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Stichler JF, Pelletier LR. Applying the Patient Empowerment, Engagement, and Activation Survey to Improve Patient Outcomes. J Nurs Adm 2023; 53:668-674. [PMID: 37983606 DOI: 10.1097/nna.0000000000001364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
This article focuses on applying the patient empowerment, engagement, and activation (PEEA) model as an implementation strategy to achieve patient- or person-centered care. There is substantial evidence linking PEEA to improved patient care outcomes and reduced healthcare costs. Interrelationships among the 3 concepts are discussed and how the PEEA survey can be used to evaluate patients' activation for self-care postdischarge and their perceptions of nurses' empowering and engaging them during the care encounter.
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Affiliation(s)
- Jaynelle F Stichler
- Author Affiliations: Consultant (Dr Stichler) and Clinical Nurse Specialist (Pelletier), Terrence and Barbara Caster Institute for Nursing Excellence, Sharp Prebys Innovation and Education Center, San Diego, California
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AY A, ÇIRAY N. Kronik Obstrüktif Akciğer Hastalığı Olan Hastaların Aktiflik Düzeyi ve Yaşam Kalitesi. DOKUZ EYLÜL ÜNIVERSITESI HEMŞIRELIK FAKÜLTESI ELEKTRONIK DERGISI 2022. [DOI: 10.46483/deuhfed.921252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Giriş: Kronik obstrüktif akciğer hastalarının etkili semptom yönetiminin, kendi bakımına katılan, aktif bir hasta ile sağlanabileceği bilinmektedir.
Amaç: Kronik obstrüktif akciğer hastalığı (KOAH) olan hastalarda aktiflik düzeyini, aktifliği etkileyen faktörleri ve aktiflik düzeyi ile yaşam kalitesi arasındaki ilişkiyi belirlemektir.
Yöntem: Tanımlayıcı, kesitsel ve ilişkisel tipte olan bu araştırma Kasım 2019- Mart 2020 tarihleri arasında bir üniversite hastanesinin göğüs hastalıkları polikliniğinde 120 KOAH’lı hasta gerçekleştirilmiştir. Veriler Hasta Tanıtım Formu, KOAH Değerlendirme Testi (CAT), Hasta Aktiflik Düzeyi Ölçeği (HADÖ) ve yaşam kalitesi için St. George Solunum Anketi (SGRQ) kullanılarak toplanmıştır. Verilerin değerlendirilmesinde tanımlayıcı istatistikler, Pearson korelasyon ve regresyon analizi kullanılmıştır.
Bulgular: Bireylerin, HADÖ puan ortalaması 67.05 ± 14.69, CAT puan ortalaması 22.33 ± 7.48, SGRQ semptom puan ortalaması 55.80 ± 20.23, SGRQ aktivite puan ortalaması 74.78 ± 21.59, SGRQ etki puan ortalaması 49.78 ± 21.30, SGRQ toplam puan ortalaması 58.35 ± 20.0 olarak bulunmuştur. HADÖ ile CAT arasında istatistiksel olarak anlamlı ve negatif yönlü (r = -.415; p = .01), HADÖ ile SGRQ toplam puan arasında istatistiksel olarak anlamlı ve negatif yönlü (r = -.529; p = .01), CAT ile SGRQ toplam puan arasında istatistiksel olarak anlamlı ve pozitif yönlü (r = .846; p = .01) ilişki vardır. CAT ve yaş arttıkça HADÖ düzeyi düşmektedir (R2 = .247). SGRQ toplam puan ve yaş arttıkça HADÖ düzeyi düşmektedir (R2 = .329).
Sonuç: KOAH’lı hastalarda aktiflik düzeyi yüksek bulunmuştur. Hasta aktifliğini etkileyen faktörler yaş, eğitim düzeyi, gelir durumu, çalışma durumu, hastalık süresi, KOAH evresi, yıllık hastane yatış sayısı, yıllık atak, KOAH durumu ve yaşam kalitesidir. Hasta aktiflik düzeyi arttıkça yaşam kalitesi artmaktadır.
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Relationships among social support, self-efficacy, and patient activation in community-dwelling older adults living with coronary heart disease: A cross-sectional study. Geriatr Nurs 2022; 48:139-144. [PMID: 36219932 DOI: 10.1016/j.gerinurse.2022.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To explore whether social support indirectly influences patient activation through self-efficacy in older adults living with coronary heart disease. METHODS A cross-sectional study was conducted. Older patients (n=451) from four communities in the city of Qingdao completed a questionnaire survey. We conducted multiple linear regression models and bootstrap testing to assess the relationships among social support, self-efficacy, and patient activation. RESULTS Patient activation was positively correlated with social support (r = 0.524, P < 0.01) and with self-efficacy (r = 0.740, P < 0.01). The of social support had indirect positive effect on patient activation through self-efficacy and the effect was 58.8%. CONCLUSIONS We identified the critical role of social support and self-efficacy for the activation of community-dwelling older patients living with coronary heart disease. Our findings provide essential knowledge for developing and evaluating effective interventions to promote patient activation and enhance self-management of coronary heart disease.
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Tang T, Dou B, Zha HX, Tao LS, Gu ZJ, Liu KY, Xie WP. Factors Related to Activation in Chinese Patients With Chronic Obstructive Pulmonary Disease: A Cross-Sectional Survey Study. J Nurs Res 2022; 30:e209. [PMID: 35471203 DOI: 10.1097/jnr.0000000000000491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Improving patient activation can lead to better health outcomes among patients with chronic obstructive pulmonary disease (COPD). However, no studies have focused on the issue of activation in patients with COPD in China. PURPOSE This study was designed to explore the status of activation in patients with COPD in China and explicate the significant influencing factors. METHODS One hundred seventy patients with COPD were recruited using a convenience sampling method from eight tertiary and secondary hospitals in Nanjing, China. Sociodemographic, clinical, and patient-reported factor data were collected. Univariate analysis and multivariate linear regression were performed. RESULTS Only 10.6% of the patients were identified as activated for self-management. Multivariate linear regression analysis revealed four explanatory elements as significantly associated with patient activation, including social support (β = .463, p < .001), free medical insurance (β = .173, p = .007), smoking status (β = -.195, p = .002), and health status (β = -.139, p = .04). CONCLUSIONS/IMPLICATIONS FOR PRACTICE The findings of this study indicate that a minority of patients with COPD are activated for self-management in China. Having a higher level of patient activation was associated with having better social support, having free medical insurance, being a nonsmoker, and having a better health status. Creating a supportive environment, promoting smoking cessation, and improving medical security and health status may be considered as potential strategies to activate patients into better self-management.
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Affiliation(s)
- Ting Tang
- MSc, RN, Department of Respiration and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, People Republic of China
| | - Bei Dou
- BD, Master Student, School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, People Republic of China
| | - Hui-Xian Zha
- BD, Master Student, School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, People Republic of China
| | - Lian-Shan Tao
- BD, RN, Chief Nurse, Department of Respiration and Critical Care Medicine, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People Republic of China
| | - Ze-Juan Gu
- MSc, RN, Associate Professor, Party Committee Office, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People Republic of China
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Moreno-Chico C, Roy C, Monforte-Royo C, González-De Paz L, Navarro-Rubio MD, Gallart Fernández-Puebla A. Effectiveness of a nurse-led, face-to-face health coaching intervention in enhancing activation and secondary outcomes of primary care users with chronic conditions. Res Nurs Health 2021; 44:458-472. [PMID: 33834505 DOI: 10.1002/nur.22132] [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: 07/19/2020] [Revised: 02/16/2021] [Indexed: 11/08/2022]
Abstract
Prevalence of chronic diseases and multimorbidity is rising, and it remains unclear what the best strategy is for activating people with chronic conditions in their self-care. We designed a two-group quasi-experimental time series trial to examine the effectiveness of a nurse-led, face-to-face, individually-tailored health coaching (HC) intervention in improving patient activation and secondary outcomes (self-efficacy, quality of life, anxiety and depression symptoms, medication adherence, hospitalization and emergency visits) among primary care users with chronic conditions. A total of 118 people with chronic conditions were recruited through a primary care center and allocated to either the intervention group (IG) (n = 58) or control group (CG) (n = 60). The IG received a nurse-led individually-tailored HC intervention involving 4-6 face-to-face multicomponent sessions covering six core activation topics. The CG received usual primary care. Data were collected at baseline, after the intervention (6 weeks after baseline for controls) and at 6 and 12 months from baseline. Compared with controls, the IG had significantly higher patient activation scores after the intervention (73.29 vs. 66.51, p = .006). However, this improvement was not maintained at follow-up and there were no significant differences in secondary outcomes across the study period. HC may be an effective strategy for achieving short-term improvements in the activation of primary care users with chronic conditions. Further studies with different methodological approaches are needed to elucidate how HC may improve and sustain changes in patient activation.
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Affiliation(s)
- Cibeles Moreno-Chico
- Department of Nursing, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain.,Rambla Mutua de Terrassa Primary Healthcare Center, Terrassa, Barcelona, Spain
| | - Callista Roy
- Mount Saint Mary's University Los Angeles, Los Angeles, California, USA.,Boston College School of Nursing, Boston, Massachusetts, USA
| | - Cristina Monforte-Royo
- Department of Nursing, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
| | - Luis González-De Paz
- Les Corts Primary Healthcare Center, Consorci d'Atenció Primària de Salut Barcelona Esquerra, Barcelona, Spain.,Primary Healthcare Transversal Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Maria D Navarro-Rubio
- Patient and Family Empowerment, Sant Joan de Deu Children's Hospital, Barcelona, Spain
| | - Alberto Gallart Fernández-Puebla
- Department of Nursing, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
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Fortin PR, Da Costa D, Neville C, Julien AS, Rahme E, Haroun V, Singer W, Nimigon-Young J, Morrison AL, Eng D, Peschken CA, Vinet E, Hudson M, Smith D, Matsos M, Pope JE, Clarke AE, Keeling S, Avina-Zubieta JA, Rochon M. The Challenges of Perceived Self-Management in Lupus. Arthritis Care Res (Hoboken) 2020; 74:1113-1121. [PMID: 33342087 DOI: 10.1002/acr.24542] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 09/21/2020] [Accepted: 12/15/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Systemic lupus erythematosus is a chronic autoimmune disease with varied and unpredictable levels of disease activity. The ability to self-manage lupus is important in controlling disease activity. Our objective was to determine levels of patient activation toward self-management in lupus. METHODS We used baseline results from the MyLupusGuideTM study that had recruited 541 lupus patients from ten centers. We used the Patient Activation Measure (PAM), a validated self-reported tool designed to measure activation towards self-management ability, as our primary variable and examined its association with demographic, disease-related, patient-provider communication and psychosocial variables captured in our study protocol. Univariable and multivariable linear regressions were performed using linear mixed models, with a random effect for centers. RESULTS The average age was 50±14 years, 93% were female, 74% were Caucasian and the average disease duration was 17±12 years. The mean PAM score was 61.2±13.5 with 36% of participants scoring in the two lower levels, indicating low activation. Variables associated with low activation included being single, lower physical health status, lower self-reported disease activity, lower self-efficacy, use of more emotional coping and less distraction and instrumental coping strategies, and perceived lack of clarity in patient-doctor communication. CONCLUSION Low patient activation was observed in more than one third of lupus patients indicating a large proportion of patients perceived that they are lacking in lupus self-management skills. These results highlight a modifiable gap in perceived self-management ability among patients with lupus.
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Affiliation(s)
- Paul R Fortin
- Centre de recherche du CHU de Québec - Université Laval, Québec, Canada
| | - Deborah Da Costa
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Québec, Canada
| | - Carolyn Neville
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Québec, Canada
| | - Anne-Sophie Julien
- Département de mathématiques et statistique, Université Laval, Québec, Québec, Canada
| | - Elham Rahme
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Québec, Canada
| | | | - Wendy Singer
- MyLupusGuideTM Patient Advisory Committee, Canada
| | | | | | - Davy Eng
- Centre de recherche du CHU de Québec - Université Laval, Québec, Canada
| | | | - Evelyne Vinet
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Québec, Canada
| | - Marie Hudson
- Jewish General Hospital, Lady Davis Institute for Medical Research and McGill University, Quebec, Canada
| | - Doug Smith
- The Ottawa Hospital - University of Ottawa, Ontario, Canada
| | - Mark Matsos
- McMaster University, Ontario, Canada, Hamilton
| | - Janet E Pope
- Department of Medicine, University of Western Ontario, Ontario, Canada
| | - Ann E Clarke
- Cumming School of Medicine, University of Calgary, Alberta, Canada, Alberta
| | | | | | - Murray Rochon
- Jack Digital Productions, Inc, Montreal, Quebec and Toronto, Ontario, Canada
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