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Mehrotra S, Bhattacharjya S, Shetty RS. Self-management interventions among community-dwelling older adults with type 2 diabetes mellitus: a scoping review protocol. BMJ Open 2024; 14:e084743. [PMID: 39181548 DOI: 10.1136/bmjopen-2024-084743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND Globally, the number of older adults is increasing rapidly; simultaneously, there is an epidemiological shift toward chronic diseases. One such chronic disease is type 2 diabetes mellitus (DM) which is caused either by the inability to produce insulin or due to the ineffective use of insulin. In recent years, self-management programmes for chronic conditions have gained importance, especially among occupational therapists. Though there is an increasing focus on 'self-management interventions' among older adults, there is still a lack of such interventions for older adults with type 2 DM in low- or middle-income countries (LMICs). OBJECTIVES Summarise the existing literature on self-management intervention programmes for community-dwelling older adults with type 2 DM; identify the principles, practices and criteria that define a self-management intervention programme for community-dwelling older adults with type 2 DM in LMICs. METHODS This present study will be a scoping review, combining quantitative and qualitative literature with a parallel results convergent synthesis design. The synthesis applies to analysing existing principles and practices that influence the selection and application of 'diabetes self-management intervention' among older adults in community settings with type 2 DM in LMICs. ETHICS AND DISSEMINATION As a secondary analysis, this scoping review does not require ethics approval. The final review results will be submitted for publication in a peer-reviewed journal in the rehabilitation, diabetes, occupational therapy or health promotion-related fields. Other dissemination strategies may be an oral presentation at international conferences or through various social media networks.
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Affiliation(s)
- Shashank Mehrotra
- Department of Occupational Therapy, Manipal College of Health Professions,Manipal Academy of Higher Education, Manipal, Karnataka, India-576104
| | - Sutanuka Bhattacharjya
- Department of Occupational Therapy, Byrdine F. Lewis College of Nursing & Health Professions, Georgia State University, Atlanta, Georgia, USA
| | - Ranjitha S Shetty
- Department of Community Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India -576104
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Ceyhan Y, Aydin C. Impact of COPD stage on self management with COPD patients: The mediating role of symptoms management. J Clin Nurs 2024; 33:3615-3623. [PMID: 38499992 DOI: 10.1111/jocn.17119] [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: 11/18/2023] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 03/20/2024]
Abstract
AIMS It is extremely important to determine the relationship between COPD and self-management (SM) in the disease process. However, the impact of symptom management (SpM) on this relationship is still unclear. The study aimed to examine the mediating role of SpM in the effect of the COPD stage on SM. DESIGN A predictive correlational study was reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. METHODS This study was conducted between 15 February 2023 and 15 June 15 2023, with 306 patients. Data were collected using the Symptom Management Scale for Self-Efficacy and the Chronic Disease Self-Management Scale. Descriptive statistics and Process Macro Model 4 in the SPSS program were used for data analysis. RESULTS Most of the patients were in the moderate stage of COPD; their SM scores were at low levels; SpM scores were at moderate levels. The model was significant, and the variables explained 65% of the model. The COPD stage was significantly positively correlated with SpM and negatively correlated with SM. There was a significant positive impact between SpM and SM. The positive and significant standardised indirect effect of SpM on SM evidenced a full mediating effect. CONCLUSIONS Symptom management has a full mediating role in the effect of the COPD stage on SM. It was revealed that the level of SM can be increased by achieving SpM. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Symptoms are vital in COPD. Progression of COPD increases symptom severity. Being successful in SpM greatly contributes to the achievement of self-management. Therefore, nurses should definitely consider symptom control in strengthening self-management in the care of patients with COPD. PATIENT OR PUBLIC CONTRIBUTION Patients' COPD stage was determined by a pulmonologist involved in the study. Voluntary patients with COPD hospitalised in the pulmonology clinic were included in the study.
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Affiliation(s)
- Yasemin Ceyhan
- Department of Internal Medicine Nursing, Kirsehir Ahi Evran University Faculty of Health Sciences, Kırşehir, Turkey
| | - Cihan Aydin
- Department of Chest Diseases, Clinic of Pulmonology, Kirsehir Ahi Evran University Training and Research Hospital, Kırşehir, Turkey
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Özkan E, İnal Özün Ö, Göktaş A, İlhan B. Patient activation in adults with visual impairment: a study of related factors. BMC Public Health 2024; 24:1599. [PMID: 38877430 PMCID: PMC11179267 DOI: 10.1186/s12889-024-18856-5] [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: 11/01/2023] [Accepted: 05/15/2024] [Indexed: 06/16/2024] Open
Abstract
This study aims to analyze variables related to patient activation in 78 individuals with visual impairment. The Patient Activation Measure (PAM) scores of participants showed no differences between males and females. It was found that the individuals living in urban areas, and participants with higher income and education levels had higher PAM scores. Still, the difference between the groups was statistically insignificant (p > 0.05). The PAM scores of the visually impaired individuals reflect taking action level of activation (66.51 ± 18.14-PAM level 3). There was a moderately significant relationship between PAM scores and visually impaired individuals' self-management, self-efficacy, healthy life awareness, social relations, and environment (p < 0.001). We found that the variables included in the regression model (marital status, self-management, self-efficacy, healthy life awareness, social relations, and environment) explained 72.2% of the PAM score. Individuals with visual impairment can be given training on self-management, self-efficacy, healthy life awareness, and quality of life associated with social relations and environment to develop positive health behaviors.
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Affiliation(s)
- Esma Özkan
- Department of Occupational Therapy, Gülhane Faculty of Health Sciences,, University of Health Sciences Turkey, Keçiören, Ankara, 06018, Türkiye.
| | - Özgü İnal Özün
- Neurological Physiotherapy-Rehabilitation, Gülhane Faculty of Physiotherapy and Rehabilitation, University of Health Sciences Turkey, Ankara, Türkiye
| | - Ayşe Göktaş
- Department of Occupational Therapy, Gülhane Faculty of Health Sciences,, University of Health Sciences Turkey, Keçiören, Ankara, 06018, Türkiye
| | - Bayazıt İlhan
- University of Health Sciences Turkey Ulucanlar Eye Training and Research Hospital, Ankara, Türkiye
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Timmer BHB, Bennett RJ, Montano J, Hickson L, Weinstein B, Wild J, Ferguson M, Holman JA, LeBeau V, Dyre L. Social-emotional well-being and adult hearing loss: clinical recommendations. Int J Audiol 2024; 63:381-392. [PMID: 36960799 DOI: 10.1080/14992027.2023.2190864] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/17/2023] [Accepted: 03/05/2023] [Indexed: 03/25/2023]
Abstract
Aim: Best-practice in audiological rehabilitation takes a holistic client- and family-centred approach and considers hearing care in the context of personal well-being. Hearing loss not only impairs the ability to hear, but can also compromise the ability to communicate, thus negatively impacting both social and emotional well-being. Hearing care professionals play a key role in fostering their client's well-being. This paper aims to provide evidence-based recommendations to ensure inclusion of social-emotional well-being in audiologic rehabilitation clinical practice.Methods: A review of current research and expert opinion.Results: This guide proposes a 5-step plan which includes: identifying the client's social-emotional well-being; including family members in audiological rehabilitation; incorporating social-emotional needs and goals in an individualized management plan; relating identified hearing needs and goals to rehabilitation recommendations; and using counselling skills and techniques to explore and monitor social-emotional well-being. Each component of the 5-step plan is discussed and clinical considerations are presented.Conclusion: These comprehensive recommendations provide guidance to hearing care professionals looking to ensure clients' social-emotional well-being are considered throughout the rehabilitation journey.
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Affiliation(s)
- Barbra H B Timmer
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
- Sonova AG, Switzerland
| | - Rebecca J Bennett
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
- Ear Science Institute Australia, Nedlands, Western Australia, Australia
- The Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Joseph Montano
- Weill Cornell Medicine, Department of Otolaryngology, New York, NY, USA
| | - Louise Hickson
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | | | - Jane Wild
- Audiology Service, Betsi Cadwaladr University Health Board, Wales, UK
| | - Melanie Ferguson
- Ear Science Institute Australia, Nedlands, Western Australia, Australia
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Jack A Holman
- Hearing Sciences (Scottish Section), Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Valeri LeBeau
- Audiology Service, Advanced Bionics LLC, Valencia, USA
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Schnoor K, Talboom-Kamp EPWA, Hajtić M, Chavannes NH, Versluis A. Facilitators of and Barriers to the Use of a Digital Self-Management Service for Diagnostic Testing: Focus Group Study With Potential Users. JMIR Hum Factors 2024; 11:e45115. [PMID: 38728071 PMCID: PMC11127139 DOI: 10.2196/45115] [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: 01/30/2023] [Revised: 01/02/2024] [Accepted: 03/20/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Health care lags in digital transformation, despite the potential of technology to improve the well-being of individuals. The COVID-19 pandemic has accelerated the uptake of technology in health care and increased individuals' willingness to perform self-management using technology. A web-based service, Directlab Online, provides consumers with direct digital access to diagnostic test packages, which can digitally support the self-management of health. OBJECTIVE This study aims to identify the facilitators, barriers, and needs of Directlab Online, a self-management service for web-based access to diagnostic testing. METHODS A qualitative method was used from a potential user's perspective. The needs and future needs for, facilitators of, and barriers to the use of Directlab Online were evaluated. Semistructured focus group meetings were conducted in 2022. Two focus groups were focused on sexually transmitted infection test packages and 2 were focused on prevention test packages. Data analysis was performed according to the principles of the Framework Method. The Consolidated Framework for Implementation Research was used to categorize the facilitators and barriers. RESULTS In total, 19 participants, with a mean age of 34.32 (SD 14.70) years, participated in the focus groups. Important barriers were a lack of privacy information, too much and difficult information, and a commercial appearance. Important facilitators were the right amount of information, the right kind of tests, and the involvement of a health care professional. The need for a service such as Directlab Online was to ensure its availability for users' health and to maintain their health. CONCLUSIONS According to the participants, facilitators and barriers were comprehension of the information, the goal of the website, and the overall appearance of the service. Although the service was developed in cocreation with health care professionals and users, the needs did not align. The users preferred understandable and adequate, but not excessive, information. In addition, they preferred other types of tests to be available on the service. For future research, it would be beneficial to focus on cocreation between the involved medical professionals and users to develop, improve, and implement a service such as Directlab Online.
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Affiliation(s)
- Kyma Schnoor
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands
| | - Esther P W A Talboom-Kamp
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands
- Zuyderland, Sittard-Geleen, Netherlands
| | - Muamer Hajtić
- Department of Medical informatics, University of Amsterdam, Amsterdam, Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands
| | - Anke Versluis
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands
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She P, Huang C, Peng L, Yang J, Wang L, Liu Q, Tang H. The effects of osteoporosis education program for patients with fragility fracture in China. Int J Orthop Trauma Nurs 2024; 52:101064. [PMID: 37956632 DOI: 10.1016/j.ijotn.2023.101064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/15/2023] [Accepted: 10/20/2023] [Indexed: 11/15/2023]
Affiliation(s)
- Pan She
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, No.87, Xiangya Road, Kaifu District, Changsha, 410008, Hunan, China; Orthopedics Department, Xiangya Hospital, Central South University, Changsha, 410008, Hunan province, China.
| | - Chun Huang
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, No.87, Xiangya Road, Kaifu District, Changsha, 410008, Hunan, China; Xiangya Nursing School, Central South University, No.172, Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, China.
| | - Lingli Peng
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, No.87, Xiangya Road, Kaifu District, Changsha, 410008, Hunan, China; Orthopedics Department, Xiangya Hospital, Central South University, Changsha, 410008, Hunan province, China.
| | - Jiaqi Yang
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, No.87, Xiangya Road, Kaifu District, Changsha, 410008, Hunan, China; Orthopedics Department, Xiangya Hospital, Central South University, Changsha, 410008, Hunan province, China.
| | - Ling Wang
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, No.87, Xiangya Road, Kaifu District, Changsha, 410008, Hunan, China; Orthopedics Department, Xiangya Hospital, Central South University, Changsha, 410008, Hunan province, China.
| | - Qingqing Liu
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, No.87, Xiangya Road, Kaifu District, Changsha, 410008, Hunan, China; Xiangya Nursing School, Central South University, No.172, Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, China.
| | - Hongying Tang
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, No.87, Xiangya Road, Kaifu District, Changsha, 410008, Hunan, China.
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Watson JC. Patient Expertise and Medical Authority: Epistemic Implications for the Provider-Patient Relationship. THE JOURNAL OF MEDICINE AND PHILOSOPHY 2024; 49:58-71. [PMID: 37874696 DOI: 10.1093/jmp/jhad045] [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] [Indexed: 10/26/2023] Open
Abstract
The provider-patient relationship is typically regarded as an expert-to-novice relationship, and with good reason. Providers have extensive education and experience that have developed in them the competence to treat conditions better and with fewer harms than anyone else. However, some researchers argue that many patients with long-term conditions (LTCs), such as arthritis and chronic pain, have become "experts" at managing their LTC. Unfortunately, there is no generally agreed-upon conception of "patient expertise" or what it implies for the provider-patient relationship. I review three prominent accounts of patient expertise and argue that all face serious objections. I contend, however, that a plausible account of patient expertise is available and that it provides a framework both for further empirical studies and for enhancing the provider-patient relationship.
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Zangger G, Mortensen SR, Tang LH, Thygesen LC, Skou ST. Association between digital health literacy and physical activity levels among individuals with and without long-term health conditions: Data from a cross-sectional survey of 19,231 individuals. Digit Health 2024; 10:20552076241233158. [PMID: 38410789 PMCID: PMC10896057 DOI: 10.1177/20552076241233158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 02/28/2024] Open
Abstract
Objectives This study explored associations between digital health literacy and physical activity levels and assessed potential interactions of long-term health conditions. Methods A cross-sectional survey was sent to 34,000 inhabitants in Region Zealand, Denmark. The survey included items on physical activity levels and three electronic Health Literacy Questionnaire (eHLQ) scales (1, 4, and 5). Associations were assessed by logistic regression and adjusted for confounders. Results A total of 19,231 participated in the survey. Positive associations were found between higher digital health literacy and being active >30 min./week at moderate-to-vigorous intensity (eHLQ 1: OR 1.24, p < 0.001; eHLQ 4: OR 1.13, p = 0.012; eHLQ 5: OR 1.25, p < 0.001), compliance with the World Health Organization minimum recommendations for physical activity (eHLQ 1: OR 1.33 p < 0.001; eHLQ 4: OR 1.08 p = 0.025; eHLQ 5: OR 1.32, p < 0.001), and self-reported physical active (eHLQ 1: OR 1.50 p < 0.001; eHLQ 4: OR 1.24 p < 0.001; eHLQ 5: OR 1.54 p < 0.001), even when fully adjusted for covariates. No significant interaction was found for long-term health conditions. However, individuals with more long-term health conditions exhibited the lowest digital health literacy scores (9% to 19% scored <2.0). Conclusion A higher digital health literacy is positively associated with higher physical activity levels. This highlights the importance of screening and promoting digital health literacy in managing digital health and digital physical activity interventions. Future research should explore strategies and targeted interventions to enhance digital health literacy and improve health outcomes.
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Affiliation(s)
- Graziella Zangger
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Region Zealand, Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Sofie Rath Mortensen
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Region Zealand, Slagelse, Denmark
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Lars Herman Tang
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Region Zealand, Slagelse, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Søren T. Skou
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Region Zealand, Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Demiray O, Gunes ED, Kulak E, Dogan E, Karaketir SG, Cifcili S, Akman M, Sakarya S. Classification of patients with chronic disease by activation level using machine learning methods. Health Care Manag Sci 2023; 26:626-650. [PMID: 37824033 DOI: 10.1007/s10729-023-09653-4] [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: 07/10/2021] [Accepted: 09/04/2023] [Indexed: 10/13/2023]
Abstract
Patient Activation Measure (PAM) measures the activation level of patients with chronic conditions and correlates well with patient adherence behavior, health outcomes, and healthcare costs. PAM is increasingly used in practice to identify patients needing more support from the care team. We define PAM levels 1 and 2 as low PAM and investigate the performance of eight machine learning methods (Logistic Regression, Lasso Regression, Ridge Regression, Random Forest, Gradient Boosted Trees, Support Vector Machines, Decision Trees, Neural Networks) to classify patients. Primary data collected from adult patients (n=431) with Diabetes Mellitus (DM) or Hypertension (HT) attending Family Health Centers in Istanbul, Turkey, is used to test the methods. [Formula: see text] of patients in the dataset have a low PAM level. Classification performance with several feature sets was analyzed to understand the relative importance of different types of information and provide insights. The most important features are found as whether the patient performs self-monitoring, smoking and exercise habits, education, and socio-economic status. The best performance was achieved with the Logistic Regression algorithm, with Area Under the Curve (AUC)=0.72 with the best performing feature set. Alternative feature sets with similar prediction performance are also presented. The prediction performance was inferior with an automated feature selection method, supporting the importance of using domain knowledge in machine learning.
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Affiliation(s)
- Onur Demiray
- Department of Computing, Imperial College London, London, SW7 2AZ, UK
| | - Evrim D Gunes
- College of Administrative Sciences and Economics, Koç University, Rumeli Feneri Yolu, Sariyer-Istanbul, Turkey.
| | - Ercan Kulak
- Ministry of Health Caycuma District Health Directorate, Zonguldak, Turkey
| | - Emrah Dogan
- Ministry of Health, Zonguldak Community Health Center, Zonguldak, Turkey
| | | | - Serap Cifcili
- Department of Family Medicine, Marmara University School of Medicine, Istanbul, Turkey
| | - Mehmet Akman
- Department of Family Medicine, Marmara University School of Medicine, Istanbul, Turkey
| | - Sibel Sakarya
- MPH, MHPE, School of Medicine, Department of Public Health, Koç University, Rumeli Feneri Yolu, Sariyer-Istanbul, Turkey
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Reistetter T, Hreha K, Dean JM, Pappadis MR, Deer RR, Li CY, Hong I, Na A, Nowakowski S, Shaltoni HM, Bhavnani SK. The Pre-Adaptation of a Stroke-Specific Self-Management Program Among Older Adults. J Aging Health 2023; 35:632-642. [PMID: 36719035 PMCID: PMC10387498 DOI: 10.1177/08982643231152520] [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] [Indexed: 02/01/2023]
Abstract
Objectives: Managing multimorbidity as aging stroke patients is complex; standard self-management programs necessitate adaptations. We used visual analytics to examine complex relationships among aging stroke survivors' comorbidities. These findings informed pre-adaptation of a component of the Chronic Disease Self-Management Program. Methods: Secondary analysis of 2013-2014 Medicare claims with stroke as an index condition, hospital readmission within 90 days (n = 42,938), and 72 comorbidities. Visual analytics identified patient subgroups and co-occurring comorbidities. Guided by the framework for reporting adaptations and modifications to evidence-based interventions, an interdisciplinary team developed vignettes that highlighted multimorbidity to customize the self-management program. Results: There were five significant subgroups (z = 6.19, p < .001) of comorbidities such as obesity and cancer. We constructed 6 vignettes based on the 5 subgroups. Discussion: Aging stroke patients often face substantial disease-management hurdles. We used visual analytics to inform pre-adaptation of a self-management program to fit the needs of older adult stroke survivors.
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Affiliation(s)
- Timothy Reistetter
- Department of Occupational Therapy, School of Health Professions, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900
| | - Kimberly Hreha
- Department of Orthopaedic Surgery, Occupational Therapy Doctorate Division, School of Medicine, Duke University, 40 Duke Medicine Circle, Durham, NC 27710
| | - Julianna M. Dean
- Department of Clinical, Health, and Applied Sciences, College of Human Sciences and Humanities, University of Houston-Clear Lake, 2700 Bay Area Blvd, Houston, TX 77058
| | - Monique R. Pappadis
- Department of Population Health and Health Disparities, School of Public and Population Health, University of Texas Medical Branch, 300 University Blvd, Galveston, TX 77555
| | - Rachel R. Deer
- Department of Nutrition, Metabolism and Rehabilitation Sciences, University of Texas Medical Branch, 300 University Blvd, Galveston, TX 77555
| | - Chih-Ying Li
- Department of Occupational Therapy, University of Texas Medical Branch, 300 University Blvd, Galveston, TX 77555
| | - Ickpyo Hong
- Department of Occupational Therapy, Yonsei University, 135 Backun Hall, Yonsei Univroad 1, Wonju, Gangwon-do, Republic of Korea, 26493
| | - Annalisa Na
- Department of Physical Therapy and Rehabilitation Sciences, Drexel University, 1601 Cherry Street, Philadelphia, PA 19102
| | - Sara Nowakowski
- Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030
| | - Hashem M. Shaltoni
- Department of Neurology, University of Texas Medical Branch, 300 University Blvd, Galveston, TX 77555
| | - Suresh K. Bhavnani
- Department of Population Health and Health Disparities, School of Public and Population Health, 300 University Blvd, Galveston, TX 77555
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Koh PPW, Mortenson WB. Evaluating a pilot community-based self-management program for adults with spinal cord injury. J Spinal Cord Med 2023:1-12. [PMID: 37548572 DOI: 10.1080/10790268.2023.2220510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Abstract
OBJECTIVE To evaluate outcomes and perceptions of participating in a pilot spinal cord injury (SCI) specific community-based self-management program. DESIGN A program evaluation conducted through the review of retrospective data. SETTING An outpatient vocational rehabilitation service in Singapore. PARTICIPANTS Adults with SCI who completed a self-management intervention. INTERVENTION A self-management educational program was delivered by healthcare professionals with involvement of peer mentors. Up to six self-selected topics were covered using a multi-modal teaching approach. OUTCOME MEASURES Retrospective data collected at baseline, post-intervention, and three-month follow-up were analyzed. Outcome measures included the University of Washington Self-Efficacy scale (UW-SES), SCI Secondary Conditions Scale (SCI-SCS), Community Integration Questionnaire (CIQ), and employment. Post-program survey findings were also reviewed. RESULTS Data from fifteen participants revealed positive changes over time for the UW-SES (η² = .27), SCI-SCS (η² = .21), and CIQ (η² = .23). Self-efficacy scores increased from baseline to post-intervention with a large effect size (Hedge's g = 0.89), and from baseline to follow-up with a medium effect size (Hedge's g = 0.50). Participants reported overall perceived benefit and satisfaction with the program's design and relevance. They valued access to useful information, effective instructional methods, program customization, and participant empowerment and affirmation. Suggestions for program refinement included: more peer support, psycho-emotional support, and continued program adaptability and accessibility. CONCLUSION A SCI-specific community-based self-management program was associated with short-term improvements in self-efficacy and was well-received. Further research is required to determine its effectiveness, essential program features that promote successful outcomes, and cost-effectiveness of program implementation.
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Affiliation(s)
- Pauline P W Koh
- Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Centralized Services, SPD, Singapore
| | - W Ben Mortenson
- Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, Canada
- Department of Occupational Sciences and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- International Collaboration on Repair Discoveries (ICORD), Vancouver, Canada
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Ismail A, Ghorashi NS, Javan R. New Horizons: The Potential Role of OpenAI's ChatGPT in Clinical Radiology. J Am Coll Radiol 2023; 20:696-698. [PMID: 36972862 DOI: 10.1016/j.jacr.2023.02.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 03/28/2023]
Affiliation(s)
- Ahmed Ismail
- George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Nima S Ghorashi
- George Washington University School of Medicine and Health Sciences, Washington, DC, and Radiology Interest Group President
| | - Ramin Javan
- Department of Radiology, George Washington University Hospital, Washington, DC, and Director of Advanced Brain Imaging and 3D Innovations Lab and Medical Student Radiology Clerkship Director.
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Persson S, Andersson AC, Gäre BA, Lindenfalk B, Lind J. Lived experience of persons with multiple sclerosis: A qualitative interview study. Brain Behav 2023:e3104. [PMID: 37246453 DOI: 10.1002/brb3.3104] [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: 02/09/2023] [Revised: 04/04/2023] [Accepted: 05/18/2023] [Indexed: 05/30/2023] Open
Abstract
INTRODUCTION Multiple sclerosis (MS) is a chronic autoimmune disease with a substantial impact on quality of life and functional capability. The prognosis of MS has changed over time due to the development of increasingly effective therapies. As the knowledge and perceptions of persons living with chronic conditions increasingly have been acknowledged, it has become important to understand lived experiences with a focus on everyday events and experiences as a way of knowing and interpreting the world. Exploring context-specific lived experiences as a source of knowledge about the disease and care may contribute to more precision in designing care services. The aim of this study was to explore the lived experience of persons living with MS in a Swedish context. MATERIALS AND METHODS A qualitative interview study was conducted with both purposeful and random sampling strategies, resulting in 10 interviews. Data were analyzed using inductive thematic content analysis. RESULTS The analysis generated 4 overarching themes with 12 subthemes, the 4 themes were: perspectives on life and health, influence on everyday life, relations with healthcare, and shared healthcare processes. The themes are concerned with the patients' own perspectives and context as well as medical and healthcare-related perspectives. Patterns of shared experiences were found, for example, in the diagnosis confirmation, future perspectives, and planning and coordination. More diverse experiences appeared concerning relations with others, one's individual requirements, symptoms and consequences, and knowledge building. CONCLUSION The findings suggest a need for a more diverse and coproduced development of healthcare services to meet diverse needs in the population with greater acknowledgement of the person's lived experience, including consideration of the complexity of the disease, personal integrity, and different ways of knowing. Findings from this study will be further explored together with other quantitative and qualitative data.
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Affiliation(s)
- Sofia Persson
- Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Futurum Academy for Health and Care, Jönköping, Sweden
| | - Ann-Christine Andersson
- Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Care Science, Malmö University, Malmö, Sweden
| | - Boel Andersson Gäre
- Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Futurum Academy for Health and Care, Jönköping, Sweden
| | - Bertil Lindenfalk
- Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Jonas Lind
- Section of Neurology, Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden
- Division of Neurobiology, Department of Biomedical and Clinical Sciences, Linköping University, Sweden
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Ricke E, Dijkstra A, Bakker EW. Feasibility, effectiveness and safety of self-management in pulmonary rehabilitation: a study protocol using a hybrid type 1 effectiveness-implementation design. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1178823. [PMID: 37228588 PMCID: PMC10203526 DOI: 10.3389/fresc.2023.1178823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/24/2023] [Indexed: 05/27/2023]
Abstract
Background As population ageing accelerates worldwide, chronic diseases will place an increasing burden on society and healthcare systems. Self-management interventions may become a key strategy for addressing chronic disease burden and healthcare costs, also in pulmonary rehabilitation (PR). One of the challenges here is long-term adherence. Understanding the level of adherence to PR may help inform clinical decision-making to focus more on self-management and less on clinical supervision. For this reason, a prediction model (PATCH) was developed. The presented protocol concerns a study that aims 1. to evaluate the safety and effectiveness of self-management within pulmonary rehabilitation (PR) on health outcomes in patients with chronic obstructive pulmonary disease (COPD), 2. to evaluate the predictive validity of the PATCH tool, and 3. to evaluate feasibility and acceptability of self-management and the PATCH tool by patients and physiotherapists. Methods and analysis This is a protocol of a hybrid type 1 effectiveness-implementation design, performed in primary physiotherapy practices in The Netherlands. The aim is to include 108 patients with COPD who have already followed PR for at least six weeks (maintenance stage of PR). According to the Dutch KNGF Guideline COPD, physiotherapists should reduce the number of supervised treatments after the maintenance phase and support self-management. In practice, this does not (always) happen. This protocol is based on implementing guideline advice: clinical supervision will be halved but patients are stimulated to engage in self-management by exercising unsupervised, leading to no change in the total planned exercise frequency. During the supervised sessions physiotherapists will assess and stimulate self-management. At baseline, and after 3, 6, 9 and 12 months, health outcomes (including adherence) will be evaluated as the primary outcome of this study. At each measurement, the physiotherapist will decide on the basis of individual scores whether the patient needs more clinical supervision or not. Secondary outcomes are the discriminatory power of the PATCH tool (can patients be correctly classified as adherent or non-adherent), and feasibility and acceptability of self-management and the PATCH tool by patients and physiotherapists. Questionnaires and semi-structured interviews will be used for assessment of the outcomes.Trial registration number: METc 2023/074.
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Affiliation(s)
- Ellen Ricke
- Department of Social Psychology, University of Groningen, Groningen, Netherlands
| | - Arie Dijkstra
- Department of Social Psychology, University of Groningen, Groningen, Netherlands
| | - Eric W. Bakker
- Department of Epidemiology and Data Science, Division EBM, Academic Medical Centre, Amsterdam, Netherlands
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15
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Snowden A, Young J, Roberge D, Schipani S, Murray E, Richard C, Lussier MT, White C. Holistic needs assessment in outpatient cancer care: a randomised controlled trial. BMJ Open 2023; 13:e066829. [PMID: 37142317 PMCID: PMC10163480 DOI: 10.1136/bmjopen-2022-066829] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
DESIGN Analyst blinded, parallel, multi-centre, randomised controlled trial (RCT). PARTICIPANTS People with confirmed diagnoses of cancer (head and neck, skin or colorectal) attending follow-up consultation 3 months post-treatment between 2015 and 2020. INTERVENTION Holistic needs assessment (HNA) or care as usual during consultation. OBJECTIVE To establish whether incorporating HNA into consultations would increase patient participation, shared decision making and postconsultation self-efficacy. OUTCOME MEASURES Patient participation in the consultations examined was measured using (a) dialogue ratio (DR) and (b) the proportion of consultation initiated by patient. Shared decision making was measured with CollaboRATE and self-efficacy with Lorig Scale. Consultations were audio recorded and timed. RANDOMISATION Block randomisation. BLINDING Audio recording analyst was blinded to study group. RESULTS 147 patients were randomised: 74 control versus 73 intervention. OUTCOME No statistically significant differences were found between groups for DR, patient initiative, self-efficacy or shared decision making. Consultations were on average 1 min 46 s longer in the HNA group (respectively, 17 m 25 s vs 15 min 39 s). CONCLUSION HNA did not change the amount of conversation initiated by the patient or the level of dialogue within the consultation. HNA did not change patient sense of collaboration or feelings of self-efficacy afterwards. HNA group raised more concerns and proportionally more emotional concerns, although their consultations took longer than treatment as usual. IMPLICATIONS FOR PRACTICE This is the first RCT to test HNA in medically led outpatient settings. Results showed no difference in the way the consultations were structured or received. There is wider evidence to support the roll out of HNA as part of a proactive, multidisciplinary process, but this study did not support medical colleagues facilitating it. TRIAL REGISTRATION NUMBER NCT02274701.
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Affiliation(s)
- Austyn Snowden
- Edinburgh Napier University, School of Nursing Midwifery and Social Care, Edinburgh, UK
| | - Jenny Young
- Edinburgh Napier University, School of Nursing Midwifery and Social Care, Edinburgh, UK
| | - Denis Roberge
- Département de médecine de famille et de médecine d'urgence, University of Quebec in Montreal, Montreal, Quebec, Canada
| | - Stefano Schipani
- Clinical Oncology, Beatson West of Scotland Cancer Centre, Glasgow, UK
- School of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Esther Murray
- Psychology, Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - Claude Richard
- MEDICODE, University of Quebec in Montreal, Montreal, Quebec, Canada
| | - Marie-Therese Lussier
- Faculté de médecine - Département de médecine de famille et de médecine d'urgence, University of Montreal, Montreal, Quebec, Canada
| | - Craig White
- School of Cancer Sciences, University of Glasgow, Glasgow, UK
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16
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Nichol L, Rodriguez AD, Pitt R, Wallace SJ, Hill AJ. "Self-management has to be the way of the future": Exploring the perspectives of speech-language pathologists who work with people with aphasia. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:327-341. [PMID: 35473422 DOI: 10.1080/17549507.2022.2055144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
PURPOSE Healthcare models have incorporated self-management approaches to facilitate increased patient responsibility for chronic condition management. As aphasia is a chronic condition, self-management may be beneficial for people with aphasia; however, the possible impacts of the language disorder on self-management must be acknowledged and addressed. Speech-language pathologists would likely be principal providers of self-management support; therefore, their perspectives should be sought when considering development of aphasia self-management approaches. This study aims to explore speech-language pathologist perspectives of aphasia self-management. METHOD In-depth, semi-structured interviews conducted with 15 speech-language pathologists in Australia. Interview data analysed using qualitative content analysis. RESULT Aphasia self-management was viewed as a person- and family-centred approach enabling comprehensive long-term care for people with aphasia and promoting control, responsibility, and independence. Speech-language pathologists were seen to have a substantial role providing self-management support and consultation, and training was required to expand this role. Communication partners and peer support were highly valued. Personal and environmental factors may influence successful aphasia self-management. Differences between aphasia self-management and chronic condition self-management were considered. CONCLUSION Self-management could facilitate long-term sustainable aphasia management. Aphasia self-management approaches should factor in how to maximise communication partner and peer support. Aphasia-friendly self-management resources are necessary.
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Affiliation(s)
- Leana Nichol
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Amy D Rodriguez
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center, Decatur, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Rachelle Pitt
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
- West Moreton Health, Ipswich, Australia
| | - Sarah J Wallace
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
| | - Annie J Hill
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
- Surgical, Treatment and Rehabilitation Service (STARS), Metro North Hospital and Health Service, Brisbane, Australia
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Amirkiai S, Obadan-Udoh E. Dental patients' perceptions of and desired content from patient health portals. J Am Dent Assoc 2023; 154:330-339.e3. [PMID: 36822909 DOI: 10.1016/j.adaj.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 10/04/2022] [Accepted: 12/27/2022] [Indexed: 02/23/2023]
Abstract
BACKGROUND Patient health portals (PHPs) encourage patient engagement to achieve the quadruple aim of health care: to improve the patient's experience of care, improve population health, reduce health care costs, and improve the work life of health care providers. The purpose of this study was to capture dental patients' perspectives on PHPs and their desired content. Specifically, the authors examined the important features for dental patients to have as well as the barriers and facilitators of PHPs. METHODS The authors conducted a cross-sectional study of adult patients attending the predoctoral, faculty, and resident clinics at an academic dental center from July through October 2020. Patients were invited to complete an 18-item self-administered survey. The survey captured patient demographics, preferences, desired content, and facilitators and barriers of PHPs. The authors performed descriptive statistical analysis and bivariate analysis. RESULTS A total of 325 people participated. Most participants had a bachelor's degree, internet access, government insurance, and a combined household income of more than $50,000 per year. Completed procedures, past visit summaries, and date of last visit were the top 3 types of information patients desired in dental health PHPs. The top 3 desired oral health topics in PHPs included signs of gingival disease and proper management, caries prevention, and proper toothbrushing and flossing techniques. Highest perceived barriers included high cost and privacy and security concerns. Highest perceived facilitators included user-friendly portals and monitoring personal health. CONCLUSIONS This study highlights dental patients' preferences for a PHP and can inform the development of dental PHPs. Dentists must overcome identified barriers to increase patient engagement in using dental PHPs. PRACTICAL IMPLICATIONS Implementing the patient-identified features in a dental PHP will help improve the quality of oral health care delivery by increasing patient engagement and improving the patient's experience.
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Nambisan P, Stange KC, Lyytinen K, Kahana E, Duthie E, Potnek M. A Comprehensive Digital Self-care Support System for Older Adults With Multiple Chronic Conditions: Development, Feasibility, and Usability Testing of myHESTIA. J Appl Gerontol 2023; 42:170-184. [PMID: 36226748 DOI: 10.1177/07334648221129859] [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: 01/21/2023] Open
Abstract
The objective of this mixed methods study is to evaluate the need for a comprehensive digital self-care support system (CDSSS) for older adults with multiple chronic conditions (MCC) and to examine whether such a system can be developed to enable daily capture of self-care data. The 3-phase study involved Phase-1: user needs assessment and prototype development; Phase-2: preliminary user evaluation of the prototype; and Phase-3: 4-week small group usability and feasibility testing of the tracking component of the prototype. Results of Phase-1 show the need for a CDSSS. Phase-2 results demonstrate interest among older adults in using such a CDSSS and Phase-3 findings show that older adults found the tracking component of the system easy to use for capturing daily inputs. Overall, the findings show that it is feasible to design a CDSSS for older adults with MCC in a way that is usable and functional for them.
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Affiliation(s)
- Priya Nambisan
- Department of Health Informatics & Administration, College of Health Sciences, 14751University of Wisconsin - Milwaukee, Milwaukee, WI, USA
| | - Kurt C Stange
- Center for Community Health Integration, and Departments of Family Medicine & Community Health, Population & 12304Quantitative Health Sciences, and Sociology, and the Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Kalle Lyytinen
- 33851Weatherhead School of Management, Case Western Reserve University, Cleveland, OH, USA
| | - Eva Kahana
- Department of Sociology, 2546Case Western Reserve University, Cleveland, OH, USA
| | - Edmund Duthie
- MCW Division of Geriatric and Palliative Medicine, Clement J. Zablocki Veterans' Administration Medical Center, 5506Froedtert & The Medical College of Wisconsin, Milwaukee, WI, USA
| | - Michael Potnek
- Internal Medicine/Geriatrics, Outreach Community Health Centers, 5505Marquette University, Milwaukee, WI, USA
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19
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Bergholdt SH, Hansen DG, Johnsen AT, Boman BS, Jensen PT. A NEw MOdel of individualized and patient-centered follow-up for women with gynecological cancer (the NEMO study)-protocol and rationale of a randomized clinical trial. Trials 2023; 24:74. [PMID: 36726187 PMCID: PMC9890753 DOI: 10.1186/s13063-022-07022-0] [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: 05/09/2022] [Accepted: 12/15/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Follow-up programs for gynecological cancer patients are currently under revision. There is limited evidence that traditional follow-up and clinical examinations improve survival in an early-stage gynecological setting. Further, traditional follow-up programs fail to accommodate the patient's need for psychosocial and sexual supportive care and to actively involve patients and their relatives in the follow-up process. Individualized programs may replace traditional routine follow-up with fixed intervals and length. Focusing on alarm-symptoms and self-reporting may ensure detection of recurrence while allowing a continuous attention to the patient's well-being and return to daily life. In this study, a nurse-led, individualized, and need-based intervention with a specific focus on patient empowerment is tested against a standard physician-led model primarily focusing on the detection of recurrence. METHODS The study is designed as a clinical, randomized trial conducted in one of four national onco-gynecological centers in Denmark. Patients with early-stage cervical or endometrial cancer are eligible for inclusion. The intervention group undergoes individualized, nurse-led follow-up supporting patient empowerment including repeated use of electronic patient-reported outcome measures (ePROMs) before each contact as a dialogue support tool. The follow-up contacts are mainly conducted by telephone. All project nurses attended a special training program before project start and are all well-educated and dedicated onco-gynecological nurses. The control group receives standard, physician-led, follow-up without use of ePROMs or specific focus on empowerment. The effect of the intervention is evaluated by questionnaires completed by patients at baseline (3 months after surgery) and 12, 18, and 36 months after surgery. Outcomes include empowerment using the Skill and technique subscale of the HEI-Q questionnaire as the primary outcome while fear of cancer recurrence and health-related quality of life as well as the remaining subscales of the HEI-Q represent secondary outcomes. Data is collected by use of the REDCap technology, which also provides a customized visual support function for the dialogue tool. DISCUSSION This study will provide new information about follow-up in early-stage gynecological cancer settings and thereby contribute to improvement of future follow-up programs. Importantly, the study will provide knowledge about the impact of specific focus on patient empowerment in follow-up programs and, further, how to facilitate empowerment among patients. TRIAL REGISTRATION The study is registered at clinicaltrials.gov: ID no. NCT03838861. Registered on 6 February 2019. Protocol version 2, issue date 21 November 2022.
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Affiliation(s)
- Stinne Holm Bergholdt
- grid.10825.3e0000 0001 0728 0170Department of Clinical Medicine, Faculty of Health Science, University of Southern Denmark, Odense, Denmark ,grid.7143.10000 0004 0512 5013Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Dorte Gilsaa Hansen
- grid.7143.10000 0004 0512 5013Center for Shared Decision Making, Lillebaelt Hospital, University Hospital of Southern Denmark, Odense, Denmark ,grid.10825.3e0000 0001 0728 0170Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark ,grid.10825.3e0000 0001 0728 0170Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Anna Thit Johnsen
- grid.10825.3e0000 0001 0728 0170Department of Psychology, University of Southern Denmark, Odense, Denmark ,grid.476266.7Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Roskilde, Denmark
| | | | - Pernille Tine Jensen
- grid.10825.3e0000 0001 0728 0170Department of Clinical Medicine, Faculty of Health Science, University of Southern Denmark, Odense, Denmark ,grid.154185.c0000 0004 0512 597XDepartment of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark ,grid.7048.b0000 0001 1956 2722Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
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Ricke E, Bakker EW. Development and Validation of a Multivariable Exercise Adherence Prediction Model for Patients with COPD: A Prospective Cohort Study. Int J Chron Obstruct Pulmon Dis 2023; 18:385-398. [PMID: 36987443 PMCID: PMC10040155 DOI: 10.2147/copd.s401023] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
Purpose Pulmonary rehabilitation (PR) is considered a cost-effective method of improving health-related quality of life in patients with chronic obstructive pulmonary disease (COPD). However, increasing demand and increasing costs of supply demands for sustainable and affordable care. One of the possible solutions to keep care affordable is self-management. A challenge here is non-adherence. Understanding who are adherent and who are non-adherent could be helpful to differentiate between patients who need more or less support. Therefore, the aim of this study was to develop and validate a model to predict adherence to PR in patients with COPD. Patients and methods A multivariable logistic regression model for exercise adherence was developed. Eight candidate predictors, that were prespecified, were obtained in a prospective cohort study from 196 patients with COPD following PR in 53 primary physiotherapy practices in the Netherlands and Belgium, between January 2021 and August 2022. To create a parsimonious model, variable selection using backward selection was performed with a p-value of >0.05 for elimination. Model performance was assessed by discrimination, calibration and clinical utility. Internal validation was assessed by bootstrapping (n = 500). Results The final model included four predictors: intention, depression, MRC-score and alliance. The optimism-corrected AUC after bootstrap internal validation was 0.79 (95% CI, 0.72-0.85). Calibration plots suggested good calibration and decision curve analysis showed great net benefit in a wide range of risk thresholds. Conclusion The exercise adherence prediction model has potential for clinical utility to predict adherence in patients with COPD. Information from such a model can be used to manage the patient instead of managing the disease, and thereby to determine the treatment frequency for each individual patient. As a result, healthcare capacity might be better distributed, potentially reducing pressure on healthcare without compromising the effectiveness of PR for the individual patient.
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Affiliation(s)
- Ellen Ricke
- Department of Social Psychology, University of Groningen, Groningen, the Netherlands
- Correspondence: Ellen Ricke, Department of Social Psychology, University of Groningen, Grote Kruisstraat 2/1, Groningen, 9712 TS, the Netherlands, Tel +31 6 211 817 02, Email
| | - Eric W Bakker
- Department of Epidemiology and Data Science | Division EBM, Academic Medical Centre, Amsterdam, the Netherlands
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Okhovati M, Bagherinezhad Z, Gavgani VZ, Safizadeh H. Physician-directed information prescription service. A scoping review. PATIENT EDUCATION AND COUNSELING 2022; 105:3369-3380. [PMID: 35985907 DOI: 10.1016/j.pec.2022.08.002] [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: 04/17/2022] [Revised: 07/31/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This scoping review aims to identify and map the characteristics of research studies, types, delivery methods, and team members of physician-directed information prescription services. METHODS Following the PRISMA-ScR checklist, a systematic search was performed on Web of Science, Scopus, Library, Information Science & Technology Abstracts (LISTA), and PubMed/Medline from 1990 to 2021. RESULTS 37 studies were included in the final analysis. Five types of providing information prescription were recognized: typical, oral, web-based, electronic, and mixed methods. Physicians, nurses, and librarians were the most agreed-upon professionals in information prescription delivery teams. The steps of prescribing information were needs assessment, content production, information evaluation, prescribing information, follow-up, and documentation. DISCUSSION This review presents a synthesis of the process of information prescription. It is suggested to determine the effective information prescription type, provide methods and develop the service according to patients' preferences and characteristics. PRACTICE IMPLICATIONS Results of this study can be used to identify the challenges, the competent individuals, roles, and steps of information prescription service, as well as design and develop the protocol, model, and flowchart of it.
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Affiliation(s)
- Maryam Okhovati
- Student Research Committee, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Islamic Republic of Iran.
| | - Zohreh Bagherinezhad
- Student Research Committee, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Islamic Republic of Iran; Kerman University of Medical Sciences, Medical University Campus, Haft Bagh Highway, Kerman, Islamic Republic of Iran.
| | - Vahideh Zarea Gavgani
- School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran.
| | - Hossein Safizadeh
- Research Center for Social Determinants of Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Islamic Republic of Iran.
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Peng MM, Ma Z, Luo W, Hu SH, Yang X, Liu B, Lai-Wan Chan C, Ran MS. Longitudinal impact of caregiver transition and family caregiving on psychiatric symptoms and psychosocial functioning among persons with schizophrenia in rural China. FAMILY PROCESS 2022; 61:1663-1680. [PMID: 34921397 DOI: 10.1111/famp.12743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 10/27/2021] [Accepted: 11/12/2021] [Indexed: 02/05/2023]
Abstract
This study examines the 21-year longitudinal impacts and predictive effects of family caregiver transition and the presence of family caregiving on the clinical status of persons with schizophrenia (PwSs) in a rural area of China. Using panel data derived from the Chengdu Mental Health Project (CMHP), 250 dyads of PwSs and their family caregivers were investigated in 1994 and 2015. The Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning (GAF) were utilized. The generalized linear model (GLM) approach was used. The results of this study showed that more severe symptoms in PwSs were found to be significantly predicted by older age and nonmarried status at baseline. Compared with "spousal caregiving in two waves," the PANSS score was significantly higher in the "transition into sibling caregiving" group. A higher degree of psychosocial functioning was found to be significantly predicted by marital status, shorter duration of illness, and better mental status. Compared with "spousal caregiving in two waves," the GAF score was significantly lower in the "transition into parental caregiving" group. The presence of family caregiving was not a significant predictor of the severity of symptoms or psychosocial functioning in the PwSs. In conclusion, this study shows the 21-year predictive effects of family caregiver transition on the mental status of PwSs but not the presence of family caregiving. Psychosocial interventions and specific guidance should be provided to family caregivers to enhance their quality of caregiving and improve the prognosis of PwSs during long periods of home care.
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Affiliation(s)
- Man-Man Peng
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University at Zhuhai, Zhuhai, China
| | - Zhiying Ma
- Crown Family School of Social Work, Policy, and Practice, The University of Chicago, Chicago, Illinois, USA
| | - Wei Luo
- Chengdu Xinjin Second People's Hospital, Xinjin, Chengdu, Sichuan, China
| | - Shi-Hui Hu
- Chengdu Mental Health Center, Chengdu, China
| | - Xin Yang
- Guangyuan Mental Health Center, Guangyuan, China
| | - Bo Liu
- Jingzhou Mental Health Center, Jingzhou, China
| | - Cecilia Lai-Wan Chan
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China.,Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
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Kim S, Xu Y, Dore K, Gewurtz R, Larivière N, Letts L. Fatigue self-management led by occupational therapists and/or physiotherapists for chronic conditions: A systematic review and meta-analysis. Chronic Illn 2022; 18:441-457. [PMID: 34515530 PMCID: PMC9397391 DOI: 10.1177/17423953211039783] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the effectiveness of occupational therapist-/physiotherapist-guided fatigue self-management for individuals with chronic conditions. METHODS Eight databases, including MEDLINE and EMBASE, were searched until September 2019 to identify relevant studies. Randomised controlled trials and quasi-experimental studies of self-management interventions specifically developed or delivered by occupational therapists/physiotherapists to improve fatigue symptoms of individuals with chronic conditions were included. A narrative synthesis and meta-analysis were conducted to determine the effectiveness of fatigue self-management. RESULTS Thirty-eight studies were included, and fatigue self-management approaches led by occupational therapists/physiotherapists were divided into six categories based on the intervention focus: exercise, energy conservation, multimodal programmes, activity pacing, cognitive-behavioural therapy, and comprehensive fatigue management. While all exercise programmes reported significant improvement in fatigue, other categories showed both significant improvement and no improvement in fatigue. Meta-analysis yielded a standardised mean difference of the overall 13 studies: 0.42 (95% confidence interval:-0.62 to - 0.21); standardised mean difference of the seven exercise studies was -0.55 (95% confidence interval: -0.78 to -0.31). DISCUSSION Physical exercises inspired by the self-management principles may have positive impacts on fatigue symptoms, quality of life, and other functional abilities.
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Affiliation(s)
- Sungha Kim
- 63662School of Rehabilitation Science, 3710McMaster University, Hamilton, ON, Canada
| | - Ying Xu
- 63662School of Rehabilitation Science, 3710McMaster University, Hamilton, ON, Canada
| | - Kelly Dore
- Department of Medicine, 12362McMaster Education Research, Innovation & Theory (MERIT), 12370David Braley Health Science Centre, Hamilton, ON, Canada
| | - Rebecca Gewurtz
- 63662School of Rehabilitation Science, 3710McMaster University, Hamilton, ON, Canada
| | - Nadine Larivière
- Department of Medicine, 12362McMaster Education Research, Innovation & Theory (MERIT), 12370David Braley Health Science Centre, Hamilton, ON, Canada
| | - Lori Letts
- 63662School of Rehabilitation Science, 3710McMaster University, Hamilton, ON, Canada
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Fawson S, Dibley L, Smith K, Batista J, Artom M, Windgassen S, Syred J, Moss-Morris R, Norton C. Developing an Online Program for Self-Management of Fatigue, Pain, and Urgency in Inflammatory Bowel Disease: Patients' Needs and Wants. Dig Dis Sci 2022; 67:2813-2826. [PMID: 34146202 PMCID: PMC8214381 DOI: 10.1007/s10620-021-07109-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 06/09/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is a lifelong relapsing-remitting condition, characterized by troublesome symptoms including fatigue, pain, and bowel urgency. These symptoms can persist even in clinical remission and have a debilitating impact on social, work-related and intimate domains of life. Symptom self-management can be challenging for some patients, who could potentially benefit from an online self-management tool. AIMS We aimed to understand patients' symptom self-management strategies and preferred design for a future online symptom self-management intervention. METHODS Using exploratory qualitative methods, we conducted focus group and individual interviews with 40 people with IBD recruited from UK clinics and from community-dwelling members of the Crohn's and Colitis UK charity; data were collected using a digital audio recorder, and transcribed and anonymized by a third party (professional) transcriber. We used framework analysis for focus group data and thematic analysis for interview data. RESULTS The data provided three core themes: ways of coping; intervention functionality; and intervention content. Participants attempt to manage all three symptoms simultaneously, recognizing the combined influence of factors such as food, drink, stress, and exercise on all symptoms. They wanted an accessible online intervention functioning across several platforms, with symptom and medication management, and activity-tracking features. CONCLUSIONS Patients reported numerous ways of self-managing symptoms of fatigue, pain, and urgency/incontinence related to IBD and expressed their needs for content, design, and functionality of the proposed intervention. Based on this and existing intervention development literature, the IBD-BOOST online self-management intervention has now been developed and is undergoing testing.
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Affiliation(s)
- Sophie Fawson
- Institute of Psychiatry, Psychology and Neurosciences, King’s College London, London, UK
| | - Lesley Dibley
- Institute for Lifecourse Development, School of Health Sciences, Faculty of Education, Health, and Human Sciences, University of Greenwich, Avery Hill Campus, London, UK
| | - Kaylee Smith
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, UK
| | - Joanna Batista
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, UK
| | - Micol Artom
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, UK
| | - Sula Windgassen
- Institute of Psychiatry, Psychology and Neurosciences, King’s College London, London, UK
| | - Jonathan Syred
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, UK
| | - Rona Moss-Morris
- Institute of Psychiatry, Psychology and Neurosciences, King’s College London, London, UK
| | - Christine Norton
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, UK
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Colombet C, Alcaraz C, de la Tribonnière X, Morsa M, Rattaz C, Baghdadli A. Self-reported needs of caregivers of people with Autism Spectrum Disorder. J Autism Dev Disord 2022:10.1007/s10803-022-05499-x. [PMID: 35441919 DOI: 10.1007/s10803-022-05499-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Autism spectrum disorder (ASD) has a major impact on caregivers. We aimed to describe caregivers' perceptions concerning their level of knowledge about ASD and their needs to better adapt education and training programs. METHODS This was a descriptive cross-sectional study conducted through a declarative and self-administered survey in France. RESULTS 1,013 individuals answered the questionnaire in 2020. If most caregivers felt they had sufficient knowledge about ASD, they still expressed a high level of needs regarding acquiring knowledge, identifying available resources, and finding social/emotional support. CONCLUSIONS This study highlights the high level of needs of caregivers and their expectations of improving their knowledge and skills to help the person with ASD.
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Affiliation(s)
- Claire Colombet
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neuro-développementaux, CHU Montpellier, Montpellier, France.
| | - Céline Alcaraz
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neuro-développementaux, CHU Montpellier, Montpellier, France
| | - Xavier de la Tribonnière
- Unité transversale d'éducation du patient (UTEP), CHU Montpellier, Montpellier, France.,Faculté de Médecine, Université de Montpellier, Montpellier, France
| | - Maxime Morsa
- Laboratoire Education et Pratiques de Santé (UR3412), Université Paris Sorbonne Paris Nord, Bobigny, France
| | - Cécile Rattaz
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neuro-développementaux, CHU Montpellier, Montpellier, France
| | - Amaria Baghdadli
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neuro-développementaux, CHU Montpellier, Montpellier, France.,Faculté de Médecine, Université de Montpellier, Montpellier, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France
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Carmienke S, Fink A, Baumert J, Heidemann C, Du Y, Frese T, Heise M. Participation in structured diabetes self-management education programs and its associations with self-management behaviour - a nationwide population-based study. PATIENT EDUCATION AND COUNSELING 2022; 105:843-850. [PMID: 34272129 DOI: 10.1016/j.pec.2021.07.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 07/08/2021] [Accepted: 07/09/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To evaluate the relationship between participation in structured diabetes self-management education programs (DSME) and self-management behaviour (SMB) in routine care. METHODS The study included 864 ever- and 515 never-DSME participants from the population-based survey German Health Update (GEDA) 2014/2015. SMB and clinical care variables were: Following a diet plan, keeping a diabetes diary, holding a diabetes pass, self-monitoring of blood glucose (SMBG), foot self-examination (FSE), retinopathy screening, haemoglobin A1c (HbA1c) measurement and examination of the feet by clinicians (FEC). We conducted logistic regression analyses for association of DSME-participation with SMB, adjusting for various variables. RESULTS DSME-participation was significantly associated with SMB including following a diet plan (OR 1.88 [95% CI 1.21-2.92]), keeping a diabetes journal (OR 3.83 [2.74-5.36]), holding a diabetes health passport (OR 6.11 [4.40-8.48]), SMBG (OR 2.96 [2.20-3.98]) and FSE (OR 2.64 [2.01-3.47]) as well as retinopathy screening (OR 3.30 [2.31-4.70]), HbA1c measurement (OR 2.58 [1.88-3.52]), and FEC (OR 3.68 [2.76-4.89]) after adjusting for confounders. CONCLUSION DSME-participation is associated with higher frequencies of various SMB and clinical care variables in routine care. Never-DSME attenders are more likely not to receive retinopathy screening, FEC and HbA1c measurements as recommended. PRACTICE IMPLICATIONS Clinicians should refer diabetes patients to a DSME and ensure a regular follow up for never-DSME attenders.
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Affiliation(s)
- Solveig Carmienke
- Institute of General Practice and Family Medicine, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Magdeburger Strasse 8, 06112 Halle, Saale, Germany
| | - Astrid Fink
- Institute of Medical Sociology, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany
| | - Jens Baumert
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Unit Physical Health, Berlin, Germany
| | - Christin Heidemann
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Unit Physical Health, Berlin, Germany
| | - Yong Du
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Unit Physical Health, Berlin, Germany
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Magdeburger Strasse 8, 06112 Halle, Saale, Germany
| | - Marcus Heise
- Institute of General Practice and Family Medicine, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Magdeburger Strasse 8, 06112 Halle, Saale, Germany.
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27
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Alushi L, Alexander J, Jones J, Lafortune L. A Systematic Review on Physical Health Education Interventions for People with Parkinson's Disease: Content, Impact, and Implementation Considerations Across the Parkinson's Trajectory. JOURNAL OF PARKINSON'S DISEASE 2022; 12:1389-1407. [PMID: 35599500 DOI: 10.3233/jpd-223259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Educational interventions promoting the role of physical activity (PA) aim to address knowledge, poor exercise self-efficacy, and low outcome expectations, which are well-researched barriers to PA participation in healthy and in people with chronic conditions. However, little is known about the effectiveness of educational interventions in addressing these barriers in people with Parkinson's (PwP). OBJECTIVE To examine the content of education interventions that promote PA behavior in PwP, and to assess their effectiveness on physical and psychosocial outcomes. METHODS An electronic search (12/2021) of MEDLINE, EMBASE, CINAHL, PubMed PsycINFO, the Web of Science and the Cochrane Library was conducted from 1990 to 2021. Education interventions, alone or combined with other strategies, promoting PA in PwP were included. Quality was assessed using the Johanna Briggs Institute and National Institute of Health quality assessment tools. A narrative synthesis was performed. RESULTS Six studies were identified. Five interventions were comprised of education and exercise sessions. Improvement in physical and psychosocial outcomes were suggested but delineating the exact impact of education was impeded due to lack of assessment. CONCLUSION Few interventions exist that provide knowledge, and skills promoting PA participation, and fewer are addressed towards newly diagnosed PwP. There is lack of assessment over the effectiveness of education as a tool to facilitate PA participation in PwP. Lack of assessment poses the risk of potentially disregarding effective interventions or adopting ineffective approaches without the evidence. Education interventions can boost PA engagement by increasing factors such as exercise self-efficacy, but further interventions are required to assess this model of relationship.
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Affiliation(s)
- Ledia Alushi
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - James Alexander
- Centre for Applied Health & Social Care Research, Kingston & St George's, University of London, London, UK
- Camden Neurology & Stroke Service, Central and North West London NHS Foundation Trust, London, UK
| | - Julie Jones
- School of Health Sciences, Robert Gordon University, Aberdeen, Scotland
| | - Louise Lafortune
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Cambridge Public Health, Interdisciplinary Research Centre, University of Cambridge, Cambridge, UK
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Howell D. Enabling patients in effective self-management of breathlessness in lung cancer: the neglected pillar of personalized medicine. Lung Cancer Manag 2021; 10:LMT52. [PMID: 34899992 PMCID: PMC8656340 DOI: 10.2217/lmt-2020-0017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 05/20/2021] [Indexed: 11/21/2022] Open
Abstract
Globally, engagement of patients in the self management of disease and symptom problems has become a health policy priority to improve health outcomes in cancer. Unfortunately, little attention has been focused on the provision of self-management support (SMS)in cancer and specifically for complex cancer symptoms such as breathlessness. Current management of breathlessness, which includes treatment of underlying disease, pharmacological agents to address comorbidities and opiates and anxiolytics to change perception and reduce the sense of breathing effort, is inadequate. In this perspective paper, we review the rationale and evidence for a structured, multicomponent SMS program in breathlessness including four components: breathing retraining, enhancing positive coping skills, optimizing exertional capacity and reducing symptom burden and health risks. The integration of SMS in routine lung cancer care is essential to improve breathlessness, reduce psychological distress, suffering and improve quality of life.
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Affiliation(s)
- Doris Howell
- Princess Margaret Cancer Research Centre, Toronto, ON, Canada
- Faculty of Nursing, University of Toronto, Toronto, ON, Canada
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29
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Nomiko D, Sepalanita W. The correlation between selfcare management and quality of life among patients undergoing hemodialysis. ENFERMERIA CLINICA 2021. [DOI: 10.1016/j.enfcli.2021.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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30
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Ould Brahim L, Lambert SD, Feeley N, Coumoundouros C, Schaffler J, McCusker J, Moodie EEM, Kayser J, Kolne K, Belzile E, Genest C. The effects of self-management interventions on depressive symptoms in adults with chronic physical disease(s) experiencing depressive symptomatology: a systematic review and meta-analysis. BMC Psychiatry 2021; 21:584. [PMID: 34800995 PMCID: PMC8605588 DOI: 10.1186/s12888-021-03504-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 09/28/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Chronic diseases are the leading cause of death worldwide. It is estimated that 20% of adults with chronic physical diseases experience concomitant depression, increasing their risk of morbidity and mortality. Low intensity psychosocial interventions, such as self-management, are part of recommended treatment; however, no systematic review has evaluated the effects of depression self-management interventions for this population. The primary objective was to examine the effect of self-management interventions on reducing depressive symptomatology in adults with chronic disease(s) and co-occurring depressive symptoms. Secondary objectives were to evaluate the effect of these interventions on improving other psychosocial and physiological outcomes (e.g., anxiety, glycemic control) and to assess potential differential effect based on key participant and intervention characteristics (e.g., chronic disease, provider). METHODS Studies comparing depression self-management interventions to a control group were identified through a) systematic searches of databases to June 2018 [MEDLINE (1946 -), EMBASE (1996 -), PsycINFO (1967 -), CINAHL (1984 -)] and b) secondary 'snowball' search strategies. The methodological quality of included studies was critically reviewed. Screening of all titles, abstracts, and full texts for eligibility was assessed independently by two authors. Data were extracted by one author and verified by a second. RESULTS Fifteen studies were retained: 12 for meta-analysis and three for descriptive review. In total, these trials included 2064 participants and most commonly evaluated interventions for people with cancer (n = 7) or diabetes (n = 4). From baseline to < 6-months (T1), the pooled mean effect size was - 0.47 [95% CI -0.73, - 0.21] as compared to control groups for the primary outcome of depression and - 0.53 [95% CI -0.91, - 0.15] at ≥ 6-months (T2). Results were also significant for anxiety (T1) and glycemic control (T2). Self-management skills of decision-making and taking action were significant moderators of depression at T1. CONCLUSION Self-management interventions show promise in improving depression and anxiety in those with concomitant chronic physical disease. The findings may contribute to the development of future Self-management interventions and delivering evidence-based care to this population. Further high-quality RCTs are needed to identify sources of heterogeneity and investigate key intervention components.
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Affiliation(s)
| | - Sylvie D. Lambert
- grid.14709.3b0000 0004 1936 8649Ingram School of Nursing, McGill University, Montreal, Canada ,St. Mary’s Research Centre, Montreal, Canada
| | - Nancy Feeley
- grid.14709.3b0000 0004 1936 8649Ingram School of Nursing, McGill University, Montreal, Canada ,Centre for Nursing Research, Montreal, Canada
| | - Chelsea Coumoundouros
- grid.8993.b0000 0004 1936 9457Healthcare Sciences and e-Health, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | | | - Jane McCusker
- St. Mary’s Research Centre, Montreal, Canada ,grid.14709.3b0000 0004 1936 8649Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Erica E. M. Moodie
- grid.14709.3b0000 0004 1936 8649Department of Epidemiology, Biostatistics, and Occupational Health, McGill University Montreal, Montreal, Canada
| | - John Kayser
- grid.459278.50000 0004 4910 4652CIUSSS du Centre-Sud-de-l’Île-de-Montréa, Montreal, Canada
| | - Kendall Kolne
- Trillium Lakelands District School Board, Lindsay, Canada
| | | | - Christine Genest
- grid.14848.310000 0001 2292 3357Faculty of Nursing Sciences, Université de Montreal, Montreal, Quebec Canada
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Patient Strategies for Managing the Vicious Cycle of Fatigue, Pain and Urgency in Inflammatory Bowel Disease: Impact, Planning and Support. Dig Dis Sci 2021; 66:3330-3342. [PMID: 33164146 DOI: 10.1007/s10620-020-06698-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/24/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) causes inter-related symptoms of fatigue, pain and urgency which can persist in remission. AIM To understand how people with IBD experience and self-manage these symptoms and to inform the future development of an online self-management programme. METHODS Using exploratory qualitative methods, we recruited participants from clinic and community settings. Focus groups, conducted across the UK, were audio-recorded and professionally transcribed. Transcripts were analysed over four rounds using framework analysis. Eight patients were consulted to agree the final structure of data and themes. RESULTS Seven focus groups were held; five gave useable data. Twenty-six participants (15 female; ages 21-60 years; disease duration 2-40 years) with Crohn's disease (n = 10), ulcerative colitis (n = 14) and IBD-unclassified (n = 2) attended one of these five focus groups. Three core themes emerged: The Negative Impact of Symptoms, Positively Taking Control and Seeking and Receiving Support. The persistent, often stark impact of multiple co-existing symptoms on physical and emotional wellbeing can force unwanted adjustments and limitations in working, social and intimate arenas of life. Unpredictable symptoms are challenging and impact each other in negative vicious cycles. Managing diet, pacing, accepting background levels of fatigue, pain and urgency, seeking support, exercising and attending to mental wellbeing, are all perceived as helpful in self-managing symptoms. CONCLUSION Fatigue, pain and urgency are troublesome for patients, especially in combination, suggesting that these should be addressed simultaneously by clinicians. Participants reported several strategies for self-management, providing patient-focused evidence to inform future development of a self-management intervention programme.
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Lorenz-Artz K, Bierbooms J, Bongers I. Integrating eHealth within a Transforming Mental Healthcare Setting: A Qualitative Study into Values, Challenges, and Prerequisites. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10287. [PMID: 34639587 PMCID: PMC8508136 DOI: 10.3390/ijerph181910287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/23/2021] [Accepted: 09/26/2021] [Indexed: 11/23/2022]
Abstract
Mental health care is shifting towards more person-centered and community-based health care. Although integrating eHealth within a transforming healthcare setting may help accomplishing the shift, research studying this is lacking. This study aims to improve our understanding of the value of eHealth within a transforming mental healthcare setting and to define the challenges and prerequisites for implementing eHealth in particular within this transforming context. In this article, we present the results of 29 interviews with clients, social network members, and professionals of an ambulatory team in transition within a Dutch mental health care institute. The main finding is that eHealth can support a transforming practice shifting towards more recovery-oriented, person-centered, and community-based service in which shared-decision making is self-evident. The main challenge revealed is how to deal with clients' voices, when professionals see the value of eHealth but clients do not want to start using eHealth. The shift towards client-centered and network-oriented care models and towards blended care models are both high-impact changes in themselves. Acknowledging the complexity of combining these high-impact changes might be the first step towards creating blended client-centered and network-oriented care. Future research should examine whether and how these substantial shifts could be mutually supportive.
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Affiliation(s)
- Karin Lorenz-Artz
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, 5000 LE Tilburg, The Netherlands; (J.B.); (I.B.)
- Mental Health Care Institute Eindhoven, 5626 ND Eindhoven, The Netherlands
| | - Joyce Bierbooms
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, 5000 LE Tilburg, The Netherlands; (J.B.); (I.B.)
- Mental Health Care Institute Eindhoven, 5626 ND Eindhoven, The Netherlands
| | - Inge Bongers
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, 5000 LE Tilburg, The Netherlands; (J.B.); (I.B.)
- Mental Health Care Institute Eindhoven, 5626 ND Eindhoven, The Netherlands
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Stock S, Altin S, Nawabi F, Civello D, Shukri A, Redaèlli M, Alayli A. A cross-sectional analysis of health literacy: patient- versus family doctor-reported and associations with self-efficacy and chronic disease. BMC FAMILY PRACTICE 2021; 22:187. [PMID: 34525978 PMCID: PMC8442421 DOI: 10.1186/s12875-021-01527-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 08/19/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Adequate health literacy (HL) levels contribute to good health outcomes and successful disease self-management in patients with chronic disease. Hence, it is essential that family doctors recognize patients with inadequate HL in need of additional support. This study had two aims: (1) to assess and compare patient self-reported versus family doctor-rated HL estimates, and (2) to explore associations between patient-reported HL, self-efficacy and chronic diseases. METHODS Participants in this cross-sectional survey were recruited through general practices in North Rhine-Westphalia, Germany. Patient self-reported HL was measured using the European Health Literacy Survey-16. Family doctor-rated HL was measured with an adapted version of this instrument. Using crosstabulations patient-reported and family doctor-rated HL estimates were compared for 346 patient-family doctor pairs. Associations between HL, self-efficacy and chronic disease were investigated using regression analyses. RESULTS Patient-reported and family doctor-rated HL estimates were concordant in 38% of all cases. On average family doctors rated their patients' HL lower than patients rated their own HL. The lower average family doctor ratings were more pronounced when patients were older, male and had more than one chronic disease. Female family doctors rated HL of male patients lower than their male colleagues. Patient reported HL had a significant positive association with self-efficacy. Mediation analysis provided support that self-efficacy acts as mediator between HL and the number of chronic diseases. CONCLUSIONS Our study findings indicate a significant discrepancy between patients' self-reported HL and externally rated HL by family doctors. A more systematic utilization of HL screeners might help reduce this discrepancy. At the same time, consideration should be given to enhancing communication training for family doctors and addressing critical HL skills in patient education.
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Affiliation(s)
- Stephanie Stock
- Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50924, Cologne, Germany
| | | | - Farah Nawabi
- Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50924, Cologne, Germany
| | - Daniele Civello
- Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50924, Cologne, Germany
| | - Arim Shukri
- Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50924, Cologne, Germany
| | - Marcus Redaèlli
- Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50924, Cologne, Germany
| | - Adrienne Alayli
- Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50924, Cologne, Germany.
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Sultan N, Swinglehurst D. Self-Management in Older Pakistanis Living With Multimorbidity in East London. QUALITATIVE HEALTH RESEARCH 2021; 31:2111-2122. [PMID: 34110228 PMCID: PMC8552379 DOI: 10.1177/10497323211019355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In this article, we explore how older British Pakistani people experience multimorbidity (defined as the coexistence of two or more medical conditions) and engage with self-management within the context of their life histories and relationships. We conducted biographical narrative interviews in Urdu and/or English with 15 first-generation Pakistani migrants living with multimorbidity, at their homes in East London. Our analysis showed that the triadic construct of family, faith, and health was central to how participants made sense of their lives, constituting notions of "managing" in the context of multimorbidity. For Pakistani patients, the lived experience of health was inseparable from a situated context of family and faith. Our findings have implications for existing public health strategies of self-management, underpinned by neoliberal discourses that focus on individual responsibility and agency. Health care provision needs to better integrate the importance of relationships between family, faith, and health when developing services for these patients.
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Affiliation(s)
- Najia Sultan
- Queen Mary University of London, London, United Kingdom
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Veenhuizen Y, Satink T, Graff MJ, Geurts AC, Groothuis JT, van Engelen BG, Nijhuis-van der Sanden MW, Cup EH. Mixed methods evaluation of a self-management group programme for patients with neuromuscular disease and chronic fatigue. BMJ Open 2021; 11:e048890. [PMID: 34433601 PMCID: PMC8388284 DOI: 10.1136/bmjopen-2021-048890] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To obtain insight into experiences of patients with a neuromuscular disease and chronic fatigue and their healthcare professionals regarding content and delivery of a multidisciplinary outpatient self-management group programme to improve social participation. This will inform future implementation. DESIGN A mixed method study alongside a randomised controlled trial. SETTING University hospital, rehabilitation centre and community health centre. PARTICIPANTS 29 patients with a neuromuscular disease and chronic fatigue and 13 healthcare professionals participated in this mixed methods study. INTERVENTION Multidisciplinary group programme, called Energetic, consisted of a 4 months intervention with weekly meetings and covered four modules: (1) individually tailored aerobic exercise training; (2) education about aerobic exercise; (3) self-management training in applying energy conservation strategies and (4) implementation and relapse prevention in daily life. MAIN MEASURES Quantitative data were collected by a questionnaire measuring patients' (n=25, all completed the programme) satisfaction with the perceived results, content and delivery of the programme. Qualitative data were collected by individual and focus group interviews to gain insight in the experiences of patients (n=18), next of kin (n=2) and healthcare professionals (n=13) with facilitators and barriers to programme implementation. RESULTS Patients were satisfied with the number and length of the sessions, the different modules and the therapists. Analysis of the interviews led to five themes: (1) the combination of modules makes a complete picture, (2) the programme is physically and mentally intensive, (3) the group setting is valuable, (4) small variations in delivery occur in different settings, (5) therapists are coaches. Suggestions for programme improvement include a combination of face to face and e-health, enhancement of therapists' skills in guiding group interventions and inclusion of more booster sessions to evaluate and maintain self-management competencies. CONCLUSIONS The Energetic programme could be implemented in different healthcare settings and group settings, and a combination of modules proved to be a facilitator for improving self-management. TRIAL REGISTRATION NUMBER NCT02208687.
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Affiliation(s)
- Yvonne Veenhuizen
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Ton Satink
- School of Occupational Therapy, HAN University of Applied Science, Nijmegen, The Netherlands
| | - Maud Jl Graff
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
- IQ Healthcare, Research Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Alexander Ch Geurts
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Jan T Groothuis
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Baziel Gm van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Maria Wg Nijhuis-van der Sanden
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
- IQ Healthcare, Research Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Edith Hc Cup
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
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Burton I. Autoregulation in Resistance Training for Lower Limb Tendinopathy: A Potential Method for Addressing Individual Factors, Intervention Issues, and Inadequate Outcomes. Front Physiol 2021; 12:704306. [PMID: 34421641 PMCID: PMC8375597 DOI: 10.3389/fphys.2021.704306] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 07/06/2021] [Indexed: 01/08/2023] Open
Abstract
Musculoskeletal disorders, such as tendinopathy, are placing an increasing burden on society and health systems. Tendinopathy accounts for up to 30% of musculoskeletal disorders, with a high incidence in athletes and the general population. Although resistance training has shown short-term effectiveness in the treatment of lower limb tendinopathy, more comprehensive exercise protocols and progression methods are required due to poor long-term outcomes. The most common resistance training protocols are predetermined and standardized, which presents significant limitations. Current standardized protocols do not adhere to scientific resistance training principles, consider individual factors, or take the importance of individualized training into account. Resistance training programs in case of tendinopathy are currently not achieving the required intensity and dosage, leading to high recurrence rates. Therefore, better methods for individualizing and progressing resistance training are required to improve outcomes. One potential method is autoregulation, which allows individuals to progress training at their own rate, taking individual factors into account. Despite the finding of their effectiveness in increasing the strength of healthy athletes, autoregulation methods have not been investigated in case of tendinopathy. The purpose of this narrative review was 3-fold: firstly, to give an overview and a critical analysis of the individual factors involved in tendinopathy and current resistance training protocols and their limitations. Secondly, to give an overview of the history, methods, and application of autoregulation strategies both in sports performance and physiotherapy. Finally, a theoretical adaptation of a current tendinopathy resistance training protocol using autoregulation methods is presented, providing an example of how the method could be implemented in clinical practice or future research.
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Affiliation(s)
- Ian Burton
- National Health Service (NHS) Grampian, Aberdeen, United Kingdom
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Simonsmeier BA, Flaig M, Simacek T, Schneider M. What sixty years of research says about the effectiveness of patient education on health: a second order meta-analysis. Health Psychol Rev 2021; 16:450-474. [PMID: 34384337 DOI: 10.1080/17437199.2021.1967184] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Although meta-analyses have examined the association between patient education and health, the validity and quality of this evidence have not been comprehensively assessed. This second order meta-analysis combined previous meta-analyses that examined the effectiveness of patient education on health outcomes as an overall weighted grand mean d¯¯. Further, measures of methodological quality, meaningful variability across first order meta-analyses, and evidence for publication bias were examined. Forty meta-analyses were identified, investigating 156 associations between patient education and health summarizing data from over 776 studies including more than 74.947 patients. Quantitative analyses showed that patient education positively affects health outcomes with d¯¯ = 0.316 (95% CI [0.304, 0.329]). Summarizing data exclusively from randomized controlled trials indicated a causal effect. Patient education was effective for patients with neoplasms, diabetes, mental and behavioral disorders, diseases of the circulatory system, the respiratory system, and the musculoskeletal system. Patient education was effective in the reduction of medication use, pain, and visits to medical facilities, and significantly improved physiological, physical, psychological outcomes, and patients' general function. Overall, the findings reveal firm evidence for the effectiveness of patient education on health outcomes. However, theory-based interventions are lacking and need to be implemented to enable a successful transfer from theory to practice.
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Affiliation(s)
| | - Maja Flaig
- University of Tübingen, Tübingen, Germany
| | - Thomas Simacek
- Department of Educational Psychology, University of Trier, Trier, Germany
| | - Michael Schneider
- Department of Educational Psychology, University of Trier, Trier, Germany
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Absetz P, Van Olmen J, Guwatudde D, Puoane T, Alvesson HM, Delobelle P, Mayega R, Kasujja F, Naggayi G, Timm L, Hassen M, Aweko J, De Man J, Álvarez Ahlgren J, Annerstedt KS, Daivadanam M. SMART2D-development and contextualization of community strategies to support self-management in prevention and control of type 2 diabetes in Uganda, South Africa, and Sweden. Transl Behav Med 2021; 10:25-34. [PMID: 32011719 DOI: 10.1093/tbm/ibz188] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Type 2 diabetes (T2D) and its complications are increasing rapidly in low- and middle-income countries, as well as among socioeconomically disadvantaged populations in high-income countries. Support for healthy lifestyle and self-management is paramount but not well implemented in health systems, and there is need for knowledge on how to design and implement interventions that are contextualized and patient centered and address special needs of disadvantaged population groups. The SMART2D project implements and evaluates a lifestyle and self-management intervention for participants recently diagnosed with or being at increased risk for T2D in rural communities in Uganda, an urban township in South Africa, and socioeconomically disadvantaged urban communities in Sweden. Our aim was to develop an intervention with shared key functions and a good fit with the local context, needs, and resources. The intervention program design was conducted in three steps facilitated by a coordinating team: (a) situational analysis based on the SMART2D Self-Management Framework and definition of intervention objectives and core strategies; (b) designing generic tools for the strategies; and (c) contextual translation of the generic tools and their delivery. This article focuses on community strategies to strengthen support from the social and physical environment and to link health care and community support. Situational analyses showed that objectives and key functions addressing mediators from the SMART2D framework could be shared. Generic tools ensured retaining of functions, while content and delivery were highly contextualized. Phased, collaborative approach and theoretical framework ensured that key functions were not lost in contextualization, also allowing for cross-comparison despite flexibility with other aspects of the intervention between the sites. The trial registration number of this study is ISRCTN11913581.
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Affiliation(s)
| | - Josefien Van Olmen
- Department of Primary and Interdisciplinary Care, University of Antwerp 2000, Antwerp, Belgium.,Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - David Guwatudde
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda
| | - Thandi Puoane
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa
| | | | - Peter Delobelle
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa.,Chronic Disease Initiative for Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Rondebosch, South Africa
| | - Roy Mayega
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda
| | - Francis Kasujja
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda
| | - Gloria Naggayi
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda
| | - Linda Timm
- Department of Public Health Sciences, Karolinska Institutet, Solna, Sweden
| | - Mariam Hassen
- School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa
| | - Juliet Aweko
- Department of Public Health Sciences, Karolinska Institutet, Solna, Sweden
| | - Jeroen De Man
- Department of Primary and Interdisciplinary Care, University of Antwerp 2000, Antwerp, Belgium.,Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Jhon Álvarez Ahlgren
- Department of Public Health Sciences, Karolinska Institutet, Solna, Sweden.,International Maternal and Child Health Division, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Meena Daivadanam
- Department of Public Health Sciences, Karolinska Institutet, Solna, Sweden.,International Maternal and Child Health Division, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
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Understanding the Experience of Osteoporosis Risk in Bariatric Surgical Patients. Orthop Nurs 2021; 40:222-234. [PMID: 34397978 DOI: 10.1097/nor.0000000000000771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Despite what is known about risk factors, preventive treatment, and increased prevalence of fragility fractures in post-bariatric surgical patients, little is known about how patient perspectives of osteoporosis risk inform their commitment to bone health. The purpose of this study was to examine the lived experience of osteoporosis risk in people who have had bariatric surgery. Interpretive phenomenology was used to explore osteoporosis from the perspectives of patients who have had bariatric surgery. Eligibility criteria included female, age older than 18 years, and able to understand and speak English. This research provided an understanding of the risk of osteoporosis from the constructed realities and experiences of those who have had bariatric surgery. Participants in this study incorrectly felt they had little to no risk for osteoporosis after bariatric surgery. Patients need to be aware of an increased risk for osteoporosis leading to the potential for fragility fractures after bariatric surgery; nurses are well positioned to enhance osteoporosis prevention efforts in this population through pre- and postoperative education.
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Does education of primary care professionals promote patient self-management and improve outcomes in chronic disease? An updated systematic review. BJGP Open 2021; 5:BJGPO.2020.0186. [PMID: 33712503 PMCID: PMC8278509 DOI: 10.3399/bjgpo.2020.0186] [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: 12/22/2020] [Accepted: 02/15/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Primary care has a vital role in supporting patient autonomy to enable people with long-term conditions to manage their own health and wellness. Evidence is needed on whether education and training of health professionals helps support patient self-management and improves outcomes. The authors' first systematic review included only two articles showing patient outcomes following health professional training for promoting patient self-management. AIM To present an updated review undertaken from September 2013 to August 2018. DESIGN & SETTING A systematic review was undertaken using the PRISMA guidelines, following the methodology of the first review and is outlined in the PROSPERO registered protocol. METHOD Six databases were searched - Cochrane Library, PubMed, ERIC, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO - in addition to web searches, hand searches, and bibliographies for articles published from 1 September 2013 to 31 August 2018. RESULTS The updated systematic review showed more evidence is now available with 18 articles in the 5-year period from the 4284 abstracts located. Twelve of these articles showed a difference between intervention and control groups. Of the 18 articles identified, 11 were assessed as having a low risk of bias and five overall were rated of weak quality. The educational interventions with health professionals spanned a range of techniques and modalities, and many incorporated multiple interventions including patient components. There may be a lack of adoption owing to several challenges, including that complex interventions may not be delivered as planned and are difficult to assess, and owing to patient engagement and the need for ongoing follow-up. CONCLUSION More high-quality research is needed on what methods work best, for which patients, and for what clinical conditions in the primary care setting. The practical implications of training healthcare professionals require specific attention.
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Creamer F, Orlando A, Brunner M, Buntzen S, Dennis A, Gómez-Fernández L, Handtrack C, Hanly A, Matzel KE, Duyos AM, Meurette G, O'Connell PR, Alonso CP, Ribas Y, Rydningen M, Wyart V, Vaizey CJ, Maeda Y. A European snapshot of psychosocial characteristics and patients' perspectives of faecal incontinence-do they correlate with current scoring systems? Int J Colorectal Dis 2021; 36:1175-1180. [PMID: 33438108 DOI: 10.1007/s00384-021-03836-7] [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] [Accepted: 01/05/2021] [Indexed: 02/04/2023]
Abstract
PURPOSE To compare the current clinical scoring systems used to quantify the severity of symptoms of faecal incontinence (FI) to patients' subjective scoring of parameters of psychosocial well-being. METHODS Patients referred to six European centres for investigation or treatment of symptoms of FI between June 2017 and September 2019 completed a questionnaire that captured patient demographics, incontinence symptoms using St. Mark's Incontinence score (SMIS) and ICIQ-B, psychological well-being (HADS, Hospital Anxiety and Depression Scale), and social interaction (a three-item loneliness scale). RESULTS Three hundred eighteen patients completed questionnaires (62 men, mean age 58.7). Sixty percent of the respondents were aged under 65. Median SMIS was 15 (11-18), ICIQ-B bowel pattern was 8 (6-11) and bowel control was 17 (13-22), similar across all demographic groups; however, younger patients were more likely to experience symptoms of depression and anxiety (HADS score > 10, 65.2% of patients age < 65 vs 54.9% of those ages > = 65, p = 0.03) with lower quality of life (ICIQ-B QoL, median score 19 (14-23)) vs age > = 65 (16 (11-21) (p < 0.005)). On loneliness score 25.5% reported often feeling isolated from others. One of the most significant concerns by patients was the fear and embarrassment related to unpredictable episodes of incontinence. CONCLUSION The SMIS remains a useful tool for quantifying incontinence symptoms but may underestimate the psychosocial morbidity associated with unpredictable episodes of incontinence. Interventions aimed at decreasing anxiety and to address feelings of disgust may be helpful for a significant number of patients requiring treatment for FI.
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Affiliation(s)
- Felicity Creamer
- Department of Colorectal Surgery, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK
| | | | | | - Steen Buntzen
- Department of Gastroenterological Surgery, University Hospital of North Norway, Tromsø, Norway
| | | | | | | | - Ann Hanly
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| | - Klaus E Matzel
- Department of Surgery, University of Erlangen, Erlangen, Germany
| | | | - Guillaume Meurette
- Department of Colorectal Surgery, Nantes University Hospital, Nantes, France
| | - P Ronan O'Connell
- Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland
| | | | - Yolanda Ribas
- Department of Surgery, Consorci Sanitari de Terrassa, Terrassa (Barcelona), Spain
| | - Mona Rydningen
- Department of Gastroenterological Surgery, University Hospital of North Norway, Tromsø, Norway
| | - Vincent Wyart
- Department of Colorectal Surgery, Nantes University Hospital, Nantes, France
| | | | - Yasuko Maeda
- Department of Colorectal Surgery, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK.
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O'Hara R, Rowe H, Fisher J. Self-management factors associated with quality of life among women with endometriosis: a cross-sectional Australian survey. Hum Reprod 2021; 36:647-655. [PMID: 33378538 DOI: 10.1093/humrep/deaa330] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 09/22/2020] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION What self-management factors are associated with quality of life among women with endometriosis? SUMMARY ANSWER Greater self-efficacy was associated with improved physical and mental quality of life. WHAT IS KNOWN ALREADY Women with endometriosis have an impaired quality of life compared to the general female population. However, most studies have investigated quality of life in a hospital or clinic setting rather than a community setting and the association between self-management factors and quality of life have not, to date, been investigated. STUDY DESIGN, SIZE, DURATION A cross-sectional, population-based online survey was performed, which was advertised through women's, community and endometriosis-specific groups. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 620 women completed the survey for this study. Mental and physical quality of life was assessed using the standardized SF36v2 questionnaire. Self-management factors included self-efficacy, partners in health (active involvement in managing the condition) and performance of self-care activities. Treatment approaches included the use of hormonal treatment, pain medications and complementary therapies and whether the participant had a chronic disease management plan. Hierarchical regression analyses were used to examine whether self-management and treatment factors were associated with quality of life. MAIN RESULTS AND THE ROLE OF CHANCE Both physical and mental quality of life were significantly lower among women with endometriosis compared to the mean scores of the general Australian female population (P < 0.001). Physical quality of life was positively associated with income sufficiency (P < 0.001) and greater self-efficacy (P < 0.001), but negatively associated with age (P < 0.001), pain severity (P < 0.001), use of prescription medications (P < 0.001), having a chronic disease management plan (P < 0.05) and number of self-care activities (P < 0.05). Mental quality of life was positively associated with being older (P < 0.001), partnered (P < 0.001), having a university education (P < 0.05), increasing self-efficacy (P < 0.001) and higher partners in health scores (P < 0.001). LIMITATIONS, REASONS FOR CAUTION Results are derived from a cross-sectional study and can only be interpreted as associations not as causal relationships. The sample was more educated, more likely to speak English and be born in Australia than the general Australian female population of the same age, which may influence the generalizability of these results. WIDER IMPLICATIONS OF THE FINDINGS This study investigated a knowledge gap by investigating quality of life of women with endometriosis in a large community sample. Self-efficacy was significantly associated with both physical and mental quality of life. Supporting women with endometriosis to improve self-efficacy through a structured chronic disease management programme may lead to improvements in this aspect of wellbeing. STUDY FUNDING/COMPETING INTEREST(S) R.O. undertook this research as part of her PhD at Monash University, which was supported by an Australian Government Research Training Program Stipend. J.F. is the Finkel Professor of Global Public Health, which was supported by the Finkel Family Foundation. There are no conflicts of interest to declare. TRIAL REGISTRATION NUMBER NA.
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Affiliation(s)
- Rebecca O'Hara
- Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia.,Robinson Research Institute, University of Adelaide, North Adelaide, South Australia 5006, Australia
| | - Heather Rowe
- Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
| | - Jane Fisher
- Public Health and Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia
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von Thiele Schwarz U, Roczniewska M, Pukk Härenstam K, Karlgren K, Hasson H, Menczel S, Wannheden C. The work of having a chronic condition: development and psychometric evaluation of the distribution of co-care activities (DoCCA) scale. BMC Health Serv Res 2021; 21:480. [PMID: 34016102 PMCID: PMC8138998 DOI: 10.1186/s12913-021-06455-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 04/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic care involves multiple activities that can be performed by individuals and healthcare staff as well as by other actors and artifacts, such as eHealth services. Thus, chronic care management can be viewed as a system where the individual interacts with people and eHealth services performing activities to maintain or improve health and functioning, called co-care. Yet, the system perspective is not reflected in concepts such as person-centered care and shared decision making. This limits the understanding of individuals' global experience of chronic care management and subsequently the ability to optimize chronic care. The aim of this study was threefold: (1) to propose a theory-based operationalization of co-care for chronic care management, (2) to develop a scale to measure co-care as a distributed system of activities, and (3) to evaluate the scale's psychometric properties. With the theory of distributed cognition as a theoretical underpinning, co-care was operationalized along three dimensions: experience of activities, needs support, and goal orientation. METHODS Informed by the literature on patient experiences and work psychology, a scale denoted Distribution of Co-Care Activities (DoCCA) was developed with the three conceptualized dimensions, the activities dimension consisting of three sub-factors: demands, unnecessary tasks, and role clarity. It was tested with 113 primary care patients with chronic conditions in Sweden at two time points. RESULTS A confirmatory factor analysis showed support for a second-order model with the three conceptualized dimensions, with activities further divided into the three sub-factors. Cronbach's alpha values indicated a good to excellent reliability of the subscales, and correlations across time points with panel data indicated satisfactory test-retest reliability. Convergent, concurrent and predictive validity of the scale were, overall, satisfactory. CONCLUSIONS The psychometric evaluation supports a model consisting of activities (demands, unnecessary tasks, and role clarity), needs support and goal orientation that can be reliably measured with the DoCCA scale. The scale provides a way to assess chronic care management as a system, considering the perspective of the individuals with the chronic condition and how they perceive the work that must be done, across situations, either by themselves or through healthcare, eHealth, or other means.
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Affiliation(s)
- Ulrica von Thiele Schwarz
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, 721 23, Västerås, Sweden.
- Procome, Medical Management Centre, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 171 77, Stockholm, Sweden.
| | - Marta Roczniewska
- Procome, Medical Management Centre, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 171 77, Stockholm, Sweden
- Psychology Department, SWPS University of Social Sciences and Humanities, 81-745, Sopot, Poland
| | - Karin Pukk Härenstam
- Clinical Management, Medical Management Centre, LIME, Karolinska Institutet, 171 77, Stockholm, Sweden
- Paediatric Emergency Department, Astrid Lindgren's Children's Hospital, Karolinska University Hospital, 171 76, Stockholm, Sweden
| | - Klas Karlgren
- MINT, LIME, Karolinska Institutet, 171 77, Stockholm, Sweden
- Department of health and functioning, Faculty of Health and Social Sciences, The Western Norway University of Applied Sciences, 5063, Bergen, Norway
- Department of Research, Education, Development and Innovation, Södersjukhuset, 118 83, Stockholm, Sweden
| | - Henna Hasson
- Procome, Medical Management Centre, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 171 77, Stockholm, Sweden
- Unit for Implementation and Evaluation, Center for Epidemiology and Community Medicine, Stockholm Region, 171 29, Stockholm, Sweden
| | - Sivan Menczel
- Procome, Medical Management Centre, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Carolina Wannheden
- Procome, Medical Management Centre, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 171 77, Stockholm, Sweden
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Crowley T, Rohwer A. Self-management interventions for adolescents living with HIV: a systematic review. BMC Infect Dis 2021; 21:431. [PMID: 33962558 PMCID: PMC8105944 DOI: 10.1186/s12879-021-06072-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/09/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Self-management interventions aim to enable people living with chronic conditions to increase control over their condition in order to achieve optimal health and may be pertinent for young people with chronic illnesses such as HIV. Our aim was to evaluate the effectiveness of self-management interventions for improving health-related outcomes of adolescents living with HIV (ALHIV) and identify the components that are most effective, particularly in low-resource settings with a high HIV burden. METHODS We considered randomised controlled trials (RCTs), cluster RCTs, non-randomised controlled trials (non-RCTs) and controlled before-after (CBA) studies. We did a comprehensive search up to 1 August 2019. Two authors independently screened titles, abstracts and full texts, extracted data and assessed the risk of bias. We synthesised results in a meta-analysis where studies were sufficiently homogenous. In case of substantial heterogeneity, we synthesised results narratively. We assessed the certainty of evidence using GRADE and presented our findings as summaries in tabulated form. RESULTS We included 14 studies, comprising 12 RCTs and two non-RCTs. Most studies were conducted in the United States, one in Thailand and four in Africa. Interventions were diverse, addressing a variety of self-management domains and including a combination of individual, group, face-to-face, cell phone or information communication technology mediated approaches. Delivery agents varied from trained counsellors to healthcare workers and peers. Self-management interventions compared to usual care for ALHIV made little to no difference to most health-related outcomes, but the evidence is very uncertain. Self-management interventions may increase adherence and decrease HIV viral load, but the evidence is very uncertain. We could not identify any particular components of interventions that were more effective for improving certain outcomes. CONCLUSION Existing evidence on the effectiveness of self-management interventions for improving health-related outcomes of ALHIV is very uncertain. Self-management interventions for ALHIV should take into account the individual, social and health system contexts. Intervention components need to be aligned to the desired outcomes. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019126313.
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Affiliation(s)
- Talitha Crowley
- Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Anke Rohwer
- Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Marques A, Santos E, Nikiphorou E, Bosworth A, Carmona L. Effectiveness of self-management interventions in inflammatory arthritis: a systematic review informing the 2021 EULAR recommendations for the implementation of self-management strategies in patients with inflammatory arthritis. RMD Open 2021; 7:e001647. [PMID: 34049997 PMCID: PMC8166594 DOI: 10.1136/rmdopen-2021-001647] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/10/2021] [Accepted: 04/19/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To perform a systematic review (SR) on the effectiveness of self-management interventions, in order to inform the European League Against Rheumatism Recommendations for its implementation in patients with inflammatory arthritis (IA). METHODS The SR was conducted according to the Cochrane Handbook and included adults (≥18 years) with IA. The search strategy was run in Medline through PubMed, Embase, Cochrane Library, CINAHL Plus with Full Text, and PEDro. The assessment of risk of bias, data extraction and synthesis were performed by two reviewers independently. A narrative Summary of Findings was provided according to the Grading of Recommendations, Assessment, Development and Evaluation. RESULTS From a total 1577 references, 57 were selected for a full-text review, and 32 studies fulfilled the inclusion criteria (19 randomised controlled trials (RCTs) and 13 SRs). The most studied self-management components were specific interactive disease education in ten RCTs, problem solving in nine RCTs, cognitive-behavioural therapy in eight RCTs, goal setting in six RCTs, patient education in five RCTs and response training in two RCTs. The most studied interventions were multicomponent or single exercise/physical activity in six SRs, psychosocial interventions in five SRs and education in two SRs. Overall, all these specific components and interventions of self-management have beneficial effects on IAs-related outcomes. CONCLUSIONS The findings confirm the beneficial effect of the self-management interventions in IA and the importance of their implementation. Further research should focus on the understanding that self-management is a complex intervention to allow the isolation of the effectiveness of its different components.
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Affiliation(s)
- Andréa Marques
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
- Higher School of Nursing of Coimbra, Health Sciences Research Unit: Nursing, Coimbra, Portugal
| | - Eduardo Santos
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
- Higher School of Nursing of Coimbra, Health Sciences Research Unit: Nursing, Coimbra, Portugal
| | | | - Ailsa Bosworth
- National Rheumatoid Arthritis Society, Littlewick Green, UK
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Chen WC, Lin CC, Wu CC, Song YC. Psychometric testing of the hemodialysis self-management instrument (HDSMI-18): A confirmatory factor analysis. Nurs Open 2021; 8:2832-2839. [PMID: 33794054 PMCID: PMC8363351 DOI: 10.1002/nop2.867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/15/2021] [Accepted: 02/28/2021] [Indexed: 01/25/2023] Open
Abstract
Aim The aim of this study was to probe the rigorousness of the factor structure of the HDSMI and to test the instrument's construct validity. Design Cross‐sectional study. Methods The hemodialysis unit of four hospitals in Taiwan provided data from 628 patients with end‐stage renal disease (ESRD), through the period of September to December in 2012. The patients were divided into a calibration sample for CFA and model modification, and a validation sample for cross‐validation of the postmodification model. Goodness of fit was tested with standard fit indices. Results The four latent variables (i.e. partnership, self‐care, problem‐solving and emotional management) were verified as dimensions of HDSMI through CFA. The construct validity of the HDSMI was improved by omitting two items, allowing one inter‐item correlation and transferring the loading of one item. These modifications improved fit indices of the calibration sample. Cross‐validation of the validation sample verified the construct validity of the modified HDSMI‐18.
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Affiliation(s)
- Wen-Chun Chen
- Department of Community Medicine, St. Martin De Porres Hospital, Chiayi, Taiwan.,School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Nursing, Chang Gung University of Science and Technology, Chiayi County, Taiwan
| | - Chiu-Chu Lin
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chia-Chen Wu
- School of Nursing, Fooyin University, Kaohsiung, Taiwan
| | - Yi-Chun Song
- Department of Nursing, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
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Alasmari A, Zhou L. Share to Seek: The Effects of Disease Complexity on Health Information-Seeking Behavior. J Med Internet Res 2021; 23:e21642. [PMID: 33759803 PMCID: PMC8074994 DOI: 10.2196/21642] [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: 07/07/2020] [Revised: 10/08/2020] [Accepted: 01/10/2021] [Indexed: 11/14/2022] Open
Abstract
Background Web-based question and answer (Q&A) sites have emerged as an alternative source for serving individuals’ health information needs. Although a number of studies have analyzed user-generated content in web-based Q&A sites, there is insufficient understanding of the effect of disease complexity on information-seeking needs and the types of information shared, and little research has been devoted to the questions concerning multimorbidity. Objective This study aims to investigate seeking of health information in Q&A sites at different levels of disease complexity. Specifically, this study investigates the effects of disease complexity on information-seeking needs, types of information shared, and stages of disease development. Methods First, we selected a random sample of 400 questions separately from each of the Q&A sites: Yahoo Answers and WebMD Answers. The data cleaning resulted in a final set of 624 questions from the two sites. We used a mixed methods approach, including qualitative content analysis and quantitative statistical analysis. Results The one-way results of ANOVA showed significant effects of disease complexity (single vs multimorbid disease questions) on two information-seeking needs: diagnosis (F1,622=5.08; P=.02) and treatment (F1,622=4.82; P=.02). There were also significant differences between the two levels of disease complexity in two stages of disease development: the general health stage (F1,622=48.02; P<.001) and the chronic stage (F1,622=54.01; P<.001). In addition, our results showed significant effects of disease complexity across all types of shared information: demographic information (F1,622=32.24; P<.001), medical diagnosis (F1,622=11.04; P<.001), and treatment and prevention (F1,622=14.55; P<.001). Conclusions Our findings present implications for the design of web-based Q&A sites to better support health information seeking. Future studies should be conducted to validate the generality of these findings and apply them to improve the effectiveness of health information in Q&A sites.
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Affiliation(s)
- Ashwag Alasmari
- University of Maryland, Baltimore County, Baltimore, MD, United States.,King Khalid University, Abha, Saudi Arabia
| | - Lina Zhou
- University of North Carolina at Charlotte, Charlotte, NC, United States
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Gomes L, Liébana-Presa C, Araújo B, Marques F, Fernández-Martínez E. Heart Disease, Now What? Improving Quality of Life through Education. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3077. [PMID: 33802701 PMCID: PMC8002524 DOI: 10.3390/ijerph18063077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The management of chronic illness assumes a level of demand for permanent care and reaches a priority dimension in the health context. Given the importance of nursing care to post-acute coronary syndrome patients, the objective of this study is to evaluate the impact of an educational intervention program on quality of life in patients after acute coronary syndrome. METHOD Quasi-experimental study with two groups: an experimental group exposed to the educational intervention program and the control group without exposure to the educational intervention program. RESULTS The results showed statistically significant differences between both groups (p < 0.001). Although only valid for the specific group of subjects studied, the educational intervention program enabled significant gains in quality of life. CONCLUSIONS According to the findings of the study, a systematized and structured educational program, integrated into the care organization and based on transition processes, is effective in developing self-care skills and improves the quality of life in patients after acute coronary syndrome.
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Affiliation(s)
- Lisa Gomes
- Nursing School, Minho University, 4710-057 Braga, Portugal;
| | - Cristina Liébana-Presa
- SALBIS Research Group, Faculty of Health Sciences, Campus of Ponferrada, Universidad de León, 24401 Ponferrada, Spain
| | - Beatriz Araújo
- Institute of Health Sciences, Universidade Católica Portuguesa, 4169-005 Porto, Portugal;
| | - Fátima Marques
- Intensive Care Coronary Unit, Centro Hospitalar De Trás-Os-Montes E Alto Douro, E.P.E., 5000-508 Vila Real, Portugal;
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Self-Care and Health-Related Quality of Life in Patients with Drainage Enterostomy: A Multicenter, Cross Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052443. [PMID: 33801488 PMCID: PMC7967580 DOI: 10.3390/ijerph18052443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 11/16/2022]
Abstract
The current article examined stoma self-care and health-related quality of life in patients with drainage enterostomy, described clinical and sociodemographic variables and analyzed the relationship between all of them. Trained interviewers collected data using a standardized form that queried sociodemographic and clinical variables. In addition, Self-Care (SC) was measured through a specific questionnaire for Ostomized Patients (CAESPO) and Health-Related Quality of Life (HRQoL) through the Stoma Quality of Life questionnaire (S-QoL), which are not included in the electronic medical record. This was a multicenter, cross sectional study conducted in four hospitals of the province of Castellon (Spain), where 139 participants were studied. As novel findings, it was found that the level of SC of the stoma was high and was positively correlated with health-related quality of life. In relation to SC and sociodemographic variables studied in the research, women, married patients and active workers presented significantly higher scores than the rest. In relation to the clinical variables, we highlight the highest scores of the autonomous patients in the care of their stoma and those who used irrigations regularly. The lowest scores were the patients with complications in their stoma. We can highlight the validity and reliability of the CAESPO scale for biomedical and social research, and the importance of skills related to self-care of ostomy patients for a good level of HRQoL.
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Magnani JW, Ferry D, Swabe G, Martin D, Chen X, Brooks MM, El Khoudary SR. Rurality and atrial fibrillation: a pathway to virtual engagement and clinical trial recruitment in response to COVID-19. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2021; 3:100017. [PMID: 34151310 PMCID: PMC8211123 DOI: 10.1016/j.ahjo.2021.100017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/10/2021] [Accepted: 05/17/2021] [Indexed: 11/18/2022]
Abstract
Study Objective To summarize trial adaptation from in-clinic to virtual design in response to the SARS-2 coronavirus-2 (COVID-19). Design A clinical trial of a mobile health intervention to improve chronic disease self-management for rural individuals with atrial fibrillation (AF). The trial has a 4-month intervention - accessible regardless of health or digital literacy - to enhance AF medication adherence and patient experience with 8- and 12-month assessments of sustainability. Setting Rural, western Pennsylvania. Participants Rural individuals with AF receiving oral anticoagulation for stroke prevention. Interventions Enrolled participants underwent a telephone-based orientation, provided verbal consent, and were randomized using a digital platform. They received a smartphone with intervention or control applications and a curriculum on usage tailored for study arm. Participants received study assessments by mail with telephone-based administration and contact for the 12-month trial. Main Outcome Measures Successful adaptation to virtual engagement and recruitment. Results The study enrolled 18 participants during in-clinic recruitment (January-March 2020). From 5/1/2020 to 5/6/2021 the study team enrolled 130 individuals (median age 72.4 years, range 40.8-92.2; 49.2% women, 63.1% without college degree, and 45.4% with limited health literacy. Retention of participants enrolled using virtual methods during the 4-month intervention phase is 92%. Conclusions We report a virtual trial of a mobile health intervention for rural individuals with AF. Our successful implementation suggests promise for engaging geographically isolated rural individuals, potential to enhance digital health access, and advance rural health equity.
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Affiliation(s)
- Jared W. Magnani
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States of America
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, United States of America
| | - Danielle Ferry
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Gretchen Swabe
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Deborah Martin
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, United States of America
| | - Xirun Chen
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, United States of America
| | - Maria M. Brooks
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, United States of America
| | - Samar R. El Khoudary
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, United States of America
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