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Friedmann Z, Kinkel HT, Kühner C, Zsolnai A, Binder A, Mick I. Shaping and shifting schemas on supervised injectable opioid treatment: findings from a cross-sectional qualitative study in two German treatment facilities. Addict Sci Clin Pract 2024; 19:45. [PMID: 38802962 PMCID: PMC11129426 DOI: 10.1186/s13722-024-00475-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 05/13/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Supervised injectable opioid treatment (SIOT) is a promising alternative for people living with opioid use disorder (OUD) who have not sufficiently benefitted from oral opioid substitution treatment. Yet, SIOT utilization remains limited in Germany. We propose that this is due to beliefs, or schemas, on SIOT among people living with OUD. Drawing from medical sociology and social psychology, this study explores the emergence and evolution of such schemas on SIOT. METHODS We conducted semi-structured interviews with 34 individuals currently in or eligible for SIOT in two German outpatient treatment facilities and paralleled an inductive qualitative content analysis with the exploration of individual cases. RESULTS The analysis revealed that peer-to-peer interaction and individuals' practical experiences in therapy are crucial in constructing and changing idiosyncratic and shared schemas of SIOT. When facing ambiguous information, cognitive strategies like subtyping served to mitigate uncertainty. CONCLUSION This research has important practical implications for integrating experiential knowledge into clinical care and improve information sharing among people living with OUD. A nuanced understanding of the complex network of informal advice-seeking and -giving among people living with OUD is indispensable to adequately expand treatment modalities of proven effectiveness.
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Affiliation(s)
- Zoe Friedmann
- Charité Universitätsmedizin Berlin (Medical University Hospital Charité Berlin), Charitéplatz 1, 10117, Berlin, Germany.
| | - Hans-Tilmann Kinkel
- Praxiskombinat Neubau, Schwerpunktpraxis für Suchtmedizin (outpatient clinic for addiction medicine), Ruschestraße 103, 10365, Berlin, Germany
| | - Claudia Kühner
- Schwerpunktpraxis für Suchtmedizin Stuttgart (outpatient clinic for addiction medicine), Kriegsbergstraße 40, 70174, Stuttgart, Germany
| | - Andreas Zsolnai
- Schwerpunktpraxis für Suchtmedizin Stuttgart (outpatient clinic for addiction medicine), Kriegsbergstraße 40, 70174, Stuttgart, Germany
| | - Annette Binder
- Universitätsklinikum Tuebingen, Sektion Suchtmedizin und Suchtforschung (addiction medicine and addiction research department, Medical University Hospital Tuebingen, University of Tuebingen), Calwerstraße 14, 72076, Tuebingen, Germany
| | - Inge Mick
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin (Medical University Hospital Charité Berlin), Charitéplatz 1, 10117, Berlin, Germany
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2
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Ahmed S, Méndez RY, Naveed S, Akhter S, Mushtaque I, Malik MA, Ahmad W, Figueroa RN, Younas A. Assessment of hepatitis-related knowledge, attitudes, and practices on quality of life with the moderating role of internalized stigma among hepatitis B-positive patients in Pakistan. Health Psychol Behav Med 2023; 11:2192782. [PMID: 37008419 PMCID: PMC10064821 DOI: 10.1080/21642850.2023.2192782] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023] Open
Abstract
Aim This study aimed to assess the Pakistani hepatitis B patients' knowledge, attitudes, and practices towards hepatitis management and the impact of self-management on the quality of life of hepatitis B patients as well as the moderating role of stigmatization. Methods A cross-sectional study design was used, and the data was collected from a total of 432 hepatitis B positive patients through a self-designed questionnaire. The studied subjects consisted of men (n = 205, 47%), women (n = 165, 38%), and transgender (n = 62, 14%). The obtained data were statistically analyzed using SPSS software version 26.0 for Windows. Results The mean age of the study participants was 48. Knowledge has a significant positive relationship with hepatitis self-management and quality of life, whereas knowledge has a negative relationship with stigmatization. Furthermore, multivariate analysis revealed that men were more knowledgeable about the disease than women and transgender people (6.14 ± 2.08 vs. 3.23 ± 1.61 vs. 1.03 ± 0.73, F = 8.2**, p = .000). On the scale of attitude and practice, significant gender differences were found. Women had more experience with hepatitis self-management than men or transgender (4.21 ± 13.0 vs. 2.17 ± 6.02 vs. 0.37 ± 0.31, F = 6.21**, p = .000). The regression analysis showed that self-management has a positive association with quality of life (B = 0.36, p = .001). The moderation analysis revealed that stigmatization negatively moderates the relationship between self-management and quality of life (B = -0.53, p = .001). Conclusion Generally, patients had good knowledge about the disease and its self-management. However, a societal and community-level awareness campaign should be organized on the quality of life and stigmatization of people with chronic illness regarding their human rights, dignity, and physical, mental, and social well-being.
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3
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Kelly C, Heslop-Marshall K, Jones S, Roberts NJ. Self-management in chronic lung disease: what is missing? Breathe (Sheff) 2022; 18:210179. [PMID: 36338256 PMCID: PMC9584548 DOI: 10.1183/20734735.0179-2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 03/22/2022] [Indexed: 11/17/2022] Open
Abstract
Self-management, as a strategy to support those living with chronic respiratory conditions such as asthma and COPD, has been widely advocated in guidelines and adopted in practice. However, there can be a disconnect between the goals of patients and healthcare professionals. Goals and barriers to self-management are often compounded by the complex social, emotional and medical needs of patients. People living with chronic respiratory conditions also often have symptoms of anxiety and depression, which can impact on self-management. Self-management therefore requires patients and healthcare professionals to work together and it is essential to involve patients when designing, implementing and evaluating self-management interventions. Patient preferences are clearly important and goal setting needs an individual, flexible and responsive approach from healthcare professionals, which aligns to a more personalised approach to management of treatable traits and the burden of disease. To achieve these goals, healthcare professionals need education to support patients in self-management and behaviour change. This approach should lead to shared decision-making and partnership working that puts the patient right at the centre of their care. Self-management is often effective in chronic respiratory disease and can improve symptoms and reduce healthcare burden. Yet patients rarely feature in the design or implementation of interventions; are patients as active partners the missing ingredient?https://bit.ly/3LiqhVg
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4
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Kiss D, Pados E, Kovács A, Mádi P, Dervalics D, Bittermann É, Schmelowszky Á, Rácz J. "This is not life, this is just vegetation"-Lived experiences of long-term care in Europe's largest psychiatric home: An interpretative phenomenological analysis. Perspect Psychiatr Care 2021; 57:1981-1990. [PMID: 33811648 DOI: 10.1111/ppc.12777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 03/06/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Understanding the experiences of long-term care (LTC) may help to improve care by assisting mental health professionals and allowing mental health policies to be customized more effectively. DESIGN AND METHODS: Semistructured interviews were analyzed using interpretative phenomenological analysis (IPA). FINDINGS Three main themes emerged as a result: 1. Perception of selves, 2. Experience and representation of the institution, 3. Maintenance of safe spaces. PRACTICE IMPLICATIONS: Communication with patients, investigation of their identity processes, and relationship toward their past and present self during LTC might aid in well-being and sense of congruency in their identities. Nurses should encourage patients to keep connected with their memories and past selves through different activities.
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Affiliation(s)
- Dániel Kiss
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Eszter Pados
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Asztrik Kovács
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Péter Mádi
- Hungarian Rapid Response Police Unit, Budapest, Hungary
| | - Dóra Dervalics
- Kilátó Piarist Career Guidance and Labor Market Development Center, Budapest, Hungary
| | | | | | - József Rácz
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.,Department of Addictology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
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5
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Ilomäki S, Ruusuvuori J, Laitinen J. Effects of Transmission Delay on Client Participation in Video-Mediated Group Health Counseling. QUALITATIVE HEALTH RESEARCH 2021; 31:2328-2339. [PMID: 34014131 PMCID: PMC8564242 DOI: 10.1177/10497323211010726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
In face-to-face group counseling, active client participation contributes to the counseling agenda by a variety of social processes, but little is known about how video mediation shapes client participation. In this article, we use conversation analysis to investigate how transmission delay affects client participation in video-mediated group counseling through shaping the resolution of overlapping talk. Data are video recordings from three video-mediated group health counseling sessions recorded simultaneously in the two participating locations. The delay changes the timing of the overlapping turns and pauses at each end of the mediated counseling, making it difficult to interpret who should take the turn after the overlap. This may pose obstacles to client participation. While mediated counseling services can increase access to services and thus improve client participation at a macro level, transmission delay can pose threats to active client participation at the micro level of interaction.
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Affiliation(s)
| | | | - Jaana Laitinen
- Finnish Institute of Occupational Health,
Helsinki, Finland
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6
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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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Marcinow M, Sandercock J, D'Silva C, Daien D, Ellis C, Dias C, Mansfield E. Making sense of symptoms, clinicians and systems: a qualitative evaluation of a facilitated support group for patients with medically unexplained symptoms. BMC FAMILY PRACTICE 2021; 22:142. [PMID: 34210272 PMCID: PMC8252243 DOI: 10.1186/s12875-021-01495-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 06/17/2021] [Indexed: 11/23/2022]
Abstract
Objectives Health services to date have inadequately addressed the physical and mental health needs of patients with medically unexplained symptoms. This qualitative study evaluates a piloted facilitated support group (FSG) developed for patients with medically unexplained symptoms to inform recommendations and resources for this patient population. Methods Using a qualitative descriptive design, we conducted and thematically analyzed semi-structured interviews with participants (n = 8) and facilitators (n = 4) to explore their experiences of the facilitated support group. Common themes that captured strengths and challenges of the facilitated support group were identified. Results The following key themes were identified through analysis of the data: Participants described 1) feeling validated through sharing similar experiences with peers; 2) learning practical symptom management and coping strategies; and 3) gaining new perspectives for navigating conversations with PCPs. Conclusions Our findings show that a facilitated support group may provide additional forms of support and resources for patients with medically unexplained symptoms, filling a gap in currently available clinical care offered by health care professionals. Potential implications: This paper highlights lessons learned that can inform the design and delivery of future supports and resources directed toward optimizing patient care for this underserved patient population. Our findings are relevant to those who are involved in direct patient care or involved in designing and implementing self-management programs. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-021-01495-9.
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Affiliation(s)
- Michelle Marcinow
- Institute for Better Health, Trillium Health Partners, Administrative Building - 6th Floor, 100 Queensway West, Mississauga, ON, L5B 1B8, Canada.
| | - Jane Sandercock
- Institute for Better Health, Trillium Health Partners, Administrative Building - 6th Floor, 100 Queensway West, Mississauga, ON, L5B 1B8, Canada
| | - Chelsea D'Silva
- Institute for Better Health, Trillium Health Partners, Administrative Building - 6th Floor, 100 Queensway West, Mississauga, ON, L5B 1B8, Canada
| | - David Daien
- Family Medicine, Institute for Better Health, Trillium Health Partners, 100 Queensway West, Mississauga, ON, L5B 1B8, Canada
| | - Carly Ellis
- Strategic Projects, Trillium Health Partners, 100 Queensway West, Mississauga, ON, L5B 1B8, Canada
| | - Christine Dias
- Medical Psychiatry Alliance, Trillium Health Partners, 100 Queensway West, Mississauga, ON, L5B 1B8, Canada
| | - Elizabeth Mansfield
- Institute for Better Health, Trillium Health Partners, Administrative Building - 6th Floor, 100 Queensway West, Mississauga, ON, L5B 1B8, Canada.,Department of Occupational Health, University of Toronto, 6 Queen's Park Crescent West, Toronto, ON, M5S 3H2, Canada
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8
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Farr M, Brant H, Patel R, Linton MJ, Ambler N, Vyas S, Wedge H, Watkins S, Horwood J. Experiences of patient-led chronic pain peer support groups after pain management programmes: A qualitative study. PAIN MEDICINE 2021; 22:2884-2895. [PMID: 34180996 PMCID: PMC8665998 DOI: 10.1093/pm/pnab189] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE A qualitative study of patients' experiences and the impacts of peer support groups that patients maintained after UK NHS group pain management programmes (PMPs). DESIGN Long-term impacts of group PMPs remain unclear, with indications that positive effects can fade. We evaluated a model of continued peer support, co-produced by patients and clinicians, to maintain the therapeutic impact of PMP groups. A protocol was implemented that encouraged patients to continue to meet in their established PMP group for patient-led peer support (without clinical input) after PMPs finished. Peer support aimed to consolidate self-management, and advance social life recovery. We examined the impacts that groups had on attendees, and why some dropped out. METHODS Semi-structured interviews with 38 patients and 7 clinicians, analysed thematically. RESULTS Friendship bonds and mutual understandings of effective ways of coping with pain encouraged participants to maintain recovery following PMPs. After PMP professional involvement has ended, these meetings enabled patients to develop greater agency from the shared sense of helping bring about new achievements or averting setbacks. Peer support extended the understanding of what is possible when living with pain. However, continuing meetings were not right for all. Reasons for not attending included lack of connection with peers. CONCLUSIONS Co-produced peer support groups after PMPs can be a low-cost, effective social intervention, providing emotional, practical and social benefits, with improved self-management skills, stronger social connections and some reduced use of health services. Project resources for developing peer support meetings after PMPs are freely available online.
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Affiliation(s)
- Michelle Farr
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, Bristol, BS1 2NT.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Heather Brant
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, Bristol, BS1 2NT.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Rita Patel
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, Bristol, BS1 2NT.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Myles-Jay Linton
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, Bristol, BS1 2NT.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nick Ambler
- Pain Management Service, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Sareeta Vyas
- Pain Management Service, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.,Trainee Clinical Psychologist, Clinical Psychology Unit, University of Sheffield, Cathedral Court, Floor F, 1 Vicar Lane, Sheffield, S1 2LT
| | - Hannah Wedge
- Pain Management Service, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.,Trainee Clinical Psychologist, Clinical Psychology, Cardiff University, 11th Floor, Tower Building, 70 Park Place, Cardiff, CF10 3AT
| | - Sue Watkins
- Pain Management Service, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Jeremy Horwood
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, Bristol, BS1 2NT.,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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9
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Kelly CA, Tsang A, Lynes D, Spencer S. 'It's not one size fits all': a qualitative study of patients' and healthcare professionals' views of self-management for bronchiectasis. BMJ Open Respir Res 2021; 8:e000862. [PMID: 33664124 PMCID: PMC7934710 DOI: 10.1136/bmjresp-2020-000862] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Bronchiectasis is a chronic respiratory condition that impacts significantly on individuals and healthcare services. Self-management is recommended in clinical guidelines for bronchiectasis as an intervention to enable patients to manage their condition, yet there is little evidence to support it. METHODS Three face to face focus groups (17 adults with bronchiectasis) were conducted at three National Health Service (NHS) sites in North West England. Additionally, semi-structured telephone interviews were undertaken with 11 healthcare professionals (HCPs), including doctors, nurses and physiotherapists. Thematic analysis identified common themes and occurrences verified by independent audit. FINDINGS Four common overarching themes were identified: the meaning of self-management; benefits; barriers and influencers to self-management; subthemes varied. Both groups recognised component interventions. Patients highlighted that self-management enabled them to learn what works and moderate behaviour. Aspects of delivery and structure were important to HCPs but a 'make do' culture was evident. Benefits for both groups included empowering patients. Common barriers for patients were time, mood and lack of access to support which could mitigate engagement with self-management. HCPs identified barriers including patient characteristics and lack of resources. Influencers for patients were peer, carer and psychosocial support, for HCPs influencers were individual patient attributes, including ability and motivation, and HCP characteristics such as knowledge and understanding about bronchiectasis. SUMMARY This is the first study to explore patients' and HCPs' views of self-management for bronchiectasis. The need for an individual, flexible and responsive self-management programme specific to bronchiectasis was evident. Personal characteristics of patients and HCPs could affect the uptake and engagement with self-management and HCPs knowledge of the disease is a recognised precursor to effective self-management. The study identified key aspects for consideration during development, delivery and sustainability of self-management programmes and findings suggest that patients' psychosocial and socioeconomic circumstances may affect adoption and activation of self-management behaviours.
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Affiliation(s)
- Carol Ann Kelly
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK
- Respiratory Research Centre, Edge Hill University, Ormskirk, Lancashire, UK
| | - Anthony Tsang
- Respiratory Research Centre, Edge Hill University, Ormskirk, Lancashire, UK
| | - Dave Lynes
- Respiratory Research Centre, Edge Hill University, Ormskirk, Lancashire, UK
| | - Sally Spencer
- Respiratory Research Centre, Edge Hill University, Ormskirk, Lancashire, UK
- Health Research Institute, Edge Hill University, Ormskirk, Lancashire, UK
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10
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Teng AK, Han S, Lin SY, Demiris G, Zaslavsky O, Chen AT. Using an Innovative Discussion Platform to Give Voice to Aging-Related Experiences: A Pilot Study. J Gerontol Nurs 2020; 45:33-40. [PMID: 31755541 DOI: 10.3928/00989134-20191105-05] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 09/06/2019] [Indexed: 12/13/2022]
Abstract
Exchanging information with peers may support older adults' management of aging-related health changes, including frailty. The current pilot study used a mixed-methods approach to develop and evaluate an online virtual community for older adults to discuss aging-related health issues and management strategies. Eight older adults (mean age = 84) were enrolled at the start of the study. During a 10-week moderated discussion, participants contributed a total of 133 responses. Common themes included (a) symptoms (e.g., pain, weakness/tiredness, sleep difficulties) and (b) management strategies (e.g., health behavior changes, psychosocial support). A positive trend of change was noted in participants' average self-reported health and chronic disease management self-efficacy scores. This platform could facilitate information exchange among older adults, empowering them to leverage their own knowledge to improve their health management strategies. Future research should expand on this study to include older adults of diverse racial, educational, and cultural backgrounds. [Journal of Gerontological Nursing, 45(12), 33-40.].
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11
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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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12
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Kidd L, Booth J, Lawrence M, Rowat A. Implementing Supported Self-Management in Community-Based Stroke Care: A Secondary Analysis of Nurses' Perspectives. J Clin Med 2020; 9:E985. [PMID: 32244792 PMCID: PMC7230474 DOI: 10.3390/jcm9040985] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 03/19/2020] [Accepted: 03/30/2020] [Indexed: 11/27/2022] Open
Abstract
The provision of supported self-management (SSM) is recommended in contemporary guidelines to address the longer-term needs and outcomes of stroke survivors and their families, yet its implementation across stroke pathways has been inconsistent. This paper presents a secondary analysis of qualitative data, which aims to identify and offer insight into the challenges of implementing SSM from the perspectives of community stroke nurses (n = 14). The findings revealed that the implementation of SSM in stroke is influenced by factors operating at multiple levels of the healthcare system. Contextual challenges arise because of different understandings and interpretations of what SSM is, what it comprises and professionals' perceptions of their roles in its implementation in practice. A professionally controlled, one-size-fits-all model of SSM continues to be reinforced within organizations, offering few opportunities for nurses to deliver contextually tailored and person-centred SSM. In conclusion, there are many professional concerns and organizational tensions that need to be addressed across multiple layers of the healthcare system to achieve the consistent implementation of contextually tailored and person-centred SSM following a stroke. Attempts to address these challenges will help to narrow the gap between policy and practice of implementing SSM, ensuring that stroke survivors and families benefit from SSM in the longer-term.
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Affiliation(s)
- Lisa Kidd
- Nursing & Healthcare, School of Medicine, Dentistry & Nursing, University of Glasgow; Glasgow G12 8LL, UK
| | - Joanne Booth
- School of Health & Life Sciences, Glasgow Caledonian University; Glasgow G4 0BA, UK; (J.B.); (M.L.)
| | - Maggie Lawrence
- School of Health & Life Sciences, Glasgow Caledonian University; Glasgow G4 0BA, UK; (J.B.); (M.L.)
| | - Anne Rowat
- School of Health & Social Care, Edinburgh Napier University; Edinburgh EH11 4DY, UK;
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13
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Tickle-Degnen L, Stevenson MT, Gunnery SD, Saint-Hilaire M, Thomas CA, Sprague Martinez L, Habermann B, Naumova EN. Profile of social self-management practices in daily life with Parkinson's disease is associated with symptom severity and health quality of life. Disabil Rehabil 2020; 43:3212-3224. [PMID: 32233702 DOI: 10.1080/09638288.2020.1741035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: Social participation is a key determinant of healthy aging, yet little is known about how people with Parkinson's disease manage social living. This study describes individual differences in social self-management practices and their association with symptom severity and health quality of life.Methods: People with Parkinson's disease (N = 90) completed measures of healthy routines, activities and relationships, symptom severity, and health related quality of life. Cluster analysis identified profiles of social self-management practices. Analysis of variance tested differences between profiles in symptom severity and health quality of life.Results: Participants clustered into one of seven groups according to different combinations of three practices: health resources utilization, activities in home and community, and social support relationships. The healthiest cluster engaged equally in all three practices at above sample average degree of engagement. Four clusters that engaged at or above sample average in activities in home and community experienced less health problems than three clusters that engaged below average. Variation in aspects of social lifestyle unrelated to health appeared also to contribute to profile diversity.Conclusion: Findings provide insight into similarity and variation in how people with Parkinson's disease engage with social self-management resources and point to person-centered interventions.Implications for RehabilitationSocial self-management is a biopsychosocial construct to identify and describe self-care practices that engage one's social resources for managing healthful daily living.People with Parkinson's disease vary in their profiles of engaging in social self-management practices in daily living, and this variability relates to severity of symptoms and health quality of life.Learning how to identify health-centered social self-management practices may help people with Parkinson's disease to focus on the healthfulness of their own practices.Learning how to strategically engage one's social resources as part of self-care may help people with Parkinson's disease to master managing their health and well-being in daily life.
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Affiliation(s)
- Linda Tickle-Degnen
- Department of Occupational Therapy, School of Arts & Sciences, Tufts University, Medford, MA, USA
| | - Michael T Stevenson
- Department of Occupational Therapy, School of Arts & Sciences, Tufts University, Medford, MA, USA
| | - Sarah D Gunnery
- Department of Psychology, New England College, Henniker, NH, USA
| | | | - Cathi A Thomas
- Department of Neurology, Boston University Medical Center, Boston, MA, USA
| | | | - Barbara Habermann
- School of Nursing, College of Health Sciences, University of Delaware, Newark, DE, USA
| | - Elena N Naumova
- The Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
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14
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Logren A, Ruusuvuori J, Laitinen J. Stories of Change: Comparative Time-Framed Experience Telling in Health Promotion Group Discussions. QUALITATIVE HEALTH RESEARCH 2020; 30:279-292. [PMID: 31578939 DOI: 10.1177/1049732319877858] [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] [Indexed: 06/10/2023]
Abstract
In this article, we examine comparative time-framed experience telling: episodes of interaction in health promotion group discussions in which one of the participants tells their experience and, in response, another participant tells their own experiences from separate moments or periods of their life and compares them. In so doing, group members reinforce and encourage the previous speaker's positive stance or challenge the negative stance toward contextually relevant objects: behavior change and suggested solutions. This practice allows group members to demonstrate their independent access to experiences that are similar to those of the other, present evidence of similarities and differences between the experiences, and show their epistemic independence regarding their claims. By recontextualizing the experience of the other in this way, it becomes possible for the group members to interpret and even oppose it while maintaining a level of understanding of the differences between the experiences in question and respecting them.
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15
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Grønning K, Lim S, Bratås O. Health status and self-management in patients with inflammatory arthritis-A five-year follow-up study after nurse-led patient education. Nurs Open 2020; 7:326-333. [PMID: 31871717 PMCID: PMC6917950 DOI: 10.1002/nop2.394] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/27/2019] [Accepted: 09/09/2019] [Indexed: 01/13/2023] Open
Abstract
Aim The aim of this study was to investigate changes in patients' self-management and health status five years after nurse-led patient education. Design A longitudinal study. Methods We collected self-reported data on physical function, pain, tiredness, disease activity, psychological status, patient activation and self-efficacy from a sample of Norwegian-speaking adults with inflammatory arthritis that had participated in a randomised controlled study investigating the effects of nurse-led patient education. Changes and associations in patients' health status and self-management were analysed with paired sample t tests and multivariable linear regression analyses, respectively. Results Except from a small deterioration in patients' physical function, there were no changes in patients' health status 5 years after the nurse-led patient education. Patients' self-management skills were improved after 5 years. Self-efficacy was positively associated with female gender, patient activation, less tiredness and less psychological distress.
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Affiliation(s)
- Kjersti Grønning
- Department of Public Health and NursingNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Department of RheumatologyTrondheim University HospitalSt.Olavs Hospital Prinsesse Kristinas gate 3TrondheimNorway
| | - Siriwan Lim
- Alice Lee Centre for Nursing StudiesYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Ola Bratås
- Department of Public Health and NursingNorwegian University of Science and Technology (NTNU)TrondheimNorway
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16
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Nguyen J, Smith L, Hunter J, Harnett JE. Conventional and Complementary Medicine Health Care Practitioners' Perspectives on Interprofessional Communication: A Qualitative Rapid Review. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E650. [PMID: 31569742 PMCID: PMC6843134 DOI: 10.3390/medicina55100650] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 09/15/2019] [Accepted: 09/24/2019] [Indexed: 01/22/2023]
Abstract
Background and Objectives: People have multi-faceted health care needs and consult a diverse range of health care practitioners (HCP) from both the conventional and complementary medicine healthcare sectors. The effective communication between HCP and with patients are obvious requisites to coordinating multidisciplinary care and shared decision making. Further, miscommunication is a leading cause of patient harm and is associated with reduced patient satisfaction, health literacy, treatment compliance and quality of life. In conventional healthcare settings, the differences in professional hierarchy, training, communication styles and culture are recognised communication barriers. Less is known about interprofessional communication (IPC) that includes traditional and complementary medicine (TCM) HCP. This review aims to summarise the experiences and perceptions of conventional and complementary HCP and identify factors that influence IPC. Methods: A qualitative rapid literature review was conducted. Six databases were searched to identify original research and systematic reviews published since 2009 and in English. Excluded were articles reporting original research outside of Australia that did not include TCM-HCP, already cited in a systematic review, or of low quality with a score of less than three on a critical appraisal skills programme (CASP) checklist. A thematic analysis of included studies was used to identify and explore important and recurring themes. Results: From the conducted searches, 18 articles were included, 11 of which reported data on complementary HCP and seven were literature reviews. Four key themes were identified that impact IPC: medical dominance, clarity of HCP roles, a shared vision, and education and training. Conclusion: IPC within and between conventional and complementary HCP is impacted by interrelated factors. A diverse range of initiatives that facilitate interprofessional learning and collaboration are required to facilitate IPC and help overcome medical dominance and interprofessional cultural divides.
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Affiliation(s)
- Janet Nguyen
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Lorraine Smith
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Jennifer Hunter
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia.
- NICM Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia.
| | - Joanna E Harnett
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, NSW 2006, Australia.
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17
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Kong LN, He S, Li L, Lei QS, Wang T, Yao Y. Factors for self-management activities among rural patients with chronic hepatitis B: A cross-sectional study. J Clin Nurs 2019; 28:3949-3956. [PMID: 31408559 DOI: 10.1111/jocn.15037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 04/03/2019] [Accepted: 08/04/2019] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To assess the self-management activities among rural patients with chronic hepatitis B (CHB), and the influence of psychosocial and demographic factors on their self-management activities. BACKGROUND Chronic hepatitis B is a serious public health concern. Rural patients may have limited access to healthcare services. Although self-management is important for controlling chronic hepatitis B, few studies focus on the self-management activities among rural patients with chronic hepatitis B. Understanding self-management activities and related factors in this population are important to design and implement appropriate intervention strategies. DESIGN A cross-sectional study. METHODS From June-December 2017, totally 236 rural patients with chronic hepatitis B were recruited from hepatology department in two hospitals in Chongqing, China. The questionnaire included demographic characteristics, Chronic Hepatitis B Self-Management Scale, Self-Efficacy for Managing Chronic Disease, and Social Support Rating Scale. The study followed the STROBE checklist. RESULTS Rural patients with chronic hepatitis B reported poor self-management activities for the score indexes of symptom management (57.36%), lifestyle management (54.89%), psychosocial coping (54.84%) and disease information management (53.11%) were all below 60%. Self-efficacy, objective support, subjective support, gender, education level and marital status showed significant effect on self-management activities. CONCLUSION Rural patients with chronic hepatitis B were found to perform insufficient self-management activities. Self-efficacy, social support, gender, education level and marital status were identified to influence their self-management activities. RELEVANCE TO CLINICAL PRACTICE Self-management activities should be promoted among rural patients with chronic hepatitis B. The factors that were identified in this study should be addressed when developing interventions to promote the performance of self-management activities for rural patients with chronic hepatitis B.
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Affiliation(s)
- Ling-Na Kong
- School of Nursing, Chongqing Medical University, Chongqing, PR China.,School of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Shan He
- School of Nursing, Chongqing Medical University, Chongqing, PR China
| | - Lin Li
- Department of liver disease, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, PR China
| | - Qing-Song Lei
- Department of infectious disease, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Tian Wang
- Department of infectious disease, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Yu Yao
- School of Nursing, Chongqing Medical and Pharmaceutical College, Chongqing, PR China
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18
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M Yatim H, Wong YY, Neoh CF, Lim SH, Hassali MA, Hong YH. Factors influencing patients' hypertension self-management and sustainable self-care practices: a qualitative study. Public Health 2019; 173:5-8. [PMID: 31207425 DOI: 10.1016/j.puhe.2019.04.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/09/2019] [Accepted: 04/25/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The objective of this study was to explore factors influencing patients with hypertension to participating in a hypertension self-management education (HSME) programme and challenges of sustaining the learnt self-care practices. STUDY DESIGN This was a qualitative study with focus group discussions. METHODS Focus group discussions using a semistructured moderator guide were conducted among participants who had attended the HSME programme. Data were audio recorded, transcribed verbatim and analysed using a thematic analysis approach. RESULTS Three focus groups involving 19 participants were conducted. Four major themes emerged from the data collected. Most participants enjoyed the group-based HSME sessions because sharing experiences with those having similar health problems can reduce their sense of isolation. However, the participants highlighted the difficulty in sustaining self-care practices in the presence of friends and family influences. CONCLUSION A number of patient-, family- and community-level motivators and barriers to patients' hypertension self-management have been identified. Efforts to tailor behavioural interventions to sustain daily self-care activities during social and cultural events are imperative.
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Affiliation(s)
- H M Yatim
- Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Selangor Branch, Puncak Alam Campus, 42300 Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia
| | - Y Y Wong
- Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Penang Branch, Bertam Campus, 13200 Kepala Batas, Pulau Pinang, Malaysia
| | - C F Neoh
- Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Selangor Branch, Puncak Alam Campus, 42300 Bandar Puncak Alam, Selangor Darul Ehsan, Malaysia; Collaborative Drug Discovery Research (CDDR) Group, Pharmaceutical and Life Sciences Community of Research, Universiti Teknologi MARA (UiTM), 40450 Shah Alam, Selangor Darul Ehsan, Malaysia.
| | - S H Lim
- Faculty of Health Sciences, Universiti Teknologi MARA (UiTM), Penang Branch, Bertam Campus, 13200 Kepala Batas, Pulau Pinang, Malaysia
| | - M A Hassali
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Minden, Pulau Pinang, Malaysia
| | - Y H Hong
- Department of Physiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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19
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Hughes S, Lewis S, Willis K, Rogers A, Wyke S, Smith L. Goal setting in group programmes for long-term condition self-management support: experiences of patients and healthcare professionals. Psychol Health 2019; 35:70-86. [DOI: 10.1080/08870446.2019.1623891] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Stephen Hughes
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, 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, La Trobe University, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Anne Rogers
- Faculty of Health Sciences, University of Southampton, Highfield, Southampton, United Kingdom
| | - Sally Wyke
- Institute for Health and Wellbeing, College of Social Sciences, United Kingdom
| | - Lorraine Smith
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, the University of Sydney, NSW, Australia
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20
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Bossy D, Knutsen IR, Rogers A, Foss C. Moving between ideologies in self-management support-A qualitative study. Health Expect 2018; 22:83-92. [PMID: 30289189 PMCID: PMC6351411 DOI: 10.1111/hex.12833] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 08/10/2018] [Accepted: 08/14/2018] [Indexed: 11/30/2022] Open
Abstract
Background Reforms in current health policy explicitly endorse health promotion through group‐based self‐management support for people with long‐term conditions. Health promotion and traditional medicine are based on different logics. Accordingly, health professionals in health‐promoting settings demand the adoption of new practices and ways of thinking. Objectives The objective of our study was to investigate how health professionals perceive the health‐promoting group‐based self‐management support that is politically initiated for people with long‐term conditions. Design This study had a qualitative research design that included focus group interviews and was guided by a social constructivist paradigm in which group‐based self‐management was viewed as a social construction. Different logics at play were analysed through the theoretical lens of institutional logic. Discussions among participants show frames of references seen as logics. Setting and participants We recruited health professionals from group‐based health‐promoting measures for people with type 2 diabetes in Norway. Two focus groups comprising four and six participants each were invited to discuss the practices and value of health promotion through group‐based self‐management support. Results The analysis resulted in three themes of discussion among participants that contained reflections of logics in movement. Health professionals’ discussions moved between different logics based on the importance of expert‐based knowledge on compliance and on individual lifestyle choices. Discussion and conclusion The study indicates that health promotion through self‐management support is still a field “in the making” and that professionals strive to establish new logics and practices that are not considered difficult to manage or do not contain incompatible understandings.
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Affiliation(s)
- Dagmara Bossy
- Norwegian National Advisory Unit on Learning and Mastery in Health, Universitetssykehus HF, Aker Sykehus, Oslo, Norway.,Department of Nursing Science, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Ruud Knutsen
- Department of Nursing Science, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Kjeller, Norway
| | - Anne Rogers
- NIHR CLAHRC Wessex, Faculty of Health Sciences, University of Southampton, Hampshire, UK
| | - Christina Foss
- Department of Nursing Science, Faculty of Medicine, University of Oslo, Oslo, Norway
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21
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Finset A. Special Section: Review articles on decision making and patient education interventions. PATIENT EDUCATION AND COUNSELING 2017; 100:2157-2158. [PMID: 29032951 DOI: 10.1016/j.pec.2017.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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