of these constructs as a national core diabetes outcome set for use in routine value-based diabetes care. CONCLUSIONS We found that patient-reported outcome (PRO) constructs and clinical indicators are needed in core diabetes outcome sets to evaluate outcomes of diabetes care which reflect key needs and priorities of people with diabetes. The incorporation of patient-reported outcome constructs should be considered complementary to clinical indicators in multi-stakeholder value-based health care strategies. We found participatory research methods were useful in facilitating the identification of a core prioritised set of diabetes outcome constructs for routine value-based diabetes care. The use of our method for involving patients may be useful for similar efforts in other disease areas aimed at defining suitable outcomes of person-centred value-based care. Future research should focus on developing acceptable and psychometrically valid measurement instruments to evaluate these outcome constructs as part of routine diabetes care.
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Affiliation(s)
- Soren Eik Skovlund
- Department of Clinical Medicine, Aalborg University, Sønderskovvej 15, 9000, Aalborg, Denmark.
- Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark.
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark.
| | - Lise H Troelsen
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark
| | - Lotte Klim
- Danish Group for European Patients' Academy on Therapeutic Innovation (EUPATI), Copenhagen, Denmark
| | - Poul Erik Jakobsen
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark
| | - Niels Ejskjaer
- Department of Clinical Medicine, Aalborg University, Sønderskovvej 15, 9000, Aalborg, Denmark
- Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
- Steno Diabetes Center North Denmark, Aalborg University Hospital, Aalborg, Denmark
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Skovlund SE, Nicolucci A, Balk-Møller N, Berthelsen DB, Glümer C, Perrild H, Kjær P, Nørgaard LM, Troelsen LH, Pietraszek A, Hessler D, Kaplan S, Ejskjær N. Perceived Benefits, Barriers, and Facilitators of a Digital Patient-Reported Outcomes Tool for Routine Diabetes Care: Protocol for a National, Multicenter, Mixed Methods Implementation Study. JMIR Res Protoc 2021; 10:e28391. [PMID: 34477563 PMCID: PMC8449301 DOI: 10.2196/28391] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/01/2021] [Accepted: 06/04/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND There is growing evidence that digital patient-reported outcome (PRO) questionnaires and PRO-based decision support tools may help improve the active engagement of people with diabetes in self-care, thereby improving the quality of care. However, many barriers still exist for the real-world effectiveness and implementation of such PRO tools in routine care. Furthermore, limited research has evaluated the acceptability, feasibility, and benefits of such tools across different health care settings. OBJECTIVE This study aims to evaluate the acceptability, feasibility, and perceived benefits of the Danish digital PRO diabetes tool in different health care settings in Denmark and to determine the factors affecting its implementation. Furthermore, the study evaluates the psychometric characteristics of the Danish PRO Diabetes Questionnaire and the validity of the scoring algorithms for dialogue support. The objective of this study is to guide the ongoing optimization of the PRO diabetes tool, its implementation, and the design of future randomized controlled effectiveness studies. METHODS We designed a multicenter, mixed methods, single-arm acceptability-feasibility implementation study protocol to contribute to the real-world pilot test of a new digital PRO diabetes tool in routine diabetes care. The use of the tool involves two main steps. First, the people with diabetes will complete a digital PRO Diabetes Questionnaire in the days before a routine diabetes visit. Second, the health care professional (HCP) will use a digital PRO tool to review the PRO results together with the people with diabetes during the visit. The PRO diabetes tool is designed to encourage and support people to take an active role for the people with diabetes in their own care and to expedite the delivery of person-centered, collaborative, and coordinated care. RESULTS A multicenter pilot study protocol and psychometrically designed digital data collection tools for evaluation were developed and deployed as part of a national evaluation of a new digital PRO diabetes intervention. A total of 598 people with diabetes and 34 HCPs completed the study protocol by April 1, 2021. CONCLUSIONS A large-scale, mixed methods, multicenter study for evaluating the use of the nationally developed PRO Diabetes Questionnaire in routine care across all health care sectors in Denmark by using the RE-AIM (Reach, Efficacy, Adoption, Implementation and Maintenance) model as a framework has been designed and is ongoing. This study is expected to provide new important and detailed information about the real-world acceptability, perceived relevance, and benefits of the PRO diabetes tool among a large heterogeneous population of people with diabetes in Denmark and HCPs in different care settings. The results will be used to further improve the PRO tool, design implementation facilitation support strategies, and design future controlled effectiveness studies. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/28391.
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Affiliation(s)
- Søren Eik Skovlund
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Steno Diabetes Center North Jutland, Aalborg University Hospital, Aalborg, Denmark
| | - Antonio Nicolucci
- Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy
| | - Nina Balk-Møller
- PRO Secretariat, National Health Data Authority, Copenhagen, Denmark
| | - Dorthe B Berthelsen
- Department of Rehabilitation, Municipality of Guldborgsund, Nykoebing F, Denmark
- Section for Biostatistics and Evidence-Based Research, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Charlotte Glümer
- Center for Diabetes, Copenhagen Municipality, Copenhagen, Denmark
| | - Hans Perrild
- Department of Endocrinology, Frederiksberg-Bisbebjerg Hospital, Copenhagen, Denmark
| | - Pernille Kjær
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | | | - Lise Havbæk Troelsen
- Steno Diabetes Center North Jutland, Aalborg University Hospital, Aalborg, Denmark
| | - Anna Pietraszek
- Steno Diabetes Center North Jutland, Aalborg University Hospital, Aalborg, Denmark
| | - Danielle Hessler
- Department of Family & Community Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Sherrie Kaplan
- School of Medicine, University of California, Irvine, Irvine, CA, United States
| | - Niels Ejskjær
- Steno Diabetes Center North Jutland, Aalborg University Hospital, Aalborg, Denmark
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Hughes S, Lewis S, Willis K, Rogers A, Wyke S, Smith L. Participants' experiences of and perceived value regarding different support types for long-term condition self-management programmes. Chronic Illn 2021; 17:242-256. [PMID: 31426657 DOI: 10.1177/1742395319869437] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Health professional-led group programmes are a common form of long-term condition self-management support. Much research has focused on clinical outcomes of group participation, yet there is limited research on how group participants perceive and experience the support they receive. We aim to identify the different types of support that participants receive from both facilitators and other participants, and how they value this support. METHODS Semi-structured interviews were conducted with 20 participants taking part in a self-management group programme for a long-term condition (obesity, type 2 diabetes or chronic obstructive pulmonary disease). Data pertaining to support types were deductively identified through a social support framework prior to interpretive thematic analysis. RESULTS Participants identified information and emotional support from both facilitators and other participants as complementary yet distinct. Facilitators' support came from professional training and other participants' support reflected the contextual, lived experience. Professional interactions were prioritised, constraining opportunities for participant-participant support to be received and exchanged. DISCUSSION We identified a key gap in how self-management support is enacted in groups. Engaging participants to share experiential knowledge will make group support more relevant and mutually beneficial to participants living with a long-term condition.
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Affiliation(s)
- Stephen Hughes
- Faculty of Medicine and Health, The University of Sydney School of Pharmacy, The University of Sydney, NSW, Australia
| | - Sophie Lewis
- Faculty of Arts and Social Sciences, University of New South Wales, New South Wales, Australia
| | - Karen Willis
- Allied Health Research, Melbourne Health, La Trobe University, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Anne Rogers
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Sally Wyke
- Institute for Health and Wellbeing, College of Social Science, Glasgow, UK
| | - Lorraine Smith
- Faculty of Medicine and Health, The University of Sydney School of Pharmacy, The University of Sydney, NSW, Australia
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Álvarez ÓS, Ruiz-Cantero MT, Cassetti V, Cofiño R, Álvarez-Dardet C. Salutogenic interventions and health effects: a scoping review of the literature. GACETA SANITARIA 2021; 35:488-494. [DOI: 10.1016/j.gaceta.2019.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 12/05/2019] [Accepted: 12/16/2019] [Indexed: 11/26/2022]
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Grønning K, Lim S, Bratås O. A longitudinal study of educational needs among patients with inflammatory arthritis. Musculoskeletal Care 2021; 20:151-157. [PMID: 34091994 DOI: 10.1002/msc.1575] [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: 05/06/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Patient education is important in the follow-up and disease management for patients with chronic inflammatory arthritis. Patients' needs for education and information varies, and it is important that the education is tailored to the individual patient. Hence, the aim of this study is to investigate whether patients' educational needs change over time, and which demographic, disease-related or self-management characteristics that are associated with patients' educational needs. METHODS The Mann-Whitney U-test was used to study patients' longitudinal educational needs and whether their needs change over time, while multivariable linear regression analyses were used to investigate associations between patients' educational needs and demographic variables, disease-related and self-management characteristics. RESULTS There were no changes in patients' educational needs in the domains of managing pain, movement, feelings, arthritis process and treatment from health professionals during the study period of seven years. A small decrease in educational needs in the domains self-help measures (p-value 0.047) and support from others (p-value 0.010) was detected. The regression analyses showed that higher educational needs were associated with being female, lower educational level, shorter disease duration, and a lower level of patient activation. CONCLUSIONS Patients with chronic inflammatory arthritis have continual needs for patient education throughout their disease trajectory. Nurses and health care professionals must therefore ask their patients what kind of education they need at every follow-up throughout the disease course.
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Affiliation(s)
- Kjersti Grønning
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Rheumatology, The University Hospital, St.Olavs Hospital, Trondheim, Norway
| | - Siriwan Lim
- Yong Loo Lin School of Medicine, Clinical Research Centre, Alice Lee Centre for Nursing Studies, Singapore
| | - Ola Bratås
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Abadi M, Richard B, Shamblen S, Drake C, Schweinhart A, Bokhour B, Bauer R, Rychener D. Achieving Whole Health: A Preliminary Study of TCMLH, a Group-Based Program Promoting Self-Care and Empowerment Among Veterans. HEALTH EDUCATION & BEHAVIOR 2021; 49:347-357. [PMID: 34018443 DOI: 10.1177/10901981211011043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE An emerging literature suggests patients with chronic illnesses can benefit from integrated, person-centric approaches to health care, including group-based programs. However, much of the research in this area is disease specific. The objective of this study was to collect preliminary evidence on the efficacy of Taking Charge of My Life and Health (TCMLH), a Whole Health group-based program that emphasizes self-care and empowerment on the overall health and well-being of veterans, a population burdened with high rates of multiple chronic conditions. METHOD Self-reported outcomes, including standardized survey measures, were collected at pretest, posttest, and 2-month follow-up from 77 participants across 15 groups at four VA sites. Random intercept mixed-model regressions were used to analyze data. RESULTS Results from this initial study showed high satisfaction with the program and facilitators, and high attendance. There were significant pre-post gains in self-care attitudes and behaviors, patient motivation, meaning and purpose, mental health, perceived stress, goal progress, and goal-specific hope. Outcomes were maintained at 2-month follow-up for patient motivation, perceived stress, goal-specific hope, and goal progress. Significant gains were observed in health care empowerment and physical health from pretest to follow-up. CONCLUSIONS Preliminary findings support the efficacy of TCMLH, a Whole Health group-based program that emphasizes patient empowerment, self-care practices, and peer support. Future research priorities include a rigorous evaluation with a larger sample size and control group to assess effectiveness.
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Affiliation(s)
- Melissa Abadi
- Pacific Institute for Research and Evaluation, Louisville, KY, USA
| | - Bonnie Richard
- Pacific Institute for Research and Evaluation, Louisville, KY, USA
| | - Steve Shamblen
- Pacific Institute for Research and Evaluation, Louisville, KY, USA
| | | | | | - Barbara Bokhour
- Center for Healthcare Organization and Implementation Research, Bedford, MA, USA.,Boston University School of Public Health, Boston, MA, USA
| | - Rachel Bauer
- Pacific Institute for Research and Evaluation, Louisville, KY, USA
| | - David Rychener
- Pacific Institute for Research and Evaluation, Louisville, KY, USA
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Heggdal K, Mendelsohn JB, Stepanian N, Oftedal BF, Larsen MH. Health-care professionals' assessment of a person-centred intervention to empower self-management and health across chronic illness: Qualitative findings from a process evaluation study. Health Expect 2021; 24:1367-1377. [PMID: 33934447 PMCID: PMC8369120 DOI: 10.1111/hex.13271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/17/2021] [Accepted: 04/17/2021] [Indexed: 01/08/2023] Open
Abstract
Background Person‐centred care (PCC) empowers patients to manage their chronic illness and promote their health in accordance with their own beliefs, values and preferences. Drawing on health‐care professional's (HCP’s) experiences implementing an empowerment‐focused, person‐centred intervention called the Bodyknowledging Program (BKP), we undertook a process evaluation that aimed to assess the impact on patient health and well‐being. Methods We used individual in‐depth interviews and semi‐structured focus groups comprising n = 8 interprofessional HCP who facilitated intervention sessions with n = 58 patients situated in Norwegian specialist care sites. Content analysis was used to analyse the data and summarize major themes. Results Health‐care professional interviews revealed four main ways in which the intervention operated in support of health‐related patient outcomes: (i) addressing the whole person; (ii) hope and affirmation; (iii) expanding recovery; and (iv) social support and revitalized relationships. The intervention provided new tools for patients to understand the social, emotional and physical impact of their illness. Health‐care professional reported new insights to facilitate patient engagement and to promote patients’ health. Conclusions The Bodyknowledging Program facilitated patient engagement through the promotion of patient‐centred care while developing the patients’ ability to exploit their own resources for effectively managing their health within illness. The process evaluation supported the underlying theoretical basis of the intervention and was suggestive of its potential transferability elsewhere.
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Kristjansdottir OB, Vågan A, Svavarsdóttir MH, Børve HB, Hvinden K, Duprez V, Van Hecke A, Heyn L, Strømme H, Stenberg U. Training interventions for healthcare providers offering group-based patient education. A scoping review. PATIENT EDUCATION AND COUNSELING 2021; 104:1030-1048. [PMID: 33583649 DOI: 10.1016/j.pec.2020.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/18/2020] [Accepted: 12/13/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To provide overview of research on training interventions for healthcare providers aimed at promoting competencies in delivering group-based patient education. METHODS A systematic literature search identified relevant studies. Data was extracted on training details, study design, outcomes and experiences. Results were summarized and qualitative data analyzed using content analysis. RESULTS Twenty-seven studies exploring various training interventions were included. Ten studies used qualitative methods, eight quantitative and nine mixed methods. Use of a comparison group, validated instruments and follow-up measures was rare. Healthcare providers' reactions to training were mostly positive. Several studies indicated positive short-term effects on self-efficacy and knowledge. Results on observed skills and patient outcomes were inconclusive. Results on healthcare providers' experience of delivery of group-based patient education following training were categorized into 1) Benefits of training interventions, 2) Barriers to implementation and 3) Delivery support. CONCLUSIONS Further evaluation of training for healthcare providers delivering group-based patient education is needed before conclusions on training efficacy can be drawn. The results indicate an expanding research field still in maturation. PRACTICE IMPLICATIONS Efficacy studies evaluating theoretically grounded training with clear attention on group facilitation and follow-up support are needed. Inclusion of validated instruments and long-term outcomes is encouraged.
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Affiliation(s)
- Olöf Birna Kristjansdottir
- The Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway.
| | - André Vågan
- The Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway
| | | | - Hilde Blindheim Børve
- The Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway
| | - Kari Hvinden
- The Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway
| | - Veerle Duprez
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Ann Van Hecke
- University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Staff Member Nursing Department, Ghent University Hospital, Ghent, Belgium
| | - Lena Heyn
- Faculty of Health and Social Sciences, Department of Nursing and Health Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Hilde Strømme
- University Library, Medical Library, University of Oslo, Oslo, Norway
| | - Una Stenberg
- The Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo University Hospital, Oslo, Norway; Frambu Competence Center for Rare Diagnoses, Siggerud, Norway
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Abadi MH, Barker AM, Rao SR, Orner M, Rychener D, Bokhour BG. Examining the Impact of a Peer-Led Group Program for Veteran Engagement and Well-Being. J Altern Complement Med 2021; 27:S37-S44. [PMID: 33788603 DOI: 10.1089/acm.2020.0124] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Objectives: Veterans often suffer from multiple chronic illnesses, including mental health disorders, diabetes, obesity, and cardiovascular disease. The improvement of engagement in their own health care is critical for enhanced well-being and overall health. Peer-led group programs may be an important tool to provide support and skill development. We conducted a pilot study to explore the impact of a peer-led group-based program that teaches Veterans to become empowered to engage in their own health and well-being through mindful awareness practices, self-care strategies, and setting life goals. Design: Surveys were collected before and immediately after participation in the Taking Charge of My Life and Health (TCMLH) peer-led group program. Settings/location: Sessions were held in non-clinical settings within a VA medical center in the Midwest. Subjects: Our sample comprised 48 Veteran participants who were enrolled in TCMLH and completed a pretest and post-test survey. Intervention: TCMLH is a 9-week peer-led group program with an established curriculum that leverages the power of peer support to improve patient engagement, empowerment, health, and well-being among Veterans through Whole Health concepts, tools, and strategies. Programs were led by 1 of 12 trained Veteran peer facilitators. Outcome measures: Program impact on Veteran well-being was assessed by pre-post measures, including the Patient Activation Measure (PAM), the Perceived Stress Scale (PSS), the Patient-Reported Outcomes Measurement Information System Scale (PROMIS-10), the Perceived Health Competency Scale (PHCS), and the Life Engagement Test (LET). Results: There was a significant decrease in perceived stress (PSS score). Significant improvements were also seen in mental health and quality of life (PROMIS-10), participant accordance with the statement "I have a lot of reasons for living" (LET), and patient engagement (PAM score). Conclusions: As the Whole Health movement expands-both in VA and elsewhere-our findings suggest that guiding patients in an exploration of their personal values and life goals can help in key areas of patient engagement and mental and physical health outcomes. Further study is warranted, and expansion of the TCMLH program will allow for a more rigorous evaluation with a larger sample size.
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Affiliation(s)
- Melissa H Abadi
- Pacific Institute for Research and Evaluation, Louisville Center, Louisville, KY, USA
| | - Anna M Barker
- Center for Healthcare Organization and Implementation Research (CHOIR), ENRM VA Medical Center, Bedford, MA, USA
| | - Sowmya R Rao
- Department of Global Health and Policy & Management, Boston University School of Public Health (BUSPH), Boston, MA, USA
| | - Michelle Orner
- Center for Healthcare Organization and Implementation Research (CHOIR), ENRM VA Medical Center, Bedford, MA, USA
| | - David Rychener
- Pacific Institute for Research and Evaluation, Louisville Center, Louisville, KY, USA
| | - Barbara G Bokhour
- Center for Healthcare Organization and Implementation Research (CHOIR), ENRM VA Medical Center, Bedford, MA, USA.,Department of Health Law, Policy & Management, Boston University School of Public Health (BUSPH), Boston, MA, USA
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Aunan ST, Wallgren GC, Hansen BS. The value of information and support; Experiences among patients with prostate cancer. J Clin Nurs 2021; 30:1653-1664. [PMID: 33590945 DOI: 10.1111/jocn.15719] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 01/29/2021] [Accepted: 02/02/2021] [Indexed: 01/23/2023]
Abstract
AIMS AND OBJECTIVES To explore and analyse prostate cancer survivors` experiences and critical reflections of information received during their cancer trajectory. BACKGROUND Prostate cancer is one of the most prevalent cancers in men worldwide. Treatment causes side effects such as urinary incontinence, bowel changes and erection problems influencing sex life and manhood. Cancer pathways are designed to give patients and their relatives a predictable and as stress-free as possible treatment trajectory and minimise waiting time. DESIGN Qualitative, explorative research design. METHODS Focus groups with 16 prostate cancer survivors after having participated in an educational programme. The COREQ checklist was followed to ensure rigour in the study. RESULTS The main theme, 'Help me stay in control', and three subthemes, 'To be met with interest and support, enough knowledge to understand what is happening and a plan to build the new life on', emerged from qualitative analysis and highlighted the participants' need for information and support, specially scheduled at critical times in the treatment trajectory: the diagnostic phase, the treatment phase and the life after treatment. They also highlighted the need for empathy and interest from healthcare professionals and highlighted the need for arenas to discuss vulnerable topics. Contact with peers was perceived as supportive and encouraging. CONCLUSION Healthcare professionals must support prostate cancer survivors with empathy, interest and information tailored to their needs in three different phases. Continuity in information flow may increase trust and satisfaction among the prostate cancer survivors. RELEVANCE TO CLINICAL PRACTICE PCa patients' need for information varied at critical times in their treatment trajectory. HCP should meet them with empathy and interest to be able to tailor their need for information and support.
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Affiliation(s)
- Siv Tove Aunan
- Faculty of Health Sciences, Department of Caring and Ethics, University of Stavanger, Stavanger, Norway
| | - Gry Ciekals Wallgren
- Department of Haematology and Oncology, Stavanger University Hospital, Stavanger, Norway
| | - Britt Saetre Hansen
- Department of Anaesthesiology and Intensive Care, Stavanger University Hospital, Stavanger, Norway.,Faculty of Health Sciences, Quality and Safety in Health Care Systems, University of Stavanger, Stavanger, Norway
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Vaagan A, Sandvin Olsson AB, Arntzen C, By Rise M, Grue J, Haugland T, Langeland E, Stenberg U, Koren Solvang P. Rethinking long-term condition management: An actor-level framework. SOCIOLOGY OF HEALTH & ILLNESS 2021; 43:392-407. [PMID: 33635559 DOI: 10.1111/1467-9566.13228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 06/12/2023]
Abstract
To understand the complexities of managing long-term conditions and develop appropriate responses, micro-, meso- and macrolevels must be considered. However, these levels have not been combined in a single analytical framework of long-term condition management (LTCM). This article aims to describe a framework of LTCM practice and research that combines societal levels and key agents. The actor-level framework, based on the works of Abram De Swaan and Randall Collins, provides a broader understanding of LTCM as an interdisciplinary research field compared to previous contributions. The framework has three main advantages. First, it encourages knowledge production across levels and actors that address the complexity of long-term illness management. Second, it broadens the scope of LTCM as an interdisciplinary research field and practice field. Finally, it facilitates the integration of knowledge production from different disciplines and research traditions. The framework could stimulate interdisciplinary research collaboration to enhance knowledge of processes and interactions influencing the lives of individuals with long-term conditions.
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Affiliation(s)
- André Vaagan
- Norwegian National Advisory Unit on Learning and Mastery in Health, Oslo, Norway
| | | | - Cathrine Arntzen
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
| | - Marit By Rise
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jan Grue
- Department of Special Needs Education, University of Oslo, Oslo, Norway
| | - Trude Haugland
- Faculty of Health Studies, VID Specialized University, Norway and Inland Norway University of Applied Sciences, Hamar, Norway
| | - Eva Langeland
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Una Stenberg
- Norwegian National Advisory Unit on Learning and Mastery in Health and Frambu Competence Center of Rare Diagnosis, Oslo, Norway
| | - Per Koren Solvang
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
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Mundal I, Gråwe RW, Hafstad H, De Las Cuevas C, Lara-Cabrera ML. Effects of a peer co-facilitated educational programme for parents of children with ADHD: a feasibility randomised controlled trial protocol. BMJ Open 2020; 10:e039852. [PMID: 33268416 PMCID: PMC7713204 DOI: 10.1136/bmjopen-2020-039852] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Significant numbers of children with attention deficit hyperactivity disorder (ADHD) display problems that cause multiple disabilities, deficits and handicaps that interfere with social relationships, development and school achievement. They may have multiple problems, which strain family dynamics and influence the child's treatment. Parent activation, described as parents' knowledge, skills and confidence in dealing with their child's health and healthcare, has been shown to be an important factor in improving health outcomes. Research suggests that parents need edification to learn skills crucial to the treatment and management of their children's healthcare. Promoting positive parenting techniques may reduce negative parenting factors in families. This study aims to assess the acceptability, feasibility and estimated sample size of a randomised controlled trial (RCT) comparing an ADHD peer co-led educational programme added to treatment as usual (TAU). METHODS AND ANALYSIS Using a randomised waitlist controlled trial, parents of children aged 6-12 years newly diagnosed with ADHD, and referred to a child mental health outpatient clinic in Mid-Norway, will receive TAU concomitant with a peer co-facilitated parental engagement educational programme (n=25). Parents in the control group will receive TAU, and the educational programme treatment within a waitlist period of 3-6 months (n=25). Parent activation, satisfaction, well-being, quality of life and treatment adherence, will be assessed at baseline (T0), 2 weeks (T1) pre-post intervention (T2, T3) and at 3 months follow-up (T4). Shared decision making, parents preferred role in health-related decisions and involvement, parent-reported symptoms of ADHD and child's overall level of functioning will be assessed at T0 and T4. Such data will be used to calculate the required sample size for a full-scale RCT. ETHICS AND DISSEMINATION Approval was obtained from the Regional Committee for Medicine and Health Research Ethics in Mid-Norway (ref: 2018/1196). The findings of this study are expected to provide valuable knowledge about how to optimise family education and management of ADHD and will be disseminated through presentations at conferences and publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT04010851.
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Affiliation(s)
- Ingunn Mundal
- Department of Mental Health, Faculty of medicine and health sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Faculty of Health and Social Sciences, Molde University College, Molde, Norway
- Division of Psychiatry, Kristiansund Community Mental Health Centre, Møre og Romsdal Hospital Trust, Kristiansund, Norway
| | - Rolf W Gråwe
- Department of Mental Health, Faculty of medicine and health sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Division of Psychiatry, Nidaros Community Mental Health Centre, St Olav's University Hospital, Trondheim, Norway
| | - Hege Hafstad
- Division of Mid-Norway, Vårres Regional User Involvement Centre, Trondheim, Norway
| | - Carlos De Las Cuevas
- Department of Internal Medicine, Dermatology and Psychiatry, Universidad de La Laguna, San Cristóbal de La Laguna, Tenerife, Spain
- Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna, San Cristóbal deLa Laguna, Tenerife, Spain
| | - Mariela Loreto Lara-Cabrera
- Department of Mental Health, Faculty of medicine and health sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Division of Psychiatry, Tiller Community Mental Health Centre, St Olav's University Hospital, Trondheim, Norway
- Department of Research and Development, Division of Mental Health, St Olav's University Hospital, Trondheim, Norway
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Treloar C, Stardust Z, Cama E, Kim J. Rethinking the relationship between sex work, mental health and stigma: a qualitative study of sex workers in Australia. Soc Sci Med 2020; 268:113468. [PMID: 33120206 DOI: 10.1016/j.socscimed.2020.113468] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/07/2020] [Accepted: 10/19/2020] [Indexed: 12/18/2022]
Abstract
AIMS Sex workers may experience stigma both related to their occupation as well as to mental health issues that they face. There is limited research on the lived experience of sex workers managing mental health and stigma. This study examined the experiences of sex workers in Australia in relation to stigma surrounding sex work, and sex workers' mental health, including self-management and experiences of accessing mental health services. METHOD Six focus groups and two interviews were conducted with 31 sex workers. Data collection was co-moderated by a sex worker and a university-based researcher. Analysis was informed by an approach which positioned sex workers as agential and capable, and which drew attention to structural aspects of stigma. RESULTS Sex workers identified that the stigma surrounding their profession had a significant impact on their mental health. The need to manage risks through selective disclosure of sex work was a pervasive experience. Management of mental health and the stigma associated with sex work was described as a responsibility primarily of the individual through self-care activities and occasional access to mental health services. Participants reported poor treatment from mental health practitioners who saw sex workers as victims lacking agency, imposed beliefs that sex work was the pathological root cause of mental health issues, or approached the issue with fascination or voyeurism. Other presenting issues (especially mental health) were lost or obscured in therapeutic encounters resulting in suboptimal care. CONCLUSION The threat of stigma is pervasive and has mental health implications for sex workers. Our findings point to the need for increased training and capacity development for mental health practitioners, funding for peer support services to ameliorate internalised stigma, and action from governments to introduce enabling legal environments, stigma reduction programs and structural protections from sex work stigma.
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Affiliation(s)
- Carla Treloar
- Centre for Social Research in Health, UNSW, Sydney, Australia.
| | - Zahra Stardust
- Centre for Social Research in Health, UNSW, Sydney, Australia; Scarlet Alliance, Australia
| | - Elena Cama
- Centre for Social Research in Health, UNSW, Sydney, Australia
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Bergum IE, Mordal E. Repetisjon – en strategi for å opprettholde gode levevaner for personer med diabetes type 2. TIDSSKRIFT FOR OMSORGSFORSKNING 2020. [DOI: 10.18261/issn.2387-5984-2020-03-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Spencer CM, Haub M, Rockers M. Living with Parkinson's disease: The benefits of community programming. Complement Ther Clin Pract 2020; 41:101241. [PMID: 32987326 DOI: 10.1016/j.ctcp.2020.101241] [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: 05/17/2020] [Revised: 08/16/2020] [Accepted: 09/18/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND and purpose. Parkinson's Disease (PD) is a common neurodegenerative disorder that has significant physical, mental and financial costs for individuals and families. It is necessary to examine ways to improve the lives of individuals living with PD. MATERIALS AND METHODS Through the use of a thematic analysis, this study examined the benefits that participants in a community PD program experienced, and the barriers that prohibited individuals from participating. RESULTS Participants of the community PD program reported that participating in the program gave them a sense of community/belonging, increased knowledge about PD, a sense of hope/improved outlook on life, and physical improvements. Two main barriers preventing individuals from participating in the program was a lack of transportation and a fear of seeing PD symptom progression in others. CONCLUSION Results highlight that community PD programs can aid in improvements in quality of life related to exercise, an improved outlook, and support.
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Cooking for Vitality: Pilot Study of an Innovative Culinary Nutrition Intervention for Cancer-Related Fatigue in Cancer Survivors. Nutrients 2020; 12:nu12092760. [PMID: 32927752 PMCID: PMC7551599 DOI: 10.3390/nu12092760] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 12/21/2022] Open
Abstract
(1) Background: Cancer-related fatigue (CRF) is one of the most prevalent and distressing side effects experienced by patients with cancer during and after treatment, and this negatively impacts all aspects of quality of life. An increasing body of evidence supports the role of poor nutritional status in the etiology of CRF and of specific diets in mitigating CRF. We designed a group-based two session culinary nutrition intervention for CRF, Cooking for Vitality (C4V), aimed at increasing understanding of how food choices can impact energy levels and establishing basic food preparation and cooking skills as well as the application of culinary techniques that minimize the effort/energy required to prepare meals. The purpose of this pilot mixed-method study was to evaluate: Feasibility of the experimental methods and intervention; acceptability and perceived helpfulness of intervention; and to obtain a preliminary estimate of the effectiveness of the intervention on fatigue (primary outcome), energy, overall disability, and confidence to manage fatigue (secondary outcomes). (2) Methods: Prospective, single arm, embedded mixed-methods feasibility study of cancer survivors with cancer-related fatigue was conducted. Participants completed measures at baseline (T0), immediately following the intervention (T1), and three months after the last session (T2). Qualitative interviews were conducted at T2. (3) Results: Recruitment (70%) and retention (72%) rates along with qualitative findings support the feasibility of the C4V intervention for cancer survivors living with CRF (program length and frequency, ease of implementation, and program flexibility). Acceptability was also high and participants provided useful feedback for program improvements. Fatigue (FACT-F) scores significantly improved from T0–T1 and T0–T2 (p < 0.001). There was also a significant decrease in disability scores (WHO-DAS 2.0) from T0–T2 (p = 0.006) and an increase in POMS-Vigor (Profile of Mood States) from T0–T1 (p = 0.018) and T0–T2 (p = 0.013). Confidence in managing fatigue improved significantly from T0–T1 and T0–T2 (p < 0.001). (4) Conclusions: The results suggest that the C4V program was acceptable and helpful to patients and may be effective in improving fatigue levels and self-management skills. A randomized controlled trial is required to confirm these findings.
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Alananzeh I, Halcomb E, Chan A. Support preferences for Arabic people with a chronic condition living in Australia: A descriptive survey. Nurs Health Sci 2020; 22:1076-1083. [PMID: 32869477 DOI: 10.1111/nhs.12773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 11/26/2022]
Abstract
Chronic diseases are becoming increasingly common and are a priority for action in the Australian health sector. This study investigated the models of support groups preferred by Arab Australians living with chronic conditions. Two hundred fifty-one Arab people with chronic conditions completed a descriptive survey. More than half of participants thought that information on palliative care, financial advice and guidance, social and emotional support for self and family, complementary therapies, and being involved in treatment decisions were extremely useful. Conversely, information about palliative care, financial advice and guidance, and complementary therapies was seen as least useful. Eighty-five percent of participants reported willingness to attend a support program. Participants indicated they preferred the program to be held at a local community organization and facilitated by health care professionals. There was a high level of agreement in the views of Arab participants about the preferred location, type of facilitator, and content of a support program. These findings should inform the design of future programs for Arab immigrants with chronic conditions.
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Affiliation(s)
- Ibrahim Alananzeh
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
| | - Elizabeth Halcomb
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
| | - Alex Chan
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
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Navarta-Sánchez MV, Ambrosio L, Portillo MC, Ursúa ME, Senosiain JM, Riverol M. Evaluation of a psychoeducational intervention compared with education in people with Parkinson's disease and their informal caregivers: a quasi-experimental study. J Adv Nurs 2020; 76:2719-2732. [PMID: 32798329 DOI: 10.1111/jan.14476] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 05/22/2020] [Accepted: 06/15/2020] [Indexed: 12/21/2022]
Abstract
AIM To evaluate the effects of a psychoeducational intervention compared with an education programme to strengthen quality of life, psychosocial adjustment, and coping in people with Parkinson's disease and their informal caregivers. DESIGN A quasi-experimental study was performed with repeated measures at baseline, after the intervention and 6 months post-intervention. METHODS The study was carried out at seven primary care centres from 2015-2017. A total of 140 people with Parkinson's and 127 informal caregivers were allocated to the experimental and the control groups. The experimental group received a 9-week psychoeducational intervention, whereas the control group received a 5-week education programme. Repeated measures ANOVA were used to test differences in quality of life, psychosocial adjustment, and coping between the experimental and control groups and over time. RESULTS Patients and informal caregivers in both the experimental and control groups showed significantly better psychosocial adjustment at the post-intervention measurement compared with baseline data. We also found significantly greater quality of life in patients and coping skills in caregivers after the end of the interventions in the experimental and control groups. Nevertheless, no significant differences were identified on the outcomes at the 6-month post-intervention measurement. CONCLUSION The effect of the psychoeducational intervention was not different from the effect of the education programme. The strategies applied in both interventions followed a group approach led by a multidisciplinary team covering information about PD, healthy lifestyles, and social resources. They might be easily sustained in Primary Care to improve care for people with Parkinson's and informal caregivers.
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Affiliation(s)
| | - Leire Ambrosio
- Faculty of Nursing, University of Navarre, Pamplona, Navarre, Spain
| | - Mari Carmen Portillo
- Faculty of Health Sciences, University of Southampton, Southampton, Hampshire, UK
| | - Maria Eugenia Ursúa
- Primary Health Care Center of San Juan, Navarre Health Service, Pamplona, Navarre, Spain
| | | | - Mario Riverol
- Department of Neurology, University of Navarra Clinic, Pamplona, Navarre, Spain
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Evald L, Graarup J, Højskov IE. Diary for self-observation: A self-management tool for recipients of lung transplantation-A pilot study. Nurs Open 2020; 7:1766-1773. [PMID: 33072360 PMCID: PMC7544857 DOI: 10.1002/nop2.562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/05/2020] [Accepted: 06/16/2020] [Indexed: 11/17/2022] Open
Abstract
Aim To (a) explore how the diary contributes to patient motivation for monitoring self‐management and (b) explore the nurses' experience of how the diary supports the patients' self‐management after lung transplantation. Design A quantitative and qualitative study design. Methods Fifteen patients and four nurses participated. Data were analysed descriptively and thematically. Results This pilot study shows that the diary strengthens patients' self‐management in the first postoperative period. Nurses were confident that the patients were structured about self‐observation when using the diary.
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Affiliation(s)
| | - Jytte Graarup
- Department of Cardiothoracic Surgery The Centre for Cardiac Vascular-, Pulmonary and Infectious Diseases Rigshospitalet University of Copenhagen Copenhagen Denmark
| | - Ida Elisabeth Højskov
- Department of Cardiothoracic Surgery The Centre for Cardiac Vascular-, Pulmonary and Infectious Diseases Rigshospitalet University of Copenhagen Copenhagen Denmark
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Franceschini C, Fante C, Filardi M, Folli MC, Brazzi F, Pizza F, D’Anselmo A, Ingravallo F, Antelmi E, Plazzi G. Can a Peer Support the Process of Self-Management in Narcolepsy? A Qualitative Narrative Analysis of a Narcoleptic Patient. Front Psychol 2020; 11:1353. [PMID: 32733314 PMCID: PMC7358570 DOI: 10.3389/fpsyg.2020.01353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 05/22/2020] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Narcolepsy type 1 (NT1) is a chronic and rare sleep disorder typically arising during adolescence and young adulthood. The main symptoms are excessive daytime sleepiness and cataplexy, a prototypical fall down elicited by huge emotions. Social relationships, school, work, and general health perception are frequently impaired in patients, who often show lower quality-of-life scores. We report which management strategies a young patient (DMG) adopted to cope with NT1 during his growth, avoiding exhibiting serious impairments to his global functioning. METHODS A clinical psychologist explores the history of the patient's disease and the self-acquired strategies used to cope with the symptoms. The patient's global adaptation to the disease, stress-related managing skills, and overall well-being are assessed by standardized scales [Illness Behavior Questionnaire (IBQ); Coping Orientations to Problems Experienced (COPE); and Psychological General Well-Being Index (PGWBI)]. We conducted a qualitative analysis of the patient's narration of his illness according to the procedure of the Grounded Theory. The MAXQDA software program was used to code the verbatim transcript. RESULTS From the qualitative analysis of the interview, three thematic cores emerged: 1) the disease history; 2) the patient's friendship with AD, a friend of his age diagnosed with NT1 since childhood; 3) the strategies used to deal with his symptoms before the diagnosis of NT1 and the related treatment. From the psychometric tests, the patient presents good coping strategies in dealing with stressful problems and events based mainly on acceptance and positive reinterpretation of the stressful situation. CONCLUSION This case shows that comparing peers of the same age and suffering from the same illness improve the patient's self-management ability to cope and live well with NT1.
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Affiliation(s)
| | - Chiara Fante
- Istituto per le Tecnologie Didattiche (ITD), National Research Council (CNR), Genova, Italy
| | - Marco Filardi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- IRCCS Institute of Neurological Sciences, Bologna, Italy
| | | | - Francesca Brazzi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Fabio Pizza
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Anita D’Anselmo
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Francesca Ingravallo
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Elena Antelmi
- Neurology Unit, Movement Disorders Division, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Giuseppe Plazzi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- IRCCS Institute of Neurological Sciences, Bologna, Italy
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Hughes S, Lewis S, Willis K, Rogers A, Wyke S, Smith L. How do facilitators of group programmes for long-term conditions conceptualise self-management support? Chronic Illn 2020; 16:104-118. [PMID: 30068222 DOI: 10.1177/1742395318792068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives Increasing self-management skills in people with long-term conditions is widely advocated in policies and guidelines. Group programmes are a common format; yet, how self-management support objectives are enacted in their delivery is poorly understood. Our aim is to explore the perspectives of group programme facilitators. Methods We undertook thematic analysis of transcribed data from in-depth semi-structured interviews with health professional facilitators (n = 13) from six diverse self-management support group programmes (of obesity, diabetes and chronic obstructive pulmonary disease). Results Facilitators viewed group programmes as responses to health system pressures, e.g. high patient demand. They focussed on providing in-depth education and instruction on physical health, risks and lifestyle behaviour change and emphasised self-responsibility for behaviour change whilst minimising goal setting and support amongst group participants. There were tensions between facilitators’ professional identity and group leader role. Discussion Group self-management support programmes may not be realising the broader aspirations advocated in long-term condition policy to support medical, emotional and social aspects of long-term conditions by minimising shared learning, problem solving, building of self-efficacy and goal setting. This suggests a disconnect at implementation. Increasing understandings of theoretical and practical self-management support in group programmes across both implementation and health professional (HCP) training will further the professional skills in this format.
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Affiliation(s)
- Stephen Hughes
- Faculty of Medicine and Health, The University of Sydney School of Pharmacy, The University of Sydney, NSW, Australia
| | - Sophie Lewis
- Faculty of Arts and Social Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Karen Willis
- Allied Health Research, Melbourne Health, Royal Melbourne Hospital, La Trobe University, Parkville, Victoria, Australia
| | - Anne Rogers
- Faculty of Health Sciences, University of Southampton, Highfield, Southampton, UK
| | - Sally Wyke
- Institute for Health and Wellbeing, College of Social Sciences, Bute Gardens, London, UK
| | - Lorraine Smith
- Faculty of Medicine and Health, The University of Sydney School of Pharmacy, The University of Sydney, NSW, Australia
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50
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Donkor HM, Grundt JH, Júlíusson PB, Eide GE, Hurum J, Bjerknes R, Markestad T. A family-oriented intervention programme to curtail obesity from five years of age had no effect over no intervention. Acta Paediatr 2020; 109:1243-1251. [PMID: 31677296 DOI: 10.1111/apa.15080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 08/01/2019] [Accepted: 10/31/2019] [Indexed: 02/01/2023]
Abstract
AIM To examine the effect of a family-oriented multidisciplinary intervention programme to curtail weight increase in young children with obesity. METHODS Children who weighed more than one kilogram above the 97th percentile for height at the preschool assessment in Oppland County, Norway, were identified. Parents residing in one part of the county were invited to participate in a group-based three-year intervention programme while the rest had no interventions. Body mass index (BMI) and family characteristics at entry and measurements at birth were explanatory variables, and change in BMI standard deviation score (SDS) the outcome measure. For the intervention group, outcome was also related to skinfold thicknesses, waist-to-height ratio and physical ability. RESULTS The programme was completed by 31 families in the intervention and 33 in the control group. At entry, the respective median (interquartile) age was 5.83 (0.36) and 5.74 (0.66) years, and the BMI SDS 2.35 (1.06) and 1.95 (0.49), P = .012. The median decrease in BMI SDS was 0.19 in both groups. The decline increased with increasing BMI SDS at entry, but irrespective of group. Social or behavioural factor or other anthropometric measures were not associated with outcome. CONCLUSION The intervention programme had no effect on BMI SDS.
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Affiliation(s)
| | | | | | - Geir Egil Eide
- Centre for Clinical Research Haukeland University Hospital Bergen Norway
- Department of Global Public Health and Primary Care University of Bergen Bergen Norway
| | - Jørgen Hurum
- Department of Paediatrics Innlandet Hospital Trust Lillehammer Norway
| | - Robert Bjerknes
- Department of Clinical Science Faculty of Medicine University of Bergen Bergen Norway
| | - Trond Markestad
- Department of Clinical Science Faculty of Medicine University of Bergen Bergen Norway
- Department of Research Innlandet Hospital Trust Brumunddal Norway
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