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Rostaminasab S, Nematollahi M, Jahani Y, Mehdipour-Rabori R. The effect of family-centered empowerment model on burden of care in parents and blood glucose level of children with type I diabetes family empowerment on burden of care and HbA1C. BMC Nurs 2023; 22:214. [PMID: 37340394 DOI: 10.1186/s12912-023-01375-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 06/10/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Parents play a critical role in caring for their children with diabetes and bear a significant burden of care. Health education has increasingly focused on empowering parents through new strategic methods. The present study aims to investigate the impact of a family-centered empowerment model on the burden of care in parents and blood glucose levels of children with type I diabetes. METHODS An interventional study was conducted in Kerman, Iran, where 100 children with type I diabetes and their parents were randomly selected as participants. The study aimed to implement a family-centered empowerment model in the intervention group, which consisted of four stages (educational phase, increasing self-efficacy, improving self-confidence, and evaluation) over a period of one month. The control group received routine training. The Zarit Caregiver Burden questionnaire and HbA1c log sheet were utilized to evaluate the effectiveness of the intervention. Questionnaires were administered before, after, and two months post-intervention, and data were analyzed using SPSS 15. Non-parametric tests were employed, and statistical significance was set at p < 0.05. RESULTS Before the study, no significant differences in demographic variables, level of burden of care, or HbA1C levels were observed between the two groups (p < 0.05). After the intervention, the burden of care score in the intervention group was significantly lower than that in the control group, both immediately post-intervention and two months later (P < 0.0001). Additionally, the median HbA1C levels in the intervention group were significantly lower than those in the control group after two months (6.5 in the intervention group and 9 in the control group) (P < 0.0001). CONCLUSION The findings of this study suggest that the implementation of a family-centered empowerment model is an effective strategy for reducing the burden of care on parents of children with type 1 diabetes and for controlling the HbA1C levels of these children. Based on these results, it is recommended that healthcare professionals consider incorporating this approach into their educational interventions.
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Affiliation(s)
- Samira Rostaminasab
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Monirsadat Nematollahi
- Department of Pediatrics and Neonatal Intensive Nursing, Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Yones Jahani
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Roghayeh Mehdipour-Rabori
- Department of Medical-Surgical Nursing, Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran.
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Xu H, Cao L, Li J, Zhang F, Wang W, Liang T, Liu X, Fu C. Is Chinese Spring Festival a key point for glycemic control of patients with type 2 diabetes mellitus in China? Front Public Health 2022; 10:975544. [PMID: 36620247 PMCID: PMC9813744 DOI: 10.3389/fpubh.2022.975544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
Objectives This study aims to explore the long-term trend of fasting blood glucose (FBG) among urban patients with type 2 diabetes mellitus (T2DM) and the impacts of the Chinese Spring Festival on their glycemic control in urban China. Methods The general information and longitudinal monitoring data of patients with T2DM in Minhang District, Shanghai China from 15 December 2006 to 31 December 2015 were collected. The FBG records were grouped into three periods, namely, the preholiday period (2 months right before the Chinese Spring Festival), the holiday period (from 28 December to 7 January of the lunar calendar year), and the postholiday period (2 months after the Chinese Spring Festival). The Mann-Kendall trend test and Cochran-Armitage trend test were occupied to explore the long-term trend, and paired t-test and chi-square (χ2) test were used to determine the differences in glycemic level and control rate between the preholiday and postholiday periods, respectively. Results From 2007 to 2015, the glycemic control rate in patients with T2DM showed an upward trend (P < 0.001), and the FBG level showed a decreasing trend (P = 0.048). After the Chinese Spring Festival, the glycemic control rate decreased significantly (P < 0.001), and the FBG level increased significantly (P < 0.001) compared to those during the preholiday period. The incidence of hypoglycemia increased during holidays. Patients who were aged 60-69 years, overweight or obese, with hypertension, with a disease duration of <3 years, or with poor glycemic control in one previous year were more likely to be affected by the holiday. Conclusion Chinese Spring Festival is a key point for glycemic control of patients with T2DM in China. Intensive holiday-specific diabetic healthcare needs to be further improved, and community-based interventions should be developed and implemented to control the possible holiday effects.
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Affiliation(s)
- Huilin Xu
- Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Li Cao
- School of Public Health, Fudan University, Shanghai, China,NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China,Key Laboratory of Public Health Safety, Fudan University, Shanghai, China
| | - Jun Li
- Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Fen Zhang
- Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Weijie Wang
- Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Tongtong Liang
- Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Xiaohua Liu
- Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China,*Correspondence: Xiaohua Liu ✉
| | - Chaowei Fu
- School of Public Health, Fudan University, Shanghai, China,NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China,Key Laboratory of Public Health Safety, Fudan University, Shanghai, China,Chaowei Fu ✉
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Nedyalkova M, Romanova J, Naneva L, Simeonov V. Developing a questionnaire for diabetes mellitus type 2 risk effects and precondition factors – multivariate statistical paths. PHYSICAL SCIENCES REVIEWS 2022. [DOI: 10.1515/psr-2021-0158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
The primary purpose of the present study is to summarize and explain the results of a questionnaire about diabetes mellitus type 2 (DMT2) endangered individuals. The 275 participants (age between 21 and 76 years) answered 18 questions related to the possible danger of DMT2 disorder. Multivariate statistical methods – cluster analysis, factor and principal components analysis applied for the survey analysis. The final goal was to detect similarity patterns between the variables of interest (questions), to reveal hidden factors regulating the data structure and susceptibility to DMT2 among the participants or between them, to elucidate the health status of the different groups and the similarities within the groups. It was found that five hidden factors regulate the data structure, which are conditionally named “declined general health status”; “metabolic syndrome factor”; “smoking, alcohol abuse and stress factor”; “heredity and sex impact”; “healthy food” impact. The participants could be divided into four similarity patterns, each with probably different susceptibility to DMT2. Thus, the results of the questionnaire could be of use for prophylactic purposes.
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Affiliation(s)
- Miroslava Nedyalkova
- Department of Chemistry , University of Fribourg , Chemin du Musée 9, 1700 , Fribourg , Switzerland
- Faculty of Chemistry and Pharmacy, University of Sofia , “St. Kl. Okhridski” , J. Bourchier Blvd. 1 , 1164 , Sofia , Bulgaria
| | - Julia Romanova
- Faculty of Chemistry and Pharmacy, University of Sofia , “St. Kl. Okhridski” , J. Bourchier Blvd. 1 , 1164 , Sofia , Bulgaria
| | - Ludmila Naneva
- Faculty of Chemistry and Pharmacy, University of Sofia , “St. Kl. Okhridski” , J. Bourchier Blvd. 1 , 1164 , Sofia , Bulgaria
| | - Vasil Simeonov
- Faculty of Chemistry and Pharmacy, University of Sofia , “St. Kl. Okhridski” , J. Bourchier Blvd. 1 , 1164 , Sofia , Bulgaria
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Kim SH, Choe YH, Cho YU, Park S, Lee MH. Effects of a partnership-based, needs-tailored self-management support intervention for post-treatment breast cancer survivors: A randomized controlled trial. Psychooncology 2022; 31:460-469. [PMID: 34549864 DOI: 10.1002/pon.5828] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 09/04/2021] [Accepted: 09/17/2021] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To examine the effectiveness of partnErship-based, needs-tailored self-Management support Program fOr Women with breast cancER (EMPOWER), a partnership-based, needs-tailored, self-management (SM) support intervention designed to empower post-treatment breast cancer survivors (BCSs) and ultimately improve their health outcomes. METHODS This multi-center, two-armed, randomized controlled trial comprised 94 female BCSs who had completed primary cancer treatment in South Korea. Participants were randomly assigned (1:1) to the intervention group or the wait-list control group. The intervention group received a 7-week EMPOWER intervention via telephone counseling. The primary outcome was empowerment. Secondary outcomes included self-efficacy for post-treatment SM behaviors, mental adjustment, anxiety, depression, and health-related quality of life. Data were collected via a self-reported questionnaire at baseline (T0) and at 8 (T1) and 20 weeks (T2) of follow-up. Linear mixed models were used to assess group differences over time. Effective sizes were calculated using Cohen's d. RESULTS Retention rates were excellent (95.7% at T1; 94.7% at T2). Linear mixed model analyses revealed that the EMPOWER group showed significantly improved empowerment (mean difference 2.24, 95% CI = 0.18 to 4.29; p = 0.016) and general health perception (mean difference 3.68, 95% CI = 0.67 to 6.72; p = 0.037) compared with the control group. Time point analysis showed that several secondary outcomes significantly improved at T1, but the effects were not sustained. CONCLUSION EMPOWER was effective in improving empowerment and general health perception among post-treatment BCS. Further studies are needed to determine the effectiveness of the EMPOWER intervention in other cancer populations.
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Affiliation(s)
- Soo Hyun Kim
- Department of Nursing, Inha University, Incheon, South Korea
| | - Yu Hyeon Choe
- Department of Nursing, Inha University, Incheon, South Korea
| | - Young Up Cho
- Department of Surgery, Ilsan Cha Hospital, College of Medicine, Cha University, Goyang, South Korea
| | - Seho Park
- Division of Breast Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Moon Hee Lee
- Division of Hematology-Oncology, College of Medicine, Inha University, Incheon, South Korea
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Patient Participation and the Environment: A Scoping Review of Instruments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042003. [PMID: 35206191 PMCID: PMC8872044 DOI: 10.3390/ijerph19042003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/28/2022] [Accepted: 02/05/2022] [Indexed: 12/04/2022]
Abstract
Patient participation and the environment are critical factors in achieving qualitative healthcare. We conducted a systematic scoping review using Arksey and O'Malley's framework to identify instruments intended to measure patient participation. We assessed those instruments' characteristics, which areas of the healthcare continuum they target, and whether environmental factors are considered. Instruments were considered eligible if they represented the patient perspective and measured patient participation in healthcare. The search was limited to articles written in English and published in the last 10 years. We extracted concepts (i.e., patient empowerment, patient participation, and patient-centeredness) based on the framework developed by Castro et al. and outcomes of significance regarding the review questions and specific objectives. The search was conducted in PsycINFO, CINHAL/EBSCO, and PubMed in September 2019 and July 2020. Of 4802 potential titles, 67 studies reported on a total of 45 instruments that met the inclusion criteria for this review. The concept of patient participation was represented most often in these studies. Although some considered the social environment, no instrument was found to incorporate and address the physical environment. Thirteen instruments were generic and the remaining instruments were intended for specific diagnoses or healthcare contexts. Our work is the first to study instruments from this perspective, and we conclude that there is a lack of instruments that measure aspects of the social and physical environment coherently as part of patient participation.
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Zare F, Ghafari M, Ramezankhani A, Kamran BL, Kavoosi A. Identifying dimensions of empowerment in patients with inflammatory bowel disease: a qualitative study. HEALTH EDUCATION RESEARCH 2020; 35:637-647. [PMID: 32995862 DOI: 10.1093/her/cyaa023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/29/2020] [Accepted: 06/28/2020] [Indexed: 06/11/2023]
Abstract
The role of patients' empowerment in enhancing the quality of life of chronic patients is undeniable and its importance in health policy making and health care is increasing day by day. However, no guidelines have been defined to empower people with inflammatory bowel disease (IBD). The purpose of this study was to identify the dimensions of IBD patients' empowerment. Semi-structured interviews were conducted with 26 participants who were purposefully selected from 2 IBD clinics in Tehran and Shiraz cities to gain diversity in the clinical and demographic characteristics. The data were analyzed based on the Granheim and Landman's content analysis method. According to the result of this study, the empowerment of IBD patients is composed of five dimensions including self-care, psychological coping with disease, social interaction skills, disease-specific health literacy and self-evaluation. The participants' most emphasis was on self-care and psychological coping dimensions. These findings can be used as a basis for educational interventions toward IBD patients' empowerment. More researches are needed to explore factors affecting the empowerment processes of IBD patients.
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Affiliation(s)
- Fatemeh Zare
- Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohtasham Ghafari
- Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Ramezankhani
- Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bagheri Lankarani Kamran
- Department of Internal Medicine, Gastroenterohepatology Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Kavoosi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Development, validation and reliability testing of ‘Perinatal Bereavement Care Confidence Scale (PBCCS)’. Women Birth 2020; 33:e311-e319. [DOI: 10.1016/j.wombi.2019.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/12/2019] [Accepted: 07/01/2019] [Indexed: 11/23/2022]
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Khanian ZS, Ghaffari F, Alipoor ZJ, Fotokian Z. Designing and validating the empowerment scale for the older individuals with chronic obstructive pulmonary disease (ESOCOPD). Heliyon 2020; 6:e03909. [PMID: 32405553 PMCID: PMC7210584 DOI: 10.1016/j.heliyon.2020.e03909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 04/01/2020] [Accepted: 04/29/2020] [Indexed: 02/03/2023] Open
Abstract
Introduction A standard scale to examine the empowerment status of older individuals with chronic obstructive pulmonary disease (COPD) can be used to assess their ability for self-care and disease management. This study aimed to design and validate the empowerment scale for the older individuals with COPD (ESOCOPD). Materials & methods This study was conducted in two phases with a deductive-inductive approach: a qualitative phase for designing the tool (the grounded theory study re-analysis, a review of texts and interviews) and a quantitative phase for validation of the questionnaire (face and content validity and reliability). Reliability was determined by test-retest and Spearman's correlation coefficient. Results Based on the results of the grounded theory study re-analysis and a review of texts and interviews, 47 items were designed, 14 of which were removed in the face and content validity assessment. The total Content validity index and content validity ratio of the questionnaire were found as 0.82 and 0.95, respectively.The final number of items in the scale was 33, and its dimensions included “information seeking, achieving independence, learning to live with COPD, participation in care, having critical thinking, psychosocial capacities management, and achieving goals”. Intra-class correlation of questionnaire dimensions was 0.86–0.99. Conclusions The ESOCOPD can be used by health care and treatment providers to determine the patient's ability for self-care and disease management because of its small number of items, it's validation, and reliability.
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Affiliation(s)
- Zahra Sam Khanian
- Student Research Committee, Nursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Ghaffari
- Nursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Jannat Alipoor
- Nursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Fotokian
- Nursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Pereyra-Rodriguez JJ, Dominguez-Cruz JJ, Hernandez-Montoya C, Galan-Gutiérrez M, Carrasco PM, Luna SA, Navarro-Triviño FJ, Del Pozo J, Ruiz-Villaverde R. Development and validation of a questionnaire to measure empowerment in adult patients with atopic dermatitis. The DATEMP questionnaire. J Dtsch Dermatol Ges 2019; 17:923-931. [PMID: 31487109 DOI: 10.1111/ddg.13934] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 03/18/2019] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND OBJECTIVES In recent years, the hypothesis that increasing the empowerment of patients can help to improve health outcomes and rationalize the use of health services has become relevant, especially for chronic diseases. Developing validated measurement tools is necessary to achieve this goal. In the field of dermatology, there are few studies related to empowerment of the patient. The aim of the present research is to develop and validate a self-administered questionnaire for adult patients diagnosed with atopic dermatitis (AD) in order to measure their level of empowerment. METHODS After a literature review and the establishment of consulting groups of patients and dermatologists, a large battery of 35 items was generated, based on the dimensions included in previous empowerment descriptions. A multidisciplinary group selected the 20 most suitable items to include in the questionnaire. A cross-sectional study was carried out with the items included in the questionnaire as well as demographic and clinical characteristics. To reduce the number of items and measure the construct validity, an exploratory factorial analysis (EFA) of the primary components and varimax rotation were used. Cronbach's α was used to measure the reliability of the individual scales and the global questionnaire. RESULTS 242 valid questionnaires were included. After completion of the EFA, the final Dermatitis Atópica EMPoderamiento (DATEMP) questionnaire was composed of 17 items that converged on four factors. The four scales had adequate reliability: "Knowledge" (Cronbach's alpha = 0.808), "Abilities" (Cronbach's alpha = 0.744), "Intention to change" (Cronbach's alpha = 0.798) and "Coping skills" (Cronbach's alpha = 0.772). The overall Cronbach's α of the questionnaire was 0.764. CONCLUSIONS The DATEMP questionnaire is the first specific empowerment measurement instrument developed for patients with AD that has demonstrated adequate levels of reliability and construct validity. It is a self-administered questionnaire that is simple and quick to answer.
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Affiliation(s)
| | | | | | | | | | | | | | - Jesús Del Pozo
- Complejo Hospitalario Universitario A Coruña, Coruña, Spain
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Pereyra‐Rodriguez JJ, Dominguez‐Cruz JJ, Hernandez‐Montoya C, Galan‐Gutiérrez M, Martín Carrasco P, Alcántara Luna S, Navarro‐Triviño FJ, Pozo J, Ruiz‐Villaverde R. Entwicklung und Validierung eines Fragebogens zur Messung des Empowerments bei erwachsenen Patienten mit atopischer Dermatitis. Der DATEMP‐Fragebogen. J Dtsch Dermatol Ges 2019; 17:923-932. [DOI: 10.1111/ddg.13934_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 03/18/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | | | | | | | | | - Jesús Pozo
- Complejo Hospitalario Universitario A Coruña Coruña Spanien
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Abstract
Extensive literature suggests that a solution to the current problems of healthcare sustainability is the active involvement of patients in health management through the empowerment of their abilities. Latest marketing frameworks suggest that patients are important resources for co-creating health value together with operators. This research aims to analyze the effects of patient empowerment on patients’ value co-creation behaviors. An empirical survey was conducted on 250 patients with chronic diseases in Italy. The results, analyzed using the structural equation modeling, showed that their empowerment enhanced value co-creation behaviors. Patients apply their health competencies and resources in their co-creation of health service with operators. It is, therefore, important to empower patients in their transformation from passive to active stakeholders, working with providers for the most optimal health outcomes. This research provides practitioners with suggestions for patient involvement which utilizes their knowledge, capabilities and responsibility to improving healthcare services.
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Moretta Tartaglione A, Cavacece Y, Cassia F, Russo G. The excellence of patient-centered healthcare. TQM JOURNAL 2018. [DOI: 10.1108/tqm-11-2017-0138] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Purpose
Nowadays, international healthcare agendas are focused on patient centeredness. Policies are aimed at improving patient’s satisfaction by enhancing patient empowerment and value co-creation. However, a comprehensive model addressing the relationships between these constructs has not so far been developed. The purpose of this paper is to develop and test a model which explains the effects of patient empowerment and value co-creation on patients’ satisfaction with the quality of the services they experience.
Design/methodology/approach
The links between patient satisfaction, empowerment and value co-creation are theoretically outlined via an in-depth literature review. The resulting model is tested through a survey administered to 186 chronically ill patients. The results are analyzed through covariance-based structural equation modeling.
Findings
The results show that patient empowerment positively influences value co-creation which, in turn, is positively related to patient satisfaction. In addition, the analysis reveals that patient empowerment has no direct effects on satisfaction.
Research limitations/implications
Although the cross-sectional design made it possible to clearly estimate the relationships among variables, it overlooked the longitudinal dimensions of co-creation processes.
Practical implications
The study provides practitioners with suggestions to design patient-centered healthcare services by leveraging on patient knowledge, participation, responsibility in care and involvement in the value-creation process.
Originality/value
Over the last decade, healthcare management literature has shifted its focus from healthcare organizations to patients. The number of contributions about patient satisfaction, empowerment and value co-creation exponentially increased. However, these dimensions are often studied separately. This work advances available knowledge by clarifying and testing the relationships between these three constructs.
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Empowerment in Dermatology. ACTAS DERMO-SIFILIOGRAFICAS 2017; 109:133-139. [PMID: 29183620 DOI: 10.1016/j.ad.2017.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 09/18/2017] [Accepted: 09/30/2017] [Indexed: 02/03/2023] Open
Abstract
The term empowerment refers to any process that facilitates behavioral changes and encourages responsibility and making informed choices. The concept has been applied mainly to help patients with chronic conditions achieve therapeutic goals. The aim of the approach in health care is to enhance self-caring and self-efficacy. The term derives from the English verb to empower meaning "to give (someone) the authority or power to do something" or "to make an individual or a group stronger or more powerful". One of the responsibilities of health professionals is to improve patients' knowledge and their ability to choose between the different alternatives available to them so that they can act accordingly. In this article, we review the various definitions of the term empowerment, the tools used to measure patient empowerment, the implications of the concept for the management of chronic disease, and its use in dermatological conditions.
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Zamanzadeh V, Zirak M, Hemmati Maslakpak M, Parizad N. Distance education and diabetes empowerment: A single-blind randomized control trial. Diabetes Metab Syndr 2017; 11 Suppl 1:S247-S251. [PMID: 28034693 DOI: 10.1016/j.dsx.2016.12.039] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 12/16/2016] [Indexed: 11/27/2022]
Abstract
AIMS Diabetes is one of the biggest problems in healthcare systems and kills many people every year. Diabetes management is impossible when only utilizing medication. So, patients must be educated to manage their diabetes. This study aims to assess the effect of education by telephone and short message service on empowering patients with type 2 diabetes (primary outcome). MATERIALS AND METHODS A single-blind randomized controlled trial was conducted in the Urmia diabetes association in Iran. Sixty six participants with definitive diagnosis of type 2 diabetes entered into the study. Patients with secondary health problems were excluded. Patients were selected by simple random sampling then allocated into intervention (n=33) and control (n=33) groups. The intervention group received an educational text message daily and instructive phone calls three days a week for three months along with usual care. The Diabetes Empowerment Scale (DES) with confirmed validity and reliability was used for collecting data. Data was analyzed using SPSS V6.1. Independent t-test, paired t-test and chi-square were used to analyze the data. RESULTS The empowerment of the intervention group compared with the control group significantly improved after three months of distance education (p<0.00, EF=1. 16). CONCLUSIONS The study findings show that the distance education has a significant effect on empowering patients with type 2 diabetes. Therefore, using distance education along with other diabetes management intervention is highly effective and should be part of the care in diabetes treatment.
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Affiliation(s)
- Vahid Zamanzadeh
- Department of Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Zirak
- Department of Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masomeh Hemmati Maslakpak
- Department of Medical Surgical Nursing, Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Naser Parizad
- Department of Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
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Aghili R, Ridderstråle M, Kia M, Ebrahim Valojerdi A, Malek M, Farshchi A, Khamseh ME. The challenge of living with diabetes in women and younger adults: A structural equation model. Prim Care Diabetes 2017; 11:467-473. [PMID: 28579058 DOI: 10.1016/j.pcd.2017.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 04/30/2017] [Accepted: 05/04/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Attitudes toward diabetes care are different between genders and age-groups. Furthermore, diabetes related challenges may cause psychosocial problems. Therefore, we were to compare the psychosocial status and glycemic control in women and men with type 2 diabetes (T2D) in different age-groups. METHODS 441 adults with T2D were recruited. Demographic, self-care behavior, resources and affective variables as well as the health related quality of life (HRQoL) were measured. The median age of 55 was used as the cut-off for the age comparison. Structured equation modeling (SEM) investigated the relationship between age, gender, psychosocial factors and glycemic control. RESULTS Finally, 203 women and 177 men completed the study (86.1%). There was no significant difference in mean duration of T2D, or glycemic control between genders or age-groups. Women, especially those below the median age of 55, had significantly higher level of diabetes-related distress (2.16±0.94 vs. 1.92±0.81), depression (9.67±5.37 vs. 7.54±5.06), and anxiety (19.81±12.04 vs. 12.81±9.04, P<0.05 for all comparisons), while people above the age of 55 reported better self-management and patient-physician relationship. HRQoL was lower in women compared to men (0.77±0.23 vs. 0.81±0.18, P=0.02). The final SEM suggested that the effect (standardized β coefficient) of gender and age on affective variables was 0.25 and -0.19 (P<0.05), respectively, though psychosocial factors did not directly influence HbA1c. CONCLUSIONS This study shows that psychosocial factors are associated with age and gender in patients with T2D; with younger women demonstrating higher level of depressive symptoms, anxiety, and diabetes-related distress independent of status of glycemic control.
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Affiliation(s)
- Rokhsareh Aghili
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
| | - Martin Ridderstråle
- Department of Clinical Sciences, Clinical Obesity, Lund University, Skåne University Hospital Malmö, S-205 02 Malmö, Sweden.
| | - Maryam Kia
- Department of Internal Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ameneh Ebrahim Valojerdi
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
| | - Mojtaba Malek
- Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
| | - Amir Farshchi
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran; Department of Pharmacoeconomics and Pharmaceutical Administration, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mohammad Ebrahim Khamseh
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
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17
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Development and Validation of a Questionnaire to Measure Quality of Life in Caregivers of Patients with Schizophrenia and Affective Disorders (SAC-QoL). IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2017. [DOI: 10.5812/ijpbs.9195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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18
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Chamroonsawasdi K, Chottanapund S, Tunyasitthisundhorn P, Phokaewsuksa N, Ruksujarit T, Phasuksathaporn P. Development and Validation of a Questionnaire to Assess Knowledge, Threat and Coping Appraisal, and Intention to Practice Healthy Behaviors Related to Non-Communicable Diseases in the Thai Population. Behav Sci (Basel) 2017; 7:bs7020020. [PMID: 28420098 PMCID: PMC5485450 DOI: 10.3390/bs7020020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/31/2017] [Accepted: 04/12/2017] [Indexed: 11/16/2022] Open
Abstract
Non-communicable diseases (NCDs) are important issues in Thailand and health sectors are now focusing on modifiable risks that include cognitive, affective and behavioral factors. This study aimed to develop and validate a questionnaire to assess knowledge about NCDs, threat appraisal, coping appraisal and intention to practice based on protection motivation theory. Content validity was determined by the mean of the item content validity index (I-CVI) from five experts. The questionnaire was pilot tested for difficulty of knowledge items and reliability test using the Kuder-Richardson (KR)-20 and Cronbach’s alpha coefficient among 30 Thai adult subjects in the health office for two sub-districts. The mean I-CVI ranged from 0.90–1.00 and difficulty of knowledge ranged from 0.3–0.9. The reliability test of knowledge by KR-20 ranged from 0.648–0.799, while Cronbach’s alpha coefficients of threat and coping appraisal and intention to practice ranged from 0.70–0.843. We compared sociodemographic data, knowledge about NCDs, threat appraisal, coping appraisal and intention to practice between 50 diabetic type 2 cases and 50 controls. T2DM cases had higher age, knowledge scores on diabetes and hypertension, threat appraisal scores on hypertension and cardiovascular disease when compared with control (p < 0.05). The questionnaire was valid and sufficiently reliable to use for data collection.
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Affiliation(s)
- Kanittha Chamroonsawasdi
- Department of Family Health, Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand.
| | - Suthat Chottanapund
- Bamrasnaradura Infectious Disease Institute, Ministry of Public Health, Nontaburi 11000, Thailand.
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19
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Cerezo PG, Juvé-Udina ME, Delgado-Hito P. Concepts and measures of patient empowerment: a comprehensive review. Rev Esc Enferm USP 2016; 50:667-674. [DOI: 10.1590/s0080-623420160000500018] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 06/30/2016] [Indexed: 02/03/2023] Open
Abstract
Abstract OBJECTIVE Analyze the definitions and dimensions of empowerment. Identify the strengths and weaknesses of empowerment measures based on the conceptual model. METHOD This was a comprehensive literature review of publications on the MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. RESULTS Twenty-nine articles were selected. Seventeen definitions and seven dimensions of empowerment, and 10 empowerment measures were selected. Empowerment can be seen as an enabling process involving a shift in the balance of power, or as an outcome of this process. The dimensions reflect outcome indicators, such as participation in decision-making and control, and process indicators, such as knowledge acquisition and coping skills. Six of the tools analyzed by this study could be said to provide a robust measure of patient empowerment. CONCLUSION we propose a definition of empowerment that helps to deepen understanding of the term and, therefore, its operationalization.
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Affiliation(s)
| | | | - Pilar Delgado-Hito
- Universidad de Barcelona, España; Instituto de Investigación Biomédica de Bellvitge, España
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20
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Aghili R, Polonsky WH, Valojerdi AE, Malek M, Keshtkar AA, Esteghamati A, Heyman M, Khamseh ME. Type 2 Diabetes: Model of Factors Associated with Glycemic Control. Can J Diabetes 2016; 40:424-430. [PMID: 27291886 DOI: 10.1016/j.jcjd.2016.02.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 02/22/2016] [Accepted: 02/23/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the related factors and their intercorrelated impacts on glycemic control in people with type 2 diabetes mellitus. METHODS Patients with type 2 diabetes were recruited for this study during their regular clinic visits at a major medical centre in Iran. Glycated hemoglobin (A1C) levels were used as the indicator of glycemic control. Regression analysis was used to determine the relationships between glycemic control and demographics, self-care behaviours, resources and affective variables. Moreover, the associations between diabetes-related distress and measured variables were tested. RESULTS Three hundred eighty people with type 2 diabetes completed the study. The mean duration of diabetes was 8.94±6.57 years, and the mean A1C levels were 7.78%±1.7%. Diabetes-related distress was significantly associated with A1C levels, controlling for all other variables (p=0.01). On the other hand, depression (p<0.001), self-management (p<0.001), anxiety (p<0.001) and patient-physician relationship (p=0.023) were significantly associated with diabetes-related distress. CONCLUSIONS Diabetes-related distress was found to be associated with glycemic control in people with type 2 diabetes, whereas age, depression, anxiety, self-management and family and social support may affect glycemic control indirectly through diabetes-related distress. Thus, it is important to assess and, if appropriate, treat people with diabetes for diabetes-related distress in order to identify and help them overcome barriers to optimal glycemic control.
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Affiliation(s)
- Rokhsareh Aghili
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | | | - Ameneh Ebrahim Valojerdi
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Malek
- Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Ali Keshtkar
- Osteoporosis Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Esteghamati
- Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mark Heyman
- Department of Psychiatry, UCSD School of Medicine, San Diego, California, United States
| | - Mohammad Ebrahim Khamseh
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
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21
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Shin SH, Park H. [Development and Validation of the Empowerment Scale for Woman with Breast Cancer]. J Korean Acad Nurs 2016; 45:613-24. [PMID: 26364536 DOI: 10.4040/jkan.2015.45.4.613] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 02/11/2015] [Accepted: 06/03/2015] [Indexed: 02/03/2023]
Abstract
PURPOSE The purpose of this study was to develop a scale to evaluate empowerment in woman with breast cancer and to examine the validity and reliability of the scale. METHODS The development process for the initial items included a literature review, interviews, and construction of a conceptual framework. The identified items were evaluated for content validity by experts, resulting in 3 factors and 48 preliminary items. Participants were 319 women with breast cancer recruited to test reliability and validity of the preliminary scale. Data were analyzed using item analysis, confirmatory factor analysis, criterion related validity, internal consistency and test-retest reliability. RESULTS The final scale consisted of 30 items and 3 factors. Factors, including 'intrapersonal factor' (14 items), 'interactional factor' (8 items), and 'behavioral factor' (8 items), were drawn up after confirmatory factor analysis. Goodness of fit of the final research model was very appropriate as shown by χ²/df=1.86, TLI=.90, CFI=.92, SRMR=.06, and RMSEA=.05. Criterion validity was evaluated by total correlation with the Cancer Empowerment Questionnaire .78. Cronbach's alpha for total items was .93 and test-retest reliability was .69. CONCLUSION Findings from this study indicate that the scale can be used in the development of nursing interventions to promote the empowerment of women having breast cancer.
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Affiliation(s)
- Sun Hwa Shin
- Division of Nursing Science, Ewha Womans University, Seoul, Korea
| | - Hyojung Park
- Division of Nursing Science, Ewha Womans University, Seoul, Korea.
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22
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Groen WG, Kuijpers W, Oldenburg HS, Wouters MW, Aaronson NK, van Harten WH. Empowerment of Cancer Survivors Through Information Technology: An Integrative Review. J Med Internet Res 2015; 17:e270. [PMID: 26614438 PMCID: PMC4704924 DOI: 10.2196/jmir.4818] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 07/28/2015] [Accepted: 10/26/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Patient empowerment may be an effective approach to strengthen the role of cancer survivors and to reduce the burden on health care. However, it is not well conceptualized, notably in oncology. Furthermore, it is unclear to what extent information technology (IT) services can contribute to empowerment of cancer survivors. OBJECTIVE We aim to define the conceptual components of patient empowerment of chronic disease patients, especially cancer survivors, and to explore the contribution of existing and new IT services to promote empowerment. METHODS Electronic databases were searched to identify theoretical and empirical articles regarding empowerment. We extracted and synthesized conceptual components of patient empowerment (ie, attributes, antecedents, and consequences) according to the integrated review methodology. We identified recent IT services for cancer survivors by examining systematic reviews and a proposed inventory of new services, and we related their features and effects to the identified components of empowerment. RESULTS Based on 26 articles, we identified five main attributes of patient empowerment: (1) being autonomous and respected, (2) having knowledge, (3) having psychosocial and behavioral skills, (4) perceiving support from community, family, and friends, and (5) perceiving oneself to be useful. The latter two were specific for the cancer setting. Systematic reviews of IT services and our additional inventory helped us identify five main categories: (1) educational services, including electronic survivorship care plan services, (2) patient-to-patient services, (3) electronic patient-reported outcome (ePRO) services, (4) multicomponent services, and (5) portal services. Potential impact on empowerment included knowledge enhancement and, to a lesser extent, enhancing autonomy and skills. Newly developed services offer promising and exciting opportunities to empower cancer survivors, for instance, by providing tailored advice for supportive or follow-up care based on patients' input. CONCLUSIONS We identified five main components of empowerment and showed that IT services may especially contribute to empowerment by providing knowledge. The components of empowerment could be used to develop IT services for cancer survivors. It is important to take into account patients' needs, follow up on these needs, and create a service that is attractive and easy to use.
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Affiliation(s)
- Wim G Groen
- The Netherlands Cancer Institute, Division of Psychosocial Research and Epidemiology, Amsterdam, Netherlands
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