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Ammous O, Kampo R, Wollsching-Strobel M, Zimmermann M, Andreas S, Friede T, Kroppen D, Stanzel S, Salem S, Windisch W, Mathes T. Adherence-enhancing interventions for pharmacological and oxygen therapy in patients with COPD: a systematic review and component network meta-analyses. Eur Respir Rev 2024; 33:240011. [PMID: 39231596 PMCID: PMC11372468 DOI: 10.1183/16000617.0011-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 06/04/2024] [Indexed: 09/06/2024] Open
Abstract
INTRODUCTION Adherence to COPD management strategies is complex, and it is unclear which intervention may enhance it. OBJECTIVES We aim to evaluate the effectiveness of adherence-enhancing interventions, alone or compared to interventions, for patients with COPD. METHODS This review comprises a component network meta-analysis with a structured narrative synthesis. We searched MEDLINE, Embase, CENTRAL, CINAHL and trial registries on 9 September 2023. We included controlled studies that explored adherence in patients with COPD. Two review authors independently performed the study selection, data extraction and the risk of bias assessment. We involved patients with COPD in developing this systematic review through focus group interviews and displayed the findings in pre-designed logic models. RESULTS We included 33 studies with 5775 participants. We included 13 studies in the component network meta-analysis that explored adherence. It was mainly assessed through questionnaires. As a continuous outcome, there was a tendency mainly for education (standardised mean difference 1.26, 95% CI 1.13-1.38, very low certainty of evidence) and motivation (mean difference 1.85, 95% CI 1.19-2.50, very low certainty of evidence) to improve adherence. As a dichotomous outcome (e.g. adherent/non-adherent), we found a possible benefit with education (odds ratio 4.77, 95% CI 2.25-10.14, low certainty of evidence) but not with the other components. We included six studies that reported quality of life in the component network meta-analysis. Again, we found a benefit of education (mean difference -9.70, 95% CI -10.82- -8.57, low certainty of evidence) but not with the other components. CONCLUSIONS Education may improve adherence and quality of life in COPD patients. Patient focus group interviews indicated that interventions that strengthen patients' self-efficacy and help them to achieve individual goals are the most helpful.
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Affiliation(s)
- Omar Ammous
- Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
| | - Regina Kampo
- Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
| | - Maximilian Wollsching-Strobel
- Cologne Merheim Hospital, Department of Pneumology, Kliniken der Stadt Köln gGmbH, Cologne, Germany
- Department of Pneumology, Witten/Herdecke University, Witten, Germany
| | - Maximilian Zimmermann
- Cologne Merheim Hospital, Department of Pneumology, Kliniken der Stadt Köln gGmbH, Cologne, Germany
- Department of Pneumology, Witten/Herdecke University, Witten, Germany
| | - Stefan Andreas
- Lungenfachklinik Immenhausen/Krs. Kassel, Clinic for Cardiology and Pneumology, University Medical Center Göttingen, Göttingen, Germany
| | - Tim Friede
- Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
| | - Doreen Kroppen
- Cologne Merheim Hospital, Department of Pneumology, Kliniken der Stadt Köln gGmbH, Cologne, Germany
- Department of Pneumology, Witten/Herdecke University, Witten, Germany
| | - Sarah Stanzel
- Cologne Merheim Hospital, Department of Pneumology, Kliniken der Stadt Köln gGmbH, Cologne, Germany
- Department of Pneumology, Witten/Herdecke University, Witten, Germany
| | - Susanna Salem
- Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
| | - Wolfram Windisch
- Cologne Merheim Hospital, Department of Pneumology, Kliniken der Stadt Köln gGmbH, Cologne, Germany
- Department of Pneumology, Witten/Herdecke University, Witten, Germany
| | - Tim Mathes
- Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
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Chittal P, Prabhu NS, Amin R, Vaishali K. Effectiveness of technology-aided education on self-efficacy among individuals post pulmonary surgery: A randomized controlled trial. J Bodyw Mov Ther 2024; 39:558-564. [PMID: 38876685 DOI: 10.1016/j.jbmt.2024.03.027] [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: 11/28/2022] [Revised: 12/02/2023] [Accepted: 03/11/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Patient education is an effective tool in enhancing compliance and comprehension to therapy. Preoperative video-based education (VBE) on knowledge and understanding of surgical procedures and physical therapy provides an insight into the essential need for treatment adherence and early post-operative recovery. Self-efficacy (SE) is an individual self-belief about one's ability to cope and is denoted as a sign of healthy behavior and empowerment. Although little is known about VBE and self-efficacy (SE) in rehabilitation of pulmonary surgery patients. The objective was to assess the influence of VBE in pulmonary rehabilitation on SE post pulmonary surgery patients using the Manipal Self Efficacy Questionnaire (MSEQ). METHODS Study design: Mixed methods pilot study. The MSEQ and educational video were designed and developed for this study. Piloting was conducted with the MSEQ (CVI = 0.95) and educational video (CVI = 1). After approval from the ethics committee, written informed consent was obtained from twenty preoperative pulmonary surgery patients were randomized to two groups. The control group (n = 30) received routine post-operative exercises and experimental group (n = 30) received preoperative VBE along with exercises. RESULTS Validation of MSEQ and educational video was derived as per content validation index. Mann- Whitney U test and Wilcoxon signed rank test were used to compare the groups. SE scores in the experimental group was higher than the control (p = 0.004). DISCUSSION AND CONCLUSION VBE on PR improved SE of the patients after pulmonary surgery. The study's main limitation was the difficulty in attaining the desired sample size because it was a time-bound study.
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Affiliation(s)
- Prerana Chittal
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Nivedita S Prabhu
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Revati Amin
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - K Vaishali
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.
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Sibold J. An Evidence Based Rationale for Health and Wellness Coaching as a Complementary Certification in Undergraduate Health Education. Am J Lifestyle Med 2024; 18:181-185. [PMID: 38559783 PMCID: PMC10979724 DOI: 10.1177/15598276231189206] [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: 04/04/2024] Open
Abstract
Health and wellness coaching (HWC) is an effective intervention for many chronic lifestyle diseases. Chronic diseases represent a majority of our severe national healthcare burden. Yet, HWC certification programs vary in delivery method and degree awarded. The purpose of this paper is to provide an evidence based rationale for HWC as a complementary area of study to non-licensure granting, undergraduate health degrees in higher education. A comprehensive review of the literature related to the efficacy of HWC was completed. In addition, the national program directory was mined for descriptive data for approved HWC programs. Given the growing body of support for HWC as an effective intervention, we recommend that institutions deliver HWC curricula as an academic minor for undergraduate students in non-licensure granting health-related degrees to position graduates for entry level careers in HWC. Evidence from the successful deployment of an undergraduate program in HWC supports our contention that HWC be delivered as an academic minor in support of lifestyle health and wellness education. In doing so, the field can offer HWC in a way that is widely accessible to the undergraduate population, while providing a mechanism for direct employment as a professional health and wellness coach.
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Affiliation(s)
- Jeremy Sibold
- Department of Rehabilitation and Movement Science, College of Nursing and Health Sciences, University of Vermont, Burlington, VT, USA
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Serrano VB, Pasipanodya EC, Montoya JL, Heaton RK, Jeste DV, Moore DJ. Reactivity of Health-Related Quality of Life to Perceived Stress: The Buffering Role of Psychosocial Resources in a Longitudinal Study of Adults with and Without HIV. J Clin Psychol Med Settings 2024; 31:174-185. [PMID: 37204645 PMCID: PMC10924706 DOI: 10.1007/s10880-023-09962-4] [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] [Accepted: 04/25/2023] [Indexed: 05/20/2023]
Abstract
People with HIV now have increased longevity; however, their health-related quality of life (HRQoL) still lags significantly compared to people without HIV. Perceived stress negatively impacts HRQoL, whereas psychosocial resources are linked to better HRQoL. This longitudinal analysis aims to explore the buffering role of psychosocial resources on the relationship between HRQoL and perceived stress. Participants (N = 240) included 142 persons with HIV (PwH) and 98 without HIV, M(SD) = 50.9(8.1) years. Multilevel models over four study years examined longitudinal relationships between HRQoL (outcome) and perceived stress (predictor) and potential moderation by psychosocial resources (personal mastery, social support, and resilience) by HIV serostatus. Among PwH only, personal mastery (p = 0.001), social support (p = 0.015), and resilience (p = 0.029) were associated with an attenuated effect of perceived stress (less negative slopes) for physical HRQoL over time. Bolstering personal mastery, social support, and resilience may have relevance for improving physical well-being among PwH.
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Affiliation(s)
- Vanessa B Serrano
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Elizabeth C Pasipanodya
- Department of Psychiatry, University of California San Diego, HIV Neurobehavioral Research Program, 220 Dickinson Street, Suite B (8231), San Diego, CA, 92103, USA
| | - Jessica L Montoya
- Department of Psychiatry, University of California San Diego, HIV Neurobehavioral Research Program, 220 Dickinson Street, Suite B (8231), San Diego, CA, 92103, USA
| | - Robert K Heaton
- Department of Psychiatry, University of California San Diego, HIV Neurobehavioral Research Program, 220 Dickinson Street, Suite B (8231), San Diego, CA, 92103, USA
| | - Dilip V Jeste
- Department of Psychiatry, University of California San Diego, HIV Neurobehavioral Research Program, 220 Dickinson Street, Suite B (8231), San Diego, CA, 92103, USA
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, San Diego, CA, USA
- Department of Neurosciences, University of California San Diego, La Jolla, San Diego, CA, USA
| | - David J Moore
- Department of Psychiatry, University of California San Diego, HIV Neurobehavioral Research Program, 220 Dickinson Street, Suite B (8231), San Diego, CA, 92103, USA.
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Adhikari S, Mukhyopadhyay A, Kolzoff S, Li X, Nadel T, Fitchett C, Chunara R, Dodson J, Kronish I, Blecker SB. Cohort profile: a large EHR-based cohort with linked pharmacy refill and neighbourhood social determinants of health data to assess heart failure medication adherence. BMJ Open 2023; 13:e076812. [PMID: 38040431 PMCID: PMC10693878 DOI: 10.1136/bmjopen-2023-076812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 11/06/2023] [Indexed: 12/03/2023] Open
Abstract
PURPOSE Clinic-based or community-based interventions can improve adherence to guideline-directed medication therapies (GDMTs) among patients with heart failure (HF). However, opportunities for such interventions are frequently missed, as providers may be unable to recognise risk patterns for medication non-adherence. Machine learning algorithms can help in identifying patients with high likelihood of non-adherence. While a number of multilevel factors influence adherence, prior models predicting non-adherence have been limited by data availability. We have established an electronic health record (EHR)-based cohort with comprehensive data elements from multiple sources to improve on existing models. We linked EHR data with pharmacy refill data for real-time incorporation of prescription fills and with social determinants data to incorporate neighbourhood factors. PARTICIPANTS Patients seen at a large health system in New York City (NYC), who were >18 years old with diagnosis of HF or reduced ejection fraction (<40%) since 2017, had at least one clinical encounter between 1 April 2021 and 31 October 2022 and active prescriptions for any of the four GDMTs (beta-blocker, ACEi/angiotensin receptor blocker (ARB)/angiotensin receptor neprilysin inhibitor (ARNI), mineralocorticoid receptor antagonist (MRA) and sodium-glucose cotransporter 2 inhibitor (SGLT2i)) during the study period. Patients with non-geocodable address or outside the continental USA were excluded. FINDINGS TO DATE Among 39 963 patients in the cohort, the average age was 73±14 years old, 44% were female and 48% were current/former smokers. The common comorbid conditions were hypertension (77%), cardiac arrhythmias (56%), obesity (33%) and valvular disease (33%). During the study period, 33 606 (84%) patients had an active prescription of beta blocker, 32 626 (82%) had ACEi/ARB/ARNI, 11 611 (29%) MRA and 7472 (19%) SGLT2i. Ninety-nine per cent were from urban metropolitan areas. FUTURE PLANS We will use the established cohort to develop a machine learning model to predict medication adherence, and to support ancillary studies assessing associates of adherence. For external validation, we will include data from an additional hospital system in NYC.
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Affiliation(s)
- Samrachana Adhikari
- New York University Grossman School of Medicine, New York City, New York, USA
| | | | | | - Xiyue Li
- New York University Grossman School of Medicine, New York City, New York, USA
| | - Talia Nadel
- New York University Grossman School of Medicine, New York City, New York, USA
| | - Cassidy Fitchett
- New York University Grossman School of Medicine, New York City, New York, USA
| | - Rumi Chunara
- New York University, New York City, New York, USA
| | - John Dodson
- New York University Grossman School of Medicine, New York City, New York, USA
| | - Ian Kronish
- Center Behavioral Cardiovascular Health, Columbia University Medical Center, New York City, New York, USA
| | - Saul B Blecker
- New York University Grossman School of Medicine, New York City, New York, USA
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Blecker S, Schoenthaler A, Martinez TR, Belli HM, Zhao Y, Wong C, Fitchett C, Bearnot HR, Mann D. Leveraging Electronic Health Record Technology and Team Care to Address Medication Adherence: Protocol for a Cluster Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e47930. [PMID: 37418304 PMCID: PMC10362494 DOI: 10.2196/47930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Low medication adherence is a common cause of high blood pressure but is often unrecognized in clinical practice. Electronic data linkages between electronic health records (EHRs) and pharmacies offer the opportunity to identify low medication adherence, which can be used for interventions at the point of care. We developed a multicomponent intervention that uses linked EHR and pharmacy data to automatically identify patients with elevated blood pressure and low medication adherence. The intervention then combines team-based care with EHR-based workflows to address medication nonadherence. OBJECTIVE This study aims to describe the design of the Leveraging EHR Technology and Team Care to Address Medication Adherence (TEAMLET) trial, which tests the effectiveness of a multicomponent intervention that leverages EHR-based data and team-based care on medication adherence among patients with hypertension. METHODS TEAMLET is a pragmatic, cluster randomized controlled trial in which 10 primary care practices will be randomized 1:1 to the multicomponent intervention or usual care. We will include all patients with hypertension and low medication adherence who are seen at enrolled practices. The primary outcome is medication adherence, as measured by the proportion of days covered, and the secondary outcome is clinic systolic blood pressure. We will also assess intervention implementation, including adoption, acceptability, fidelity, cost, and sustainability. RESULTS As of May 2023, we have randomized 10 primary care practices into the study, with 5 practices assigned to each arm of the trial. The enrollment for the study commenced on October 5, 2022, and the trial is currently ongoing. We anticipate patient recruitment to go through the fall of 2023 and the primary outcomes to be assessed in the fall of 2024. CONCLUSIONS The TEAMLET trial will evaluate the effectiveness of a multicomponent intervention that leverages EHR-based data and team-based care on medication adherence. If successful, the intervention could offer a scalable approach to address inadequate blood pressure control among millions of patients with hypertension. TRIAL REGISTRATION ClinicalTrials.gov NCT05349422; https://clinicaltrials.gov/ct2/show/NCT05349422. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/47930.
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Affiliation(s)
- Saul Blecker
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
- Department of Medicine, NYU Grossman School of Medicine, New York, NY, United States
| | - Antoinette Schoenthaler
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
- Department of Medicine, NYU Grossman School of Medicine, New York, NY, United States
| | - Tiffany Rose Martinez
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Hayley M Belli
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Yunan Zhao
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Christina Wong
- Medical Center Information Technology, NYU Langone Health, New York, NY, United States
| | - Cassidy Fitchett
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Harris R Bearnot
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Devin Mann
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
- Department of Medicine, NYU Grossman School of Medicine, New York, NY, United States
- Medical Center Information Technology, NYU Langone Health, New York, NY, United States
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7
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Yuan Y, Xu HW, Zhang S, Wang Y, Kitayama A, Takashi E, Gong WJ, Liang JY. The mediating effect of self-efficacy on the relationship between family functioning and quality of life among elders with chronic diseases. Nurs Open 2021; 8:3566-3574. [PMID: 33960735 PMCID: PMC8510730 DOI: 10.1002/nop2.906] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 04/07/2021] [Accepted: 04/14/2021] [Indexed: 01/01/2023] Open
Abstract
Aim To explore whether self‐efficacy has any positive or negative mediating effects between family functioning and quality of life among elders with chronic diseases. Design A cross‐sectional study. Methods Questionnaires were collected from 516 community‐dwelling elderly individuals with chronic diseases using a convenience sampling method. The questionnaires included the Self‐efficacy for Managing Chronic Disease Six‐Item Scale, the Family Adaptation Partnership Growth Affection Resolve Index and the MOS 36‐Item Short Form Health Survey. Results Family functioning and self‐efficacy impacted the quality of life of community‐dwelling elderly individuals with chronic diseases. Family functioning was mediated by self‐efficacy and had an indirect impact on quality of life. The mediating effect accounted for 62.50% of the total effect.
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Affiliation(s)
- Yuan Yuan
- School of Nursing, Yangzhou University, Yangzhou, China.,Nagano College of Nursing, Komagane, Japan
| | - Hui-Wen Xu
- School of Nursing, Yangzhou University, Yangzhou, China.,Nagano College of Nursing, Komagane, Japan
| | - Song Zhang
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Ying Wang
- Affiliated Hospital of Yangzhou University, Yangzhou, China
| | | | - En Takashi
- Nagano College of Nursing, Komagane, Japan
| | - Wei-Juan Gong
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Jing-Yan Liang
- School of Medicine, Yangzhou University, Yangzhou, 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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Kivelä K, Elo S, Kyngäs H, Kääriäinen M. The effects of health coaching on frequent attenders’ adherence to health regimens and lifestyle factors: a quasi‐experimental study. Scand J Caring Sci 2020; 35:1075-1085. [DOI: 10.1111/scs.12920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 10/05/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Kirsi Kivelä
- Research Unit of Nursing Science and Health Management University of Oulu Oulu Finland
| | - Satu Elo
- Lapland University of Applied Sciences Kemi Finland
| | - Helvi Kyngäs
- Medical Research Center Oulu University Hospital University of Oulu Oulu Finland
| | - Maria Kääriäinen
- Research Unit of Nursing Science and Health Management Oulu University Hospital University of Oulu Oulu Finland
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10
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Kivelä K, Elo S, Kyngäs H, Kääriäinen M. The effects of nurse-led health coaching on health-related quality of life and clinical health outcomes among frequent attenders: A quasi-experimental study. PATIENT EDUCATION AND COUNSELING 2020; 103:1554-1561. [PMID: 32111383 DOI: 10.1016/j.pec.2020.02.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 02/12/2020] [Accepted: 02/17/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To evaluate the effects of the nurse-led health coaching on health-related quality of life and clinical health outcomes among frequent attenders in primary healthcare. METHODS A quasi-experimental study design. A total of 110 patients were enrolled in the study. The experimental group (n = 52) received nurse-led health coaching and the control group (n = 58) received the usual care at primary health care centres in Finland. The data were collected before the intervention and 12 months via a questionnaire of health-related quality of life and clinical health outcomes as measured by health-coaching nurses. RESULTS This study found frequent attenders have low health-related quality of life. The nurse-led health coaching showed no differences in health-related quality of life between the experimental and control groups. However, the nurse-led health coaching had statistically significant effects on the blood pressure and health-related quality of life among the experimental participants, especially in emotional role limitation and energy. CONCLUSIONS This study suggests that nurse-led health coaching may lead to an improvement in the health-related quality of life and blood pressure among frequent attenders. PRACTICE IMPLICATIONS The health-coaching sessions with own health-coaching nurses and action plans support the frequent attenders´ health promotion goals and implementation.
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Affiliation(s)
- Kirsi Kivelä
- Research Unit of Nursing Science and Health Management, University of Oulu Finland University of Oulu, P.O.Box 5000, 90014, Finland.
| | - Satu Elo
- Lapland University of Applied Sciences, Kemi, Finland.
| | - Helvi Kyngäs
- University of Oulu University Hospital, Medical Research Center Oulu, Oulu, Finland.
| | - Maria Kääriäinen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu University Hospital, Oulu, Finland.
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King J, Barclay R, Ripat J, Dubouloz CJ, Schwartz CE. An Investigation of Occupational Therapists' and Physical Therapists' Perspectives on the Process of Change That Occurs among Clients during Rehabilitation, Including Their Use of Response Shift and Transformative Learning. Physiother Can 2019; 71:355-366. [PMID: 31762546 DOI: 10.3138/ptc-2018-0047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Purpose: A significant change in one's health status creates a process of change that has an impact on one's health-related quality of life. This process has been conceptualized in several theories, including response shift (RS) and transformative learning (TL). The purpose of this study was to investigate occupational therapists' and physical therapists' perspectives on the process of change that occurs in clients during rehabilitation. Method: An interpretive description approach guided this study. Five profession-specific focus groups were conducted. Participants were asked about their ideas, thoughts, and understanding of processes of change. Focus group discussions were recorded and transcribed. Data analysis was carried out using both inductive and deductive methods. Results: Participants were 14 physiotherapists and nine occupational therapists with 5-30 years of experience in rehabilitation settings. Participants recognized personal change in clients and noted that it involves many steps. They tried to facilitate this change by identifying signs of readiness. Without using theory-specific terminology, participants described observing and using concepts of RS and TL. Conclusions: Occupational therapists and physiotherapists play an important role in helping people learn to live with their chronic illnesses and disabilities. Further studies are needed to investigate how therapists can facilitate the process of change, including using RS and TL concepts and how this facilitation could improve clients' health-related quality of life.
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Affiliation(s)
| | | | - Jacquie Ripat
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man
| | - Claire-Jehanne Dubouloz
- Occupational Therapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa
| | - Carolyn E Schwartz
- DeltaQuest Foundation, Inc., Concord, MA.,Tufts University Medical School, Boston
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Achury-Beltrán L, Garcia-Peñuela P. Efecto de una actividad grupal educativa en la calidad de vida de la persona con EPOC. ENFERMERÍA UNIVERSITARIA 2019. [DOI: 10.22201/eneo.23958421e.2019.2.649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introducción: La enfermedad pulmonar obstructiva crónica (EPOC), es un importante problema de salud pública que repercute sobre la calidad de vida. Se requieren intervenciones que reduzcan su impacto. Objetivo: Determinar el efecto de una actividad educativa grupal sobre la calidad de vida de personas con EPOC, que asisten a una institución de cuarto nivel durante septiembre-2017 y junio-2018, en Bogotá, Colombia. Métodos: Diseño cuasi-experimental. La variable independiente fue la actividad educativa grupal y la variable dependiente la calidad de vida, medida con el Cuestionario Respiratorio de Saint George (SGRQ). Los pacientes se aleatorizaron con una tabla generada por computador. El grupo control (n=30) recibió la intervención usual y el grupo experimental (n=30) una actividad educativa grupal diseñada bajo recomendaciones internacionales, impartida por el personal de enfermería. Se excluyeron pacientes con asistencia a actividades grupales durante los últimos dos meses. Resultados: La media de la calidad de vida pos-intervención fue 41% y 32% para el grupo control y experimental, respectivamente, se redujeron dos puntos con respecto a la medición inicial. La dimensión de actividad fue la más comprometida. No se encontraron diferencias estadísticamente significativas en el análisis intragrupal ni intergrupal. Discusión: La leve mejoría pos-intervención en las dimensiones de actividad e impacto, así como las variables sociodemográficas son congruentes con otros estudios. Los resultados pueden guardar relación con la cantidad de actividades desarrolladas. Conclusiones: La actividad grupal no genera mejoría estadísticamente significativa en la calidad de vida de las personas con EPOC. Se identificó una mejoría clínica en las dimensiones de actividad e impacto, así como en la puntuación global.
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